Search PubMed⌕ Search

Biomedical subjects

B L Carter

Publications and source records attributed to B L Carter.

At least 91 records · Page 5Linked to original sources
PubMed1987

Evaluation of three dosage-prediction methods for initial in-hospital stabilization of warfarin therapy.

Three dosage-prediction methods for initial in-hospital stabilization of warfarin therapy were evaluated. Adult inpatients who had received warfarin sodium 10 mg daily for less than three days were eligible for the study. After receiving their third warfarin dose, patients were randomly assigned to have their warfarin dosages adjusted using one of three dosage-prediction methods: by analog computer (n = 31), linear regression (n = 22), or empiric dosing by the physician (n = 34). A prothrombin time (PT) ratio (patient PT divided by control PT) between 1.3 and 2.5 was considered to be in the therapeutic range. For patients who achieved a stable PT ratio (defined as a PT ratio between 1.3 and 2.5 that varied by less than 0.05 on two consecutive days or by less than 0.1 on three consecutive days without a dosage change) before discharge, the number of days (time to stabilization) from administration of the first warfarin dose to achievement of the warfarin dosage that produced a stable PT ratio (stabilization dosage) was compared. A total of 54 patients met the study criteria for a stable PT ratio before hospital discharge (analog computer, n = 20; linear regression, n = 15; empiric dosing, n = 19). The mean times to stabilization were 6.8 days in the analog-computer group, 7.3 days in the linear-regression group, and 8.4 days in the empiric-dosing group; these times were not significantly different. All 20 stabilized patients in the analog-computer group achieved a stable PT ratio by the fourth dosage prediction.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1986

Computed tomography of choanal atresia: special considerations of the unilateral type.

Seven cases of choanal atresia are presented: four cases with bilateral choanal atresia, and three cases with unilateral choanal atresia. The patients in three of these cases were born with the CHARGE association--an association of choanal atresia with coloboma, heart disease, retarded growth, genital hypoplasia, and ear anomalies. Diagnosis in all cases was confirmed. Computed tomography generally confirms the clinical diagnosis of bilateral choanal atresia. Unilateral choanal atresia, however, presents late, and both the clinical and radiographic manifestations may be subtle. In all our cases of unilateral choanal atresia, computed tomography demonstrated the definitive components accounting for this deformity. Computed tomography, because it so accurately defines the anatomic malformation, is now the imaging modality of choice in this entity.

Adolescent↗
PubMed1986

Plunging ranula: CT diagnosis.

A plunging ranula is a cystic mass in the submandibular area arising from an occluded sublingual gland. Fluid from the obstructed gland dissects between the fascial planes and muscle of the base of the tongue to the submandibular triangle. A plunging ranula can be readily identified preoperatively with computed tomography as a cystic mass in the suprahyoid anterior neck. Three case reports are presented.

Adult↗
PubMed1986

Secretion of mammalian polypeptides from yeast.

Yeast cells are capable of expressing and secreting foreign polypeptides into the medium. Mammalian glycoproteins are glycosylated when secreted from yeast although the exact oligosaccharide sequence is not reproduced.

Amino Acid Sequence↗
PubMed1986

Effect of a rapid diagnostic method on prescribing patterns and ordering of throat cultures for streptococcal pharyngitis.

The sensitivity and specificity of a rapid identification test for group A beta-hemolytic streptococcus and its impact on prescribing antibiotics and ordering throat cultures were evaluated in a primary care office setting. The calculated sensitivity, specificity, positive predictive value, and negative predictive value were 82 percent, 92 percent, 76 percent, and 94 percent, respectively. Throat cultures were ordered for 98 percent of patients with acute pharyngitis regardless of the method of testing available. After use of the rapid identification test within the office, a reduction was observed in physician prescribing of antibiotics before the throat culture results were known. Physicians were more likely to initiate antibiotics immediately when rapid test results for streptococcal infection were positive and provide patient education regarding symptomatic treatment when the results were negative. The rapid identification test is an acceptable alternative to the standard culture technique in the family practice office. The rapid test was apparently responsible for the observed reduction in antibiotic prescribing and should reduce unnecessary cost and antibiotic exposure in the ambulatory setting.

Adolescent↗
PubMed1986

Theophylline clearance during pregnancy.

Theophylline clearance was prospectively studied in eight pregnant asthmatic patients who were receiving maintenance doses of theophylline. The study was designed to analyze theophylline clearance on three occasions during pregnancy and once postpartum. Theophylline clearance during the third trimester was significantly lower than that postpartum. Six patients had clearance measured both during pregnancy and postpartum and of these, five displayed a reduction in theophylline clearance during pregnancy that ranged between 20 and 53%. Two patients required dosage reductions due to symptoms of toxicity. These results indicate that theophylline clearance is frequently reduced during pregnancy, resulting in excessive serum levels. Patients should be observed for toxicity, and theophylline serum levels should be measured more frequently during the last half of pregnancy.

Adolescent↗
PubMed1985

CT detection of necrotising enterocolitis.

Necrotising enterocolitis may occur as a complication of granulocytopenia of any aetiology. The clinical presentation may be non-specific and the diagnosis therefore depends heavily on radiographic findings, particularly changes seen by CT. In immune-compromised patients being investigated for possible abdominal sources of fever, CT may be particularly helpful in elucidating bowel sources of infection. Two cases of necrotising enterocolitis demonstrated by CT are presented. The two cases were in immune-compromised patients with malignant disorders who presented with fever. The CT findings of this disorder are presented.

