The value of routine preoperative medical testing before cataract surgery

Article Abstract:

Preoperative medical tests do not improve the outcome of patients having cataract surgery. These tests include and electrocardiogram, a complete blood count, and blood levels of various compounds. Researchers randomly assigned 18,189 patients scheduled for cataract surgery to receive preoperative medical tests or no tests. The rate of surgical complications either during or after surgery was similar in both groups. The most frequent complications were hypertension and arrhythmia.

Preoperative care, Cataract extraction, Postoperative complications

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The use of angioplasty, bypass surgery, and amputation in the management of peripheral vascular disease

Article Abstract:

Percutaneous transluminal angioplasty is a surgical procedure to reopen blood vessels blocked by disease. The procedure is safer and cheaper than bypass surgery, and is often used to treat diseased arteries of the heart. The same procedure is often used to treat artery disease in the arms and legs. Although the procedure results in an impressive improvement in the period after surgery, concern has been expressed that the improvement does not last. Numerous reports have been published in the medical literature on the effectiveness of transluminal angioplasty for arteries in the arms or legs, but most have been small studies on patients at one medical center. A major study was therefore conducted to review the cases in which angioplasty was used in 52 hospitals, as well as evaluating cases of peripheral vascular disease in which bypass surgery or limb amputation was performed. A total of 30,637 cases of peripheral vascular disease were identified between 1979 and 1989. An additional 36,715 cases were identified in which peripheral vascular disease was likely. A total of 5,791 angioplasty procedures, 37,660 bypass operations, and 23,901 amputations were performed during this period. A review of the data indicated that the increasing use of angioplasty during the period from 1979 to 1989 was not associated with a decrease in the rate of bypass procedures. Indeed, the adoption of angioplasty for peripheral vascular disease was associated with an increase in bypass operations. Furthermore, the necessity of amputation was not reduced by the use of angioplasty as an accepted procedure. The available data do not permit the analysis of how individual cases progressed. Therefore, while the overall outcome of peripheral vascular disease has not been appreciably affected by the introduction of transluminal angioplasty, it is not possible to determine how the quality of life of the patients might have improved after treatment. (Consumer Summary produced by Reliance Medical Information, Inc.)

Arteriosclerosis, Peripheral vascular diseases, Blood vessels, Amputation, Vascular surgery, Angioplasty

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Racial differences in the cause-specific prevalence of blindness in East Baltimore

Article Abstract:

Planning appropriate treatments and rehabilitation programs for patients with eye diseases requires an understanding of the causes of blindness and accurately estimating the number of people who suffer from blindness. To investigate these issues, eye examinations were performed on 2,913 whites and 2,395 blacks living in urban communities in East Baltimore. All of the subjects were between 40 and 80 years of age. Sixty-four of the subjects were blind in both eyes. Overall, senile cataracts were the leading cause of blindness (22 percent), followed by primary open-angle glaucoma (15 percent) and age-related macular degeneration (13 percent). Among blacks, the leading causes of blindness were senile cataract (27 percent) and primary open-angle glaucoma (19 percent). Among whites, the leading causes of blindness were age-related macular degeneration (30 percent) and senile cataract (13 percent). The number of white subjects with cataracts was 1.4 cases per 1,000; there were 4.6 cases per 1,000 among blacks. Although the prevalence of cataracts among blacks was higher than among whites, whites were almost twice as likely to have undergone cataract surgery than blacks. These findings indicate that socioeconomic or cultural barriers may prevent appropriate eye health care among blacks. Glaucoma was six times more common among blacks than whites, and began an average of 10 years earlier in blacks than in whites. Blindness caused by age-related macular degeneration was the leading cause of blindness among whites. Half of the cases of blindness reported in this study probably could have been prevented or were reversible, health care services were probably underused. It is also concluded that the causes of blindness vary between blacks and whites. (Consumer Summary produced by Reliance Medical Information, Inc.)

Demographic aspects, Blindness, Retinal degeneration, Cataracts, Maryland, Eye diseases, Baltimore, Maryland, Open-angle glaucoma

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