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Biomedical subjects

J R Fuller

Publications and source records attributed to J R Fuller.

At least 19 recordsLinked to original sources
PubMed2005

Tear film lipid layer thickness and ocular comfort after meibomian therapy via latent heat with a novel device in normal subjects.

AIM: This study measures changes in tear film lipid layer thickness (LLT) and ocular comfort in normal subjects after 10 min use of a novel device, which delivers meibomian therapy with latent heat. The device is designed to promote the release of meibomian sebum into the tear film by delivering latent heat to the eyelids, thus thickening the lipid layer. Normal lid movements are maintained, facilitating resurfacing of the tear film. METHOD: A prospective, controlled, observer masked, single intervention trial in which 24 normal subjects were randomised into three groups. Group I underwent 10 min treatment with the activated device, Group II used the inactivated device for the same duration of time, and Group III had no intervention. The LLT of each subject was measured with a Keeler Tearscope prior and subsequent to the 10-min period. Subjective alteration in ocular comfort was also assessed. RESULTS: Seven of eight subjects (87.5%) in Group I exhibited an increase in LLT. The mean LLT in this group showed a statistically significant increase (left eyes 1.0 levels, P<0.001, right eyes 0.9 levels, P<0.003) compared to Groups II and III. Six of eight subjects (75%) using the activated device experienced subjective improvement in ocular comfort. CONCLUSION: Meibomian therapy with this device increases LLT in normal individuals. This implies a more stable tear film, reflected in subjective improvement in ocular comfort.

Adult↗
PubMed2002

Anti-inflammatory fibrosis suppression in threatened trabeculectomy bleb failure produces good long term control of intraocular pressure without risk of sight threatening complications.

AIMS: To determine the long term outcome of systemic anti-inflammatory fibrosis suppression in cases of threatened trabeculectomy bleb failure in open angle glaucoma. METHODS: This prospective non-comparative case series followed 77 eyes of 63 patients which showed signs of threatened early bleb failure and were treated with oral anti-inflammatory fibrosis suppression of prednisone, a non-steroidal anti-inflammatory agent, and colchicine taken for a mean period of 6 weeks, in addition to standard postoperative topical treatment, for a mean follow up of 6 years. RESULTS: Trabeculectomy with anti-inflammatory fibrosis suppression controlled the IOP at < or =21 mm Hg with a probability of 0.91 (95% CI: 0.81 to 1.0) at 8 years and 0.89 (95% CI: 0.56 to 1.1) at 12 years. There were no reported cases of endophthalmitis, hypotonous maculopathy, late bleb leak, or serious systemic side effects. CONCLUSION: Anti-inflammatory fibrosis suppression provided good control of bleb fibrosis without risk of sight threatening complications in a patient group at high risk of bleb failure.

Adult↗
PubMed2001

Long-term follow-up of traumatic glaucoma treated with Molteno implants.

PURPOSE: To determine the long-term outcomes of patients with traumatic glaucoma treated with Molteno implants at Dunedin Hospital, New Zealand. DESIGN: Prospective, noncomparative, interventional case series. PARTICIPANTS: Thirty-eight patients with traumatic glaucoma and with a mean follow-up of 10.9 years. INTERVENTION: Insertion of Molteno implant. MAIN OUTCOME MEASURES: Intraocular pressure (IOP) and intraocular pressure-related surgical interventions after Molteno implant insertion. RESULTS: Insertion of a Molteno implant controlled the IOP at 21 mmHg or less (with or without hypotensive medication) with a probability of 0.80 (95% confidence interval [CI], 0.66, 0.93) at 5 years and 0.72 (95% CI, 0.56, 0.88) at 10 years. At final follow-up, intraocular pressure was controlled solely with the implant in 26 cases and controlled with the addition of hypotensive medication in three cases, whereas nine eyes were failures. Eleven patients (29%) underwent intervention for implant repositioning or tube orifice blockage. Thirty-four double- and six single-plate Molteno implants were inserted. Two patients had implants replaced. Seventy-nine percent became aphakic or pseudophakic from their trauma before or at the time of Molteno implant insertion. There were no exclusions resulting from extensive ocular damage. CONCLUSIONS: Insertion of Molteno implants in traumatic glaucoma produced intraocular pressure control at long-term follow-up in 76% of cases.

Adolescent↗
PubMed2001

Upside-down orbitopathy: unilateral orbital dependent-tissue oedema causing total visual loss.

