Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0086543 (cataract)
 29,165 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Hypnosis is able to induce a state of total psychological calm in very many subjects, including maintenance or even enhancement of their ability to cooperate. A smaller number of more receptive subjects may even achieve ocular anaesthesia, though this is not suitable for the performance of operations because the Dagnini-Aschner reflex persists and hypotonia is not attained. It is considered, therefore, that the association of hypnosis, retrobulbar pharmacological anaesthesia, and akinesia offers the best conditions for the performance of operations involving major opening of the eyeball, such as those associated with cataract, i.e. psychological tranquility with the ability to cooperate, anaesthesia with neurovegetative areflexia, hypotonia, and a postoperative course undisturbed by coughing and vomiting. The results of several years' experience have shown the complete suitability of the method and its wide possibilities of application.
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PMID:[Hypnosis in ophthalmology]. 118 37

Several studies comparing retrobulbar block (RB) and general anaesthesia (GA) for cataract surgery in the elderly have been published. Most of them were retrospective. Our prospective study was designed in order to determine the benefits or disadvantages using RB or GA. Arterial blood gases (ABG) and cardiovascular stability were explored in high-risk patients undergoing elective unilateral cataract extraction. METHODS. Forty patients over 65 years of age and with other co-existing diseases (ASA III-IV) were allocated randomly to receive either GA or RB. No premedication was given to either group of patients. On arrival in the anaesthetic room, a radial artery was cannulated for collection of blood samples and direct monitoring of the blood pressure. Pulse oximetry and ECG were continuously monitored in all patients, the end-expiratory CO2 (F(eexCO2)) only in the GA group. GA was induced with vecuronium 0.1 mg/kg and thiopentone 5 mg/kg; the lungs were ventilated with 100% oxygen. After intubation of the trachea controlled mechanical ventilation was continued with N2O/O2 (55:45) and enflurane 1%-2%. Only enflurane concentrations were varied to correct changes in mean arterial pressure (MAP) if these exceeded +/- 20%. Respiratory frequency and tidal volume were kept constant until completion of surgery. The patients were extubated when they were able to ventilate more than 5 1/min (pressure support 10 cmH2O; PEEP 5 cmH2O). After extubation no O2 was given. In the RB group neural block was undertaken with prilocaine 2% (3 ml) as a retrobulbar injection and prilocaine 1% (5 ml) to block the facial innervation of the orbicularis muscle (Van Lint, O'Brien). Oxygen 3 1/min was administered by nasal tube during the operation. Nine arterial samples for blood gas analysis were collected: (1) control; (2) before operation; (3) 5 min after beginning the operation; (4) 15 min after beginning the operation and before i.v. administration of 500 mg acetazolamide over 5 min; (5) after acetazolamide; (6 and 7) 10 and 20 min after acetazolamide; and (8 and 9) 15 and 30 min after operation (RB) or extubation (GA). RESULTS. The patient demography, including duration of anaesthesia and operation, was similar in both groups (Table 1). Four patients in the GA group (2 needed O2 after extubation because of hypoxaemia) and 2 in the RB group were excluded. No significant differences were seen in base excess (BE) and standard bicarbonate (SHCO3). Arterial O2 tension, arterial O2 saturation, and pulse-oximetric O2 saturation were higher in the RB group intra- and postoperatively (Figs. 1, 3, 4). Arterial CO2 tension (PaCO2) was significantly higher in the GA group during the pre- and postoperative period (Fig. 2), but not during the operation. The PaCO2- F(eexCO2) gradient ranged between 5 and 9 mmHg. Administration of acetazolamide did not influence this gradient by regressive analysis. The postoperative outcome of the patients was comparable in both groups. Nausea or vomiting did not occur. MAP was significantly higher in the RB group during the operation. No significant differences were seen in the pre- and postoperative period. Heart rate in the GA group was higher only after extubation, but was within physiological limits. DISCUSSION. Despite the differing results between the two groups, our study showed no important advantage related to either RB or GA. Changes in ABG, MAP, and heart rate during the investigation period were within physiological limits in elderly patients. Intravenous acetazolamide did not influence ABG in a significant manner. With regard to the preference of each patient, we recommend both RB and GA for cataract surgery in high-risk patients on the assumption of sufficient preoperative treatment of co-existing diseases. In conclusion, cardiovascular and ABG stability were maintained during both anaesthetic techniques.
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PMID:[General anesthesia vs. retrobulbar anesthesia in cataract surgery. A randomized comparison of patients at risk]. 152 60

