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Biomedical subjects

A D Walling

Publications and source records attributed to A D Walling.

At least 19 recordsLinked to original sources
PubMed1991

Influence of exercise-induced myocardial ischemia on the pattern of left ventricular diastolic filling: a Doppler echocardiographic study.

Previous studies using Doppler echocardiography to evaluate left ventricular diastolic filling have shown that myocardial ischemia induced by coronary balloon angioplasty or atrial pacing results in a decrease in the left ventricular inflow peak early (E) to peak atrial (A) velocity ratio. To investigate the effects of exercise-induced ischemia on Doppler-derived filling variables, 20 patients with coronary artery disease and exercise-induced electrocardiographic changes and regional wall motion abnormalities determined by two-dimensional echocardiography were evaluated and compared with 20 patients without evidence of exercise-induced ischemia. Doppler echocardiography was performed at rest and immediately after exercise before the resolution of exercise-induced wall motion abnormalities. Peak E and A velocities increased from rest to postexercise in both the ischemic and nonischemic groups, although the ischemic group demonstrated a greater increase in peak E velocity (from 68 +/- 15 cm/s at rest to 88 +/- 22 cm/s after exercise) than the nonischemic group (70 +/- 13 to 77 +/- 18 cm/s) (p less than 0.05 for the difference in response between groups). Accompanying these changes was a slight increase in the peak E/A velocity ratio in the ischemic group (1.04 +/- 0.28 at rest to 1.13 +/- 0.42 after exercise) versus a decrease in the nonischemic group (1.07 +/- 0.30 to 0.90 +/- 0.28) (p less than 0.05 intergroup difference).(ABSTRACT TRUNCATED AT 250 WORDS)

Blood Flow Velocity↗
PubMed1991

The odd couple.

Explore the source record for details and available documents.

Female↗
PubMed1991

Abortion attitudes and practices of family and general practice physicians.

BACKGROUND: Approximately 1.5 million abortions are performed each year in the United States. Little information has been published on the abortion attitudes and practices of family physicians. The object of this investigation was to assess the abortion attitudes and practices of family and general practice physicians in Kansas. METHODS: A 19-item self-administered survey questionnaire was designed and mailed to 856 family and general practice physicians in Kansas. RESULTS: A 63% survey response rate was obtained. Seventy-eight percent of the physicians reported that abortion should be legal, but only 56% of the respondents classified themselves as pro-choice. Conversely, only 8% reported that legal abortion should not be available, even though 33% classified themselves as pro-life. The majority of physicians reported that abortion is an appropriate option to save the life of the mother, in cases of rape or incest, and when a fetal anomaly is diagnosed. Only three respondents (0.5%) had performed abortions during the previous year. In general, female physicians and physicians over the age of 40 years (regardless of sex) were more likely to be pro-choice and to view a woman's personal decision as a circumstance in which abortion may be appropriate. CONCLUSIONS: Physician's views about abortion and their practice patterns are important components of health care for thousands of women each day.

Abortion, Induced↗
PubMed1990

Single lung transplantation for primary pulmonary hypertension.

Single lung transplantation has become a therapeutic option for end-stage interstitial lung disease and obstructive lung disease. Our group recently extended this treatment to three patients with primary pulmonary hypertension. All patients had marked decreases in pulmonary artery pressures and pulmonary vascular resistance and increases in cardiac output following single lung transplantation. Spirometry, lung volumes, and diffusion capacity were not different in comparison to preoperative studies. Quantitative ventilation-perfusion scans revealed the majority of perfusion distributed to the transplanted lung, with ventilation approximately equally divided between the native and the transplanted lung. Despite ventilation-perfusion imbalance, there was no resting hypoxemia and there was no arterial oxygen desaturation with exercise. One patient expired on the 30th postoperative day due to cytomegalovirus infection of the lungs. In the remaining two patients, maximum exercise capacity following transplantation was near normal in one recipient and reduced in the second recipient. Of note, there was no evidence of ventilatory limitation or impaired oxygenation during exercise in these two recipients. Although an exaggerated exercise ventilatory response was present, this did not limit exercise performance. This report supports the use of single lung transplantation for the treatment of primary pulmonary hypertension.

