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Biomedical subjects

R J Canter

Publications and source records attributed to R J Canter.

18 recordsLinked to original sources
PubMed2005

Successful liver, kidney, and pancreas transplantation from a donor with cerebral emboli from a left atrial myxoma.

Although transmission and engraftment of donor-derived malignancies is rare in recipients of solid organ transplants, it is associated with unfavorable allograft and patient survival. Therefore, a recent history of malignancy is considered a contraindication to organ donation. Although atrial myxomas are benign cardiac tumors of stromal origin, they can lead to systemic embolization with ectopic myxoma formation. We report successful liver, kidney, and pancreas transplantation into 3 recipients from a donor with cerebral emboli from a left atrial myxoma. Eighteen months after transplantation, all 3 patients enjoy good allograft function and are free of donor-derived atrial myxoma. Although the duration of follow-up in this report is limited, we suggest that the presence of atrial myxoma should not be viewed as an absolute contraindication to organ recovery, particularly in view of the shortage of organ donors and the attendant morbidity and mortality for patients on waiting lists.

Adolescent↗
PubMed2001

A comparison of sleep quality in normal children and children awaiting (adeno)tonsillectomy for recurrent tonsillitis.

Poor quality sleep and sleep-related hypoxia have been described in children awaiting (adeno)tonsillectomy even in the absence of a history which would suggest such problems. However, restless sleep has also been commonly reported in children from a normal population. It has not been shown whether an increasing frequency of tonsillitis is associated with deterioration in sleep quality. This study directly compares sleep quality in three groups of children: (1) a normal population; (2) children from a normal population who have tonsillitis but are not awaiting tonsillectomy; and (3) children awaiting tonsillectomy for recurrent tonsillitis. A questionnaire was completed by the parents and the answers compared using the chi2 and Spearman's rank correlation tests. The results show that children awaiting tonsillectomy have poorer sleep quality than their normal peers. However, there is no dose-response effect between deteriorating sleep quality and increasing frequency of tonsillitis.

Adenoidectomy↗
PubMed2001

Is there agreement among general practitioners, paediatricians and otolaryngologists about the management of children with recurrent tonsillitis?

Tonsillectomy is the second most common operation undertaken in children in the United Kingdom, but the rate at which tonsillectomy is performed varies greatly across the Health Authorities. The reasons for the variation appear to be related to differences in local medical practice rather than differences in regional morbidity. This study was undertaken to compare the factors used to diagnose tonsillitis in children, the indications for tonsillectomy and the expected benefits of tonsillectomy in children by general practitioners, paediatricians and otolaryngologists. There was poor correlation between general practitioners, paediatricians and otolaryngologists in all study objectives. There appears to be no consistent clinical pathway by which children with recurrent tonsillitis are managed. The wide variation in tonsillectomy rates across the United Kingdom will probably continue until the decision-making process of doctors involved in the treatment of children with recurrent tonsillitis is better understood.

Child↗
PubMed2001

How well do parents recognize the difference between tonsillitis and other sore throats?

Little evidence exists from randomized controlled trials to support the role of tonsillectomy in children with recurrent tonsillitis. Despite this, parents report a great change for the better in their children following the operation. Previous trials vary in their inclusion criteria, both in terms of the definition of tonsillitis and in the frequency of sore throats required before entry into the study is permitted. The aims of this study are to define tonsillitis from the perspective of parents whose children are awaiting tonsillectomy for recurrent sore throats, and to determine whether such parents have a better understanding of the difference between tonsillitis and other sore throats than parents of children from a normal population control group. These aims demonstrate whether parents who request tonsillectomy for their children do so on the basis of a recognized clinical problem. We report that parents can clearly identify a sore throat illness that they call tonsillitis and which is differentiated from other sore throats by different symptom complexes. The parental history is important in the assessment of a child prior to tonsillectomy. The views of parents whose children have recurrent tonsillitis must be further investigated if the difference between randomised controlled trial results and parents' opinions regarding the benefit of tonsillectomy is to be understood.

Case-Control Studies↗
PubMed2001

Is the incidence of tonsillectomy influenced by the family medical or social history?

