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W Myers

Publications and source records attributed to W Myers.

31 records · Page 2Linked to original sources

Multivariate discriminant analysis of the clinical and angiographic predictors of operative mortality from the Collaborative Study in Coronary Artery Surgery (CASS).

The Collaborative Study in Coronary Artery Surgery (CASS) is a large multi-institutional study of the medical and surgical treatment of coronary artery disease (CAD). Fifteen cooperating institutes have carried out isolated coronary artery bypass grafting (CABG) on 6,176 patients from August, 1975, through December, 1978. The operative mortality (OM) was 2.3%. In an effort to better understand the clinical and angiographic characteristics predictive of OM, we have done a multivariate discriminant analysis of variables associated with OM. Numerous clinical and angiographic variables were selected from the CASS data file and evaluated in a univariate manner for their relationship to OM. Twenty of these variables were then selected for multivariate discriminant analysis. Clinical variables of most predictive value were age, female sex, increased heart size, and congestive heart failure (CHF). Angiographic variables of importance included left ventricular wall motion abnormalities, and left main coronary disease (LMCD). The priority of operation (elective, urgent, or emergent) was also associated with OM. Six variables that contained the most predictive information were selected by discriminant analysis for a group of 6,176 patients who had isolated bypass operations. In descending order of importance they were age, left main coronary artery stenosis greater than or equal to 90%, female sex, left ventricular wall motion score, left ventricular end-diastolic pressure (LVEDP), and râles. Five other groups or subgroups of patients were also analyzed in a similar manner. There is a strong association of OM with advanced age, female sex, and variables associated with left ventricular dysfunction. The risk of OM for an individual patient may be estimated with the use of these clinical and angiographic characteristics.

Adult↗

Absence of parasympathetic denervation of the iris in alcoholics.

Forty patients with a history of alcohol abuse were treated with a 2% solution of methacholine to determine the prevalence of iridic parasympathetic denervation. Three (8%) of the alcoholics showed iris constriction of 1.0 mm or more, compared with three (8%) control subjects. In contrast, damage to the iridic parasympathetic nerve supply occurs in approximately 80% of patients with diabetes mellitus as determined by the same pharmacological technique.

Alcoholism↗

Dreams deferred.

Explore the source record for details and available documents.

Educational Measurement↗

Smoke inhalation and airway management at a regional burn unit: 1974-1983. Part I: Diagnosis and consequences of smoke inhalation.

Victims of smoke inhalation with and without burns and burn patients with respiratory insufficiency for reasons other than smoke at a regional burn unit are profiled in terms of age, burn size, length of stay, and mortality. The diagnostic characteristics of patients with an inhalation injury (N = 108) are listed; 7% of all patients (N = 52) have known smoke exposure with equivocal evidence for injury to the airway or pulmonary parenchyma. The degree of respiratory (visceral) failure experienced by patients with inhalation injury is not uniformly severe. Many of the clues to this diagnosis are indirect and not always related to the severity of pulmonary injury. Timing and degree of visceral failure control the severity of the injury, which increases progressively from that in patients with a burn only (parietal injury) through those with a visceral injury only (smoke without burn), those with both smoke and burn, to those with a burn and uniformly severe respiratory failure on the basis of sepsis.

Adult↗

Smoke inhalation and airway management at a regional burn unit: 1974 to 1983. II. Airway management.

According to criteria established to define patients with smoke inhalation, the airway management of all victims of smoke and burns (1974 to 1984; n = 805) was reviewed. Fourteen percent of all patients were intubated (n = 117); patients intubated on the day of injury (n = 41) were more likely to extubate themselves or have technical problems with the endotracheal tube. Twelve percent of patients with smoke inhalation without burns required endotracheal intubation versus 62% of those with burns. An endotracheal tube was required for a median of 5 days. Tracheotomies were performed in 48 patients: 40% of those intubated and 6% of all patients. The mean postburn day for tracheotomy was day 15. There was no difference in the mortality rate for patients with an endotracheal tube only and those who had a tracheotomy as well: 42% and 37%, respectively. The prolonged length of stay for patients with a tracheotomy relates to the severity of the burn. Tracheotomy was not the cause of death in any patient. The strategy of grafting the neck before tracheotomy was used successfully in eight patients.

Adolescent↗

Primary and secondary orbital teratomas.

Two patients with primary teratomas of the orbit and a third patient with a teratoma invading the orbit from the maxillary sinus are presented. The clinical presentation of each patient was spectacular. In the primary teratomas, the globe was displaced out of the orbit by the attached tumor, causing extreme proptosis. Computed tomography was virtually diagnostic, showing a variegated orbital mass with solid and cystic components. Histologic examination showed multiple tissues derived from two or three germinal layers. The surgical removal of the tumors and reasons for the poor visual outcome are discussed. The appearance of teratomas in the orbit and other cephalic structures appears to arise from the survival and proliferation of germ cells deposited there during embryogenesis.

Female↗

Selected soft tissue malignancies of the foot: an in-depth study with case reports.

Soft tissue malignancies represent a diagnostic and therapeutic challenge to the podiatric physician. In order to improve prognosis and increase survival rates of affected patients, prompt clinical and histologic recognition of suspect lesions is necessary. Here we present information and case reports on selected soft tissue malignancies including Kaposi's sarcoma, malignant melanoma, synovial sarcoma, and epithelioid sarcoma to aid the practitioner in recognizing these serious lesions that occur in the foot.

Acquired Immunodeficiency Syndrome↗