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Biomedical subjects

R M Milner

Publications and source records attributed to R M Milner.

9 recordsLinked to original sources
PubMed2007

The use of local isolates in Western blots improves serological diagnosis of Lyme disease in Scotland.

Nine Scottish Borrelia burgdorferi isolates were investigated in IgG Western blot tests. Sera previously found to be positive and negative when tested by routine Western blots prepared from reference strain B. burgdorferi sensu stricto antigen had different outcomes with these isolates. Two isolates, E5 (Borrelia afzelii) and G4 (B. burgdorferi sensu stricto) performed well, reproducing Western blot-positive results in 90 and 95% of tests, respectively. When antigens from both isolates were incorporated into a single IgG Western blot, the results of a panel of sera were improved when compared to the routine reference strain IgG Western blot. All of the sera positive by the routine Western blot remained positive using the Scottish isolate antigen mix. Twenty-three of the 25 negative sera remained negative and two produced an equivocal result. Of the 15 samples that tested IgG Western blot equivocal with the B. burgdorferi sensu stricto reference strain, 11 (73%) became weak or strong positive when tested with the B. afzelii/B. burgdorferi sensu stricto antigen mix (chi(2)=14.35, Yates' correction, P<0.001). In seven of these, a clinical picture of Lyme disease was consistent with the new results. The use of Scottish strains of B. afzelii and B. burgdorferi sensu stricto to provide antigen for the IgG Western blot improves the diagnosis of Lyme disease for patients in Scotland.

Antibodies, Bacterial↗
PubMed1986

Use of hydrogen peroxide to clear blocked ventilation tubes.

Blocked tympanostomy tubes re-create the problem for which they were initially inserted. Hydrogen peroxide offers a noninvasive alternative to extracting the blocked tube and inserting a new tube. In this article we present the results of a long-term retrospective study of 95 patients (113 ears) who had occluded ventilation tubes following myringotomy. An 85% rate of success in opening the clogged tube with hydrogen peroxide is documented. The ototoxicity of the treatment is also examined. Ninety-nine percent of the patients showed no immediate change in bone conduction thresholds following the use of hydrogen peroxide. We have concluded that hydrogen peroxide is a convenient, noninvasive, and inexpensive treatment for blocked ventilation tubes.

Bone Conduction↗
PubMed1985

Management of the hearing impaired child with serous otitis media.

The majority of research and informative papers dealing with otitis media with effusion (OME) are concerned with normally hearing children who display a mild conductive hearing loss associated with the infection. In contrast, the target of our manuscript is the child who has a previously documented sensori-neural hearing loss that is complicated by the onset of a middle ear infection. It is our clinical experience that OME in the hearing impaired child must be treated aggressively in order to adequately override the additional loss that accompanies a middle ear infection. A number of our patients are children who have various degrees of sensori-neural hearing loss. A significant number of these children also have experienced bouts of OME. The case studies presented will examine the effect that middle ear effusion has had on these hearing impaired children and discuss the importance of vigorous treatment of OME in hearing impaired children. Our intention is to alert the otologist and the audiologist to the possibility of OME in the hearing impaired child and to demonstrate the need for and the benefit of aggressive medical and/or surgical intervention.

Acoustic Impedance Tests↗
PubMed1983

Estimating total body calcium from peripheral bone measurements.

In a heterogeneous group of 12 male and 30 female patients, total body calcium (TBCa) was measured by neutron activation analysis, and bone mineral content of the distal femur and six regions of the distal radius and ulna were measured by photon absorptiometry. TBCa was an average of 71 g (9%) lower than normal in the females and 119 g (11%) lower than normal in the males. Of the forearm measurements, those of the radial shaft provided the best estimate of TBCa with a standard error of estimation (SEE) of 88 g (14% of the mean value) for female patients alone, and 113 g (16%) for the whole group. The measurement on the femur provided a better estimate with SEE 80 g (13%) for female patients and 90 g (13%) for the whole group. These SEE are comparable with the variability in TBCa between normal subjects, which has a coefficient of variation of the order of 20% in both sexes. A slightly better estimate of TBCa can be obtained by using a multiple regression equation involving both the femur and radial shaft measurements with a SEE of 74 g (12%) for female patients and 81 g (11%) for the whole group. The correlation between the estimated deficit of TBCa and the estimated deficit of bone mineral from the forearm and the femur has been calculated.

Adolescent↗
PubMed1983

Elevated bone conduction thresholds associated with middle ear fluid in adults.

Longitudinal observations of adult patients with documented cases of otitis media revealed fluctuations in bone conduction thresholds as well as air conduction thresholds. Previous investigations in this area presented conflicting information regarding temporary and permanent effects of serous otitis media on sensori-neural function. We conducted a detailed study, including complete otologic, audiologic, and tympanometric evaluation, of 30 adult patients exhibiting serous otitis media. Myringotomies were performed on all patients after appropriate medical management failed to clear the middle ear fluid and subsequent hearing loss. Pre- and postmyringotomy audiograms support our conclusion that middle ear fluid can produce artifactual shifts in bone conduction thresholds. Although the data presented was collected from a cohort of adults, the clinical implications are applicable to the pediatric population. We have observed a similar shift in bone conduction thresholds in children exhibiting serous otitis media, and we have observed improvement in the thresholds with removal of the fluid either by appropriate medical management or by myringotomy with fluid aspiration.

Adult↗
PubMed1982

Myringotomy and tube ventilation in adults.

Otitis media is commonly diagnosed in children and is often successfully treated with myringotomy and tube insertion. It also occurs in adults but is frequently undetected and therefore untreated. Adults with hearing loss are often assumed to need a hearing aid, without consideration of a treatable problem. Physicians should be aware of otitis media in adults and the benefits of prompt medical or surgical intervention.

Adult↗
PubMed1982

Sudden hearing loss.

This article describes a patient with documented sudden, severe, unilateral, sensorineural hearing loss occurring four days after audiometric evaluation for nonspecific complaints. He was hospitalized immediately; treatment included I.V. histamine and oral steroid therapy. He noted improvement within two days, and serial audiometry has documented recovery to the initial audiometric levels. We believe that this documentation of recovery to pre-illness levels is unique.

Adult↗