bluuebunny/crossref_metadata_2025 huggingface dataset:
Obstructive sleep apnoea syndrome: Translating science to clinical practice
Authors: McNICHOLAS Walter T. , RYAN Silke
Published: February 2006

Abstract:  OSA syndrome is characterized by recurring episodes of upper airway (UA) obstruction during sleep. The UA is subjected to collapse when the negative airway pressure generated by inspiratory activity of the diaphragm and intercostal muscles exceeds the force produced by the UA dilating muscles. Factors that reduce UA calibre lead to increased UA resistance with the generation of a more negative pharyngeal pressure during inspiration, and thereby predispose to UA occlusion during sleep. As a consequence, UA dilating muscles must contract more forcefully to maintain a patent UA, which may predispose to fatigue. Nasal CPAP counteracts these collapsing forces and is associated with resting of the UA muscles. The more recent development of auto‐adjusting CPAP (APAP) is a reflection of the understanding that the pressure required to prevent UA collapse fluctuates throughout the night and results in a lower mean pressure that may be more comfortable for some patients. The predominant morbidity of the OSA syndrome is cardiovascular and there is growing understanding of the basic mechanisms involved. Intermittent hypoxia appears to play a central role by activating transcription factors that predispose to atherogenesis, particularly NFκB. Sympathetic overactivity also appears to play an important role but the mechanisms involved are unclear.
Oxygen cost of ventilation during incremental exercise to VO2 max
Authors: VELLA Chantal A. , MARKS Derek , ROBERGS Robert A.
Published: February 2006

Objective:  Evidence of significant oxygen requirements for ventilation during exercise (exercise hyperpnoea) prompted the investigation into whether the oxygen cost of ventilation affects the presence of a whole‐body VO2 plateau at maximal exercise. The purposes of this study were to: (i) use isocapnic hyperpnoea trials to determine the oxygen cost of ventilation (VO2VENT) across a range of ventilation (VE); (ii) determine the mean VO2VENT at maximal exercise expressed as a percentage of whole‐body VO2 max; and (iii) determine if a plateau in VO2 is more evident when the VO2VENT is subtracted from whole‐body VO2 at maximal exercise.

Methods:  A total of 21 subjects performed a VO2 max test on the cycle ergometer to determine the range of VE for each subject. From the initial VO2 max test, nine VE values across the range of VE were selected for each subject and the oxygen cost of each was measured.

Results:  The mean maximal VO2VENT equalled 8.8 ± 3.3% of VO2 max and ranged from 5.0% to 17.6%. VO2VENT increased exponentially with increasing VE, but there was considerable subject variability in the oxygen cost per litre of VE as VE increased. Subtracting the VO2VENT from whole‐body VO2 at maximal exercise increased the detection of a plateau in VO2 at VO2 max.

Conclusions:  The data of the present study indicate that the VO2VENT is a significant portion of VO2 max and may be a limiting factor of maximal exercise performance in some subjects.
Gefitinib‐induced interstitial lung disease showing improvement after cessation: Disassociation of serum markers
Authors: KITAJIMA Hiroko , TAKAHASHI Hiroki , HARADA Kazutoki , KANAI Akiko , INOMATA Shin‐Ichiro , TANIGUCHI Haruko , SAIKAI Toyohiro , ABE Shosaku
Published: February 2006

Abstract:  Gefitinib (ZD1839), a small‐molecule epidermal growth factor receptor tyrosine kinase inhibitor, is an anticancer agent for patients with non‐small cell lung carcinoma. Recently, however, as a result of accumulating evidence, it has been recognized that gefitinib can give rise to lethal lung toxicity. The authors report a case of interstitial lung disease (ILD) induced by gefitinib, which improved promptly following cessation of the administration of the agent. Clinical signs suggesting a good prognosis were noted, namely, findings similar to acute eosinophilic pneumonia on CT and a disassociation in the elevation of specific serum markers of ILD. At the time of onset of ILD, serum concentrations of surfactant protein (SP)‐A and SP‐D were significantly increased, whereas that of KL‐6 was not increased. A previous study of three cases of lethal lung toxicity resulting from gefitinib administration revealed a significant and almost equal increase in KL‐6, SP‐A and SP‐D. These results suggest that SP‐A and SP‐D may be indicators of gefitinib‐induced ILD and that KL‐6 is a predictor of outcome. Using a combination of these markers may help to establish a differential prognosis in patients with gefitinib‐induced ILD.
Morbidity, mortality and economic burden of renal impairment in cardiac intensive care
Authors: Chew D. P. , Astley C. , Molloy D. , Vaile J. , De Pasquale C. G. , Aylward P.
Published: February 2006

Background: Moderate to severe impairment of renal function has emerged as a potent risk factor for adverse short‐ and long‐term outcomes among patients presenting with cardiac disease.

Aims: We sought to define the clinical, late mortality and economic burden of this risk factor among patients presenting to cardiac intensive care.

Methods: A clinical audit of patients presenting to cardiac intensive care was undertaken between July 2002 and June 2003. All patients presenting with cardiac diagnoses were included in the study. Baseline creatinine levels were assessed in all patients. Late mortality was assessed by the interrogation of the National Death Register. Renal impairment was defined as estimated glomerular filtration rate <60 mL/min per 1.73 m2, as calculated by the Modified Diet in Renal Disease formula. In‐hospital and late outcomes were compared by Cox proportional hazards modelling, adjusting for known confounders. A matched analysis and attributable risk calculation were undertaken to assess the proportion of late mortality accounted for by impairment of renal function and other known negative prognostic factors. The in‐hospital total cost associated with renal impairment was assessed by linear regression.

