Search PubMed⌕ Search

Biomedical subjects

D R Jordan

Publications and source records attributed to D R Jordan.

At least 73 records · Page 4Linked to original sources
PubMed1998

Assessment of ocular trauma associated with head and neck injuries.

We reviewed the real and potential ocular problems in all head and neck injuries at a tertiary care and regional trauma center from April of 1994 to March of 1995. Through a retrospective study, 127 charts were reviewed, specifically looking at the mechanism of injury, types of injury, whether there was any ocular trauma noted in the chart, and whether there was a consultation to the ophthalmology department. Forty-one of these patients were seen by an ophthalmologist as the initial consultant for ocular and orbital injuries recognized by the emergency staff. In the 86 remaining patients, signs of potential ocular injury were recorded in the chart in 62 (72%) of these patients, yet an ophthalmology consultation was requested for only 23 of them (37%). This survey reveals the lack of awareness in a regional trauma center of certain ocular and periocular signs that may be indicative of more serious ocular injuries. It is the purpose of this article to highlight these concerns to the various health professionals involved with head and neck trauma patients in the hope that the patients will, in the end, benefit from a more thorough and complete assessment of the potential ocular and periocular injuries.

Adolescent↗
PubMed1998

Senate voting and social construction of target populations: a study of AIDS policy making, 1987-1992.

Scholars have devoted considerable attention to analyzing the social construction of AIDS. To explore the politics of AIDS policymaking, this research uses Schneider and Ingram's (1993) theory of the social construction of target populations to evaluate the U.S. Senate's response to AIDS between 1987 and 1992. Our study found that Schneider and Ingram's model provides important insights into how political processes affect AIDS policy design. While our data did not strictly conform to all of the model's theoretical expectations, the data provided evidence confirming its predictions about broad patterns in the allocation of both substantive and symbolic policy benefits and burdens to different target populations.

Acquired Immunodeficiency Syndrome↗
PubMed1998

Scanning electron microscopic examination of porous orbital implants.

OBJECTIVE: To compare the structural makeup of five porous orbital implants: two made of coralline hydroxyapatite (Bio-Eye and Chinese implant), one of synthetic hydroxyapatite (FCI), one of porous polyethylene (Medpor) and one of alumina. The Bio-Eye, Medpor and alumina implants are currently available in Canada. OUTCOME MEASURES: Pore size, pore interconnectivity and microcrystalline architecture. RESULTS: The Bio-Eye had multiple interconnected pores ranging from 300 microns to 700 microns in width; higher-power views showed coarse-appearing crystals approximately 2 microns wide. The FCI implant showed similar interconnectivity of the pores but fewer pores, which were about 300 microns to 500 microns in size. Higher-power views showed hexagonal crystals about 1 micron to 5 microns in size. The Chinese hydroxyapatite implant had multiple interconnected pores ranging from 200 microns to 700 microns in size. The crystals were similar in appearance to those of the Bio-Eye but were smaller and more granular. The 150-micron pore size Medpor implant had irregularly shaped pores ranging from 100 microns to 500 microns in size. The 400-micron pore size implant had pores that looked more like channels that coalesced; the pores and channels ranged in size from 125 microns to 1000 microns. In both cases higher-power views showed a woven texture. In the alumina implant the pores were well connected and evenly distributed and were approximately 500 microns in size. On high-power studies the implant showed a cobblestone-like pattern of crystals approximately 4 microns to 5 microns wide. CONCLUSIONS: There are notable differences in pore size, pore interconnectivity and microcrystalline architecture between the implants studied. These features may be important in the overall biocompatibility of the implant.

Aluminum Oxide↗
PubMed1998

Cavernous hemangiomas of the orbital apex with intracranial extension.

Cavernous hemangiomas are benign vascular tumors that usually present as unilateral, intraconal mass lesions in middle-aged women. They may on occasion extend to the orbital apex or have intracranial extension. The authors present three patients with deep apical hemangiomas, two of whom had intracranial extension to the cavernous sinus area.

Adult↗
PubMed1998

Blepharospasm: past, present, and future.

To investigate causes, associations, and results of treatment with blepharospasm, 1,653 patients were evaluated by extensive questionnaires to study blepharospasm and long-term results of treatment with the full myectomy operation, botulinum-A toxin, drug therapy, and help from the Benign Essential Blepharospasm Research Foundation (BEBRF). The percent of patients improved by the BEBRF was 90%, full myectomy 88%, botulinum-A toxin 86%, and drug therapy 43%. The patient acceptance rate for the BEBRF was 96%, full myectomy 82%, botulinum-A toxin 95%, and drug therapy 57%. Blepharospasm is multifactorial in origin and manifestation. A vicious cycle and defective circuit theory to explain in origin and direct treatment rather than a defective specific locus is presented. All four forms of therapy evaluated are useful and must be tailored to the patient's needs. Mattie Lou Koster and the BEBRF have helped blepharospasm sufferers more than any other modality, and all patients should be informed of this support group. The full myectomy is reserved for botulinum-A toxin failures, and the limited myectomy is an excellent adjunct to botulinum-A toxin.

