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Biomedical subjects

K A Baker

Publications and source records attributed to K A Baker.

33 records · Page 2Linked to original sources
PubMed1993

Clinical, historic, and therapeutic features of cicatricial pemphigoid. A literature review and open therapeutic trial with corticosteroids.

Cicatricial pemphigoid is at present an incurable, autoimmune disease that involves mucosa and skin. We have documented the clinical, microscopic, and therapeutic features of 23 patients with cicatricial pemphigoid and added these to reports of past literature. The mean age at the time of diagnosis was 63 years, and women were involved twice as often as men. Eighty-three percent of patients had oral mucosal involvement, 70% had conjunctival involvement, and 22% had skin involved. Direct immunologic evaluation revealed IgG at the basement membrane in 57% of cases and C3 in 66%. We have been able to manage the disease adequately in most patients with topical or systemic corticosteroids. The most commonly encountered side effect was oral candidiasis.

Aged↗
PubMed1991

Pressure-controlled inverse-ratio ventilation.

The routine use of PCIRV in adult critical illness remains an area of considerable controversy and debate. This stems in large part from a lack of well-controlled studies demonstrating improved patient outcome over conventional mechanical ventilation techniques. Although it is unlikely that clinicians will stop using PCIRV until such data are available, nurses and other caregivers should exercise caution whenever this form of therapy is employed.

Adult↗
PubMed1990

Oral lichen planus: the clinical, historical, and therapeutic features of 100 cases.

Lichen planus is a chronic inflammatory epidermal and mucosal disease, the cause of which is poorly understood. We reviewed the clinical and historic features of 100 patients referred to our clinic for diagnosis and management of lichen planus. The age, gender, chief complaint, duration of the chief complaint, medical history, medications, and clinical findings were recorded. Past therapeutic modalities were reviewed. Of therapeutic significance, 25 patients with oral lichen planus had a secondary oral candidiasis. Management of symptomatic lichen planus with topical and systemic steroid is discussed. The pharmacology of topical and systemic steroid usage and the rationale for treatment are discussed.

Administration, Topical↗
PubMed1990

Simultaneous, multiple point mapping during surgery for Wolff-Parkinson-White syndrome without the use of a computer.

Epicardial mapping of patients undergoing surgical correction of the Wolff-Parkinson-White syndrome is usually accomplished by using a single point probe. This somewhat tedious and time consuming method has been streamlined by computer-based systems allowing multiple simultaneous point maps to be developed either by electrodes applied as a band around the atrioventricular groove or a sock over the ventricle. Because the computer technology required to access, analyze, and display this data is not widely available, a system was devised to display ten simultaneous electrograms from a wrap of ten electrodes placed about the atrial or ventricular side of the atrioventricular groove. Using this technique three patients undergoing surgery for accessory pathway removal were accurately and quickly mapped allowing surgical cure of the preexcitation in each case.

Electrocardiography↗
PubMed1986

Review of systemic fluoride supplementation and consideration of the pharmacist's role.

Interprofessional contact and consultation among dentists, physicians, and pharmacists can help to optimize patient care. Because pharmacists are readily accessible to the public, their influence is essential for the appropriate prescribing and continued use of systemic fluoride supplements. Pharmacists should be familiar with various aspects of fluoride therapy, such as mechanisms of caries inhibition, dosages associated with acute and chronic toxicity, and recommended daily dosage levels. The impact of breastfeeding, multiple sources of water intake, and changing age of the patient must be considered in determining proper systemic fluoride dosage. Pharmacists should consult with both physicians and dentists to coordinate water fluoride assay and prescribing responsibilities. They also can help to educate both prescribers and patients. Because of frequent patient contact and access to medication records, pharmacists can encourage and monitor patient compliance. Fluoride prescriptions and results of water fluoride assays should be documented on the patients' computerized or card profiles. In addition, pharmacists can counsel patients about the fluoride ion content of various home-use products and make recommendations to ensure that an optimal level of fluoride ingestion is maintained.

Dental Caries↗
PubMed1986

Considerations in differential diagnosis of adverse reactions to local anesthetic: report of case.