Adult↗
PubMed1990

The incidence of Haemophilus influenzae meningitis in a midwestern metropolitan county.

The incidence of H. influenzae meningitis in children under five years of age was monitored during the years 1983-87 by a retrospective study of records from all hospitals serving a metropolitan county in Kansas. The mean annual incidence rate for the five years studied was 26.0 per 100,000. This compares with a mean of 56.0 per 100,000 measured in the same county during 1979-82.

Child, Preschool↗
PubMed1990

Drug prophylaxis for migraine headaches.

Drug prophylaxis of migraine headaches is not indicated for all patients; however, it may be useful for patients who experience considerable disruption of their daily lives because of migraine attacks. To be most effective, drug prophylaxis should be one component of a comprehensive approach that includes avoidance of precipitating factors, improvement in coping skills and, for most patients, increased exercise. The prophylaxis regimen should be individually tailored for each patient. Both physician and patient need to determine whether the benefit of prophylaxis outweighs the inconvenience and possible side effects of the medication used. Beta-adrenergic blocking drugs, notably propranolol, are most frequently chosen for prophylaxis. Other effective agents include tricyclic antidepressants, calcium channel blockers and nonsteroidal antiinflammatory agents, particularly naproxen.

Adrenergic beta-Antagonists↗
PubMed1989

Chloroquine overdosage in infancy: a case report.

Increased foreign travel and changes in the prevalence of malaria have made chloroquine more widely prescribed for prophylaxis. It is particularly important to ensure that appropriate doses of chloroquine are administered to children, because even small increases in the therapeutic dose may be toxic. Rapid absorption of the drug from the gastrointestinal tract produces sudden clinical symptoms after overdosage. Cardiac and neurological abnormalities are the most important acute consequences of excess chloroquine.

Africa↗
PubMed1988

An unusual cause of hip pain in a child.

In this perplexing case, a child with signs of apparent hip pain was treated for a sewing needle embedded in the sole of the foot. The diagnosis of foreign body easily could have been missed, because the external signs were minimal and the clinical findings indicated hip disease. However, the child's extreme distress seemed inconsistent with the initial normal findings. Only reexamination and looking beyond the obvious led to the diagnosis.

Child, Preschool↗
PubMed1988

Cysticercosis.

Cysticercosis is probably more common in the United States than is generally realized. The most frequent sites of involvement are the brain, the eye and the skeletal muscle. Normally, the larval stage of the pork tapeworm occurs in pig muscle. Occurrence in humans follows the ingestion of ova.

Adolescent↗
PubMed1987

Ectopic thyroid tissue.

Abnormalities in the embryologic development and migration of the thyroid gland can result in ectopic thyroid tissue, which may occur on the midline in any position from the base of the tongue to the mediastinum. Although ectopic thyroid tissue may be asymptomatic, local obstructive, hemorrhagic or other complications may occur. Radionuclide thyroid scan is confirmatory when the diagnosis is suspected. Hypothyroidism is common in lingual thyroid, and thyroid supplementation is generally required.

Child↗
PubMed1987

Pyoderma gangrenosum.

Pyoderma gangrenosum is a serious skin disorder. About half of the cases are associated with systemic diseases such as inflammatory bowel disease or arthritis. Many management regimens have been recommended, but treatment must be individualized and must include concern for the physical and psychologic needs of the patient. This particularly stressful and uncertain lesion is a challenge to the physician.

Administration, Topical↗
PubMed1985

Meningitis: describing the community health problem.

We identified all 391 cases of meningitis hospitalized in a metropolitan community (population 367,094) over a four-year period to assess incidence, morbidity, and mortality. The crude incidence rate was 27 per 100,000 person years; the incidence rate for children under 5 years of age was 174 per 100,000 person years. The case fatality rate was 3 per cent. Bacterial organisms were identified in 33 per cent of all cases, with H. influenzae most commonly observed (53 per cent). Only 16 per cent of hospitalized cases were known to the county health department.

Adolescent↗