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Biomedical subjects

R E Carter

Publications and source records attributed to R E Carter.

At least 55 records · Page 3Linked to original sources
PubMed1979

Experiences with high tetraplegics.

Of the 1468 patients with traumatic spinal cord injury who were admitted to the Texas Institute for Rehabilitation and Research (TIRR) between 1959 and 1977, 67 patients were complete tetraplegics with motor levels of C4 and above. The age, sex, motor level, aetiology of injury, and initial and final vital capacity of these patients are analysed. A substantial gain in vital capacity was attained in all C4 motor tetraplegics regardless of their initial vital capacity. Twenty patients with motor levels of C3 and above have been admitted to TIRR since 1963. Five of these 20 C3 and above tetraplegics have had bilateral phrenic stimulators implanted. The mortality rates and causes of death in these groups of patients are presented. Survival curves are presented on 615 traumatic spinal cord injuried patients as compared to a standard matched group. Survival curves are also presented for the two groups of high tetraplegics who were admitted to TIRR from 1963 through 1969 and from 1970 through 1977.

Adolescent↗
PubMed1978

A system for clinically evaluating wheelchair pressure-relief cushions.

Pressure-related decubitus ulcers are a frequent disability and life-threatening complication in the management and rehabilitation of patients with spinal cord injuries. This paper describes a system developed to quantitate and evaluate a patient's response to wheelchair pressure-relief cushions. Maximum pressure and the tissue pressure distribution on six varieties of wheelchair cushions were determined for a sample of 57 patients with a history of decubitus ulcers. Wide variations in (mean) maximum pressure were observed. However, even greater variations were found in the distribution (bony/soft tissue) of the pressure. These data demonstrate that no single cushion was clearly superior in relieving pressure for all patients. Therefore, individualization of wheelchair cushions for each patient may be essential in order to minimize the probability that the person will experience a tissue-pressure problem.

Equipment and Supplies, Hospital↗
PubMed1977

Immediate endocrine and metabolic consequences of traumatic quadriplegia in a young woman.

Onset of paralysis by cervical spinal cord injury led immediately to temporary adrenocortical activation and, within 2 days, to sustained skin and bone breakdown. Urine cAMP was increased, blood parathyroid hormone, renin activity, and electrolytes were normal, and fluid and electrolytes balance became negative during the initial 6 days of paralysis.

17-Hydroxycorticosteroids↗
PubMed1977

Traumatic spinal cord injuries due to automobile accidents.

Of the 1,164 patients with traumatic spinal cord injury admitted to the Texas Institute for Rehabilitation and Research from February 1959 through December 1975, 389 were injured in automobile accidents. The patients with spinal cord injury were predominantly male, and the average age was in the late 20s. Two thirds of the accidents involved a single automobile and occurred less than 50 miles from the residence. The driver's seat was the most common seating position. Seat belts were not worn in over 90% of the cases; many of the other victims wore their seat belts improperly. Some of the patients were probably injured because of structural defects of the automobile.

Accidents, Traffic↗
PubMed1977

Family therapy training: program and outcome.

A family therapy training program has been conducted for staff of mental health agencies located throughout Pennsylvania. This paper is a report on the content and results of the four-year-old training program. Three hundred practitioners have been trained in family therapy. The program has also led to the development of a core group of 64 family therapy trainers. There has been an associated delivery of more family-oriented mental health services throughout the Commonwealth.

Adult↗
PubMed1977

Steady state hormonal secretion in traumatic quadriplegia.

Physiologically complete cervical spinal cord transection results in motor and sensory quadriplegia and interruption of the sympathetic neural pathways; this condition leads to metabolic deficiencies suggestive of abnormal endocrine function. An investigation of the non-stimulated secretion of some of the hormones influencing metabolism was undertaken by evaluating thyroxine, iodothyronine binding index, testosterone, growth hormone, calcitonin, and parathyroid hormone in venous blood of fasting healthy subjects and quadriplegic patients. The effect of the duration of the paralysis was examined by repeating the evaluations at different periods after onset. The results show that 1) thyroxine was low for 2 months after onset in 21 patients and normal thereafter in 53 patients, 2) testosterone was low throughout the study in 62 patients; the decrease is greatest during the first 2 months, 3) growth hormone was often increased in 46 patients for 8 months after onset, and nearly normal afterward in 25 patients, 4) calcitonin was normal in 22 patients throughout the study, and 5) parathyroid hormone was normal in relation to normal serum calcium as early as 6 days after onset in 79 out of 83 patients. These data do not preclude a parathyroid hormone increase at onset or alterations in the patterns of circadian secretion and in the responses to specific stimulation for the hormones evaluated. Therefore, it may be concluded only that the steady state secretion of these hormones is not altered by traumatic quadriplegia per se, but is temporarily modified by the original insult to the nervous system, and by changes in life pattern and the heavy sedation that follows. The results suggest that the minor endocrin changes occurring in quadriplegic patients during the early period of paralysis will be rapidly overcome by rehabilitation to an active life pattern.

Calcitonin↗
PubMed1975

Early neuromuscular development of the premature infant.

A case study is presented which documents the neuromuscular development of a premature infant (34-35 weeks gestation) during the first eight weeks of postnatal life. The development of postural tone, spontaneous activity, and responsiveness to stimulation is described and compared with that of the full-term infant. This information is of value to physical therapists involved in evaluation and therapeutic intervention programs for high risk infants.

Humans↗
PubMed1975

Bone metabolism in quadriplegia: dissociation between calciuria and hydroxyprolinuria.

Relationships between duration of paralysis, recumbency, muscular activity, and urinary loss of calcium (Cau), phosphorus (Pu), and hydroxyproline (OHPu) were studied daily in 32 traumatic quadriplegic patients during comprehensive rehabilitation and randomly in those readmitted for treatment. Within days after onset, quadriplegic patients had increases in Pu, then OHPu, and finally, Cau. Patients actively engaged in rehabilitation exercises showed a steady fall in OHPu, whereas CAU remained high for up to 18 months. Patients paralyzed for over 18 months (late) had low Cau, Pu and OHPu; but if the patients were kept in bed, OHPu increased rapidly. Patients with early quadriplegia have an increased bone remodeling, suggesting that the excess OHPu and Cau are derived from resorbed bone. Patients with late quadriplegia have little bone remodeling, therefore the excess OHPu occurring during recumbency may be derived from the resorption of new collagen produced during the removal of weight bearing without further change in muscular activity. Resorbed new collagen is excreted in part as large, OHP-containing polypeptides; these were found in the urine of quadriplegic patients, and therefore were present in blood and may play a role in initiating ectopic bone and renal calculi. The presence of OHP in 11 bladder calculi from quadriplegic patients tends to support this hypothesis. These studies indicate that muscular activity and weight bearing influence the bone metabolism of quadriplegic patients and suggest that the presence in body fluids of increased catabolic products from bone may have a role in bone-related complications.

Adolescent↗