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Biomedical subjects

L F Walts

Publications and source records attributed to L F Walts.

At least 19 recordsLinked to original sources
PubMed1985

Total hip arthroplasty. An investigation of factors related to postoperative urinary retention.

The predisposing factors to urinary retention in patients undergoing hip arthroplasty were investigated by a review of the charts of 272 patients. Age, sex, surgeon, choice and duration of anesthesia, volume of fluid replacement, and use of postoperative intramuscular narcotics did not correlate significantly with urinary retention. However, urinary retention increased from 24% to 62% with the use of epidural morphine for postoperative pain management.

Age Factors↗
PubMed1982

Tourniquet-induced hypertension.

The anaesthetic records of 600 patients undergoing lower limb surgery were reviewed to determine the frequency of intraoperative arterial hypertension (defined as a 30% incision). The overall frequency of hypertension during operation in 500 patients to whom a tourniquet was applied during surgery was 11%. The probability of hypertension was increased if the patient was elderly, had cardiac enlargement shown by x-ray or e.c.g., or had nitrous oxide and narcotic anaesthesia. Pre-existing hypertension, increased serum creatinine concentration, anaemia, or treatment with antihypertensives, diuretics, or steroids were not strongly associated with intraoperative hypertension. A control group of 100 patients undergoing hip surgery without application of a tourniquet exhibited hypertension in 1% of cases.

Adolescent↗
PubMed1981

Perioperative management of diabetes mellitus.

Hourly plasma glucose concentrations in 191 diabetic patients undergoing 200 operations were measured. The glucose infusion rate was controlled. Insulin-taking diabetics given no insulin or a fraction of their usual dose preoperatively developed rising plasma glucose concentrations beginning with the start of operation. The mean rate was 22 mg.dl-1.h-1 (no insulin) and 17 mg.dl-1.h-1 (one-half to one-fourth the usual dose of insulin). Eight per cent of the patients achieved plasma glucose concentrations greater than 400 mg/dl. Patients given regular insulin during the operation had no hourly rise in plasma glucose. However, hypoglycemia occurred in 5.5 per cent of these patients. The authors suggest that arbitrary management regimens should be abandoned. Plasma glucose levels should be measured frequently and insulin and/or sugar should be given to each patient as needed.

Aged↗
PubMed1980

Vocal cord function following short term endotracheal intubation.

This study was undertaken to determine whether brief periods of vocal cord paralysis might commonly occur as a result of tracheal intubation. The vocal cords of 100 patients were examined prior to and after intubation for operation. Although soft tissue trauma was observed in nearly all patients none had evidence of vocal cord paralysis.

Humans↗
PubMed1976

Azathioprine: effects on neuromuscular transmission.

The neuromuscular effects of azathioprine were examined in the in-vivo cat soleus muscle preparation. In concentrations ranging from 10 to 1,000 mug/kg, administered intra-arterially, the agent caused motor axons to fire repetitively and produced a dose-related increase in the force of contraction. The drug reversed neuromuscular blockage produced by d-tubocurarine and potentiated the neuromuscular blockade produced by succinylcholine. The effects of theophylline, a phosphodiesterase inhibitor, on neuromuscular transmission were identical to those produced by azathioprine. Using an in-vitro assay preparation, azathioprine was found to produce 50 per cent inhibition (IC50) of phosphodiesterase at a concentration of 2 X 10(-5) M. In the same preparation, theophylline had an IC50 of 1 X 10(-4) M. Neither agent in concentrations to 10(-2) M affected cholinesterase activity measured in vitro. It is concluded that the effects of azathioprine on neuromuscular transmission are due to inhibition of phosphodiesterase in the motor nerve terminal.

Animals↗
PubMed1975

Anaesthesia for dwarfs and other patients of pathological small stature.

Sixty-nine anaesthetics were administered to 29 patients of pathological proportionate and disproportionate small stature. The anaesthetic course in most cases was uncomplicated. The few complications noted were similar in type and severity to those found in normal size patients undergoing similar anaesthesia and operative procedures. Achondroplastic dwarfs often develop neurological problems due to their bony deformities. General anaesthesia should be given preferential consideration in these patients. Non-achondroplastic dwarfs may have an associated odontoid dysplasia and if the neck is placed in flexion there is a potential risk of spinal cord damage. Tube size for proportionately small children is best estimated from body weight. No definite recommendations concerning proper tybe size in dwarfs can be given on the basis of the findings in the study.

Achondroplasia↗