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Biomedical subjects

S Dyke

Publications and source records attributed to S Dyke.

4 recordsLinked to original sources
PubMed1998

Evaluation of an extended period of use for preserved eye drops in hospital practice.

AIM: To evaluate and compare the microbial contamination arising from 1 and 2 weeks' use of eye drops by hospital inpatients and hence determine the validity of apportioning a 2 week in use expiry date for these preparations. METHODS: Eye drop residues were collected from inpatients of Worthing, Southlands, and Brighton General hospitals after 7 days' use (341 samples) and also after 14 days' use (295 samples). The contents of the containers were examined for the presence of contaminating bacteria and fungi. RESULTS: The incidence of microbial contamination was shown to be not significantly different (p > 0.1 chi 2 test) between the 7 and 14 day samples. In addition, the contaminating micro-organisms were of a broadly similar pattern between the two sample groups and were mostly those normally associated with the skin. Less frequent contaminants were organisms of environmental origin. None of the micro-organisms isolated were considered to be of clinical significance and the mean number of cells found per sample was very low. CONCLUSIONS: The evidence therefore suggests that increasing the period of use for eye drops in hospitals from 7 to 14 days would not present a clinically significant threat to patients' health and yet may lead to annual savings to the NHS of Pounds 0.5 million.

Bacteria↗
PubMed1996

Hemoptysis and hematemesis due to a broncholith: granulomatous mediastinitis.

A 40-year-old man had new onset of hemoptysis and hematemesis. Bronchoscopy revealed red, inflamed mucosa with apparent rich blood supply in the left primary bronchus. Computed tomography revealed calcified subcarinal lymph nodes with a small extension into the left primary bronchus. Shortly after admission, the patient had an episode of gastrointestinal bleeding. Esophagogastroduodenoscopy showed a lesion in the posterior wall of the esophagus, 12 cm from the upper incisors. During exploratory thoracotomy, a single piece of irregular-shaped tan tissue measuring 3.5 x 2.5 x 2.0 cm and engulfing the esophagus, carina, and left primary bronchus was dissected. A single stonelike mass, or broncholith, was found to involve both the trachea and the esophagus. Microscopic examination showed multiple caseating granulomas with surrounding lymphoid tissue and germinal centers. During 12 months of follow-up, the patient has remained asymptomatic. The chronic inflammation in this case suggested granulomatous mediastinitis, a rare disease whose mass-like effects may contribute to structural compression. The trachea and esophagus are rarely involved. Tuberculosis and histoplasmosis are thought to be the two most common causes of granulomatous mediastinitis. Chronic inflammation leading to calcification and broncholith may invade bronchial lumen or esophageal wall, causing life-threatening hemorrhage and necessitating prompt surgical intervention.

Adult↗
PubMedDate not supplied

The efficacy and safety of valsartan compared with placebo in the treatment of patients with essential hypertension.

A multicenter, randomized, placebo-controlled, double-masked, parallel-group study was performed to compare the efficacy and safety of valsartan 20, 80, 160, and 320 mg with placebo in the treatment of patients with essential hypertension. A total of 736 adults with uncomplicated essential hypertension stages 1 to 3 were randomized to receive placebo or valsartan 20, 80, 160, or 320 mg daily for 8 weeks. Assessments were made at baseline, after 4 and 8 weeks of treatment, and 2 to 3 days after stopping treatment. The primary efficacy variable was change from baseline in mean sitting diastolic blood pressure (MSDBP). Other variables included change from baseline in mean sitting systolic blood pressure (MSSBP) and responder rates (ie, MSDBP < 90 mm Hg or decrease of > or = 10 mm Hg from baseline). All doses of valsartan produced statistically significant reductions in both MSDBP and MSSBP at end point compared with placebo. A dose-response effect was seen, although the incremental reduction in blood pressure with doses of valsartan > 80 mg was relatively small. Statistically significant differences in responder rates at end point were seen for doses of valsartan of 80 mg and above compared with placebo, whereas the responder rates for valsartan 20 mg was not significantly different from that for placebo. Safety and tolerability variables included data on adverse experiences, rebound hypertension, and clinical laboratory evaluations. Tolerability was good, with headache being the most common complaint and occurring most frequently in placebo patients. The incidence of dizziness was similar among the placebo (5.4%) and valsartan 20-mg to 160-mg groups (2.1% to 3.4%); there was an increase in the incidence of dizziness in the 320-mg group (9.3%). No cases of symptomatic orthostatic hypotension occurred. Analysis of rebound showed that 11.6% of patients receiving placebo and 16.6% receiving valsartan had an increase in MSDBP to baseline levels or above 2 to 3 days after stopping treatment. No clinically significant adverse experiences were noted after stopping treatment. There were no clinically or statistically significant changes in laboratory values during treatment. Thus valsartan proved to be both effective and safe in reducing blood pressure in adults with essential hypertension. The optimal dose range is 80 to 160 mg, given once daily.

Adult↗