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Biomedical subjects

B Carson

Publications and source records attributed to B Carson.

At least 19 recordsLinked to original sources
PubMed2001

Goal setting & Network 9/10 efforts to improve care.

TRN, through its Medical Review Board, has developed, endorsed, and articulated goals for two aspects of dialysis treatment. These goals promote the use of continuous quality improvement by encouraging dialysis programs to perform internal examinations of their own data in the context of regional and national data. TRN believes that this combination of data feedback, CQI, and goal setting will impact positively on patient outcomes for all dialysis patients within The Renal Network.

Goals↗
PubMed1999

Language recovery after left hemispherectomy in children with late-onset seizures.

We investigated the language capabilities of the isolated right hemisphere in 6 children (age, 7-14 years) after left hemidecorticectomy for treatment of Rasmussen's syndrome. Patients were right-handed before surgery and had at least 5 years of normal language development before the onset of seizures. Language testing included speech sound (phoneme) discrimination, single word and phrasal comprehension, repetition, and naming. Within 4 to 16 days after surgery, patients showed improved phoneme discrimination compared with their performance shortly before surgery. Other language functions remained severely impaired until at least 6 months after surgery. By 1 year after surgery, receptive functions were comparable with, or surpassed, patient presurgery performance. Although word repetition was intact by 1 year after surgery, naming remained impaired, and patient speech was limited largely to production of single words. These results suggest that the right hemisphere is innately capable of supporting multiple aspects of phoneme processing. Recovery of higher level receptive and, to a lesser extent, expressive language functions is attributed to plasticity of the right hemisphere, which appears to persist beyond the proposed critical period for language acquisition and lateralization.

Adolescent↗
PubMed1998

The injured drunk driver in central Texas: incidence, demographics, and legal ramifications.

INTRODUCTION: This study was designed to define 1 trauma center's drunk driver patient population, determine the incidence of alcohol intoxication in motorists admitted to the hospital following a collision, and ascertain the frequency of the Driving Under the Influence (DUI) charges filed against this population. METHODS: Hospitalized motorists were divided into 2 groups--those who did and did not have blood alcohol levels measured--then further classified into 3 subsets based on serum ethanol values. A 2-year retrospective trauma registry review established patient demographics, outcomes, hospital costs, blood alcohol levels, and concomitant drug use. Local police records were accessed to determine the number of patients cited for DUI. RESULTS: Eighty percent of those intoxicated were men. On the average, drunk drivers were 1.7 years younger than were sober patients. Minimally to moderately intoxicated motorists had the highest overall injury severity scores and hospital costs and were the most likely to concomitantly abuse illegal drugs. Patients who did not have ethanol levels measured had the highest mortality rate. DISCUSSION: Overall, 60% of admitted injured drivers who were tested had positive results for 1 or more substances known to impair driving ability, yet only 16% of those with a blood alcohol level of > or = 100 mg/dL were charged with DUI. This finding supports previously published data suggesting that injury and transport to a hospital protect the alcohol-impaired driver from legal consequences.

Accidents, Traffic↗
PubMed1994

Chromosome abnormalities in meningeal neoplasms: do they correlate with histology?

Thirty-three meningeal neoplasms were karyotyped, and the results were compared with histologic features. Thirteen neoplasms had no discernible abnormality or sex chromosome loss only; nine had monosomy or structural abnormality involving only chromosome 22; and 11 had other chromosome abnormalities with or without chromosome 22 involvement. Histologic evidence of invasion was not associated with an abnormal karyotype in the three angioblastic tumors examined. All seven fibroblastic meningiomas had abnormal karyotypes, with monosomy 22 the most common change. Abnormal karyotypes were detected in 76% of syncytial and 55% of transitional meningiomas. When these results were combined with those from 259 meningeal tumors reported since 1987, abnormal karyotypes were detected in at least half of all histologic types. Chromosome changes secondary to those involving chromosome 22 may indicate additional areas of the genome that play a role in tumor progression. In the combined series, chromosome losses were most frequently observed in meningiomatous and transitional histologies; chromosomes 1, 6, 14, 18, and Y each were lost in 10 or more meningiomas, whereas only chromosome 20 was gained at the same frequency. Structural abnormalities most frequently involved chromosome 1. These changes are distinctly different from those observed in other common intracranial neoplasms, specifically astrocytic neoplasms.

