A5080939320- Primary Care and Health Outcomes
- Tracheal and airway disorders
- Ear and Head Tumors
- Ear Surgery and Otitis Media
- Vestibular and auditory disorders
- Voice and Speech Disorders
- Head and Neck Surgical Oncology
- Innovations in Medical Education
- Head and Neck Cancer Studies
- Healthcare Policy and Management
- Hearing, Cochlea, Tinnitus, Genetics
- Head and Neck Anomalies
- Facial Nerve Paralysis Treatment and Research
- Sinusitis and nasal conditions
- Dysphagia Assessment and Management
- Cancer Diagnosis and Treatment
- Mindfulness and Compassion Interventions
- Clinical Reasoning and Diagnostic Skills
- COVID-19 and healthcare impacts
- Infectious Diseases and Mycology
- Reconstructive Surgery and Microvascular Techniques
- Respiratory viral infections research
- Obstructive Sleep Apnea Research
- Palliative Care and End-of-Life Issues
- Brain Metastases and Treatment
Western University
2000-2025
West Virginia University
1999-2021
Office of Naval Research
2016
London Health Sciences Centre
2002-2014
West Virginia University Hospitals
1993-2013
Iowa City Public Library
2005
Morgantown High School
1993-2005
YMCA of Greater Vancouver
2000
Arkansas Department of Agriculture
1978-1995
University of Arkansas for Medical Sciences
1980-1988
Objective This guideline provides evidence‐based recommendations on managing cerumen impaction, defined as an accumulation of that causes symptoms, prevents assessment the ear, or both. We recognize term “impaction” suggests ear canal is completely obstructed with and our definition impaction does not require a complete obstruction. However, preferred since it consistently used in clinical practice published literature to describe symptomatic ear. intended for all clinicians who are likely...
Objective: To describe the clinical presentation, diagnosis, surgical management, and outcome of patients with spontaneous cerebrospinal fluid otorrhea. Study Design: Retrospective case series. Setting: Tertiary referral center. Methods: The authors conducted a chart review all previously unreported cases surgically confirmed otorrhea at their institution between September 1996 February 2005. Acquired were excluded from this study. Eleven identified among 10 patients. Results: Nine...
Family physicians play important roles throughout all stages of a pandemic response; however, actionable descriptions outlining these are absent from current plans. Using multiple case study design, we conducted document analysis and interviewed 68 family in four Canadian regions. We identified performed by five distinct response: pre-pandemic, phased closure re-opening, acute care crisis, vaccination, recovery. In addition to adopting public health guidance ensure continued access primary...
Management of patients with cerebrospinal fluid rhinorrhea (CSF) remains controversial. Most studies recommend either an endoscopic or external extracranial approach, depending on the surgeon's preference. Eighteen CSF have been managed at our institution since 1990. The causes consisted functional sinus surgery (7), lateral rhinotomy excision a benign nasal tumor (3), spontaneous and secondary repair after intranasal ethmoidectomy (1). In 11 leak was recognized time surgery; in 10 these it...
We treated 21 previously untreated T1 or tumor in situ squamous cell carcinomas of the true vocal cords by carbon dioxide laser excision. The mean follow-up was 42 months, with a range 26 to 64 months. Recurrent cord carcinomas, an average interval recurrence months developed four patients. Three recurrences involved anterior portion cord, including commissure. One patients again laser, and other three underwent radiotherapy. All are alive have retained their larynges. Laser excision...
Purpose Strong leadership in primary care is necessary to coordinate an effective pandemic response; however, descriptions of roles for family physicians are absent from previous plans. This study aims describe the and functions played during COVID-19 Canada identify supports barriers formalizing these future Design/methodology/approach conducted semi-structured qualitative interviews with across four regions as part a multiple case study. During interviews, participants were asked about...
Planning for surge capacity, that is, the ability of a health service to expand beyond normal capacity and meet an increased demand clinical care, is essential component public emergency preparedness. During COVID-19 pandemic, family physicians (FPs) were called upon provide in settings such as hospital units departments while also maintaining their primary care responsibilities. Most research reports on projection models, settings, or use virtual with limited focus firsthand experiences FPs...