Results: Glomerular filtration rate <60 mL/min per 1.73 m2 was evident in 33.0% of this population. Among these patients, in‐hospital and late mortality were substantially increased: risk ratio 13.2; 95% CI 3.0–58.1; P < 0.001 and hazard ratio 6.2; 95% CI 3.6–10.7; P < 0.001, respectively. In matched analysis, renal impairment to this level was associated with 42.1% of all the late deaths observed. Paradoxically, patients with renal impairment were more conservatively managed, but their hospitalizations were associated with an excess adjusted in‐hospital cost of $A1676.

Conclusion: Impaired renal function is associated with a striking clinical and economic burden among patients presenting to cardiac intensive care. As a marker for future risk, renal function accounts for a substantial proportion of the burden of late mortality. The burden of risk suggests a greater potential opportunity for improvement of outcomes through optimisation of therapeutic strategies.
The obesity‐driven rising costs of type 2 diabetes in Australia: projections from the Fremantle Diabetes Study
Authors: Davis W. A. , Knuiman M. W. , Hendrie D. , Davis T. M. E.
Published: February 2006

Background: The cost of diabetes is high for both the individual and society. Future health‐care planning requires patient‐level diabetes‐attributable health‐care cost data that have not previously been available for Australia.

Aim: To determine Australian national direct diabetes‐attributable health‐care costs for known type 2 diabetes in 2000 and project these to 2051.

Methods: A total of 1294 patients with type 2 diabetes was recruited to the Fremantle Diabetes Study between 1993 and 1996. A bottom‐up, prevalence‐based approach using diabetes‐attributable costs provided average annual per patient health‐care costs (in year 2000 A$). Costs were extrapolated to 2051 using Australian type 2 diabetes prevalence figures and Australian Bureau of Statistics population projections, assuming that prevalence rates (i) remain at current levels and (ii) rise steadily.

Results: Total annual direct diabetes‐attributable health‐care costs in 2000 in Australia for people ≥25 years with known type 2 diabetes were estimated at A$636 million. As a result of ageing, the number of people with type 2 diabetes will double between 2000 and 2051 with a 2.5‐fold increase in diabetes‐attributable health‐care costs. If obesity and inactivity prevalence rates continue to rise, prevalence rates of type 2 diabetes will further increase. The number of people with type 2 diabetes in 2051 may be 3.5 times higher than in 2000 with a 3.7‐fold cost increase.

Conclusions: The financial burden of treating type 2 diabetes could quadruple by 2051 unless more is done to prevent type 2 diabetes and its complications. A smaller proportion of the population will have the capacity to fund these rising health‐care costs.
Characteristics of adolescent depression
Authors: Crowe Marie , Ward Nic , Dunnachie Bronwyn , Roberts Morian
Published: February 2006

ABSTRACT:  Depression is a common psychiatric disorder that is acknowledged to be increasing in disease burden. The rates of adolescent depression is particularly concerning as they continue to increase. The seriousness and pervasive effects of depression on young people's lives supports the view that research that extends the knowledge in this area is vital. This is a descriptive study of the characteristics of depression in a sample of 121 adolescents attending an outpatient specialist adolescent mental health service in New Zealand. The adolescents were required to complete two self‐report measures to assess presence of depressive symptoms, severity of depression, and particular characteristics of the depression. The findings revealed that irritability was the most common characteristic along with other interpersonal and thought processing symptoms. It is important that mental health nurses are able to identify the specific characteristics of adolescent depression that may differ from adult depression in order to manage this patient population effectively.
‘Consumer consultant’: Expanding the role of consumers in modern mental health services
Authors: Cleary Michelle , Walter Garry , Escott Phil
Published: February 2006

ABSTRACT:  We aim to increase understanding about issues affecting ‘consumer consultants’ at an Area Mental Health Service level in the hope that consumers and mental health staff are informed of the challenges and changes associated with that role. Anecdotal feedback indicates that consumer consultants are working harder than ever and that their role is more diverse and challenging than before. Increased organizational demands and responsibilities are testing traditional roles and approaches. There is opportunity for greater sharing of expertise and skills among health professional staff and consumer consultants to enhance current work practices, increase workplace satisfaction, and achieve positive patient outcomes.
Nurses’ narratives about their residents when caring for people with long‐term mental illness in municipal group dwellings
Authors: Hellzén Ove , Asplund Kenneth
Published: February 2006

ABSTRACT:  Nurses working in community psychiatric care are expected to spend time with the residents, in a genuine, professional way, irrespective of their own feelings towards them. Fourteen nurses at two group dwellings in Sweden were interviewed about their experiences when caring for people with long‐term mental illness. Narrative interviews were conducted and interpreted using a method inspired by Ricoeur. The analyses were performed in two steps: the first shows that residents could be divided into four different typologies or patterns – the good, the disabled, the invisible, and the bad residents, of which the nurses liked the first two and disliked the last two. In the second analysis, two themes were formulated to describe the nurses’ experiences of ‘replenishing one's self‐worth and self‐esteem’ and ‘giving up the caring role’. These results were interpreted and reflected on in the light of a theoretical framework in order to obtain a deeper understanding of the text. The study indicates that the question of whether nurses liked or disliked the residents appears to be closely related to whether or not the individual resident confirmed the nurse. Residents who confirmed nurses were liked and given attention, whereas those who did not were disliked and given a minimum of time together with the nurse.
Educational interventions for mental health consumers receiving psychotropic medication: A review of the evidence
Authors: Fernandez Ritin S. , Evans Venita , Griffiths Rhonda D. , Mostacchi Maria S.
Published: February 2006

