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At least 253 records · Page 14Linked to original sources

[AIDS and non Hodgkin's malignant lymphoma disclosed by massive hematemesis].

A 40-year-old man was admitted for a major haemorrhage from the upper gastro-intestinal tract. An emergency gastrectomy was performed to control the bleeding. The histopathological study revealed a non-Hodgkinian lymphoma associated with an AIDS, which had remained unknown. The postoperative period was complicated by several infections. The patient died 2 1/2 months after the hematemesis. Such major haemorrhage from the upper gastro-intestinal tract as the presenting symptom of AIDS is very rare, although this has been described during the course of the disease. This case illustrates the importance in reminding operating theater staff (anaesthetists, surgeons, nurses) of the risk of viral contamination when treating a young patient with hematemesis and the necessity of wearing gloves, face masks and glasses.

Acquired Immunodeficiency Syndrome↗

Correlation between ultraviolet radiation level and the incidence of late-onset corneal haze after photorefractive keratectomy.

PURPOSE: To investigate the correlation between environmental changes in ultraviolet (UV) radiation levels and the incidence of late-onset cornea haze (LOCH) after photorefractive keratectomy (PRK). SETTING: SynsLaser Clinic, Tromsø, Norway. METHODS: The study comprised 404 eyes that had myopic PRK and photoastigmatic refractive keratectomy from February 1996 through July 1998. The high latitude (70 degrees N) of the observation site provided "natural laboratory" conditions to look at the occurrence of LOCH with high and low UV-radiation levels, which occurred during summers and winters, respectively. The diagnostic criterion for LOCH was acute haze of grade > or =2 occurring between 4 and 12 months postoperatively. RESULTS: The follow-up ranged from 12 to 41 months. Of the 314 eyes that met the inclusion criteria, 11 developed LOCH when the environmental UV-radiation level was high. No eye developed LOCH when the level was low. The correlation between a high level of environmental UV radiation and the occurrence of LOCH was statistically significant (P =.001). CONCLUSION: Environments with high UV-radiation levels may increase the risk of LOCH after PRK in eyes with moderate to high myopia. Use of UV-protective eyewear should be encouraged during the first year after PRK.

Adult↗

Fox shield treatment of the UGH syndrome.

The uveitis-glaucoma-hyphema (UGH) syndrome has been described with all types of intraocular lenses. The usual forms of therapy include miotics, mydriatics, steroids, antiglaucomatous medications, laser therapy, and surgical explanation. I describe five patients in whom the UGH syndrome resolved after long-term Fox shield treatment to prevent nocturnal hand-eye trauma.

Aged↗

Compliance with infection-control procedures among Illinois orthodontists.

The authors of previous studies have reported an increasing percentage of orthodontists complying with infection-control procedures in their offices, yet compliance was found to be less than ideal. In this study we surveyed Illinois orthodontists to evaluate their compliance with the infection-control guidelines established by the American Dental Association and the Centers for Disease Control and Prevention. This study is an addition to a small number of studies in the field of orthodontics on infection-control procedures. The study population was taken from the World Directory of Orthodontists, which contains 374 listings for the state of Illinois. Responses were received from 140 orthodontists, for a response rate of 37%. Thirty-two percent of the responding orthodontists stated that they always wear masks; 13% said they never do. Almost 97% of the orthodontists said they always wear gloves, and no orthodontist reported never wearing gloves. Nearly 64% of the orthodontists reported always using eyewear, and 34% said they wear gowns, whereas only 5% do not wear eye protection and 35% never wear gowns. With regard to instruments and pliers, most of the orthodontists reported using dry-heat ovens (72% and 80%, respectively), whereas nearly 58% said they use chemical disinfection to some extent on instruments and 39% said they use chemical disinfection on pliers. Only 51% of the orthodontists surveyed in our study reported using a steam autoclave to sterilize handpieces, whereas 27% said they use dry-heat ovens, 11% reported using chemical vapor, and 37% said they use chemical disinfection. In conclusion, compliance with infection control procedures among orthodontists has improved from recent studies but is still less than full compliance.

Adolescent↗

Eye trauma in children: epidemiology, management, and prevention.

Eye injuries in children are frequently evaluated by nurse practitioners. The child with serious eye trauma is quickly assessed and referred to an ophthalmologist. However, many of the cases are managed in the ambulatory setting. Appropriate and swift management of eye trauma is essential to ensuring optimal outcome for the child. In addition, pediatric nurse practitioners play a critical role in educating children, families and the public about the prevention of eye trauma, particularly the use of protective eyewear. This article discusses the epidemiology, assessment, and prevention of eye trauma in children.

