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Biomedical subjects

A Foster

Publications and source records attributed to A Foster.

At least 109 records · Page 6Linked to original sources

A code of ethics for the medical dosimetrist--the American Association of Medical Dosimetrists experience.

The Committee on Protocol and Ethics of the American Association of Medical Dosimetrists (AAMD) has developed a Code of Ethics for a radiation oncology society of medical dosimetrists. The purpose of the code of ethics is fourfold: (1) Establish an ideal of professional conduct specific to the medical dosimetry profession; (2) Develop a statement of the moral values and commitment of the AAMD; (3) Recognize professional relationships and obligations; and (4) Define goals to which the medical dosimetrist should aspire. The Code of Ethics was adopted as AAMD policy in October 1995.

Ethics, Professional↗

A code of ethics for the medical dosimetrist--the American Association of Medical Dosimetrists experience.

The Committee on Protocol and Ethics of the American Association of Medical Dosimetrists (AAMD) has developed a Code of Ethics for a radiation oncology society of medical dosimetrists. The purpose of the code of ethics is fourfold: (1) Establish an ideal of professional conduct specific to the medical dosimetry profession; (2) Develop a statement of the moral values and commitment of the AAMD; (3) Recognize professional relationships and obligations; and (4) Define goals to which the medical dosimetrist should aspire. The Code of Ethics was adopted as AAMD policy in October 1995.

Ethics, Medical↗

The importance of prenatal factors in childhood blindness in India.

The causes of visual loss in 1411 children attending schools for the blind in different geographical areas in India are described. Ninety-three percent (1318) of the children were severely visually impaired (SVI) or blind (i.e. corrected acuity in the better eye of <20/200 [<6/60]). In 60% of SVI/blind children vision loss was attributable to factors operating in the prenatal period, in 47% the prenatal factors were known and definite, and in 13% prenatal factors were the most probable causes. Hereditary retinal dystrophies and albinism were seen in 19% of SVI/blind children and 23% had congenital ocular anomalies. There were variations in the relative importance of different causes by state. The observed pattern of causes of visual loss is intermediate between those seen in industrialised countries and in the poorest developing countries. This suggests that strategies to combat childhood blindness in India need to address concurrently both preventable and treatable causes. The need for aetiological studies, particularly on anophthalmos and microphthalmos, is highlighted.

Abnormalities, Multiple↗

Causes of blindness in northwest Cambodia.

A hospital-based study in the northwest of Cambodia identified 453 blind adults and 30 blind children seen consecutively at the provincial ophthalmic department between January and September 1994. Blindness was defined as a visual acuity of less than 3/60 in the better eye. Cataract was the cause of blindness in 266 (59%) adults, of which 15 cases (3.3%) were surgical complications. Sixty-three cases (14%) were due to glaucoma and 53 (11.5%) patients had corneal scars, of which 12 (2.5%) were due to trachoma. Bilateral trauma, usually due to landmine injuries, accounted for 17 patients (4%). Of the 30 blind children, corneal scarring accounted for 12 cases (40%), congenital causes for 14 (47%) and optic atrophy secondary to meningitis for 4 (13%). There is at present an inadequate ophthalmological service for the vast majority of people living outside the capital Phnom Penh. These hospital-based data suggest that there is a need to train general doctors to surgically manage patients with visual loss from cataract and glaucoma, which together account for 70% of all cases of blindness, and highlight the need for a large population-based survey.

Adolescent↗

The causes of childhood blindness in South Africa.

OBJECTIVES: 1. To ascertain the causes of severe visual impairment and blindness in children in schools for the blind in South Africa. 2. To determine the major avoidable causes. 3. To determine causation by ethnic group. DESIGN: A cross-sectional survey, undertaken at 15 of the 16 schools for the blind in South Africa, during May-September 1996, using standard WHO methodology. SUBJECTS: Children less than 16 years of age on May 1996. RESULTS: Of 1,615 eligible children, 1,311 were examined. According to WHO categories of visual impairment, using the corrected visual acuity in the better eye, 30.4% of children were blind (< 3/60, BL), 12.6% had severe visual impairment (< 6/60-3/60, SVI), 42.3% were visually impaired (< 6/18-6/60), and 12.0% had no impairment (6/18 or better). The anatomical sites of SVI/BL in 564 children were: retina 38.5%; optic nerve 15.2%; cornea/phthisis bulbi 11.0% and glaucoma 6.7%. Aetiological categories of SVI/BL were: hereditary diseases 33.0%; intra-uterine factors 0.9%; perinatal conditions 13.1%; acquired conditions of childhood 11.5%. In 41.5% the underlying cause could not be determined. In 38.8% of children with SVI/BL the cause was avoidable, i.e. preventable or treatable. The main causes varied between ethnic groups, the major difference being the higher proportion of retinopathy of prematurity in white and Indian children. CONCLUSIONS: The study suggests that 38.8% of causes of SVI or blindness in children in schools for the blind in South Africa are avoidable, and that specific control measures need to be targeted at different ethnic groups.