ABSTRACT:  The objective of this systematic review is to investigate the efficacy of educational interventions, relating to psychotropic medications, for consumers with a mental health disorder. This review included only randomized controlled trials that compared the effects of various educational interventions on knowledge retention, compliance to medication and treatment, incidence of relapse, and insight into illness in patients aged 18 years and over with a mental disorder. Twenty‐one trials met the quality criteria and were included in the final analysis. Patients who were provided with education demonstrated a significant increase in the level of knowledge and compliance compared with those who were not. However, there was no difference in the incidence of relapse and insight in those who were provided education. A structured education session using both written and verbal methods followed by discussion of the contents is demonstrated to be effective. The evidence suggests that consumers who were provided multiple education sessions had greater knowledge gains in the short term (up to 1 month); however, the effectiveness of multiple sessions in the long term (2 years) is inconclusive. The review provides evidence that multiple education sessions are better than single education sessions in improving knowledge relating to medications and insight into illness. Evidence from the trials demonstrates that structured educational interventions delivered at frequent intervals are useful as part of the treatment programme for people with a mental illness. More well designed and reported randomized studies investigating the efficacy of education are urgently needed.
Association between senescence‐related uncoupling protein 2 gene polymorphisms and abdominal obesity in Japanese subjects: The Tanno and Sobetsu study
Authors: Xu Rui , Ishikawa Kazuhiko , Katsuya Tomohiro , Fu Yuxiao , Akasaka Hiroshi , Ikushima Masashi , Chihara Yukana , Ura Nobuyuki , Shimamoto Kazuaki , Rakugi Hiromi , Ogihara Toshio
Published: February 2006

Background:  Uncoupling protein 2 (UCP2) plays an important role in regulating body weight, energy expenditure and insulin secretion. UCP2 is upregulated in white fat in response to fat feeding, and negatively controls insulin secretion. UCP2 also has a function that protects cells from apoptosis and oxidative stress, which shows UCP2 might be a senescence‐related gene. Previously, UCP2‐866G/A polymorphism in the promoter region has been reported to alter adipose tissue mRNA expression and is associated with obesity in Caucasians.

Methods:  In this study, we investigated the association between this polymorphism and obesity, insulin secretion and hypertension in the general Japanese population.

Results:  The allele frequency of UCP2‐866G/A polymorphism was significantly higher in Japanese subjects compared to Caucasians. It revealed that subjects only in the obese group with the AA type of UCP2‐866G/A polymorphism had significantly higher levels of body mass index (BMI) and waist circumference. Multiple logistic regression analysis showed that this polymorphism was independently associated with waist circumference. This positive association remained in the analysis of the subgroup younger than 65 years, but not in the older group. This polymorphism did not affect levels of insulin and homeostasis model assessment ratio (HOMA‐R).

Conclusions:  These results suggest that the AA type of UCP2‐866G/A polymorphism is related to abdominal obesity, which indicates the possible role of this polymorphism in causing metabolic syndromes.
Endocrinological aspects of aging: Adaptation to and acceleration of aging by the endocrine system
Authors: Hashizume Kiyoshi , Suzuki Satoru , Takeda Teiji , Shigematsu Satoshi , Ichikawa Kazuo , Koizumi Yoichi
Published: February 2006

Endocrinological functions of aging subjects deviate from those of young subjects during the aging process. There are two types of deviation expressed as: (i) an adaptation to the aging process; and (ii) an acceleration of aging. The former includes hyperparathyroidism, hyperglycemia and hyperinsulinemia. The latter includes growth hormone resistance and low‐T3 syndrome. Excess adaptation promotes the metabolic syndrome. Excess acceleration of aging easily leads subjects to mental disorder and death. In order to prevent subjects from both excess adaptation to and excess acceleration of aging, endocrinological intervention is required.
Henoch–Schonlein purpura as a complication of a myelodysplastic syndrome
Authors: Feldman Jacob , Benchetrit Sydney , Gichka Anna , Chernes Relu , Alterman Peter , Bernheim Joelle , Korzets Ze’ev
Published: February 2006

Henoch–Schonlein purpura (HSP) is considered as a small blood vessel systemic vasculitis. We describe a 78‐year‐old female, known to suffer from a myelodysplastic syndrome (MDS), who developed HSP with renal involvement. The ensuing decline in kidney function progressed to the point where the patient required dialysis. Surprisingly, renal biopsy did not show crescentic glomerulonephritis. MDS, essentially a hematological disorder of the elderly, has been associated with various autoimmune diseases including vasculitis, predominantly cutaneous. Our patient, however, is only the third reported in whom the combination of MDS with HSP was found. The occurrence of HSP in our patient with underlying MDS may represent a paraneoplastic phenomenon.
Depressive symptoms are associated with both immune suppression and leucocytosis among elderly with acute hospitalization
Authors: German Larissa , Gidron Yori , Shahar Avner , Yirmiyahu Tikva , Castel Hanna , Harman‐Boehm Ilana , Shahar Danit R
Published: February 2006

Background:  The relation between immune parameters and depression has been inconsistent, with some studies reporting immunosuppression while others reporting excessive immune responses in depressed people. This topic has not been extensively studied in the elderly, nor have researchers attempted to examine it in a non‐linear manner, given previously observed contrasting findings.

