The Oklahoma Attorney General's Task Force report on the State of End-of-Life Health Care, 2005.

This article includes the recommendations submitted by the 15 members of the Oklahoma Attorney General's Task Force in their Report on the State of End-of-Life Health Care. The task force was created on April 21, 2004, and their report was accepted by Attorney General W.A. Drew Edmondson at a press conference April 11, 2005. It has been forwarded to members of the Oklahoma Legislature, relevant state agencies and organizations with an invitation to join with members of the task force to continue efforts to improve end-of-life care for Oklahomans. Copies of the report are available upon request to the Office of Attorney General.

Treatment of ocular bacterial infections: an update.

BACKGROUND: Because of increased bacterial resistance and the addition of new antimicrobial medications, the current and appropriate treatment of ocular bacterial infections is an important issue for eye care practitioners. METHODS: The literature on the antimicrobial treatment of ocular bacterial infections is reviewed to provide the practicing optometrist with an overview of the issues and medications involved in therapy. RESULTS: New topical, oral, and parenteral antibiotic medications continuously become available to eye care practitioners. Clinicians must routinely reassess the conventional antimicrobial therapy in light of the drugs available for the treatment of bacterial eye infections. The clinician must be familiar with distinct protocols and medications for the management of different ocular bacterial infections. CONCLUSIONS: Knowledge of the results of controlled antimicrobial studies and a review of standard practices in managing bacterial eye disease can provide the necessary background to help the eye care clinician make appropriate antimicrobial therapeutic decisions in patient care.

Laser Doppler perfusion imaging of proximal interphalangeal joints in patients with rheumatoid arthritis.

OBJECTIVE: A non-invasive imaging technique (laser Doppler perfusion imaging-LDI) based on measurement of backscattered Doppler-broadened near infra-red laser radiation was used to provide two-dimensional images of perfusion over the proximal interphalangeal (PIP) joints of a group of normal subjects compared to a group of patients with rheumatoid arthritis (RA). RESULTS: Some PIP joints of the RA group showed areas of increased perfusion whereas normal subjects showed much less variation in perfusion between joints. These hyperaemic areas arose from the underlying joint, as scans taken with a less penetrating red laser did not show such areas. CONCLUSION: Apart from its obvious dermatological uses, LDI could be employed to image hyperaemia associated with a variety of inflammatory conditions affecting subcutaneous structures.

Extemporaneous preparation of antibiotic ophthalmic solutions.

Until the introduction of ocular ciprofloxacin, the standard of practice in treating bacterial corneal ulcers required topical antibiotic ophthalmic solutions that were either not commercially available or not available in the higher concentrations needed. A survey was mailed to 125 hospital pharmacies and 125 community pharmacies in Oklahoma to determine the availability of extemporaneously prepared antibiotic ophthalmic solutions. Of 72 hospital pharmacies and 60 community pharmacies that responded, 17 hospital and 2 community pharmacies reported that they do compound these solutions. The main reasons given by the other pharmacies for not offering this service were the lack of a laminar flow hood or other equipment and lack of an aseptic environment. If extemporaneously prepared antibiotic ophthalmic solutions are needed to treat corneal ulcers, then pharmacists have a responsibility to prepare them. The recent publication of a handbook providing formulations for those products and the "ASHP Technical Assistance Bulletin on Pharmacy-Prepared Ophthalmic Products" may encourage more pharmacies to provide this needed service.

Spectacles and custom toric hydrogel contact lenses: a comparison of vision.

BACKGROUND: The quality of vision obtained through spectacles and toric hydrogel contact lenses is important when determining which correction type is best. METHODS: Twenty-six subjects with 0.75D-3.50D of refractive astigmatism were selected to wear Sunsoft Custom toric hydrogel contact lenses. Snellen acuity and contrast sensitivity measurements were gathered with both toric hydrogel lenses and spectacles. At the conclusion of the study each subject completed a questionnaire rating his or her preference for spectacles or toric hydrogel lenses based on the quality of vision with each. RESULTS: Our findings reveal no statistically significant difference when comparing contrast sensitivity thresholds, Snellen acuity thresholds or subjective preference between spectacles and toric hydrogel lenses. CONCLUSIONS: Based on quality of vision, practitioners should not hesitate to recommend toric hydrogel lenses in addition to the traditional spectacle correction as a viable method of correction for the moderately astigmatic patient.

Infusion of propofol to identify smallest effective doses for induction of anaesthesia in young and elderly patients.

We studied 110 patients older than 60 yr or aged 18-50 yr as separate groups in two stages to identify the smallest effective doses of propofol for induction of anaesthesia. In the elderly patients, in stage 1, at infusion rates of 25, 50 or 100 mg min-1 the mean (SD) doses administered were propofol 0.82 (0.14) mg kg-1, 1.22 (0.24) mg kg-1 and 1.65 (0.60) mg kg-1 and the induction times 140.1 (21.9) s, 103.2 (23.5) s and 69.4 (10.0) s, respectively. In stage 2, after induction with a fixed dose of 0.82 mg kg-1 as a bolus over 5 s or as an infusion at 25 mg min-1, the times for induction were 38.5 (14.0) s and 144.5 (36.6) s, respectively. In the young patients, at induction rates of 33.3, 50, 100 or 200 mg min-1, the doses administered were propofol 1.36 (0.28) mg kg-1, 1.46 (0.12) mg kg-1, 1.85 (0.43) mg kg-1 and 2.39 (0.50) mg kg-1 and the induction times 145.0 (25.4) s, 120.0 (18.4) s, 80.2 (19.2) s and 54.5 (10.4) s, respectively. In stage 2, a fixed induction dose of 1.46 mg kg-1 resulted in induction times of 35.0 (8.5) s and 134.0 (26.8) s, respectively. In stage 2 of each age group, induction was achieved with smaller doses than those recommended previously and there was no difference in the number of patients in whom induction of anaesthesia was successful or in the measured cardiorespiratory variables between the two induction regimens. This suggests the latter effects are caused by the dose administered and not the rate of administration.

Phosphorus, nitrogen, and algae in Lake Washington after diversion of sewage.

After diversion of sewage effluent from Lake Washington, winter concentrations of phosphate and nitrate decreased at different rates. From 1963 to 1969, phosphate decreased to 28 percent of the 1963 concentration, but nitrate remained at more than 80 percent of the 1963 value. Free carbon dioxide and alkalinity remained relatively high. The amount of phytoplanktonic chlorophyll in the summer was very closely related to the mean winter concentration of phosphate, but not to that of nitrate or carbon dioxide.