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Biomedical subjects

W L Whitlock

Publications and source records attributed to W L Whitlock.

25 records · Page 2Linked to original sources
PubMed1990

Pulmonary hyperinfection syndrome with Strongyloides stercoralis.

A 65-year-old man with steroid-dependent chronic airflow obstruction presented with progressive dyspnea and weight loss. Travel history included a military tour in southeast Asia. A chest roentgenogram revealed hyperexpanded lung fields with diffusely increased interstitial markings. The Papanicolaou stain of expectorated sputum demonstrated the rhabditiform larvae of Strongyloides stercoralis. Endemic areas of infection include the southeastern United States, Puerto Rico, Central America, the Pacific basin, and central Africa. In recent immigrant groups and veterans of the Vietnam conflict, rates of infection are as high as 6 percent. The hyperinfection syndrome occurs in immunocompromised hosts and is associated with glucocorticoid steroid therapy. This allows massive proliferation of larval forms. Clinical clues include an appropriate travel history (even in the remote past), gastrointestinal symptoms, cutaneous symptoms, eosinophilia, or thrombocytosis. Our patient demonstrated a classic presentation of the hyperinfection syndrome, and the condition responded well to thiabendazole.

Aged↗
PubMed1990

The impact of thoracic computed tomography in clinically staged T1, N0, M0 chest lesions.

We assessed the impact of thoracic computed tomography (CT) in 38 patients considered for thoracotomy for solitary pulmonary lesions characterized as T1, N0, M0 by clinical and roentgenographic staging. False-positive lymph nodes were identified by CT in four patients prompting additional surgical staging procedures in two cases. Two of three patients with false-negative clinical, roentgenographic, and CT findings had successful complete resections. The CT scan did not correctly advance the stage of, or alter the plan for, these lesions in any patient. We conclude that CT is not helpful in patients considered for diagnostic and therapeutic thoracotomy for clinical and roentgenographic T1, N0, M0 lesions.

Adenocarcinoma↗
PubMed1989

Sleep apnea syndrome after irradiation of the neck.

After irradiation of the neck for a squamous cell carcinoma of the tonsillar pillar and vocal cord, a 71-year-old man presented with a rapidly progressive sleep apnea syndrome. Previous reports describe the condition of patients with obstructive sleep apnea that developed after neck irradiation and secondary to supraglottic edema. Our patient had an obstructive component to his apnea similar to that described in previous cases, but, in addition, he had hypothyroidism. Myxedema is a well-described cause of both obstructive and central apnea. We believe both contributed to his condition. He was successfully treated by placement of a tracheostomy and by thyroid supplementation. In patients who present with sleep apnea after neck irradiation, especially with acute or severe symptoms, the differential diagnosis should include both a central cause from hypothyroidism as well as a peripheral obstructive cause from laryngeal edema.

Aged↗