Tinnitus due to idiopathic stapedial muscle spasm.
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Adult↗
Biomedical subjects
R T Jackson
Publications and source records attributed to R T Jackson.
Mortality from asthma: a new epidemic in New Zealand.
Trends in mortality attributed to asthma in the 5-34-year age group were examined in New Zealand, Australia, England and Wales, the United States, Canada, and West Germany for the years 1959-79. An epidemic of deaths from asthma occurred in the mid-1960s in New Zealand, Australia, and England and Wales but not in the other countries. In Australia and England and Wales the death rate quickly returned to pre-epidemic levels, but in New Zealand the decline in mortality was slow, and by 1974 the death rate was still almost double the pre-epidemic level. Of great concern was an abrupt increase in reported deaths from asthma in New Zealand after 1976 with the mortality rate during 1977-9 being greater than during the previous epidemic. In contrast, asthma mortality had remained relatively stable in the other populations.The new epidemic in New Zealand was investigated and appeared to be real. It could not be explained by changes in the classification of deaths from asthma, inaccuracies in death certification, or changes in diagnostic fashions. The most likely explanation appeared to be related to the management of asthma in New Zealand, and this is being investigated.
Adolescent↗
Changing face of treatment of peritonsillar abscess.
Changing trends in the treatment of peritonsillar abscess are demonstrated by this retrospective study of 74 patients treated from 1975 through 1980 by a standardized regimen. This included needle aspiration at three points, intravenous antibiotics, hydration, and pharyngeal douches. The patients ages ranged from 11 to 73 years. There were 45 males and 29 females. Needle aspiration was positive in 52 patients (70%) and repeat aspiration was necessary in 10% of patients. Tonsillectomy was performed in 42 patients. No recurrent peritonsillar abscesses occurred during the 1 to 5 year follow-up of the 32 patients who did not have tonsillectomy. Recurrent tonsillitis did occur in 4 of these patients and 3 of them had a past history of recurrent tonsillitis. The authors conclude that treatment of peritonsillar abscess should consist of needle aspiration, intravenous antibiotics and supportive measures. Interval tonsillectomy should be performed only when there is a history of recurrent tonsillitis or previous peritonsillar abscess.
Adolescent↗
Anemia of pregnancy in Liberia, West Africa: a therapeutic trial.
Research was conducted in Liberia, West Africa to ascertain which hematinics produce the best Hb response in women during the 3rd trimester of pregnancy. After obtaining background information, each of the 621 subjects was randomly assigned to one of four treatment groups. Group 1 was given 60 mg iron once daily, group 2 was given 60 mg iron 3 times daily, group 3 was given 60 mg iron 3 times daily plus a 5-mg folic acid tablet once daily, and group 4 was given the same treatment as group 3 but also a weekly antimalarial prophylactic. For comparison, 58 untreated women in their 3rd trimester were also studied. Before therapy the five groups were similar with respect to selected socioeconomic status, health, and dietary variables. Hb response to therapy was measured at 4-wk intervals from the 24th wk of gestation until term. The Hb rises in all four treatment groups were significantly (p less than 0.001) higher than the base-line values at 4, 8, and 12 wk after the interventions. The percentage of anemic women was reduced from 78 to 45% over the 12 wk of supplementation. Hb rises in groups 3 and 4 were not significantly different from those in groups receiving iron alone. It is concluded that iron deficiency is the main cause of anemia in this population.
Adolescent↗
Low-dose topical atropine for rhinorrhea.
One hundred years ago, atropine sulfate was commonly used to treat rhinorrhea. Atropine sulfate was applied topically at a dose of approximately 0.08 mg to each nostril in seven patients with rhinorrhea caused by allergic rhinitis and in 24 patients with rhinorrhea caused by viral rhinitis. All but one of the 31 patients had symptomatic relief. Twenty-four of the 31 patients showed a visible decrease in secretions, and three patients showed an obvious vasoconstriction of nasal blood vessels. None of the patients experienced any of the side effects of atropine. Since this was a one-dose pilot study, there are no data available on possible rebound or chemical rhinitis effects.
Administration, Topical↗
Nasal vasoconstrictor activity of a novel PGE2 analog.
