Search PubMed⌕ Search

Biomedical subjects

C W Howard

Publications and source records attributed to C W Howard.

18 recordsLinked to original sources
PubMed2001

Ocular manifestations of Seckel syndrome.

PURPOSE: To report ophthalmic findings in three siblings with Seckel syndrome. METHODS: Observational case report. Three siblings with Seckel syndrome were examined. RESULTS: Severe bilateral pigmentary retinopathy with severe myopia and astigmatism was found in all three patients. Electroretinography was performed on the eldest sibling and showed no detectable rod or cone responses. CONCLUSION: Severe, early onset, bilateral retinal degeneration with severe myopia and astigmatism may be associated with Seckel syndrome.

Abnormalities, Multiple↗
PubMed2000

Surgical alternatives for treatment of obstructive sleep apnoea: review and case series.

Obstructive sleep apnoea (OSA) affects up to 24% of middle aged males, resulting in excessive daytime sleepiness, cognitive dysfunction, hypertension, increased risks for acute coronary events, stroke and auto accidents. At special risk are individuals with BMI greater than 29, neck circumference greater than 43 cm (17 inches), macroglossia and retrognathia. Although non-surgical nasal positive air pressure (nCPAP) and mandibular advancement oral appliances are often effective and are the most widely used therapy, they are not definitive for more severe OSA and patients show poor long-term compliance. Surgical reduction of palatal, lingual and nasal soft tissue volumes improve airway functions in approximately 40% of patients with mild to moderate OSA. Maxillary and mandibular advancement osteotomies have proven over the past decade to reverse even severe OSA at greater than the 90% efficacy levels. Surgical treatment targeted to skeletal and airway soft tissue anomalies using a multidisciplinary treatment approach can have a major impact on this widespread and high-risk disorder.

Adolescent↗
PubMed1992

The injuries to JFK.

Explore the source record for details and available documents.

Craniocerebral Trauma↗
PubMed1992

Risk factors for drug use in urban adolescents: identification and cross-validation.

Examined the relationship between 26 dichotomous risk factors and drug use in derivation (N = 1,352) and cross-validation (N = 1,309) samples of seventh graders in the public school system of a large southeastern city. The majority of students was African American, many came from low-income, single parent families. A total of 20 risk factors representing a variety of variables was significantly related to at least one category of drug use in both samples. Regression analyses identified a subset of 11 risk factors with minimum overlap. The simple sum of these 11 risk factors was significantly associated with prevalence of use for cigarettes, beer and wine, hard liquor, marijuana, and other drugs. The total number of risk factors also showed a curvilinear relationship with the frequency of 30-day use for each category of drug. Theoretical and practical implications of these findings are discussed.

Adolescent↗
PubMed1992

Simultaneous split-thickness skin grafting and placement of endosteal implants in the edentulous mandible: a preliminary report.

Reconstruction of the edentulous atrophic mandible continues to be a treatment problem for the oral and maxillofacial surgeon. Clearly, endosteal osseointegrated implants are indicated for rehabilitation, but a total implant-supported prosthesis may not always be possible. The implant-supported overdenture is an excellent alternative, but modifications of the unfavorable residual ridge may be necessary. Attached crestal soft tissue, resistant to mechanical trauma, and improvement of the residual ridge anatomy are provided by adding a split-thickness skin graft vestibuloplasty (VSG) and lowering of the floor of the mouth (LFM). Simultaneous VSG and LFM with placement of endosteal implants provides the optimal condition for maximal rehabilitation of the atrophic mandible with specific indications. Results of four skin grafts and eight implants simultaneously placed are reported.

Alveoloplasty↗
PubMed1992

Relationship between drug use and other problem behaviors in urban adolescents.

This study tested the generality of Jessor and Jessor's (1977) problem behavior theory, which states that a variety of problem behaviors constitute a behavioral syndrome in normal adolescents. Relationships among 5 adolescent problem behaviors (cigarette use, alcohol use, marijuana use, delinquency, and sexual intercourse) were examined in 7th-grade boys (n = 556) and girls (n = 715), and 9th-grade boys (n = 481) and girls (n = 485) in an urban school system in which the majority of students were African American and from low-income families. Measures of problem behavior frequency were positively correlated with each other and negatively correlated with several measures of conventional behavior. Confirmatory factor analyses replicated findings of previous studies that a single common factor underlies adolescent problem behaviors.

Achievement↗
PubMed1992

High prevalence of Kingella kingae in joint fluid from children with septic arthritis revealed by the BACTEC blood culture system.

In an effort to improve detection of fastidious organisms, joint fluid aspirates of pediatric patients were inoculated into BACTEC 460 aerobic blood culture bottles, in addition to cultures on solid media. Culture records for the 1988 to 1991 period were reviewed to compare the performance of both methods for the recovery of pathogens. Overall, 216 children underwent a diagnostic joint tap, and 63 specimens grew significant organisms, including Kingella kingae in 14. While both methods were comparable for recovery of usual pathogens, with a single exception, K. kingae isolates were detected by the BACTEC system only. K. kingae appears to be a more common cause of septic arthritis in children than has been previously recognized. The BACTEC blood culture system enhances the recovery of K. kingae from joint fluid and improves bacteriologic diagnosis of pediatric septic arthritis.

Adolescent↗
PubMed1992

Risk factors for drug use in rural adolescents.

