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Biomedical subjects

C C Carson

Publications and source records attributed to C C Carson.

At least 55 records · Page 3Linked to original sources
PubMed1988

Severe penile curvature after implantation of an inflatable penile prosthesis.

We describe 6 cases of penile curvature following implantation of inflatable penile prostheses. Exploration revealed severe scarring of the corpora cavernosa, which produced the curvature in 4 patients. In all 4 cases this area was incised and the defect was filled with a polytetrafluoroethylene vascular graft. The penis was straightened and the prosthesis functioned normally. The remaining 2 patients were treated with inflation for 8 weeks with resolution of the curvature. To our knowledge, these cases represent the first reported complications produced by abnormal scar tissue outside of the inflammatory pseudocapsule after implantation of an inflatable penile prosthesis.

Blood Vessel Prosthesis↗
PubMed1988

Nosocomial urinary tract infections.

Convenience to the hospital staff is certainly not an acceptable reason for the use of a potentially dangerous drainage tube. An indwelling urinary drainage catheter should be used only in patients who need multiple straight urinary catheterizations, develop urinary obstruction or incontinence, or are comatose and require frequent urinary output measurements. An indwelling catheter may also be needed for drainage or stenting during or following genitourinary surgery. Once it has been determined that urinary catheterization is necessary, a closed urinary drainage system catheter must be carefully and aseptically inserted by experienced hospital personnel after careful preparation. The closed drainage system must be meticulously maintained throughout the patient's hospitalization and catheterization. After the catheter is removed, a urinary culture should be performed to identify any postcatheter infection. If there is infection, the patient must be treated with antibiotics. If symptoms of a urinary tract infection, bacteremia, or sepsis ensue, treatment must be rapidly begun with antibiotics as appropriate on the basis of drug sensitivity testing. These techniques will not eliminate bacteriuria associated with urinary drainage catheters. However, they will reduce the incidence, morbidity, and mortality associated with urinary catheterization.

Catheters, Indwelling↗
PubMed1988

Percutaneous antegrade approach to ureteral calculi.

Using the percutaneous techniques described here, antegrade ureteral calculus extraction has been successful in more than 90 per cent of reported cases. Thus, stones in the proximal two thirds of the ureter that cannot be managed with standard retrograde techniques alone or in combination with ESWL or that are associated with large renal calculi can be removed with low morbidity by percutaneous methods and endourologic techniques.

Colon↗
PubMed1987

Low dose pulse methotrexate in rheumatoid arthritis: an 8-year experience with hepatotoxicity.

The clinical utility of standard liver function tests for monitoring low dose pulse methotrexate therapy is reviewed in 163 rheumatoid arthritis patients over an eight-year period. Abnormalities of hepatic enzymes were seen in 58% of patients but led to cessation of therapy in only 5%. Moderate alcohol intake did not affect the frequency of liver test abnormalities. Abnormalities were seen more frequently in patients with longer duration of methotrexate therapy and in those with higher total dose. There was no correlation between liver test abnormalities and day of serum sampling relative to day of methotrexate dosing, nor was a correlation seen between liver test abnormalities and total weekly dose of methotrexate. Methotrexate has been demonstrated to be an effective drug in the treatment of rheumatoid arthritis. The clinical utility of standard liver tests to predict the potential for hepatotoxicity is questionable.

Adult↗
PubMed1987

Results and morbidity of percutaneous nephrolithotripsy.

The medical records of the first 210 patients treated with percutaneous nephrolithotripsy at Duke University Medical Center were reviewed. Eleven patients were treated for bilateral stones for a total of 221 renal units. The procedure failed in 6 patients (2.7%). Stone fragments were retained in 55 patients (24.9%), with unplanned fragments in 41 cases (18.6%). Open surgery was subsequently performed in 4 patients (1.8%). There were no nephrectomies or deaths in our patients. Percutaneous nephrolithotripsy is a highly successful method for removal of upper tract stones and has a complication rate no higher than that of open surgical procedures.

Adolescent↗
PubMed1987

Fournier's gangrene: a complication of penile prosthetic implantation in a renal transplant patient.

The management of erectile impotence in renal transplant patients remains problematical. The enhanced risk of surgical infection in this immunosuppressed patient population must be addressed if prosthetic implantation is contemplated. A case of Fournier's gangrene (synergistic necrotizing gangrene of the genitalia) following implantation of a Small-Carrion penile prosthesis is reported. This potentially life-threatening infection demonstrates graphically the surgical infection risk of this population and suggests extreme caution before proceeding with a prosthetic operation in this unique subset of impotent patients.