Objective:  To examine the non‐linear relation between initial white blood cell count (WBC) and depressive symptoms among acutely hospitalized elderly people.

Methods:  The investigation was designed as a cross‐sectional analysis within a longitudinal study. Two‐hundred and four patients aged 65 and above (60.3% men), admitted to internal medicine at the Soroka University Medical Center, Israel, were recruited for this study. Depression was assessed using the total 30‐item Geriatric Depression Scale (GDS). WBC was obtained from medical records as well as demographic data, diagnoses and medications, and nutritional status was assessed also with self‐report. To analyze a non‐linear relation, we trichotomized WBC levels into low (< 6000), normal (≥ 6000 to ≤ 10 000) and high (> 10 000).

Results:  The prevalence of depression (GDS > 10) was 26.5%. GDS scores were significantly higher among patients with low and high WBC (P < 0.005) than in patients with normal WBC levels. After adjustment for sex, education, nutritional status and diagnoses of arthritis and gastrointestinal diseases, this non‐linear relation remained significant (P < 0.05). Finally, 40.5%, 17.1% and 37% of patients with low, normal and high WBC, respectively, were categorically depressed (P < 0.003).

Conclusions:  Our findings suggest that depressive symptoms are associated with immunological dysregulation among hospitalized elderly patients with an acute illness. Future studies need to identify which elements of the immune system are suppressed and which are excessively active among depressed elderly people and the health consequences of this immune dysregulation.
Cognitive profiles and response to donepezil treatment in Alzheimer's disease patients
Authors: Shimizu Soichiro , Hanyu Haruo , Sakurai Hirofumi , Iwamoto Toshihiko , Takasaki Masaru
Published: February 2006

Background:  The aim of this study was to determine whether there are certain characteristic neuropsychological profiles, assessed by the Mini‐Mental State Examination (MMSE) at baseline, which predict donepezil treatment response.

Methods:  A total of 112 consecutive outpatients with Alzheimer's disease (AD) were treated with donepezil for 3–4 months. Multiple regression analysis was performed to estimate the relative contributions of individual subscales at baseline to the MMSE change (study point – baseline). To identify the characteristic patterns in cognitive deficits of patients with AD who responded to donepezil therapy, the subscales of the MMSE at baseline of responders and non‐responders were compared.

Results:  Multiple regression analysis revealed that lower scores on attention and calculation, and language function, and a higher scale on orientation (date) are related to an improvement of the MMSE. When an improvement of 4 or more points on the MMSE score was defined as a significant response, responders scored significantly lower than non‐responders on attention and calculation, whereas non‐responders scored significantly lower than responders on memory.

Conclusion:  Our results suggest that individual differences in patterns of neuropsychological impairments may partly contribute to the diversity of the response to donepezil treatment. Although further studies with more detailed neuropsychological tests are needed to confirm our results, the MMSE may add to the prediction of response to donepezil treatment in patients with AD.
Cold drawn steel wires—processing, residual stresses and ductility Part II: Synchrotron and neutron diffraction
Authors: PHELIPPEAU A. , POMMIER S. , ZAKHARCHENKO I. , LEVY‐TUBIANA R. , TSAKALAKOS T. , CLAVEL M. , CROFT M. , ZHONG Z. , PRIOUL C.
Published: February 2006

Cold drawing of steel wires leads to an increase of their mechanical strength and to a drop in their ductility. The increase of their mechanical strength has long been related to the reduction of the various material scales by an intense plastic deformation. Besides, it was discussed in the companion paper that large plastic deformation leads to the loss of the material hardening capabilities and that, in such a case, residual stresses preserve the elongation to failure of wires. Experimental measurements of residual stresses inside the wire have therefore been undertaken. In this paper, lattice parameters as measured using synchrotron diffraction are compared with those calculated using the residual stress fields as determined by the finite‐element method. There is a major disagreement between experimental and numerical results that is too large to be attributed to the errors of the finite‐element analyses. Therefore, neutron diffraction experiments have also been performed. These measurements show that there is a significant variation of the lattice parameter with the drawing level, which is not inherited from residual stresses, and that variation is very sensitive to the cooling rate after processing. It is therefore proposed that cold drawing would induce a phase transformation of the steel, possibly a martensitic transformation.
Mechanism for blockade of angiotensin subtype 1 receptors to lower plasma glucose in streptozotocin‐induced diabetic rats
Authors: Chan P. , Liu I.‐M. , Tzeng T.‐F. , Yang T.‐L. , Cheng J.‐T.
Published: February 2006

Aims:  We investigated the mechanism(s) by which valsartan, a selective antagonist of angiotensin subtype 1 (AT1) receptor, decreased plasma glucose in streptozotocin (STZ)‐induced diabetic rats.

Methods:  The plasma glucose concentration was assessed by the glucose oxidase method. The concentration of β‐endorphin in plasma or medium incubating adrenal medulla was measured using an enzyme‐linked immunosorbent assay. The mRNA levels of the subtype 4 form of glucose transporter (GLUT4) in soleus muscle and phosphoenolpyruvate carboxykinase (PEPCK) in the liver were detected by Northern blotting analysis, while the protein levels of GLUT4 in isolated soleus muscle and hepatic PEPCK were investigated using Western blotting analysis.

