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Biomedical subjects

W Waring

Publications and source records attributed to W Waring.

15 recordsLinked to original sources
PubMed1998

Bowel management in children and adolescents with spinal cord injury.

There is little in the literature regarding bowel management in children and adolescents with spinal cord injuries (SCI). This study was undertaken to examine specific patterns of bowel care, individual levels of satisfaction with bowel management, the incidence of incontinence in this population, and effects on lifestyle because of time commitment and dependence in bowel management. Surveys were sent to all persons (n = 45) under age 19 with a diagnosis of SCI who had received care at our medical center since 1985. Thirty-one subjects (69 percent) returned the surveys. The average age at injury was 8.1 years, with an average follow-up period of 3.9 years. Fifty-five percent were individuals with tetraplegia and 77 percent had a complete injury (ASIA Class A). A bowel management program, including medications or manual manipulation, was required for 81 percent of the subjects; only two were independent in their bowel management. Over half of the subjects performed evening bowel care and over half performed their care daily. Digital stimulation tended to be used more commonly by younger children. Medications, either oral, rectal, or both, were used by 88 percent. Sixty percent of the subjects reported they were completely or very satisfied with their bowel management. About half the subjects had limited freedom because of their bowel programs, which caused some dissatisfaction. Sixty-eight percent reported occasional or frequent interference with school activities because of their bowel programs. No correlation was found between bowel accidents and satisfaction with bowel management, despite the fact that almost 84 percent of the children reported at least rare accidents. Lifestyle limitations, bowel accidents, dependence in bowel management, and subject and family dissatisfaction continue to be significant problems for children and adolescents with SCI.

Adolescent↗
PubMed1992

Osteoarthritis of the hand and wrist in the post poliomyelitis population.

People with a chronic motor disability of the legs become increasingly more dependent upon their upper limbs for mobility and self-care skills as they age. Many of them complain of hand and wrist pain. A cross-sectional study of 61 post-poliomyelitis survivors was done to determine the prevalence of osteoarthritis within this population and to determine any inherent risk factors. Each subject underwent a radiographic evaluation of both hands and wrist as well as a detailed physical examination. A questionnaire was used to ascertain a history of hand activity, use of canes/crutches, walkers and wheelchairs. The mean age of the population sample was 49 +/- 6 with a mean duration of disability of 35 +/- 4 years. The prevalence of moderate or severe osteoarthritis of either the hand or wrist was 13% whereas the prevalence was 68% when cases with mild arthritic changes were also included. The risk factors associated with hand and wrist osteoarthritis in this population included age, lower limb weakness, use of an assistive devices, and severity of disability.

Activities of Daily Living↗
PubMed1991

Compressive mononeuropathies of the upper extremity in chronic paraplegia.

Controversy exists with regard to the actual prevalence of compressive mononeuropathies at the wrist which may occur following chronic paraplegia. Thirty one chronic paraplegics, with a mean age of 37.9 years (range 20-68 years), and mean time since injury of 9.7 years (range 1-28 years), were studied with a comprehensive neurologic and electrodiagnostic (EDX) assessment. No patient had any clinical or EDX evidence of a peripheral polyneuropathy. The diagnosis of a median mononeuropathy at the wrist was determined by the following criteria: (a) prolonged median sensory distal latency greater than ipsilateral ulnar sensory distal latency greater than or equal to 0.5 msec; (b) a median mid-palmar sensory latency greater than ipsilateral ulnar mid-palmar sensory latency of greater than or equal to 0.3 msec; or (c) a median motor distal latency greater than or equal to 1.7 milliseconds as compared to the ipsilateral ulnar motor distal latency. Ulnar mononeuropathy at the wrist or across the elbow was also characterised. The EDX criteria for a median mononeuropathy at the wrist was met in 55% of subjects (24% of these with bilateral presentations). The location of ulnar mononeuropathies included: two at the superficial sensory branch at the wrist, one at the deep motor branch at the wrist, and three patients with a conduction block across the elbow. Overall, 67% of all patients tested had evidence of at least one mononeuropathy of the upper extremity. There was no association between prevalence of compressive mononeuropathies and age of the patient or time since onset of injury.

Adult↗
PubMed1989

Risk factors for median mononeuropathy of the wrist in postpoliomyelitis patients.

There is evidence that chronic cane, crutch, and wheelchair users are at increased risk for developing pain and functional compromise of the wrist and hand. This investigation examined the prevalence and risk factors for median mononeuropathy at the wrist in the postpoliomyelitis population. The medical records of 148 consecutive patients with histories of poliomyelitis were reviewed. Forty-nine percent of this cohort had complaints of wrist pain. The prevalence rate of carpal tunnel syndrome was 22% (n = 33). Age, sex, duration of disability, and work history did not significantly influence the relative risk of developing this disorder. However, the relative risk of developing this compression neuropathy at the wrist by using the combination of a cane and/or a crutch and a wheelchair was 4.86 (95% confidence interval 2.35-10.06). The high risk associated with chronic cane, crutch, and wheelchair use shows the need for developing preventive strategies.

Adult↗
PubMed1988

Comparison of piperacillin alone versus piperacillin plus tobramycin for treatment of respiratory infections in children with cystic fibrosis.

Seventeen patients with cystic fibrosis (CF) and pulmonary exacerbations were randomly assigned to two treatment groups: piperacillin 600 mg/kg/day (P), and piperacillin 600 mg/kg/day plus tobramycin (PT), in order to determine the safety and pharmacokinetics of high-dose piperacillin and whether piperacillin alone was effective for the treatment of Pseudomonas infections. The mean half-life of piperacillin was 0.54 hours, with a peak concentration of 232 micrograms/ml. No differences between P and PT groups were noted in clinical assessment, as judged by Shwachman scores, pulmonary function testing, or weight gain. However, during the course of treatment, quantitative sputum cultures decreased by greater than 10(2) colony-forming units in only 5 out of 19 Pseudomonas isolates from the P group, compared with 12 of 19 isolates from the PT group (P less than 0.03, Chi-square). Although emergence of resistance was not seen, one isolate had an increase in minimum inhibitory concentration from 8 to 128 micrograms/ml. There were no serious adverse reactions to piperacillin; only one patient developed fever possibly related to piperacillin. Therapy with high-dose piperacillin was safe in children with CF. Treatment with piperacillin alone was less effective than combination therapy with gentamicin for reduction in titer of Pseudomonas in sputum. However, the role of antimicrobial agents in the treatment of CF remains undefined. A double-blind placebo-controlled trial is indicated.

Child↗
PubMed1980

A comparison of cell-mediated immunity and suppressor T-cell function in asthmatic and normal children.

The role of general and suppressor T-cell function was investigated in a group of twelve children with atopic asthma and ten non-atopic control children. Studies of active E rosettes, lymphocyte stimulation, and delayed type skin responsiveness revealed no statistically significant group differences. Data obtained employing a concanavalin A-induced, suppressor T-cell assay revealed that the asthmatics generated significantly less suppressor cell activity than did the normal control group. There was no correlation between lack of suppressor cell function and serum IgE levels. The results of this study support the concept of suppressor T-cell dysfunction in atopic disease.

Asthma↗
PubMed1976

Digital simulation of the membrane voltages and currents in nerve and muscle fibers.

This paper describes digital computer simulations of the membrane voltages and currents in axons and muscle fibers. The simulations, which allow calculations ona nonuniform fiber, are based on the discrete Hodgkin-Huxley and Falk-Fatt equations. An efficient algorithm is used to solve the set of equations generated. Calculations are made of the voltage and current at the natural end of a muscle fiber and the results are compared with measurements by other investigators.

Axons↗