bluuebunny/crossref_metadata_2025 huggingface dataset:
Gabapentin: Can It Be Misused?
Authors: Howland Robert H.
Published: February 2014

Gabapentin, a gamma-aminobutyric acid analog drug, appears to be safe and efficacious for the treatment of alcohol dependence. Gabapentin is not a controlled drug, but there are anecdotal reports of its misuse and abuse as well as reports of withdrawal symptoms associated with abrupt discontinuation. The risk of gabapentin misuse is inconsistent, the magnitude of the risk is small, and the risk is not comparable to the much higher risks associated with alcohol use; benzodiazepine, opioid, and stimulant drug use; or illicit drug use. Reports of gabapentin misuse are not unique to this drug, as misuse of prescription medications not typically considered “drugs of abuse” can also occur. [
Journal of Psychosocial Nursing and Mental Health Services, 52
(1), 12–15.]
Moving Beyond Caregiver Burden: Identifying Helpful Interventions for Family Caregivers
Authors: Sorrell Jeanne M.
Published: February 2014

Family members serving as informal caregivers for loved ones often experience physical, psychological, emotional, social, and financial consequences that can be conceptualized as caregiver burden. As the number of older adults in our society continues to increase, there will be even more demand for family caregivers. It is important to move beyond a focus on the statistics and characteristics of caregiver burden and identify helpful interventions to reduce this burden. Interventions that decrease caregiver burden can enable family caregivers to delay placement of the individual in an institutional setting and improve quality of life for both the caregiver and care recipient. [
Journal of Psychosocial Nursing and Mental Health Services, 52
(3), 15–18.]
Afghanistan and Iraq War Veterans’ Health Care Needs and Their Underuse of Health Care Resources: Implications for Psychiatric-Mental Health Nurses
Authors: Nworah Uchenna , Symes Lene , Young Anne , Langford Rae
Published: February 2014

U.S. Veterans who have served in the Afghanistan and Iraq wars have combat-related medical and mental health issues, notably posttraumatic stress disorder and traumatic brain injury, but underuse health care resources. To better understand their health care needs, resource use, and facilitators and barriers to seeking health care, a literature review was conducted. The results suggest high prevalence of mental and medical health issues and disproportionate use of quantitative research design that lacked approaches to understanding the psychosocial, cultural, and contextual factors that affect help-seeking by Veterans. Strategies to increase the likelihood that Veterans will seek needed health care, gaps in the literature, and the need for further research are discussed. [
Journal of Psychosocial Nursing and Mental Health Services, 52
(6), 42–49.]
Visual Outcomes of a Trifocal Aspheric Diffractive Intraocular Lens With Microincision Cataract Surgery
Authors: Alió Jorge L. , Montalbán Raúl , Peña-García Pablo , Soria Felipe A. , Vega-Estrada Alfredo
Published: February 2014

PURPOSE:

To evaluate the visual outcomes of patients with a new diffractive trifocal intraocular lens (IOL).

METHODS:

A trifocal diffractive Fine Vision IOL (Physiol, Liege, Belgium) was implanted after microincision cataract surgery (MICS) in 40 eyes of 20 patients with bilateral cataract. The monocular and binocular visual performance and the refractive status were assessed, as well as the defocus curve and contrast sensitivity at 1 and 6 months postoperatively.

RESULTS:

The monocular visual outcomes (logMAR) at 6 months postoperatively were uncorrected distance visual acuity 0.18 ± 0.13, uncorrected near visual acuity 0.26 ± 0.15, and uncorrected intermediate visual acuity 0.20 ± 0.11. With the best distance correction, the visual outcomes were 0.05 ± 0.06 for corrected distance visual acuity, 0.16 ± 0.13 for distance corrected near visual acuity, and 0.17 ± 0.09 for distance corrected intermediate visual acuity. Binocular defocus curve at 6 months shows a wide range of useful vision with 0.19 ± 0.08 (logMAR) at −1.50 diopter defocus. The monocular contrast sensitivity under scotopic conditions (3 cd/m
2
) was within normal range for a population older than 60 years.

CONCLUSION:

The trifocal Fine Vision IOL can restore vision at different distances after cataract surgery, specifically intermediate and near vision.

[
J Refract Surg.
2013;29(11):756–761.]
Multi-Component Adjustable Intraocular Lenses: A New Concept in Pediatric Cataract Surgery
Authors: Portaliou Dimitra M. , Kymionis George D. , Pallikaris Ioannis G.
Published: February 2014

PURPOSE:

The multi-component intraocular lens (IOL) (IVO; SAS, Strasbourg, France) is a novel approach to the treatment of pediatric cataract. Because the refractive requirements for pediatric eyes often change over time, current IOL technology does not easily allow refractive adjustments after the primary surgical intervention. The multi-component IOL concept allows easy, surgical refractive adjustments to the initial surgical implantation at any postoperative time period. Thus, both surgical implantation and enhancement surgery have been successfully accomplished in adult patients.

METHODS:

A novel surgical approach to pediatric cataract surgery is described. At the time of the primary surgery, a two component IOL was implanted. At any postoperative time period, the front lens component, located in front of the capsular bag, could be easily surgically exchanged because the dioptric power requirements of the pediatric eye changed over time.

