Biomedical subjects

P House

Publications and source records attributed to P House.

13 recordsLinked to original sources

PubMed2001

Proliferation of lens epithelial cells on the Acrysof intraocular lens: clinical and histological features of a case.

Postoperative deposits on the surface of intraocular lenses (IOLs) have been demonstrated in vivo for many IOL material types. The Acrysof acrylic lens develops a granular material extending from the capsulorhexis margin onto the IOL's anterior surface during the first 4 weeks after surgery in a significant proportion of cases. Complete resolution of this membrane occurs by 3 months in almost all cases. The case is presented of an 81-year-old woman who had a persisting membrane coverng the IOL surface at 6 months. This membrane was removed surgically and pathology showed the constituent cells to be of lens epithelial cell origin.

Acrylic Resins↗

PubMed2000

Long-term topical timolol and blood lipids: the Blue Mountains Eye Study.

OBJECTIVES: To examine whether an association exists between long-term use of topical timolol and blood lipids, including high-density lipoprotein cholesterol (HDL-C), cholesterol, and triglycerides, among participants of the Blue Mountains Eye Study. METHODS: From 1992 through 1994, a detailed medical and eye examination was performed in 3,654 people aged 49 years or older, representing 82% of permanent residents in two postcode areas west of Sydney. Glaucoma and ocular hypertension were diagnosed, and an ophthalmic history was taken, including use of topical timolol. Fasting blood tests were performed in 89% of subjects. Lipid levels were compared in subjects using topical timolol for at least 1 year with those not using timolol, after excluding people using oral beta-blockers, topical beta1-selective agents, or oral lipid-lowering medications. RESULTS: Analyses compared blood lipids of 63 people who had used topical timolol for at least 1 year with 2,597 nonusers. No statistically significant differences were found in any blood lipid mean levels between treated and untreated people, after multivariate adjustment. However, subgroup analyses of men and women separately showed that male timolol users had a mean value of HDL-C 0.13 mmol/L (11%) lower then the mean value of male nonusers, while female timolol users had a mean value of HDL-C 0.09 mmol/L (5%) higher than the mean for female nonusers. There were no statistically significant associations between timolol treatment duration and HDL-C or other lipid levels. Previously reported adverse effects of oral beta-blockers on blood lipid levels were confirmed. CONCLUSIONS: These population-based data suggest that long-term administration of topical timolol for glaucoma or ocular hypertension can cause adverse effects on HDL-C in men, but not in women. The magnitude of the effect in men was similar to that previously described in a number of short-term studies.

Adrenergic beta-Antagonists↗

PubMed2000

The use of community surveys for health planning: the experience of 56 northwest rural communities.

A rural health services development program of the University of Washington School of Medicine has worked for 15 years with communities throughout the five-state region of Alaska, Idaho, Montana, Washington and Wyoming to strengthen their health systems. In the course of that work, 56 communities were surveyed about their utilization and opinions of local health systems. This database allows the following generalizations to be made about rural Northwest communities: (1) People think highly of their local hospitals, physicians and other key components of the acute medical care system and want their hospitals to remain open. Older respondents are more satisfied than younger respondents; (2) the typical hospital market share is 36 percent, the typical physician market share is 50 percent (3) satisfaction with discrete, well-funded services such as pharmacy, ambulance and dentistry is quite high, whereas satisfaction with mental health and substance abuse treatment is significantly lower; (4) the most commonly cited serious problems in surveyed communities were "too few physicians or- services" and "care is too expensive"; and (5) there is great variation between communities in both satisfaction and utilization.

Alaska↗

PubMed2000

Comparison of optic disc image assessment methods when examining serial photographs for glaucomatous progression.

AIM: To assess serial, simultaneous stereo optic disc images by four methods for glaucomatous progression. METHODS: Using varying techniques, two ophthalmologists assessed serial optic disc images of 52 eyes from 27 patients with a mean duration between images of 18 months. The neuroretinal rim width was qualitatively assessed by four assessment methods and compared with quantitative rim measurements made using PC based software. RESULTS: The highest sensitivity of 83% was achieved using computerised stereo chronoscopy. CONCLUSION: Stereo chronoscopy improved the detection of subtle optic disc changes when compared with simpler assessment techniques.

Disease Progression↗

PubMed1999

Postoperative deposits on the Acrysof intraocular lens.

