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Biomedical subjects

J Balentine

Publications and source records attributed to J Balentine.

6 recordsLinked to original sources
PubMed2000

The predictability of corneal flap thickness and tissue laser ablation in laser in situ keratomileusis.

OBJECTIVE: To evaluate the relationship between predicted flap thickness and actual flap thickness and between predicted tissue ablation and actual tissue ablation. DESIGN: Prospective, nonrandomized comparative (self-controlled) trial. PARTICIPANTS: A total of 60 patients (102 eyes) who underwent laser in situ keratomileusis (LASIK). MAIN OUTCOME MEASURES: Subtraction pachymetry was used to determine actual corneal flap thickness and corneal tissue ablation depth. Other measurements included flap diameter and keratometry readings. RESULTS: Actual flap thickness was significantly different (P < 0.0001) from predicted flap thickness. Fifteen eyes had a predicted flap thickness of 160 micrometer and a mean actual flap of 105 micrometer (standard deviation [SD], +/-24. 3 micrometer range, 48-141 micrometer). Sixty-four had a predicted flap of 180 micrometer with an actual flap mean of 125 micrometer (SD, +/-18.5 micrometer range, 82-155 micrometer). Seventeen eyes had a predicted flap of 200 micrometer, with an actual flap mean of 144 micrometer (SD, +/-19.3 micrometer range, 108-187 micrometer). In addition, we found that significantly more tissue (P < 0.0001) was ablated than predicted. Linear regression of the observed ablation on predicted ablation yielded the following relationship: actual ablation = 14.5 + 1.5 (predicted ablation). Neither flap diameter nor flap thickness were found to increase with respect to steeper corneal curvatures. CONCLUSIONS: Actual corneal flap thickness was consistently less than predicted regardless of the depth plate used; actual tissue ablation was consistently greater than predicted tissue ablation for the laser used in this study.

Cornea↗
PubMed1999

Collagen shield delivery of ofloxacin to the human eye.

PURPOSE: To determine the ocular penetration of ofloxacin into the anterior chamber of the human eye when delivered by a presoaked collagen shield. SETTING: University of Colorado School of Medicine, Denver, Colorado. METHODS: This prospective randomized clinical study comprised 31 patients having cataract surgery. Patients were divided into 2 groups: the first received 3 preoperative drops of commercially available topical ofloxacin 0.3% given 10 minutes apart; the second had a collagen shield soaked in the same medication applied to the eye before surgery. Aqueous humor was extracted immediately before surgery for analysis. RESULTS: Mean aqueous concentration was 287 ng/mL +/- 69 (SEM) (range 40 to 1141 ng/mL) in the drops group and 957 +/- 189 ng/mL (range 214 to 2437 ng/mL) in the shield group. The difference was statistically significant (P < .005). The minimum inhibitory concentration (MIC) for selected ocular pathogens is between 500 and 4000 ng/mL. CONCLUSIONS: A collagen shield presoaked in commercially available topical ofloxacin and applied before surgery appears safe. The MICs for many common ocular pathogens were reached or exceeded. Further study is recommended to determine whether this method of infection prophylaxis is an acceptable substitute for subconjunctival injections of antibiotics.

Aged↗
PubMed1996

Emergency department do-not-attempt-resuscitation orders: next-of-kin response to the emergency physician.

OBJECTIVE: To evaluate the response by families of incompetent, chronically debilitated, and/or terminally ill patients who were contacted for do-not-attempt-resuscitation (DNAR) status by an emergency physician (EP). METHODS: A prospective observational study was performed to assess next-of-kin willingness to support DNAR status for incompetent, chronically debilitated, and/or terminally ill patients. The families also were contacted by telephone follow-up 48-72 hours after the ED visit. Upon follow-up evaluation, the families were surveyed regarding prior DNAR instructions and their perceptions of the establishment of DNAR status in the ED. The study was conducted in an urban teaching hospital with an emergency medicine residency training program. RESULTS: Of the 71 patient families contacted, 60 (85%) of the patients had DNAR orders written in the ED. The families of these 60 patients had no negative response regarding contact by ED personnel. Of the 11 (15%) patients whose families wished no DNAR order, only two families had negative responses to being contacted by the EP. In both cases the families had previously given detailed instructions to the chronic care facility. CONCLUSION: The EP can play an important role in assisting the decision making process of families of incompetent, chronically debilitated, and/or terminally ill patients regarding institution of DNAR orders in the ED. Improved communication regarding existing DNAR orders with chronic care facilities might minimize the rare complaints received from families with preestablished DNAR orders.

Advance Care Planning↗
PubMed1990

Residents' attitudes toward the legal system and court testimony in child abuse.

Resident physicians' contacts with the legal system during management of abused children may influence their attitudes, which were evaluated in a pilot survey completed by 42 pediatric and medicine/pediatric residents. Although negative attitudes toward attorneys were common, almost all of the residents considered general and hearing-specific legal training to be a legitimate part of their residency program. They reported lower levels of stress of court testimony than expected by the authors. Most who had testified in court believed their testimony had been needed and helpful, but all who believed their testimony had been a waste of time were senior-level residents. Although most residents believed the laws and courts usually work for protecting children, only 8 of the 20 residents who had previously testified in court responded affirmatively, and none of the 10 senior residents who had previously testified held this belief. The disillusionment of senior-level residents appeared to affect attitudes toward patient care less than expected, in that 90% of those who planned to enter private practice indicated they would perform physical abuse evaluations and 70% planned to perform sexual abuse evaluations. Only one resident who did not expect to perform the evaluations gave as a reason the prospect of having to testify in court.

Arkansas↗
PubMedDate not supplied

Evaluating applicants to emergency medicine residency programs.

This article reviews the pertinent literature related to the selection process of medical students to emergency medicine residency programs. The impact that academic performance in medical school, the interview, letters of recommendation, and other achievements have on the performance of the future resident are reviewed. All articles identified by an English language MEDLINE search were reviewed by the authors as to significance to the subject. Review of relevant literature indicates that no precise correlation can be made between performance in medical school and achievements during the residency, although there seems to be a correlation between academic performance in medical school and similar performance on board certification examinations.

Clinical Clerkship↗