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Biomedical subjects

T M Davidson

Publications and source records attributed to T M Davidson.

At least 19 recordsLinked to original sources
PubMed2000

Clinical study and literature review of nasal irrigation.

OBJECTIVES/HYPOTHESIS: Nasal disease, including chronic rhinosinusitis and allergic rhinitis, is a significant source of morbidity. Nasal irrigation has been used as an adjunctive treatment of sinonasal disease. However, despite an abundance of anecdotal reports, there has been little statistical evidence to support its efficacy. The objective of this study was to determine the efficacy of the use of pulsatile hypertonic saline nasal irrigation in the treatment of sinonasal disease. STUDY DESIGN: A prospective controlled clinical study. METHODS: Two hundred eleven patients from the University of California, San Diego (San Diego, CA) Nasal Dysfunction Clinic with sinonasal disease (including allergic rhinitis, aging rhinitis, atrophic rhinitis, and postnasal drip) and 20 disease-free control subjects were enrolled. Patients irrigated their nasal cavities using hypertonic saline delivered by a Water Pik device using a commercially available nasal adapter twice daily for 3 to 6 weeks. Patients rated nasal disease-specific symptoms and completed a self-administered quality of well-being questionnaire before intervention and at follow-up. RESULTS: Patients who used nasal irrigation for the treatment of sinonasal disease experienced statistically significant improvements in 23 of the 30 nasal symptoms queried. Improvement was also measured in the global assessment of health status using the Quality of Well-Being scale. CONCLUSIONS: Nasal irrigation is effective in improving symptoms and the health status of patients with sinonasal disease.

Humans↗
PubMed2000

Does tongue size differ between patients with and without sleep-disordered breathing?

OBJECTIVES/HYPOTHESIS: To determine whether there is a difference in the tongue size of patients with and without sleep-disordered breathing (SDB) and to evaluate whether tongue volume correlates with body mass index (BMI), neck circumference, age, Epworth Sleepiness Scale score, or apnea-hypopnea index (AHI). STUDY DESIGN: Nineteen patients (9 with SDB; 10 without SDB) were enrolled in this prospective study. METHODS: All patients completed a sleep questionnaire including the Epworth Sleepiness Scale and underwent a physical examination, portable sleep study, and magnetic resonance imaging (MRI) study. An examiner masked to the patients' disease status measured tongue volume from the MRI films. RESULTS: There was a trend for patients with SDB to have a larger tongue volume than patients without SDB (P = .065). Tongue volume only positively correlated with BMI (P = .005) and neck circumference (P = .013), but there was no correlation with age (P = .23) or AHI (P = .40). CONCLUSIONS: There is a statistical trend for patients with SDB to have larger tongue size compared with non-SDB patients, but tongue size is independent of AHI and correlates significantly with BMI and neck circumference. We interpret these findings to suggest that variations in tongue size alone cannot account for disease severity and may simply reflect the larger body habitus often seen in patients with SDB.

Adult↗
PubMed2000

Sinonasal disease and olfactory impairment in HIV disease: endoscopic sinus surgery and outcome measures.

OBJECTIVES: To investigate the effects of ESS (ESS) on olfactory impairment, disease-specific symptoms, and general quality of well-being In HIV+ patients with sinonasal disease. STUDY DESIGN: Study 1: Nasal cytology, rhinomanometry, nasal examination including endoscopy, disease-specific sinonasal symptoms, olfactory threshold sensitivity, and odor identification testing were performed before and after ESS in HIV+ patients with sinonasal complaints. Study 2: Quality of well-being was assessed before and after ESS in HIV+ patients with sinonasal complaints and controls. RESULTS: Significant olfactory sensitivity loss persisted for patients with chronic sinusitis after ESS, suggesting that the impairment in these patients may be due to viral disease rather than inflammation. Significant improvement in other disease-specific symptom scores (nasal obstruction, nasal congestion, headache, sinus pain, etc.) and results of the general quality of well-being assessment showed ESS to be beneficial in the extended health management of HIV illness. CONCLUSIONS: The current study indicated both olfactory dysfunction and subjective negative symptoms in HIV+ patients with chronic sinusitis. Although olfactory dysfunction remained, ESS was successful in providing marked alleviation of symptomatology in HIV+ patients with chronic sinusitis. The results support ESS as an appropriate treatment option for HIV+ patients with chronic sinusitis.

Adult↗
PubMed2000

Sleep-disordered breathing: a survey of otolaryngologic practice at military hospitals.

We conducted a survey of otolaryngologists at all Veterans Administration and Department of Defense hospitals in the United States to ascertain the nature and scope of their treatment of sleep-disordered breathing. Questionnaire responses indicated that head and neck surgeons in military hospitals have a strong interest in the management of patients with snoring and sleep apnea. Because of the difficulty in obtaining timely sleep test results and the low number of referrals from physicians who perform such testing, many otolaryngologists expressed a desire to be able to perform their own sleep testing.

