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Biomedical subjects

A Wade

Publications and source records attributed to A Wade.

At least 91 records · Page 5Linked to original sources
PubMed1994

[Congenital glaucoma (apropos of 58 cases)].

In a retrospective study on 10 years, the authors analyse epidemiological clinical and therapeutic aspects of congenital glaucoma. From 1979 to 1989, 58 cases of congenital glaucoma were found in children between 0 and 12 years, of which 53 bilateral and 5 unilateral cases (111 eyes). The frequency of 0.10% is considered high. According to studies carried out by Europeans, it is estimated between 0.01 and 0.024%. The authors stressed the important rate of consanguinity (46.5%) and masculine prevalence (74.1%). Disappointing therapeutic results and bad prognostic depend on the advanced cases of clinical forms found during the first consultation. The authors advocate preventive measures by genetic counsel and an early surgical treatment for best functional results.

Child↗
PubMed1994

Pharmacokinetics and pharmacodynamics of trandolapril after repeated administration of 2 mg to young and elderly patients with mild-to-moderate hypertension.

The new angiotensin-converting enzyme (ACE) inhibitor trandolapril 2 mg was administered daily for 10 consecutive days to young (mean age +/- SEM 44.1 +/- 2.3 years; n = 10) and elderly (mean age +/- SEM 69.3 +/- 0.9 years; n = 14) patients with mild-to-moderate hypertension. All groups had similar baseline blood pressures: mean 164/100 mm Hg. Maximal plasma ACE inhibition on day 10 and residual inhibition 24 h after the last dose was the same, irrespective of age: young, 85.2 and 57.4%; elderly 89.1 and 59.8%, respectively. There was no difference between the results on day 1 for the young and elderly groups. The absorption of trandolapril was rapid (< 1 h in all groups). The peak plasma concentration (Cmax) and the area under the plasma concentration-time curve (AUC) were slightly higher in the older group, but the elimination half-life (t1/2) was the same, with no accumulation after repeat dosing. A steady-state plasma concentration of the active metabolite of trandolapril, trandolaprilat, was reached after 4 days in the two groups, with similar accumulation ratios (young, 1.48; elderly, 1.49). At steady state, the Cmax and AUC 0-24 h for trandolaprilat were similar in the two groups: young, 7.49 +/- 0.98 ng/ml and 82.27 +/- 6.95 ng/ml/h; elderly, 8.35 +/- 0.67 ng/ml/h and 96.75 +/- 5.67 ng/ml/h. Maximal reductions in systolic/diastolic blood pressures (at 6 h postdose) were -14.1%/-16.1% in young patients and -14.6%/-17.5% for the elderly. Significant blood pressure reduction persisted for 48 h after the last dose.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

[Ocular hypertension after intra-capsular cataract extraction].

During 20 months, 593 intracapsular cataract extractions have been studied, the authors founded 10 cases of ocular hypertension representing 1.68%. These eyes did not present any ocular pathology before and the intraocular pressure was normal before the operation. Among the 10 cases, 4 developed pupillary block. In 7 cases, the intraocular pressure was normalized within one month by local and general low pressure treatment, while 3 cases developed persistent ocular hypertension. The authors preconise to have a low pressure by premedication before surgery and to survey every day the intraocular pressure after intracapsular cataract extraction to prevent irreversible modifications of the optic nerve.

Aged↗
PubMed1994

[Pupillary blockage after intracapsular cataract extraction in the adult apropos of 4 cases].

Intra capsular extraction is the most employed surgical technics for the treatment of senile cataract in developing countries. Nevertheless complications are usual, among them the pupillary block. The authors notified in 365 intra capsular cataract extractions, executed during 8 months, 4 cases of pupillary block occurred after operation without incident. The 3 cases had favorable evolution after an average of 4 days with medical treatment. 1 case had unfavorable evolution to aphakic glaucoma in spite of medical and surgical treatment. They point out in the necessity of strict post operative supervision and early treatment.

Adult↗
PubMed1993

[Expulsive hemorrhage (report of 2 cases)].

Two cases of expulsive haemorrhage consecutive to an operation of intumescent cataract responsible of major ocular overpressure (60 and 70 mmHg) are reported by the authors. No other risk factor has been found in our patients, one of 45 years old and the other 72 years old. First nor the operative wound suture neither the posterior sclerotomy were stitched, because of the inability to discover the site of choroidal haematoma with quat amount of blood in the operative field. The second reason was the use of an inadequate material of suture (vicryl 9/0). Finally both cases presented were eyes without any light perception. The final phase results in phtysis phenomena.

