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Biomedical subjects

C M Witten

Publications and source records attributed to C M Witten.

8 recordsLinked to original sources
PubMed1993

A case of cerebral infarction in association with free protein S deficiency and oral contraceptive use.

The purpose of this article is to describe protein S deficiency as a cause of cerebral infarction in the young adult. We report a 27-year-old previously healthy woman with a primary free protein S deficiency, who developed a left temporoparietal infarction. Protein S is a naturally occurring vitamin K-dependent protein which, in conjunction with active protein C, inhibits the clotting cascade. Protein S deficiency is known to be of clinical significance in patients with deep venous thrombosis or pulmonary emboli and in these patients, treatment is long-term anticoagulation. Protein S deficiency has been found to be associated with cerebrovascular occlusion and may possibly warrant long-term anticoagulation in these patients as well. Measurement of total and free protein S levels should be part of the evaluation for any young adult who has had a stroke.

Adult↗
PubMed1992

Methylphenidate in stroke patients with depression.

The treatment of depression after stroke is a difficult clinical problem. Many of the medications used to treat patients with depression in the general population have significant potential side effects that are of particular concern in elderly patients. We reviewed the records of ten patients with stroke treated with methylphenidate for depression during an inpatient rehabilitation program. Improvement was noted in seven patients. This suggests that methylphenidate in the treatment of post-stroke depression merits further study.

Aged↗
PubMed1992

Thoracic disk herniation and recurrent dislocation of total hip prosthesis.

We have described a patient who had thoracic disk herniation, recurrent dislocation of a total hip prosthesis, and heterotopic ossification. The recurrent dislocation resulted from spasticity from a spinal lesion, but the treatment focused on technical solutions related to the hip. Evaluation for total hip arthroplasty should include careful neurologic examination. If recurrent dislocation occurs, spasticity from an occult lesion should be considered. Resection of calcified thoracic disks should be approached with caution.

Female↗
PubMed1990

Popliteal artery entrapment syndrome.

The purpose of this article was to describe popliteal artery entrapment syndrome, which is a cause of intermittent claudication in a young person, and to illustrate the importance of early diagnosis for successful treatment of this entity. A case report of a 28-year-old man with popliteal artery entrapment syndrome is presented. This patient had a classic history of calf pain that worsened with walking and was relieved by rest, running, or bicycle riding. Physical examination revealed evidence of ischemia in the distal extremity, and arteriography demonstrated signs of chronic occlusive disease. Early treatment might have included surgical release of the popliteal artery and arterial grafting. Due to extensive vascular disease, grafting was not possible and a below-knee amputation was performed. It is therefore essential to diagnose popliteal artery syndrome early for appropriate management.

Adult↗
PubMed1989

Pulmonary toxicity of nitrofurantoin.

Nitrofurantoin is frequently used by the physiatrist for treatment of urinary tract infections or for urinary antimicrobial prophylaxis. There is a substantial risk of acute and chronic pulmonary side effects with this medication. The acute pulmonary toxicity presents with fever, leukocytosis, dyspnea, and nonproductive cough. Chronic nitrofurantoin use can lead to interstitial pulmonary fibrosis. A case is reported of a 47-year-old spinal cord injured woman with an acute pulmonary reaction to nitrofurantoin. The literature pertaining to pulmonary toxicity of nitrofurantoin is reviewed.

Dyspnea↗