The Singer-Blom tracheoesophageal puncture (TEP) technique is an effective and safe surgical method for speech rehabilitation of the alaryngeal patient. silicone prosthesis, which fitted in TEP tract, allows pulmonary air to be used voice production but prevents aspiration. In a series 63 patients, 56 (89%) were able develop fluent speech, only 45 patients (71%) currently use as their prime mode communication. Of 18 (29%) who no longer 11 experienced either inadvertent dislodgement...
Abstract Uvulopalatopharyngoplasty (UPPP) is an operation that frequently performed for the treatment of obstructive sleep apnea (OSA). While UPPP usually eliminates or decreases snoring and often reduces excessive daytime sleepiness, decrease in number episodes hypopnea, improvement oxygen saturation (SaO2) have been less predictable. We compared preoperative postoperative polysomnography (PSG) 27 patients with OSA found no single PSG parameter could accurately reflect changes respiration...
Carbon dioxide laser surgery has become the treatment of choice for laryngeal papillomatosis. The purpose this study was to determine type, incidence, and severity complications that occur with microlaryngoscopy a disease often requires multiple operations. Forty patients papillomatosis underwent total 222 carbon laryngoscopies over 6 1/2-year period from June 1977 through December 1983. results showed 13 sustained 23 separate complications. Intraoperative consisted one episode bilateral...
Background As the first point of contact in health care, primary care providers play an integral role pandemic response. Despite this, has been overlooked previous plans, with a lack emphasis on ways which unique characteristics family practice could be leveraged to create more effective Aim To explore physicians’ perceptions integration COVID-19 Design and setting Descriptive qualitative approach examining physician roles during across four regions Canada. Method Semi-structured interviews...
Abstract Introduction Health system disruptions, caused by unexpected emergencies such as disease outbreaks, natural disasters, and cybercrimes, impact the delivery of routine preventative care. As comprehensive care providers, family physicians (FPs) devote significant time to prevention. However, without emergency pandemic plans in place primary care, FPs face added barriers prioritizing sustaining when health systems are strained, which was evident during COVID-19 pandemic. This study...
Abstract Background. Carcinoma of the paranasal sinuses is rare. The majority these originate in maxillary sinus with primary ethmoid carcinomas occurring up to 20% cases. Adenocarcinomas comprise 50% malignancy. relative rarity tumors originating this area has led their inclusion series that consist mainly antral tumors. Methods . A retrospective chart review all patients presenting adenocarcinoma at West Virginia University Hospitals between 1988 and 1993 was undertaken. Only whose...
The presence of anterior and posterior nasal packs in patients with epistaxis is known to be associated cardiorespiratory problems sometimes death, although the mechanism has not been well understood. To determine incidence severity obstructive sleep apnea treated both packs, we obtained polysomnograms on twelve while were place. Ten these demonstrated apnea. index (apneas/hour sleep) ranged from 1 83, a mean 29; hypopnea (hypopneas/hour 9 33, 20; lowest oxygen saturation (SaO2) 17% 91%,...
To analyze the results of primary and revision endolymphatic sac surgery for treatment Ménière's disease in patients who failed medical therapy.Retrospective chart review.Tertiary referral center.Fifty-one adult with therapy.Endolymphatic to mastoid shunts were performed. Revision procedures performed developed clinically significant recurrent vertiginous spells 5 months or longer after their original procedure.Frequency major episodes measured by standards listed 1995 American Academy...
Background Late-life depression (LLD) is a disabling disorder and antidepressants are ineffective in as many 60% of cases. Converging evidence shows strong correlation between LLD subsequent risk cardiovascular disease. There need for new, well-tolerated, non-pharmacological augmentation interventions that can treat depressive symptoms well improve heart rate variability (HRV), an important prognostic marker development Meditation-based techniques interest based on positive findings other...