Animals↗

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Humans↗

Vulvar intraepithelial neoplasia in women infected with human immunodeficiency virus-1.

The purpose of this study was to determine the response of vulvar intraepithelial neoplasia (VIN) lesions to standard treatment methods in women infected with human immunodeficiency virus (HIV). We reviewed all cases of VIN over a 4-year period at an inner-city hospital. We reviewed the clinical records of these women to abstract demographic information as well as information about tobacco use, injection drug use, results of HIV testing, T cell count, stage of HIV infection, colposcopic and cytologic findings, treatment of lesions, and follow-up. Eight of the 28 women (29%) with VIN were infected with HIV. The relative risk for recurrence or persistence of VIN after treatment was 3.3 (95% confidence interval, 1.4-7.4; P = 0.01) in the HIV+ compared with the HIV- group. The high rate of HIV infection among women with VIN supports recommendation of HIV testing for women with VIN. Women known to have HIV infection should be carefully examined for vulvar lesions. Further study is needed to determine the optimum treatment for VIN in women infected with HIV.

Acquired Immunodeficiency Syndrome↗

Penetrating keratoplasty in Africa: graft survival and visual outcome.

AIM: To study the survival and visual outcome of penetrating keratoplasty in an African setting. METHODS: A retrospective analysis of 216 corneal grafts, performed on 203 eyes of 186 patients, at Kikuyu Hospital, Kenya over a 5 year period. RESULTS: Half of the transplants were carried out for keratoconus with only 5% of the grafts being undertaken for corneal scarring caused by trachoma or measles. The average follow up was 27.3 months. The probability of graft survival at 2 years was 87.4% (95% CI 80.6%-94.3%) for keratoconus and 64.7% (95% CI 54.8%-74.6%) for other corneal pathologies. Forty seven grafts (21.8%) in 36 patients (17.7%) are known to have become opaque. The commonest causes of graft opacification were bacterial keratitis (6.0%), endothelial failure (6.0%), and graft rejection (5.1%). Preoperatively 55% of keratoconus eyes and 75.7% of non-keratoconus eyes were blind. Postoperatively, 5% of keratoconus eyes and 41.7% of the non-keratoconus eyes were blind. Normal vision was achieved in 53.7% of operated eyes. Grafts carried out for keratoconus had a better visual outcome than grafts performed for other corneal pathologies. Preoperatively, 12.4% of keratoconus and 48.5% of non-keratoconus patients were blind in their better eye. Postoperatively, 1.1% of keratoconus patients and 25.7% of non-keratoconus patients were blind. The number of patients with normal vision in the better eye increased from 32 (17.2%) to 106 (57.0%). Sight was restored to 34 blind patients, but two patients with severe visual impairment preoperatively were blind at their last follow up. There was therefore a net reduction of 32 in the number of blind patients after 216 keratoplasties. CONCLUSIONS: Penetrating keratoplasty can be successful in Africa, particularly for keratoconus and other corneal dystrophies. However, penetrating keratoplasty has a limited role in the treatment of blindness from corneal scarring due to trachoma, measles, and vitamin A deficiency for which community based preventive measures must remain the priority.

Adolescent↗

Aetiology of childhood cataract in south India.

