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Biomedical subjects

J S Wright

Publications and source records attributed to J S Wright.

At least 37 records · Page 2Linked to original sources
PubMed1987

The rural-urban distribution of health professionals in Georgia.

In this paper, the rural/urban geographic distribution of licensed health professionals living in the state of Georgia is examined. Using 1983 data from the State Examining Boards, 13 health professions were studied to determine rural and urban differences. Three indicators of ruralness were used to classify county of residence: metropolitan/nonmetropolitan, metropolitan proximity, and size of county population. Results from data analyses indicate a severe geographic maldistribution of health professionals. With all three indicators, 11 of the 13 professions had urban rates of professionals-to-population substantially higher than the corresponding rural rates. A linear configuration seems to illustrate the relationship between the availability of health professionals and the ruralness of the county--as the county becomes more rural, the number of health professionals per population decreases. The percentage increase in physicians since 1968 and nurses since 1979 in nonmetropolitan counties was slightly higher than in metropolitan counties, indicating that this gap is closing somewhat. The most severe rural/urban differences in the number of professionals which per population were found in the more specialized health professions per tended to be the smallest in terms of numbers of members (e.g., occupational therapists, psychologists, speech pathologists/audiologists, podiatrists, opticians and physical therapists). These differences ranged up to a 20 plus-fold difference. Physicians, chiropractors, dentists, physician assistants and registered nurses also had relatively large rural/urban differences but less than the more specialized professions.

Data Collection↗
PubMed1985

Primary (spontaneous) chordal rupture: relation to myxomatous valve disease and mitral valve prolapse.

The excised valves of 152 consecutive patients who underwent isolated primary mitral valve replacement between May 1979 and July 1983 were studied to determine the cause of primary (spontaneous) rupture of the chordae tendineae and estimate the prevalence of floppy mitral valve with underlying myxomatous disease. Of these 152 patients, 72 had nonrheumatic disease; 42 (28% of the total group) had a floppy valve, and 39 of these valves had microscopic changes of myxomatous disease. Primary chordal rupture had occurred in 31 patients, including 29 with myxomatous disease. Seven of these patients had prior documentation of mitral valve prolapse and an additional 20 patients had a long-standing murmur. Ischemic mitral regurgitation (22 patients) accounted for the majority of the remaining 30 patients with nonrheumatic disease. Therefore, approximately half of all isolated mitral valve replacements in this institution are now performed for nonrheumatic disease, the majority for a floppy valve in which myxomatous disease was the underlying abnormality. Primary chordal rupture almost invariably occurs as a complication of myxomatous disease, and mitral valve prolapse may be a common precursor.

Adult↗
PubMed1984

Early and long-term results of coronary artery bypass grafting with severely depressed left ventricular performance.

The effects of coronary artery bypass grafting (CABG) on ventricular performance and long-term clinical status were studied in 18 consecutive patients with disabling angina pectoris and severely depressed left ventricular (LV) performance (ejection fraction [EF] 27 +/- 9%). All patients survived CABG, although 1 patient had a perioperative myocardial infarction. There was no change in LVEF at rest, 29 +/- 12%, in the other 17 patients. However, LVEF during peak exercise increased from 22 +/- 7% to 27 +/- 14% (p less than 0.05). The 17 patients were separated into 2 groups: those who increased their peak exercise LVEF by at least 10% (group A, 8 patients) and those who increased it by less than 10% (group B, 9 patients). Preoperatively, patients in group A had a higher LVEF at rest (p less than 0.001) and smaller end-systolic and end-diastolic volumes at rest (p less than 0.001) and during exercise (p less than 0.005). Preoperatively, the LVEF in group A decreased with exercise, from 36 +/- 4% to 27 +/- 5% (p less than 0.01), but was unchanged in group B (19 +/- 3% vs 17 +/- 4%, difference not significant). After CABG, patients in group A had a smaller increase in end-systolic volume with exercise than those in group B (13 +/- 7 vs 34 +/- 22 ml/m2, p less than 0.05), but the changes in end-diastolic volume with exercise were not significantly different. At 27 +/- 5 months after CABG, 5 of 8 patients in group A were asymptomatic.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1984

Isolated congenital pulmonary incompetence: case report and literature review.

Although the literature fails to clearly define the prognosis of isolated congenital pulmonary incompetence (ICPI), there are suggestions that the lesion is not necessarily benign. A case report is presented of pulmonary valve replacement for ICPI which reversed not only symptoms but also electrocardiographic manifestations of right ventricular overload. A literature review is included with the case report.

Electrocardiography↗
PubMed1981

Saphenous vein grafting for angina.

An analysis of 200 consecutive patients treated by saphenous-vein bypass grafting has been carried out. One patient died in hospital, and one died nine months after surgery. Some of the factors which predispose to postoperative complications can be defined preoperatively. These are unstable angina, multiple vessels disease, and impaired left ventricular function. The complications of postoperative infarction, low cardiac output, and arrhythmia were higher in the presence of these factors. The use of cardioplegic myocardial protection lessened the incidence of complications in patients with impaired left ventricular function. Early follow-up revealed 96% of patients truly or virtually angina-free. Three patients suffered infarction within nine months of operation.

Angina Pectoris↗
PubMed1981

Needle in the heart.

A patient accidentally drove a darning needle through her chest wall into her left ventricle. After referral five weeks later as possible case of infective endocarditis, the needle was detected and removed successfully by open heart surgery. It was localised precisely by echocardiography.

Echocardiography↗
PubMed1980

Complications with glutaraldehyde-preseved bioprostheses.

Between May, 1975, and May, 1979, 184 glutaraldehyde-preserved valve bioprostheses were implanted (92 aortic, 76 mitral, and 16 multiple). In the last two years, anticoagulants have been administered for the first three post-operative months. Of 176 patients, 10 patients had simultaneous coronary surgery, and five had previous valve surgery; endocarditis had occurred in eight patients before operation, and heart block existed in four patients. In the group of patients who underwent aortic valve replacements, there were four early deaths, all in patients with associated severe coronary artery disease. There was one late death in this group caused by bacterial endocarditis. In the group with mitral valve replacements, there were three early deaths, one related to massive thrombosis of the prosthesis, and two late deaths of unknown cause. Within the whole group, there were seven instances of significant thromboembolism, and nine instances of incompetence, including five mitral periprosthetic leaks which required reoperation. Three patients had stenosis of the mitral prosthesis. There has been no known incidence of intrinsic leaflet incompetence.

Adolescent↗
PubMed1980

Peripheral neuropathy due to perhexilene maleate.

Observations are presented on 3 patients, including one autopsy report, with peripheral neuropathy due to perhexilene maleate (Pexid). Clinically and biochemically perhexilene neuropathy presents features unusual for a drug-induced neuropathy. Patients liable to develop neuropathy can be recognised from clinical criteria or by the use of routine electrophysiological determinations of nerve conduction velocities. At this stage the neuropathy is readily reversible if perhexilene therapy is discontinued. We have sought to examine the problems entailed in the future safety of perhexilene and allied drugs.

Aged↗