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Biomedical subjects

F S Pettyjohn

Publications and source records attributed to F S Pettyjohn.

13 recordsLinked to original sources
PubMed1995

Warfarin sodium-induced skin necrosis.

Skin necrosis is a rare complication of treatment with coumarin derivatives. Since it was first identified by Verhagen in 1952, approximately 200 cases of skin necrosis have been reported worldwide, but only 73 have been reported in the English language literature. A telltale clinical scenario of pain and petechiae progressing to sharply demarcated ecchymosis, bullae formation, and gangrenous necrosis manifests most often in the adipose tissues of middle-aged women. Necrosis usually appears within 3 to 6 days of the initiation of warfarin sodium therapy. We report a case of cutaneous necrosis that began 46 days after warfarin sodium therapy was begun.

Adipose Tissue↗
PubMed1995

Pseudohypertension.

The purpose of this review is to integrate information available regarding pseudohypertension. A MEDLINE search (1966 to December 1993) was conducted using the key words pseudohypertension and Osler's maneuver. All articles containing reference to pseudohypertension were selected and reviewed. Additional articles were obtained from the citations included within these articles. Quantitative information from each reference was reviewed to derive qualitative statements about new perspectives on the pathophysiology and evaluation of pseudohypertension. The prevalence of pseudohypertension is unknown but probably increases with advancing age. Diagnosis requires a high index of suspicion. Demographic information has not been shown to be useful for identifying patients with pseudohypertension. Symptoms of postural hypotension despite antihypertensive therapy, treatment-resistant hypertension, and the absence of end-organ effects in long-standing "hypertension" are clinical features that suggest pseudohypertension. Automatic infrasonic blood pressure measurements may offer more accurate estimates of intra-arterial blood pressure than indirect sphygmomanometry in patients with these clinical features.

Algorithms↗
PubMed1985

Intracardiac electrophysiologic studies in the medical evaluation of aviators.

Ten aviators with cardiac symptoms or electrocardiographic abnormalities underwent electrophysiologic testing. Four patients were studied because of symptoms including palpitations, nearsyncope, and sudden cardiac death. Six patients were studied because of electrocardiographic abnormalities including AV block, right bundle branch block, sinus bradycardia, ventricular tachycardia, and questionable Wolff-Parkinson-White syndrome. Three patients with bradycardia and/or AV block were found to have increased vagal tone. A fourth patient had nearsyncope and intra-Hisian block. Of four patients evaluated for palpitations and/or tachycardias; one had nonsustained ventricular tachycardia; one had easily inducible ventricular tachycardia and fibrillation; one had a normal study, and one had coronary artery disease with an unanticipated prolonged HV interval. The diagnosis of congenital right bundle branch block and Wolff-Parkinson-White syndrome were confirmed in the final two patents. Performance of electrophysiologic testing provided objective data to allow appropriate therapeutic and administrative decisions in these aviators.

Adult↗
PubMed1977

Joint Committee on Aviation Pathology: XIII. Sarcoid and the heart--an aeromedical risk.

Sarcoid lesions of the heart are reported in 13% to 20% of sarcoidosis patients. Sudden death and ventricular arrhythmias occur in 40% to 50%. In view of this frequency and life-threatening significance, review of military aircrew with documented sarcoidosis for myocardial involvement was undertaken. Case records were available for 11 US Army, 19 US Air Force, and 6 US Navy patients. Four patients (11%) had significant cardiac abnormalities to include sustained ventricular arrhythmias, and acquired anteroseptal infarction pattern by ECG with nomal coronary angiography. ECG abnormalities were found in eight additional patients. Suspected involvement of the heart in 33% of this series warrants complete cardiovascular evaluation of the sarcoid patient prior to return to flying duties. A case report demonstrates the difficulty in evaluating ECG abnormalities in the antemortem diagnosis of sarcoid heart disease.

Adult↗
PubMed1976

Prehospital use of the military anti-shock trouser (MAST).

Complications of prehospital use of the military anti-shock trouser (MAST) in treating hypotensive and hypovolemic patients have been few and minor. Undesirable consequences--compromised respiratory excursion or autonomic disturbances such as emesis, urination or defecation--were rare. Forty-seven (88.7%) of 53 patients with conditions classed as potentially lethal or severe survived. Close communications between prehospital and emergency department personnel can assure accurate transmission of circumstances of MAST application and result in optimal responses and improved inhospital patient care. Both "false positives" (supposed initial hypotension or hypovolemia) and "false negatives" (seeming stability in the face of major anatomic derangements) require a carefully structured operational sequence. Further evaluation of the device, particularly in cardiovascular/cardiopulmonary cases, is in progress.

Allied Health Personnel↗
PubMed1975

Coronary artery disease and preventive cardiology in aviation medicine.

A review of 6,500 autopsied cases on record at the Armed Forces Institute of Pathology of deaths occurring in aircraft accidents or mishaps revealed that 816 cases (13%) had been diagnosed as heart disease other than traumatic (i.e., pre-existing at the time of the accident). Of these 816 cases (592 military and 135 civilian), 89.1% had atherosclerotic coronary artery disease (CAD). This autopsy series compared the severity of CAD, year of death, and crew position within the military 5-year age groups. CAD was found in 86.6% of the 20- to 34-year-old military group. Moderate and severe CAD was present in 17.1%. CAD in previous autopsy studies of U.S. military casualties in the Korean and Vietnam conflicts was reported as 77.3% and 45%, respectively. Study of severe and moderate CAD by year of death in the 20- to 34-year age group demonstrates 26.2% in 1965-1969 and 21.1% in 1970-74. These findings do not support the conclusion of the Vietnam autopsy study that CAD is decreasing. Preventive and predictive cardiology in aviation medicine should be instituted early and aggressively in the young aircrew population.

Accidents, Aviation↗