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Biomedical subjects

R H Stewart

Publications and source records attributed to R H Stewart.

At least 37 records · Page 2Linked to original sources
PubMed1988

Suprofen treatment of contact lens-associated giant papillary conjunctivitis.

This multicenter study of patients with contact lens-associated giant papillary conjunctivitis (GPC) was a randomized, double-masked comparison of a 1.0% suprofen solution versus the suprofen vehicle solution (placebo). Patients were given two drops of medication four times daily for up to 28 days and were clinically examined on days 0, 2, 7, 14, 21, and 28. The physicians' clinical judgments of the patients' responses to therapy significantly favored suprofen over placebo at day 21 (P = 0.02), while strongly favoring suprofen at day 14 (P = 0.057) and at day 28 (P = 0.067). The patients' opinions of their response to therapy significantly favored suprofen on day 14 (P = 0.03); a trend for suprofen was evident on day 28 (P = 0.1). Treatment with suprofen led to a greater overall reduction in ocular signs and symptoms than with placebo. Strong trends approaching statistically significant levels were found for reductions in the principal ocular sign, papillae, at day 28 (P = 0.068) and in mucus strands at days 14 and 28 (P = 0.09), which also favored suprofen.

Adult↗
PubMed1988

ALO 2145 reduces the intraocular pressure elevation after anterior segment laser surgery.

The effect of an alpha adrenergic agonist, ALO 2145 (para-amino-clonidine [PAC]), was examined in a double-masked, multicenter study on the postoperative intraocular pressure (IOP) elevation after laser surgery in 165 patients (83 trabeculoplasty, 36 iridotomy, and 46 capsulotomy). One drop of 1.0% ALO 2145 or vehicle was instilled 1 hour before and immediately after laser surgery. The mean IOP increase in the ALO 2145-treated group was lower (P less than 0.05) than in the placebo group at each of the first three postoperative hours. Overall, 18% of placebo-treated eyes experienced IOP increases greater than or equal to 10 mmHg as compared with 4% of ALO 2145-treated eyes (P less than 0.003). Ocular and systemic side effects were minimal and did not differ between the treatment groups. ALO 2145 safely and effectively reduced the incidence and magnitude of potentially harmful IOP elevations after anterior segment laser surgery.

Aged↗
PubMed1988

Effectiveness of apraclonidine in preventing the rise in intraocular pressure after neodymium:YAG posterior capsulotomy.

Apraclonidine (para-aminoclonidine) is an alpha agonist that was studied for its effect on the IOP rise following YPC. In a prospective multicentered double-masked study 63 eyes were pretreated with one drop of either 1% apraclonidine or placebo 1 hour prior to performing YAG and again after the laser treatment. The greatest IOP rise in the placebo-treated eyes occurred in the third hour after YPC when the mean IOP rose from a baseline pressure of 16.4 +/- 3.7 mm Hg to 20.8 +/- 6.8 mm Hg (P less than .01). In apraclonidine-treated eyes the IOP fell from a mean of 15.6 +/- 3.8 mm Hg to 12.8 +/- 6.0 mm Hg 3 hours postoperatively (P less than .001). There were five times as many eyes that had a pressure rise greater than 10 mm Hg in the placebo-treated group compared to those treated with apraclonidine. Apraclonidine proved to be highly effective in preventing the rise in IOP following YPC.

Administration, Topical↗
PubMed1988

Lidocaine: an anti-tussive for ophthalmic surgery.

Intravenous lidocaine suppresses the cough reflex in patients undergoing local operative procedures. Many anti-tussive agents suppress the cough reflex by suppressing the respiratory center. Intravenous lidocaine produces no respiratory depression in doses that suppress the cough reflex. Intravenous lidocaine should be available during all intraocular surgical procedures so it can be used when indicated.

Antitussive Agents↗
PubMed1987

Central nervous system trauma.

Traumatic injury to the central nervous system causes immediate damage and sets in motion a complex series of pathophysiologic events that result in further neuronal injury. This secondary damage seems to be related to changes in blood flow and pressure on a systemic, regional, and microvascular level. Currently, there is evidence that these changes are, in part, mediated by endogenous opioids and arachidonic acid metabolites, namely thromboxane A2. Medical management is generally designed to intervene at one or more stages in this secondary cascade of events. Further research should lead us to better understanding of the mechanisms involved in trauma to the central nervous system and, subsequently, more specific and effective treatments.

Animals↗
PubMed1987

Medical management of spinal cord disease.

In spinal cord disease of horses, a complete history, neurologic examination, and adjunctive diagnostic procedures are very helpful in establishing a tentative diagnosis; however, a definitive diagnosis may be difficult or impossible to establish antemortem. Medical management should be initiated with full consideration of possible etiologies and knowledge of the effects and consequences of medical therapies. This article discusses the drugs commonly used in the management of spinal cord disease and the rationale for their use.

Adrenal Cortex Hormones↗
PubMed1987

A modified Gills' block and its effectiveness for lid muscle akinesia.

We developed a prospective clinical study to determine the effectiveness of a new method of retrobulbar anesthesia and akinesia of the levator and orbicularis muscles. This study involved 50 patients who underwent extracapsular cataract extractions (ECCE) with intraocular lens implant (IOL). We found levator and orbicularis muscle akinesia was achieved in 49 of 50 eyes. One reblock was necessary. We also wish to point out the advantages of this technique as a means of reducing the rare but serious complications associated with retrobulbar anesthesia.

