Publications by authors named "Niles C"

Purpose: To evaluate the accuracy of the new Tono-Vera rebound tonometer (Reichert Inc, Buffalo, NY) compared to Goldmann Applanation Tonometry.

Methods: This prospective, observational, cross-sectional study was designed in accordance with ANSI Z80.10-2014 and ISO 8612-2009 guidelines for tonometer comparison.

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Background: Extensive data consistently demonstrates inequities in access and delivery of healthcare for patients from historically marginalized populations, resulting in poorer health outcomes. To address this systemic oppression in healthcare, it is necessary to embed principles of equity, diversity, and inclusion (EDI) at an early stage within medical education. This study aimed to assess pediatric trainees' perceived interest in EDI curricula as well as their confidence in applying this knowledge to provide culturally responsive care.

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Gas embolism is a potential and often life-threatening complication of central venous catheters. We report a case of air embolism after tearing of the central catheter associated with severe acute respiratory distress syndrome. The severity of the clinical situation meant choices had to be made regarding the order of treatments.

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Background: Stereotactic body radiotherapy (SBRT) is a well-established treatment option for early stage non-small-cell lung cancer (NSCLC) tumors < 5 cm. There is limited information on tumors > 5 cm.

Patients And Methods: We performed retrospective data collection of patients enrolled onto a prospective SBRT registry study.

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Out-of-hospital emergencies occur frequently, and laypersons are often the first to respond to these events. As an outreach to our local communities, we developed "Basic Emergency Interventions Everyone Should Know," a three-hour program addressing cardiopulmonary resuscitation and automated external defibrillator use, heart attack and stroke recognition and intervention, choking and bleeding interventions and infant and child safety. Each session lasted 45 minutes and was facilitated by volunteers from the emergency department staff.

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Article Synopsis
  • The study aimed to evaluate the use and effects of low-dose ketamine (LDK) for pain relief in an emergency department (ED) setting.
  • A review of patient charts over two years identified 35 cases where LDK was administered for pain control, often alongside opioids.
  • Results showed that 54% of patients experienced pain improvement, with no significant adverse events reported, but larger trials are necessary before recommending routine use.
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Venous thromboembolism (VTE) prophylaxis in high-risk patients is frequently underutilised. We previously devised a one-screen computer alert program that identified hospitalised patients at high risk for VTE who were not receiving prophylaxis and advised their physicians to prescribe prophylaxis. While this strategy reduced the 90-day incidence of symptomatic VTE by 41%, the majority of electronic alerts were ignored.

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We studied the efficacy and safety of an investigational enoxaparin regimen, 1.5 mg/kg once daily, as a bridge to warfarin for the outpatient treatment of acute venous thromboembolism. We undertook a case-control design.

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Background: At the University of New Mexico School of Medicine (UNM-SOM) we have noticed that some first year medical students have difficulty accurately assessing their academic skills and are often afraid to seek help. This leads to marginal performance and sometimes even failure. Therefore, we developed a preemptive intervention using peer-led study groups based on the personalized System of Instruction (PSI).

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Objective: The purpose of this study was to determine whether cognitive appraisals of stress level and hypertensive responses to ambulatory ophthalmic surgery can be ameliorated by patient-selected music.

Methods: We studied 40 elderly individuals requiring ophthalmic surgery, 20 in an experimental group (mean age, 74 years) and 20 in a control group (mean age, 77 years). All patients had an established resting blood pressure <140/90 mm Hg.

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This paper summarizes the findings gleaned from detailed clinical examinations of three groups of residents who were exposed to trichloroethylene in well water. Also summarized are diagnostic findings for peripheral neuropathy. A detailed description of the neuropsychological test results is included, as well as a summary of domain-specific findings and diagnostic outcomes.

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Purpose: To evaluate the results of excimer laser photorefractive keratectomy (PRK) using an erodible mask to treat myopic astigmatism.

Setting: Douglas Memorial Hospital Medical Centre, Fore Erie, Ontario, Canada.

Methods: Photorefractive keratectomy was done on 25 consecutive eyes of 25 patients with myopic astigmatism using the OmniMed excimer laser and a compound single-use myopic erodible mask manufactured to produce a specific spherical and cylindrical correction for each individual patient.

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Trichloroethylene (TCE) exposure is known to have specific toxic effects on cranial nerves, the trigeminal nerve (V) in particular. The electrophysiological measurement of the blink reflex (BR) can quantify latency changes in the Vth and VIIth cranial nerve reflex arc. Prior study looked at the blink reflex measurement in a community group exposed to TCE in their drinking water.

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To evaluate the effects of chronic lead exposure on the nervous system in adults, a set of neurobehavioural and electrophysiological tests was administered to 99 lead exposed foundry employees and 61 unexposed workers. Current and past blood lead concentrations were used to estimate the degree of lead absorption; all previous blood lead concentrations had been less than or equal to 90 micrograms/100 ml. Characteristic signs (such as wrist extensor weakness) or symptoms (such as colic) of lead poisoning were not seen.

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One hundred forty-seven persons exposed to arsenic from well water were evaluated by neurologic examination and nerve conduction studies. Total arsenic concentrations in well water ranged from 1 to 4781 micrograms/L and from 6 to 4964 micrograms/L in urine; a calculated index of arsenic ingestion ranged from 1 to 4521 micrograms/day. No dose-response relationship existed between arsenic ingestion and symptoms or physical findings compatible with peripheral neuropathy.

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Following a 1978 outbreak of bladder neuropathy among workers exposed to dimethyl-aminopropionitrile (DMAPN), follow-up studies were performed 2 a after the original epidemic to evaluate the persistence of symptoms among a small group of initially affected workers. Although the overall prevalence of urologic and neurological symptoms fell for the 11 persons interviewed, significantly high rates of persistent symptoms were seen. Of particular concern was the increase in the prevalence of symptoms of sexual dysfunction.

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Neurogenic bladder dysfunction, characterized by hesitancy, need to strain, decreased stream, and increased duration of urination, developed in 104 (63%) of 166 employees working in the manufacture of polyurethane foam. Highest rates of illness (69%) occurred in production workers, and no illness occurred in office or warehouse workers. Onset of the epidemic coincided with introduction of a catalyst, dimethylaminopropionitrile (DMAPN), and monthly case incidence rates increased as DMAPN use increased.

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We conducted a double-blind controlled study of individuals exposed to arsenic trioxide in a copper-smelting factory. Subjects fell into three categories of peripheral neuropathy: none, subclinical, and clinical. The subclinical group had no symptoms or signs of numbness or reduced reflexes, but did have reduced nerve conduction velocity and amplitude measurements.

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