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Biomedical subjects

J Hern

Publications and source records attributed to J Hern.

12 recordsLinked to original sources
PubMed2003

Nasal deformity and interpersonal problems.

Several studies in facial plastic surgery have suggested that changes in body image that initiate a positive psychological cycle play an important role in a successful outcome. The change in the patient's self-perception leads to a sense of well-being, rather than there being a direct impact from the changed features. One area in which this change in self-perception may be manifest is in the development and maintenance of interpersonal relationships. Due to the impact of negative body image preoperatively, we hypothesized that patients with nasal deformity may have problems with their interpersonal relationships. This theory was tested using the IIP-32: a short version of the inventory of interpersonal problems. A prospective trial was undertaken of 27 rhinoplasty patients with nasal deformity and 16 septoplasty patients without nasal deformity, the latter group used as a control. The results show that the null hypothesis that the two groups are from the same population on all dimensions of the IIP-32 cannot be rejected (total mean score 0.753). From this data, it seems that patients with nasal deformity have no more difficulties in their interpersonal relationships and, as such, this particular issue cannot be used in support of rhinoplasty surgery.

Adult↗
PubMed2002

Assessing psychological morbidity in patients with nasal deformity using the CORE questionnaire.

The aesthetic facial surgeon's evaluation of the patient seeking cosmetic surgery must be thorough. Those with emotional disturbances and overt psychiatric disorders are considered to be poor candidates for elective cosmetic surgery. In patients with nasal deformity, the prevalence of subclinical psychological morbidity and the role of cosmetic surgery in these circumstances are uncertain. This study investigates the use of the CORE questionnaire in assessing the psychological status of patients awaiting rhinoplasty or septorhinoplasty and compares this with the psychological status of patients awaiting septoplasty. A prospective trial of 27 rhinoplasty patients and 16 septoplasty patients revealed that in terms of life functioning, patients with nasal deformity have significantly higher psychological morbidity compared with patients without nasal deformity. However, there was no significant difference in global psychological status. In addition, female patients with nasal deformity are more distressed in terms of general wellbeing than male patients with nasal deformity and there is a tendency for higher global psychological impairment in women. These results may have implications in terms of health care rationing in patients with nasal deformity and preoperative psychological screening.

Adult↗
PubMed2002

Topical bupivacaine in paediatric day-case tonsillectomy: a prospective randomized controlled trial.

Post-operative pain and delayed oral intake are common reasons for failure of discharge in day-case tonsillectomy. A double blind prospective randomized study was devised to investigate the effectiveness of topical bupivacaine in reducing post-operative pain in paediatric day-case tonsillectomy. Ninety-nine patients aged between three and 16 years were recruited into the study. One group received bupivacaine soaked swabs tightly packed in their tonsillar fossae while the control group received saline-soaked swabs. The bupivacaine group was found to drink (p < 0.001) and eat (p = 0.006) earlier than the control group. The pain scores at one (p < 0.001), three (p < 0.001) and six (p < 0.001) hours post-operatively were also found to be lower in the bupivacaine group than the control group. We conclude that topical bupivacaine has a role in facilitating recovery in day-case tonsillectomy in children.

Adolescent↗
PubMed2002

Major ear surgery in a paediatric day care unit.

Abstract Traditionally major ear surgery in children has been regarded as an in-patient procedure. Evidence from the USA for adults, however, concludes that it is both safe and effective to perform many major ear procedures as day cases. We have been carrying out major ear operations on children as day cases routinely for six years in a dedicated children's day unit and examined our data to find out whether it was both safe and feasible to perform major ear surgery in children on a day-case basis. As our main outcome measure we used the rate of unplanned admissions. We found that the unplanned admission rate for surgery, excluding mastoid surgery, was 6.7 per cent and that procedures such as myringoplasty, ossiculoplasty, bilateral pinnaplasty, meatoplasty and tympanotomy with excision of cholesteatoma, were eminently suitable for day surgery.

Adolescent↗
PubMed2001

Characterisation of [(125)I]-apamin binding sites in rat brain membranes with HE293 cells transfected with SK channel subtypes.