The case is reported of a 24-year-old man who was involved in a road traffic accident and became trapped upside down with the right side of his face being the most dependent part of his body. Marked hemifacial tissue oedema was associated with right acute compressive orbitopathy and vascular compromise. Acute dysfunction of al orbital nerves was found on examination. Such neuropathy is usually related to the consequences of direct trauma, fractures or haemorrhage; however, computed tomography scanning demonstrated no evidence of orbital fracture or haemorrhage. Immediate anterior surgical orbital decompression was performed in the emergency room in addition to high dose intravenous steroids. Dependent orbtal tissue oedema is proposed as a mechanism of compressive orbitopathy with consequent ischaemic damage to all orbital nerves, total visual loss and complete ophthalmoparesis. Good recovery of other orbital nerves has occurred and the globe has reperfused. Despite intervention, no visual function has returned.

Accidents, Traffic↗
PubMed1995

Astigmatism in Bangladeshi and white school entrants in East London: a prospective comparative study.

A prospective comparative study was undertaken to determine the prevalence of significant astigmatism in school entrants living in the same area of East London. Thirty-one Bangladeshi and thirty-one white school entrants were refracted in two local state schools. In the Bangladeshi group, 7 right and 5 left eyes had more than 1 dioptre of astigmatism. Most of this astigmatism was with the rule. In the white group, 1 left eye had more than 1 dioptre of astigmatism. This study has shown a statistically significant incidence of astigmatism in an ethnic group in East London. This difference between two racial groups living in the same area of East London has not previously been documented. In our study, Bangladeshi school entrants may be at greater risk of amblyopia if their refractive error is not identified and corrected.

Astigmatism↗
PubMed1995

Endophthalmitis after routine intra-ocular surgery in an asplenic patient.

A 72-year-old asplenic man developed an acute early pneumococcal endophthalmitis after a routine endocapsular cataract extraction with poor final visual outcome. It is recognized that splenectomy increases the risk and severity of pneumococcal infections. Our patient had not received pneumococcal vaccination or been prescribed prophylactic antibiotics since his splenectomy or at the time of surgery. Failure of these measures to occur may have affected visual outcome.

Aged↗
PubMed1995

An outcome study of patient-controlled morphine analgesia, with or without ketorolac, following radical retropubic prostatectomy.

PURPOSE: We compared the effects of postoperative pain control strategies on recovery after radical retropubic prostatectomy. MATERIALS AND METHODS: The results in 22 consecutive patients who underwent radical retropubic prostatectomy between 1993 and 1994 were evaluated. Pain control was achieved using morphine patient-controlled analgesia in 11 patients or nonsteroidal anti-inflammatory ketorolac in 11. Outcome measures were compared between the 2 groups. RESULTS: The interval to return of bowel function, length of hospitalization and total hospital costs were significantly decreased in the ketorolac treated patients. CONCLUSIONS: Pain control with ketorolac affords excellent analgesia while allowing for earlier recovery of bowel function, shorter hospitalization and lower overall costs in patients undergoing radical retropubic prostatectomy.

Aged↗
PubMed1993

In vitro activity of danofloxacin, tylosin and oxytetracycline against mycoplasmas of veterinary importance.

The activities of danofloxacin, a novel fluoroquinolone, and two other antimicrobials were determined in vitro against field isolates of seven Mycoplasma species of veterinary importance isolated from cattle, swine and poultry in five European countries. The minimum inhibitory concentrations (MIC) of danofloxacin, tylosin and oxytetracycline were determined against a total of 68 isolates. Danofloxacin showed excellent activity against isolates of all Mycoplasma species (range 0.008 to 0.5 microgram ml-1), but in some isolates there was evidence of reduced sensitivity to tylosin (range 0.008 to 2.0 micrograms ml-1) and oxytetracycline (range 0.008 to over 16.0 micrograms ml-1). Danofloxacin was more active than other antimicrobials against M hyopneumoniae, M dispar and M bovigenitalium, and showed activity similar to that of tylosin against M bovis and M gallisepticum. Tylosin was the most active against M synoviae and M hyosynoviae. Generally, oxytetracycline showed the poorest activity, but was superior to tylosin against M bovigenitalium. A second (final) MIC reading was taken for all isolates 14 or 21 days after the initial reading, and MIC values rose during that time. However, the increase seen in danofloxacin values (typically one to two dilutions) was less than that seen for tylosin and oxytetracycline. It is concluded that danofloxacin is highly active in vitro against all of the Mycoplasma species tested, and thus shows great potential for the treatment of respiratory and other infections caused by Mycoplasma species in cattle, pigs and poultry.

Animals↗
PubMed1992

Staging of advanced bladder cancer. Current concepts and pitfalls.

