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P Keogh

Publications and source records attributed to P Keogh.

At least 19 recordsLinked to original sources
PubMed2004

Management of sudden sensorineural hearing loss - a national survey.

The management of Sudden Sensorineural Hearing loss is a controversial issue and there is no universally agreed protocol in its management The aim of this study was to ascertain the referral trends, treatment strategies, and outcome of treatment adopted by the Consultant Otorhinolarygologists in this country. A postal questionnaire was sent to all 32 Consultants in the Republic of Ireland, which achieved 21(65.62%) responses. Patients were referred to 13(61.9%) respondents within two weeks of the onset of symptoms and 3(14.28%) Consultants were referred patients within twenty four hours of the onset of symptoms. All specialists routinely performed full blood count and erythrocyte sedimentation rate, 15(71.42%) routinely assess fasting blood sugar and 5(23.80%) investigate fasting lipids and perform a syphilis screen. MR imaging to outrule vestibular schwanoma is performed by 11(52.38%) respondents. When treated within two weeks of the symptoms 6(28.57%) of the respondents were optimistic about recovery of hearing upon treatment whereas 2(9.52%) considered recovery of useful hearing less likely if treated more than two weeks after onset The triple therapy with oral vasodilators, oral steroids, and Carbogen inhalation was favoured by 9(42.85%). Oral steroid was the sole therapeutic modality by 4(19.04%). The opinion of Consultants was that the referral trend from the primary care physician is appropriate and 20(95.23%). Consultants considered an optimistic outcome if treated within two weeks. The investigations and management protocol for sudden sensorineural hearing loss is not uniform which is consistent with the treatment strategies world wide.

Audiometry, Pure-Tone↗
PubMed2003

Stoned 2.

Explore the source record for details and available documents.

Humans↗
PubMed2002

Nail-gun limb injuries.

We present four cases and a review of the literature regarding nail-gun related limb injury. Nail guns have significant potential to cause limb and other major injuries. In most cases improper use of the nail-gun is the single most important factor in causing such types of injuries. Treatment of these injuries requires careful assessment of the limb and the type of nail involved in order to enable safe extraction. We recommend the introduction of training in the workforce to encourage awareness of the danger of such devices. We also emphasize the continuing requirements for improved workplace safety and adequate safety equipment when working with such dangerous devices.

Accidents, Occupational↗
PubMed1997

Risk of pelvic injury from femoral neck guidewires.

Many of the devices used in the internal fixation of femoral neck fractures are cannulated and require the initial placement of one or more guidewires for accurate positioning. These wires are occasionally advanced inadvertently through the hip joint and the acetabulum. Pelvic visceral damage may follow. To assess this risk, we inserted three guidewires to a depth of 16 cm into each femoral neck of ten cadavers and explored the pelvis during autopsy. Thirty-two of the 60 guidewires had penetrated a pelvic organ. The literature on intrapelvic injuries associated with hip surgery is reviewed, and suggestions are offered on the avoidance of pelvic penetration during hip fracture fixation.

Cadaver↗
PubMed1997

Loss of flexor pollicis longus function after plating of the radius. Report of six cases.

Six cases of loss of flexor pollicis longus function after plating of a radius fracture are presented. The exact aetiology of the postoperative deficit is uncertain, but is probably a traction neuropraxia of the anterior interosseous nerve branches to the flexor pollicis longus. All six patients had full recovery within 5 months. An initial conservative approach is recommended if this complication is encountered.

Adolescent↗
PubMed1996

Safety of 65 degrees C intravenous fluid for the treatment of hypothermia.

