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Biomedical subjects

J McAlister

Publications and source records attributed to J McAlister.

At least 19 recordsLinked to original sources

Single intraoperative application of 5-Fluorouracil versus placebo in low-risk trabeculectomy surgery: a randomized trial.

PURPOSE: Trabeculectomy is the procedure of choice for the surgical control of glaucoma, and is often augmented by intraoperative 5-fluorouracil application to reduce scarring. This study aims to assess the validity of this technique with a randomized placebo-controlled trial. METHODS: Patients without risk factors for bleb failure other than previous drop use who were undergoing trabeculectomy surgery as their first ocular procedure were randomized to receive fluorouracil or placebo. The main outcome measures were intraocular pressure and bleb morphology. RESULTS: Results from 40 eyes of 36 patients are presented; 23 eyes were treated with fluorouracil, and 17 eyes were treated with placebo. Mean intraocular pressure at 1 year and at the final follow-up examination was significantly lower than preoperatively, but was not different between fluorouracil and placebo groups. Kaplan-Meier survival analysis also failed to show any difference, though there was a trend toward better survival of an intraocular pressure of 16 mm Hg or lower. Bleb morphology was examined postoperatively in 24 patients, with no differences found between fluorouracil and placebo groups. CONCLUSIONS: No significant difference was found in trabeculectomy outcome between fluorouracil-treated and placebo-treated eyes. The study was too small to state definitively that no such difference exists, but suggests that any treatment effect is likely to be small.

Aged↗

Use of complementary therapies by patients attending musculoskeletal clinics.

Patients with musculoskeletal disorders commonly seek treatment outside orthodox medicine (complementary therapy). In patients attending hospital clinics we investigated the prevalence of such behaviour and the reasons for it. Patients attending rheumatology and orthopaedic clinics who agreed to participate were interviewed on the same day by means of a structured questionnaire in three sections: the first section about demographic characteristics; the second about the nature and duration of the complaint, the length of any treatment and whether the patient was satisfied with conventional treatment; and the third about the use of complementary medicine, the types of therapy that had been considered and the reasoning behind these decisions. The data were examined by univariate and bivariate analysis as well as logistic regression multivariate analysis. 166 patients were interviewed (99% response rate) and the predominant diagnosis was rheumatoid arthritis (22.3%). 109 patients (63%) were satisfied with conventional medical treatment; 63 (38%) had considered the use of complementary therapies, and 47 (28%) had tried such a therapy. 26 of the 47 who had used complementary therapy said they had gained some benefit. Acupuncture, homoeopathy, osteopathy and herbal medicine were the most popular types of treatment to be considered. Patients of female gender (P = 0.009) and patients who had expressed dissatisfaction with current therapies (P = 0.01) were most likely to have considered complementary medicine. These results indicate substantial use of complementary therapy in patients attending musculoskeletal disease clinics. The reasons for dissatisfaction with orthodox treatment deserve further investigation, as does the effectiveness of complementary treatments, which must be demonstrated before they are integrated with orthodox medical practice.

Adolescent↗

Hemosiderosis in a patient on regular hemodialysis: treatment by desferrioxamine.

Hemosiderosis following regular administration of parenteral iron was observed in a patient receiving maintenance hemodialysis. Infusions of desferrioxamine in doses of 2,3 and 4 g each resulted in the removal of approximately 45 mg of iron during dialysis. Desferrioxamine 2 g was infused thrice weekly during dialysis for twelve months. Body iron stores, as judged by liver iron and serum ferritin concentrations, fell by about half. This agrees well with the result calculated from the amount of iron administered and the amount removed during dialysis.

Deferoxamine↗

Comparison of two triiodothyronine uptake techniques for the assessment of thyroid function.

The present study was designed to compare the Thyopac and Triosorb triiodothyronine uptake tests. A normal range was established for the two procedures. Neither test was affected by iodine-containing drugs or contrast media but abnormal results were obtained during pregnancy and in subjects receiving oestrogens. Both tests proved satisfactory in the diagnosis of hypo- and hyperthyroidism, giving results consistent with clinical assessment and with serum protein-bound iodine determinations. The Thyopac procedure was preferred for a number of reasons. It requires less plasma; it is slightly simpler and quicker and it is not time dependent.

Estrogens↗

Potassium depletion in severe heart disease.

Exchangeable sodium and potassium, total body water, and sulphate space were measured in 42 patients with severe valvular heart disease who were free of oedema. Compared with normal subjects of the same height, no increase in exchangeable sodium was found but a mean potassium depletion of 27% was shown. This depletion was not related to diuretic therapy, and no relationship between the degree of depletion and postoperative arrhythmias was found. It is concluded that the major cause of the low exchangeable potassium is the reduction in cell mass that occurs in chronic heart disease, and that there is no significant fall in the intracellular potassium concentration.

Adult↗