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Biomedical subjects

R Ryan

Publications and source records attributed to R Ryan.

At least 37 records · Page 2Linked to original sources
PubMed1992

The morbidity from nasal splints in 105 patients.

The results of a randomized prospective trial investigating the morbidity from intranasal splints in 105 patients, were analysed. Intranasal splints are associated with considerable morbidity (significantly greater post-operative pain and a higher incidence of septal perforation and vestibulitis) and although they significantly reduce the likelihood of developing intranasal adhesions, a similar benefit can be obtained by careful nasal toilet at one week.

Adult↗
PubMed1992

Babesiosis: an underdiagnosed disease of children.

Babesiosis is a malaria-like illness caused by the intraerythrocytic parasite Babesia microti and is transmitted by the same tick that transmits Borrelia burgdorferi, the causative agent of Lyme disease. Babesiosis is well recognized in adult residents of southern New England and New York but has been described in only five children. To determine whether children are infected with B microti less often than are adults, a prospective serosurvey was carried out on Block Island, RI, where babesiosis is endemic. Randomly recruited subjects completed a questionnaire and provided a blood sample. Antibodies against B microti and B burgdorferi were measured using a standard indirect immunofluorescence assay and enzyme-linked immunosorbent assay, respectively. Of 574 subjects, 9% tested positive for B microti, including 12% of the 52 children (7 months through 16 years) and 8% of the 522 adults (not significant, P less than .6). Although babesiosis had not been diagnosed in any of the Babesia-seropositive subjects, 25% of the children and 20% of the adults reported symptoms compatible with this infection during the previous year. Of the 6 children and 45 adults seropositive for B burgdorferi, 17% and 14%, respectively, were also seropositive for B microti. It is concluded that children are infected with B microti no less frequently than are adults and that this infection is underdiagnosed in all age groups. Physicians who practice where Lyme disease is endemic should become familiar with the clinical presentation and diagnosis of babesiosis, both in adults and children.

Adolescent↗
PubMed1991

The miscarriage clinic: an audit of the first year.

We preview the results of the first year in a Miscarriage Clinic set up in 1989 in an effort to improve the support and counselling of women who have a miscarriage. Of 381 patients referred, 79% attended. The only statistically significant difference between the women who attended and those who did not attend was in the proportion of women who had planned their pregnancies (65% versus 33%, P less than 0.01). Of the 300 patients who attended, 4% reported no grief reaction; 75% experienced a reaction which had resolved within one month and 21% experienced a reaction which had not resolved. No factor was identified which could predict the duration of the grief reaction. This audit demonstrates that there is a strong demand and need for this service for couples who experience a miscarriage.

Abortion, Spontaneous↗
PubMed1991

Geographical and temporal distribution of babesial infection in Connecticut.

Human babesiosis was first recognized in Connecticut in 1989, nearly 15 years after Lyme disease, a similarly transmitted spirochetosis, was detected in the state. To determine the seroprevalence for the babesial pathogen and whether it was recently introduced, we used an indirect immunofluorescence assay to test for Babesia microti antibody in 1,285 Connecticut residents. Four groups were studied: I, people seropositive for Lyme disease, tested from 1986 to 1989; II, randomly selected outpatients tested in 1989; III, college students residing in Connecticut, tested from 1959 to 1989; and IV, healthy people without tick exposure or Lyme disease, tested in 1989. Babesia seropositivity was significantly higher in group I (9.5%; n = 735) than in groups II (2.6%; n = 304, P less than 0.0001) and III (1.0%; n = 206, P less than 0.0001) but not group IV (2.5%, n = 40). Babesia seropositivity for group I ranged from 9.2 to 10.2% between 1986 and 1989, and Babesia seropositivity for group III ranged from 0% between 1959 and 1985 to 2.9% between 1986 and 1989. There is a considerable risk of babesial infection among residents of the Connecticut mainland who are seropositive for Lyme disease, a risk that appears to have remained constant over the past 5 years.

Animals↗
PubMed1989

Spinal epidural abscess. An infectious emergency. Case report and review.

Spinal epidural abscess is an unusual disease in the pediatric age group, requires early diagnosis and prompt surgical drainage to insure a good clinical outcome. Back pain and fever are usually the only presenting symptoms occurring before precipitous neurologic deterioration. The causative organism is most often Staphylococcus aureus, which presumably is spread to the epidural space hematogenously. Diagnosis is facilitated by computed tomography (CT) scan, but the entire spine must be imaged by either myelography or magnetic resonance imaging (MRI) to assess for skip lesions.

Abscess↗
PubMed1988

Recurrent tonsillitis and growth in children.

Anecdotal observations suggest an association between tonsil disease and growth retardation. This study compared height, weight and skinfold thickness measurements between a group of children (44) suffering from recurrent tonsillitis for a mean duration of 4 years, and a control group (34). No important differences were observed between the groups. Recurrent tonsil infection does not appear to retard the growth of children.

Body Height↗
PubMed1987

The effect of swimming in chlorinated water on middle ear pressure.

This study evaluated whether an important fall in middle ear pressure (MEP) was recordable several hours after swimming. MEPs were measured in 52 normal school children on an average of four occasions immediately before swimming and "control" exercise sessions, and were repeated four hours after the activity. Twenty-nine children swam in a high chlorine concentration, with a mean free chlorine level of 2.3 parts per million, and 23 children swam in a low chlorine environment, with a mean concentration of 0.4 parts per million. For the former there was an average decrease of 0.5 daPa after swimming and an increase of 34.7 daPa after exercise; for the latter there were increases of 13.3 and 15.6 daPa after swimming and exercise respectively. It is concluded that swimming does not adversely affect middle ear function. Exercise induces an increase in MEP, and exposure to high chlorine levels appears to cause a small reduction in middle ear pressure.