BACKGROUND: To demonstrate the safety and efficacy of 65 degrees C (149 degrees F) centrally administered intravenous fluid (CIVF) compared to conventional 40 degrees C (104 degrees F) CIVF in the treatment of hypothermia. METHOD: Ten beagles (9-13 kg) were prospectively randomized to receive 65 degrees C or 40 degrees C CIVF. They were anesthetized and data were collected at baseline, during hypothermia, and after 1 and 2 hours of rewarming. The plasma free/total hemoglobin (PFHb/THb) was measured to detect hemolysis. Each subject was cooled to 30 degrees C (86 degrees F) and then received either 65 degrees C or 40 degrees C CIVF through a specialized catheter in the superior vena cava for 2 hours in addition to conventional rewarming techniques. All subjects survived 7 days, after which they were sacrificed and a complete autopsy was performed. RESULTS: The rewarming rate was 3.7 degrees C/hr in the 65 degrees C CIVF group and 1.75 degrees C/hr in the 40 degrees C CIVF group. Core temperatures were significantly different after 1 hour (33.4 degrees +/- 0.77 degrees versus 31.7 degrees +/- 0.57 degrees, P < 0.01) and 2 hours (37 degrees +/- 1.03 degrees versus 33.4 degrees +/- 0.89 degrees, P < 0.001). PFHb/THb was not different. Two intimal injuries occurred in each group but these were remote from the infusion site. Blinded examination by two pathologists could not differentiate the etiology of these injuries from mechanical trauma. CONCLUSION: CIVF at 65 degrees C is a safe and effective means of treating hypothermia.

Animals↗
PubMed1994

The social impact of HIV infection on women in Kigali, Rwanda: a prospective study.

In Rwanda, a central African country, the prevalence of HIV infection now exceeds 30% in urban adults. This study identifies the social services and counseling needs of women who are already infected with the HIV virus, the outcome after disclosure of the woman's HIV test result to her partner and estimates the social support available to the women from their partners and relatives. Fifty-five HIV-positive women in Kigali were interviewed in 1988 and 47 of this group were interviewed again in 1991. The social services most needed by the women in 1988 were housing, employment and money. By 1991, the women prioritised food, housing and money as their current needs and food, childcare and money were their future needs in the event they became ill. The preferred sources of support in 1988 were individual counseling and women's support groups. By 1991, the preferred sources of support were individual counseling and their priest. In 1988, almost 75% of the women did not expect a supportive reaction from their partners after disclosure of the test result. In 1991, acceptance, understanding and sympathy were the most common reactions of the partners after disclosure. However, 8 (21%) had not told their partner their test result. After disclosure, 18 of the 37 partners were subsequently tested. Of those tested, 75% were HIV-positive and 25% were HIV-negative. Condom use was almost twice as high when the partner was informed of the test result, although in couples overall, a third were not using condoms despite knowing the test result.(ABSTRACT TRUNCATED AT 250 WORDS)

Activities of Daily Living↗
PubMed1994

Pseudosarcoma of the larynx: the value of ploidy analysis.

An 82-year-old male presented with a two-month history of hoarseness. A 2 cm pedunculated lesion was removed from the base of his epiglottis. Microscopy showed a polypoid atypical spindle cell lesion. Multiple levels failed to reveal an invasive squamous cell carcinoma. On the basis of haematoxylin and eosin stained sections the main differential diagnosis was a pseudosarcoma with an overlying dysplastic squamous mucosa or infiltrating spindle cell carcinoma. Immunohistochemistry showed positive staining for vimentin but no convincing staining with antibodies to cytokeratin and EMA. Ultrastructural analysis also failed to reveal epithelial characteristics. Ploidy analysis by static cytophotometry of the spindle cell proliferation revealed an aneuploid stem line with a DNA index of 1.67. On the basis of this the process was felt unlikely to be reactive and a diagnosis of a spindle cell squamous carcinoma was made. This diagnosis was subsequently supported by a clinical recurrence of the nodule at a six-month follow-up.

Aged↗
PubMed1994

Bacterial arthritis in the neurosurgical patient: report on four cases.

Bacterial arthritis that occurred in four patients during neurosurgical convalescence is reported. Three patients had a cerebral aneurysm clipped after a subarachnoid hemorrhage, and one had herpes simplex encephalitis with a possible temporal lobe hemorrhage. All four patients had been treated with steroids. A total of six joints were infected, two patients with an infection in one joint each, and two with a metachronous infection in two joints. The interval between the onset of local symptoms and the definitive diagnosis ranged from 0 to 44 days. A delay in diagnosis severely compromises joint function, and all four of these patients were left with an associated significant musculoskeletal disability. Bacterial arthritis is well recognized in the immunocompromised patient, but, to our knowledge, has not been described in this particular clinical setting. A patient with a sustained pyrexia of unknown origin in the neurosurgical convalescent period should be suspected of having an occult musculoskeletal infection. An isotope bone scan to facilitate early diagnosis is recommended, and this, combined with specific aggressive therapy, should preserve joint function.