PURPOSE: To report a commonly occurring change on the anterior surface of the Acrysof intraocular lens which is presumed to be due to the proliferation of lens epithelial cells from the capsulo-rhexis margin. METHOD: Forty-one consecutive cases (31 patients) of Acrysof intraocular lens implantation were followed prospectively. Clinical charts were reviewed for changes on or within the lens and visual acuity and refractive changes recorded. All cases were dilated at 3-5 weeks postoperatively to facilitate observation of changes. Representative slit lamp photos were taken. RESULTS: Deposits on the intraocular lens surface were noted on 18 of 41 lenses at 3-5 weeks post surgery. Deposits were not found on examinations conducted during the first postoperative week. All changes had fully resolved by 3 months. CONCLUSIONS: The changes recorded had no impact on visual acuity. The deposits noted do not represent clinically important pathology. They may be an unusual marker of biocompatibility with this lens. Surgeons using this lens should be aware of these changes.

Biofilms↗

PubMed1998

Non-mydriatic fundus photography: a viable alternative to fundoscopy for identification of diabetic retinopathy in an Aboriginal population in rural Western Australia?

PURPOSE: To evaluate the Canon CR5-45NM non-mydriatic fundus camera (Canon, Kanagawa, Japan) for identifying retinopathy and the need for laser treatment in a population of Aboriginal patients with diabetes mellitus in rural Western Australia. METHODS: Diabetic Aboriginal patients were photographed through undilated pupils using a Canon CR5-45NM non-mydriatic fundus camera, after which ophthalmoscopy was performed using indirect ophthalmoscopy through dilated pupils. The examining ophthalmologist recorded the presence of retinopathy and the need for laser treatment. A proportion of patients were rephotographed through dilated pupils. Photographs were reviewed by a second ophthalmologist who evaluated the quality of the image, the presence of retinopathy and the need for laser treatment. Results of fundus photographs and ophthalmoscopy were compared. RESULTS: Three hundred and twenty-eight eyes in 164 Aboriginal patients were examined. The mean patient age was 48.2 years (range 16-81 years) and the mean duration of diabetes was 7.5 years (range 1-35 years). Seventy-four eyes (22.6%) were diagnosed with retinopathy using combined examination techniques, 44 (59.5%) of which were identified by ophthalmoscopy and 55 (74.3%) by photography. Thirty-five eyes were deemed to need treatment, 18 (51.4%) of which were identified by ophthalmoscopy and 30 (85.7%) by photography. Kappa coefficient measurement for agreement for presence of retinopathy and need for referral was 0.41 and 0.53, respectively. Photograph quality was significantly improved following pupil dilation. CONCLUSIONS: The Canon CR5-45NM non-mydriatic fundus camera was relatively good at identifying diabetic retinopathy and could usefully be applied within a screening programme for treatable disease within this population.

Adolescent↗

PubMed1996

Vision testing in atrophic macular degeneration.

PURPOSE: To determine the correlation between a group of vision tests in atrophic macular degeneration (AMD) in an office setting. METHODS: Patients with documented vision loss from atrophic macular degeneration in one eye were invited to attend an eye clinic every three months for a series of six vision tests for their good eye followed by fundus photography. Modified contrast sensitivity, blue/yellow anomaloscopy, flicker fusion frequency, Amsler grid, and photostress recovery time were correlated with Snellen acuity using the Pearson correlation coefficient. The regression of the Snellen acuity on sex, age and the presence of disciform macular degeneration in the other eye was obtained using a general linear model. RESULTS: The correlation with Snellen acuity result was low for all tests. It was highest for Amsler grid abnormality (r = -0.33345) and blue/yellow anomaloscopy matching range (r = -0.20742), where r denotes the correlation coefficient. Patient age was strongly correlated with Snellen results (P = 0.0001), but it was not significantly related to sex (P = 0.1187) or the presence of disciform macular degeneration in the other eye (P = 0.9989). The photostress recovery time showed enormous inter-visit variations and poor correlation with Snellen acuity (P = 0.0526). CONCLUSIONS: The course of AMD is routinely assessed by Snellen acuity and any of several additional tests. When employing a test battery in an office setting, a clinician needs to know the relative utility and correlation between the tests at his disposal. Of the tests used in this study, the Amsler grid was the most useful addition to the Snellen acuity at all stages of atrophic macular degeneration, and blue/yellow anomaloscopy was useful only in mild macular degeneration where Snellen acuity was 6/12 or better.

Aged↗

PubMed1995

Herbicide regulation: a case study of Michigan.

