PubMed Health⌕ Search

Biomedical subjects

J S Reilly

Publications and source records attributed to J S Reilly.

66 records · Page 4Linked to original sources
PubMed1982

Acquired subglottic stenosis following prolonged endotracheal intubation. A canine model.

We developed a canine animal model of subglottic stenosis following prolonged intubation with modified non-cuffed endotracheal tubes. None of the puppies intubated for seven days had an irreversible stenosing subglottic lesion, whereas all animals intubated for 14 days or more had at least a 40% to 50% reduction of the subglottic lumen secondary to maturing fibrotic stenosis. The model described is more congruent with the known and suspected pathogenesis in those infants and children who require prolonged endotracheal intubation and subsequently acquire subglottic stenosis, and can be used in evaluating the efficacy of medical therapy or surgical therapy, or both, in the prevention or management of this disease.

Animals↗
PubMedDate not supplied

Lyme disease and seventh nerve paralysis in children.

PURPOSE: This study was undertaken to determine the frequency of Lyme disease (LD) as a cause of transient facial nerve palsy (FNP) in children. Acute onset FNP in children has been primarily associated with acute otitis media (AOM). Recently, LD has emerged in regions where the deer-tick vector is present and has been associated with multiple cranial neuropathies. PATIENTS AND METHODS: Fifty children with transient FNP were evaluated and treated at our institution over a 5.5-year period. RESULTS: The rank of etiologies confirmed LD to now be the most common (50%), followed by AOM (12%), varicella (6%), Herpes zoster (4%), and coxsackievirus (2%). Thirteen children (26%) had idiopathic FNP consistent with Bell's palsy. CONCLUSION: We conclude that transient FNP in children is most commonly caused by LD for regions with endemic infections caused by Borrelia burgdorferi.

Adolescent↗
PubMedDate not supplied

Sulbactam/ampicillin in the treatment of acute epiglottitis in children.

Acute epiglottitis, a life-threatening illness, is characterized by the sudden onset and rapid progression of respiratory obstruction. The etiologic agent is almost exclusively Haemophilus influenzae type b (Hib). During the past decade as many as 25% of strains of Hib have been shown to produce beta-lactamase and be resistant to ampicillin. Recommendations for treatment, in addition to the immediate intubation of the airway, include the administration of chloramphenicol in combination with ampicillin. The combination of sulbactam and ampicillin was evaluated in an effort to develop a safer, but equally effective, regimen. Thirty-one infants and children (mean age, three years six months) with documented acute epiglottitis received parenteral sulbactam sodium (30 mg/kg per day) in combination with ampicillin (200 mg/kg per day). Of the 31 subjects, 26 (84%) had Hib isolated from the blood; seven (27%) of the 26 strains of Hib isolated were beta-lactamase-positive. Twenty-five cases (96%) of Hib epiglottitis responded rapidly to treatment. The combination of sulbactam and ampicillin appeared to be an effective and safe alternative to chloramphenicol/ampicillin therapy for acute epiglottitis in infants and children.

Acute Disease↗
PubMedDate not supplied

Liver transplants in children: importance for the otolaryngologist.

Orthotopic liver transplantation (OTLT) for children with end stage liver failure has doubled 1-year survival rates to over 70% with the employment of cyclosporine and prednisone in conjunction with skilled surgical and medical specialists providing supportive care. The otolaryngology service has assisted in the care of 18 of 61 children undergoing OTLT, particularly in managing respiratory problems that required improved pulmonary toilet and prolonged intubation. The prevention of atelectasis of the lung and subsequent sepsis appears to be improved by prompt bronchoscopy.

Adolescent↗
PubMedDate not supplied

Tidal flow measurement in the decision to decannulate the pediatric patient.

Measurements of peak inspiratory flow obtained through the tracheostomy cannula (MIFT) during tidal breathing were compared to peak inspiratory flow measurements obtained through the mouth (MIFM) in 40 children to assess physiologic readiness to decannulate the tracheostomized pediatric patient. Ratio of peak flow MIFM/MIFT was 1.40 for 34 successfully decannulated children compared to 0.83 for 22 unsuccessful attempts (p less than 0.01). Tidal flow measurements are highly predictive (84%) in identifying children who are unlikely to be ready for decannulation. A schema is proposed to utilize tidal flow measurements as the first step in the decannulation process.

Adolescent↗
PubMedDate not supplied

Tracheotomy in the preterm infant.

Over the last decade, prolonged survival of preterm infants (gestation less than or equal to 36 weeks) who require lengthy periods of mechanical ventilation has necessitated that many of these infants undergo tracheotomy. The complication rate for tracheotomy in these preterm infants has not been reported. We compared 83 full-term (FT) infants who underwent tracheotomy in their first year of life with 41 preterm infants. Twenty-three preterm infants had birth weight greater than or equal to 1,500 g (PT), and 18 of the preterm infants had gestational age less than or equal to 32 weeks and birth weight less than or equal to 1,500 g (PT-VLBW). Early complications (day 0 to 7) occurred in over 50% of the PT-VLBW compared to only 24% of the FT infants. Late complication rates were similar for all three groups. This higher early complication rate for PT-VLBW infants may be related to gestational age, low birth weight, and medical condition rather than surgical technique.

Female↗
PubMedDate not supplied

Synchronous airway lesions in infancy.

Stridor in the young infant is evaluated by careful laryngoscopy. When a lesion of the larynx is diagnosed, the necessity and risk of bronchoscopy are challenged. To assess the need for careful examination of both the upper and lower respiratory tract, a 2-year retrospective study was performed at the Children's Hospital of Pittsburgh. Of 103 infants who underwent diagnostic laryngoscopy and bronchoscopy for airway obstruction, stridor, or both, 18 (17.5%) had two or more synchronous airway lesions detected. Laryngoscopy alone, without further workup of the entire respiratory tract (ie, bronchoscopy, radiographic studies) may fail to detect concurrent disorders in infants with airway obstruction.

Airway Obstruction↗
PubMedDate not supplied

Vocal cord paralysis associated with cystic fibrosis.

The course of the left recurrent laryngeal nerve through the chest brings it in close proximity with the heart and great cardiac vessels. Diseases of the heart and the great vessels are known to cause vocal cord paralysis, probably by mechanical injury to the recurrent laryngeal nerve. Pulmonary artery hypertension and dilation occur in up to 80% of patients with cystic fibrosis. We report a case of a 23-year-old woman with cystic fibrosis and left vocal cord paralysis. We believe that sudden pulmonary artery expansion produced recurrent laryngeal nerve injury and vocal cord paralysis. This is only the second association of unilateral vocal cord paralysis and cystic fibrosis in the medical literature. The pathophysiology of the cardiovocal syndrome is discussed.

Adult↗
PubMedDate not supplied

Intraoral keloid: complication of forehead flap.

Intraoral keloids are rare de novo, but can occur on transplanted skin. A case in which an unusual complication of forehead flap reconstruction resulted in the formation of a large keloid in the oral cavity is presented. Therapy is discussed.

Carcinoma, Squamous Cell↗