PubMed Health⌕ Search

Biomedical subjects

P G Harries

Publications and source records attributed to P G Harries.

At least 19 recordsLinked to original sources
PubMed2005

Recurrent epistaxis after treatment with tadalafil (Cialis).

A 66-year-old male presented to our department with recurrent epistaxis. On examination it was not possible to identify the source of the bleeding, despite various measures. The bleeding stopped spontaneously each time and advice on nose bleeds was given to the patient. During a consultation the patient volunteered that the trigger for the epistaxis appeared to have been energetic sexual activity. To enhance his sexual performance he had taken Viagra; however, on stopping the Viagra and changing to the newer drug Cialis, the episodes of epistaxis continued. We document what we believe to be the first case of epistaxis caused by Cialis.

Aged↗
PubMed2004

Recurrent extracranial sinonasal meningioma presenting 27 years after complete surgical eradication of right frontal meningioma.

A 79-year-old man presented to our department with nasal obstruction and postnasal drip. On examination he had unusual bilateral nasal polyps, which were histologically diagnosed as meningioma. Twenty-seven years earlier he had undergone successful removal of a right frontal meningioma. A CT scan performed 7 years after his primary surgery had shown complete excision with no evidence of recurrence. Extracranial meningiomas are rare tumours and are usually extensions from an intracranial mass lesion. We document what we believe to be the first case of an extracranial meningioma, presenting as nasal polyps, 27 years after successful surgical eradication of the primary lesion.

Aged↗
PubMed2003

Can the Sino-nasal Outcome Test (SNOT-22) be used as a reliable outcome measure for successful septal surgery?

Septoplasty and submucous resection are common procedures in the UK. This study looks prospectively at 40 patients undergoing surgery at two hospitals. A pre- and postoperative assessment (3 months) was made using the Sino-nasal Outcome Test. This test was originally designed for rhinosinusitis but our study suggests that it is a useful tool in nasal septal surgery, in that it combines both nasal specific and general health questions, which can be analysed individually or together. Improvements in nasal obstruction (75%), facial pain (33%) and catarrh (10%) were noted.

Adult↗
PubMed1997

Treatment of hereditary haemorrhagic telangiectasia by the pulsed dye laser.

Hereditary haemorrhagic telangiectasia (Osler-Weber-Rendu syndrome, Osler's disease) is an inherited abnormality of the vasculature characterized by abnormal subepithelial vessels. Treatment has included repeated intranasal cautery, intra-arterial embolization and arterial ligation. Historically, the operation of septodermoplasty and the use of systemic/topical oestrogens have been the most effective and lasting treatments, but over time the telangiectasias recur. There is increasing interest in the use of a variety of lasers for intranasal photocoagulation. A report of nine patients suffering from hereditary haemorrhagic telangiectasia who have undergone laser treatment with the Chromos pulsed dye laser is presented. This laser produces light energy at a wavelength of 585 nm and causes localized thermal damage to the blood vessel wall. Initially, no patient saw an improvement in their symptoms, but following an average of approximately three courses of treatment, all have reported a measurable reduction in the number of epistaxes suffered. Although no treatment completely resolves the epistaxis associated with this condition, we have found the pulsed dye laser to be effective at treating telangiectasias within the anterior nasal cavity.

Adult↗
PubMed1997

Retropharyngeal abscess and acute torticollis.

Acute torticollis may result from an inflammatory process irritating the cervical muscles. In children there is often an association between acute torticollis and retropharyngeal cellulitis/abscess. Over six weeks, two children with acute torticollis presented to our Department. Both children were found to have retropharyngeal cellulitis/abscess. The problem of differentiating between the non-suppurative and the suppurative phases of the disease process is discussed.

Acute Disease↗
PubMed1996

Idiopathic tracheal stenoses.

The case histories are presented of three patients with circumferential subglottic stenoses who presented, over a six-month period, to a teaching hospital's Otolaryngology department. No recognisable cause for their subglottic stenoses was found. Traumatic, iatrogenic, infectious and specific inflammatory processes were excluded. The histopathological evidence suggested a chronic inflammatory process. All patients were treated by resecting the stenosis with a carbon dioxide laser. One patient required an emergency tracheostomy for airway obstruction. A review of the published literature on this rare condition is given.

Adult↗
PubMed1996

Foreign body impaction arising in adulthood: a result of neonatal repair of tracheo-oesophageal fistula and oesophageal atresia.