A 62-year-old woman with reported allergies to procaine and lidocaine requested dental care. Consultation with the patient, the patient's physicians, and the patient's dentists did not identify the causes of the adverse reactions had occurred only when anesthetic was administered without vasoconstrictor. There were no reactions when vasoconstrictor was used. Skin testing by an allergist disclosed no evidence of true allergic reaction to any of the 'caine drugs. In addition, no evidence of reaction to preservatives was found during patch testing. The adverse reactions were determined to be caused by an idiosyncratic low threshold to toxic side effects of 'caine drugs. The use of vasoconstrictor (epinephrine) apparently promoted the retention of the anesthetic locally and prevented systemic absorption sufficient to cause the toxic reaction. Practitioners must be aware that adverse reactions to dental anesthetic may be a result of true allergy, psychogenic reaction (syncope), normal toxic overdose, or idiosyncratic toxic overdose.

Anesthesia, Dental↗
PubMed1983

Effect of age, sex and illness on salt taste detection thresholds.

Salt taste detection thresholds have been measured by a forced-choice, up-down sip method in 146 healthy subjects aged 10-95 years, and in 43 ill elderly patients. Thresholds are shown to increase log linearly with age after the age of 20 years. Thresholds are higher in smokers than non-smokers and the lower thresholds of women are accounted for by their lower prevalence of smoking. Ill patients have higher thresholds than healthy subjects of the same age and this is not specifically associated with any diagnosis. The methodology of taste threshold measurement and earlier studies of taste thresholds are reviewed.

Adult↗
PubMed1976

Preliminary field-testing of The Physician's Developmental Quick Screen for Speech Disorders ("PDQ"). A 5-minute procedure for testing children six months to six years.

This report describes the development of The Physician's Developmental Quick Screen for Speech Disorders (the PDQ), a screening test designed for use by nonspeech pathologists with children aged six months to six years. Disorders of language, articulation, voice, rhythm of speech, and the speaking mechanism are considered by the PDQ. Validation studies resulted in 90 per cent agreement (p less than .001) between nonspeech pathologists utilizing the PDQ and speech pathologists employing a battery of more established tests.

Adult↗
PubMedDate not supplied

Medications with dental significance: usage in a nursing home population.

The institutionalized elderly use more drugs per capita than do other segments of the population and are more likely than other population groups to have adverse drug reactions. Many of these drugs could affect oral health or dental treatment. This paper provides data on the frequency with which a population of nursing home residents took medications with possible oral effects. Information regarding prescription and nonprescription drug use was obtained from nursing home records of 481 subjects. Nine medication effect categories of possible significance in dentistry were established. Dentists treating institutionalized patients must be knowledgeable about patient drug use because 94% of this institutionalized population were taking medications that could alter oral health or dental treatment.

Aged↗
PubMedDate not supplied

Treatment of trigeminal neuralgia: use of baclofen in combination with carbamazepine.

A patient with trigeminal neuralgia who became refractory to carbamazepine but responded well to the addition of baclofen to his regimen is described, and the drug and surgical treatment of trigeminal neuralgia are discussed. A 57-year-old white man sought medical help following a six-week history of paroxysmal pain in the right jaw. Rubbing the skin in the right third division of the trigeminal nerve produced a paroxysm of pain. Trigeminal neuralgia was diagnosed, and carbamazepine therapy was initiated with good results. Pain recurred upon discontinuation of the therapy, and carbamazepine was restarted. However, debilitating pain persisted despite continuous treatment that produced moderate postdose ataxia. Baclofen was added to the patient's regimen and increased to 60 mg daily with subsequent reductions in the carbamazepine dosages. The patient remained pain-free during the following 10 months. Carbamazepine is considered the drug of choice and is initially very effective in treating trigeminal neuralgia. However, many patients are forced to discontinue drug therapy because of intolerance or ineffectiveness and are faced with surgery as their only option. Baclofen does not appear to be as effective as carbamazepine when used as a single agent. However, its apparent synergism with carbamazepine and phenytoin combined with its low incidence of serious side effects make baclofen a valuable adjunct in the treatment of refractory trigeminal neuralgia.

Baclofen↗