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Biomedical subjects

A Curran

Publications and source records attributed to A Curran.

13 recordsLinked to original sources
PubMed2001

Hyperkinetic movement disorder in an 11-year-old child treated with bilateral pallidal stimulators.

Pallidal stimulation is widely used in the treatment of movement disorder in adults but is less well reported in the treatment of dystonia in children. Despite inconsistent results in the past, its use in dystonia in Parkinson's disease is again attracting interest with promising results. Bilateral as well as unilateral pallidotomies have been performed and are felt to be required in some cases of dystonia. Use of depth electrodes to provide long-term electrical stimulation to pallidum and other basal ganglia structures has recently become more widespread. This technique is felt to have a lower morbidity, especially in bilateral procedures. Here we present the case of an 11-year-old boy with severe hyperkinetic movement disorder who showed sustained improvement after bilateral pallidal stimulation implantation.

Cerebral Palsy↗
PubMed2001

The use of fibrin glue in refractory coagulopathic epistaxis.

Epistaxis can be particularly difficult to treat when a patient has a coagulopathy, even if the area bleeding is visible. Where routine measures fail to arrest the bleeding (e.g., nasal cautery and packing), the application of fibrin glue is successful in stopping the bleeding without having to address the underlying coagulopathy. Ten patients with epistaxis secondary to an underlying coagulopathy were treated by local application of fibrin glue to the area bleeding. The bleeding stopped immediately in all patients when the fibrin glue was applied. No patients suffered complications. Fibrin glue application should be considered as a cost-effective means of controlling epistaxis from an identifiable area in the nasal cavity in patients with a coagulopathy.

Cost-Benefit Analysis↗
PubMed2000

Mesenteric angina complicating a mesodermal anomaly.

A child with macrocephaly-cutis marmorata developed severe abdominal pain thought to represent mesenteric angina. There were abnormalities of the aortic and mesenteric vasculature not previously reported in this condition. Angina therapy afforded amelioration of his symptoms. Mesenteric angina should be considered as a cause for abdominal pain in children with mesodermal anomalies.

Abdominal Pain↗
PubMed1999

Leukoplakia of the maxillary vestibule--an association with Viadent?

OBJECTIVE: This report investigates a possible correlation between chronic use of Viadent products and the subsequent development of leukoplakia in the maxillary vestibule. STUDY DESIGN: A retrospective review of 88 patients with leukoplakia of the maxillary vestibule is presented. Prevalence of Viadent use was determined in this group and in a group of 100 randomly selected adults who presented themselves for routine preadmission screening at a dental school. RESULTS: Of the patients diagnosed with leukoplakia of the maxillary vestibule, 84.1% reported having used Viadent, whereas the prevalence of use was only 3% in the 100 randomly selected adults. CONCLUSIONS: Use of Viadent products appears to be associated with an increased prevalence of leukoplakia in the maxillary vestibule.

Adult↗
PubMed1996

Pitfalls in the determination of intracranial spread of complicated suppurative sinusitis.

We present two cases of suppurative sinusitis that presented to our casualty department over a one-week period. Both patients suffered complications of the disease secondary to extension of the inflammatory process beyond the bony confines of the sinus. Neither of the patients had a previous history of sinus disease. The first patient deteriorated suddenly 24 hours after admission. The initial computed tomography (CT) scan failed to demonstrate a developing subdural empyema. This complication was confirmed following repeat scanning 24 hours later and the patient required urgent neurosurgical intervention and drainage. The second patient presented with periorbital cellulitis secondary to sinusitis and suffered a grand mal seizure on admission. Once again initial CT scan changes were subtle and significant intracranial extension was not noted until the subsequent magnetic resonance imaging (MRI) scan was performed. The purpose of this paper is to highlight the potential dangers over reliance on CT scanning in diagnosing early intracranial spread of sinus disease and we emphasise that the clinician must interpret any radiological investigations in light of the associated clinical findings.

Adolescent↗
PubMed1993

Cystic fibrosis presenting as kwashiorkor with florid skin rash.

Two infants with a florid erythematous rash and generalised oedema, hypoalbuminaemia, and anaemia were found to have cystic fibrosis. This rare presentation is associated with false negative sweat tests, delays in diagnosis, and a considerable mortality. It is proposed that this presentation represents a manifestation of kwashiorkor secondary to malabsorption. The recognition that these infants have kwashiorkor provides some insight into the pathogenesis and management of their illness.

Cystic Fibrosis↗
PubMed1989

Effects of heparin and chlorbutol on bacterial colonisation of intravascular cannulae in an in vitro model.

An in vitro model was used to study the effects of heparinised saline, with or without the preservative chlorbutol, on the colonisation of intravascular cannulae. Chlorbutol significantly reduced cannula colonisation by Staphylococcus epidermidis. Flushing colonised cannulae with heparinised saline plus chlorbutol significantly reduced the number of organisms adhering to the inner surface of cannulae, when compared with the use of heparinised saline without preservative. Chlorbutol-preserved heparinised saline may not only maintain cannula patency by the prevention of thrombus formation, but may also reduce the incidence of bacterial colonisation of cannulae in vivo.

Bacterial Infections↗
PubMed1982

Threshold for lead damage to heme synthesis in urban children.

Although lead has no physiological function and is present in only negligible amounts in the blood of remote populations, it has become customary to accept the usual blood Pb level(s) (BPb) observed in industrialized society as "normal." Pb interferes with many biochemical systems, among them the heme biosynthetic pathway; this is reflected by an exponential increase in erythrocyte protoporphyrin concentration (EP) as PBb increases. The present study estimated the threshold PBb at which an increase of EP occurs in a population of urban children. In the 2,004 children studied, BPbs ranged from 2 to 98 micrograms/dl, with 1,852 having a BPb of less than or equal to 30 micrograms/dl, a value presently considered normal. Preliminary analysis suggested that an exponential increase in the concentration of EP occurred after a threshold BPb (apparently between 12 and 20 micrograms/dl) was reached. Precise definition of the threshold BPb for an increase of EP was next determined by two approaches: segmented line techniques and probit analysis. Whether the entire population was analyzed or only the subset of samples with "normal" BPb (less than or equal to 30 micrograms/dl), both methods yielded a threshold BPb of 15-18 micrograms/dl (average value, 16.5). These studies indicate that the heme synthetic pathway is affected by Pb at a level of exposure commonly observed in urban children, which is well below the limit that is presently too easily accepted as normal.

Child↗
PubMedDate not supplied

Suppurative complications of infective sinusitis.

We report three cases of suppurative sinusitis that presented to our casualty department over a one week period. All three patients suffered complications of the disease secondary to extension of the inflammatory process beyond the bony confines of the sinus. None of the patients had previous history of sinus disease. We wish to remind the clinician that such complications still exist and we highlight the necessity of rapid diagnosis and early intervention in the management of complicated sinus disease.

Adolescent↗