Aged↗
PubMed1993

[Ocular manifestations of AIDS in Dakar].

In this prospective study undertaken between november 1989 and december 1991, the authors report their observations of ocular lesions seen in a cohort of 67 AIDS patients hospitalised in the Infectious Diseases department CHU Fann Dakar. Ocular lesions were discovered in 52.23%. These lesions were observed in both HIV-1 and HIV-2 positive patients, however they were much more common in the former group (77.14%). Rétinal pathology was by far the most frequently observed (63%) and yet classic retinis was not discovered in our series. We feel that the ophtalmologist should play a key role in the routine care of AIDS patients especially in surveillance of retinal changes.

Acquired Immunodeficiency Syndrome↗
PubMed1991

Community HIV/AIDS teams.

This paper describes a consecutive series of 103 patients with HIV and AIDS related illnesses who were referred to, and remained in, the care of two community teams. The characteristics of the patients are outlined and the early experiences of the teams are described. The findings of this study should assist doctors and nurses caring for patients with HIV and AIDS related illnesses in the community, and provide valuable data for service planners.

Acquired Immunodeficiency Syndrome↗
PubMed1991

[Tonometric results and complications of trabeculectomy in Black Africa. (Apropos of 170 cases of chronic open angle glaucoma operated on at the Ophthalmologic Clinic of CHU in Dakar)].

Intraocular pressure results and complications of trabeculectomy in Black African. The authors reported in 16 years 170 cases of trabeculectomy in Black African with open angle glaucoma. They observed excellent control of intraocular pressure (84% of normalisation at four years). This compared with others, shows that troubles are less important. All this advantages make that trabeculectomy is the best choice that authors advocate in surgical treatment of open angle glaucoma in our countries.

Chronic Disease↗
PubMed1991

[Congenital serous cyst of the orbit with anophthalmos].

The authors reported a case of orbital congenital serous cyst with anophtalmos. It was a third type of Duke Elder classification. Although it looked sporadic, this malformation is hereditary and due to a disharmony between optic cup growth and differenciation. Ultrasonography and scanner could confirm the diagnosis and helped to discard orbital and eyelid angioma and meningocele. After excision, a prosthesis must be adapted in the orbit.

Anophthalmos↗
PubMed1990

Palliative care: views of patients and their families.

OBJECTIVE: To investigate the current problems and needs of terminally ill cancer patients and their family members, and to discover their views of hospital, community, and support team services. DESIGN: Prospective study of patients and families by questionnaire interviews in the patients' homes. SETTING: Inner London and north Kent (London suburbs). SUBJECTS: 65 Patients, each with a member of their family or a career. MAIN OUTCOME MEASURES: Ratings of eight current problems and ratings and comments on three services-hospital doctors and nurses, general practitioners and district nurses, and the support team staff-obtained after a minimum of two weeks' care from palliative care support teams. RESULTS: Effect of anxiety on the patient's nearest career. and symptom control were rated as the most severe current problems by both patients and families; a few patients and families identified other severe problems. Families' ratings of pain control, symptom control, and effect of anxiety on the patient were significantly worse than the patients' ratings (p less than 0.05). Support teams received the most praise, being rated by 58 (89%) patients and 59 (91%) of family members as good as excellent. General practitioners and district nurses were rated good or excellent by 46 (71%) patients and 46 (71%) family members, but six (9%) in each group rated the service as poor or very bad, and ratings in the inner London district were significantly worse than those in the outer London district. Hospital doctors and nurses were rated good or excellent by 22 (34%) patients and 35 (54%) of family members, and 14 (22%) patients and 15 (23%) family members rated this service as poor or very bad. Negative comments referred to communication (especially at diagnosis), coordination of services, the attitude of the doctor, delays in diagnosis, and difficulties in getting doctors to visit at home. Family members were more satisfied with the services than were patients. CONCLUSIONS: Palliative care needs to include both the patient and family because the needs of the family may exceed those of the patient. Support teams and some hospital and community doctors and nurses met the perceived needs of dying patients and families, but better education and organisation of services are needed.

Adult↗
PubMed1990

Postoperative analgesia after paediatric orchidopexy: evaluation of a bupivacaine-morphine mixture.