Health Care Surveys↗
PubMed1999

A sleep medicine curriculum for otolaryngology-head and neck surgery.

As otolaryngologists play increasingly important roles in the evaluation and treatment of sleep disordered breathing, it is important that all practitioners systematically study the field of sleep. The curriculum outlined in this article has been developed for resident training at the University of California, San Diego, School of Medicine. It is divided into goals and objectives, curriculum, differential diagnosis of sleep disordered breathing, international classification of sleep disordered breathing, a glossary of sleep terms, and a list of resources.

Adult↗
PubMed1999

The use of ENT-prescribed home sleep studies for patients with suspected obstructive sleep apnea.

Sleep disordered breathing, including obstructive sleep apnea, is a common and morbid health problem. Traditionally, sleep disordered breathing is diagnosed by complex sleep studies. However, newer, easy-to-use, highly sensitive, and highly specific home sleep study equipment is now available. The present study was undertaken to determine whether an otolaryngologist could easily and effectively dispense home sleep equipment from the office. We used a portable AutoSet home sleep machine. Our experience with the first 100 consecutively presenting patients was recorded and analyzed under institutional review board approval. Ninety-nine of the 100 tests were completed successfully on the first attempt; the one failure was successful on the second attempt. Our results were consistent with those reported from in-house polysomnogram sleep studies; 71% of our patients had an apnea-hypopnea index (AHI) of 15 or higher, and 93% had an AHI at least 5. We conclude that an otolaryngologist, using state-of-the-art home sleep testing equipment, can accurately and cost-effectively prescribe home sleep studies.

Equipment Design↗
PubMed1999

Standard of care?

Explore the source record for details and available documents.

Facial Nerve↗
PubMed1998

Rapid clinical evaluation of anosmia in children: the Alcohol Sniff Test.

Smell impairment affects 1-2% of Americans and leads to frequent physician visits. Olfactory functional testing is available in chemosensory centers, but is frequently omitted in routine cranial nerve examinations. A new smell test, using the standard 70% isopropyl alcohol pad, was developed at the UCSD Nasal Dysfunction Clinic: The Alcohol Sniff Test (AST). The current study examined the reliability of the AST in children, using test-retest measures. A standard 70% isopropyl alcohol pad was moved upward 1 cm per exhalation until the participant reported detection. Test-retest reliability of the AST in children was significant, r = 0.80. The AST predictably classified children as anosmic, hyposmic or normosmic, p < 0.0001. The AST requires only 5 minutes to administer with materials readily available in any physician's office or hospital. The AST is an effective screening tool, even in children, for the average physician who can then refer patients who show less than normal function for further comprehensive testing.

2-Propanol↗
PubMed1998

Morbidity and mortality in the wilderness.

The medical literature is limited regarding current wilderness morbidity and mortality statistics. Available studies concentrate on selected wilderness activities. This study retrospectively examines wilderness injuries, illnesses, and mortality based on case incident report files from eight National Park Service parks within California over a three-year period. Data were extracted regarding type of illness or injury, body area affected, age, gender, month in which the event occurred, and activity in which the victim was involved at the time of the event. The overall occurrence of nonfatal events was 9.2 people per 100,000 visits. More than 70% of all nonfatal events were related to musculoskeletal or soft-tissue injury. The most frequently involved body area was the lower limbs (38%). Seventy-eight mortalities occurred during the three years studied, resulting in an overall mortality rate of 0.26 deaths per 100,000 visits. Men accounted for 78% of the deaths. Heart disease, drowning and falls were the most common causes of death. The information and statistics on morbidity and mortality in California wilderness areas that this study provides may be used to guide future wilderness use, education, and management. A standardized, computerized database would greatly facilitate future evaluations, decisions, and policies.

California↗
PubMed1997

Rapid clinical evaluation of anosmia. The alcohol sniff test.

BACKGROUND: Smell impairment affects 1% to 2% of Americans and leads to frequent physician visits. Olfactory testing is available in chemosensory centers, but not as part of a routine cranial nerve examination. The alcohol sniff test (AST), which uses the standard 70% isopropyl alcohol pad, was developed as a quick, reliable measure of olfactory function. METHODS: Sixty-four patients and 36 healthy control subjects (N = 100) were tested with the AST and with a standard butanol threshold test. RESULTS: The AST reliably, consistently, and correctly measured olfactory function. CONCLUSIONS: The AST is a rapid, reliable olfactory test that can be used for screening olfactory function and should be incorporated in the routine cranial nerve examination.

1-Propanol↗