A novel PGE2 analog (CL 116,069) was shown to be effective in dogs as a nasal decongestant. Threshold doses were approximately 0.1 microgram/kg with intravenous administration and between 0.08 and 4 microgram with topical administration. CL 116,069 was compared to 17-phenyltrinor PGE2 (CL 116,147), a compound recently studied in humans, and xylometazoline, a well-known nasal decongestant. When given i.v., efficacious doses of xylometazoline tended to raise blood pressure and be shorter acting than the PGs, which did not affect blood pressure. When given topically, all three were long-acting. CL 116,069 usually had the lowest threshold and CL 116,147 usually induced the smallest response. All three agents were more effective than PGE1 or PGE2. A 30-day (b.i.d., topical) toxicity test with CL 116,069 produced no inflammation or nasal pathology and no loss in tissue sensitivity. In vitro examination of xylometazoline and CL 116,069 for vasoconstrictor activity on dog isolated mucosa revealed a response profile similar to that observed with these agents in vivo; i.e., the magnitude of response was comparable for both agents but the t 1/2 was only 74 minutes for xylometazoline and greater than 6.5 hours for CL 116,069. The data suggest that CL 116,069 may provide a therapeutic alternative in which constriction of the nasal blood vessels need not be associated with a generalized vasoconstrictor liability.
Animals↗
CPA tumors with normal routine audiometry and positive reflex and BSER tests.
Recently, in a ten-day-period, three patients whose hearing was within normal limits with good speech discrimination were found to have large cerebellopontine angle tumors. There were neurologic symptoms in only one patient. In these three cases, stapedius reflexes were absent with the affected ear stimulated. Brain stem evoked responses (BSER) were clearly abnormal in the three cases. Postoperative brain stem testing showed essentially no change in the nonoperated ear owing to brain stem manipulation. In two cases hearing was preserved. In one patient, the brain stem recordings returned to near-normal after surgery. In another, brain stem responses remained the same and the stapedius reflexes returned to normal. It appears that stapedius reflex testing and the BSER are highly useful tools that can be used to diagnose an acoustic neuroma before it grossly affects hearing.
Adult↗
Set-back tongue flap for carcinoma of the tongue base.
Carcinoma of the base of the tongue has been treated with various combinations of radiotherapy and surgery. Resection of this area poses a major problem in reconstruction because of the need for establishing normal physiologic characteristics. This article emphasizes the benefits of a lateral pharyngotomy and mandibulotomy for resection of large portions of the tongue base. We describe a tongue flap with a neurovascular pedicle that is set back into the tongue-base deficit. This one-stage procedure is relatively easy to perform and provides good physiologic results.
Aged↗
6-Methylcoumarin photocontact dermatitis.
Sporadic cases of a severe photocontact dermatitis have appeared in the last few years following use of fruity-smelling suntan preparations and sunlight exposure. We report five such cases in women who developed severe edema and erythema of sun-exposed areas shortly after application of agents containing 6-methylcoumarin used as fragance. Routine photopatch testing was unproductive in reproducing the reaction, but immediate application of 6-methylcoumarin before ultraviolet A (UVA) radiation elicited significant positive results.
Adult↗
Diminished immune response in sun-damaged skin.
In previously sensitized volunteers, higher concentrations of 2,4-dinitrochlorobenzene were necessary to elicit positive patch test reactions on the sun-damaged skin of the neck than on the protected skin of the upper part of the back. This difference was not found in subjects without evidence of sun damage, and there was no difference between sun-damaged and nondamaged skin in response to a primary irritant. Responses to intradermally injected common antigens were also less intense in sun-damaged skin that in nonexposed skin. These findings suggest the existence of a local defect in cell-mediated immunity in skin altered by long-term sun exposure.
Adolescent↗
Subarachnoid space of the CNS, nasal mucosa, and lymphatic system.
We have briefly reviewed the literature pertaining to the movement of tracer molecules and infectious organisms within the olfactory nerve. There is a body of evidence indicating that tracers placed in the CSF will quickly move via the olfactory nerve to the nasal mucosa and then to the cervical lymph nodes. Organic and inorganic tracer materials and organisms as diverse as viruses, a bacillus, and an amoeba, when placed in the nasal cavity, have been shown to move from the nasal mucosa via the olfactory nerve to the olfactory bulb and the CSF. We think that a portion of the data on tracer movement is due to incorporation of tracer materials and organisms into the axoplasm of the olfactory neurons with subsequent anterograde or retrograde axoplasmic transport. However, some of the movement of tracers may occur within the olfactory perineural space. This space may be continuous with a subarachnoid extension that surrounds the olfactory nerve as it penetrates the cribriform plate. To our knowledge, no one has yet followed the perineural space to determine if it is continuous from olfactory receptor to olfactory bulb. The consideration of this space and its role is the main reason for this review.