Adult↗
PubMed1986

Betaxolol vs timolol. A six-month double-blind comparison.

Betaxolol hydrochloride (0.5%) and timolol maleate (0.5%) were compared in a six-month randomized, double-blind study involving 29 patients with glaucoma. The two drugs were comparable with regard to efficacy in lowering intraocular pressure. Betaxolol effected an average reduction of 7.6 mm Hg (26%); timolol, 8.4 mm Hg (29%). No patient required adjunctive medications during this study. Ocular side effects were mild and similar for both treatments. Neither drug affected corneal sensitivity, visual acuity, basal tear production, or pupil size. Since betaxolol has been shown to have little effect on the cardiopulmonary system, it should be strongly considered for the treatment of glaucoma.

Adult↗
PubMed1986

Reduction of pupillary constriction during cataract surgery using suprofen.

The efficacy of a new nonsteroidal anti-inflammatory agent, suprofen, for reducing pupillary constriction during cataract surgery was ascertained in a double-masked, multicenter, clinical study. Prior to surgery 1.0% suprofen or a placebo was instilled; the surgeon's normal regimen of mydriatics and cycloplegics was used. Suprofen (209 patients) was far more effective than the placebo (203 patients) in maintaining a dilated pupil prior to intraocular lens (IOL) implantation (or instillation of a miotic). The mean pupillary area prior to IOL implantation was 6.3 sq mm larger (20% larger) in patients treated with suprofen than in patients receiving the placebo. The investigators' subjective evaluations of the adequacy of pupil size for IOL implantation and of the difficulty of IOL implantation favored patients treated with suprofen over those receiving the placebo.

Adult↗
PubMed1986

Trabeculectomy with implantation of the Mendez Glaucoma Seton: early results.

We present the early results in a small series of 12 eyes of 12 patients with uncontrolled glaucoma who underwent trabeculectomy with implantation of a Mendez Glaucoma Seton. All eyes, except one with neovascular glaucoma, had had multiple glaucoma surgery and all, without exception, were on maximal tolerated medical therapy prior to surgery. The follow-up period ranged from one and one fourth to three and three fourths months. The surgical technique was the same in all cases. Our success rate was 33.3% or 40%, if one eye with persistent hypotonia could be counted as a success. This result is inferior to those quoted in the literature with the use of other types of setons, and especially to the results of Dr. Antonio Mendez who used a similar implant.

Adult↗
PubMed1985

Pupillary block associated with posterior chamber lenses.

Two patients developed pupillary block glaucoma after extracapsular cataract extraction with implantation of a posterior chamber lens but without peripheral iridectomies. The intraocular pressure of each eye was successfully controlled with laser iridotomy. No long-term medication was necessary to control their intraocular pressures.

Adult↗
PubMed1984

Ocular pressure response to fluorometholone acetate and dexamethasone sodium phosphate.

The intraocular pressure elevating potentials of fluorometholone acetate ophthalmic suspension and dexamethasone sodium phosphate ophthalmic solution were compared in human subjects who were previously documented to respond to dexamethasone sodium phosphate. In this double-masked, crossover study of 17 subjects, the same eye of each subject was dosed with both steroids, instillation of the second steroid following a one-month washout period. The length of time necessary to respond with an increase of 10 mmHg was ascertained. The mean response time for fluorometholone acetate was four weeks and for dexamethasone sodium phosphate, three weeks. This difference, in favor of fluorometholone acetate, is statistically significant.

Adult↗
PubMed1983

Use of steroid/antibiotic prophylaxis in intraocular lens implantation: a double-masked study v placebo.

A prospective, randomized, double-masked study was conducted to compare the efficacy of steroid/antibiotic treatment to placebo in reducing postoperative ocular inflammation. Patients undergoing planned extracapsular cataract extraction with intraocular lens implantation were treated with either placebo or a combination product containing dexamethasone, neomycin, and polymyxin B for three days prior to surgery and three weeks following surgery. Five of thirteen (38%) patients treated with placebo developed significant iritis postoperatively, while none of ten (0%) patients treated with the combination product developed excessive inflammation (P = 0.027). Two patients treated with the steroid/antibiotic combination product experienced a broken suture postoperatively followed by iris prolapse, as compared to none in the placebo group (P greater than 0.10). More types and significant numbers of bacteria were isolated from the eyes of the placebo-treatment group after therapy than were found in the steroid/antibiotic-treatment group.

Bacterial Infections↗
PubMed1981

Norepinephrine dipivalylate dose-response in ocular hypertensive subjects.

Norepinephrine dipivalylate, a prodrug analog of the catecholamine mediator norepinephrine, was given to 12 ocular hypertensive patients. Single instillations of four concentrations, 0.05%, 0.1%, 0.25%, and 0.5%, were administered weekly to one eye only with the fellow eye receiving a placebo. Intraocular pressure, pupil size, ocular signs, subjective symptoms, heart rate, and blood pressure were monitored at 2, 4, 6, 8, and 12 hours following instillation. An intraocular pressure reduction dose response was seen. After a slow (four-hour) onset of activity, the 0.5% concentration produced clinically acceptable (less than 22 mm Hg) tensions at the 6-, 8-, and 12-hour observations which were significantly (p less than 0.05, paired t test) lower than placebo-control eyes. No clinically important side effects were seen.

Clinical Trials as Topic↗