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Biomedical subjects

L W Carter

Publications and source records attributed to L W Carter.

13 recordsLinked to original sources
PubMed1995

Determination of accuracy of preoperative templating of noncemented femoral prostheses.

The purpose of this study was to determine the accuracy of preoperative templating of primary, noncemented femoral components. A retrospective review of charts and radiographs was performed on 74 hips in 64 patients who had undergone either noncemented total hip arthroplasty (THA) or placement of an endoprosthesis (including bipolar). Preoperative radiographs were templated by a total joint arthroplasty attending surgeon, a senior orthopaedic resident, and a junior resident. The templated size corresponded to the actual femoral implant used in approximately 50% of cases. When femoral prostheses within one size above or below the templated size were included, the accuracy of preoperative templating rose to 88-95%. When implants within two sizes of the templated size were included, the accuracy approached 100%. Factors associated with discrepancies in the size of femoral stem used included placement of an undersized implant, presence of metal hardware that obscured the ability to template accurately, proximal bone deformity, sclerotic bone, acute femoral neck fracture, and inadequate preoperative radiographs. The accuracy of templating increased gradually with the level of training. The most experienced investigator was able to template within one size of the actual implant used in 95% of cases, compared with 88% and 82% for the less experienced investigators. Acute femoral neck fractures and proximal bone deformity were associated with the largest discrepancies in templated sizes.

Adult↗
PubMed1994

Bacterial translocation: nursing implications in the care of patients with neutropenia.

PURPOSE/OBJECTIVES: To describe bacterial translocation; the potential causes and influencing factors of bacterial translocation; the anatomy, physiology, and immunology of the small intestine; and the significance of bacterial translocation in patients with cancer. DATA SOURCES: Published articles and books, as well as clinical experience. DATA SYNTHESIS: 50% of infections in patients with cancer who are neutropenic result from endogenous sources such as the normal microbial flora of the bowel. This process called bacterial translocation may be responsible for symptoms such as fever of unknown origin in these patients. CONCLUSION: Maintaining normal bacterial ecology and mucosal integrity of the bowel can reduce the risk of bacterial translocation. IMPLICATIONS FOR NURSING PRACTICE: Care is directed at preventing constipation and maintaining integrity of the normal bowel and microbial flora by providing a low-microbial diet that contains adequate fluid and fiber and by encouraging good oral care.

Bacterial Physiological Phenomena↗
PubMed1993

Influences of nutrition and stress on people at risk for neutropenia: nursing implications.

Neutropenia may be influenced by malignancy type, treatment, age extremes, inadequate nutrition, or psychological stress. Of these five factors, only nutrition and stress are amenable to nursing intervention and management. The increasing trend of providing treatment in the outpatient setting and managing the patient with neutropenia in the home challenges nurses to develop innovative methods of care. This article offers suggestions to assist nurses in the creative management of individuals at risk for neutropenia by maximizing nutrition and minimizing psychological stress. This discussion addresses the physiology of the inflammatory immune response; pathophysiology of neutropenia; factors that may influence the risk of infection, such as sustained stress, dietary fiber, antioxidant vitamins, and food-borne bacteria; and interventions that reduce the potential for neutropenic sepsis. Nursing implications that reduce the risk of neutropenic infection include patient education related to nutrition, stress management, and self-care.

Bacterial Infections↗
PubMed1993

Ipsilateral fractures of the femoral neck and shaft.

The management of ipsilateral fractures of the femoral neck and shaft has proved to be a challenge to the orthopaedist. Most major institutions have treatment protocols that emphasize early rigid stabilization of the femoral-neck fracture to minimize the incidence of avascular necrosis of the femoral head. Since 1985, the authors' protocol has been to reduce and stabilize the femoral-neck fracture anatomically, followed by treatment of the femoral-shaft fracture. In 1990, we began treating this segmental fracture pattern with reconstruction nails. This study reviews the cases of 11 patients treated at the Medical College of Georgia Hospital from November 1985 to March 1992. Nine of the 11 underwent surgery within 12 hours of injury; 4 of these patients were treated with reconstruction nails. The mean follow-up was 2 years. Seven of the 11 had a good functional outcome, whereas 4 had a fair outcome. The results indicate that patients with ipsilateral fractures of the femoral neck and shaft can obtain good results when early (< 12 hours) rigid anatomic stabilization of the femoral neck is performed. The authors recommend utilizing a reconstruction nail for stabilizing this dual fracture whenever possible.

Adolescent↗
PubMedDate not supplied

Calcium intake in young adult women: implications for osteoporosis risk assessment.

A nonexperimental pilot study surveyed a convenience sample of 41 healthy women, aged 25 to 35 years, who were not pregnant, lactating, or menopausal, to identify those women who may be at risk for osteoporosis based on daily calcium intake. Data analysis suggested that 31 of 41 subjects surveyed consumed less than 1250 mg calcium daily and were, therefore, at risk for osteoporosis in late adulthood.

Adult↗