Blepharospasm↗
PubMed1998

Dysmorphophobia: a distorted perception of one's self-appearance.

Patients with dysmorphophobia are preoccupied with an imagined or grossly exaggerated defect of appearance. These patients may seek cosmetic surgical procedures to alter their perceived abnormal appearance. Treatment of patients with dysmorphophobia has not been previously addressed in the ophthalmologic literature. The authors present three case reports and discuss the syndrome of dysmorphophobia.

Adult↗
PubMed1997

Ptosis secondary to amyloidosis of the tarsal conjunctiva and tarsus.

PURPOSE: To report a case of chronic unilateral ptosis in a 63-year-old, otherwise healthy woman with visual restriction. METHODS: We performed a biopsy on an enlarged tarsal plate that we believed had caused ptosis. A levator aponeurotic advancement was performed subsequently. RESULTS: Histologic and ultrastructural examination of the biopsy specimen disclosed amyloidosis of the tarsal conjunctiva and tarsus. There was no evidence of systemic amyloidosis. CONCLUSION: Localized amyloidosis involving the tarsal conjunctiva and tarsus is a rare cause of chronic eyelid thickening and ptosis.

Amyloidosis↗
PubMed1997

Periocular necrotizing fasciitis: a review of five cases.

OBJECTIVE: The purpose of the study is to display a spectrum of clinical presentations of periocular necrotizing fasciitis caused by group A streptococci and to discuss recent trends and treatment of this disease. DESIGN AND INTERVENTION: A case series of five patients (four female and one male) was seen between July 1990 and January 1995 in four university centers. All had clinical evidence of periocular necrotizing fasciitis and grew group A streptococci on wound cultures or had serologic evidence of streptococcal infection. Details of patient presentation, treatment, and outcome are examined. RESULTS: The five patients showed a spectrum of clinical severity from a necrotizing infection confined to the eyelid to a potentially fatal, severe shock-like syndrome characterized by sepsis and multiorgan system failure. A history of trauma often was absent. Patients were treated successfully by a combination of appropriate antibiotics and surgical debridement. CONCLUSIONS: Group A streptococci can cause severe necrotizing infections of the eyelids. Early recognition and prompt treatment can be essential to these patients' survival.

Adult↗
PubMed1997

Trichotillomania.

PURPOSE: Trichotillomania is characterized by an irresistible urge to pull one's hair, and may involve the eyelashes or eyebrows. The authors present four cases of trichotillomania, and review the management of this unusual disorder. METHODS: The cases of four patients with trichotillomania were reviewed retrospectively. RESULTS: All four patients had characteristic areas of broken lashes along the lid in the absence of other signs of disease. Three of the four knew they were plucking the hair, yet could not control it. In the fourth, it was only after a lengthy observation period that she was discovered plucking. CONCLUSIONS: Trichotillomania has been infrequently reported in the ophthalmic literature. Management can be difficult. Many of these patients are aware of their behavior, but are unable to curtail it. Others may conceal or deny their habit. Psychiatric counseling may be of some benefit if patients are willing to undergo it.

Adult↗
PubMed1997

The universal implant for evisceration surgery.

The Universal implant is a quasi-integrated buried orbital implant designed to provide the same motility advantages as does an Iowa implant, but is simpler to implant and associated with fewer complications. The protruding mounds on the implant are keyed to corresponding indentations on the posterior prosthetic surface, allowing more life-like motility. We describe a straight-forward technique for its use as an evisceration implant and report the results in 24 patients. The Universal implant is simple to use and the lock-and-key mechanism obtained between implant and prosthesis provides the patient with a high degree of life-like motility. Its cost is significantly lower than the more popular hydroxyapatite implant and it does not require a drilling procedure for coupling.

Adult↗
PubMed1996

Abscessed hydroxyapatite orbital implants. A report of two cases.

PURPOSE: The authors describe the rare condition of an abscess within a hydroxyapatite orbital implant in two patients who had undergone seemingly uncomplicated enucleation and orbital implant surgery. METHODS: In the first patient, 14 weeks postoperatively, a chronic discharge developed and the socket became uncomfortable. A pyogenic granuloma was present, occurring over an area of dehiscence. The hydroxyapatite orbital implant was removed 10 months postoperatively. In the second patient, moderate orbital discomfort was noted during the first week postoperatively along with a temporal shift of the implant. The discomfort persisted, and 1 week later a discharge began. The implant was removed 9 weeks after implantation. At the time of surgery, an unsuspected pyogenic granuloma was found in the medial conjunctival formix overlying a small area of implant dehiscence. RESULTS: Conjunctival and implant cultures grew Staphylococcus aureus in our first patient, whereas coagulase-negative staphylococci were cultured from the conjunctiva and implant in our second patient. Results of histopathologic examination of both implants disclosed an abscess cavity containing clusters of gram-positive cocci. CONCLUSION: Persistent orbital discomfort, discharge, and the development of a pyogenic granuloma after hydroxyapatite implant should warn the ophthalmic surgeon of potential implant infection.

Abscess↗