Adult↗
PubMed1986

Patient satisfaction in Scott and Small-Carrion penile implant recipients: a study of 52 patients.

Physical penile sensations and levels of sexual satisfaction and activity were assessed in a questionnaire survey of 52 penile implant recipients. Although technical surgical success rates were high and 90% of recipients would elect to have surgery again, overall sexual adjustment did not approach premorbid conditions. Reasons for incomplete satisfaction included altered sensations of erection, decreased penile dimensions when compared with recalled preoperative dimensions, and decreased sensations during ejaculation. Some of these changes may have been due to decreased arousal during intercourse. Potential implant recipients should be counseled regarding realistic expectations of the benefits of penile prosthesis implant surgery.

Adult↗
PubMed1986

Partial nephrectomy using a new dissecting instrument.

The kidney is made of friable parenchyma with flexible blood vessels and collecting system structures. A dissecting clamp with interlacing blunt teeth was designed that, by repeated action of closing and opening over the renal parenchyma, crushes and dissects away the friable tissue, leaving the blood vessels and collecting system structures intact. Thus, individual ligation of blood vessels and collecting system structures can be performed at the line of resection. We report our experience in 10 dogs and 1 patient in whom partial nephrectomy was performed with this instrument.

Animals↗
PubMed1986

Factors affecting the success rate of percutaneous nephrolithotripsy and the incidence of retained fragments.

The medical records of the first 210 patients treated with percutaneous nephrolithotripsy at our university medical center were reviewed. The data were analyzed in an attempt to define those factors that affect the success rate and incidence of retained fragments of these procedures. We found that stone location and extent, and to some degree stone size are the major factors affecting the success rate and incidence of retained stones. Chemical composition of the calculus, history of renal surgery and energy source used for stone removal have lesser roles.

Adolescent↗
PubMed1986

Comparison of the costs and morbidity of percutaneous and open flank procedures.

A series of 47 percutaneous procedures for renal calculi was matched by description of calculi and previous flank exploration to 47 open flank procedures for comparison of relative morbidity and cost-efficiency. A retrospective analysis of paired data demonstrated that patients undergoing percutaneous procedures experienced significantly decreased duration of anesthesia, number of transfusions, postoperative disability, and duration and cost of hospitalization. These findings support the cost-effectiveness of the percutaneous approach to removal of renal calculi.

Adult↗
PubMed1986

The effect of ultrasonic disintegration on the outcome of percutaneous nephrolithotripsy.

Concern has been expressed regarding the use of ultrasonic lithotripsy in the percutaneous treatment of renal calculi with the suggestion that high rates of retained stones may be experienced. Evaluation of 89 patients with stones confined to the renal pelvis treated both with and without ultrasonic lithotripsy were evaluated with regard to stone size, retained fragments, stone composition and previous renal surgery. It is felt that it is not the use of ultrasonic lithotripsy that leads to longer hospitalization and retained fragments, but rather the size of the renal calculi and the complexity of arrangement.

Evaluation Studies as Topic↗
PubMed1986

Urolithiasis.

Explore the source record for details and available documents.

Female↗
PubMed1985

Overview of first-line amikacin therapy for urologic infections.

Severe infections in urologic patients are frequently and effectively treated with aminoglycoside medications. Because of the frequency of nosocomial gram-negative infections in urologic patients, antimicrobial therapy with broad-spectrum antibiotics, such as aminoglycosides, is an integral part of management of urinary infections. Amikacin, because of its activity against infections caused by Pseudomonas, Serratia, and other frequently resistant bacteria, as well as its ability to achieve high blood and tissue levels, provides a significant advantage over other aminoglycoside agents in hospitalized urologic patients with suspected nosocomial infections. Although amikacin remains the most expensive of the aminoglycoside agents, its use is prudent in infections in which the causative organism is suspected but not definitively identified and when treatment must be started before specific culture and sensitivity information is available. In these situations, the most potent antibiotic agent with the broadest spectrum for eliminating infections caused by suspect organisms must be chosen, and amikacin is an ideal choice.

Amikacin↗
PubMed1985

Priapism: etiology, treatment, and results in series of 35 presentations.

Of 35 cases of priapism a successful outcome with detumescence of the erection and preservation of potency was achieved in only 6 instances. Patients with sickle cell disease enjoyed a more optimistic outcome, and early presentation appeared to be the key factor. The different therapeutic approaches did not have great impact on the outcome, and we advise an initial conservative approach progressing to glans-cavernosa fistula creation and subsequently to cavernosum-spongiosum shunting for patients failing to respond.

Adolescent↗