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Biomedical subjects

W K McNabney

Publications and source records attributed to W K McNabney.

8 recordsLinked to original sources
PubMed1992

The role of early surgical intervention in civilian gunshot wounds to the head.

Surgical management of gunshot wounds of the head has remained a controversial issue in the care of civilian patients. In an attempt to determine who might benefit from aggressive surgical intervention, we examined 89 patients over a 3-year period who had suffered cranial gunshot wounds and had at least one computed tomographic scan of the head after admission. Patients were divided into those receiving early (less than 24 hours) surgical intervention (ES, n = 27), late (greater than 24 hours) surgical intervention (LS, n = 6) or no surgical intervention (NS, n = 56). Overall mortality was 63%. Ten of 27 patients (37%) in the ES group died compared with 46 of 56 patients (82%) in the NS group (p less than 0.0001). Glasgow Coma Scale (GCS) scores in the ES group averaged 7.86 +/- 4.72 and in the NS group 5.59 +/- 4.42 (p less than 0.05). The GCS scores in the LS group (all of whom survived) were significantly higher than those of the other two groups, 12.17 +/- 4.10. The number of patients with GCS scores of 3 or 4 on admission was significantly less in the ES (41%) than in the NS group (66%, p = 0.035) and survival was better with surgery (36%) than without (3%, p = 0.007). Patients with mass lesions (clot, ventricular blood) were more often found in the ES group (17/27) than in the NS group (18/56) (p = 0.008). Patients with bihemispheric injuries fared better with surgery (7 of 14 survivors) than without (2 of 33 survivors, p = 0.0003). Only one infectious complication (brain abscess) was encountered in the LS group. No delayed intracranial complications in survivors in the NS group were seen.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1979

Traumatic injuries in the parotid region.

The facial nerve, parotid duct, and external ear canal are at risk from penetrating injuries in the parotid region. The areas of the face supplied by the major branches of the facial nerve should be checked in the emergency department so that repair of a cut nerve can be performed while the distal end is able to be stimulated electronically. The parotid duct can be probed and lacerations repaired. The external ear canal should be repaired and stented to prevent stenosis.

Ear, External↗
PubMed1978

External ear injuries.

The unique shape of the external ear depends on the underlying cartilaginous framework. Injuries of the external ear are common. In dealing with lacerations, subperichondrial hematomas, perichondritis, burns and frostbite, particular care should be taken to maintain the cartilaginous framework and to prevent infection. In this way cosmetic deformities of the external ear can be prevented.

Burns↗
PubMed1977

The clinical pharmacist in emergency medicine.

The function of a pharmacist in emergency medicine, encompasing clinical practice, education and research, are described, and an evaluation of physicians' and nurses' attitudes toward pharmacist involvement in these areas is presented. In July 1974, a pharmacist joined the staff of a department of emergency health services in a medical center. In June 1976, a 14-item questionnaire was administered to physicians and nurses associated with the department. Seventy-two percent of the questionnaires were completed and returned. All respondents felt the pharmacist was an important component of the department and a benefit to its patient care and educational programs. Eighty-seven percent of the physicians stated that the pharmacist is capable of offering primary care to certain patients once the diagnosis has been made by a physician; 95% felt the role of the pharmacist is transferrable to other emergency room facilities and 83% were willing to have their patients charged for his services.

Attitude of Health Personnel↗
PubMed1976

Abscess formation as a complication of parenteral methylphenidate abuse.

Case reports of five patients suffering from either skin abscesses or cellulitis following parenteral methylphenidate abuse are presented. Four patients had similar lesions consisting of abscesses or cellulitis which demonstrated typical signs and symptoms of an infective process and were treated with local symptomatic therapy, incision and drainage if indicated, and systemic antibiotics. The fifth patient suffered from a circular, necrotic, nonpurulent ulcer on the dorsum of the right foot which produced no local or systemic toxic effects. Attempts to culture a responsible organism yielded Streptococcus viridans, an organism which is normal flora of the skin and, although opportunistic, is generally considered nonpathogenic. These cases further substantiate the belief that local vasospasm, chemical irritation, or both, produced by the methylphenidate solution may primarily cause a necrotic ulcer susceptibble to secondary bacterial infection.

Abscess↗
PubMed1976

Hereditary angioneurotic edema treated by partial uvulectomy.

Hereditary angioneurotic edema (HANE) is a rare familial disease of C1 esterase inhibitor deficiency that produces recurring attacks of acute, circumscribed, noninflammatory edema. The technique of partial uvulectomy to treat HANE can reduce the mortality from this condition due to asphyxiation. Three cases in which partial uvulectomy was the successful mode of treatment are described.

Adult↗
PubMedDate not supplied

The significance of gallbladder trauma.

This study reviewed patients with gallbladder trauma over a 14-year period treated at Truman Medical Center to determine the complications, associated injuries, and mortality rate. Fourteen patients had gallbladder trauma, 12 penetrating and two blunt. All patients underwent cholecystectomy and 10 had 3 or more associated injuries that required operative care. There were no biliary duct injuries or postoperative biliary complications. Seven patients had postoperative wound, pulmonary, or abdominal infections. There was one mortality due to delayed splenic hematoma, myocardial infarction, and cardiac dysrhythmia. Gallbladder trauma was always associated with significant multi-organ injuries that required early operative intervention.

Adult↗