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Biomedical subjects

Charles E Stewart

Publications and source records attributed to Charles E Stewart.

7 recordsLinked to original sources
PubMed2006

Application of mitomycin-C for head and neck keloids.

Keloids of the head and neck are a relatively common entity in darker-skinned races, occurring in 5%-15% of skin wounds. Keloids are fibrotic lesions that are a result of an abnormal wound-healing process that lacks control of the mechanisms that regulate tissue repair and regeneration. The proliferation of normal tissue-healing processes results in scarring that enlarges well beyond the original wound margins. Many treatment modalities for keloids have been tried with variable amounts of success. Surgical excision, compressive therapy, silicon dressings, corticosteroid injections, radiation, cryotherapy, interferon therapy, and laser therapy have all been used alone or in combination. Despite this wide range of available treatments, recurrence rates typically remain in the 50%-70% range. In this study, we present our results in a series of 10 patients who were treated with surgical excision of head and neck keloids and the application of topical mitomycin-C. Mitomycin-C is a chemotherapeutic agent that inhibits DNA synthesis and fibroblast proliferation. It has been used in ophthalmologic procedures and airway surgery to decrease scar formation. In these 10 patients, we combined surgical excision of keloids with the application of topical mitomycin-C. The patients were then followed postoperatively for recurrence (range, 7-14 months). We have found topical application of mitomycin-C to be an effective therapy for prevention of keloid recurrence in the head and neck, with a success rate of 90% as reported in this series.

Adolescent↗
PubMed2005

Fortuitous detection of pseudoaneurysm by three-phase bone scan.

We report the diagnosis of an unsuspected pseudoaneurysm in the lower extremity when 3-phase bone scan was used to evaluate a presumed malignancy. We confirmed the diagnosis with duplex ultrasonography and angiography. Although the primary diagnostic modality for detection of pseudoaneurysm remains duplex sonography, the nuclear medicine practitioner should be vigilant for characteristic presentation of a pseudoaneurysm on a 3-phase bone scan, an area of increased radiotracer activity on blood-flow and blood-pool images that becomes a photopenic area on delayed images. This also underscores the need to consider benign vascular lesions in the differential diagnosis of abnormal 3-phase bone scans for presumed tumors.

Aneurysm, False↗
PubMed2005

Recognizing imminent danger: characteristics of a suicide bomber.

By all reports, the public is at increasing risk of attack by terrorist organizations. Citizens have been asked to increase their vigilance and report suspicious individuals to reduce the chance of a suicide or homicide bombing. Terrorist groups often target their actions to inflict the most casualties and may choose mass gatherings to detonate an explosive device. Since EMS providers are frequently assigned to work special details where large numbers of people may gather, EMTs and paramedics can assist law enforcement in identifying individuals who may pose a threat to the people gathered at the event. The characteristics of suicide bombers discussed here are meant to increase your awareness level to recognize a potential problem. The astute EMS provider can then notify appropriate law enforcement personnel for further investigation and action.

Emergency Medical Services↗
PubMed2002

Emergency management of cardiac injuries.

Cardiac trauma is not usually treatable in the field. EMS providers must recognize the possibility of cardiac trauma rapidly and evacuate the patient to an appropriate facility. Most therapy for cardiac trauma requires an operating room, preferably with cardiopulmonary bypass capability. Basic patient care should occur en route to the treatment facility. Ensure that the airway is intact, control respirations and bleeding, and restore circulatory volume to a pressure of about 100 systolic. Advanced providers should re-expand any associated tension pneumothorax and ensure the chest wall is stable. Consider early intubation, since operative intervention is likely.

Aortic Rupture↗
PubMed2002

Heavy weather.

Explore the source record for details and available documents.

Communication↗
PubMedDate not supplied

Fluoroquinolone-induced arthralgia and myalgia in the treatment of sinusitis.

BACKGROUND: Because of their broad-spectrum coverage, fluoroquinolone antibiotics are widely used in the treatment of acute sinusitis and acute exacerbations of chronic sinusitis. Generally, they are well tolerated, and adverse effects are usually mild. In our experience with quinolones, patients have frequently complained of arthralgias and/or myalgias. Although tendon rupture has been described as one of the more severe side effects, there are few published reports of arthralgias and/or myalgias associated with these drugs. METHODS: A retrospective review of fluoroquinolone prescriptions in a tertiary rhinology clinic was completed. Patients treated with oral levofloxacin for sinusitis over a 12-month period were contacted by mail and asked to complete an anonymous survey regarding adverse effects. Of 81 patients identified, 36 responses were received. RESULTS: Among respondents, the incidence of arthralgias and/or myalgias was 25%, which was more than twice the incidence of any other adverse effect reported. Occurrence of arthralgias and/or myalgias did not appear to be influenced by respondent age, course length, concurrent use of oral steroids, or a history of arthritis. Among those reporting arthralgia or myalgia, symptoms began after an average of 3 days of therapy and resolved an average of 7.5 days after cessation of treatment. Fourteen percent of respondents were unable to complete their course of therapy because of arthralgias and/or myalgias. CONCLUSION: Although effective and generally well tolerated in the treatment of sinusitis, fluoroquinolone antibiotics may produce adverse effects of arthralgia and/or myalgia.

Adult↗