Biomedical subjects

K H Walsh

Publications and source records attributed to K H Walsh.

5 recordsLinked to original sources

PubMed2003

Comparison of the effects of two intrathecal anaesthetic techniques for transurethral prostatectomy on haemodynamic and pulmonary function.

BACKGROUND AND OBJECTIVE: Transurethral prostatectomy is routinely performed under spinal anaesthesia. This technique can cause hypotension, which is particularly undesirable in the elderly. The objective was to compare spinal anaesthesia for transurethral prostatectomy using hyperbaric bupivacaine 15 mg (control group) and hyperbaric bupivacaine 10 mg (limiting spread by maintaining the upright position for 15 min) and fentanyl 25 microg (fentanyl group) in terms of haemodynamic and pulmonary function. METHODS: Thirty ASA I-III patients were randomly selected and underwent spinal anaesthesia with either hyperbaric bupivacaine 15 mg (immediately positioned supine) or hyperbaric bupivacaine 10 mg (upright for 15 min) and fentanyl 25 microg. RESULTS: The greatest changes in mean arterial pressure (P = 0.9), ephedrine requirements (P = 0.8) and mean maximum change in forced vital capacity (P = 0.5) were similar in both groups. CONCLUSIONS: The addition of fentanyl 25 microg to bupivacaine 10 mg and limiting the spread of the block does not improve either haemodynamic or pulmonary function compared with bupivacaine 15 mg in patients undergoing transurethral prostatectomy.

Adjuvants, Anesthesia↗

PubMed2001

Trichotillomania. Presentation, etiology, diagnosis and therapy.

Trichotillomania (TTM) is an impulse disorder, in which patients chronically pull hair from the scalp and/or other sites. Very early onset of hair pulling in children under the age of 6 may be more benign and self-limiting than the more common syndrome of late childhood onset hair pulling. While far more women and adolescent girls appear for treatment, survey studies suggest chronic hair pulling also occurs in males. Diagnosis may be complicated by patient and family denial or ignorance of the hair pulling; accurate scalp examination and biopsy can be critical. Classic scalp biopsies for TTM feature trichomalacia, pigment clumps, peribulbar hemorrhage and hair canal pigment casts, and lack lymphocytic infiltrates seen in alopecia areata. Treatment is difficult: the tricyclic antidepressant clomipramine is the most promising agent, although many patients find it difficult to tolerate at adequate dosages, and treatment response may not be maintained over the long term. More benign medications have not demonstrated efficacy in controlled studies. Augmentation with topical preparations or psychotropic medications may be helpful for patients experiencing limited efficacy or relapse. Specialized psychotherapy, known as habit reversal training, is highly recommended; however, the treatment is intensive and highly specialized. Skilled therapists are difficult to locate.

Adolescent↗

PubMed1999

Risperidone in the treatment of two very young children with autism.

This report describes the use of risperidone in the treatment of two very young children with autistic disorder, a 29-month-old boy and a 23-month-old boy, respectively. These children presented with severe and persistent symptoms of aggression and irritability that had not responded to previous treatment. In both cases, risperidone significantly reduced aggression and improved social relatedness. One patient's treatment with risperidone was complicated by persistent tachycardia and QTc interval prolongation that was dose-related. Consideration should be given to the appropriate use of medication in the treatment of very young children with autism when other interventions do not prove helpful.

Antipsychotic Agents↗

PubMed1989

The heat-shock response in cultured cells exposed to ethanol and its metabolites.

Many stresses, including elevated temperature and exposure to toxins or heavy metals, activate a stereotyped response of cultured cells known as the heat-shock response. The products of several highly conserved heat-shock genes (heat-shock proteins) protect the cells against subsequent stresses. The intracellular signal for the response is unknown, but may include the presence of damaged and abnormal proteins in the cell. Ethanol at high concentration (1.3 mol/L) has been shown to activate the heat-shock response in hamster ovary fibroblasts, suggesting that this response might be an important consequence of exposure of cells to ethanol and might mediate some of its cellular toxicity. To determine if lower concentrations of ethanol or its metabolites could activate a heat-shock response, we transfected COS-1 cells with a reporter gene (the Drosophila 70 kd heat-shock protein promoter fused to the beta-galactosidase gene), then exposed them to various compounds. Exposure to heat induced at least a threefold to fourfold increase in beta-galactosidase activity, whereas 1.3 mol/L ethanol induced a sixfold increase. Lower concentrations of ethanol (100 to 500 mmol/L) or acetaldehyde (100 to 500 mumol/L) did not induce a measurable heat-shock response. Similarly, high concentrations of metabolites generated during ethanol oxidation (10 mmol/L lactate or acetate) did not induce the response. We conclude that the heat-shock response cannot be detected with this assay system in COS-1 cells after short exposure to physiologically achievable concentrations of ethanol or its metabolites. However, it is possible that it is induced at a low level or in tissues directly exposed to alcoholic beverages (e.g., oropharynx, esophagus, and stomach).

Acetaldehyde↗

PubMed1971

Osteopetrosis.

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Calcium, Dietary↗