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Biomedical subjects

W H Replogle

Publications and source records attributed to W H Replogle.

17 recordsLinked to original sources
PubMed1999

Endoscopic-assisted adenoidectomy.

Adenoidectomy is a commonly performed procedure. The advent of endoscopic sinus surgery has popularized the use of endoscopes. Endoscopic-assisted adenoidectomy (EAA) is a natural progression of this technology to allow a more complete adenoidectomy. Two hundred thirty-six patients undergoing adenoidectomy were evaluated with an endoscopic technique. A routine transoral adenoidectomy was performed first. Then a 4-mm 0 degrees telescope was used transnasally, and residual adenoid tissue was removed from the anterior superior nasopharynx. Invariably, residual adenoid tissue was found after transoral adenoidectomy. The EAA technique is minimally invasive, adds less than 5 minutes to the procedure, and is not associated with excessive bleeding. Readily available telescope and endoscopic equipment is used. The EAA technique is advocated for use as an adjunct to a more complete adenoidectomy.

Adenoidectomy↗
PubMed1996

Halitosis.

Although halitosis is generally thought of as a social handicap related to poor oral hygiene or disease of the oral cavity, it may also indicate a serious systemic illness that requires diagnosis and treatment. Halitosis can be the result of pathologic or nonpathologic factors, both local systemic. A complete physical examination, with laboratory and radiographic studies as indicated by the history and physical examination, will generally identify a treatable cause for halitosis. Treatment is directed at the underlying cause. Simple measures, including careful oral hygiene, may be employed to lessen breath odor.

Adolescent↗
PubMed1994

Efficacy of sliding-scale insulin therapy: a comparison with prospective regimens.

OBJECTIVE: To compare the efficacy of retroactive sliding-scale insulin therapy, proactive therapy, and a combination of the two methods in establishing glycemic control in hospitalized diabetic patients. METHODS: Medical records of 47 diabetic ketoacidosis inpatients were reviewed retrospectively. RESULTS: The sliding-scale insulin therapy group's glucose deviation score (167.4) was significantly higher than the deviation for the proactive (112.9) and combination (121.3) groups. The sliding-scale insulin therapy group also had a significantly higher median glucose value (262.5) than the proactive (199.9) and combination (221.2) groups as well as a significantly higher number of nursing shifts (0.70) in which a glucose of 250 mg/dl or greater was recorded than in the proactive (0.37) and combination (0.40) groups. The proactive group was on their treatment regimen significantly less time than the combination group (5.5 vs 10.4 nursing shifts, respectively). The proactive group was hospitalized significantly fewer days (4.4) than the combination (6.3) and sliding-scale insulin therapy (6.3) groups. CONCLUSIONS: The present study lends support to previous concerns that sliding-scale insulin therapy is less effective than preventive therapy in the management of hospitalized diabetic patients.

Acid-Base Equilibrium↗
PubMed1994

Clinical evaluation for colonic polyps: usefulness of signs and symptoms in diagnosis.

This article reports a prospective cross-sectional study of the relationship between various signs and symptoms commonly ascribed to colorectal cancer and the presence or absence of colonic polyps found by colonoscopic examination. Of the 166 patients who participated in the study, 96 were positive for colonic polyps and 70 were negative. There was a significant increase in risk for adenomas polyps as age increased among males. For females, the step-wise logistic regression indicated that an absence of abdominal pain/cramping (p < .01), a change in stool shape (p < .01), and a history of colorectal polyps (undifferentiated) in first-degree relatives (p < .05) were associated with adenomatous polyps.

Colonic Polyps↗
PubMed1994

Fatigue: a new approach to an old problem.

Previous research regarding the fatigued patient has dealt primarily with the diagnostic labels applied by physicians, rather than specific presenting symptoms of the fatigued patient. The purpose of the present study was to identify, based on presenting symptoms, gender, marital status, and race, relatively homogeneous sub-groups within a sample of fatigued patients that would aid in the diagnosis and treatment of the underlying disorder(s). Results of cluster analysis suggested the presence of an Organic, Anxiety, Depression, and Mixed Anxiety/Depression group within the sample of 197 fatigued patients. Significant differences among these four groups were found on 13 of the 15 symptoms included in the cluster analysis. The proportion of males, married patients, and white patients in the Organic Group was significantly greater than in the other three inorganic clusters as a whole. Positive or negative responses to these 13 symptoms can facilitate the diagnosis and treatment of the fatigued patient.

