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Biomedical subjects

J W Fairley

Publications and source records attributed to J W Fairley.

12 recordsLinked to original sources
PubMed1994

Day case tonsil and adenoid surgery: how many are eligible?

We wished to estimate the percentage of children undergoing tonsil and adenoid surgery who would make suitable day cases. To achieve this a prospective study of 100 consecutive children admitted for the above surgery was undertaken. A medical and social history was obtained along with the parents' attitude to the possibility of day case tonsil and adenoid surgery. We found that 59% of our population would be eligible for day case surgery on the strict criteria we used. Reasons for failure were social in 26%, medical in 6% and both in 9%.

Adenoidectomy↗
PubMed1992

Acute stridor due to bilateral vocal fold paralysis as a presenting sign of myasthenia gravis.

We describe a case of myasthenia gravis in a 46-year-old man presenting as acute stridor with bilateral abductor paralysis of the vocal folds. Prompt diagnosis and medical treatment with pyridostigmine avoided the need for tracheostomy. It is important to remember the possibility of myasthenia gravis in cases of stridor due to bilateral vocal fold paralysis, since effective medical treatment is available.

Acute Disease↗
PubMed1991

Patrick Watson-Williams and the concept of focal sepsis in the sinuses: an historical caveat for functional endoscopic sinus surgery.

From 1900 to 1940 the theory of focal sepsis was invoked to justify a number of dubious surgical procedures. Surgeons believed they were acting rationally. Patrick Watson-Williams advocated suction exploration of the paranasal sinuses for mental patients, claiming to cure criminal insanity by sphenoidotomy. Favourable contemporary reviews showed international approval. The rational basis of treatment was emphasised, but there was little systematic evaluation of outcome. Current enthusiasm for functional endoscopic sinus surgery is also based on a rational approach, logical deductions from pathophysiological 'facts'. Outcome has still not been evaluated scientifically. We should learn from history. Treatment should not be based too readily on what seems to be rational now. Ideas of physiology and pathology change. What seems logical today may appear ridiculous tomorrow. Careful analysis of outcome, preferably by controlled clinical trials, is needed as a rational treatment requires empirical validation just as much as any other.

Endoscopy↗
PubMed1991

Kikuchi's necrotising lymphadenitis.

Three cases of Kikuchi's necrotizing lymphadenitis without granulocytic infiltration presented to the ENT department as cervical lymphadenopathy with neutropaenia. Differential diagnosis from malignant lymphoma was difficult both clinically and histopathologically. Two recovered spontaneously without treatment within three months, one improved initially but was lost to follow-up after one month.

Adult↗
PubMed1990

Unusual lymphoproliferative oropharyngeal lesions in heart and heart-lung transplant recipients.

Three unusual cases of oropharyngeal lympho-proliferative lesions were seen in recipients of heart and heart-lung transplants. Two caused acute upper respiratory obstruction necessitating urgent ENT intervention. All patients were receiving immunosuppressive drugs including cyclosporin. The two obstructive cases were adenotonsillar enlargement in a 6-year-old, and a tumour of the tonsil and tongue base with cervical lymph node enlargement in a 32-year-old male. Both were caused by Epstein-Barr Virus-associated lymphoproliferative disorder. The third patient, a 32-year-old female, had a presumed low grade T-cell lymphoma that regressed spontaneously. Histopathological diagnosis of these lympho-proliferative disorders after transplantation usually requires immunocytochemistry to distinguish polyclonal proliferative disorders from true lymphoma. Polyclonal lymphoproliferative disorders after transplantation do not usually require aggressive cytoreductive therapy, but respond to simple measures such as the reduction of immunosuppression.

Adult↗
PubMed1981

An intradermal study of the local anaesthetic and vascular effects of the isomers of mepivacaine.

The duration of action and vascular effects of L(+) and D(-) and racemic mepivacaine were investigated in a double-blind study in 23 fit volunteers. Isosmolar 0.1-ml intradermal injections of a range of concentrations of each agent from 0.011% to 2.7%, and physiological saline were given in duplicate to at least 14 subjects. Local colour changes were observed 5-10 min after injection, and analgesia to pinprick was tested at 5-min intervals thereafter until full recovery. Both isomers were vasoconstrictor at concentrations of 0.3% and less; at greater concentration the L isomer produced more vasodilation and haemorrhagic change. The duration of action of both isomers increased with concentration between 0.05 and 0.9%, but the L isomer was significantly longer acting than the D at 0.3% and more. The log dose-duration curve could be interpreted as linear between 0.1 and 0.9% with the slope of L isomer being twice as steep as the D. The findings for racemic mepivacaine were between those of the two isomers. The longer duration of analgesia of L-mepivacaine was not associated with superior vasoconstrictor power.

Adult↗