Biomedical subjects
Publications and source records attributed to M Goggin.
We describe a case of topical exposure to a commercial solution of paraquat. Chronic, severe ocular surface destruction resulted, probably due to absorption of the herbicide into the surface tissues, facilitated by a surfactant present in the preparation, and to intracellular redox cycling of the paraquat cation. Ocular paraquat toxicity is described and explained in the context of the toxicity of systemic absorption.
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Eleven patients, 10 with lentigo maligna (LM) and one with lentigo maligna melanoma (LMM), were treated with cryotherapy. The symptoms cleared in all patients except one with LM. There were recurrences in four patients and three cleared with further treatment.
We completed a national study of blindness in children under 16. Approximately 80% of the blind children (that is, with vision of 3/60 or less) in the Republic of Ireland (172 children) were seen, 93 males and 79 females. The survey was carried out between July 1989 and June 1990. It is the first such study to be carried out. Ninety seven (56%) children had lesions due to factors acting before the perinatal period. Of these, 28 (16% of the total number surveyed) had lesions due to genetic causes; 69 (40%) had lesions due to factors operating in the prenatal period other than genetic factors. Forty six (27%) had lesions due to factors acting in the perinatal period. Twenty two (13%) had lesions due to factors acting in childhood. (4% could not be categorised in this way). The commonest single primary diagnoses were birth asphyxia in 19 (11%) cases and retinopathy of prematurity in 19 (11%) cases.
Retrobulbar block for eye surgery is associated with adverse reactions. We performed retrobulbar block in 10 patients using prilocaine (Citanest) and found mean (SD) peak serum concentrations of 851 (165.6) ng ml-1 (range 540-1100 mg ml-1). Peak serum concentrations occurred 3-7 min after the end of administration of the block, and in all cases were less than those associated with toxicity.
For evaluation of the adequacy of luteal function after in vitro fertilization-embryo transfer (IVF-ET), serum progesterone (P) levels were measured on days 3, 7, and 10 after laparoscopic follicle aspiration. Fifty-six infertile patients were treated during 86 cycles with human menopausal gonadotropin-human chorionic gonadotropin (hMG-hCG) for stimulation of follicular development. Serum estradiol (E2) levels were measured daily during hMG-hCG treatment. P levels were determined in 67 cycles. The mean (+/- standard deviation [SD]) of the sums of 3 P levels was 55.63 +/- 24.13 ng/ml. There were 11 pregnancies. The mean of the sums of 3 P levels of pregnant patients was 64.45 +/- 26.23 ng/ml and of 56 nonpregnant cycles was 53.90 +/- 23.35 ng/ml. The duration of luteal phase varied from 9 days to 15 days. The mean of the sums of 3 P values of patients with different luteal phase lengths ranged from 28.8 ng/ml to 60.51 +/- 25.68 ng/ml. The mean of the sums of 3 P levels of women with normal luteal phase and that of women with luteal phase defect by endometrial biopsy study were used as controls for comparison. There was poor correlation (r = 0.3441) between E2 peak levels and P levels; the sum of 3 P levels did not indicate luteal phase inadequacy in IVF-ET patients; and the majority of the nonpregnant cycles (32/56) showed a luteal phase of 11 days or less, in spite of adequate P levels.(ABSTRACT TRUNCATED AT 250 WORDS)
PURPOSE: To determine the prevalence of moderate to severe subepithelial haze following photorefractive keratectomy for myopia and to compare the prevalence in eyes treated with the Summit ExciMed UV 200 and the Nidek EC5000. SETTING: The Wellington Ophthalmic Laser Clinic, Dublin, Ireland. METHODS: A retrospective study of 726 consecutive eyes treated with the Summit system and 494 consecutive eyes treated with the Nidek system with similar mean preoperative refractive errors and outcome was carried out. In the group treated with the Summit system, data were available on 692 eyes at 3 months, 612 at 6 months, and 402 at 1 year. In the group treated with the Nidek system, equivalent numbers were 456 at 3 months, 379 at 6 months, and 242 at 1 year. The degree of haze was assessed at these times by two observers using an established six point scale. RESULTS: At 3 months, 82 eyes (11.8%) in the Summit group and 15 (3.3%) in the Nidek group had grade 1 or 2 haze (P = .0000006). At 6 months, 58 (9.5%) and 6 (1.6%), respectively, had grade 1 or 2 (P = .0000017). At 1 year, 28 (7.0%) in the Summit group had grade 1, 2, or 3, whereas only 3 (1.2%) in the Nidek group were in this category (all with grade 1) (P = .0019). CONCLUSION: In the first postoperative year, moderate and more severe haze was significantly less prevalent in eyes treated with the Nidek EC5000 than in those treated with the Summit ExciMed UV200.
This paper examines the extent to which five states are becoming "prudent purchasers" in their oversight of Medicaid managed care. Our conclusions are mixed. These states are making more sustained efforts along these lines than most private purchasers are and have improved the amount and quality of the data they collect on the experiences of Medicaid clients when compared with the traditional fee-for-service program. They have been less successful in ensuring data quality that is adequate to support contracting decisions and in developing the analytical or political capacity to use data to "manage" the managed care system. Becoming a prudent purchaser appears to be a complex task for states that may prove difficult to achieve.
BACKGROUND: Sodium hyaluronate (Healon) has been reported to promote corneal epithelial healing following severe eye burns in humans and rabbits. Endogenous hyaluronate has been shown to be significantly increased in the corneal tissue following extracapsular lens extraction, anterior segment trauma, and radial keratotomy. The authors report the use of topical sodium hyaluronate administration on the cornea of eyes which have been treated by photorefractive keratectomy for myopia. METHODS: Forty eyes of 40 patients undergoing excimer laser photorefractive keratectomy for myopia were studied to evaluate the effect of topical sodium hyaluronate versus placebo (Healon buffer) instillation on pain and corneal epithelial healing in an observer blind randomized clinical trial. RESULTS: There was no significant difference between patients whose eyes were treated with sodium hyaluronate and those treated with a placebo (Healon buffer), with regard to the amount of postoperative pain or the rapidity of corneal epithelial healing. CONCLUSIONS: Topical sodium hyaluronate administration showed no effect on pain or corneal epithelial healing following photorefractive keratectomy in this study.
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BACKGROUND: Astigmatism following photorefractive keratectomy for myopia has been reported as stable as early as 2 to 3 months. The authors report 36 out of 60 consecutive eyes with variations in the cylindrical component of their refraction at 6 months after laser treatment. METHOD: A standard photorefractive keratectomy was carried out on 60 consecutive eyes in 52 patients over a 7-month period. The manifest refraction of these eyes was followed for 6 months. RESULTS: Thirty-six eyes demonstrated a change in the cylindrical element of their refraction manifested as a change in cylinder power or axis, or both. The mean pretreatment cylinder power in the group that underwent a change in the cylindrical element was significantly higher than the mean of the group where this did not take place. The mean cylinder power change was 0.75 diopters (D) and in 9 eyes this change was 1.00 D or more. The corrected and uncorrected postoperative visual acuities were the same in the two groups. CONCLUSIONS: This observation implies meridional variability in the healing process of the anterior cornea following photorefractive keratectomy.