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Biomedical subjects

R Michaud

Publications and source records attributed to R Michaud.

At least 19 recordsLinked to original sources

A dominantly inherited progressive disease in a black family characterised by cerebellar and retinal degeneration, external ophthalmoplegia and abnormal mitochondria.

A report is given of a black family with a dominantly inherited, neuro-retinal degeneration associated with abnormally large mitochondria, in which the cristae are disoriented. The disease is characterised by progressive external ophthalmoplegia, clear-cut macular degeneration, cerebellar dysarthria, spastic paraplegia and finally facial and bulbar weakness. A similar illness has been described in black families and individuals and we suggest that the disease may represent a specific syndrome, possibly confined to blacks, that lies within the spectrum of the so-called mitochondrionopathies.

Adolescent↗

Treatment assessment of learning disabled children: is there a role for frequently repeated neuropsychological testing?

Test/retest practice effects among learning disabled (LD) and non-learning disabled (NLD) children were examined using the Halstead Category Test. Two experimental paradigms were performed. The first compared subjects on successive trials. The second paradigm used a control group to compare second trial performance of the experimental group with first trial performance of the controls. Both paradigms provide evidence of the relative inability of LD children to profit from practice. It is suggested that neuropsychological data can be used for short term test/retest as one indication of the efficacy of treatment intervention for learning disabled children without the practice effect being a significantly confounding variable.

Journal Article↗

HLA-A,B and DR matching in corneal transplantation.

One hundred eighty-five consecutive corneal transplants were performed in recipients selected on the basis of the best available HLA-A,B and DR match. Endothelial rejection-free transplant survival in this group was compared to a retrospective historical control group of 199 consecutive transplants performed in recipients selected on the basis of age and longest wait criteria. The two groups were comparable with regards to primary diagnosis, preoperative corneal vascularization, donor and recipient age, and operative techniques. Thirty-eight transplants in the study group and 28 transplants in the control group were at high risk for endothelial transplant rejection. At 12 months, the estimated rejection-free survival (Kaplan-Meier method) of the high-risk study group transplants was 87% compared to 74% for the high-risk historical control group and transplants. This difference did not reach the significant level of 0.05 with the log-rank test. The 12-month estimated rejection-free survival of low-risk study group and historical control group transplants were similar. In the study group, the 12-month estimated rejection-free survival of well-matched transplants was 95% compared to 83% for poorly matched transplants (log rank, P less than 0.02). These findings suggest that a relationship exists between HLA-A,B and DR compatibility of donor and recipient and the corneal rejection-free transplant survival.

Corneal Transplantation↗

Corneal ulcers associated with contact lens wear.

We reviewed the experience with ulcerative keratitis associated with contact lens wear at Wills Eye Hospital, Philadelphia, from Jan 1, 1978 through July 1, 1983. Of the 322 cases of ulcerative keratitis, 56 cases (17%) were associated with the use of contact lenses. Twenty-nine (52%) of the 56 cases of contact lens-associated ulcers were culture positive. Pseudomonas was the most common isolate, occurring in 13 (23%) of the 56 cases. Staphylococcus species were the second most common, occurring in 11 (20%) of the 56 cases. In this series, contact lens-associated ulcers were seen frequently in those wearing soft lenses (48/56 cases or 86%) and in those wearing aphakic lenses (32/56 cases or 57%). Contact lens use is an increasingly important risk factor for the development of corneal ulcers. Prompt, appropriate, and intensive treatment is necessary to prevent visual loss.

Adolescent↗

Treatment of herpes simplex keratitis: comparison of acyclovir and vidarabine.

At three university centres 66 patients presenting with herpetic dendritic or geographic ulcers participated in a double-blind comparative study of 3% acyclovir and 3% vidarabine ointment. There was healing in 31 (97%) of the 32 patients treated with acyclovir, in a mean time of 6.3 days, and in 30 (88%) of the 34 treated with vidarabine, in a mean time of 7.1 days. The two medications were statistically equally effective, no difference being demonstrated in the healing rate, in the frequency of punctate epithelial keratitis or stromal keratitis, or in the final visual acuity.

Acyclovir↗

A clinical comparison of tobramycin and gentamicin sulfate in the treatment of ocular infections.

We evaluated the safety and efficacy of tobramycin and gentamicin sulfate ophthalmic solutions in the treatment of patients with bacterial infections of the conjunctivas. In this double-masked study involving 66 patients, the two aminoglycosides were found to be equally safe and effective, although the in vitro data suggested that tobramycin may be more efficacious against Pseudomonas infections. Staphylococcus aureus and S. epidermidis were the most frequent isolates from the infected eyes (59.8% and 20.6%, respectively).

Adult↗

[Diplopia in monocular aphakia].

In monocular aphakia, diplopia results from disparities between the two retinal images in form, size, outline, luminous intensity and colour. If one wishes to give the best binocular vision possible to a monocular aphake, it is important to recognize the different factors which may give rise to diplopia.

Aniseikonia↗