Previous reports have suggested that the incidence of tonsillectomy, and/or tonsillitis in children, is influenced by factors such as parental smoking, maternal health and previous parental tonsillectomy. The reports have considered single factors and have not considered the possible confounding effect of the factors upon one another. Previous studies have not investigated the influence of social class. This paper uses the background of a large case-control trial of children awaiting tonsillectomy for recurrent tonsillitis, and a normal control group to study the influence of parental smoking, parental surgical history, parental tonsillectomy, family atopy and social class upon the reported incidence of sore throats and tonsillitis. A multivariate analysis is used. The paper shows that parental smoking, previous parental surgery and social class have no effect upon the number of sore throat episodes. A history of parental tonsillectomy and a family history of atopy are both significant predictive factors for the number of reported sore throats and episodes of tonsillitis in children.

Case-Control Studies↗
PubMed1996

Overnight pulse oximetry in normal children and in children undergoing adenotonsillectomy.

This study investigates the hypoxia that has been described during sleep in children admitted for adenotonsillectomy. Two hundred and twenty-two randomly selected children and 33 children awaiting adenotonsillectomy had overnight pulse oximetry performed at home. Children undergoing surgery had a second study in hospital on the eve of surgery and a third at home 3 months post-operation. Analysis of pulse oximetry data failed to detect a clinically significant difference in oxygen saturation levels between these populations. Snoring is reported in 76% of children undergoing adenotonsillectomy and 11% of the normal population. Sleep apnoeic episodes occur in 52% of children prior to surgery compared with 8% of the normal population. Overnight pulse oximetry has failed to differentiate children with symptoms suggestive of obstructive sleep apnoea from the normal population. Its use as a screening procedure should be used with caution until more is known about its ability to predict significant disease.

Adenoidectomy↗
PubMed1996

Snoring, apnoea and ENT symptoms in the paediatric community.

This study was designed to determine the prevalence of snoring and assess the extent of associated ENT symptoms in children up to 10 years of age. A questionnaire was presented to the parents of 245 children chosen at random from the General Practice list of the town of Frome, Somerset, UK. The prevalence of snoring was found to be 27%. This increased to 47% in the presence of an upper respiratory infection. Snoring was found to be significantly (P < 0.001) associated with a history of poor hearing, restless sleep, and having a cold. Less significant (P < 0.01) associations occurred with parental smoking, eczema, sleep talking, moving around the bed at night, sore throats, having a runny nose and mouth breathing. Snoring is a common symptom in children up to 10 years of age. Without evidence of other ENT disease the snoring child does not require referral to an ENT department for further investigation.

Child↗
PubMed1995

Overnight pulse oximetry in snoring and non-snoring children.

The effect of snoring on overnight pulse oximetry recordings in the paediatric community was investigated. A random sample of 222 children up to 10 years of age from the town of Frome, Somerset, UK, had overnight pulse oximetry performed in the home environment. The oximetry recordings obtained from 58 snoring and 164 non-snoring subjects were compared. No clinically relevant difference in oxygen saturation level could be detected between these two groups of children. In conclusion, snoring in children up to 10 years of age is common, 11% often snore. It is not associated with hypoxia as measured by overnight pulse oximetry. This would suggest that surgical intervention for the symptom of snoring alone is not indicated.

Child↗
PubMed1992

Granulomatous cutaneous T-cell lymphoma of the neck.

A case of cutaneous T-cell lymphoma is presented in which the diagnosis was obscured by a concomitant granulomatous infiltrate. A working diagnosis of tuberculosis delayed appropriate treatment for several months over which time rapid progression of the disease was seen. Inclusion of overlying skin in the repeat biopsies yielded the histological information to establish the correct diagnosis and there was rapid regression on completion of a course of radiotherapy.

Aged↗
PubMed1986

Is no treatment good treatment in the management of acoustic neuromas in the elderly?

Two hundred twenty-eight patients with acoustic neuromas were seen between 1974 and 1985. Twenty-eight received no surgical treatment. Five patients who had undergone previous partial excision were excluded. The mean age was 71 years. The mean expected survival was 14.3 years. The mean follow-up interval was 51 months (range 12 to 120 months). All patients underwent at least two CAT scans (mean = 4). Tumor size ranged from 4 mm to 30 mm. Three patients underwent insertion of ventricular-peritoneal shunt for hydrocephalus (mean 16 months after presentation) and two patients partial tumor removal (mean 30 months after presentation). Tumor growth was measured in each patient using CAT scanning. Monitoring by clinical examination and regular CAT scanning is possible, but in this study 20% of patients required surgical treatment within one third of their expected survival time. This suggests that an expectant attitude for this group of patients may be a debatable form of management.