Adult↗
PubMed1993

A 2-year clinical evaluation of two pit and fissure sealants placed with and without the use of a bonding agent.

The purpose of the study was to evaluate whether the clinical effectiveness of pit and fissure sealant was increased (as demonstrated by an increased retention rate) when a bonding agent was used prior to the placement of the sealant. Two pit and fissure sealants, Concise Light Cured White Sealant and Prisma Shield Light Cured Sealant, were placed in vivo with and without the use of the bonding agents, Scotchbond 2 and Prisma Universal Bond. After 2 years, 55% of the sample was available for recall. The retention rates for the sealants were 77% for Concise with Scotchbond 2, 84% for Concise with no bonding agent, 77% for Prisma Shield with Universal Bond, and 77% for Prisma Shield with no bonding agent. Results of this study indicated that the use of a bonding agent prior to the application of a pit and fissure sealant does not increase the retention rate.

Bisphenol A-Glycidyl Methacrylate↗
PubMed1990

Ventriculoamniotic shunt for treatment of hydrocephalus in one of twins: medical, ethical and legal considerations.

One of a pair of preterm twin fetuses was identified as having progressive hydrocephalus. After an extensive evaluation of the parents and both fetuses, a ventriculoamniotic shunt was placed. The affected twin, despite multiple additional neonatal procedures, has done well as matched against her normal twin sister. Both children are well 4 years after the surgery. The case presented a remarkable complexity of medical, ethical and legal issues which are presented.

Adult↗
PubMed1990

Craniocervical decompression for cervicomedullary compression in pediatric patients with achondroplasia.

The congenital osseous abnormalities associated with achondroplasia include stenosis of the foramen magnum and the upper cervical spinal canal. In the pediatric achondroplastic patient, such stenosis may lead to cervicomedullary compression with serious sequelae, including paresis, hypertonia, delayed motor mile-stones, and respiratory compromise. Using a standardized protocol the authors have treated 15 young achondroplastic patients with documented cervicomedullary compression by craniocervical decompression and duroplasty. Following this procedure, significant improvement in presenting neurological or respiratory complaints was noted in all patients. The mortality rate in this series was zero. The major cause of morbidity associated with this procedure was perioperative cerebrospinal fluid (CSF) leakage from the surgical wound, presumably related to coexisting abnormalities of CSF dynamics. This problem was successfully managed by temporary or, when necessary, permanent CSF diversion procedures. It is concluded that craniocervical decompression is an effective and safe treatment for young achondroplastic patients with cervicomedullary compression.

Achondroplasia↗
PubMed1989

Foramen magnum decompression in an infant with homozygous achondroplasia. Case report.

Homozygous achondroplasia is a rare yet distinct clinical entity. Most infants succumb to an early death as a result of respiratory compromise due to upper airway obstruction, thoracic cage deformity, and/or cervicomedullary compression. The successful cervicomedullary decompression of a 16-week-old infant with homozygous achondroplasia is described. This report suggests that homozygous achondroplasia is not universally fatal and that these infants are potentially viable if managed by aggressive respiratory and surgical measures.

Achondroplasia↗
PubMed1988

The pericranial flap for reconstruction of anterior skull base defects.

In 1981, the senior author first reported the use of the pericranial flap for support of the brain following resection of the anterior skull base. Since the initial report, considerable experience has been gained with this flap. It is currently deployed via a bifrontal craniotomy and is placed primarily as a support beneath the frontal lobes. The pericranial flap may also be used to repair dural laceration and defects. The sinonasal surface is routinely grafted with split-thickness skin or dermis. This technique provides an excellent barrier between the sinonasal cavity and the cerebrospinal fluid, establishing a tough, fibrous platform. Herniation of intracranial contents has not occurred. One major complication has been reported in which radiation necrosis occurred during postoperative therapy, leading to progressive devitalization of the pericranial flap. Ultimately, dural repair and closure with a latissimus dorsi free flap was required. The pericranial flap repair of anterior skull base defects has a 90% complication-free and 95% overall success rate. It is simple and extremely effective. Bone grafting has not been necessary in our experience.

Adult↗