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Biomedical subjects

P Carter

Publications and source records attributed to P Carter.

169 records · Page 10Linked to original sources
PubMedDate not supplied

Ten-year review of pediatric tracheotomy.

One hundred sixty-four consecutive tracheotomies are reviewed over the 10-year period 1972-1981. Early in the series acute inflammatory airway obstruction was the major indication for tracheotomy, being 60% of cases in the first 3 years. In the last 3 years this fell to approximately 15%. After 1975 nasotracheal intubation replaced tracheotomy for acute epiglottis. More recently it has become the treatment of choice for acute laryngotracheobronchitis. Tracheotomy prior to reconstructive surgery for major craniofacial abnormalities is becoming more frequent. Acquired subglottic stenosis is not a problem in our hospital despite the use of long-term nasotracheal intubation in premature infants, and no tracheotomies were performed for this indication. There were few major complications. Decannulation difficulties were due to obstruction by stomal granulation tissue or displaced flap of anterior tracheal wall. There was no case of hemorrhage, no posttracheotomy stenosis, and no death was attributable to tracheotomy. These results demonstrate that in a major pediatric hospital tracheotomy is a relatively safe and effective procedure with minimal morbidity.

Acute Disease↗
PubMedDate not supplied

Congenital laryngeal hemangioma.

Congenital subglottic hemangioma consistently occurs in a site below the vocal cord. It is a distinct clinical entity with typical clinical features. However, congenital hemangioma in other sites can cause airway obstruction. An anatomical classification is proposed on the basis of review of 23 consecutive cases. It is important to accurately identify the site and distribution of the lesion before commencing treatment. Radiation has been an acknowledged form of treatment, and in our hospital we have confirmed that radiation therapy, either by external beam, or by insertion of a radioactive gold grain, gives good results. The theoretical possibility of radiation-induced malignancy in the thyroid gland is reduced to an absolute minimum by use of a radioactive grain for localized tumor-dose with minimum radiation of surrounding tissue.

Female↗
PubMedDate not supplied

Use of thyroxine-binding prealbumin in the nutritional assessment of children with cancer.

The level of thyroxine-binding prealbumin was evaluated in 87 pediatric cancer patients ages 1 through 16 years whose cancer was newly diagnosed but untreated, and 39 children with benign disease or no disease. There was no difference in levels of thyroxine-binding prealbumin between the patients with either malignant or benign disease, nor was there a difference between diagnostic categories. Prealbumin values did correlate with age. When the data were compared, there was a correlation between nutritional status and prealbumin level when the total population (N = 126) was age corrected, but not within the malignant disease group by itself. This confirms data that suggest malnutrition in children with cancer is not a result of protein depletion.

Adolescent↗
PubMedDate not supplied

Rotten apples.

Explore the source record for details and available documents.

Attitude of Health Personnel↗
PubMedDate not supplied

Do oral contraceptive agents affect the risk of breast cancer? A meta-analysis of the case-control reports.

BACKGROUND: We designed a study to assess the association of oral contraceptive use and the development of breast cancer for women in the following groups: (1) ever oral contraceptive users, (2) long-term oral contraceptive users, and (3) oral contraceptive users before a first full-term pregnancy. METHODS: A MEDLINE search of studies published in English from 1966 to 1990 was conducted using the following key words: "oral contraceptive and breast carcinoma." Eligible studies included all published case-control reports of nonduplicated data on a population (hospital or community-based). The following data were extracted from each report: country, age of subjects, number of cases and controls, whether it was a hospital or community-based study, and results. Two evaluators using a quality-assessment instrument independently and blindly reviewed the methods and data analysis section from each eligible study. In the category of "ever oral contraceptive users," an estimate of the pooled relative risk with 95 percent confidence intervals (CIs) was calculated. In the categories of "duration of oral contraceptive use" and "duration of oral contraceptive use before a first full-term pregnancy," Spearman's rank correlation coefficient (rs) was calculated. RESULTS: For the categories of "ever oral contraceptive users" and "long-term oral contraceptive users," no association between the use of oral contraceptives and the development of breast cancer could be detected (pooled relative risk "ever oral contraceptive users" = 1.07, 95 percent CI 0.78 to 1.36, rs "duration of use" -0.153, P = 0.189). For the category of "oral contraceptive use before a first full-term pregnancy," a significant correlation was found (rs = +0.497, P = 0.011). Many reports failed to demonstrate adequate protection against the biases most relevant to case-control methods (namely, recall bias, interviewer bias, surveillance bias, and nonresponse bias) and therefore received low-quality scores. CONCLUSIONS: This meta-analysis suggests a possible increased risk for breast cancer in women who use oral contraceptives before a first full-term pregnancy. The data, however, are confounded by studies that are generally of low quality. Further studies addressing the risk for breast cancer in oral contraceptive users need to be designed with methods that limit the biases inherent in case-control studies.

Adolescent↗