Results:  A single intravenous injection of valsartan dose‐dependently increased plasma β‐endorphin‐like immunoreactivity (BER) in parallel with the lowering of plasma glucose concentration in STZ‐induced diabetic rats. Naloxone and naloxonazine inhibited the plasma glucose‐lowering action of valsartan at doses sufficient to block opioid µ‐receptors. In contrast to its action in wild‐type diabetic mice, valsartan failed to modify plasma glucose in opioid µ‐receptor knockout diabetic mice. Bilateral adrenalectomy in STZ‐induced diabetic rats eliminated both the plasma glucose‐lowering action and the plasma BER‐elevating action of valsartan. In the isolated adrenal medulla of STZ‐induced diabetic rats, angiotensin II (Ang II) or valsartan did not affect spontaneous BER secretion. Activation of cholinergic receptors by 1.0 µmol/l acetylcholine (ACh) enhanced BER secretion from the isolated adrenal medulla of STZ‐induced diabetic rats, but not in the presence of 1.0 nmol/l Ang II, while valsartan reversed this inhibition by Ang II in a concentration‐dependent manner. Treatment of STZ‐induced diabetic rats with valsartan (0.2 mg/kg) three times daily for 3 days resulted in an increase in gene expression of GLUT4 in soleus muscle and impeded the reduction of elevated mRNA or protein level of hepatic PEPCK. Both of these effects were blocked by opioid µ‐receptor antagonist.

Conclusions:  The results suggest that blockade of AT1 receptor by valsartan may enhance the adrenal β‐endorphin secretion induced by ACh, activating the opioid µ‐receptors to increase glucose utilization and/or to decrease hepatic gluconeogenesis, resulting in the reduction of plasma glucose in STZ‐induced diabetic rats.
Novel insulin analogues and its mitogenic potential
Authors: Zib Ivana , Raskin Philip
Published: February 2006

Abstract:  Insulin analogues were developed to modify the structure of the human insulin molecule in order to more accurately approximate the endogenous secretion of insulin. With the help of recombinant technology and site‐directed mutagenesis, the insulin molecule can be modified to either delay or shorten absorption time, providing better insulin treatment options and facilitating the achievement of glycaemic goals. Changing the structure of the insulin molecule, however, may significantly alter both its metabolic and mitogenic activity. Multiple factors such as residence time on the receptor, dissociation rate, rate of receptor internalization and the degree of phosphorylation of signalling proteins can affect the mitogenic potencies of insulin analogues.

Changes in the structure of the insulin have raised concern about the safety of the insulin analogues. For example, questions have emerged about the relationship between the use of insulin lispro and insulin glargine and the progression of diabetic retinopathy. Two studies have shown progression of retinopathy with the use of insulin lispro. However, others have not confirmed these results, and causality could not be proven as progression of retinopathy can occur with rapid improvement in glycaemic control, and methods of assessments among studies were not consistent.

Therefore, we examine the metabolic and mitogenic characteristics of the three insulin analogues, insulin lispro, insulin aspart and insulin glargine, that are currently on the market, as well as the two insulin analogues, insulin glulisine and insulin detemir, that are soon going to be available for clinical use.
Efficacy of two chondroitin sulfate ophthalmic solutions in the therapy of spontaneous chronic corneal epithelial defects and ulcerative keratitis associated with bullous keratopathy in dogs
Authors: Ledbetter Eric C. , Munger Robert J. , Ring Rachel D. , Scarlett Janet M.
Published: February 2006

Objective  To determine the efficacy of two antimicrobial‐chondroitin sulfate ophthalmic solutions in the therapy of spontaneous chronic corneal epithelial defects (SCCED) and ulcerative keratitis associated with bullous keratopathy in dogs.

Animals Studied  Eighty dogs with SCCED and 14 dogs with ulcerative keratitis associated with bullous keratopathy.

Procedure  Following manual debridement of nonadherent epithelium, dogs were treated topically with a chondroitin sulfate ophthalmic solution containing either tobramycin or ciprofloxacin. Patients were re‐evaluated at 2‐week intervals for 4 weeks.

Results  After 2 weeks of treatment, 53.6% of eyes with SCCED and 17.6% of eyes with ulcerative keratitis associated with bullous keratopathy had healed. After 4 weeks of treatment, 81.0% of eyes with SCCED and 23.5% of eyes with ulcerative keratitis associated with bullous keratopathy had healed. There were no statistically significant differences in healing percentages between the tobramycin‐chondroitin sulfate solution treatment groups and the ciprofloxacin‐chondroitin sulfate solution treatment groups. Two dogs with SCCED, one treated with the tobramycin‐chondroitin sulfate solution and the other treated with the ciprofloxacin‐chondroitin sulfate solution, developed sterile corneal stromal abscesses during the study.

Conclusions Topical therapy with an antimicrobial‐chondroitin sulfate ophthalmic solution combined with manual debridement of nonadherent epithelium compares favorably with other published medical and surgical therapies for SCCED; however, these compounds are only equivocally more effective than therapy with manual debridement alone. These solutions appear to be ineffective in the treatment of ulcerative keratitis associated with bullous keratopathy.