The pharmacology of [(125)I]-apamin binding sites was examined in rat cortical and hippocampal tissue and compared with membranes prepared from human embryonic kidney (HEK293) cells transfected with SK channel subtypes hSK1, rSK2 and rSK3. The K(D) of [(125)I]-apamin in rat cortex and hippocampus was similar to the apamin-sensitive subtypes, rSK2 and rSK3 (K(D) (pM): 6.4, 7.08, 6.56 and 8.94, respectively). In addition, [(125)I]-apamin had a K(D)=270.4pM for the putatively 'apamin-insensitive' hSK1. Apamin had about a three-fold higher affinity than [(125)I]-apamin in brain tissue and in the cells expressing the different SK channel subtypes. Pancuronium, bicuculline and d-tubocurarine displayed micromolar affinity for all five-membrane preparations, whereas dequalinium and gallamine appear to show some subtype selectivity. Tetraethylammonium (TEA) and 4-aminopyridine (4-AP) had millimolar affinity and linopirdine had no effect. In conclusion, the pharmacology of [(125)I]-apamin binding in the cortex and hippocampus was similar to that in the apamin-sensitive clones, rSK2 and rSK3. In addition, we demonstrated low affinity [(125)I]-apamin binding for hSK1 and identified compounds that show subtype selectivity. These data cast further doubt on the identification of SK1 as encoding for the K(+) channel responsible for the apamin-insensitive sAHP.

Animals↗
PubMed2000

Functional laryngeal dyskinesia: an important cause of stridor.

Functional laryngeal dyskinesia is a disorder that presents with stridor. Failure to recognize its features can result in inappropriate investigation and treatment for a condition that has a psychogenic origin. The key feature in diagnosis is paradoxical vocal fold adduction on inspiration, as seen on fibre-optic nasendoscopy. This phenomenon together with the associated stridor may disappear after distraction techniques or when the patient is asleep. We present five such cases which presented to hospitals in south west London over a 12 month period.

Adolescent↗
PubMed1999

Day case paediatric tonsillectomy: a review of three years experience in a dedicated day case unit.

Tonsillectomy is one of the most common surgical procedures performed in children. Day case tonsillectomy is common in many parts of the USA but remains controversial in the UK. Day case tonsillectomy in children has been performed in a dedicated paediatric day care unit at the May day Hospital since 1994. The results for the years 1995-1997 were reviewed. In these years 928 true day case tonsillectomies were performed. Reactionary haemorrhage occurred in 0.97% (nine children) but only three children required a return to theatre. All bleeding occurred within the standard observation period. There were no deaths. The overall effective day case rate was 95.7%, only 31 children needing unplanned admission, mainly for postoperative vomiting. The results suggest that day case tonsillectomy can be safely and successfully performed, with a dedicated paediatric day case unit and a favourable population geography.

Adolescent↗
PubMed1997

Contact dermatitis with cervical lymphadenopathy following exposure to the hide beetle, Dermestes peruvianus.

Contact with beetles of the family Dermestidae can produce a variety of disorders including skin, gastrointestinal and respiratory tract disease. Dermatological disorders include dermatitis, vesicular, pustular and vasculitic lesions. In addition, there may be pruritus, desquamation and urticaria. We report a patient who developed dermatitis, a vasculitic eruption, cervical lymphadenopathy and pulmonary nodular interstitial infiltration as a result of contact with the 'hide beetle' Dermestes peruvianus.

Adult↗
PubMed1996

Local anaesthesia in flexible nasendoscopy. A comparison between cocaine and co-phenylcaine.

Flexible nasendoscopy is now an integral part of the diagnostic process in Otorhinolaryngology. Topical local anaesthesia is generally recommended and cocaine is usually the drug of choice in view of its concurrent vasoconstrictor action. However, it is expensive, a controlled drug and serious side effects have been reported. Co-phenylcaine forte is a new preparation which also has both local anaesthetic and vasoconstrictor properties. This study compares the efficacy of cocaine and Co-phenylcaine in flexible nasendoscopy and concludes that they provide similar local anaesthesia and vasoconstriction of the nasal mucosa. Co-phenylcaine forte can therefore be used as an alternative to cocaine in flexible nasendoscopy.

Adolescent↗
PubMed1996

Primitive neuroectodermal tumour of the masseter muscle.

Masseter muscle enlargement is one of the differential diagnoses of swelling of the cheek. We discuss a unique case of a malignant tumour of the masseter which was found to be a peripheral primitive neuroectodermal tumour (PNET). A review of tumours of the masseter is presented.

Adult↗
PubMedDate not supplied

Emergency tracheostomy in general practice.

We set out to review the need for general practitioners (GPs) to be skilled at forming an emergency alternative airway by assessing mortality figures for acute airways obstruction. We also solicited the views of 100 GPs on the theory and practice of emergency tracheostomy and assessed whether they considered they were equipped to carry out such a procedure in the community. The results suggest a significant number of deaths of otherwise young and healthy individuals could be avoided by training community practitioners in emergency alternative airway formation. The results showed a marked lack of confidence in the practice of emergency airway formation and few GPs felt able to carry out the procedure. They indicated an overwhelming interest in receiving further education on the subject. We recommend that formal training programmes in the techniques of emergency airway formation should be available for community GPs.

Airway Obstruction↗