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Biomedical subjects

M L Walker

Publications and source records attributed to M L Walker.

At least 109 records · Page 6Linked to original sources
PubMed1982

Spinal dysraphia as an autosomal dominant defect in four families.

Four families were selected randomly on the basis of the occurrence of spina-bifida cystica and/or spina bifida occulta in one or more family members. Sixty-three relatives were studied clinically and roentgenologically; their roentgenograms were evaluated blindly. Twenty-eight were clinically and roentgenologically normal; 35 were diagnosed as having spina bifida occulta (SBO), spina bifida cystica (SBC), vertebral anomalies, and/or external defects usually interpreted as evidence for SBO. Excluding one proband we found the frequency of SBO to be 19/51 (37%) and the frequency of all types of spinal/vertebral defects (excluding five probands) to be 30/58 (52%). The distribution of these defects in the four families was analyzed using likelihood methods corrected for random ascertainment. The log likelihood values for sporadic, recessive, and dominant models were -26.69, -20.95, and -18.90, respectively, indicating a higher likelihood of autosomal dominant inheritance than sporadic occurrence or recessive inheritance. The penetrance probability in this dominant model, estimated by maximum likelihood, is 0.749 +/- 0.100. Further examination of these data suggest that SBO and SBC represent different expressions of the same dominant gene in these kindreds.

Female↗
PubMed1982

Emergency intracranial pressure monitoring in pediatrics: management of the acute coma of brain insult.

Over an 18-month period, 56 pediatric patients who sustained severe neurologic insults underwent intracranial pressure (ICP) monitoring. Indications for monitoring ICP were (1) a Glasgow Coma Scale (GCS) score of 7 or less or (2) loss of consciousness with inability to utter recognizable words or follow commands. Diagnoses were head trauma (n = 40), Reye's syndrome (n = 10), and hypoxic encephalopathy due to near-drowning (n = 6). Eighty per cent of patients had ICP elevations requiring treatment. The complication rate was 5.3 per cent, with no serious complications or infections noted. Overall mortality was 14 per cent, but patients with hypoxic encephalopathy had significantly higher mortality (33%) when compared to patients with head trauma (12.5%) or Reye's syndrome (10%). Other factors associated with a poor outcome included presence of an intracranial mass lesion, GCS score, ICP elevations, hypoxemia, hypotension, hypercarbia, and the presence of multiple injuries (p less than 0.01). Early diagnosis and aggressive treatment in these patients, including the use of ICP monitoring, has resulted in acceptable recovery in over 85 per cent of these patients.

Acute Disease↗
PubMed1982

Reproductive performance in capture-acclimated female rhesus monkeys (Macaca mulatta).

Behavioral and physiological data were collected over a three-year period on a colony of compound-housed rhesus monkeys (Macaca mulatta) to examine endocrine influences on sexual behavior. The reproductive performance of the experimental animals was compared to controls which were not routinely handled. The groups did not differ significantly with regard to the percentage of conceptions or other parameters of reproductive biology. The demonstration that manipulations attendant to data collection did not jeopardize reproductive success has important implications for research on primate colonies which are maintained primarily for breeding purposes. Additionally, female copulatory behavior was found to be a reliable indicator of ovulation which allows for an accurate prediction of the parturition date.

Acclimatization↗
PubMed1981

Causes of morbidity and mortality in severe pediatric trauma.

In a two-year period, we studied 160 patients with multiple trauma (injury to at least two body areas) and graded severity of neurologic injury according to the Glasgow Coma Scale. Injuries to other body areas were categorized by the Modified Injury Severity Scale. Neurologic injury was present in nearly 80% and constituted the most severe injury in 60%. Chest (40%) and extremity (30%) injuries were next most frequently encountered. Overall mortality was 13.8%, with 11.3% disability and 74.3% of patients achieving good recovery. There was some degree of neurologic injury in all patients who died or were disabled. Among all patients with head injuries (126), mortality was 16%, vs 6% in those without head injury (34). Other deaths were caused by chest (9%) or abdominal (14.5%) injuries.

Accidents, Home↗
PubMed1981

Subspecies differences in curiosity and general activity for developing squirrel monkeys.

Curiosity and general activity characteristics in different squirrel monkey (Saimiri sciureus) phenotypes were assessed. Ten infant squirrel monkeys, representing 2 subspecies (Bolivian and Colombian) and both genders, were observed on 4 testing sessions during which novel and familiar objects were presented to each subject. No consistent object-contact differences were found between subspecies or genders, but significant subspecies differences were found for the amount of time during each trial that the subjects climbed, remained stationary, vocalized, and showed abnormal behaviors. Familiar objects were handled most often, whereas novel objects that were shiny or yellow were moderately preferred.

Animals↗
PubMed1981

Medical student acquisition and retention of communication and interviewing skills.

Medical students' interpersonal and communication skills were assessed over the course of their first two years of medical training. During the first year, students participated in a nine-week course designed to develop effective interviewing skills. On the average, students improved significantly on two standardized measures of communication and discrimination skills as a result of this training. Upon completion of this course, the students conducted a videotaped interview with "screened patients," persons trained in interviewing skills. Evaluation of these videotapes indicated a level of performance commensurate with performance on the written measures. A similar interview was conducted about one year after the first " screened patient" interview to assess retention of these skills. Results of the first and second video analyses indicated a significant decline in student process-oriented skills. These findings indicate that effective interviewing and communication skills can be not only learned but also forgotten.

Communication↗
PubMed1981

Effect of multiple trauma on outcome of pediatric patients with neurologic injuries.

In a 3-year period, 95 patients with severe head injury (unconsciousness greater than 6h duration) were treated at our institution. Of these, 46 patients (48%) had isolated head injury and 49 (52%) had head injury plus severe multiple trauma. Multiple trauma was scored using the Modified Injury Severity Scale. All patients in the multiple trauma group had at least one additional area of severe injury. Severity of head injury, judged by Glasgow Coma Score, presence of mass lesions, abnormal posturing or flaccidity, impaired or absent oculocephalic reflexes, and fixed, dilated pupils, was much greater in the isolated head injury group. In spite of this, poor outcome (death or vegetative/severe disability) was 2 1/2 times as frequent in the multiple trauma group. Shock, refractory hypoxemia and sepsis were contributing factors in this increased morbidity and mortality. Increasing Modified Injury Severity Scale scores were associated with increased morbidity and mortality.

Adolescent↗
PubMed1976

The quality of caring.

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Professional-Patient Relations↗