Adult↗
PubMed1984

Combined posteroanterior subepicardial fat simulating the echocardiographic diagnosis of pericardial effusion.

The location and relative size of echo-free spaces observed by cardiac ultrasound have been considered reliable signs for distinguishing pericardial fat from fluid; spaces that are exclusively anterior have been considered to represent fat, while spaces that are exclusively or predominantly posterior have been considered to represent fluid. In the present study, the location and relative size of echo-free spaces in eight patients suggested the diagnosis of pericardial effusion; evaluation by computed tomography or thoracotomy, or both, in six and necropsy in two, however, disclosed that these echo-free spaces--posterior as well as anterior--were exclusively due to fat. Age appeared to be as important a predisposing factor as obesity in the accumulation of excess subepicardial fat. No M-mode or two-dimensional features were found to be reliable in differentiating fat from fluid, although excessive amplitude of the posterior pericardial echo on the M-mode study favored the diagnosis of fat. Thus, the finding of echo-free spaces by cardiac ultrasound, even when the posterior space is isolated or larger than an accompanying anterior space, is not necessarily indicative of pericardial fluid. In elderly patients, in particular, posterior echo-free spaces due to fat may invite an incorrect diagnosis of pericardial effusion or pericarditis. In patients in whom echo-free spaces represent an unexpected finding of cardiac ultrasound examination, computed tomography of the chest may be helpful in establishing whether they are due to fat or fluid.

Adipose Tissue↗
PubMed1984

Computed tomography in tarsal coalition.

The limitations of routine radiography of the feet in demonstrating tarsal coalitions are well known. Even with the use of multiple projections of the foot, tarsal coalitions may escape detection. Computed tomographic examinations of the feet were performed in persons suspected of having tarsal coalitions. The CT images were obtained in both the longitudinal and axial axes of the foot. Results of these examinations suggest the longitudinal projection to be most helpful in demonstrating talonavicular coalitions and the axial projection in demonstrating talocalcaneal coalitions. The history, pathology, and other imaging modalities of tarsal coalitions are reviewed.

Adolescent↗
PubMed1984

Percutaneous catheter drainage of deep neck infections guided by CT.

We report success with CT guided percutaneous catheter drainage of deep neck abscesses. The cost efficacy and decreased morbidity of percutaneous catheter drainage has been proved in abdominal and retroperitoneal abscess management, and CT for diagnosis of deep neck infections is well established. The logical application of a proven technique to a new anatomical location has the added potential benefit of improved cosmetic result.

Abscess↗
PubMed1984

Computed tomography of neuroblastic tumors in children.

Computed tomography (CT) was performed in 16 children with neuroblastic tumors. CT aided significantly in the accurate preoperative delineation of tumor extent and in the demonstration of tumor features not visualized by conventional radiography. CT provided excellent postoperative follow-up, particularly in assessing the effects of chemotherapy and radiation therapy. The results of CT, ultrasound, radionuclide imaging, and conventional radiography have been compared.

Abdominal Neoplasms↗
PubMed1984

Evaluation of family physician prescribing: influence of the clinical pharmacist.

This study was designed to determine whether prescribing patterns in family practice residency training offices were more favorable in offices with clinical pharmacists. Two family practice residency training offices with clinical pharmacists and two offices without clinical pharmacists served as study sites. At each office, 100 prescription copies were selected by stratified random sampling, and a case abstract was constructed from the medical record. An additional 38 prescriptions that resulted from clinical pharmacist consultation were studied. A blinded review panel evaluated the cases for appropriateness of drug choice and dose and anticipated benefit of the prescription. Prescriptions from offices with clinical pharmacists and consult prescriptions were rated significantly more favorably both for drug choice and drug dose (p less than 0.02). These data suggest that clinical pharmacists involved in family practice residency programs may refine and improve otherwise acceptable prescribing.

Drug Prescriptions↗
PubMed1984

Multicenter study of family physician prescribing.

The objective of this study was to examine differences in prescribing characteristics among four Iowa family practice offices, each associated with family practice residency programs. This prospective study collected data over a four-month period, utilizing duplicate, carbon-copy prescriptions. The prescriptions were tabulated according to individual drug and therapeutic categories. Differences in prescribing frequency among offices were analyzed using chi-square 2 X 2 contingency tables. The number of prescriptions written at each office (designated A through D) were as follows: A, 1,034; B, 1,449; C, 2,965; and D, 2,335. The most frequently prescribed drug category was systemic antibiotics, followed by cough, cold, or allergy products, analgesic and anti-inflammatory drugs or muscle relaxants, diuretics, and topical anti-infectives. There were statistically significant differences in the frequencies of these categories among offices. The most frequently prescribed drug was amoxicillin at offices A, B, and C, and erythromycin at office D. There were statistically significant differences in the frequencies of the top ten drugs at each office. From these data the family practice faculty and clinical pharmacists can identify therapeutic areas that may require additional educational emphasis for the resident.

Drug Prescriptions↗
PubMed1983

Perspectives on massive osteolysis. Report of a case and review of the literature.

Massive osteolysis is a rare, chronic disease characterized by the progressive dissolution of contiguous osseous structures. There is no regeneration following the osteolysis. Pathologic fracture often leads to its discovery. The etiology and pathophysiology of the disease remain obscure. Chemo- and radiotherapeutic attempts at arresting the osteolytic process are generally unsuccessful. Bone grafting has proved disappointing, as the graft usually undergoes osteolysis. A new case of facial bone involvement in a 13-year-old boy is presented. The literature is reviewed, and the clinical experience gained from treating the disease is discussed.

Adolescent↗