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Biomedical subjects

John R Hayes

Publications and source records attributed to John R Hayes.

23 records · Page 2Linked to original sources
PubMed2004

Frequency and preventability of adverse drug reactions in paediatric patients.

PURPOSE: To evaluate the frequency, severity and preventability of adverse drug reactions (ADRs) in paediatric patients during the 6-year period from 1 January 1994 to 31 December 1999. METHODS: Data on patient demographics, documented allergies, suspected drug, American Hospital Formulary Service drug classification and dosage regimen were collected retrospectively from ADRs reported to a hospital surveillance programme. ADRs were categorised by severity, preventability and causality. Analysis was conducted by Chi-square and Wilcoxon rank sum (Mann-Whitney) tests. RESULTS: During the 6-year period, 565 ADRs were reported at a rate of 0.85 ADRs per 100 admissions. The mean patient age was 9.6 years. No history of allergies was documented in 87.4% of the cases, although 2.8% of patients had a documented allergy to the suspected medication. Opioids (narcotics) [n = 65, 11.5%], anticonvulsants (n = 67, 11.9%) and antibiotics (n = 149, 26.4%) were the most frequently implicated drug classes. Over 50% of the reported ADRs resulted in treatment intervention and/or temporary patient harm and of these, 73% required drug therapy. Causality was classified as 'definite' (44.1%), 'probable' (49.9%) or 'possible' (6.0%). Of the reported ADRs, 20.7% were preventable. CONCLUSIONS: ADRs resulted in treatment intervention or temporary patient discomfort in >50% of patients. The incidence of preventable ADRs is similar to that found in adult literature. No single drug caused >5% of reported ADRs. Opioids, anticonvulsants and antibiotics were the most common drug classes associated with ADRs. Thus, strategies targeting these drug classes and interventions during the medication ordering and administration processes may reduce the number of ADRs and possibly the associated costs. Even though preventable ADRs may not be entirely eliminated, the goal should be to increase ADR awareness and encourage early detection and intervention to minimise patient discomfort.

Adolescent↗
PubMed2003

What are the visual benefits of eyelid squinting?

PURPOSE: We propose that eyelid squint can reduce the impact of several conditions known to cause eyestrain such as uncorrected refractive error, accommodative dysfunction, presbyopia, and glare. Clinicians commonly accept that squint improves visual acuity (VA) in the presence of refractive error, and even though the benefit of eyelid squint in bright light seems self-evident, data are not available to support either benefit. The purpose of this study was to measure the effect of eyelid squint on VA in the presence of refractive blur and on visual field sensitivity. METHODS: Nineteen subjects with optimal refractive correction were tested, with and without squinting, as follows: (1) distance VA with induced refractive errors of +0.50, +1.00, +2.00, +3.00, +1.00 -1.00 x 90, and +1.00 -1.00 x 180; (2) near VA with induced refractive errors of -1.00 x 90 and -1.00 x 180; and (3) central and peripheral threshold visual fields with a Humphrey Field Analyzer. Differences in visual acuity between squinting and nonsquinting were tested for significance with repeated-measures analysis of variance, and differences in visual fields were tested using mixed model analysis of variance with repeated measures. RESULTS: Eyelid squint significantly improved (p < 00.016) distance VA measurements for 1.00 to 3.00 D of induced myopia. The squint-induced VA improvement increased from 0.06 logarithm of the minimum angle of resolution for 1.00 D to 0.24 logarithm of the minimum angle of resolution for 3.00 D of myopia. Eyelid squint also significantly reduced visual field sensitivity below the horizontal meridian by an average of 1.4 dB, by 1.6 dB on the horizontal meridian, and with increasing reductions in the vertical field up to 11.6 dB for measurements 40 degrees above fixation. This pattern of decreased superior field sensitivity would decrease visual discomfort from overhead glare. CONCLUSIONS: The results provide empirical support that eyelid squint improves visual acuity for subjects with refractive error and reduces glare in the superior visual field.

Adult↗
PubMed2002

Duloxetine, 60 mg once daily, for major depressive disorder: a randomized double-blind placebo-controlled trial.

BACKGROUND: Despite treatment advances, major depressive disorder (MDD) is still a significant cause of morbidity and mortality. Current therapies frequently fall short of providing full remission. In addition, physical symptoms are commonly seen in MDD patients, increasing overall morbidity and health care utilization. Duloxetine hydrochloride, a dual reuptake inhibitor of serotonin and norepinephrine, was evaluated for efficacy and tolerability/safety in the treatment of MDD and associated physical symptoms. METHOD: In this multicenter, double-blind, parallel-group study, adult patients with DSM-IV MDD were randomly assigned to receive placebo (N = 122) or duloxetine (60 mg/day, N = 123) for 9 weeks. The primary efficacy measure was the 17-item Hamilton Rating Scale for Depression (HAM-D-17) total score. Painful physical symptoms were assessed using visual analog scales, and global illness and quality of life were evaluated using the Clinical Global Impressions-Severity scale, the Patient Global Impressions-Improvement scale, and the Quality of Life in Depression Scale. Safety and tolerability were determined by monitoring discontinuation rates, adverse events, vital signs, and laboratory results. RESULTS: Duloxetine was significantly superior to placebo (p < .001) in reducing HAM-D-17 total scores, starting at week 2. The estimated probability of remission for duloxetine-treated patients (44%) was almost 3 times that of placebo patients (16%). Duloxetine significantly reduced painful physical symptoms in comparison with placebo. Discontinuation due to adverse events for duloxetine-treated patients (13.8%) compared favorably with the rates reported for SSRIs in other studies. Nausea, dry mouth, and somnolence were the most common adverse events; no significant incidence of hypertension was seen. CONCLUSION: Duloxetine, 60 mg/day, is a well-tolerated and effective treatment for MDD that reduces painful physical symptoms. These findings suggest that duloxetine may be a first-line treatment for patients with MDD and associated painful physical symptoms.

Adult↗
PubMedDate not supplied

Relationship between sports drinks and dental erosion in 304 university athletes in Columbus, Ohio, USA.

Acidic soft drinks, including sports drinks, have been implicated in dental erosion with limited supporting data in scarce erosion studies worldwide. The purpose of this study was to determine the prevalence of dental erosion in a sample of athletes at a large Midwestern state university in the USA, and to evaluate whether regular consumption of sports drinks was associated with dental erosion. A cross-sectional, observational study was done using a convenience sample of 304 athletes, selected irrespective of sports drinks usage. The Lussi Index was used in a blinded clinical examination to grade the frequency and severity of erosion of all tooth surfaces excluding third molars and incisal surfaces of anterior teeth. A self-administered questionnaire was used to gather details on sports drink usage, lifestyle, health problems, dietary and oral health habits. Intraoral color slides were taken of all teeth with erosion. Sports drinks usage was found in 91.8% athletes and the total prevalence of erosion was 36.5%. Nonparametric tests and stepwise regression analysis using history variables showed no association between dental erosion and the use of sports drinks, quantity and frequency of consumption, years of usage and nonsport usage of sports drinks. The most significant predictor of erosion was found to be not belonging to the African race (p < 0.0001). The results of this study reveal no relationship between consumption of sports drinks and dental erosion.

Adolescent↗