Animals↗
A new in vitro method of drug assay of nasal blood vessels.
If nasal mucosa is removed from the dog's septum, mounted in a muscle bath and treated with a small dose of a nasal decongestant, the mucosa contracts, It appears, from the nature of the tissue and the nature of the drug responses, that nasal vascular smooth muscle is the contracting element. If the nasal mucosa is treated with a vasodilating agent, such as histamine, there is no relaxation response unless the mucosa is first pretreated with a vasoconstricting agent such as epinephrine. Both vasoconstricting and vasodilating drugs induce dose-related responses. It appears that this new preparation may be useful to assay drug effects in the absence of nervous and humoral control.
Animals↗
Lactose malabsorption among Masai children of East Africa.
There is much disagreement about milk and its use in feeding programs both in the United States and internationally. A few authors suggest that milk consumption should not be encouraged in lactose intolerant populations due to adverse symptoms. Others suggest, however, that small or modest quantities of milk can be tolerated and can be nutritionally useful to such groups. Data are presented in this paper that show that 1) the Masai regularly drink considerable quantities of milk without apparent symptoms, 2) milk is an important constituent of the Masai diet, and 3) 62% of 21 Masai examined were malabsorbers of lactose as measured by the lactose tolerance test. This finding of lactose malabsorption in a nomadic cattle raising and milk drinking people is interesting and is contrary to the views often expressed by anthropologists and others. An ability to drink nutritionally useful quantities of milk does not, however, necessarily mean that milk production or imports should be encouraged in the Lesser Developed Countries.
Adolescent↗
Sodium clavulanate potentiation of cephalosporin activity against clinical isolates of cephalothin-resistant Klebsiella pneumoniae.
Plasmid-carrying Klebsiella pneunomiae clinical isolates with agar dilution minimum inhibitory concentrations (MIC) of 32 mug/ml or greater were tested for in vitro potentiation of cephalothin activity by clavulanic acid (BRL-14151), an inhibitor of beta-lactamases. The addition of 10 mug of clavulanate per ml caused greater than a 500-fold reduction in geometric mean cephalothin agar dilution MIC, with lesser but significant reductions resulting from clavulanate concentrations of 5 or 1 mug/ml. Clavulanate-potentiated reduction of cephalothin MICs in broth against resistant Klebsiella were comparable to reduction in agar dilution MICs as a rule. However, a low concentration (1 mug/ml) of clavulanate produced cephalothin MICs in broth several-fold higher than by the agar dilution method. Modest cephalothin-potentiating effects of clavulanate on cephalothin-susceptible strains and on cefoxitin against cephalothin-resistant Klebsiella strongly suggested that the major effect of clavulanate was beta-lactamase inhibition.
Amidohydrolases↗
Anaerobic septicemia after transrectal prostatic biopsy.
Transrectal biopsy of the prostate resulted in anaerobic septicemia in two patients, despite parenteral gentamicin sulfate prophylaxis. Bacteroides fragilis sepsis developed subacutely in one patient having a postbiopsy pelvic abscess. Clostridium perfringens sepsis occurred fulminantly in another patient 24 hours after biopsy of a gland extensively involved with adenocarcinoma. These cases indicate a potential hazard of sepsis due to anaerobic contamination with rectal microflora at the time of transrectal prostatic biopsy and the futility of prophylaxis directed only at aerobic bacteria.
Adult↗
Case report. Tularemia presenting as unresponsive pneumonia: diagnosis and therapy with gentamicin.
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Diagnosis, Differential↗
Lactose and milk intolerance in Tanzania.
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Adolescent↗
Studies in permeability of the middle ear mucosa. The feasibility of blocking inflammatory mediators.
The permeability and vasodilation of the middle ear mucosa was measured in dogs that were treated topically with histamine, bradykinin, prostaglandins, and bacterial endotoxin. All of these inflammatory mediators increased permeability and caused vasodilation. The antihistamine diphenhydramine hydrochloride, when given topically or intravenously, prevented the increase in permeability caused by histamine but had little or no effect on vasodilation. The antihistamine also reduced the permeability response to bradykinin. As antihistamines are not always useful in treating otitis media, other inflammatory mediators found in human effusions may be responsible for the condition. Because of our relative ignorance of the inflammatory process in otitis media, control of the process by drug treatment is not hopeful at present.
Animals↗