 The significance of the two cases of corneal stromal abscessation is unknown at this time and warrants further investigation.
Dacryocystomaxillorhinostomy for chronic dacryocystitis in a dog
Authors: Giuliano Elizabeth A. , Pope Eric R. , Champagne Erin S. , Moore Cecil P.
Published: February 2006

A 10‐year‐old female spayed Vizsla had intermittent mucoid ocular discharge from the right eye for 7 years. History, clinical findings, imaging studies, and culture and histopathology results confirmed chronic dacryocystitis with granuloma. A dacryocystomaxillorhinostomy was performed to preserve the functional portions of the nasolacrimal system remaining in this patient, as well as to promote healing of the lacrimal sac granuloma and secondary infection. Complete resolution of the clinical abnormalities was achieved, and the dog remains healthy 3 years postoperatively.
The phenol red thread tear test in large Psittaciformes
Authors: Holt Elaine , Rosenthal Karen , Shofer Frances S.
Published: February 2006

Objective To develop a standard method for measuring tear production in large Psittaciformes using the phenol red thread (PRT) tear test. To establish mean PRT tear test values in clinically normal pet birds and to assess the reproducibility of the test.

Animals Two geographically distinct populations of healthy, large Psittaciformes (pilot study and study population). Species groups include: cockatoo (17), macaw (22), Amazon (10), African gray (1), eclectus (1) and pionus (1).

Procedure The PRT was placed under the upper eyelid and both eyelids were held closed throughout the test. The PRT tear test was repeated after 2 months in the pilot study and after approximately 5 min in the study population.

Results The mean PRT tear test values for the pilot study were OD = 28.2 mm/15 s (± 6.3 mm), OS = 24.1 mm/15 s (± 6.6 mm) and OD = 25.4 mm/15 s (± 3.3 mm), OS = 25.5 mm/15 s (± 5.2 mm), for the first and second visits respectively. The mean PRT tear test value for the study population was: OD = 19.8 mm/15 s (± 4.3 mm), OS = 20.1 (± 3.9 mm) and OD = 20.0 mm/15 s (± 4.5 mm), OS = 19.1 mm/15 s (± 3.3 mm), for the first and second tests respectively. There was poor repeatability between tests.

Conclusions and clinical relevance Results suggest that the PRT tear test is a practical method for measuring tear production in large Psittaciformes, although adaptations to the established diagnostic method are necessary to overcome some anatomical differences present in birds. Good reproducibility of the PRT tear test could not be demonstrated in a clinically normal population of birds but geographic location appears to significantly influence results.
Combination of phosphodiesterase‐5 inhibitors and α‐blockers in patients with benign prostatic hyperplasia: treatments of lower urinary tract symptoms, erectile dysfunction, or both?
Authors: CARSON CULLEY C.
Published: February 2006

As the prevalence of both erectile dysfunction (ED) and lower urinary tract symptoms (LUTS) increases with age, physicians could be in the position to manage these two conditions simultaneously. Moreover, medical therapies for either one of these conditions can affect the other and this should be carefully considered when making treatment decisions. Pharmacotherapy for benign prostatic hyperplasia (BPH)/LUTS can cause side‐ effects affecting sexual function. Hence, 5α‐reductase inhibitors such as finasteride and dutasteride are associated with a greater risk of ED, ejaculatory disorders (EjD) and decreased libido than is placebo. Among α1‐adrenergic blockers, tamsulosin is associated with an increased risk of EjD. However, some α1‐adrenergic blockers can also have a positive impact on erection. This is the case for alfuzosin, which has been shown to enhance erectile function in experimental models, probably by reducing the sympathetic tone and thus relaxing corpus cavernosum smooth muscle cells. Phosphodiesterase 5 (PDE‐5) inhibitors are commonly used to treat ED. There is increasing evidence that they might also have a beneficial effect on LUTS, probably through the nitric‐oxide pathway. Nitric oxide is an important mediator of the relaxation of isolated bladder and urethral smooth muscle, and could modulate prostatic smooth muscle tone. α1‐adrenergic blockers and PDE‐5 inhibitors can therefore have a positive impact on both ED and LUTS. Although placebo‐controlled studies are needed to confirm the impact of these drugs, alone or combined, on both ED and LUTS, this reinforces the need for a common approach to managing these two highly prevalent and bothersome conditions.
From British Colony to American Satellite? Australia and the USA during the Cold War
Authors: McLean David
Published: February 2006

This article challenges the widely‐accepted view that Australia's strategic relationship with the USA during the period 1945–69 thwarted the full development of Australian nationhood and, in so doing, formed an obstacle to Australia's accommodation with its region. It argues that the most influential perspectives on the subject place too much emphasis on the 1940s as a watershed in Australian foreign policy history, exaggerate differences between Labor and conservative policies, fail to appreciate that the pursuit of Australian interests was central to Australian policy during this period, and exaggerate the limitations that ANZUS imposed upon Australian freedom of action. Not a thwarted nationalism but flawed understanding of the limitations and possibilities of the US alliance as a vehicle for Australian interests shaped Australian government policies during this period.
Separatism or Status‐Quo?: Indigenous Affairs from the Birth of Land Rights to the Death of ATSIC*
Authors: Bradfield Stuart
Published: February 2006

