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Biomedical subjects

D B Welch

Publications and source records attributed to D B Welch.

10 recordsLinked to original sources
PubMed1987

A randomized study of 5-fluorouracil and filtration surgery.

We conducted a randomized study of 26 patients with a poor prognosis undergoing filtration surgery with and without a low dose of 5-fluorouracil. Mean preoperative intraocular pressure (+/- S.E.M.) in the 5-fluorouracil group (n = 14) was 38.4 +/- 3.08 mm Hg; in the control group (n = 12) it was 41.2 +/- 5.0 mm Hg. Mean postoperative intraocular pressure (+/- S.E.M.) at six to 18 months was 14.4 +/- 1.4 mm Hg in the 5-fluorouracil group and 30.7 +/- 3.9 mm Hg in the control group (P less than .01). Of 14 patients in the 5-fluorouracil group, 12 had a successful outcome at 12 months. Of 12 patients in the control group, three had a successful outcome during this same interval.

Female↗
PubMed1987

A prospective, randomized study of 5-fluorouracil and filtration surgery.

Our study shows that use of a small dose of subconjunctival 5-FU provides significantly lower postoperative intraocular pressure than does no antimetabolite treatment. Morphology of the postoperative blebs suggests that increased filtration results in lower intraocular pressure in the 5-FU group. Corneal epithelial defects were as common with a low dose as with higher doses previously described.

Adolescent↗
PubMed1986

Application of a self-tonometer to home tonometry.

Although home tonometry has been advocated in the management and diagnosis of glaucoma, the lack of proper instrumentation has precluded its routine performance. We have developed a self-tonometer that can be used by the patient at home and at work and have evaluated the performance of the instrument under these conditions. The results show that reproducibility of self-tonometer measurements is +/- 1.4 mm Hg and is independent of the user. When the readings of the self-tonometer in a given individual were compared with those of the Goldmann tonometer, they varied by +/- 2.4 mm Hg. Patients who could be trained in the clinic performed well and safely on their own. An average of fewer than five attempts was necessary to obtain four readings at each time of day. Our preliminary findings obtained during home tonometry demonstrated some of the benefits of repeated diurnal curves.

Adult↗
PubMed1986

Lens injury following iridotomy with a Q-switched neodymium-YAG laser.

By scanning electron microscopy, we studied eight lenses from eyes that had received a neodymium-YAG laser iridotomy one day prior to elective intracapsular cataract extraction. In some of these cases, pitting lesions were found on the anterior-equatorial lens surface, thereby showing that lenticular damage may occur following this procedure if the iridotomy is applied too centrally. It is recommended that care be taken to ensure that the iridotomy be placed at a site peripheral to the outer circumference of the lens.

Corneal Opacity↗
PubMed1984

Gynaecological laparoscopy: clinical experiences of two anaesthetic techniques.

Two anaesthetic techniques were assessed in 120 fit young women having non-emergency gynaecologial laparoscopy as in-patients. One group breathed halothane spontaneously via a face mask, and the second group were given neuromuscular blocking drugs and ventilation was controlled. There was no significant difference in intraoperative anaesthetic or surgical complications between the two groups although morbidity was greater in the intubated group when assessed 4 h after surgery. After 24 h there was no difference in postoperative morbidity. In an appendix to the study, 40 day-stay patients having the same operation under similar conditions were reviewed. After 24 h abdominal pain, lethargy and weakness were still present; 30% of the patients stated that they would prefer to be admitted overnight for a similar procedure in the future.

Adolescent↗
PubMed1984

Postoperative analgesia for Caesarean section using epidural methadone.

A prospective randomised double blind study was carried out to compare the use of epidural methadone, morphine and bupivacaine for pain relief after Caesarean section. The results indicate that methadone is the most effective agent with few side effects. Subsequently this method was used routinely for postoperative analgesia in all patients undergoing Caesarean section. A retrospective study of 178 patients having this method of analgesia was carried out and indicated that epidural methadone is an effective and safe method of postoperative pain relief.

Anesthesia, Epidural↗
PubMed1983

Acute epiglottitis and severe croup. Experience in two English regions.

The case histories of 50 children who required tracheal intubation for epiglottitis or croup in two English regions have been reviewed. The incidence of severe croup was different in the two regions. The presentation of epiglottitis was variable, and the correct diagnosis was frequently made only at laryngoscopy. Unexpected and rapid deterioration occurred in both diseases, and cyanosis was commonly present on hospital admission and at laryngoscopy. Two children required planned tracheostomy and there were two deaths. The principles of safe management are discussed.

Acute Disease↗
PubMed1981

Postoperative analgesia using epidural methadone. Administration by the lumbar route for thoracic pain relief.

The effectiveness of methadone given postoperatively by the lumbar epidural route to patients following upper abdominal or thoracic surgery was assessed. Intermittent injections of methadone diluted in large volumes of normal saline were given during the first 48 hours after surgery. Pain relief was assessed by both the patient and an observer using a visual linear analogue scoring system. Methadone 4-5 mg in 18-20 ml normal provided good postoperative pain relief for 6-8 hours.

Adolescent↗