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Biomedical subjects

R S Fowler

Publications and source records attributed to R S Fowler.

At least 37 records · Page 2Linked to original sources
PubMed1980

Kinesthetic biofeedback: a treatment modality for elbow range of motion in hemiplegia.

Two treatment modalities for increasing active elbow extension with hemiplegic subjects were tested. Twenty subjects were randomly assigned to one of two treatment groups--an experimental treatment technique using kinesthetic biofeedback, or a control group consisting of an occupational therapy approach aimed at increasing functional use of the envolved upper extremity. The results indicate that kinesthetic biofeedback was as beneficial as conventional occupational therapy. It was also demonstrated that an individual's age, sex, or length of time beyond one-year post-CVA did not significantly affect treatment outcome. A majority of subjects in both treatment groups improved in ways not directly related to treatment, which suggests the need for long-term follow up of hemiplegic patients.

Adult↗
PubMed1980

Tricuspid atresia, transposition of the great arteries, and banded pulmonary artery. Repair by arterial switch, coronary artery reimplantation, and right atrioventricular valved conduit.

A 14-year-old boy with tricuspid atresia, transposition of the great arteries, and previous pulmonary artery banding underwent repair by arterial switch procedure with coronary arterial reimplantation, plus connection of the right atrium and ventricle with a valved conduit. Pre- and postoperative hemodynamic and angiographic investigations are presented with comments on operative technique and the rationale for this unique operation.

Adolescent↗
PubMed1977

A simple method for ECG and VCG assessment of the severity of pulmonary valve stenosis.

In patients with isolated pulmonary valve stenosis, the right ventricular (RV) hypertrophy is related to the hemodynamic severity of their lesions. We estimated the peak RV pressure noninvasively in 112 patients with isolated pulmonary valve stenosis by a Frank lead vectorcardiogram (VCG), an orthogonal electrocardiogram (ECG), and a standard scalar ECG. In 78 randomly assigned patients, 10 ECG measurements and 13 VCG measurements were correlated with the peak RV pressure at cardiac catheterization; the best multiple linear regression equation used the R wave in standard lead 1 (ECG), maximal rightward voltage in the terminal part of the frontal vector loop (VCG), and the Q wave in the orthogonal Z lead, giving R = 0.66 (SEM 25). The equation was validated in the other 34 patients; correlation of estimated with actual peak RV pressure was r = 0.64. A nomogram for clinical use was devised from this regression equation.

Adolescent↗
PubMed1976

Mucocutaneous lymph node syndrome with coronary artery aneurysm.

A white North American girl with clinical features of the mucocutaneous lymph node syndrome had a myocardial infarct and angiographic evidence of a coronary artery aneurysm and mitral regurgitation. The mucocutaneous lymph node syndrome has been extensively diagnosed in Japan in recent years. It appears to be a distinct entity, although not precisely separated from polyarteritis nodosa in childhood. The condition may be more common than previously realized.

Aneurysm↗
PubMed1976

Tricuspid atresia: results of treatment in 160 children.

Experience in managing 160 patients with tricuspid atresia is reviewed. The majority of these children require operative treatment in the 1st year of life. Clinical management of this rather complex anomaly is simplified by classifying each child according to total pulmonary blood flow. An overall plan of management for patients with decreased pulmonary flow is suggested. This consists of a Potts shunt as an initial procedure, limiting its anastomotic growth so that pulmonary flow becomes inadequate at age 10 to 12 years. A Glenn anastomosis is then constructed as the second procedue. The Fontan procedure should be considered carefully as an alternative to the Glenn anastomosis in these older children. Children with increased pulmonary blood flow and transposition of the great arteries are likely to require pulmonary arterial banding in infancy. Otherwise, patients in this smaller group are managed with the same overall plan. Results of long-term palliation have been good.

Adolescent↗
PubMed1975

Sudden unexpected death in children with congenital heart disease.

Of 18,000 children with organic heart disease evaluated at The Hospital for Sick Children, Toronto between 1940 and 1971, 33 died suddenly and unexpectedly between 1 and 21 years of age. Nine had discrete obstruction of the left ventricular outflow tract and five had muscular narrowing of the left ventricular outflow tract and five had muscular narrowing of the left ventricular outflow tract. Pulmonary vascular disease caused seven sudden deaths, and arrhythmias (usually due to atrioventricular block) caused seven more. Of the five other children who died suddenly three had transposition of the great arteries, one had a complex cyanotic heart defect and one had an anomalous course of the left coronary artery, which originated from the right sinus of Valsalva. With earlier investigation of aortic stenosis, earlier closure of ventricular septal defect to avoid pulmonary vascular disease, better design of artificial pacemakers and better investigation of patients with angina, many of these deaths will be avoided in the future.

Adolescent↗
PubMed1975

Stroke: Does rehabilitation affect outcome?

A sample of 114 consecutive stroke admissions to a rehabilitation center was studied statistically to determine functional gains achieved and retained after rehabilitation. In order to provide a measure of function, a functional profile was developed that evaluates seven activities, each according to a five-point scale. It was found that significant gains were achieved which could not be attributed merely to spontaneous recovery. An estimate of the cost benefit ratio showed that the reduced cost resulting from returning patients to the family or to independent living more than paid for the cost of providing rehabilitation services to the whole sample.

Activities of Daily Living↗
PubMed1975

Stroke rehabilitation: Outcome and prediction.

Predictors of functional outcome were developed in a group of 114 stroke patients consecutively admitted to a tertiary rehabilitation center. These predictors included a pool of medical data, the age of the patient, psychological tests and the patient's educational level. None of these predictor items showed a correlation with outcome high enough to allow precise prediction of individual outcome. They did, however, provide general indicators for those patients with severe functional impairment who are more likely to gain from a rehabilitation program. The group of medical predictors indicated that a patient with a more extensive, severe lesion, with signs of congestive heart failure, generalized arteriosclerosis, gross perceptual deficit, a lower level of education, and who is older, is less likely to improve in the rehabilitation program. Since a prediction on an individual basis was not possible, it was concluded that even the most severely involved patient should be provided with a therapeutic rehabilitation trial. There was no correlation between severity of the functional impairment at admission and the gains obtained in the rehabilitation program. The same predictors were used to predict whether the patient went home or to an institution. It was found that family income and involvement in support of the patient predicted this outcome, whereas medical data did not. Since family involvement can sometimes be changed by a therapeutic team, this predictor may also present a major target for therapeutic intervention.

Age Factors↗