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Biomedical subjects

A C Reynolds

Publications and source records attributed to A C Reynolds.

15 recordsLinked to original sources
PubMed2001

Management of blebitis by members of the American Glaucoma Society: a survey.

PURPOSE: To investigate the practice patterns among glaucoma subspecialists in the American Glaucoma Society regarding the management of blebitis. METHODS: An anonymous survey incorporating 14 questions regarding the management of blebitis was mailed to all current active American Glaucoma Society members, including provisional members, in October 1999. RESULTS: A total of 319 physicians received the survey, and 204 members (64%) returned surveys. Sixty-nine percent of respondents do not ask their patients with functioning blebs to use topical antibiotics at home for early symptoms of blebitis. Thirty-four percent never or almost never obtain conjunctival cultures at the onset of isolated blebitis, whereas 44% always or usually do. Fifty-one percent prescribe a topical fluoroquinolone alone as the initial empirical treatment of isolated blebitis. Twenty-three percent use a fluoroquinolone in combination with one or two other antibiotics. Twenty-one percent choose a combination of fortified topical agents, usually including a fortified aminoglycoside, vancomycin, or cephalosporin. Thirty-one percent use fortified agents in some combination with or without a fluoroquinolone. Five percent prescribe some other single agent alone. Only 6% routinely use an oral antibiotic in cases of blebitis. Sixty-two percent use topical corticosteroids in conjunction with antibiotic treatment. Of these, 68% start them after initial antibiotic treatment is established or once improvement of blebitis is noted. Fifty-six percent indicated that a moderate or severe anterior chamber reaction, including fibrin, would prompt treatment as a possible endophthalmitis. In a persistently Seidel-positive bleb, 77% generally attempt surgical bleb revision. CONCLUSIONS: Methods of the management of blebitis differ among members of the American Glaucoma Society. Treatment recommendations generated from randomized clinical trials are needed.

Anti-Infective Agents↗
PubMed1997

The effect of a brief education program on glaucoma patients.

PURPOSE: To assess our patients' knowledge of glaucoma and to measure the effect of a brief education program on their understanding of glaucoma. METHODS: Patients attending glaucoma clinics at a university and a Veterans' Affairs hospital were randomized into two groups: "exposed" and "unexposed" to a simple education program of a video and brochures. Glaucoma knowledge was assessed twice by an oral questionnaire, at 2 weeks and 6 months after randomization plus or minus education. RESULTS: Younger patients and those with more years of formal schooling knew more about glaucoma. Two weeks after the education program, the exposed group performed significantly better than did the unexposed group. Analysis of the results showed benefit from both brochures and video. This effect of education was not seen at retesting 6 months later. CONCLUSION: Older patients and those with less formal education know less about glaucoma. A brief, simple education program can significantly improve levels of knowledge about glaucoma, even in a relatively well-informed population. However, patient education must be repeated to maintain a useful effect.

Aged↗
PubMed1997

Probability maps of sequential glaucoma-scope images help identify significant change.

PURPOSE: The purpose of this study was to identify areas of the optic disc showing high variability of repeated depth measurements, and to minimize the effect of baseline variability in interpretation of possible change over time using the Glaucoma-Scope. METHODS: Seventy-four eyes from 70 subjects were analyzed with the Glaucoma-Scope. Three images were obtained on each of two separate sessions during the same day. At each location, the mean depth of the three images for each session was calculated to create a "baseline image." A contour map of standard deviation (SD) values at each topographic location was created for each subject reflecting local variability at different parts of the disc. The contour map and disc photograph were compared to determine what photographic features predicted high variability. A modified two-sample t-test was used at each topographic location to obtain p-values for the likelihood that a difference in mean depth between sessions was attributable to measurement variability alone. RESULTS: Contour plots of SD for most subject eyes showed high variability in steeply sloped areas of the disc and along large blood vessels, with low variability near the cup center. The use of probability plots for significance of depth changes between test sessions automatically accounted for increased pointwise variability. The proportion of topographic locations showing statistically significant change but attributable to chance variation when no true change has occurred approximated the predicted proportion based on our modified t-test model. CONCLUSION: A contour map of standard deviations of depth based on Glaucoma-Scope baseline images can identify areas of the disc with high variability. Statistical methods such as probability maps that account for local variability in the baseline image may be helpful in distinguishing true change from artefactual change over time.

