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Biomedical subjects

R Watkins

Publications and source records attributed to R Watkins.

At least 73 records · Page 4Linked to original sources
PubMed1980

A long term study of low concentration guanethidine and adrenaline therapy in glaucoma.

A long term study was undertaken to evaluate the efficacy of combined guanethidine (1%) and adrenaline (0.05-0.5%) therapy in controlling intra-ocular pressure in 89 patients with chronic open angle glaucoma, in whom ocular tensions proved difficult to control on miotics and/or carbonic anhydrase inhibitors. Visual acuity, fields of vision, applanation tension, size of the pupil, anterior chamber depth and gonioscopic examination of the angle were recorded before and during treatment. The follow-up extended over a period of 12 to 42 months, the mean being 28 months. The combined therapy was found to lower the intra-ocular pressure significantly in a large number of patients and the most potent combination was guanethidine 1% and adrenaline 1/4% and the average fall of intraocular pressure with the combined therapy was around 8 mm Hg. Intolerance to the combined preparation was noticed in three patients during a period of 12-18 months with the symptoms of sore eyes, conjunctival hyperaemia and lid irritation of such severity that the treatment had to be withdrawn. Resistant to treatment developed in four patients during a period of 12-36 months and treatment had to be changed. Addition to guanethidine (1%) and adrenaline up to 1/4% to pilocarpine therapy (2-4%) in eyes with narrow angles did not result in any appreciable change of the width of the angle, the size of the pupil and the depth of the anterior chamber.

Adult↗
PubMed1980

Addition of timolol maleate to routine medical therapy: a clinical trial.

A double-blind cross-over trial of timolol maleate (Timoptol) while routine medical therapy was continued gave the result that pressure was reduced by 3.22 mmHg is compared to placebo and 5.01 compared to pre-timolol levels in 24 patients. There was also a small (1.858 mmHg) drop in pressure in placebo treated eyes, a small and statistically significant drop in resting pulse rate, 76.67 to 71.39/min, and a small but not statistically significant drop in diastolic blood pressure.

Adult↗
PubMed1980

The cost of medical student instruction in the practice setting.

Using an incremental cost approach, the cost of instruction for medical students participating in a variety of ambulatory-care, chiefly family-practice, experiences in several clinical practice sites was examined. The costs ranged from $5 per student per day for a first-year observational experience to $112 per student per day for a second-year preceptorship with direct patient care involvement by the students. Factors such as the previous experience of the student, the baseline productivity of the site, the number of examining rooms, the income source of the preceptor (salary vs fee-for-service), and the clarity of preceptor role definition are discussed in relation to cost. The lack of defined, stable income to offset costs is noted. In view of the substantial costs of instruction in ambulatory family practice clerkships, clearly defined ongoing sources of income must be provided to ensure the continuation or expansion of these vital experiences.

Ambulatory Care↗
PubMed1979

The costs of a family practice residency ambulatory care program.

The cost of patient care service and education occurring in a family practice residency unit of a community based prepaid health program was determined from accounting records. The cost of producing the same number of patient visits in comparable family practice units which did not have residents on-site was determined in a similar manner. The cost per visit in the residency unit was $15.53 while that in the nonresidency unit was $13.92. There was an excess cost of $1.61 per visit in the residency, or, based on the number of residents present, a net cost of $7 per resident per day. None of the costs of central residency program administration or of ambulatory based subspecialty rotations were included. While a small increase (ten percent) in productivity or efficiency would result in the residency patient care unit itself being self-sustaining, this study casts considerable doubt on the ability of the model family practice residency unit to offset the full costs of the ambulatory care portion of family practice residency training.

Ambulatory Care↗
PubMed1975

Pilocarpine dispensation for the soft hydrophilic contact lens.

The use of hydrophilic soft contact lenses for dispensation of pilocarpine is described. The release rate of pilocarpine from three materials of different water content was estimated and from this the surface concentrations were calculated. It is estimated that PolyHEMA can after 15 hours provide a 1 per cent surface concentration of pilocarpine, whereas higher water content materials (70 and 85 per cent) halve this, although they provide a much higher concentration in the first few hours of use. These results are based upon pre-soaking in 4 per cent pilocarpine solution. Because contact lenses present a management problem, this method of dispensation will be used only for selected cases. Some clinical examples treated successfully over a 20 month period are discussed.

Contact Lenses, Hydrophilic↗