Biomedical subjects

D S Gomez

Publications and source records attributed to D S Gomez.

6 recordsLinked to original sources

PubMed1998

Contraction and myofibroblasts in restored skin.

Myofibroblasts and the contraction of split skin-graft donor sites were studied in 18 patients. For each patient five samples were studied, taken on days 0, 14, 21, 28, and 35. On each occasion the extensions and densities of myofibroblasts were calculated. After the initial measurement, the subsequent extensions were expressed in percentages of the first, resulting in mean measurements of 100, 95, 97, 99, and 99%, respectively. The myofibroblasts in 10 dermic fields were counted under light microscopy at a magnification of 1000 marked with anti-alpha-smooth muscle actin antibodies using immunoperoxidase, resulting in the means of 0.2, 3.8, 1.3, 1.3, and 0.4, respectively. The contraction and the increase in density of myofibroblasts were transitory and significant in the samples measured on day 14, but in sample 35 neither of the variables was significantly different from the initial sample. These variables evolved concurrently, corroborating the hypothesis that myofibroblasts are responsible for the contraction.

Cell Count↗

PubMed1988

Chronic alcoholism and microbial keratitis.

In a series of 227 consecutive, non-referred patients with microbial keratitis an analysis of the accumulated hospital records showed that one-third were associated with chronic alcoholism. The diagnosis of alcoholism was usually unsuspected on admission to hospital. The microbial pathogenesis in these patients was distinctive; coagulase-negative staphylococci, alpha- and beta-streptococci, moraxellae, enteric Gram-negative bacilli, and polymicrobial infections were unusually prominent. Pseudomonas aeruginosa was uncommon. Trauma, exposure, bullous keratopathy, other external ocular diseases, and self-neglect were the major recognised predisposing causes. The nutritional, toxic and immunological sequelae of alcoholism may also have been contributory. Ophthalmologists should be alert to the diagnosis of chronic alcoholism in their patients. Chronic alcoholism may be an important and underrated risk factor for microbial keratitis.

Alcoholism↗

PubMed1987

Epidemiology of microbial keratitis in southern California. A multivariate analysis.

Two hundred twenty-seven cases of microbial keratitis reported in nonreferral county practice were studied. The staphylococci, Pseudomonas aeruginosa and Streptococcus pneumoniae, were the major isolates. A multivariate statistical model was developed to evaluate possible predisposing and outcome determinants. Several racial and age-related relationships were shown. The interaction of numerous local ocular and systemic factors played a fundamental role in causing disease. The authors found significant association between S. pneumoniae and topical steroid use, and direct and indirect linkage of S. aureus with diabetes and trauma, respectively. S. pneumoniae and Moraxella were risk factors for major complications (24% of cases); S. pneumoniae was related to enucleation and late perforation. Corneal exposure and prior topical steroids were associated with prolonged hospital stays. Hypopyon was associated with pneumococcal infection, 60 years of age or older, and trauma. The identification of groups at high-risk for microbial keratitis and problems of preventive management are discussed.

Bacterial Infections↗

PubMed1987

Post-traumatic and postoperative endophthalmitis: a comparison of visual outcomes.

We retrospectively studied 50 consecutive cases of exogenous endophthalmitis treated between 1972 and 1985. Twenty-two of these cases occurred after penetrating ocular trauma and the remaining 28 followed ocular surgery. Thirty-two (64%) of the cases were culture-positive. A wide variety of organisms were identified in the post-traumatic cases, while the isolated agent in the majority of postoperative cases was Staphylococcus epidermidis. Twenty-nine of the 50 patients received treatment with vitrectomy and intraocular antibiotics; of these, 14 (48%) achieved final visual acuities better than or equal to 20/400. Of the 21 patients who were treated with parenteral, topical, and subconjunctival antibiotics alone eight (38%) reached this same final visual acuity. Culture-negative cases, postoperative cases, and cases treated with vitrectomy and intraocular antibiotics were associated with improved visual outcomes.

Adolescent↗

PubMed1986

Microbial keratitis in children.

Forty-seven eyes with microbial keratitis occurring in 44 children under 16 years of age were studied. Under the age of three, 92% of the infections involved Pseudomonas aeruginosa and/or various streptococcal species; later in childhood the typical adult pattern of infection was more common. Overwhelming systemic infections, malignant disease with orbital involvement and congenital ocular adnexal disease were important predisposing factors in the infant years; trauma and acquired external eye disease became increasingly important in mid-childhood. Surgery was necessary in 28% of the eyes. Frequent tearing and lack of patient cooperation preclude reliance on topical antibiotic therapy alone. Despite the difficulties, the mainstay of management involves daily biomicroscopic evaluation and regular subconjunctival antibiotic injections. The logistical problems of achieving these aims are discussed.

Age Factors↗

PubMed1984

Results of penetrating keratoplasty for aphakic and pseudophakic bullous keratopathy.

We retrospectively studied 61 consecutive cases of penetrating keratoplasty performed for aphakic bullous keratopathy or pseudophakic bullous keratopathy. After keratoplasty, the mean visual acuities of both groups of patients improved significantly from preoperative levels (P less than .0001). One year after keratoplasty, 18 eyes had visual acuities of 20/40 or better. Twelve of the 24 eyes followed up for at least two years after surgery had visual acuities of 20/40 or better. The mean visual acuities for the eyes with aphakic bullous keratopathy and the eyes with pseudophakic bullous keratopathy were not significantly different at either one or two years after keratoplasty. Cystoid macular edema (11 eyes) and glaucoma (12 eyes) were the most common causes of visual acuities worse than 20/40. There were no significant differences in the incidences of these complications in the group with aphakic bullous keratopathy and in the group with pseudophakic bullous keratopathy. Intraocular lens removal did not significantly affect either visual acuity or macular complications after keratoplasty.

Aged↗