Data presented in the preceding paragraphs should highlight to the reader several important features of clinical bladder cancer staging. Irrespective of the staging level being addressed, the available techniques uniformly have limitations, as well as advantages and disadvantages with respect to each other. A common shortcoming of both plain and cross-sectional techniques employing conventional X-rays is their lack of specificity. Every radiographic finding has an associated differential diagnosis in which neoplasia-related change is but one of many possibilities. Solitary abnormalities on bone scan or chest film serve as an excellent examples of this dilemma. The specificity of conventional imaging techniques is further compromised by attempts to increase sensitivity. As long as nonspecific anatomic changes are used as discriminating criteria, increases in test sensitivity will always occur at the price of specificity. It is hoped that advances in PET scanning and the use of isotope-labeled, tumor-selective monoclonal antibodies will overcome the limitations of currently available techniques. The significance of the limitations of a given test depends to some degree on whether the test is being used for clinical decision making or for patient stratification in a clinical trial. As an example, an aggressive transurethral resection of bladder tumors provides excellent information for clinical management but may introduce bias into multicenter studies in which this technique is not uniformly practiced. Similarly, the results of bimanual examination under anesthesia are important in the reference framework of the managing physician but are a poor quantifier of disease extent in multi-investigator clinical trials. Which staging studies are indicated and their optimal sequence for performance are influenced by pre-existing clinical information. Recognizing this, the staging algorithm in Figure 6 is intended to serve only as a guide to assist the clinician in the evaluation of patients with bladder neoplasms. As clarifications, several points concerning this algorithm merit mention. The literature suggests that as a single study, transurethral ultrasonography provides excellent local staging information. However, given that it is not widely available, the authors have chosen not to incorporate it into the staging schema. Optimally, it would be used immediately prior to transurethral resection of bladder tumors and bimanual examination. In addition, the algorithm lists MRI interchangeably with CT. While MRI appears to have slightly better sensitivity and specificity for both local and regional tumor stage relative to CT, its benefits are to some degree offset by its greater cost and the need to image the patient in multiple planes for lengthy intervals.(ABSTRACT TRUNCATED AT 400 WORDS)

Algorithms↗
PubMed1990

Early patterns of maternal attachment.

The relationship between maternal-fetal attachment and maternal-child interaction was examined. The Maternal Fetal Attachment Scale (Cranley, 1981) was administered to 32 women between their 35th and 40th weeks of pregnancy. These mothers were observed again while they fed their infants once on the second and once on the third postpartum days. Their interactive behaviors were then rated on the Nursing Child Assessment Feeding Scale (University of Washington) and the Funke Mother-Infant Interaction Assessment. The findings indicated a positive and significant relationship between maternal fetal attachment behaviors and mother-infant interaction. Qualitative data collected during the research process gave meaning and interpretation to observed behaviors. Implications for nursing practice are discussed.

Adolescent↗
PubMed1988

Martial arts and psychological health.

The misleading public image of the martial arts masks a rich though esoteric psychological legacy containing informative parallels for contemporary psychotherapeutic concepts and practices. To date, empirical research on the martial arts has lacked sophistication in the questions it has posed and in the methodology adopted to answer them. Whilst not entirely consistent, findings from studies of martial artists' personalities, outlooks and behaviour have generally indicated positive psychological effects of training. Clinical and psychotherapeutic applications are at an exploratory stage but appear promising. As an exemplar the psychological facets of the art of Aikido are discussed, and prospective uses of martial arts principles as systemic or adjunctive therapies are considered.

Aggression↗
PubMed1987

Performance-enhancing drugs in sport: a different form of drug abuse.

The use and abuse of drugs in American society is recognized as a major issue among those who study youth. This paper addresses an often overlooked area of drug abuse: performance-enhancing drugs in sport. The reasons these vocational drugs are used by athletes are different from those of the recreational drug user. This paper examines the seriousness and prevalence of performance-enhancing drugs and presents the results of a series of interviews with steroid users to determine their attitudes. These attitudes and rationalizations suggest that an expanded view of drugs is required if performance-enhancing drug use is to be understood.

Adolescent↗
PubMed1984

2-Hydroxylaminoimidazoles--unstable intermediates in the reduction of 2-nitroimidazoles.

An unstable 2-hydroxylaminoimidazole (2-hydroxylamino-1-methylimidazole) was prepared by the reaction of 2-fluoro-1-methylimidazole with hydroxylamine. This substance was sufficiently stable (half-life of 1-2 days) in acid solutions to be observed and characterized by NMR spectroscopy; decomposition at neutrality was, however, rapid (half-life of 1-10 min). Radiochemical and electrochemical reduction experiments were carried out at pH 4 and pH 7 with 2-nitro-1-methylimidazole and misonidazole [1-(3'-methoxy-2'-hydroxypropyl)-2-nitroimidazole]. A four electron stoichiometry was found in every case. The pH 4 reduced product was identified as the 2-hydroxylamino derivative (greater than 80% yield). The pH 7 reduced solutions, on the other hand, showed no aromatic 1H NMR signals, suggesting that a simple imidazole ring was no longer present. A shift to pH 7 of the hydroxylamine produced at pH 4, however, resulted in very similar NMR spectra. The conclusion, therefore, is that the hydroxylamine was produced initially on reduction of the nitroimidazole, but it was not stable.

Chemical Phenomena↗