AIM: To identify the causes of childhood cataract in south India with emphasis on factors that might be potentially preventable. METHODS: A total of 514 consecutive children with cataract attending an eye hospital outpatient clinic were examined and their parents interviewed by a trained interviewer using a standardised questionnaire in the local language. Serology was performed on children under 1 year of age to detect congenital rubella syndrome (CRS). Other investigations were performed as clinically indicated. RESULTS: Of the 366 children with non-traumatic cataract 25% were hereditary, 15% were due to congenital rubella syndrome, and 51% were undetermined. In children under 1 year of age 25% were due to rubella and cataract of nuclear morphology had a 75% positive predictive value for CRS. Mothers of children in the undetermined group were more likely to have taken abortifacients than a group of age matched controls (p = 0.1) but use of other medications in pregnancy was similar in both groups. Of the 148 (29%) children with traumatic cataracts three quarters were over the age of 6 years. Stick injuries were responsible for 28%, thorn injuries for 21%, and firecrackers for 5%. CONCLUSION: Nearly half of non-traumatic cataract in south India is due to potentially preventable causes (CRS and autosomal dominant disease). There is need for further work to identify the factors leading to childhood cataract in at least half of the cases for which no definite cause can as yet be determined.

Abortifacient Agents↗

Effect of thiopental, saffan, and propofol anesthesia on cardiovascular parameters and bronchial smooth muscle in the rhesus monkey.

The application of human pediatric equipment for measuring respiratory function in nonhuman primates is rapidly gaining popularity in the evaluation of anti-asthma drugs. An important difference between primate procedures and the human clinical situation is the requirement for anesthesia for some techniques because of poor animal compliance. We studied the actions of three potential maintenance anesthetic agents-thiopental, saffan, and propofol-and their effects on a range of cardiovascular parameters under conditions of a broncho-provocation test in rhesus monkeys. The spasmolytic effect of saffan on bronchial smooth muscle was investigated in smooth muscle preparations in vitro and in the rhesus monkey in vivo. Thiopental proved to be a useful sedating agent for this application. Saffan proved to be a bronchodilator in vitro, but the sedative dose was lower than that required to induce appreciable bronchodilator activity in vivo. In comparison, propofol was not appropriate for this application because of the poor sedative effect at nonbronchodilator doses.

Alfaxalone Alfadolone Mixture↗

Myocardial atrophy in acquired immunodeficiency syndrome--associated wasting.

This study evaluated the effects of acquired immunodeficiency syndrome wasting syndrome (AWS) on the heart in a population free of overt opportunistic infection or clinical evidence of cardiac disease. Data from 53 patients with AWS and 16 healthy age-matched controls were studied. By echocardiography, a significant reduction in left ventricular mass was found in patients with AWS that remained significantly reduced when corrected for body surface area. Mean ejection fraction was within the normal range in patients with AWS but was significantly less than in controls. End-systolic volume index was slightly elevated in patients with AWS. Although no difference in end-systolic wall stress was seen, the end-systolic wall stress-shortening relation differed significantly. These findings are consistent with myocardial atrophy and subtle left ventricular dysfunction in patients with AWS.

Acquired Immunodeficiency Syndrome↗

Childhood blindness in India: causes in 1318 blind school students in nine states.

It is estimated that at least 200,000 children in India have severe visual impairment or blindness and approximately 15,000 are in schools for the blind. Although this represents a small percentage of the estimated 5 million blind in India, it is significant in terms of 'blind-years'. Strategies to combat childhood blindness require accurate data on the causes to allocate resources to appropriate preventive and curative services. Since socio-economic factors vary in different areas of this industrializing country data should be representative of the country as a whole. This is the first multi-state study to be undertaken in India using the Record for Children with Blindness and Low Vision from the World Health Organization/PBL Programme. A total of 1411 children in 22 schools from nine states in different geographical zones were examined by an ophthalmologist and optometrist. Of these, 1318 children were severely visually impaired or blind (SVI/BL). The major causes of SVI/BL in this study were: (1) corneal staphyloma, scar and phthisis bulbi (mainly attributable to vitamin A deficiency) in 26.4%; (2) microphthalmos, anophthalmos and coloboma in 20.7%; (3) retinal dystrophies and albinism in 19.3%; and (4) cataract, uncorrected aphakia and amblyopia in 12.3%. This mixed pattern of causes lies in an intermediate position between the patterns seen in developing countries and those seen in industrialised countries. The causes identified indicate the importance both of preventive public health strategies and of specialist paediatric ophthalmic and optical services in the management of childhood blindness in India.

Adolescent↗