Child↗
PubMed1985

Imipramine poisoning in a child: lack of efficacy of resin hemoperfusion.

A three-year-old boy ingested up to 1,500 mg of the tricyclic antidepressant imipramine (Tofranil). He entered our facility within two hours of discovery, and multiple resuscitative efforts, which proved unsuccessful, followed. Resin hemoperfusion was used in an effort to remove imipramine from the systemic circulation. Serum concentrations of imipramine and its major metabolite desipramine were determined from serum drawn before, during, and after hemoperfusion. Serum concentrations of imipramine and desipramine did not change appreciably. No improvement in the clinical condition was noted during the hemoperfusion period, which was due in part to the fact that our patient was clinically brain dead upon arrival in our intensive care unit. Our subsequent literature review documents that this case represents the first reported use of hemoperfusion in a pediatric tricyclic antidepressant ingestion, hemoperfusion removes an insignificant portion of the total amount of tricyclic antidepressant ingested, and some pediatric literature misleadingly suggests that hemoperfusion may be useful in such patients. Physicians treating tricyclic antidepressant ingestion cases should avoid using hemoperfusion; standard supportive care remains the essential management response.

Child, Preschool↗
PubMed1985

Five haplotypes in Black beta-thalassaemia heterozygotes: three are associated with high and two with low G gamma values in fetal haemoglobin.

Genotypes at seven different polymorphic restriction sites (5' to the epsilon gene, at the G gamma, at the A gamma, at the psi beta, 3' to the psi beta, at the beta, and 3' to the beta genes) were analysed by restriction endonuclease mapping of the DNA from 66 Black beta-thalassaemia heterozygotes from Georgia and several of their normal relatives. Five different haplotypes were observed. Three of these were associated with high G gamma values in the small amount of Hb F (0.8-8.3%) present in the blood of these patients and two with low G gamma values. One haplotype [- + - + + + +] that occurred on two of every three beta thalassaemia chromosomes was associated with high G gamma levels, and is the same as that found in some Black SS patients also having high G gamma values (Gilman & Huisman, 1984). Two others [- + + - + - +] and [- + - - + + +] were also associated with high G gamma, while two [- - - - + + +] and [+ - - - - + +] were associated with low G gamma. Variation in haematological data, mainly MCV and MCH values, was found to be caused in part by the type of beta-thalassaemia (defined by its haplotype) and by the presence of an additional alpha-thalassaemia-2 heterozygosity or homozygosity.

Alleles↗
PubMed1982

[Comparative therapeutic activity of pirprofen and acetylsalicylic acid in rheumatoid arthritis. A 12-month controlled multicenter study].

This double-blind cooperative study comparing pirprofen and acetylsalicylic acid (ASA) in the treatment of rheumatoid arthritis was conducted in 12 centres and involved 342 patients distributed throughout the United States. The patients were randomized to either pirprofen 200 mg four times a day or ASA 900 mg four times a day. The drugs were administered for 52 weeks. Nine standard clinical criteria were used for assessment of the therapeutic results by the investigators and by the patients themselves. Fifty-five % of the total patient population reported that they were highly satisfied with pirprofen, as against 47% with ASA. The investigators preferred pirprofen in 51% of the cases and ASA in 38% (p less than 0.05). Side effects (tinnitus, gastrointestinal disorders) were more frequent in the ASA group than in the pirprofen group. During the 52-week treatment-period, biological alterations were only observed in two patients (1 on pirprofen, 1 on ASA).

Anti-Inflammatory Agents↗
PubMed1982

Validation of an early language milestone scale in a high-risk population.

Detailed language evaluations were obtained by interviewing the parents of 191 healthy children aged 0 to 3 years, and by testing the children themselves. From these data, normative values were derived for 41 language milestones in the first 36 months of life. These values were used to construct the Early Language Milestone Scale (ELM Scale), a brief language assessment tool suitable for use by general pediatricians. Physician use of the ELM Scale in a population of 119 children considered at high risk for the presence of developmental disability yielded 97% sensitivity and 93% specificity for the ELM Scale as a detector of developmentally delayed children, when compared with more formal developmental measures as applied by a clinical psychologist or speech pathologist. Early language milestones are a sensitive indicator of developmental integrity; delayed achievement of early language milestones strongly suggests the presence of a significant underlying developmental disability. The ELM Scale may be adopted as a valid measure of developmental status among children considred at high risk for the presence of developmental disabilities.

Cerebral Palsy↗
PubMed1980

The stigma of epilepsy as a self-concept.

To study the extent to which persons with epilepsy feel stigmatized by the disorder, a sample of 445 individuals with epilepsy is analyzed. By first defining stigma in quantifiable terms and then by assessing the prevalence of stigma among the individuals studied, two alternative models that postulate the causes of stigma are investigated. The first model, a simple medical approach, assumes that because epilepsy is stigmatizing for an individual with the disorder, a direct relationship exists between the severity of the individual's seizure and the perception of stigma. The second model, a sociopsychological approach, assumes that the effects of seizure severity on the perception of stigma are mediated by other individual characteristics. The results of the study suggest, first, that persons with epilepsy do not universally feel stigmatized by the disorder. Second, by investigating the validity of these assumptions with regression and path analysis techniques, the findings support the premise of the sociopsychological model. The relationship between the severity of seizures and the perception of stigma due to the disorder is found to be highly dependent on other characteristics in the individual with epilepsy, such as the perception of employment discrimination, the perception of limitations imposed by the disorder, and the years of school attained by the individual.

Adult↗