ABSTRACT
The clinical significance of a proper eye drop application technique was evaluated in Japanese glaucoma patients. Patients diagnosed with primary open-angle glaucoma having intraocular pressure (IOP) greater than 21 mmHg were treated with eye drops at home. In some patients, however, the topical treatment was ineffective. They returned to the hospital to receive surgical treatment. On admission, 56% of these patients had IOP greater than 21 mmHg. Patient instillation technique was evaluated based on the proximity of the eyedropper tip to the eyes, application position, eyelid closure, treatment (removal) of excess fluid, and nasolacrimal occlusion. In addition, pharmacists interviewed patients to determine the level of understanding of glaucoma, knowledge of prescribed drugs, home application technique, and sensation after application. Multivariate analysis revealed that the key factors influencing the control of IOP to less than 21 mmHg with topical medication were: application of drops in the center of the eye and removal of excessive fluid, in addition to gender and age. Proper topical application at home was dependent on the patient's understanding of the disease, knowledge of prescribed drugs, patient education on the use of drugs, the competence of the instructor, and knowledge of correct application technique. This study indicates that easily comprehensible patient education on the use of eye drops, the nature of glaucoma and the proper use of prescribed drugs is vital to improving the clinical efficacy of topical ophthalmic medication of glaucoma in adult patients.
Subject(s)
Glaucoma/drug therapy , Ophthalmic Solutions/administration & dosage , Ophthalmic Solutions/therapeutic use , Administration, Topical , Adult , Aged , Female , Glaucoma/diagnosis , Humans , Intraocular Pressure , Male , Middle Aged , Multivariate Analysis , Ophthalmic Solutions/adverse effects , PharmacistsABSTRACT
A multidisciplinary panel of experts convened to discuss the basic concepts of prevention and treatment of pressure ulcers. Special emphasis was placed on four types of debridement: mechanical, surgical, autolystic, and enzymatic. Debridement of burns was also discussed. Team management by informed practitioners is vital to successful wound care and all treatments should be based on a holistic appraisal of patients and their individualized plans of care.
Subject(s)
Debridement/methods , Patient Care Team , Wound Healing , Wounds and Injuries/therapy , Humans , Inflammation , Wounds and Injuries/pathology , Wounds and Injuries/physiopathologyABSTRACT
An open, nonrandomized study of 25 patients was conducted to evaluate the efficacy of cefoxitin in the prevention of postoperative infection following orthopedic surgical procedures. Cefoxitin was administered in a 2 g dose preoperatively and continued postoperatively at a dose of 2 g every six hours for 72 hours. The mean peak serum level achieved ten minutes after the preoperative dose was 153.7 mcg/ml. The mean bone level in samples taken during the procedure was 10.14 mcg/ml. All patients were monitored postoperatively and at intervals of six weeks, four months and six months for signs of early or late morbidity. No signs of major morbidity were observed in the study group.
