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Biomedical subjects

D Waller

Publications and source records attributed to D Waller.

51 records · Page 3Linked to original sources
PubMed1982

Work in progress. Flashing tomosynthesis: a tomographic technique for quantitative coronary angiography.

Flashing tomosynthesis, a procedure that consists of a recording step and a reconstruction step, facilitates the tomographic imaging of coronary arteries. In a comparative study 10 postmortem coronary arteriograms were examined with 35-mm cine technique and with flashing tomosynthesis. The degrees of stenosis found with both of these techniques were compared with morphometrically obtained values. A higher correlation coefficient existed for the degrees of stenosis obtained with tomosynthesis and morphometry (r = 0.92, p less than 0.001, SEE = 9%) than for those obtained with cine technique and morphometry (r = 0.82, p less than 0.001, SEE = 16%). The technique has also been successfully carried out in 5 patients with coronary artery disease.

Angiography↗
PubMed1980

Smoking and vigilance. The effects of tobacco smoking on CFF as related to personality and smoking habits.

The effects of tobacco smoking on vigilance (Critical Flicker Fusion, CFF) measured by a computerized forced-choice interactive technique, was studied in a group of 28 male moderate smokers. Subjects participated in a Smoking (S) and a Non-Smoking (NS) condition each of 1 h duration. CFF performance was measured during fifteen 2-min trials in each condition. In the S condition subjects smoked three puffs during each of five pauses between five successive trials. Vigilance was significantly improved by smoking. An initial sharp increase in CFF performance was noticed with a maximum 8 min after the first puff. Performance was significantly higher in the S condition compared to the NS condition up to 20 min after the last puff. Two extreme groups, based on differences in CFF performance between the S and NS condition were compared by questionnaires on personality and smoking habits. The most improved group had significantly higher scores in an extraversion scale. Ratings of the effect of smoking on level of alertness indicated that the objective effect of increased vigilance had no counterpart on the subjective level.

Adult↗
PubMed1978

A trial of adenine arabinoside in genital herpes.

Twenty-four episodes of genital herpes in 22 men, all confirmed by virus isolation, were studied in a double blind trial. They were treated either with 3% adenine arabinoside (Ara-A) in petrolatum ointment base or with the base alone applied four times daily for one week. The lesions were counted and sketeched on days 0, 2, and 7. There was no demonstrable advantage to be gained from the use of Ara-A ointment. The results of the Papanicolaou smears and virus isolation agreed in the diagnosis of 75% of cases. The presence of continuing lesions or fresh ones in some patients after the acute phase of the initial or recurrent attack of herpes necessitates the man taking precautions on resuming sexual intercourse.

Clinical Trials as Topic↗
PubMed1975

Neutral red with photoinactivation in the treatment of herpes genitalis.

A clinical trial was undertaken to compare the efficacy of neutral red photodynamic inactivation treatment of genital herpes infections with that of a non-photoactive dye, phenol red, as a control. In a series of nineteen patients with virologically proven herpes genitalis who were adequately followed, eleven were treated with neutral red, and eight with phenol red; no difference in response to therapy was found between the two groups, and it is concluded that under the conditions of this trial neutral red with photoinactivation was not effective in the treatment of acute genital herpes infections. Approximately 75 per cent. of those with vulval lesions also had concurrent cervical infection, so that an effective topical treatment would need to be applicable to both anatomical sites.

Antibodies, Viral↗
PubMed1975

Incidence of Herpesvirus hominis antibodies among blood donor populations.

The microneutralization test was used to determine the occurrence of antibodies to Herpesvirus hominis Type 1 and Type 2 in sera from patients attending the Special Clinic, Bristol Royal Infirmary, with proven herpes genitalis, and in sera taken from blood donors in Bath, Dursley, and Bristol, as well as from donors in three different prison populations. The findings in patients with herpes genitalis indicate that the test accurately reflects the antibody response expected in relation to the type of herpes virus isolated from the lesions. The incidence of Type 2 antibodies among the blood donors ranged from 5 per cent. for donors from the Bath area up to 60 per cent. among donors from Dartmoor prison. The findings suggested that Type 2 herpes infection could spread among longterm prison populations, and it is postulated that this may be due to both homosexual contact, and also by non-sexual contact, either directly or via fomites.

Adolescent↗
PubMedDate not supplied

Effect of simulated American, Bulgarian, and Japanese human diets and of selenium supplementation on the incidence of virally induced mammary tumors in female mice.

In attempts to simulate the effects of diet on human breast cancer development groups of female C3H mice infected with mammary tumor virus (MMTV-) were maintained on diets formulated to resemble the typical American, Bulgarian, and Japanese human diets. The incidence of mammary tumors was the highest (84%) in group of mice receiving the simulated meat- and fat-rich American diet, which was also low in selenium (Se content: 0.15 ppm). The appearance of mammary tumors was delayed in the mice maintained on the simulated Bulgarian diet, and the final tumor incidence (27%) paralleled the correspondingly lower Bulgarian breast cancer incidence. The simulated Bulgarian diet contained more Se (0.25 ppm), and was lower in fat, meat, and sugar and higher in complex carbohydrates (cereals) than the simulated American diet. In the mice fed the simulated Japanese diet, the appearance of mammary tumors was also delayed, and the tumor incidence was diminished to 47%. In this diet, fish meal was a major source of Se, which is known to have low bioavailability. Additional supplementation of the Japanese-type diet with bioavailable Se (1 ppm) lowered the tumor incidence to 10%. Based on these studies, recommendations are made for breast cancer risk reduction by dietary means.

