Biomedical subjects

Ivan Keogh

Publications and source records attributed to Ivan Keogh.

4 recordsLinked to original sources

PubMed2005

Informed consent: a patients' perspective.

The medico-legal issues surrounding informed consent are highly topical and contentious. Current attitudes to consent emphasize the high level of 'good medical practice' expected by a 'reasonable patient/parent'. The authors' objectives were to assess the levels of knowledge and information expected by patients and parents, prior to signing consent forms for a surgical procedure. Each patient or parent was asked a series of questions prior to signing a consent form. Answers were recorded on a standard questionnaire. More than 80 per cent of respondents were happy with the information provided in out-patients, however, over half of these could not list even one complication of their operation. Two-thirds of those surveyed sought information elsewhere, while over half expected to be informed of all known complications, even if the rate of complications was less than one per cent. In conclusion, the information provided by surgeons might not meet the expectations of today's informed patients.

Attitude to Health↗

PubMed2003

The Internet-current trends and future expectations among Brazilian pediatricians and otolaryngologists with a special interest in pediatric otolaryngology.

OBJECTIVE: To assess Internet use among a group of Brazilian pediatricians and otolaryngologists and to inquire about possible Web based medical resources. METHODS: Questionnaires were distributed among attendees of a 2001 Pediatric Otolaryngology meeting in Brazil. Multiple choice or yes/no questions related to the use of the Internet among physicians were presented. RESULTS: All of the 99 respondents of an estimated 900 attendees, had Internet access (high-speed 18%, conventional 77%); 52% at home, 42% in the office and 6% at both sites. Eighty-one percent of those responding regularly used the Internet for medical updating. Sharing a pediatric otolayngology medical association Web site with patients was desired by 73%; an interest in personal Web based medical information and updates was demonstrated by 97%. Five percent of respondents already had established personal practice Web sites and 54% agreed with potential benefits for improving medical practice. CONCLUSION: The potential role of electronic communication and a desire to establish a pediatric otolaryngology Web site that would maximize inclusiveness is appreciated by this group of Brazilian otolaryngologists and pediatricians.

Attitude of Health Personnel↗

PubMed2003

The use of cortical evoked response audiometry in the assessment of noise-induced hearing loss.

OBJECTIVES: The study aims were to determine the incidence of exaggerated hearing thresholds in individuals complaining of noise-induced hearing loss (NIHL) as a result of impulse noise using cortical evoked response audiometry (CERA) and to identify any associated audiometric features. SETTING: We conducted an office-based study. STUDY DESIGN: In this prospective case series, 1154 males complaining of NIHL were assessed with pure tone audiometry; 673 had CERA. Pure tone averages (PTA) and hearing disability were calculated using the Irish and American Medical Association systems. A PTA of >10 dB worse than the CERA average was considered evidence of exaggerated thresholds. RESULTS: The mean PTA was 33 dB. Seventy-two percent had a hearing disability of an average of 26% when assessed by the Irish system. Fifty-four percent had a hearing disability of an average of 30% when assessed by the American Medical Association system. Twenty-six percent of subjects had exaggerated thresholds based on CERA. A binaural hearing threshold of >25 dB at 500 Hz had a sensitivity of 94% and a specificity of 59% for the detection of exaggerated thresholds. CONCLUSION: Exaggerated hearing thresholds are common. A hearing threshold of >25 dB at 500 Hz should be considered an indication for CERA testing.

Adult↗

PubMedDate not supplied

Otogenic intracranial complications. a 7-year retrospective review.

OBJECTIVES: The objectives of this study were to review our experience on intracranial complications secondary to otitis media (OM), and to compare the results to those occurring 10-15 years ago. We also reviewed the timing of both otologic and neurosurgical treatments. MATERIAL AND METHODS: All patients with intracranial complications secondary to OM over a 7-year period were identified. A retrospective chart review was undertaken at Beaumont University Hospital, Dublin, Ireland. Clinical presentation, radiological findings, microbiology, surgical management, and antibiotic use were studied. We compare our findings to those of other international investigators. RESULTS: Twelve cases were identified. Five had brain abscesses, 4 had lateral sinus thrombosis, and 3 had petrous apicitis. Eight of these cases were secondary to chronic OM and 4 were secondary to acute OM. Malodorous otorrhea, otalgia, headache, fever, and vertigo were the primary symptoms. Anaerobic bacteria were the most commonly isolated organisms followed by Staphylococcus aureus, Proteus mirabilis, and Pseudomonas aeruginosa. Patients with cholesteatoma underwent modified radical or radical mastoidectomy, and those who did not have cholesteatoma underwent cortical mastoidectomy. Two brain abscesses were drained before mastoid surgery; 2 were drained after mastoid surgery and 1 at the same time as otologic surgery. All patients received broad-spectrum intravenous antibiotics targeted at individual culture and sensitivity results. The mortality rate was zero. CONCLUSION: Clinical presentation and the frequency of occurrence of intracranial complications are similar to those occurring 10 years ago. The choice of antibiotics should include adequate anaerobic cover. We recommend that otologic surgery be performed at the same time as intracranial surgery for patients with mature brain abscesses.

Adolescent↗