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Biomedical subjects

K Wylie

Publications and source records attributed to K Wylie.

7 recordsLinked to original sources
PubMed1998

Diagnosis and surgical management of obstructive ureteral calculi in cats: 11 cases (1993-1996).

OBJECTIVE: To evaluate diagnostic methods, surgical treatment, perioperative management, and renal function of cats with obstructive calcium oxalate ureteroliths. DESIGN: Retrospective case series. ANIMALS: 11 cats that underwent surgery for removal of calcium oxalate ureteroliths. PROCEDURE: Medical records were reviewed, and the following information was recorded: signalment; results of physical examination, clinicopathologic analyses, and abdominal imaging; surgical procedure; postoperative management; and results of ureterolith quantitative analysis. RESULTS: Ureteroliths in the proximal portion of the ureter were removed from 5 cats (pyelotomy, 1 cat; unilateral ureterotomy, 2 cats; bilateral ureterotomies, 2 cats). Calculi in the middle and distal part of the ureter were removed by partial ureterectomy and ureteroneocystostomy (6 cats). Ten cats recovered from surgery and were discharged from the hospital. One cat died from unknown causes 4 months after surgery, and 1 cat had a nephrectomy elsewhere 5 weeks after ureterolith removal. Eight cats were evaluated 12 to 20 months after surgery. Of these, 2 cats that were markedly azotemic before surgery improved after surgery, and 2 cats developed nephroliths after surgery. Also, of 5 cats that had nephroliths that were not removed at the time of surgery, 4 still had visible nephroliths. One cat had recurrent ureteral obstruction from a ureterolith and persistent urinary tract infection. Ureteroliths or ultrasonographic evidence of ureteral obstruction were not detected in other cats. CLINICAL IMPLICATIONS: A combination of microsurgical techniques and intensive postoperative care is necessary to minimize morbidity of cats after removal of a ureterolith. Renal function may improve or stabilize after removal of the ureteral obstruction.

Animals↗
PubMed1996

Pacing-induced chronic atrial fibrillation impairs sinus node function in dogs. Electrophysiological remodeling.

BACKGROUND: We assessed the effects of pacing-induced chronic atrial fibrillation (AF) on sinus node function, intra-atrial conduction, and atrial refractoriness. METHODS AND RESULTS: In 15 mongrel dogs (20 to 30 kg), AV nodal block was produced by radiofrequency catheter ablation, and a ventricular-inhibited (VVI) pacemaker (Minix 8330, Medtronic) was implanted and programmed to pace at 80 pulses per minute. In 11 of these dogs, right atrial endocardial pacing leads were connected to a pulse generator (Itrel 7432, Medtronic) and set at a rate of 20 Hz to induce AF. Corrected sinus node recovery time, P-wave duration, 24-hour Holter ECG to assess AF duration, maximal heart rate in response to isoproterenol (10 micrograms/min), intrinsic heart rate after administration of atropine (0.04 mg/kg) and propranolol (0.1 mg/kg), and atrial effective refractory periods (ERPs) were obtained at baseline (EPS-1) and after 2 to 6 weeks (EPS-2) of VVI pacing alone (n = 4) or VVI pacing and rapid atrial pacing (n = 11). At EPS-2, corrected sinus node recovery time and P-wave duration were prolonged, maximal heart rate and intrinsic heart rate were decreased, atrial ERPs were shortened, and the duration of AF was increased significantly compared with EPS-1. These changes partially reversed toward baseline 1 week after conversion to sinus rhythm. Sinus node function and AF inducibility observed in the control dogs that underwent ventricular pacing alone (n = 4) did not change. CONCLUSIONS: Pacing-induced chronic AF induces sinus node dysfunction, prolongs intra-atrial conduction time, shortens atrial refractoriness, and perpetuates AF, changes that reverse gradually after termination of AF.

Animals↗
PubMed1996

Deliberate self-harm and substance dependence: the management of patients seen in the general hospital.

The aim of this study was to examine management decisions made at the time of assessment of an episode of deliberate self-harm seen in the general hospital and examine the extent of referral to a specialized addiction unit. Factors involved in making a clinical decision regarding the appropriate management of self-harm cases when alcohol factors were identified are reviewed. Simply referring to a specialized addiction unit was found to be an unsatisfactory method of providing a comprehensive response to the problem of substance misuse and deliberate self-harm. It is suggested that services should be developed using active posthospital discharge community follow-up. Motivational interviewing used in such a setting may increase the number of patients who will go on to accept specialist care.

Adult↗
PubMed1996

Pilot mental health assessment and diversion scheme for an English Metropolitan Petty Sessional Division.

A three-month pilot mental health assessment and diversion scheme was carried out at one of the busiest magistrates' courts outside London. In terms of demographic characteristics the sample of prisoners seen in this study was similar to those seen in diversion schemes in London and Manchester. Although 77 per cent of prisoners were found to be suffering from a psychiatric disorder, almost half were suffering from alcohol or drug dependence or misuse and the number with psychotic illnesses was small compared with the London sample. These differences may be partly due to the earlier diversion of acutely mentally ill prisoners from police custody into the health care system in Leeds. The low rate of psychiatric admission from the pilot scheme largely reflected these differences although in the cases of four patients admission was recommended by the assessing psychiatrist but not effected because of the lack of regional secure beds. Other problems identified by those involved in the scheme were the need for the provision of bail hostels specializing in the care of those with psychiatric difficulties and the need for the involvement of community psychiatric nurses within the assessment and diversion scheme.

Adolescent↗