Search PubMed⌕ Search

Biomedical subjects

J A Walker

Publications and source records attributed to J A Walker.

139 records · Page 8Linked to original sources
PubMedDate not supplied

Patterns of cognitive recovery in sudden cardiac arrest survivors: the pilot study.

OBJECTIVE: To determine the prevalence, type, severity, and natural evolution of cognitive impairments in survivors of sudden cardiac arrest over time and to assess the relation of selected clinical and psychologic variables to those outcomes. DESIGN: Longitudinal with repeated measures. Twenty-five consecutive patients underwent extensive neuropsychologic testing during hospitalization within 3 weeks of their initial cardiac arrest. Of these, 17 completed additional testing at 6 to 9 weeks, 12 to 15 weeks, and 22 to 25 weeks after the event. SETTING: Cardiac electrophysiologic services at a university teaching hospital, a community hospital, and home. OUTCOME VARIABLES: Orientation, attention, concentration, immediate recall, early retention, delayed recall, reasoning, motor speed, and motor regularity were measured. RESULTS: During hospitalization, 72% of the patients had mild to severe impairments in one or more cognitive areas. Memory, particularly delayed recall, was the most common deficit. At 6 months after the arrest event, 29% (5 of 17) of the patients continued to be impaired, and all had deficits in delayed recall. Depression was significantly related to deficits in attention and delayed recall at 6 months only. Time to postarrest awakening was the most reliable predictor of long-term cognitive functioning in this patient sample. CONCLUSION: A significant minority of sudden death survivors incur long-term cognitive impairments, particularly in delayed recall or short-term memory. The occurrence of long-term cognitive deficits in these patients can be estimated from the duration of unconsciousness after resuscitation (time-to-awakening).

Adult↗
PubMedDate not supplied

New detachable poly(ethylene glycol) conjugates: cysteine-cleavable lipopolymers regenerating natural phospholipid, diacyl phosphatidylethanolamine.

A new strategy for the reversible attachment of methoxypoly(ethylene glycol) (mPEG) to an amino-containing substrate is described. The strategy is based on formation of a benzyl carbamate linkage substituted with a disulfide in the para or ortho position. While being stable under nonreducing conditions, the dithiobenzyl (DTB) urethane linkage is susceptible to cleavage by mild thiolysis with cysteine resulting in release of the parent amino component of the conjugate in its original form. The method is exemplified by preparation of mPEG-DTB-alcohol, its activation and attachment to distearoylphosphatidylethanolamine (DSPE). The resulting lipopolymer incorporates into liposomes, which are capable of losing their polymer coating under conditions approximating those existing in vivo. Implications for drug delivery are briefly discussed.

Carbamates↗
PubMedDate not supplied

Medulloscopy for sepsis or nonunion: Early clinical experience with the tibia and femur.

We report the clinical use of "medulloscopy" for the visualization and irrigation of sepsis or nonunion of the tibia and femur in 7 cases. Included were 2 cases of aseptic femoral nonunion, 1 infected femoral nonunion with chronic osteomyelitis, 2 cases of healed tibia fracture with chronic osteomyelitis, 1 aseptic nonunion of the tibia, and 1 case of tibial osteomyelitis secondary to intravenous drug use. Visualization of the nonunion site or pathologic lesion was achieved in 86% of cases (6 of 7) and additional diagnostic information was obtained by medulloscopy in 86% of cases (6 of 7). A representative case is presented. Medulloscopy appears to be clinically useful for the treatment of sepsis or nonunion of the tibia and femur when access to the intramedullary canal is necessary.

Adult↗
PubMedDate not supplied

Risk factors and coronary artery obstruction in male and female patients with aortocoronary bypass operation.

In order to learn about some possible reasons for the low proportion of women among the patients with aortocoronary bypass operation (12-20%) we have compared the prevalence of hypertension, hyperlipidemia, history of smoking and chest pain in 110 women and 813 men with this surgical intervention. In spite of the similar or even higher prevalence of abnormal risk factors, the women patients showed less extensive coronary artery impairment than the male patients indicating their higher tolerance of the risk factors and lesser need for the bypass operation.

Coronary Artery Bypass↗