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Biomedical subjects

Rory McConn Walsh

Publications and source records attributed to Rory McConn Walsh.

9 recordsLinked to original sources
PubMed2006

Hyperresponsiveness of congestive nasal reflexes in allergic rhinitis.

BACKGROUND: Nasal secretory hyperresponsiveness is well documented in allergic rhinitis, and is mediated in part by neural mechanisms. In contrast, reflex-mediated congestion is poorly documented in both normal and allergic subjects. OBJECTIVE: To characterize congestive responses to unilateral nasal bradykinin challenge in normal and allergic subjects, and to investigate whether congestive hyperresponsiveness is present in allergic rhinitis. METHODS: Normal subjects (n = 13), and subjects with out-of-season seasonal allergic rhinitis (SAR) (n = 16) underwent a unilateral nasal challenge protocol using filter paper disks, using Hartman's solution and bradykinin as challenge substances. Congestive responses were measured using acoustic rhinometry. RESULTS: Normal subjects demonstrated a transient ipsilateral congestive response, and a circumscribed contralateral congestive response away from the major flow limiting section. Subjects with SAR demonstrated a more persistent ipsilateral congestive response, and a more pronounced, generalized contralateral congestive response affecting all areas of the contralateral nasal cavity. Significant differences were present between normal and SAR subjects. CONCLUSION: Congestive reflexes are present in normal and allergic subjects. Congestive hyperresponsiveness is present in allergic rhinitis.

Adult↗
PubMed2005

Use of an intra-operative nerve stimulator in identifying the hypoglossal nerve.

Previously, the hypoglossal nerve has not undergone intra-operative monitoring during neck operations in which the nerve is at risk. As society becomes increasingly litigious, this may change. This study describes the technique and the microvoltages used in 10 patients for intra-operative stimulation of the hypoglossal nerve with the Magstim nerve stimulator. We confirm that the technique is possible, simple and safe, with minimal disturbance to the patient, anaesthetist and surgeon.

Electric Stimulation↗
PubMed2005

Bilateral peritonsillar abscess revisited.

Bilateral peritonsillar abscess is uncommon. When it does occur; patients usually present with sore throat; other clinical signs and symptoms may differ from those usually associated with unilateral peritonsillar abscess. We describe 2 cases of bilateral peritonsillar abscess that were successfully treated with needle aspiration of both sides with a 14-gauge intravenous cannula. Needle aspiration is an accepted form of treatment for unilateral peritonsillar abscess, but to the best of our knowledge, its use as a sole treatment modality (with observation under intravenous antibiotic coverage) for bilateral peritonsillar abscess has not been previously reported in the literature. We also believe that the incidence of acute bilateral peritonsillar abscess may be higher than the rates that have been reported in the literature. Finally, we recommend that the threshold for imaging be low for any patient who is suspected of having acute bilateral peritonsillar abscess to avoid any delay in diagnosis and treatment.

Adult↗
PubMed2004

Cavernous angioma of the internal auditory canal.

Cavernous angiomas of the internal auditory canal are rare lesions. The authors present a case of a 29-year-old lady with multiple infratentorial cavernous angiomas, whose sister had previously undergone surgery for a similar supratentorial lesion. She initially presented with an acute brainstem haematoma, secondary to a pontine cavernous angioma. Three years later she developed progressive right-sided sensorineural hearing loss and facial nerve paresis due to an internal auditory canal lesion. This was removed via the translabyrinthine approach and was found to be a cavernous angioma. This report underlines the multiple and dynamic nature of familial cavernous angiomas, as well as the importance of follow up to determine whether new symptoms are due to the enlargement of known angiomas or the development of new ones. As far as the authors are aware, this is the first report describing a cavernous angioma of the internal auditory canal in the context of familial and multiple infratentorial angiomas.

Adult↗
PubMed2003

vCJD risk in the Republic of Ireland.

BACKGROUND: The Republic of Ireland has the second highest incidence of BSE worldwide. Only a single case of vCJD has been identified to date. METHODS: We estimate the total future number of clinical cases of vCJD using an established mathematical model, and based on infectivity of bovine tissue calculated from UK data and on the relative exposure to BSE contaminated meat. RESULTS: We estimate 1 future clinical case (95% CI 0-15) of vCJD in the Republic of Ireland. Irish exposure is from BSE infected indigenous beef products and from imported UK beef products. Additionally, 2.5% of the Irish population was exposed to UK beef through residing in the UK during the 'at-risk' period. The relative proportion of risk attributable to each of these three exposures individually is 2:2:1 respectively. CONCLUSIONS: The low numbers of future vCJD cases estimated in this study is reassuring for the Irish population and for other countries with a similar level of BSE exposure.

Animals↗
PubMed2003

Supralabyrinthine approach to petrosal cholesteatoma.

Petrosal cholesteatomas are rare lesions, which may be congenital or acquired in nature. We report an exceptional case occurring in a seven-year old girl who presented with a unilateral conductive hearing loss, despite normal tympanic membrane appearance. Early diagnosis was facilitated by computed tomography (CT) scanning. Although this case satisfied the criteria for congenital cholesteatoma, it is likely that the petrous apex was secondarily involved. Complete cholesteatoma removal was accomplished using a transtemporal supralabyrinthine approach, which allowed for hearing preservation, while avoiding the morbidity associated with a craniotomy. The present case constitutes the youngest case of petrosal cholesteatoma reported. We suggest that a lower threshold for the use of CT scanning in unilateral conductive hearing loss may allow for the earlier detection of more cases of petrosal cholesteatomas, as well as facilitating their removal using more limited approaches associated with less morbidity.

Child↗
PubMed2002

Computerized tomography is not reliable in the diagnosis of brainstem infection.

The case of a 17-year-old girl who presented with a two-day history of absolute dysphagia secondary to a bulbar palsy due to a pre-pontine abscess is described. Rigid oesophagoscopy was normal and a neurology consultation suggested a central cause for her dysphagia. However the diagnosis was delayed because a computed tomography (CT) scan of her brain and brainstem was reported as normal. A subsequent magnetic resonance image (MRI) scan revealed a pre-pontine abscess. CT scanning is not as reliable as MRI in the diagnosis of infective lesions of the brainstem/brain, especially early in the course of the infection.

Adolescent↗