Forty pregnant long-tailed macaques were dosed via nasogastric intubation with 0, 25, 150, or 300 micrograms/kg of L-selenomethionine (Se) daily during organogenesis [Gestational Day (GD) 20-50]. Clinical examination of the dams, maternal body weights, sonographic evaluations, clinical chemistry screens, and measures of serum progesterone and urinary estrone conjugates were used as indicators of maternal and fetal status in all animals. The pregnancies of two to three dams from each dose group were followed until term (approximately GD 165); the remainder (N = 7/dose group) were scheduled for hysterotomy on GD 100 +/- 2. A standard teratologic evaluation was performed including visceral and skeletal examinations. Fetal liver, kidney, skin, and smooth, cardiac, and skeletal muscles were examined by light microscopy; heart muscle was also evaluated by transmission electron microscopy. Neonates delivered at term remained with the dams and were removed periodically for morphometric, neurologic, behavioral, and ophthalmologic assessments on Days 1, 8, 15, 22, and 30 of age. Dose-dependent maternal toxicity as evidenced by anorexia, vomiting, and a significant reduction in body weight increased with increasing duration of Se exposure. One growth-retarded fetus was recovered on GD 131 from a compromised dam exposed to 25 micrograms/kg-day; one early embryonic death (GD 35) and two fetal deaths [GD 68 (followed by maternal death) and GD 123] occurred among animals dosed with 300 micrograms/kg-day. Pregnancy loss among treated animals was not significantly different from concurrent or historical controls. No statistically significant treatment-related effects were observed at necropsy on GD 100 +/- 2. One infant exposed to 150 micrograms/kg-day prenatally exhibited a unilateral cortical cataract, which may have been a spontaneous occurrence. The limited developmental effects observed and reported teratogenesis in nonmammalian species suggest that comparative pharmacokinetic studies are required before the full public health significance of elevated Se is understood.
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PMID:Developmental toxicity of L-selenomethionine in Macaca fascicularis. 201 39

The acute reaction in the course of a total body irradiation (TBI) appears in an organ-specific damage of the stem cells. Moreover, there are unspecified central-nervous stress reactions. Clinical reactions are obtained by the study and symptomatic therapy is proposed. 90 patients with different forms of leukaemia were observed. We documented the course in a specific "protocol system". Reactions like an increase of body temperature, changes of pulse and blood pressure were registered. The occurrence of gastro-intestinal reactions is a typical symptom of the acute radiation syndrome e.g. vomiting and diarrhoea are demonstrated in dependence of the applicated dose of irradiation. Further symptoms of TBI appeared in the later period. Mucositis, parotitis, a decreased function of the salivary glands and diarrhoea as well as vomiting are characterized by different intensity and temporary termination. A difference between allogeneic and autologous transplantation is caused by a medicamental additional treatment. During the late period these symptoms will disappear completely. Moreover, after TBI and BMT late effects are a cataract and some changes in the hormonal system demanding a specific correction or substitution respectively.
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PMID:Acute and late effects in the course of and after total body irradiation with following bone marrow transplantation in patients with different forms of leukaemia. 248 Feb 95

The relationship between Bendectin exposure during the first trimester of pregnancy and the occurrence of congenital malformations was prospectively studied in 31,564 newborns registered in the Northern California Kaiser Permanente Birth Defects Study. The odds ratio for any major malformation and Bendectin use was 1.0 (95% confidence interval 0.8-1.4). There were 58 categories of congenital malformations; three of them were statistically associated with Bendectin exposure (microcephaly--odds ratio = 5.3, 95% confidence interval = 1.8-15.6; congenital cataract--odds ratio = 5.3, 95% confidence interval = 1.2-24.3; lung malformations (ICD-8 codes 484.4-484.8)--odds ratio = 4.6, 95% confidence interval = 1.9-10.9). This is exactly the number of associations that would be expected by chance. An independent study (the Collaborative Perinatal Project) was used to determine whether vomiting during pregnancy in the absence of Bendectin use was associated with these three malformations. Two of the three (microcephaly and cataract) had strong positive associations with vomiting in the absence of Bendectin use. We conclude that there is no increase in the overall rate of major malformations after exposure to Bendectin and that the three associations found between Bendectin and individual malformations are unlikely to be causal.
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PMID:Bendectin and human congenital malformations. 277 50

A 7-year-old boy presented with a history of postprandial vomiting, failure to thrive, hematuria, proteinuria and decreased renal function. Electron microscopy of a renal biopsy specimen demonstrated the typical glomerular basement membrane changes associated with Alport's syndrome. Audiometry revealed a moderate bilateral high-tone sensorineural hearing loss. Bilateral anterior lenticonus and a unilateral cataract were also diagnosed. Achalasia diagnosed radiologically and confirmed by biopsy was corrected by surgery. Evaluations of the parents and three siblings were negative. The patient subsequently developed end-stage renal failure. This case report and a review of the literature suggest that achalasia may be part of Alport's syndrome in some patients.
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PMID:Alport's syndrome and achalasia. 315 32

