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Biomedical subjects

H Walters

Publications and source records attributed to H Walters.

At least 37 records · Page 2Linked to original sources
PubMed1996

An audit of antibiotic prescribing by general practitioners in the initial management of acute dental infection.

A sub-regional audit showed a high rate of referral of acute dentoalveolar infections as emergencies. In Torbay Hospital alone, 21 patients required admission following such referrals in a period of 3 months. A questionnaire was therefore sent out to all general medical and general dental practitioners in the area covered by Torbay Hospital in order to survey their choice of antibiotics in the initial management of acute dentoalveolar infections. The results showed that the prescribing patterns of general medical practitioners differed significantly from those of general dental practitioners and that practitioners were reluctant to prescribe metronidazole as a first choice, even in patients allergic to penicillin. The authors conclude that awareness about the use of antibiotics, particularly among general dental practitioners, needs to be increased.

Abscess↗
PubMed1995

Reducing lingual nerve damage in third molar surgery: a clinical audit of 1350 cases.

Several publications reporting lingual nerve damage in the region of 11% caused the author to undertake a retrospective personal clinical audit of 100 cases which demonstrated a comparable complication rate of 10%. This audit prompted a re-evaluation of the detailed surgical anatomy, the design and manufacture of a new type of periosteal elevator and lingual nerve retractor and a modification of the surgical technique. A subsequent prospective personal clinical audit of 1001 consecutive wisdom tooth operations has resulted in a 20-fold improvement (0.5%) in the incidence of lingual nerve damage. The technique and instrumentation has been used under local anaesthesia and under general anaesthesia by surgeons of varying experience and has a group audit complication rate of only 1% in 300 consecutive cases. The value of clinical audit has become self evident.

Humans↗
PubMed1993

Pleuropulmonary abnormalities in primary Sjögren's syndrome.

Sixteen patients with primary Sjögren's syndrome (1 degree SS) who complained of dyspnea were investigated with high resolution computerized tomography of the thorax, bronchoalveolar lavage, and transbronchial biopsy. Six patients had evidence of interstitial fibrosis, 5 had a peribronchiolar lymphocytic infiltration and 3 had pleural thickening. We conclude that significant pulmonary disease is not uncommon in patients with 1 degree SS.

Adult↗
PubMed1992

Arteriovenous fistulas in renal transplants: color Doppler ultrasound observations.

One hundred twenty-six new renal transplants were scanned regularly with color Doppler ultrasound (CDU). In 22 (17.5%) of the grafts there was evidence of postbiopsy arteriovenous (AV) fistula during the first 6 months postoperatively. In 14 cases the fistula closed spontaneously. In the remaining eight, the fistula was still present up to 24 months later (four cases) or until the graft failed (four cases). Additionally, 163 established grafts were scanned for evidence of vascular abnormality. AV fistulas were observed in 15 grafts (8%). Circulatory complications of fistulas observed include vascular steal and a possible association with graft vein and artery stenosis.

Arteriovenous Fistula↗
PubMed1991

Renal transplant vein stenosis: demonstration and percutaneous venoplasty of a new vascular complication in the transplant kidney.

Stenosis of the renal transplant vein has been demonstrated in eight patients undergoing investigation for renal dysfunction arising 3 weeks to 3 years after transplantation. The stenoses were diagnosed by duplex Doppler ultrasound in three cases and by angiography in the presence of arterio-venous fistula in five cases. In four patients percutaneous venous dilatation was performed with technical success in three. In two patients this was repeated for recurrent stenosis but sustained improvement in renal function was not observed. Progression of the venous stenoses was documented with one patient suffering graft loss due to complete venous occlusion.

Adult↗
PubMed1990

Aortic dissection presenting as acute leg ischaemia.

Lower limb ischaemia as the only or main clinical manifestation of aortic dissection is a rare event. Two cases are presented where this occurred resulting in attempted embolectomy before the correct diagnosis was made. The diagnosis should be considered when embolectomy fails to retrieve thrombus and when angiography demonstrates spiral lucencies within the lumen of large vessels or non-filling of major vascular branches. The value of pre-operative angiography is emphasized.