Unlike other settler societies, Australia has yet to recognise Indigenous peoples as “peoples” or “nations”. Despite this, we see something of a consensus emerging which suggests Indigenous “separatism” has been tried and failed in Australia, and it is time to revisit an integrationist approach in order to improve Indigenous peoples' socio‐economic position. This paper challenges the assumption that, beginning in the 1970s, Indigenous‐state relations have been characterised by the realisation of a separatist agenda. On the contrary, assessing three decades of Indigenous‐state relations reveals a consistent logic from the state which ultimately seeks to integrate Indigenous Australians, rather than recognise them as having a distinct — and separate — political identity. This logic reached its “natural” conclusion with the abolition of elected Indigenous political representation in 2005.
Attention and Eye Movements in Reading
Authors: Weger Ulrich W. , Inhoff Albrecht W.
Published: February 2006

A spatial cuing task was used to identify two types of readers, those with a relatively fast and those with a relatively slow buildup of inhibition of return (IOR). Backward-directed eye movements (regressions) during sentence reading were then examined as a function of the two IOR types. The results revealed that readers with fast IOR executed larger regressions than readers with slow IOR, as they directed the eyes away from the most recently attended area of text. Forward-directed eye movements (saccades), by contrast, were not a function of IOR type. Ease of sentence comprehension influenced the size of regressions, but this effect was also independent of IOR type. Multiple mechanisms of spatial attention, including IOR, bias eye movements toward upcoming words in the text during reading.
Visual Control of Action Without Retinal Optic Flow
Authors: Loomis Jack M. , Beall Andrew C. , Macuga Kristen L. , Kelly Jonathan W. , Smith Roy S.
Published: February 2006

In everyday life, the optic flow associated with the performance of complex actions, like walking through a field of obstacles and catching a ball, entails retinal flow with motion energy (first-order motion). We report the results of four complex action tasks performed in virtual environments without any retinal motion energy. Specifically, we used dynamic random-dot stereograms with single-frame lifetimes (cyclopean stimuli) such that in neither eye was there retinal motion energy or other monocular information about the actions being performed. Performance on the four tasks with the cyclopean stimuli was comparable to performance with luminance stimuli, which do provide retinal optic flow. The near equivalence of the two types of stimuli indicates that if optic flow is involved in the control of action, it is not tied to first-order retinal motion.
Visual Selective Attention and the Effects of Monetary Rewards
Authors: Libera Chiara Della , Chelazzi Leonardo
Published: February 2006

Outcomes of actions, in the form of rewards and punishments, are known to shape behavior. For example, an action followed by reward will be more readily elicited on subsequent encounters with the same stimuli and context—a phenomenon known as the law of effect. These consequences of rewards (and punishments) are important because they reinforce adaptive behaviors at the expense of competing ones, thus increasing fitness of the organism in its environment. However, it is unknown whether similar influences regulate covert mental processes, such as visual selective attention. Visual selective attention allows privileged processing of task-relevant information, while inhibiting distracting contextual elements. Using variable monetary rewards as arbitrary feedback on performance, we tested whether acts of attentional selection, and in particular the resulting aftereffects, can be modulated by their consequences. Results show that the efficacy of visual selective attention can be sensibly adjusted by external feedback. Specifically, although lingering inhibition of distractors is robust after highly rewarded selections, it is eliminated after poorly rewarded selections. This powerful feature of visual selective attention provides attentive processes with both flexibility and self-regulation properties.
Central Interference in Driving
Authors: Levy Jonathan , Pashler Harold , Boer Erwin
Published: February 2006

Participants attempted to perform two tasks concurrently during simulated driving. In the choice task, they responded either manually or vocally to the number of times a visual or auditory stimulus occurred; in the braking task, they depressed a brake pedal in response to the lead car's brake lights. The time delay between the onset of the tasks' stimuli, or stimulus onset asynchrony (SOA), was varied. The tasks were differentially affected by the manipulations. Brake reaction times increased as SOA was reduced, showing the psychological refractory period effect, whereas the choice task showed large effects of the stimulus and response modalities but only a small effect of SOA. These results demonstrate that a well-practiced “simple” task such as vehicle braking is subject to dual-task slowing and extend the generality of the central-bottleneck model.
The Influence of Facial Feedback on Race Bias
Authors: Ito Tiffany A. , Chiao Krystal W. , Devine Patricia G. , Lorig Tyler S. , Cacioppo John T.
Published: February 2006

Two studies were conducted to examine whether facial feedback can modulate implicit racial bias as assessed by the Implicit Association Test (IAT). Participants were surreptitiously induced to smile through holding a pencil in their mouth while viewing photographs of unfamiliar Black or White males or performed no somatic configuration while viewing the photographs (Study 1 only). All participants then completed the IAT with no facial manipulation. Results revealed a spreading attitude effect, with significantly less racial bias against Blacks among participants surreptitiously induced to smile during prior viewing of Black faces than among participants surreptitiously induced to smile during prior viewing of White faces.
Islamic Legal, Ethical, and Political Theory: The Search for the Good Society and the Moral Law
Authors: Anderson Owen
Published: February 2006

Book reviewed:

Standing Trial: Law and the Person in the Modern Middle East, Baudouin Dupret (ed.), I.B. Tauris 2004 (1‐86064‐997‐1), x + 382 pp., $75.00

Muslim Ethics: Emerging Vistas, Amyn B. Sajoo, I.B. Tauris 2004 (1‐85043‐550‐2), xvi + 164 pp., $39.50
History of the United Church of Christ
Authors: Gros Jeffrey
Published: February 2006

Book reviewed:

The Living Theological Heritage of the United Church of Christ, Barbara Brown Zikmund (ed.), Pilgrim Press 1995–2005. Vols I–VII

