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Biomedical subjects

P Beasley

Publications and source records attributed to P Beasley.

11 recordsLinked to original sources

Posterior tragal perichondrium harvesting for myringoplasty.

We present a modified harvesting approach for tragal perichondrium, used in tympanic membrane reconstruction. The technique described avoids amputation of the targus thereby facilitating dissection of the perichondrium from the cartilage as compared to the traditional method. The approach described is technically easier, and removes any potential for cosmetic deformity associated with tragal cartilage amputation and reimplantation. Furthermore, both the anterior tragal perichondrium and the temporalis fascia remain intact if further surgery is required. We recommend this approach for permeatal, tragal perichondrial grafting of small to medium sized tympanic membrane perforations.

Ear Cartilage↗

The use of Merocel nasal packs in the treatment of epistaxis.

Over the period of a year, Merocel nasal packs were used routinely as the primary form of packing in patients referred to the hospital with epistaxis that had not resolved with simple measures, and in whom packing was thought to be required. Their effectiveness was assessed. The packing was usually performed by inexperienced senior house officers. The Merocel packs successfully controlled bleeding in 91.5 per cent of the patients in whom they were used. Use of the correct insertion technique is very important but is very easy to learn and perform. The actual insertion takes only a couple of seconds. Discomfort during insertion, whilst in situ and on removal was assessed. Merocel nasal packing is an effective form of first line treatment in patients with epistaxis.

Epistaxis↗

Day-case tonsillectomy--is it appropriate?

There is continued encouragement to increase the use of day surgery. Recent publications have suggested that day-case tonsillectomy is a safe procedure due to the low primary haemorrhage rates (0.14-3.5%). One of the suggested benefits of day surgery is that patients want it. They prefer to recover at home after an operation. With tonsillectomy, personal experience suggested that this was not the case. A review of 117 patients having tonsillectomy was undertaken. All patients stayed in for at least one post-operative night. No patients or parents thought that the post-operative stay was too long (80% 'just right', 20% 'too short') and only 7% would have been happy to go home on the day of operation. 'Safety' does not automatically make an operation suitable for day-case surgery. Pain, nausea, vomiting, drowsiness and anxiety about the operation and post-operative course were all reasons given for not wanting to go home on the day of surgery. The justification for the increased use of day surgery is that it increases efficiency by reducing costs per case while maintaining the quality of care. One aspect of quality of care is patient acceptability and before day-case tonsillectomy is acceptable to patients the factors responsible for the post-operative morbidity need to be addressed.

Adult↗

Benign myoepithelioma of the salivary glands: a true entity?

Myoepithelioma is a rare neoplasm of the salivary glands which is now recognized as an individual entity in the revised WHO classification. In this study, eleven benign tumours are presented. Most patients gave a history of a slowly enlarging mass, which was cured by surgical excision. However, one case recurred several times over 50 years, and another still has residual tumour and removal is not possible. The histological appearances included solid, myxoid and reticular growth patterns, composed predominantly of spindle shaped or plasmacytoid (hyaline) cells. Many of the tumours also contained occasional small ducts. All 11 tumours were positive for S-100 protein, variable reactions being seen for various other antigens--keratins, human milk fat globulin, carcinoembryonic antigen, alpha smooth muscle actin and vimentin. It is probable that myoepithelioma constitutes one end of a biological spectrum which also includes pleomorphic adenoma and some (non-membranous) basal cell adenomas. In practice, however, we still advocate retention of myoepithelioma as a separate diagnostic category, on the grounds that it has a range of distinctive microscopic appearances and poses its own unique problems in correct identification.

Adult↗

Adrenal suppression with intranasal betamethasone drops.

Intranasal betamethasone sodium phosphate drops (Betnesol) are frequently used to relieve nasal congestion due to polyposis. We report a case of significant hypothalamic-pituitary-adrenal suppression secondary to the long-term use of intranasal betamethasone drops. This case emphasizes that the topical application of potent corticosteroids may produce systemic effects.

Administration, Intranasal↗

Exacerbations of asthma in adults during experimental rhinovirus infection.

To determine the incidence of wheezing in adult asthmatics with rhinovirus infection, we exposed 21 asthmatic volunteers to 1 of 2 rhinovirus serotypes. Symptoms, spirometry, and histamine inhalation challenge were assessed prior to, daily during, and 3 wk after the rhinovirus infection. Four volunteers had fiberoptic bronchoscopy performed on the fourth study day. Nineteen volunteers became infected with rhinovirus; 17 of 19 had typical coryzal symptoms. Volunteers did not have significant changes in spirometry or histamine sensitivity during rhinovirus infection when taken as a group or when categorized by severity of asthma or severity of the clinical illness. A subgroup of 4 volunteers was identified that had a 10% or greater decrease in FEV1 and a parallel increase in histamine sensitivity during rhinovirus infection; these 4 volunteers were not otherwise distinguishable from the group as a whole. Rhinovirus was recovered from bronchoscopy specimens of 1 of the 4 infected volunteers bronchoscoped. Thus, exacerbations of wheezing occurred in the minority of experimental rhinovirus infections in adult asthmatics, suggesting that other viral pathogens may play a more important role in precipitating asthma attacks.

Adult↗

Gastroenteritis due to rotavirus in an isolated Pacific island group: an epidemic of 3,439 cases.

In the spring of 1964, 3,439 cases of acute gastroenteritis were reported from Truk District, an island group in the mid-Pacific. The causative agent was not identified in laboratory studies performed in that year. Retrospective serologic studies 15 years later with the complement fixation test and the enzyme-linked immunosorbent assay provided serologic evidence that this outbreak was caused by the human rotavirus that was first isolated in 1973.

Adolescent↗

Spasmodic torticollis: a combined clinical study.

The prognosis in 30 patients with spasmodic torticollis proved to be unexpectedly bad, only one patient making a full and sustained recovery. Investigation did not confirm previously reported reflex influences on the degree of spasm. Detailed otological investigation did not suggest that spasmodic torticollis originates in vestibular dysfunction. Psychological assessment of the patients showed no deviation from normal in premorbid personality but confirmed the severe adverse effects of the condition.

Adult↗

Hepatitis B antigen in infants born to mothers with chronic hepatitis B antigenemia in Taiwan.

Hepatitis B antigen (HB Ag) was detected by complement fixation (CF) in serum samples of 7.5% of 1,106 pregnant Chinese women tested in Taipei, Taiwan. HG Ag persisted in all but one of 42 women followed for 1 to 18 months (average, nine months) after delivery, and 27 of the 43 infants (63%) born to those women became antigen-positive. Persistance of the antigen was more common than transient or intermittent antigenemia. Twelve had antigenemia when first tested, while 15 later developed antigenemia, usually during the first six months of life. Only one infant developed antibody to HG Ag (anti-HB Ag), and this occurred after transient antigenemia. The HB Ag was found in two of 32 (6%) fathers, and in 18 of 27 (67%) older siblings. The antigen was more common among siblings of antigen-positive than among those of antigen-negative infants. These findings demonstrate that in Taiwan, infants born to mothers who are asymptomatic carriers of HB Ag commonly become infected by heaptitis B (HB) virus. Exposure of infants near the time of birth may be important maintaining the high, chronic HB Ag carrier rate in Taiwan.

Carrier State↗