Adult↗
PubMed1993

Aneurysmal bone cysts in the hand treated by free non-vascular transfer of metatarsal or proximal phalanx from the foot.

Two cases of aneurysmal bone cyst in the hand are reported. In one case the entire first metacarpal was resected and grafted using the fourth metatarsal. In the second case diaphysectomy of the middle phalanx of the index digit was performed, and the proximal phalanx of the second toe was used as graft. Satisfactory length and function were maintained, the grafts remained viable and there was no donor site morbidity. Transplant of a metatarsal or toe phalanx to the hand, as a free non-vascularized graft, is a relatively straight forward operation, requires minimal refashioning of the graft, provides articular surfaces for joint reconstruction and leaves little donor site morbidity.

Adult↗
PubMed1993

Investigation of motivational and behavioural factors influencing men who have sex with other men in public toilets (cottaging).

One-hundred-and-thirty-four individuals engaging in cottaging returned postal questionnaires. The sample was mainly urban and gay identified. Cottagers reported that cottaging was one way of meeting partners amongst a range of others they used. Most enjoyed it and felt in control of their cottaging. The majority of cottagers engaged in safer sexual activity, but there were a significant number who engaged in unsafe sexual activity last time they cottaged. Of those who had been voluntarily tested in the past and reported their serostatus, 23% were seropositive. Unsafe sexual activity was unrelated to whether tested or not, known serostatus or knowledge of the risks of transmission.

Adult↗
PubMed1993

The role of radiography and computed tomography in the diagnosis of acute dislocation of the proximal tibiofibular joint.

A cadaveric study was undertaken to determine the best radiographic method of diagnosing dislocation of the proximal tibio-fibular (PTFJ) joint. Three pairs of cadaver knees were used, the right side serving as a control in each case. Plain radiographs, antero-posterior (AP) lateral and 45 degrees oblique films, and axial computed tomography (CT) scans were obtained with the joints in each of three positions: (1) anatomical, (2) dislocated anteriorly and (3) dislocated posteriorly. Similar views were obtained in the control joints with the PTFJ undisturbed. The radiographs were assessed by eight independent observers and the results were analysed. The diagnostic accuracy with plain AP and lateral radiographs was 72.5%. This was unchanged with the addition of oblique views, but improved to 82% with the control films and 86% with the axial CT scans. The authors conclude that in the diagnosis of suspected dislocation of the PTFJ, axial CT scanning is the investigation of choice. Plain AP, lateral and comparison views are useful but less accurate, while oblique views are unhelpful and unnecessary.

Acute Disease↗
PubMed1992

Cheilectomy for hallux rigidus.

Cheilectomy is the excision of an irregular osseous rim that interferes with joint motion. Twenty cases of hallux rigidus/limitus treated by cheilectomy have been reviewed 18 months after surgery. A satisfactory outcome was achieved in all but 2 cases, which were failures. Range of joint motion, in particular dorsi flexion, improved in all but 6 cases. Cheilectomy is a simple and effective alternative to arthrodesis in the treatment of hallux rigidus.

Adult↗
PubMed1992

Percutaneous screw fixation of tibial plateau fractures.

A series of 13 patients with displaced fractures of the tibial plateau treated by closed reduction and percutaneous pinning have been reviewed 17 months after surgery. All the operations were performed using image intensification to aid reduction of the fracture by ligamentotaxis and to guide screw placement. In two cases, arthroscopy was used in addition to facilitate elevation of the articular surface using a probe inserted through a cortical window in the proximal tibial metaphysis. The postoperative rehabilitation programme consisted of early mobilization and non-weight bearing for at least 2 months. Of the patients, 11 had a satisfactory result, one patient had a fair result with persistent pain and the other had a poor result when the fixation failed in a comminuted bicondylar fracture in porotic bone. This technique is minimally invasive and avoids many of the complications of both conservative and operative treatment and will have an expanding role to play in the management of these fractures.

Adult↗