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Biomedical subjects

I S Begg

Publications and source records attributed to I S Begg.

18 recordsLinked to original sources
PubMed1989

Epidemiologic approach to open-angle glaucoma: 2. Survival analysis of adverse drug reactions. Report of the Canadian Ocular Adverse Drug Reaction Registry Program. The Collaborative Glaucoma Study Group.

Medical treatment, intraocular pressure (IOP) and adverse drug reactions were recorded in a prospective multicentre study of 71 unselected, newly diagnosed cases of open-angle glaucoma. Eight ophthalmologists recorded standard information at five visits over a mean interval of 12.1 months. No limitations were imposed on the choice of drugs or interval between visits. The IOP was satisfactorily controlled throughout the follow-up period with the first drug prescribed in 36% of eyes. In an additional 10% to 13% the IOP was stabilized with alternative therapy, prescribed for approximately one-third of eyes per visit. A total of 27 patients reported 18 severe and 31 mild suspected adverse reactions during the follow-up period. Survival analysis showed that there was no significant difference between the proportions of patients continuing treatment with the first, second and third drug prescribed (half-life of treatment approximately 210 days in all three cases). However, when only changes for unsatisfactory pressure were considered, the half-life of treatment was significantly longer, 350 days (p = 0.02).

Acetazolamide↗
PubMed1988

Epidemiologic approach to open-angle glaucoma: 1. Control of intraocular pressure. Report of the Canadian Ocular Adverse Drug Reaction Registry Program.

In a multicentre study eight glaucoma consultants prospectively followed 71 unselected cases (130 eyes) of newly diagnosed open-angle glaucoma at five visits over a mean interval of 12.1 months. A standard flow chart was used to record the medical treatment, intraocular pressure (IOP) and indications for any changes in therapy. No limitations were imposed on the choice of drugs. The mean IOP before treatment was 28 mm Hg. There was a significant reduction in mean IOP of 7.64 mm Hg in response to the first drug prescribed (p less than 0.0001) but none thereafter, despite changes in treatment in 25% to 32% of eyes at each visit. The mean standard deviation of IOP for all eyes was 2.62 mm Hg. Of 99 changes in therapy in 67 eyes, 40% were made when the IOP was within 3 mm Hg of the mean satisfactory pressure for a particular case. The findings indicate the need to make corrections for variation and fluctuation in IOP when evaluating pressure response. The pharmacologic effect of the drugs appeared less important than the patient's ability to tolerate the drugs without severe adverse reactions.

Adult↗
PubMed1984

Diabetic retinopathy: a review of general medical factors in patient care.

Current concepts of the pathogenesis of retinal microangiopathy strongly suggest that it is dependent on the metabolic abnormalities of diabetes mellitus. This has led to speculation that retinal microangiopathy might be prevented or its progression halted by controlling the blood glucose concentration to lower levels than has been possible in the past with conventional insulin therapy and conventional monitoring. Intensive regulation of the blood glucose level in insulin-dependent diabetes mellitus is a therapeutic choice made available by technologic advances: the introduction of devices for insulin delivery and for the patient's self-monitoring of the blood glucose level, as well as of methods for measuring the level of glycosylated hemoglobin. For an individual patient, selection of the optimal insulin regimen and the optimal target for the blood glucose levels should take into account the susceptibility to microvascular complications inherent in the classification of that patient's diabetes, the patient's retinopathy status and the potential risks, such as severe hypoglycemia and, perhaps, acceleration of retinopathy. With normal or nearly normal blood glucose levels many of the metabolic and endocrine abnormalities of diabetes are corrected, but the biologic significance and the impact on diabetic retinopathy of this improvement remain to be clarified.

Adolescent↗
PubMed1976

Visual field changes in branch retinal 'vein' occlusion.

The visual field defects in 20 consecutive patients who had branch retinal "vein" occlusions included arcuate nerve fiber bundle scotomas, central scotomas, paracentral scotomas, and segmental peripheral constriction. The role of retinal arteriolar insufficiency in the production of these field defects is discussed. The available evidence suggests that the term "branch retinal vascular occlusion" is a preferable term to describe such clinical findings.

Adult↗
PubMed1976

Clinico-pathological study of an organized plaque in exudative diabetic maculopathy.

A clinical and histopathological study of an organized macular plaque in a diabetic with hard exudate plaques showed diabetic microangiopathy, degeneration, proliferation and serious separation of the pigment epithelium, but no evidence of disease of Bruch's membrane or the choriocapillaris. The possible absence of choroidal neovascularization suggests that the fibrous scar originated in the retina and pigment epithelium. This lesion may be a specific response to the development of a plaque of hard exudate at the macula.

Diabetic Angiopathies↗
PubMedDate not supplied

Use of tactile techniques for self-monitoring of blood glucose in visually impaired patients with diabetes mellitus.

Twenty-eight patients with type I diabetes mellitus, legally blind as a result of proliferative retinopathy, were recruited into a program designed to teach and evaluate tactile methods for self-monitoring of blood glucose (SMBG). Vision ranged from "blind" to "able to read large print." Techniques with wipe-off strips (Chemstrip bG or BM Test BG, Boehringer-Mannheim, Canada Ltd., Dorval, Quebec, Canada) use the opposite hand as a guide, operation of timing devices by touch, and special methods for labeling and storing strips. Methods with wash-off strips (Dextrostix, Ames Division, Miles Laboratories, Rexdale, Ontario, Canada) employ the fingers as a guide in directing the wash water. The accuracy of tactile methods was documented. Clinical parameters of glucose control improved in patients with adequate data after 6 mo of tactile SMBG. Glycosylated hemoglobin in 17 patients decreased from 11.3 +/- 2.1% to 9.4 +/- 1.5% (P = 0.005). Patients experienced significantly fewer reactions and low blood sugar readings as well as lowering of mean blood glucose values from 158 +/- 56 to 141 +/- 51 (P = 0.025).

Adult↗