Upsala journal of medical sciences
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Of all patients attended to in a clinic during 1986, 441 had open angle glaucoma diagnosed during 1974-1986 on the basis of either a verified visual field defect, a glaucomatous disc, or a repeated intraocular pressure value of at least 35 mm Hg. At first presentation of recent cases 1984-1986 (N = 128) 65 per cent were more than 70 years old. Capsular glaucomas were twice as common as simple glaucomas (low tension cases included). 62 per cent of capsular but only 26 per cent of simple glaucomas had an initial pressure of 35 mm Hg or more (p < 0.001). ⋯ Almost half remained unilateral cases, and the rate of severely impaired visual function in the better eye did not exceed 15 per cent. While generally 30-50 per cent of glaucomatous field defects had progressed in five years, the progression in early detected cases was only three per cent (p < 0.05). Visual field defects with breakthrough to the periphery already at first presentation progressed more often than circumscribed scotomas (p < 0.02).
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Randomized Controlled Trial Clinical Trial
EMLA for pain relief during arterial cannulation. A double-blind, placebo-controlled study of a lidocaine-prilocaine cream.
The aim of the study was to evaluate the effect of a lidocaine-prilocaine cream (EMLA cream, Astra) in relieving pain during arterial cannulation. The study had a random, double-blind, placebo-controlled design and included altogether 90 patients. All the patients were premedicated with an opioid before cannulation. ⋯ Between these groups pain experience measured by VAS did not show any significant difference although the mean value was lower in the EMLA group. Observer ratings showed a significant (p less than 0.01) difference in distribution towards lower ratings in the EMLA group. In conclusion EMLA was found to have a weak, but measurable effect when the application time exceeded 90 minutes but not after 60 minutes.
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In early ARDS (Adult Respiratory Distress Syndrome) and other inflammatory pulmonary disorders the lung might benefit from a high local deposition of an active drug, in order to optimize the local concentration without systemic side effects. In this methodological study we used pigs under controlled ventilation. The study was carried out in two steps. ⋯ This study shows that it is possible, under reproducible conditions, to administer aerosolized Evans blue dye and liposomes and to achieve a deposition in the terminal airways and/or alveolar spaces. The broncho-alveolar lavage demonstrated an interaction of liposomes with alveolar macrophages. The results imply that liposomes carrying active drugs and administered by inhalation may be used for local pulmonary treatment in early ARDS and other related inflammatory pulmonary diseases.
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Comparative Study
Implantable drug delivery systems in computed tomography and magnetic resonance imaging--a comparison between titanium and stainless steel.
The effect of implantable drug delivery systems on computed tomography (CT) and magnetic resonance imaging (MRI) was investigated in a phantom and in two patients. The implantable systems of identical construction consisted either of medical grade titanium alloy or stainless steel. ⋯ These artefacts were substantially reduced in images of the titanium port. Similar results were found in situ in two patients.
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The accuracy of transcutaneous CO2 monitoring (PtcCO2) was studied in 22 subjects suspected of having sleep-related breathing disorders, by comparison with arterial CO2 measurements (PaCO2). At rest 40 simultaneous sets of PaCO2 and PtcCO2 were obtained. The mean PaCO2 (+/-SD) was 5.3 +/- 0.9 kPa and PtcCO2 was 5.7 +/- 1.0 kPa (r = 0.79). ⋯ During sleep there was an increase in PtcCO2 (by 0.1-0.3 kPa) with each apneic event, the magnitude of the increase depending on the length and distribution of these events. With repeated long apneas there was a cumulative increase in PtcCO2, especially during REM sleep. Continuous PtcCO2 monitoring proved useful in monitoring and diagnosing sleep-related breathing disorders.