Over a 3-month period, four patients presented to Salisbury District Hospital with symptoms of oesophageal foreign body impaction and dysphagia for solids. In their first few days of life all four patients had undergone successful operations for the repair of congenital oesophageal atresia with or without a tracheo-oesophageal fistula. Despite our efforts, the previous medical records were unavailable to ascertain the exact form of surgery each patient had received. All four patients had flexible oesophagogastroscopy by one of the authors (RAF). Three were found to have a food bolus obstructing the oesophagus, lodged above or within a ring stricture at the presumed level of their surgical repair and oesophageal anastomosis. The fourth patient had a ring stricture only; it was assumed that the food bolus had become disimpacted. All four patients had successful dilatations using thermoplastic oesophageal dilators. After the procedure all the patients were symptom free and remain so at varying lengths of follow-up. Case studies of these patients are presented below along with a review of the literature concerning the relatively rare presentation of dysphagia in adults who had previously undergone neonatal surgery for congenital oesophageal anomalies.

Adult↗
PubMed1995

Adult floppy epiglottis: a simple surgical remedy.

Epiglottic prolapse during inspiration is an unusual cause of upper airway obstruction. We present a case of a previously fit, 73-year-old, male with upper airway obstruction secondary to a floppy epiglottis. We describe a simple method of treatment without the need for partial or total excision of the epiglottis or tracheostomy.

Aged↗
PubMed1994

What constitutes general surgical training? Evidence from the log books of trainees in one district general hospital.

It is accepted wisdom that surgical expertise in the UK is achieved by virtue of long service, and perhaps not enough genuine training. The average age at appointment to consultant posts in general surgery has risen from 37.0 years in 1978 to 38.0 in 1992. This message has reached the politicians who run the Health Service: at the Association of Surgeons in Training Annual General Meeting in September 1991 Mrs Virginia Bottomley said 'A complaint often made to me is that trainees, particularly surgical trainees, in the UK are over-experienced but under-trained'. Training posts acquire a reputation (good or bad) based on word of mouth, pass rate in examinations, and success in placing trainees into higher grades. Little is known about the relationship between training and operative experience. Log books have been introduced as a compulsory requirement for the Clinical Surgery in General and Intercollegiate Specialty Examinations. This report aims to define the operative experience of trainees at a District General Hospital by analysis of data obtained from their log books. This information has been used to calculate trainee workload in terms of intermediate equivalents (IE) and service equivalent value (SEV).

Education, Medical, Graduate↗
PubMed1980

Royal Naval dockyards asbestosis research project: nine-year follow-up study of men exposed to asbestos in Devonport Dockyard.

Progression of asbestos-related disease was assessed in a group of 253 dockyard workers examined in 1966 and 1975. Despite the almost complete protection from exposure to asbestos since 1966, radiographic parenchymal abnormalities increased and occurred more frequently during the next 9 years in those men who had been more heavily exposed to asbestos. Lung function values were lower in those most heavily exposed and were declining at a faster rate than in those with less dust exposure. The most sensitive lung function index was the transfer factor.Those men with persistent crackles in 1966 exhibited a restrictive pattern of lung function, whereas an obstructive pattern was seen in men with wheezes in 1966. The men with irregular small opacities of category 1/1 or more or with diffuse pleural change in 1966 and who survived to 1975 had worse lung functions than any other groups.Progression of disease was greater for smokers than non-smokers, with those who gave up smoking between 1966 and 1975 suffering the greatest changes. This latter group showed most increase in small opacities and included almost all new cases of diffuse pleural changes. They also showed the greatest declines in forced expiratory volume and forced vital capacity.

Asbestos↗
PubMed1979

UK Naval Dockyards asbestosis study: survey of the sample population aged 50-59 years.

As part of a general morbidity study of all civilian employees in the four Royal Naval Dockyards, the clinical, radiological and physiological effects of exposure to asbestos in 1200 men aged 50-59 years were studied in detail. The sample included all men on the Register of Asbestos Workers, one in three of those currently in occupations where intermittent exposure to asbestos may occur, and one in 30 of the remainder. The conclusions are mainly in accord with those of the comprehensive morbidity study of all the civilian dockyard workers, and show that smoking played a large part in increasing prevalence rates of radiographic, clinical, and physiological abnormalities in this population. A sub-group of 39 men, who were working as asbestos laggers or sprayers before 1957, was identified. These men showed much more extensive disease than any other sub-group, yet, even so, the smokers were worse than the non-smokers. Of these smokers, 48% had small opacities of category 1/1 or more, 76% reported that they coughed during the day and 53% had crepitations; forced expiratory volume and transfer factor were also markedly reduced in these 21 smokers. Although asbestos exposure had been intermittent for the majority of the population, the prevalences of pleural thickening, small opacities, current respiratory symptoms and crepitations were shown to be related to duration of exposure to asbestos.

Asbestosis↗