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Biomedical subjects

M Whelan

Publications and source records attributed to M Whelan.

31 records · Page 2Linked to original sources
PubMed1982

Acromegaly and spinal stenosis. Case report.

Spinal stenosis is a well defined clinical entity that is occasionally encountered in patients with acromegaly. Persistent elevation of growth hormone promotes hypertrophy of the bones and ligaments, resulting in widening of the thoracolumbar vertebral bodies, and developmental narrowing of the spinal canal. This report describes the case of a 54-year-old acromegalic man with a 30-year history of low-back pain. Who developed symptoms of spinal stenosis. This case and two similar cases from the literature are discussed, and the appropriate therapeutic approaches reviewed.

Acromegaly↗
PubMed1979

Management of extracranial carotid stenosis and intracranial aneurysms.

Twenty patients with extracranial carotid stenosis and intracranial aneurysms are reviewed. Fifteen of these patients had transient ischemic attacks (TIA's) and incidental aneurysms. The other five presented with symptoms referrable to an aneurysm, and angiography revealed significant carotid stenosis. None of the patients who presented with TIA's and underwent endarterectomy suffered subarachnoid hemorrhage. However, those patients who presented with symptoms referrable to an aneurysm and underwent endarterectomy seem to be at greater risk for subarachnoid hemorrhage.

Adult↗
PubMedDate not supplied

A new system for sternal intraosseous infusion in adults.

BACKGROUND: Intraosseous (IO) infusion provides an alternative route for the administration of fluids and medications when difficulty with peripheral or central lines is encountered during resuscitation of critically ill and injured patients. OBJECTIVE: To report the first 50 uses of a new system for emergency IO infusion into the sternum in adults, the Pyng F.A.S.T.1 IO infusion system. METHODS: Six emergency departments and five prehospital emergency medical services (EMS) sites in Canada and the United States provided clinical and/or research data on their use of the IO system in a pilot study of success rates, insertion times, and complications. Indications for use included adult patient, urgent need for fluids or medications, and unacceptable delay or inability to achieve standard vascular access. A basic data set was standardized for all sites, and some sites collected additional data. RESULTS: The overall success rate for achieving vascular access with the system was 84%. Success rates were 74% for first-time users, and 95% for experienced users. Failure to achieve vascular access occurred most frequently in patients (5 of 9) described subjectively by the user as "very obese," in whom there was a thick layer of tissue overlying the sternum. Mean time to achieve vascular access was 77 seconds. Flow rates of up to 80 mL/min were reported for gravity drip, and more than 150 mL/min by syringe bolus. Pressure cuffs were also used successfully, although fluid rate was controlled by clamping the line. Further research on flow rates is needed. No complications or complaints were reported at two-month follow-up. CONCLUSION: These early data indicate that sternal IO infusion using the new F.A.S.T.1 IO system may provide rapid, safe vascular access and may be a useful technique for reducing unacceptable delays in the provision of emergency treatment.

Adolescent↗
PubMedDate not supplied

The importance of social histories for assessing sexually transmitted disease risk.

BACKGROUND: Although identifying risk groups for sexually transmitted diseases based on age or race may be useful for targeting screening efforts, clinicians should recognize that even members of most "low-risk" groups include some individuals at higher risk of infection. GOAL OF THIS STUDY: This case series of generally older people with sexually transmitted diseases illustrates how assumptions regarding age and risk group can lead to missed opportunities for sexually transmitted disease prevention. STUDY DESIGN: Records were compiled from two clusters of patients with sexually transmitted diseases seen at a Springfield, Mass., health center between March and September 1992. RESULTS: Nine patients with a sexually transmitted disease (one with syphilis/human immunodeficiency virus co-infection, one with herpes/human immunodeficiency virus co-infection, two with human immunodeficiency virus infections, and five with syphilis) are described. Eight of the patients are linked epidemiologically. CONCLUSIONS: A social history is essential during a medical encounter for sexually transmitted disease prevention purposes. Relying on assumptions regarding risk groups, as well as sexual activity, age, or other medical conditions, may lead to a patient's level of risk of infection going unrecognized. Discomfort associated with asking the sensitive questions involved in a social history also is a barrier to recognizing risks or infections. Non-judgmental sexual histories are appropriate when evaluating all patients.

Adult↗
PubMedDate not supplied

The development and implementation of a hospital safety and sanitation task force.

We have found that the above activities are facilitated by utilizing a computerized filing program. The computer formal provides quick, concise reports and statistical data analysis. The formation catalogued can be easily analysis. The information catalogued can be easily categorized and analyzed. The time invested in organizational meetings concerning committee membership, guideline review and creating an efficient incident coding scheme was essential to the success of the project. Problems seem to arise when several different departments share a common space for different activities. For example, medication room sanitation throughout the hospital was suboptimal probably related to the fact that Nursing, Pharmacy and General Stores all utilized the area. No individual department felt it was their sole responsibility to ensure appropriate sanitation. Through the efforts of the task force, we were able to facilitate cooperation among the departments with each doing their share. As a result, medication rooms are now cleaner, neater and therefore safer. Additional incidents have been corrected since the original tabulation of this report. A priority goal is to facilitate corrective action in a more timely manner. It is critical that surveys should not be intended to be "white glove inspections" with criticisms placed on specific departments. This can be accomplished by informing department managers of the intent of the surveys and by allowing staff to participate in all activities. In addition, the support and cooperation of administration is a major factor in the potential success of a program of this nature. As a result of the interdisciplinary team approach, the general safety environment for patients, visitors, employees and volunteers has significantly been improved at our institution.

Accident Prevention↗
PubMedDate not supplied

Manpower planning.

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Health Planning↗