Adolescent↗
PubMed1993

Practice and attitudes of primary care physicians in a rural southern state concerning HIV/AIDS patients.

In preparing for the development of a plan of care for persons with AIDS and other HIV related conditions, the HIV Services Planning Program, a joint effort of the Department of Family Medicine of the University of Mississippi Medical Center and the Bureau of Preventive Health of the Mississippi State Department of Health, conducted a survey of all primary care physicians throughout the state of Mississippi. The purpose of the survey was to determine health care services provided to persons with HIV/AIDS. Specific areas of interest included: (a) type of medical specialty; (b) location of primary practice; (c) services provided for persons with HIV/AIDS; and (d) utilization of universal blood and body fluid precautions, i.e., barrier techniques. Descriptive statistics were utilized in analyzing responses.

Acquired Immunodeficiency Syndrome↗
PubMed1993

An assessment of obstetric services in Mississippi.

Seven hundred and six (80.6% response rate) obstetricians, family physicians, and general practitioners responded to a survey designed to elicit information regarding their obstetric practice. Results of the study were compared to a similar survey conducted in 1985. The proportion of obstetricians offering obstetric care has remained relatively constant since 1985. Among family physicians and general practitioners, however, there was a significant decrease in the proportion who practice obstetrics (p < .01), and a significant increase in the proportion who have discontinued obstetric practice in the last five years (p < .01) and who plan to discontinue obstetric care in the next five years (p < .05). Consistent with the 1985 data, cost of malpractice insurance, threat of litigation, and time demand were the three most frequently reasons for discontinuing obstetric care. Without changes in the current system, the provision of obstetric care in rural areas will continue its current dramatic decline.

Adult↗
PubMed1991

The Cytobrush effect on Pap smear adequacy.

One hundred twenty-four Papanicolaou smears were studied to compare the yield of endocervical cells obtained with the Cytobrush/Ayre spatula method to that of the cotton-tipped applicator/Ayre spatula method. Forty-nine of the 62 Pap smears (79%) obtained with the combination Cytobrush/Ayre spatula method contained endocervical cells, compared to 22 of the 62 smears (35%) obtained with the cotton swab/Ayre spatula method (chi 2 = 24.02, P less than 0.0001). The Cytobrush/Ayre spatula method obtained endocervical cells in 14 of 17 (82.4%) of the patients with stenotic ora, compared to 0 of 12 (0%) patients for the cotton swab/Ayre spatula method (P less than 0.001). The Cytobrush/Ayre spatula method obtained endocervical cells in 8 of 11 (72.7%) postmenopausal patients, compared to 4 of 14 (28.6%) patients for the cotton swab/Ayre spatula method (P = 0.05). Using the cervical Cytobrush for Pap smears increases the recovery rate of endocervical cells, which may improve the detection of cervical dysplasia in the patient population as a whole, in postmenopausal women, and in women with stenotic cervical ora.

Adult↗
PubMed1988

Scuba diving injuries.

Scuba diving has become increasingly popular, and family physicians may encounter patients who have been injured in a dive. Manifestations of diving injuries may not occur until 12 hours or more after a dive. Initial treatment, based on knowledge of the pathophysiology of decompression sickness, lung expansion injuries and ear barotrauma, may prevent severe and permanent sequelae. Decompression sickness and air embolism are medical emergencies.

Air Pressure↗
PubMedDate not supplied

Chaperone use in primary care.

Two recently published surveys showed that a significant number of male adolescent medicine specialists performed unchaperoned pelvic examinations. Since this is a surprising finding, primary care physicians in Mississippi were surveyed to assess their use of chaperones during patient examinations. The survey found that male physicians typically did use chaperones for pelvic examinations. The frequency of chaperone use among male physicians when performing pelvic examinations did not vary by physician specialty. There was considerable variability in chaperone use by female physicians for both male and female patients.

Adolescent↗