Adolescent↗

A simple eye-lens shielding technique compatible with independent jaws of a linear accelerator.

A technique, compatible with accelerators having independent collimators, is presented, which greatly simplifies alignment of pencil eye-lens shields. The patient is placed so that the eye to be shielded is on the central axis of the beam and the accelerator's collimators are adjusted independently to define the field. A divergent lead shield 14 cm long is suspended from a wire that hangs along the central axis from a blocking tray in its usual location. The suspension length is variable and adjusted on the first day so that the shield is about 1 cm above the patient's eye. On subsequent treatment days, the wire is simply put in place on the tray with no further adjustment required. This technique reduces setup time and makes the shield positioning highly reproducible.

Eye Protective Devices↗

Photoprotection of the eye - UV radiation and sunglasses.

Although most health scientists now agree that health risks to the skin (e.g., skin cancer) exist from exposure to the ultraviolet radiation in sunlight, a scientific consensus has not really been achieved vis-à-vis sunlight and ocular health. A growing number of scientists warn of hazards to the eye if ultraviolet radiation - and perhaps even shorter wavelength visible radiation also - is not filtered by lenses. Despite a substantial literature on the adverse effects of ultraviolet radiation (UVR) and intense light upon ocular structures, particularly upon the retina, controversy still surrounds the question of whether the levels of natural and man-made light sources are damaging when encountered under normal viewing conditions. Although scientific evidence accumulates to indicate that chronic exposure conditions may accelerate ageing processes in ocular tissues, the quantitative question of "How much is safe?" remains to be answered conclusively.

Environmental Exposure↗

Finding a nursing role in the prevention of eye injuries in the construction trades.

Construction workers have mostly preventable eye injuries. This pilot study investigated a convenience sample of 75 (72 men, 3 women) apprentice operating engineers. Most (52%) of the apprentices had been injured twice on the job. Injury was associated with age and longevity in the construction industry. There were no significant differences in health perceptions as measured by the Health Self-determinism Index when the safety glasses wearers were compared with non wearers of safety glasses (t[52] = -.94, P > .05) and the injured group was compared with the noninjured group (t[62] = -.38, P > .05). Literacy issues, recall, and underreporting of injuries may have affected the results. Nurses need to teach health promotion strategies to operating engineers.

Accidents, Occupational↗

Severe allergic contact eyelid dermatitis caused by swimming goggles.

BACKGROUND: Contact dermatitis of the eyelids is the most common cutaneous reaction that affects the eyelids. It is frequently caused by the cosmetics used on face, hair, and fingernails. Rarely, eyelid contact dermatitis can be caused by direct contact with either irritant or allergen. OBJECTIVE: To report a case of severe eyelid dermatitis caused by swimming goggles. METHODS: Patch skin tests were performed in duplicate using a small piece of black rubber foam padding from the swimming goggles. Allergy skin prick tests for inhalant aeroallergens were also performed. RESULTS: The results of the patch skin tests were strongly positive. The results of allergy skin prick tests for inhalant aeroallergens were positive for both seasonal and perennial aeroallergens. CONCLUSIONS: This case illustrates that sensitization to the black, foam rubber padding on swimming goggles can occur after long-term contact with the goggles and should be considered in the differential diagnosis of eyelid dermatitis in an appropriate setting.

Dermatitis, Allergic Contact↗

Impact resistance of common spectacle and safety lenses to airgun and rimfire projectiles.

PURPOSE: To evaluate the penetration resistance of common spectacle and safety lenses to high-velocity projectiles and to examine the current recommendations regarding the use of such lenses. METHODS: The penetration threshold of glass, high-index, and polycarbonate spectacle and safety lenses was determined by firing BBs, pellets, and 0.22-caliber projectiles. The mass, diameter, velocity, and energy of each projectile were measured, and the center thickness, mass, and refractive power of each lens were recorded. The penetration threshold for each lens type was calculated, and a comparison of impact resistance was made. RESULTS: The maximum velocity of the BB was measured at 221 m/s; pellets at 210 m/s; CB.22 rimfire projectiles at 204 m/s; and 0.22 rimfire projectiles at 290 m/s. The BB penetration thresholds were as follows: glass lenses = 84.0 m/s (2.4 J) and high-index lenses = 107.7 m/s (4.09 J). Polycarbonate spectacle and safety lenses were not penetrated by BBs regardless of their velocity; however, these lenses were penetrated by CB.22 rimfire projectiles (89.2 J). Review of the penetrated lenses showed that center thickness and refractive power was comparable between the various groups of projectiles. CONCLUSIONS: Polycarbonate offers a vastly superior degree of penetration resistance compared with other commonly used lens materials. The current recommendations regarding the use of polycarbonate in prescription and protective lenses, as endorsed by the American Academy of Ophthalmology and the American Academy of Pediatrics, must be reevaluated.