Aged↗
PubMed1990

Superselective embolization using a coaxial catheter technique.

A method of superselective embolization of 0.64 mm or 0.89 mm coils using a coaxial catheter system is described. The normally functioning parts of an organ can be easily preserved. A number of clinical cases are briefly described which illustrate the application of this method. It is particularly suited to the control of bleeding points in diseased organs or precious organs such as transplants where embolization of a larger volume of tissue would have serious consequences.

Arteriovenous Fistula↗
PubMed1989

The effect of filtration on absolute and differential cell counts in fluid obtained at bronchoalveolar lavage.

We have studied the effects of filtering mucus from bronchoalveolar lavage (BAL) fluid on its cellular contents. We examined BAL fluid from 18 patients without excessive endobronchial mucus, and from three patients with bronchiectasis. In the non-bronchiectatic subjects there was a fall of 18% in mean absolute cell count from 2.66 +/- SD 1.9 x 10(9) l-1 to 2.18 +/- 1.4 x 10(9) l-1 (P less than 0.05) as a result of filtration. This was due to a selective loss of macrophages and there were no significant changes in the absolute numbers of either lymphocytes or neutrophils. The differential macrophage count fell from a mean of 82 +/- 14% to 76 +/- 16%, while the mean differential lymphocyte count rose from 14 +/- 7% to 19 +/- 9% and the mean differential neutrophil count increased slightly from 4 +/- 4% to 5 +/- 4%. In the three patients with bronchiectasis the absolute cell counts were grossly raised, due almost entirely to an excess of neutrophils. In these patients, filtration reduced the absolute macrophage count by 61% and the absolute neutrophil count by 27%. Overall, change in absolute cell count correlated significantly with mucus volume (r = 0.76, P less than 0.05). Removal of mucus by filtration affects absolute cell count and may have a selective effect on cell numbers. If filtration of BAL fluid is unavoidable, its effect on cell counts should be clearly established if data from different centres are to be meaningfully compared.

Adult↗
PubMed1988

The effect of bronchoalveolar lavage on bronchial responsiveness in patients with airflow obstruction.

This study assessed the effect of bronchoalveolar lavage (BAL) on nonspecific bronchial responsiveness in 31 patients. Of these, 20 had airflow obstruction; 11 control subjects had normal pulmonary function. Bronchial responsiveness to methacholine, expressed as the dose of inhaled methacholine required to provoke a 20 percent fall in forced expiratory volume in one second (PD20 FEV1), was measured before and after BAL. We found no evidence for the induction of responsiveness by BAL in 11 control subjects with negative methacholine tests prior to the procedure. There were small but significant falls in FEV1 following BAL in both the control group and in patients with airflow obstruction. Thus, BAL does not appear to induce nonspecific bronchial hyperresponsiveness in subjects without airflow obstruction, nor does it affect airway responsiveness in emphysema patients. Among asthmatics, bronchial responsiveness can be increased as a result of BAL; this increase was greatest in patients who were most responsive initially.

Adolescent↗
PubMed1986

Computerised planning of maxillo-facial osteotomies: the program and its clinical applications.

A totally computerised program has been developed which undertakes the 2-dimensional planning of a complete maxillo-facial reconstruction using Le Fort I, II & III, Wassmund, Schuchardt, Küfner, Köle, Dingman, Obwegeser and VSS osteotomies with augmentation or reduction genioplasty and rhinoplasty. The program incorporates the calibration of the equipment, initialization of new discs, a filing system for osteotomy patients, unlimited expansion facilities for storage of files and an automatic cephalometric analysis which is updated at each stage. A suggested operation, which may be altered for aesthetics, is generated spontaneously by the computer. The surgeon or the patient is free to accept or reject the computer's suggestion in part or whole.

Cephalometry↗