Ancient and Medieval Legacies, Vol. I, Richard Ulrich (ed.), Pilgrim Press 1995 (0‐8298‐1064‐1), 583 pp., $60.00

Reformation Roots, Vol. II, John Payne (ed.), Pilgrim Press 1997 (0‐8298‐1143‐5), xii + 683 pp., $60.00

Colonial and National Beginnings, Vol. III, Charles Hambrick‐Stowe (ed.), Pilgrim Press 1998 (0‐8298‐1113‐3), x + 518 pp., $60.00

Consolidation and Expansion, Vol. IV, Elizabeth Nordbeck, Lowell Zuck (eds), Pilgrim Press 1999 (0‐8298‐1110‐9), xvi + 668 pp., $60.00

Outreach and Diversity, Vol. V, Margaret Lamberts Bendroth, Lawrence Jones, Robert Schneider (eds), Pilgrim Press 2000 (0‐8298‐1111‐7), xiv + 536 pp., $60.00

Growing Toward Unity, Vol. VI, Elsabeth Slaughter Hilke (ed.), Pilgrim Press 2001 (0‐8298‐1112‐5), xvi + 744 pp., $70.00

United and Uniting, Vol. VII, Frederick Trost, Barbara Brown Zikmund (eds), Pilgrim Press 2005 (0‐8298‐1113‐3), xx + 828 pp., $70.00
The Marriage of Archaeology and Religion
Authors: Bunta Silviu
Published: February 2006

Book reviewed:

Did God Have a Wife? Archaeology and Folk Religion in Ancient Israel, William G. Dever, William B. Eerdmans Publishing Company 2005 (0‐8028‐2852‐3), hardcover, xvi + 344 pp., Hb £15.95/$25
Long‐term safety and efficacy of poly‐L‐lactic acid in the treatment of HIV‐related facial lipoatrophy
Authors: Moyle GJ , Brown S , Lysakova L , Barton SE
Published: February 2006

Objective

We evaluated the long‐term safety and efficacy of injectable poly‐L‐lactic acid (PLLA) for the correction of facial lipoatrophy.

Methods

This was a randomized, open‐label, comparative, single‐centre study of injected PLLA in patients with HIV‐related facial lipoatrophy. Thirty subjects were randomized to immediate or delayed PLLA treatments, administered as three sets of bilateral injections, 2 weeks apart, into the deep dermis above the buccal fat pad. Week 24 results have been published previously (Moyle et al, HIV Medicine 2004, Vol. 5, pp. 82–87). Long‐term efficacy was assessed at a recall visit using visual analogue scales (VASs) to record patient satisfaction, and by the Hospital Anxiety and Depression Scale (HADS). Patients also reported any adverse events (AEs) during the treatment period and at the recall visit.

Results

Twenty‐seven patients returned for the recall visit, a minimum of 18 months post final study treatment. Fourteen of these patients were excluded from the recall visit because of additional treatment with PLLA. Improvements in VAS scores for facial appearance were sustained from baseline to the recall visit in both randomization groups (P<0.05 and P<0.001). Trends in improvement in HADS scores were also noted, with patients in the delayed group experiencing significant improvements in depressive symptoms (P<0.05). One case of injection‐site induration and nine cases of injection‐site nodules were noted at the recall visit, none of which was described as serious or severe.

Conclusions

Physical and psychological benefits of PLLA are sustained over at least 18 months. Delayed AEs include mild nodularity at the treatment site.
Effects of nandrolone decanoate compared with placebo or testosterone on HIV‐associated wasting
Authors: Gold J , Batterham MJ , Rekers H , Harms MK , Geurts TBP , Helmyr PME , Silva de Mendonça J , Falleiros Carvalho LH , Panos G , Pinchera A , Aiuti F , Lee C , Horban A , Gatell J , Phanuphak P , Prasithsirikul W , Gazzard B , Bloch M , Danner SA
Published: February 2006

Objectives

Current research is unclear about the most effective pharmacological agents for managing the loss of weight and fat‐free mass common in HIV/AIDS. The aim of this study was to compare nandrolone decanoate with placebo and testosterone.

Methods

The study was a multicentre randomized double‐blind placebo‐controlled trial. Three hundred and three adult HIV‐positive male patients with a weight loss of 5–15% in the last 12 months, or a body mass index of 17–19 kg/m2, or a body cell mass/height ratio lower than 13.5 kg/m, were randomly assigned to receive nandrolone decanoate (150 mg), testosterone (250 mg) or placebo intramuscularly every 2 weeks for 12 weeks. Fat‐free mass, weight, immune markers and perception of treatment were the main outcome measures.

Results

Treatment with nandrolone resulted in significantly greater increases in fat‐free mass [mean increase 1.34 kg; 95% confidence interval (CI) 0.60; 2.08 kg] and in weight (mean increase 1.48 kg; 95% CI 0.82; 2.14 kg) compared with placebo. The mean increase in weight with nandrolone of 1.00 kg (95% CI 0.27; 1.74 kg) when compared with testosterone was significant, although the difference in fat free mass did not reach significance (mean increase 0.69 kg; 95% CI–0.13; 1.51 kg). Patient perception of benefit was significantly greater in the nandrolone group when compared with both the placebo and the testosterone groups.

Conclusions

Treatment with nandrolone decanoate increased body weight when compared with placebo and testosterone. Nandrolone decanoate treatment resulted in greater increases in fat‐free mass than placebo and demonstrated a trend for a significant increase when compared with testosterone.