Lawn-care herbicides are a type of pesticide regulated under federal and state pesticide legislation. The Michigan Department of Agriculture implements herbicide regulation to protect the public's health and welfare. Yet, due to gaps that exist in all levels of government in the regulation of lawn-care herbicide application, the public is placed at risk. The federal pesticide legislation (Federal Insecticide, Fungicide, and Rodenticide Act) provides for a lower standard of safety in the classification of herbicides applied in the residential context as opposed to the agricultural context. Michigan legislation (The Pesticide Control Act) exempts from the law persons applying general herbicides on their own premises. The state does not require public notification of risks or safety precautions prior to commercial application of these herbicides. Furthermore, on-site inspections are not performed for residential application of herbicides and the state applicator certification program is not assessed for effectiveness.

2,4-Dichlorophenoxyacetic Acid↗

PubMed1991

Characteristics of the normal central visual field measured with resolution perimetry.

The ring perimeter is an innovative device that measures the resolution threshold at 50 locations in the central visual field in approximately 6 min. This study was undertaken to define the characteristics of the resolution visual field in normal eyes using this instrument and to check the repeatability of the measurement. A total of 114 perimetrically naive, normal subjects aged from 20 to 79 years were prospectively enrolled; 55 randomly chosen subjects were tested twice, with a rest period of less than or equal to 60 s elapsing between examinations. The resolution threshold increased towards the periphery in all subjects. A small but significant decline in sensitivity occurred with age; this loss was greatest in the inner part of the field. Variability in threshold between subjects was not found to increase towards the periphery or in the upper field as compared with the lower. The field was highly repeatable when reexamined in the same subject. This study defines the resolution visual field in normal subjects, along with its inter- and intra-observer variability, and gives age-corrected predictive confidence intervals for each location of the field using the ring perimeter.

Adult↗

PubMed1989

[Argon laser trabeculoplasty for open angle glaucoma--a four year follow-up].

79 patients (105 eyes) with uncontrolled open angle glaucoma underwent argon laser trabeculoplasty (ALT). The average pressure drop was 10.7 mmHg in 58 eyes at one year, 10.1 mmHg in 35 eyes at two years, 9.9 mm Hg in 48 eyes at three years and 10.2 mmHg in 24 eyes at four years. Teh mean success rate was 78%, failures occurred in the first six months in 21 of 23 eyes, the remaining eyes failed at three years, 18 eyes (17%) required filtering surgery. Average medication scores varied little from year 1 through year 4, 45 eyes (42.9%) were being treated with few medications after ALT. The results of ALT depend on the severity of glaucoma: the eyes with advanced disc damage (C/D greater than 0.9, visual field less than 20 degrees) had 59% rate of filtering surgery, while the eyes with C/D 0.6-0.8, visual field greater than 20 degrees at ALT had a filtering surgery rate of 3%.

Aged↗

PubMed1988

Ocular abnormalities in deaf children: a discussion of deafness and retinal pigment changes.

In a survey of 78 hearing impaired children, 33% were found to have ocular abnormalities. The abnormalities were relatively minor, the most frequent being altered retinal pigmentation. Although congenital rubella infection was the most common cause of this finding the cause in others was more obscure. Possible causes for hearing loss associated with retinal pigment and other tissue changes are abnormal cilia, abnormalities in cells with similar embryological origins and genetic defects affecting pigmentation.

Adolescent↗

PubMedDate not supplied

Developing laser-induced glaucoma in rabbits.

PURPOSE: An animal mode of glaucoma is necessary for the study of its pathogenesis and treatment. The purpose of this study was to create open-angle glaucoma using a laser in rabbits. METHODS: The trabecular meshwork of anaesthetized, adult, pigmented and albino rabbits was ablated internally using a diode laser via a gonioscopy lens, or externally through the limbus. In albino rabbits we used Chinese ink to pigment the angle and methylcellulose to open the iridocorneal angle. The eyes were examined weekly and histological assessment was performed. RESULTS: The success rate of intra-ocular hypertension was low (15%) and a result of synechial angle closure. A narrow angle prevented access of the laser beam to the trabecular meshwork and promoted damage to the ciliary processes located on the posterior iris. CONCLUSIONS: Due to the unique anatomy of the rabbit eye, laser-induced glaucoma is difficult to achieve. To create a successful model it is necessary to widen the iridocorneal angle, selectively damage the trabecular meshwork and reduce inflammation.

Animals↗

PubMedDate not supplied

Improving a rural hospital's peer review process.

Quality monitoring in a small rural hospital is a challenge on many fronts. The case study presented here illustrates a quality monitoring failure and analyzes the contributing factors. Based on their experience, the authors suggest methods to improve small rural hospital quality monitoring.

Hospital Bed Capacity, under 100↗