Forty patients more than 65 years old were anaesthetized with propofol for cataract surgery. Patients were divided into two groups: those intubated after topical oropharyngeal anaesthesia and those intubated after muscle relaxation obtained with suxamethonium. Induction and maintenance of anaesthesia were carried out with 2.5 mg . kg-1 and 4 mg . kg-1 . h-1 respectively. Concurrent use of muscle relaxants had no effect on the action and characteristics of the general anaesthesia or recovery. Relative bradycardia (7%) and arterial hypotension (25%) occurred rapidly following induction and continued during the entire period of anaesthesia despite the systematic infusion of 500 ml of electrolyte solutions. Recovery was extremely rapid. The original Glasgow score was obtained within 20 min. The only negative side-effects were generally late occurring (4-6 h): postanaesthetic nausea or vomiting. Otherwise, tolerance was excellent. Use of propofol was ideal for this type of surgery due to its strong and durable ocular hypotensive effect.
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PMID:[Use of propofol in ophthalmological anesthesia in elderly patients]. 349 5

Fifty-five unpremedicated outpatients scheduled for cataract surgery were randomly allocated to receive either a fixed dose of nalbuphine and methohexitone or fentanyl and diazepam administered in a dose adjusted to produce the required sedative effect. Statistical analysis revealed no difference between groups with regard to immediate side effects, intra-ocular pressure or postoperative nausea or vomiting. Recovery time from administration of the sedative until compliance with simple commands was significantly longer in the nalbuphine/morphine group (89 vs 196 seconds) but this was not felt to be of clinical importance. This combination was better in terms of sedation at the time of insertion of the nerve blocks, lack of recall of insertion of the nerve block, incidence of intra-operative complications, surgeon's assessment of operating conditions and patient acceptability. This fixed dose by weight drug combination for intravenous sedation should be applied widely.
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PMID:Intravenous sedation for cataract surgery. 368 87

The authors performed galactose loading tests in children suffering from chronic diseases: recurrent bronchitis vomiting, diarrhoea, milk-intolerance, somatic and mental retardation, cramps. In 32 of the 92 examined cases galactose levels rose until pathological, pseudo- diabetic levels. Stillbirth, cataract, hyperbilirubinaemia, convulsions occurred among family members of 10 patients. Galactose-1-phosphat-uridyl-transferase levels were decreased only in 4 of the 17 patients examined. In the other cases some different pathway of galactose metabolism is suspected. Complete remission of symptoms was achieved with diet devoid of milk sugar (lactose) in 29 patients: one infant died and two others remained mentally retarded. According to the examinations presented minor deviations of galactose metabolism cause clinical symptoms more frequently in early life as it was supposed until now.
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PMID:[Galactose loading test in infants and small children suffering in recurrent bronchitis and other chronic illness (author's transl)]. 611 85

A prospective randomized study was undertaken on elderly patients undergoing intraocular, predominantly cataract, surgery to compare the intraoperative, recovery and postoperative features associated with general anaesthesia employing either the spontaneous (SV) or controlled ventilation (IPPV) techniques of respiration using isoflurane, nitrous oxide and a constant FiO2 of 0.33. SV patients received isoflurane 0.97% (mean). IPPV patients were intubated with atracurium alone, and received isoflurane 0.60% (mean). Heart rates were lower intraoperatively with IPPV, and blood pressures were lower with SV. Intraocular pressure measurement identified three subgroups of patients within each respiratory group: a large subgroup (70% of SV, 64% of IPPV patients) with a high-normal initial mean intraocular pressure which fell intraoperatively; a small subgroup (25% of SV, 24% of IPPV patients) with a low normal initial mean intraocular pressure which rose intraoperatively; and a small subgroup (5% of SV and 11% of IPPV patients) in whom the intraocular pressure remained unchanged. A satisfactory operative field was reported by surgeons in 87% of SV and in 86% of IPPV patients. SV patients had a lower mean end-operative SaO2 than IPPV patients (SV 95.0%; IPPV 96.7%), and were extubated sooner at the end of anaesthesia. In the recovery ward the times to awakening, vomiting incidences, analgesic usages and recovery times were similar, and patients were similarly restful. Postoperatively, the incidences of vomiting, headache, fever, sore throat and myalgia were similar, but SV patients required more analgesia for headache. We conclude that both technique properly performed are similarly satisfactory for cataract surgery in elderly patients.
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PMID:Clinical comparison of spontaneous respiration versus controlled ventilation general anaesthesia using isoflurane for intraocular surgery: intraoperative, recovery and postoperative effects. 789 72


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