Equipment Safety↗

Unprotected eyes in squash: not seeing the risk of injury.

The use of appropriate eyewear in squash can protect the eyes against injury. However, few adult squash players adequately protect their eyes against potential severe injuries. We describe the characteristics of non-users of protective eyewear and examine predictors of appropriate eyewear use. Self-report surveys of adult players were conducted in metropolitan Melbourne, Australia. Information on players' knowledge, behaviours and attitudes associated with protective eyewear use was collected, in addition to player demographic data. Appropriate eyewear was defined as Standards-approved polycarbonate lens eyewear. The majority 92.2% of players did not adequately protect their eyes while playing squash. Significant predictors of reported eyewear use were: previous eye injury: playing squash on average more than 2 hr per wk: having played for more than 20 y; and having more favourable attitudes towards eye safety in squash. The significant predictors of appropriate eyewear use were: being female; previous eye injury; playing squash on average more than 2 hr per week; and having more favourable attitudes towards eye safety in squash. Understanding the characteristics of both users and non-users of appropriate eye protection in squash is essential for informing future prevention strategies.

Adolescent↗

Do squash players accurately report use of appropriate protective eyewear?

Self-report surveys are a common method of collecting data on protective equipment use in sport. The aim of this study was to assess the validity of self-reported use of appropriate protective eyewear by squash players. Surveys of squash players' appropriate protective eyewear behaviours were conducted over two consecutive years (2002 and 2003) at randomly-selected squash venues in Melbourne, Australia. Over the two years, 1219 adult players were surveyed (response rate of 92%). Trained observers also recorded the actual on-court appropriate protective eyewear behaviours of all players during the survey sessions. Eyewear use rates calculated from both data sources were compared. The self-reported appropriate protective eyewear use rate (9.4%; 95% CI 7.8, 11.0) was significantly higher (1.6 times more) than the observed rate (5.9%; 95%CI 4.6, 7.2). This suggests that players may over-report their use of appropriate protective equipment, though some may have incorrectly classified their eyewear as being appropriate or suitably protective. Studies that rely only on self-report data on protective equipment use need to take into account that this could lead to biased estimates.

Adult↗

An avoidable occupational hazard during mastoid surgery.

Conjunctival innoculation is a previously unrecognized hazard for the otologist during mastoid surgery. This experiment assess the spread of droplet contamination during temporal bone dissection. The results suggest that otologists and assistants should wear eye protection during exposure of the mastoid antrum by drilling.

Acquired Immunodeficiency Syndrome↗

Eye protection in ear, nose and throat surgery.

The aim of this study was to quantify the risk of blood splashes to the conjunctiva during ear, nose and throat surgery. Two hundred and sixty consecutive operations by three surgeons were assessed for contamination of safety glasses and other factors. We found that 15 per cent of operations resulted in blood droplet contamination of safety glasses. In 92 per cent of these, contaminations were on the exterior of the glasses and eight per cent were on both sides. We concluded that about one and a half per cent of operations would result in droplet contamination of the conjunctiva and that safety spectacles reduced the risk by a factor of about 10. This study generally concurs with that of previous research in the areas of general and orthopaedic surgery and necropsies. We substantiate the need for eye protection for all ear, nose and throat procedures. Spectacles do provide a reasonable degree of protection but where absolute protection is needed i.e. in high risk groups, goggles should be used in preference to safety spectacles.

Blood-Borne Pathogens↗

Eye protection during mastoid surgery.

A questionnaire was sent to all Full Members of the British Association of Otolaryngologists to ascertain whether and what type of eye protection surgeons and theatre nurses wear during mastoid surgery. Despite Department of Health recommendations only 58 per cent of surgeons and 19 per cent of theatre nurses routinely wear any form of eye protection.

Eye Protective Devices↗