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Biomedical subjects

R Holden

Publications and source records attributed to R Holden.

At least 37 records · Page 2Linked to original sources
PubMed1991

Opportunistic screening of visual acuity of elderly patients attending outpatient clinics.

A standard Snellen letter chart was used to screen the visual acuities of 202 elderly patients while they attended outpatients clinics. Patients overestimated the adequacy of their vision: only 34 patients reported inadequate vision while 72 had significant measured visual impairment. Of these, 30 patients had refractive errors and 42 primarily non-refractive problems. Thirty patients were examined by an ophthalmologist, of whom 24 had previously undiagnosed conditions. Eighteen patients had treatable conditions, predominantly cataracts and glaucoma. Ten patients with untreatable conditions had the benefit of a definitive diagnosis, most commonly of age-related macular degeneration, and an assessment of eligibility for registration of blindness. The routine assessment of elderly patients should include objective screening of their visual acuity.

Aged↗
PubMed1991

Intra-ocular pressure changes using the laryngeal mask airway and tracheal tube.

Intra-ocular pressure was measured before and throughout airway establishment with either the laryngeal mask airway or tracheal tube. Similar measurements were made on removal of either airway and the amount of coughing noted in the first minute after removal. There was a significantly smaller increase in intra-ocular pressure (p less than 0.001) using the laryngeal mask airway, both on placement and removal, than with the tracheal tube. Postoperative coughing was significantly reduced using the laryngeal mask airway (p less than 0.001). There was a significantly greater rise in heart rate using the tracheal tube (p less than 0.01) probably related to an increased cardiovascular response. The laryngeal mask airway is recommended as an alternative to tracheal intubation in routine and emergency intra-ocular surgery.

Aged↗
PubMed1991

Spontaneous hyphaema as a result of systemic anticoagulation in previously abnormal eyes.

Spontaneous hyphaema in patients on systemic anticoagulants has been described in normal eyes and also in eyes with certain intraocular lenses following cataract surgery. These cases are rare and in all the reported cases the hyphaemas resolved without sequelae. Four cases are reported here of spontaneous hyphaemas in previously abnormal eyes of patients on anticoagulants. Three of these patients suffered considerable pain as a result of this. The reasons for this are discussed and early ophthalmic referral recommended if a hyphaema is suspected in these situations.

Adult↗
PubMed1989

Naltrexone treatment--the problem of patient acceptance.

Since the release of naltrexone for general use, we have offered it to approximately 300 narcotics-addicted patients admitted to our 4-week intensive treatment program at the Psychiatric Institute of Washington. Despite active persuasion, only 15 patients agreed to take the drug, and 11 started the outpatient phase of treatment. Only 3 of the 11 remained on naltrexone for more than 2 months. Negative local community attitudes toward all pharmacologic treatments, a strong focus on total abstinence by the recovering patient group, and self-elimination of poor candidates in this unselected population appear to be important factors in the poor acceptance of naltrexone.

Adult↗
PubMed1985

Assessment of blood collection systems for the high performance liquid chromatography measurement of propranolol.

The effect of blood collection devices on the high performance liquid chromatography (HPLC) measurement of propranolol was assessed. Blood was collected from hypertensive patients treated with propranolol for at least 7 days. Two venipunctures (opposite arm technique) were performed on each patient using the reference (syringe/silanized, ethylene diamintetraacetate tubes) procedure and the Vacutainer Brand Tubes (lavender-, royal blue-, green-, and red-stoppered) that were free of tris(2-butoxyethyl) phosphate. Propranolol concentrations were determined utilizing a published HPLC procedure. This study showed that in the four evacuated tubes, propranolol concentrations in serum or plasma were highly correlated to those of the reference procedure (correlation coefficients, 0.986 to 0.997; and slope, 0.912 to 1.013). Mean propranolol concentrations of the red-stoppered tube serum were lower (7.5%) than that of the reference syringe (0.01 less than p less than 0.05). Thus, lavender-, royal blue-, green-, and red-stoppered tubes would be acceptable for propranolol monitoring.

Blood Specimen Collection↗
PubMed1984

The outpatient treatment of heroin addicts with methadone: a two- to five-year follow-up study.

This study is a two- to five-year follow-up of 40 patients who were discharged from a methadone maintenance program. Both "graduates" and prematurely discharged patients were surveyed. Forty-five percent of patients had been in treatment for one year or more. Outcome evaluation was based on a reduction of illicit drug use, an increase in social stability, and a decline in criminal activity. Eighteen of 40 clients were located and interviewed. Seven (39 percent) were found to be either drug free or using only prescribed methadone, and five had substantially reduced their drug use. Relapse to illicit drug use was associated with a pre-treatment history of poly-drug use, poorer work and arrest records, and a greater number of previous treatments. Abstinence appeared to be a realistic goal for only a few. The importance of retaining patients in treatment longer is discussed.

District of Columbia↗
PubMed1983

First-trimester rudimentary horn pregnancy: prerupture ultrasound diagnosis.

A case of pregnancy in the rudimentary horn of a bicornuate uterus is presented, and a discussion of this rare and potentially catastrophic phenomenon follows. This is the first such case reported in which the diagnosis was made early in gestation through the use of ultrasonography. An extrauterine gestation accompanied by a well-defined placenta visible on ultrasound scan is suggested as a criterion for differentiating rudimentary horn pregnancy from abdominal pregnancy.

Adolescent↗
PubMed1982

Double-contrast examination of the oesophagus: the radiological changes of peptic oesophagitis.

A simple method for obtaining double-contrast views of the oesophagus as part of the routine double contrast examination of the upper gastrointestinal tract using high-density low-viscosity barium is described. The typical radiological changes of early peptic oesophagitis (confirmed by endoscopy) which can be readily demonstrated with this technique are illustrated as an example of its practical value. These consist of 'smudged' or 'cobble-stone' mucosa with thickened and distorted longitudinal folds. Superficial erosions and deep ulcers may also be seen. It is suggested that endoscopic confirmation of these characteristic radiological signs of peptic oesophagitis is unnecessary.

Barium↗
PubMed1976

Immune response to phi X 174 in man. 5. Primary and secondary antibody production in primary biliary cirrhosis.

In primary biliary cirrhosis, the primary immune response to the bacteriophage phi X 174 is normal but the secondary response is significantly reduced. The reduction is primarily of IgG antibody, while IgM is proportionately less affected. These changes may be the result of a reduction in helper T lymphocyte function and may contribute to the increase in the ratio of serum concentration of IgM to IgG.

Adult↗