Adolescent↗
PubMed1990

Cardiovascular effects of pancuronium, vecuronium, and atracurium during induction of anesthesia with sufentanil and lorazepam for myocardial revascularization.

The hemodynamic effects of three commonly used muscle relaxants, pancuronium, vecuronium, and atracurium were investigated during induction of anesthesia with sufentanil and lorazepam in patients undergoing coronary artery bypass surgery. Direct hemodynamic variables were recorded, and indirect parameters were calculated using standard formulae. Changes in heart rate differed with the three muscle relaxants. Pancuronium increased the heart rate whereas vecuronium and atracurium produced a decrease 5 minutes after induction (P less than 0.05). No differences were found in any other parameter during the study. A slow induction with sufentanil, lorazepam, and any of the three muscle relaxants was shown to minimize the hemodynamic changes.

Aged↗
PubMed1983

Chronic pain therapy with transcutaneous electrical nerve stimulation: predictive value of questionnaires.

A retrospective study of 200 chronic pain patients was conducted to determine whether preexisting physical or social factors influence treatment success with transcutaneous electrical nerve stimulation (TENS). Responses to 30 questions from a preadmission questionnaire were analyzed against short-term treatment success. Patients with pain of more than a year's duration, who had undergone multiple surgical operations for pain control, who used tranquilizers, or who were not working because of pain, demonstrated a generally lower rate of treatment success, although the differences were not statistically significant. Treatment success rate was significantly higher for retired patients than for those with blue-collar jobs or those who were unemployed. There was no association between treatment success rate and site, frequency, character or severity of pain, age, sex, use of narcotic analgesics, or the presence of financial compensation or litigation. The value of TENS for chronic pain remains largely empirical.

Adolescent↗
PubMed1982

Horner syndrome during lumbar epidural analgesia for obstetrics.

Horner syndrome (ptosis, miosis, anhidrosis, and facial and conjunctival vasodilation) is a recognized complication of lumbar epidural analgesia for labor and delivery. Alone, it presents no significant risk to mother or fetus, as resolution is spontaneous and complete. Horner syndrome may, however, be associated with significant maternal hypotension and therefore should be an indication for close maternal and fetal monitoring to provide reassurance.

Adult↗
PubMed1981

Failure of naloxone to reverse analgesia from transcutaneous electrical stimulation in patients with chronic pain.

To investigate the possible role of endogenous opiates in the mediation of analgesia produced by low intensity, high frequency transcutaneous electrical stimulation in the presence of chronic pain, an attempt was made to reverse stimulation-induced analgesia with naloxone. Fifteen patients with chronic pain who were consistently relieved of pain by low intensity, high frequency transcutaneous stimulation were studied. During stimulation at 58 Hz, patients were given double-blind intravenous injections of either naloxone (0.4 or 1.2 mg) or saline. Subjective pain ratings were recorded before stimulation, after stimulation, and after naloxone and saline injections. No reversal of analgesia was seen after naloxone or saline. These results suggest that transcutaneous stimulation at low intensity and high frequency may provide analgesia that is not associated with release of endogenous opiates in patients with chronic pain.

Adult↗
PubMed1980

Increased skin temperature during transcutaneous electrical stimulation.

Conflicting reports have appeared in the literature concerning the effects of transcutaneous electrical nerve stimulation on skin temperature. This report studied 33 patients with chronic pain involving one extremity (13 upper, 20 lower) to determine whether changes in sympathetic tone, as reflected in skin temperature, occurred in response to electrical stimulation of painful areas. Stimulation was carried out for 20 to 45 minutes. Skin temperatures were measured from the thumbs or great toes of stimulated and contralateral extremities before and during stimulation. Skin temperature rose 2.5 +/- 0.7 (mean +/- SEM) in both the ipsilateral and contralateral extremity in patients who experienced relief of pain during stimulation. There was no significant change in skin temperature in patients who experienced no relief.

Analgesia↗