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Biomedical subjects

W N May

Publications and source records attributed to W N May.

8 recordsLinked to original sources
PubMed1992

Pharmacologic treatment of childhood migraine.

This review of pharmacologic treatment of childhood migraine shows that no agent for abortive treatment has been proved effective in controlled studies and that most commonly used prophylactic agents (e.g., propranolol and cyproheptadine) lack proof of their effectiveness. Flunarizine seems to be the only agent with positive results in controlled studies. This drug, although well tolerated, is slow to act. For the treatment of an acute attack, aspirin or acetaminophen may be chosen. Two of us currently use propranolol as the first-choice prophylactic agent because of its tolerance and cost, and on the assumption of its effectiveness reported by the adult studies. For children with a history of asthma, metoprolol may be chosen because of its selective blocking of the beta 1-adrenoreceptor. One of us (W.N.M.) prefers cyproheptadine as the drug of choice. Behavioral therapy may be a good alternative to pharmacotherapy in the management of childhood migraine.

Child↗
PubMed1988

Syncope associated with hair-grooming.

We report 20 girls who experienced episodes of unconsciousness while standing for hair grooming. The episodes were syncopal in character, electroencephalograms were normal in most cases, and at least 11 of the 20 had definite episodes of syncope in other circumstances. A number of these girls underwent extensive diagnostic testing. We consider this a form of situational or reflex syncope, perhaps related to orthostatic hypotension, the recognition of which may spare unnecessary diagnostic and therapeutic interventions.

Adolescent↗
PubMed1986

The clinical characteristics and course of adult gonococcal conjunctivitis.

We studied 21 cases of adult conjunctivitis caused by Neisseria gonorrhoeae, confirmed by either Gram's stain or culture, that were seen between 1972 and 1986. The patients, typically young men, had irritation or pain, a copious purulent discharge, and marked conjunctival inflammation. Keratitis, anterior chamber inflammation, periocular edema and tenderness, gaze restriction, and preauricular lymphadenopathy were common. All patients were hospitalized and treated with high doses of parenterally administered antibiotics. Two patients had severe ulcerative keratitis at initial examination, which ultimately resulted in light-perception visual acuity, despite antibiotic therapy and keratoplasty. In the remainder of the patients, corneal involvement was milder and transient, and treatment with parenteral penicillin and topical antibiotics was uniformly effective in reversing the course of the infection and preventing significant visual loss. Careful ophthalmologic and microbiologic monitoring is suggested to prevent possible complications caused by penicillin-resistant strains.

Adolescent↗
PubMed1985

The California syndrome. Functional visual complaints with potential economic impact.

The records of 84 patients with functional visual loss (59 adults and 25 children) were reviewed over a six-year period. The patients were between 7 and 69 years of age. In the young patients, psychosocial problems relating to parental divorce, poor school performance and attention-getting behavior were common, while in adult patients, financial gain was present in 51 of 59 (86%) individuals. Over 90% of the claimed abnormalities related to the afferent visual system. Fifty-three percent of the patients had underlying organic problems with functional overlay. Inconsistent test results were the most reliable means of identifying the malingering patients. In California, both ophthalmologists and optometrists are able to declare a patient legally blind as well as visually disabled for the purpose of income tax, workers' compensation, and disability benefits. The potential financial impact of malingering patients is discussed.

Adolescent↗
PubMedDate not supplied

Plasmapheresis for Guillain-Barré syndrome.

Guillain-Barré syndrome is the most common cause of paralytic illness in children. An 8-month-old infant presented with severe Guillain-Barré syndrome associated with parainfluenza 3 infection, was treated with plasmapheresis, and had complete recovery. Plasmapheresis can be technically difficult to perform in small children and infants, but should be considered. Controlled trials should be performed to determine the indications for plasmapheresis in children with Guillain-Barré syndrome.

Humans↗