PubMed Health⌕ Search

Biomedical subjects

W L Whitlock

Publications and source records attributed to W L Whitlock.

At least 19 recordsLinked to original sources
PubMed2000

Telemedicine improved diabetic management.

Effective control of diabetes is known to delay or prevent the end-organ complications of this disease. Can telemedicine improve a patient's ability to self-manage diabetes? Twenty-eight patients entered a study comparing home telemedicine consultation with standard outpatient care. A nurse case manager contacted the telemedicine group once a week under the direction of a primary care physician, who contacted the telemedicine group once a month. Laboratory studies and total body weight were measured at the beginning and at the end of the 3-month study. The hemoglobin A1c (HbA1c) and total body weight improved significantly in the intervention (telemedicine) group, as shown by a 16% reduction in mean HbA1c level (from 9.5 to 8.2%) and a 4% mean weight reduction (from 214.3 to 206.7 pounds). Based on our experience, we present a functionally based telemedicine classification system to improve the application of electronic medicine in future studies.

Adult↗
PubMed1996

Foreign body aspiration in dentistry: a review.

This article reviews the dangers of aspirating foreign bodies of dental origin. Two illustrative cases are presented, including an unusual case involving aspiration of an elastomeric impression material. The authors describe the techniques used to identify the foreign body. A radiodensimetric study of four impression materials demonstrates the difficulty of identifying most impression materials. The authors also present some strategies for reducing the risk of aspiration during dental procedures.

Adult↗
PubMed1994

Pulmonary dysfunction secondary to mandibular retrognathia in Marfan's syndrome.

Referrals to pulmonary physicians for polysomnography to evaluate snoring or the possibility of sleep apnea syndrome often evolve into a multidisciplinary clinical problem. We present a young woman with two congenital abnormalities (Marfan's syndrome and retrognathism) which both may affect her decreased exercise tolerance, daytime hypersomnolence, and fatigue. Polysomnography and pulmonary exercise testing documented improvement in her upper airway diameter and exercise capacity. Her improved sleep pattern and her understanding of her exercise performance limitations afforded her a new outlook on life.

Adult↗
PubMed1994

Human papilloma virus associated with solitary squamous papilloma complicated by bronchiectasis and bronchial stenosis.

A 28-year-old man presented with recurrent pneumonias for 6 years. Chest radiograph and computed tomography showed localized bronchiectasis of the anterior segment of the left upper lobe. Bronchoscopy showed bronchial stenosis without an endobronchial lesion. After 6 weeks of antibiotic treatment, the patient had a recurrent pneumonia and underwent left upper lobectomy that showed a solitary squamous papilloma. In situ hybridization studies of the papilloma were reactive for human papilloma virus subtypes 6/11.

Adult↗
PubMed1992

A model for conversion from small volume nebulizer to metered dose inhaler aerosol therapy.

Rationing of medical services will be necessary if we do not develop a more rational and efficient health care system. Respiratory care services are receiving emphasis as we try to curtail spiraling health care costs. In analysis of our respiratory care services, we found that small volume nebulizer (SVN) therapy was still a major portion of our workload. We instituted a protocol to convert to metered dose inhaler (MDI) therapy. All hospitalized patients, excluding those admitted to the spinal cord unit and intensive care units, with a physician's order for aerosol delivery by SVN, were evaluated by respiratory care practitioners for conversion to MDI therapy. A simple protocol for the therapist to use in this conversion was developed. All patients converted to MDI were trained in appropriate MDI use by the therapist. A three-day follow-up of each patient's compliance with proper MDI therapy was initiated. Even with a 72-h allowance for initial SVN treatment, we realized a 9,350 procedure reduction from deleted treatments and an additional 7,650 conversions to MDI. Less than 2 percent of our patients failed to make a completely successful conversion to MDI. Those patients who successfully converted to MDI resulted in reduced hospital costs of $43,758 based on excess medication, supplies, and labor costs associated with SVN treatments. We also saved 5,000 h of technician time that was used to further instruct patients in appropriate MDI therapy. Aerosol therapy by MDI is cost-effective therapy. The institution of guidelines for MDI conversion has reduced fear of failure for both clinicians and patients and illustrates the importance of patient education by qualified respiratory therapists.

Adrenergic beta-Agonists↗
PubMed1992

Rhodotorula rubra contamination in fiberoptic bronchoscopy.

Rhodotorula rubra was recovered in 18 bronchoscopic specimens from 15 patients from May to November 1987. One hundred and twenty-one bronchoscopies were performed during that period by two bronchoscopists (W. W.; R.D.) at Letterman Army Medical Center in San Francisco. Isolation of R rubra occurred in 11 bronchoalveolar lavage (BAL) specimens, four bronchial washes, and three transbronchial biopsies. Clinical infection was not present in any of these patients, although five were immunocompromised hosts. After a stepwise infection control review of the laboratory, the bronchoscopy suite, bronchoscopists, and the fiberoptic bronchoscope failed to recover the organism, a systematic evaluation of the cleaning procedure was undertaken. We discovered that replacement of the suction valve and the rubber biopsy valve on the biopsy channel immediately after cleaning allowed moisture to accumulate in these areas. Removal of both the suction valve and biopsy valve during periods of nonuse resulted in adequate drying of the biopsy channel and eradication of contamination from December 1987 to May 1990 (350 bronchoscopies). Epidemiologic and infection control surveillance is critical for bronchoscopy, especially when possible pathogens are recovered by BAL in the immunocompromised patient.

Bronchoalveolar Lavage Fluid↗
PubMed1990

Sarcoidosis complicated by HIV infection: three case reports and a review of the literature.

We report three cases of sarcoidosis complicated by human immunodeficiency virus (HIV) infection and review four other isolated case reports in the literature. There is clinical overlap of both diseases, including symptoms, pulmonary function abnormalities, and lymphocyte function. Bronchoalveolar lavage (BAL) in these patients showed a lymphocytic alveolitis without pathogens. BAL lymphocyte subset analysis showed markedly depressed CD4+/CD8+ ratios in three patients. These data were clinically useful for distinguishing the CD8+ alveolitis associated with HIV infection from the CD4+ alveolitis associated with sarcoidosis. Three patients improved with corticosteroid therapy. Two patients with BAL-documented CD8+ alveolitis tolerated discontinuation of steroids. One patient's sarcoidosis improved without therapy concurrent with the diagnosis of Kaposi's sarcoma. Another patient developed sarcoidosis 1 yr after manifesting HIV positive serology. BAL can be used to distinguish the lymphocytic alveolitis of sarcoidosis from that associated with HIV infection. Patients with active sarcoidosis complicated by HIV infection can be effectively treated with corticosteroid therapy.

Adult↗