Age Factors↗
PubMed1986

A non-invasive method of demonstrating the nasal cycle using flexible liquid crystal thermography.

The relationship between air flow at 38 degrees C and area colour change on a flexible liquid crystal film was found to be virtually linear between the values of 1 and 31 min-1 cm-2. This value of flow per unit area corresponded to values expected at the level of the nostril during quiet breathing. A series of 6 subjects were asked to breathe over a flexible liquid crystal film regularly during the day and the area of colour change produced by flow from each nostril was examined. Four subjects showed a regular change in relative flow through each nostril whilst 2 subjects showed a constant flow through each nostril. This simple and non-invasive technique provides a method of examining the nasal cycle in adults and children in health and disease.

Adult↗
PubMed1986

Radiologic assessment of acoustic neuroma in the elderly. Is no treatment good treatment?

Twenty-three elderly patients with acoustic neuroma have been followed conservatively (no treatment) for a mean of 3.8 years. Five patients subsequently required ventricular shunting. Two patients required partial excision of their tumors (one previously treated by shunting). Eleven patients who have required no treatment have no significant complaints. There was significant variation in tumor growth rates making predictability for surgical intervention hazardous. A mean growth rate of 0.22 cm/year was noted. Our statistics suggest tumor removal in healthy patients with larger tumors at time of presentation; in other patients, conservative follow-up may be more appropriate.

Age Factors↗
PubMed1986

Evoked electromyography in Bell's palsy: a clinically useful test?

One hundred and forty-four patients presenting with a Bell's palsy were seen at Sunnybrook Medical Centre, University of Toronto, between the years 1978 and 1985. Only patients with a complete paralysis and not treated with either steroids or surgical decompression of the facial nerve were included in the study. The results of electrical tests performed on days 8, 9 or 10 after the onset of paralysis in 23 patients were used to predict clinical recovery at 12 weeks, six months and 12 months. There was good statistical correlation for values of conduction latency and amplitude with good clinical recovery after 12 weeks (p = 0.01). Electrical tests could not be used to predict clinical recovery at six months and at 12 months. The rationale for any surgical intervention based on the results of electrical tests is questioned.

Adolescent↗
PubMed1985

Cricoid pressure and sharp foreign bodies.

Cricoid pressure may be performed when a sharp object such as an animal bone is lodged in the post-cricoid oesophagus. This study was undertaken to determine what damage, if any, may be caused to the oesophagus. A sharp foreign body was inserted into the post-cricoid region of 15 cadavers. In five cases no other procedure was performed. In the remaining 10 cases, intubation with and without cricoid pressure was also performed. No significant damage was visible to the naked eye when the oesophagus was subsequently examined. Cricoid pressure does not seem to result in significant damage in this situation.

Aged↗
PubMed1984

Post tonsillectomy haemorrhage in children: The value of routine monitoring of the pulse.

Twenty-one children with reactionary haemorrhage after tonsillectomy were returned to theatre for the control of this haemorrhage. This group was matched for age and weight with 21 patients who underwent an uncomplicated tonsillectomy. The maximum pulse rate, the mean pulse rate and the maximum rise in pulse rate were recorded during the post-operative period and were noted for each group. No statistical difference existed between the groups. The monitoring of children in the period following tonsillectomy may be inadequate if the pulse alone is measured.

Adolescent↗
PubMedDate not supplied

The reproducibility of caloric tests of vestibular function in young and old subjects.

The test-retest repeatability of the hot caloric response alone and of the hot and cold caloric responses combined, was evaluated in 29 subjects, over a 6-month period. The subjects were from two different age groups, 20-30 years (15 subjects) and 65-75 years (14 subjects). Intersubject variability was statistically significant in both age groups, though of greater magnitude in the older subjects. Once a vestibular caloric response baseline was established, for any given subject, there was reasonably reliable test-retest repeatability over time, in both age groups, with coefficients of reliability greater than 0.90.

Adult↗