Decision analysis: a tool for infection control

The medical world would seem to be one of increasing technology and shrinking financial resources. New tests and therapies constantly appear on the market. Most have been examined for efficacy and side effects. The real question is: where does the new test or therapy fit in with all previous products? Decision analysis is a mathematical tool adapted to assess the relative cost-effectiveness of complex diagnostic and therapeutic strategies.     

Dietary intake of healthy subjects before and one year after dietary advice

This study was conducted to follow up healthy subjects from a previous study (Warwick & Williams, 1987) in which favourable dietary changes were achieved during 1 week immediately after dietary advice but were accompanied by reduced energy intakes and weight loss. Twenty-one subjects (8m, 13f; 57 per cent of the original group) participated in the follow-up study. Dietary intakes were measured using 7-d weighed records on three occasions: before, immediately after and 1 year after receiving dietary advice. Intakes 1 year after dietary advice continued to show some of the favourable changes observed immediately after the advice but were not accompanied by reduced energy intakes and weight loss. Intakes before, immediately after, and 1 year after dietary advice respectively were: energy, 9.0, 7.8 and 8.9 MJ/d (2150, 1860 and 2120 kcal/d); fat, 36.9, 32.9 and 31.5 per cent of total energy; carbohydrate, 44.2, 47.9 and 49.6 per cent of total energy; dietary fibre, 32, 36 and 36 g/d; sodium, 116, 97 and 110 mmol/d; and Na:K ratio, 1.4, 1.2 and 1.2 mmol. Nutrient densities for fibre and most micronutrients tended to be higher 1 year after dietary advice than before, but were highest immediately after the advice. Nutrient densities for sodium and total sugars did not vary between the 3 study weeks. It was concluded that our healthy subjects adapted their intakes to maintain energy balance while retaining favourable dietary changes for at least 1 year after dietary advice.     

The rotating contact glass holder

A rotating contact lens holder for the three-mirror Goldmann lens permits circular examination of the fundus or chamber angle without having to change the position of the fingers on the edge of the lens. The contact lens holder consists of an outer polygonal ring hold by the thumber and index finger. An inner rotating ring holds the contact lens. Continuous rotation of the contact lens is performed with the free middle Finger. This device permits circular examination of the retina without interruption of fixation. The instrument improves not only the speed but also the reliability of the examination.     

A comparative study of two preservative-free tear substitutes in the management of severe dry eye

Between mid-May and mid-July 1987 we performed a prospective crossover study of two unit-dose preservative-free artificial tear solutions, 1.4% polyvinyl alcohol (Refresh) and 0.1% sodium hyaluronate (Hylorin) in 14 female patients with severe dry eye syndrome. The patients were examined before treatment and after each of two trials with both products. A significant reduction in the mean score for dry-eye-induced keratitis (p = 0.001) and for mucous strands (p = 0.03) was observed following the second of two trials with sodium hyaluronate. A significant reduction in the mean score for burning and irritation was observed with both solutions (p = 0.009). We believe that the elimination of preservatives from artificial tear preparations may substantially reduce the iatrogenic effects of these frequently applied medications.