The value of combining morphine with bupivacaine for caudal analgesia was investigated. Thirty children, undergoing orchidopexy, received a caudal block of 0.125% bupivacaine with or without morphine 0.05 mg kg-1. Analgesia, side-effects, ventilatory frequency and oxygen saturation (SaO2) were recorded after operation. None of the 15 patients receiving the bupivacaine-morphine mixture required post-operative opioids, whereas eight of 15 patients receiving bupivacaine alone needed additional opioid analgesia. The incidence of side effects after surgery was similar for the two groups and there was no detectable difference in ventilatory frequency or SaO2.

Analgesia, Epidural↗
PubMed1990

Multiple dose pharmacokinetics of cefpodoxime in young adult and elderly patients.

Multiple dose pharmacokinetics of a new third-generation cephalosporin, cefpodoxime, were evaluated in adults (15, 18-60 years) and elderly adults (10, greater than or equal to 70 years), all out-patients suffering from acute lower respiratory tract infection. A dose of 200 mg cefpodoxime proxetil (expressed in mg cefpodoxime) was administered 12-hourly for seven to ten days and timed blood samples were evaluated on days 0, 3, 5, 6/7 and on the last day of treatment. Results showed that the pharmacokinetics in adult and elderly patients were comparable with those of healthy volunteers and with each other, with the exception of one elderly patient with severe renal impairment. Dosage adjustment of cefpodoxime proxetil does not therefore appear to be necessary in the elderly unless there is evidence of severe renal insufficiency.

Adolescent↗
PubMed1990

[Pleuropneumopathies in children in an infectious pathology department in Dakar. Epidemiological, clinical and radiological features. Apropos of 150 cases].

The high rate of pleuropulmonary afflictions in children makes this pathology a daily concern for the practitioner in both industrialized and developing countries. This study concerns 150 patients aged between 0 and 15 years admitted to the Infectious Illnesses Unit at Dakar (Fann) U.H.C. between January 1st, 1985 and December 31st, 1987. The following observations are made: in this Unit, a morbidity of 1.7% has been recorded for pleuro-pneumopathies, which occur throughout the year with high points in January and during the rainy season; the 0-5 year age group is the most affected, with a sex ratio of 1/2 for males; hospitalization, which can be long, averages 8 days; a combination of measles and whooping cough, present in 36.6% of the cases, provides a prime breeding group for pleuro-pneumopathies; in 77% of the cases, recovery requires at least 20 days, partly because of delay in consultation. 10% require more than 30 days; the small proportion of patients vaccinated (14% completely treated) underlines the need for publicity and mass health education. Clinical polymorphism is normal; however, 80% of the children were found to be hyperthermic while (only) 6% show a productive cough. From a radiological point of view, suppurated afflictions are the most numerous, with a majority of alveolar or mixed attacks. Treatment produced generally satisfactory results in 83.7% of the cases.

Adolescent↗
PubMed1990

[Neuro-surgical exophthalmias (retrospective study of 27 cases at the C.H.U. of Dakar)].

The report covers 27 cases of neuro-surgical exophthalmia treated at Dakar U.H.C. between 1970 and 1987. Unilateral forms are the most common (25 cases), usually discovered at the bulging stage. Exploration was undertaken by the usual means of X-ray without contrast, echography, arteriography, and fractioned, gaseous encephalography employed together in varying degrees. The main etiologies are tumours (70%), largely benign, and specific and non-specific inflammation (18.5%). Surgery was prescribed in 18 cases, including 11 orbitotomies--8 frontal and 3 fronto-temporal. Malformation syndromes, and above all very advanced pathologies challenged surgical skill in 9 of the cases. Generally speaking, post operational results are favourable, but 3 deaths are reported and one relapse. Tomodensitometry, modern anaesthetic and revival techniques, and the important collaboration between the ophthalmologist and the neuro-surgeon are all factors in successfully mastering neuro-surgical protrusions.

Adolescent↗
PubMed1990

[Dermoid of the cornea. Report of 2 cases of Ida Mann's 2nd type].

At the opposite of epibulbar dermoids (which are isolated or combined), dermoids of IDA MANN's second type are uncommon. The two cases reported had a big size and covered almost the cornea, without damage on the descemet's membrane, the endothelium and the other eyeball structures. This lesion is classified by the W.H.O. among choristomas. It's made of skin recovering fat which includes in different figures, hair follicle, eccrine and sweat glands. Total excision is the best treatment, but couls become complicated by cornea perforation. It could be followed in some cases by keratoplasty. Amblyopia could go with this malformation.

Cornea↗