Aging↗
PubMedDate not supplied

The pharmacokinetic properties of intramuscular quinine in Gambian children with severe falciparum malaria.

Plasma quinine concentrations were measured in 21 Gambian children with severe falciparum malaria after intramuscular administration of a 20 mg (salt) per kg loading dose of quinine dihydrochloride followed by 10 mg/kg at 12 h intervals. Quinine was well absorbed reaching mean peak concentrations of 15.6 (standard deviation [SD] 4.5) mg/litre in a median time of 3 h (range 1-6 h). A one compartment model was fitted to the plasma concentration-time profile. The mean estimated systemic clearance (Cl/F) was 0.89 (SD 0.81) ml/kg/min and the mean elimination half life was 18.8 (SD 8.0) h. Two patients, one of whom died, had low plasma quinine levels which remained below 10 mg/litre. Mean peak and trough plasma concentrations after subsequent intramuscular doses ranged between 11.1 and 15.1 mg/litre. In most cases this dose regimen provided a satisfactory profile of blood concentrations for the treatment of severe malaria in children.

Animals↗
PubMedDate not supplied

Intracranial pressure in childhood cerebral malaria.

Lumbar punctures were performed in 40 Gambian children with acute cerebral malaria aged between 18 months and 10 years. The mean opening pressure was elevated in 32 (80%) of the children, but was not significantly different in the 14 fatal cases compared with survivors: 110 (standard deviation 71) versus 131 (58) mm of cerebrospinal fluid respectively. Cerebral perfusion pressures were also similar in the 2 groups: 64 (20) mm Hg versus 64 (11) mm Hg respectively. There was no clear clinical evidence of raised intracranial pressure, and no evidence of deterioration immediately following lumbar puncture. Nevertheless brain swelling, and consequent brain-stem compression, may contribute to a fatal outcome in cerebral malaria--particularly in those children who die from sudden respiratory arrest. A prospective evaluation of osmotic agents in childhood cerebral malaria seems to be justified.

Child↗
PubMedDate not supplied

Electrocardiographic monitoring in severe falciparum malaria.

Electrocardiographic monitoring over 24 h was performed with 53 patients with severe Plasmodium falciparum malaria (11 adults and 42 children) to assess the frequency of unrecognized cardiac arrhythmias. Nine patients (17%) died, 5 during the monitoring period and 4 afterwards. Pauses lasting 2-3 s were observed in 3 children, a single couplet in one, and a further child experienced frequent supraventricular ectopic beats which had not been detected clinically. In none of the patients who died could death be attributed to cardiac arrhythmia. Furthermore, no abnormality was detected which could have resulted from the often large doses of quinine, chloroquine or the artemisinin derivatives used for treatment. These results suggest that the heart is remarkably resilient even in the face of heavy parasite sequestration and other vital organ dysfunction, and that deaths from cardiac arrhythmias in severe malaria are rare. The need for routine cardiac monitoring of patients with severe and complicated P. falciparum malaria is questionable.

Adolescent↗
PubMedDate not supplied

Hemofiltration in a cardiac intensive care unit: time for a rational approach.

The typical annual expenditure for patients requiring continuous hemofiltration (CHF) is high. To audit the benefit of this expensive treatment, the outcome of 48 consecutive patients (34 men, 14 women; mean age, 65 years) requiring hemofiltration for acute renal failure was analyzed during a period of 24 months. The operations performed were 26 CABG, 8 AVR, 3 AVR/MVR, 2 post infarction VSD repairs, and 1 thoracoabdominal aneurysmectomy. Indications for hemofiltration were oliguria and fluid overload in 69%, uremia in 56%, acidosis in 33%, and hyperkemia in 13%. Twenty five patients (52%) died while in the hospital, and 10 more died within 9 months of discharge. Of the remaining 13 survivors, 6 (46%) were classified as III or IV according to the New York Heart Association classification system. The mean ITU and hospital stay per patient requiring CHF was 15.3 days and 25.4 days, respectively. There were no statistically significant differences between patients who did and did not survive in the hospital in age, pre-operative renal function, ejection fraction, duration of cardiopulmonary bypass, or urine output before CHF. However, there were no survivors when the cardiac index was less than 1.7 L/m2 and adrenalin requirement was more than 30 micrograms/min before CHF (seven patients). These results suggest that the short- and long-term outcome in patients requiring CHF after cardiac surgery is poor. Considering the large demand on resources, the use of CHF should be rationalized, particularly in patients with persistent low cardiac output.

Acute Kidney Injury↗
PubMedDate not supplied

Developing and implementing a comprehensive program for children and adolescents with eating disorders.

TOPIC: Treatment of eating disorders in children and adolescents across a continuum of care. PURPOSE: To describe the development and implementation of a comprehensive pilot program for children and adolescents with eating disorders. SOURCES: Published literature and clinical experience. CONCLUSIONS: The pilot program to provide comprehensive care to children and adolescents has been successful. As of November 2000, the inpatient modal eating disorder census has been 4 (highest = 10, lowest = 1). With the focus on prevention and early intervention, the multidisciplinary team continues to educate the public and providers.

Adolescent↗