This study tested the relevance of a risk factor model for predicting drug use among rural adolescents. A questionnaire battery assessing drug use and the presence/absence of twenty risk factors derived from a previous study of urban adolescents was administered to a sample of seventh graders (N = 235) in the public school system of a rural community. All but one of these risk factors were found to be significantly related to at least one category of drug use. In addition, a risk factor index based on a subset of ten risk factors was significantly associated with the prevalence and frequency of use for cigarettes, beer and wine, hard liquor, marijuana, and other drugs. These findings support the generalizability of a risk factor approach to predicting drug use, and underscore the need for increased prevention and research efforts directed at rural adolescents.

Adolescent↗
PubMed1989

The plasma endorphin, prostaglandin and catecholamine profile of patients with fibrositis treated with cyclobenzaprine and placebo: a 5-month study.

During a 5 month, double blind crossover study of the clinical effect of cyclobenzaprine on 7 patients with fibrositis, weekly measurements were done of plasma beta-endorphin (endorphin, prostaglandin E (PGE) and catecholamines). Endorphin levels were normal but varied with tender point tenderness. Mean plasma dopamine and PGE were elevated. Norepinephrine was normal to very high while epinephrine levels were continuously low to normal. We conclude that patients with fibrositis have a neurotransmitter plasma profile like other chronic pain states having stress and increased vasomotor activity with the possible exception of having low circulating epinephrine. This disparity may mark a failure of central nervous system pain modulation in fibrositis.

Adult↗
PubMed1986

Use of adjustable sutures: a helpful modification.

Adjustable suture surgery helps achieve visual axis alignment in special cases. We describe a modification of adjustable suture surgery that provides better patient comfort and easier assessment of the muscle function at the time of adjustment. These beneficial features are achieved by using the cul-de-sac approach and by delaying final adjustment up to one week postoperatively. We review our experience involving 52 cases and discuss the surgical methods and reasoning behind delayed suture adjustment through the cul-de-sac approach.

Adolescent↗
PubMed1984

Coronoid process hyperplasia causing restricted opening and facial asymmetry.

A case of coronoid process hyperplasia is presented. The primary presenting complaint and clinical feature was restriction of opening, although there was marked facial asymmetry in the area of the right zygoma. Presurgical documentation of this anatomic variation by routine radiography and computed tomography with sagittal reconstruction is presented.

Adolescent↗
PubMed1980

Computed tomographic features in optic neuritis.

A computed tomography scan obtained in two patients with monocular visual loss showed diffuse enlargement and enhancement of the intraorbital portion of the involved optic nerve. Although these tomographic features were initially interpreted as an optic nerve glioma by the neuroradiologist, the ensuing clinical course established the diagnosis of optic neuritis.

Adolescent↗
PubMedDate not supplied

Clinical practice guidelines for the management of orbital cellulitis.

PURPOSE: A retrospective study was performed to review the management of periorbital and orbital cellulitis at Miami Children's Hospital, between January 1, 1993 and February 15, 1996. RESULTS: One hundred and one patients were included in this study. The variables analyzed in this study included age, sex, length of hospital stay, imaging studies, laboratory tests, and microbiology specimens collected. Patients were classified according to the modified Chandler classification. Average length of stay for our patient population was 4.5 days. Data regarding the radiologic studies, laboratory tests, and microbiology yield of specimens were analyzed. CONCLUSIONS: The incidence of orbital infection, manifested by lid swelling alone is much more common (stages I and II) than orbital infection involving postseptal findings (stages III, IV, and V); 84.16% compared with 15.84%, respectively. An updated approach and a general guideline for the management of periorbital and orbital cellulitis according to the clinical staging of the process is presented.

Anti-Bacterial Agents↗
PubMedDate not supplied

Optic neuritis in children.

PURPOSE: To describe the clinical characteristics of optic neuritis in children, including final visual acuity and development of multiple sclerosis (MS). METHODS: Charts were reviewed of all patients < 15 years of age who presented with optic neuritis to the Bascom Palmer Eye Institute or the Miami Children's Hospital between 1986 and 1998. RESULTS: Fifteen patients were identified. There was a slight female predilection in the study group (60%), with a mean age of 9.8 years at presentation. A preceding febrile illness within 2 weeks of visual symptoms was reported in 66% of patients. Initial visual acuity ranged from 20/15 to no light perception. Involvement was bilateral in 66% of patients, and disc swelling was present in 64% of involved eyes. Of the patients who underwent magnetic resonance imaging, 33% had focal demyelinating lesions in the brain, and 63% of affected nerves were enlarged or enhanced with gadolinium. Eleven patients were treated with intravenous steroids. Final visual acuity was > or = 20/40 in 58.3% of eyes. Thirty percent of the patients had vision of finger counting or worse. Four (26%) patients developed MS. The mean age of patients with MS was 12 years, compared with 9 years in children who did not develop MS. Patients with unilateral involvement had an excellent visual prognosis (100% > 20/40), but a higher rate of development of MS (75%). Two patients had positive serology for Lyme disease. CONCLUSIONS: Optic neuritis presents differently in children than in adults. Children typically have bilateral involvement with papillitis following an antecedent viral illness. Although visual prognosis is poorer in children than adults, the development of MS is less common in children. Children who present with unilateral involvement have a better visual prognosis; however, they also develop MS at a greater frequency than children with bilateral involvement. Patients who developed MS were, on average, older at presentation with optic neuritis than those who did not develop MS.

Adolescent↗