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Biomedical subjects

D W Evans

Publications and source records attributed to D W Evans.

At least 19 recordsLinked to original sources
PubMed1992

Maternal emotional reactions to young children with different types of handicaps.

Emotional reactions were examined cross-sectionally over the 1- to 6-year period in mothers of children with Down syndrome (N = 25) and with predominantly motor impairments (N = 20). Mothers rated their degree of concern about 16 early milestones and four events, and were also interviewed with the Vineland Adaptive Behavior Scales. Although milestones occurring during the first year caused higher levels of maternal concern than did later-occurring ones, concern was also evident for some later milestones. Mothers of Down syndrome and of motor-impaired children were equally concerned about motor milestones, but mothers in the Down syndrome group were more concerned about developments in communication. The two groups modulated their maternal concern based on different aspects of the child's communication skills. The timing, specificity, and sensitivity of maternal reactions identified in this study are discussed in relation to the unindirectional, time-bound model of "maternal mourning."

Adaptation, Psychological↗
PubMed1979

Child abuse prevention--implementation within the curriculum.

The number of reported cases of child abuse and neglect is increasing. Most educators are aware of the problem; however, awareness alone has minimal impact on prevention. Specific planning is needed, and this article explores various avenues for including child abuse education as a part of the regular school curriculum. The ultimate goal is to develop educational strategies as one means of preventing abuse when school children grow to adulthood and become parents.

Adult↗
PubMed1979

Age, sex, and ischaemic heart disease as prognostic indicators in long-term cardiac pacing.

The influence of age, sex, and overt ischaemic heart disease on survival after pacing was studied in a population of 427 patients. The median survival for the whole group was 7.75 years. Women between 55 and 74 years and men between 65 and 74 years enjoyed median survivals in excess of 10 years. Patients over 74 years and men with ischaemic heart disease had median survivals of the order of 5 years and 3 1/2 years, respectively. The findings may help to match generator lifetimes to patient-survival prospects.

Adolescent↗
PubMed1979

Coexistence of asymmetric septal hypertrophy and aortic valve disease in adults.

Echocardiography detected asymmetric septal hypertrophy (ASH) in five of 200 adults being assessed for aortic valve surgery. Four of these were among 119 patients with dominant aortic stenosis, which was severe in three. ASH was confirmed at the time of aortic valve replacement in two of these patients; the third declined operation. The finding of ASH in only one of 81 patients with free aortic reflux is consistent with chance association. While the same explanation could apply to the higher prevalence in those with aortic stenosis, it may be that a long-standing pressure overload can trigger inappropriate septal hypertrophy in predisposed individuals.

Adolescent↗
PubMed1979

Persistent lone atrial fibrillation--its prognosis after clinical diagnosis.

Eighty-three patients whose atrial fibrillation appeared to be permanent and the sole cardiac abnormality at the time of diagnosis were followed for one to 19 years (mean 7.5 years). None suffered systemic embolism. Three died, none of cardiac disease. Sinus rhythm returned in seven. Another six developed features suggestive of other heart disease. In the remaining 67, the initial diagnosis of persistent lone atrial fibrillation remained tenable and they remained well.The medium-term prognosis for patients with this disorder seems good.

Aged↗
PubMed1977

Hyperventilation: An important cause of pseudoangina.

50 patients initially referred to a cardiac clinic for confirmation or exclusion of angina were found to be habitual hyperventilators. 13 of them also had some organic heart disease. Simple physiotherapy aimed at restoring a normal breathing pattern proved an effective treatment, 76% of those followed for 11-68 months being symptom-free.

Adult↗
PubMed1976

Echocardiographic assessment of mitral valve calcification.

The mitral valve was assessed by echocardiography in 20 patients, aged 27 to 67 years, who subsequently underwent mitral valve replacement. After removal, the mitral valve cusps were examined by direct measurement, radiography, and quantitative calcium extraction. Increased thickness of the E-F echo was found where calcification or fibrosis was present, differentiation by echocardiography alone being unreliable. However, multiple dense parallel E-F echoes were found in all 10 patients with more than 80 milligrammes of calcium in the valve, while a single thin E-F echo indicated the absence of significant calcification or fibrosis.

Adult↗
PubMed1976

Analysis of time intervals involved in admission to a coronary care unit.

Time intervals between the onset of the presenting symptom (chest pain) and arrival in a coronary care unit were studied for 221 admissions arranged by conventional means. The median figure for "patient delay" was 60 minutes, for "general-practitioner delay" 20 minutes, for "ambulance delay" 30 minutes, and for "transit delay" 30 minutes. The median "total delay" was three hours 30 minutes.Only 4.5 per cent of the patients were under intensive coronary care within one hour, the time of the highest mortality risk. A mobile coronary service should be capable of increasing the proportion of patients brought under special care within the first hour, but the time taken by the patient to realise the nature of the emergency and summon aid is likely to remain the most critical factor.

Adult↗
PubMed1975

Intravenous urography in investigation of hypertension.

Eighty intravenous pyelograms, carried out as part of the routine investigation of hypertension, revealed only one unsuspected renal lesion of possible relevance to the long-term management. Such a low therapeutic return, in the light of its cost and not entirely negligible risk, raises doubts about the place of excretion urography amongst the screening tests aimed at discovering tractable underlying causes of hypertension.

Adult↗
PubMed1975

Echocardiographic left ventricular dimensions in pressure and volume overload. Their use in assessing aortic stenosis.

Left ventricular 'relative wall thickness', determined from the ratio between echocardiographic measurements of end-systolic wall thickness and cavity transverse dimension, was related to peak systolic intraventricular pressure in 15 normal subjects, in 15 patients with left ventricular volume or pressure overload without aortic stenosis, and in 23 patients with aortic stenosis. All these patients had a mean rate of circumferential fibre shortening greater than 1.0 circumference per second and were regarded as having good ventricular function. Relative wall thickness was found to be normal in cases of volume overload and to be increased in pressure overload, being proportional to the systolic intraventricular pressure. Values for the ratio of systolic intraventricular pressure to relative wall thickness in the normal subjects and patients without aortic stenosis were similar (mean 30 +/- 2.5). Based on this relation, estimates of peak systolic intraventricular pressure were made in the cases of aortic stenosis using the formula: systolic intraventricular pressure (kPa) equals 30 x wall thicknes divided by transverse dimension. Peak systolic aortic value gradients derived by subtracting brachial artery systolic pressure, measured by sphygmomanometer, from the echocardiographic estimates of intraventricular pressure compared favourably with the gradients measured at left heart catheterization (r equals 0.87, P less than 0.001). Aortic value orifice areas, derived from echocardiographic estimates of stroke volume, ejection time, and value gradient, ranged from 0.21 to 3.16 cm2 and appeared to correlate with the severity of aortic stenosis. All patients with aortic stenosis, with or without coexistent mild aortic regurgitation, who were recommended for aortic valve surgery, had estimated valve orifice areas of less than 0.8 cm2. A further 10 patients with pressure or volume overload had mean rates of circumferential fibre shortening of less than 1.0 circumference per second and were regarded as having poor ventricular function. In these cases values for relative wall thickness were lower than in those with good ventricular function and were not proportional to systolic intraventricular pressure. In patients with good left ventricular function systolic intraventricular pressure is proportional to, and can be estimated from, echocardiographic measurement of relative wall thickness.

Adolescent↗