Biomedical subjects

Patrick J Collison

Publications and source records attributed to Patrick J Collison.

4 recordsLinked to original sources

PubMed2004

"Spontaneous" perilymph fistula: a case report.

A surgically documented case of barotrauma-induced perilymph fistula is presented in this case report. A brief review of the literature on this entity confirms the difficulty of making a definitive preoperative diagnosis in most instances. Clinical, audiometric, radiologic, and intraoperative findings are presented, and the classic presumed mechanisms for this uncommon cause of sudden sensorineural hearing loss are discussed. The presence of intact evoked otoacoustic emissions in an ear demonstrating a severe cochlear-type loss was considered helpful in narrowing the differential diagnosis in this case, and may suggest a productive avenue for future study.

Adult↗

PubMed2004

Harmonic scalpel versus conventional tonsillectomy: a double-blind clinical trial.

We conducted a prospective, double-blind clinical trial to evaluate the differences in operating time, intraoperative blood loss, postoperative pain at 3 hours and 1 week, and delayed (>24 hr) bleeding associated with ultrasonic harmonic scalpel tonsillectomy and conventional tonsillectomy. The study was carried out on 28 patients with recurrent tonsillitis and/or adenotonsillar hypertrophy who underwent harmonic scalpel tonsillectomy on one side and cold dissection tonsillectomy with suction electrocautery hemostasis on the other. The harmonic scalpel was associated with significantly less intraoperative blood loss (mean: 6.2 vs. 58.8 ml; p < 0.0001) and less early (3 hr) postoperative pain as determined by scores on a 10-point visual analog scale (mean: 3.5 vs. 4.4; p = 0.0042); although the difference in early pain scores is statistically significant, it is probably not clinically significant. Pain scores at 1 week were nearly identical (mean: 2.7 vs. 2.6; p = 0.9246). The length of operating time was similar (mean: 10.9 vs. 7.7 min; p = 0.0022). An unanticipated finding was the fact that delayed bleeding, which occurred in 3 patients (10.7%), occurred only on the harmonic scalpel side. We conclude that the only clearly demonstrable advantage that the harmonic scalpel had over cold dissection was that it caused less intraoperative blood loss.

Adolescent↗

PubMed2003

Middle ear pathogens in otitis-prone children.

A cohort of 191 children with recurrent otitis media and persistent middle ear effusion underwent myringotomy and tubes, at which time middle ear cultures were taken. The indications, fluid type, culture and sensitivity results, and pre- and post-procedure frequency of otitis media were evaluated. Sixty-seven percent of the effusions were mucoid in nature, and 24% of cultures grew pathogens, including Hemophilus influenzae, Streptococcus pneumoniae, Moraxella catarrhalis, and Staphylococcus aureus in that order of frequency. A relatively high rate of antibiotic resistance was noted, with 75% of Streptococcus pneumoniae being penicillin resistant. Prognosis with respect to recurrent otitis media was favorable after myringotomy and tubes, even in children with antibiotic-resistant organisms.

Child↗

PubMed2003

Glandular tularemia in a Native American child.

This case report details the clinical manifestation and course of glandular tularemia, an uncommon but significant cause of cervical lymphadenopathy in children. We discuss the unique attributes of this disease along with appropriate steps that lead to early identification of the organism and effective treatment. The potential use of the organism as a bioterrorism agent is another interesting aspect of this entity.

Bioterrorism↗