RESULTS:

Both primary and enhancement surgeries have been done in adult patients with good results. Implantations have occurred uneventfully in all cases with no intraoperative or postoperative complications. There was no statistically significant difference in the endothelial cell density, anterior chamber depth, and pachymetry readings preoperatively and 2 years postoperatively. There was no interlenticular fibrosis present.

CONCLUSION:

The multi-component IOL should provide a unique and greatly needed surgically adjustable approach to the treatment of pediatric cataract.

[
J Refract Surg.
2014;30(1):62–66.]
Four-Year Visual, Refractive, and Contrast Sensitivity Outcomes After Wavefront-Guided Myopic LASIK Using an Advanced Excimer Laser Platform
Authors: Shaheen Mohamed Shafik , Massoud Tamer Hamdy , Ezzeldin Hani , Khalifa Mounir Ahmed
Published: February 2014

PURPOSE:

To evaluate the 4-year visual, refractive, and contrast sensitivity outcomes of wavefront-guided LASIK for the correction of low to moderate myopia using the VISX CustomVue technology (Abbott Medical Optics, Inc., Santa Ana, CA).

METHODS:

This was a prospective study including 255 consecutive eyes of 145 patients (age range: 19 to 55 years) with low to moderate myopia (mean spherical equivalent: −3.36 ± 1.71 diopters [D]) undergoing laser refractive surgery. Wavefront-guided LASIK was performed in all eyes using the VISX STAR S4 IR excimer laser platform and the CustomVue procedure for the ablation profile design. Visual, refractive, and contrast sensitivity changes were evaluated during a 4-year follow-up period.

RESULTS:

Postoperative logMAR uncorrected distance visual acuity was 0.1 or better (20/25 Snellen) in 98.0% and 100% of eyes at 1 and 4 years, respectively. At 4 years postoperatively, mean spherical equivalent was reduced significantly to a mean value of −0.22 ± 0.28 D (
P
< .01), with 97.3% of eyes with a spherical equivalent within ±0.50 D. The astigmatic power vector component J
0
of manifest refraction was also reduced significantly (
P
< .01). Postoperative logMAR corrected distance visual acuity was 0.0 or better (20/20 Snellen) in 96.1% and 98.8% of eyes at 1 and 4 years, respectively. Improvement in contrast sensitivity was observed in some spatial frequencies between 1 and 4 years postoperatively. No significant correlations were found between 4-year contrast sensitivity and corrected distance visual acuity (0.024 ⩽
r
⩽ −0.120,
P
⩾ .06).

CONCLUSION:

Wavefront-guided LASIK using the VISX CustomVue technology provides an effective and predictable correction of low to moderate myopia in the long term, preserving the patient’s visual acuity and quality.

[
J Refract Surg.
2013;29(12):816–822.]
Early Clinical Outcomes of Wavefront-Guided Myopic LASIK Treatments Using a New-Generation Hartmann-Shack Aberrometer
Authors: Schallhorn Steven , Brown Mitch , Venter Jan , Teenan David , Hettinger Keith , Yamamoto Hiromi
Published: February 2014

PURPOSE:

To provide an initial retrospective evaluation of early postoperative outcomes after wavefront-guided myopic LASIK using a new-generation Hartmann-Shack wavefront sensor.

METHODS:

A noncomparative, retrospective study of 243 eyes of 126 patients that underwent primary wavefront-guided LASIK, using wavefront data obtained with a new Hartmann-Shack aberrometer (iDesign Advanced WaveScan aberrometer; Abbott Medical Optics, Inc., Santa Ana, CA). Visual acuity, refraction, and patient satisfaction were evaluated 1 month after surgery.

RESULTS:

The manifest spherical equivalent was reduced from −3.28 ± 1.79 diopters (D) (range: −9.88 to −0.38 D) before surgery to −0.03 ± 0.29 D (range: −1.00 to +1.25 D) 1 month after surgery. The manifest spherical equivalent was within 0.50 and 1.00 D of target in 93.0% and 99.6% of eyes, respectively. Manifest astigmatism preoperatively (−0.72 ± 0.67 [range: 0.0 to −5.00 D]) was reduced to −0.14 ± 0.20 (range: 0.0 to −1.00 D) at 1 month and the vector-derived correction ratio (surgically induced refractive change/intended refractive correction) was 1.02 ± 0.30. Uncorrected distance visual acuity of 20/16, 20/20, and 20/25 or better was achieved in 79.0%, 93.4%, and 96.7% of eyes, respectively. No eyes lost two or more lines of corrected distance visual acuity, whereas a gain of one or more lines was observed in 14.0%. Most patients (98.5%) reported that they were satisfied with the outcome of their procedure.

CONCLUSIONS:

Wavefront-guided LASIK using the new aberrometer in this retrospective evaluation was effective, safe, and predictable in the early postoperative time period for the correction of myopia with high patient satisfaction.

[
J Refract Surg.
2014;30(1):14–21.]
Prospective Randomized Contralateral Eye Evaluation of Subjective Quality of Vision After Wavefront-Guided or Wavefront-Optimized Photorefractive Keratectomy
Authors: He Lingmin , Manche Edward E.
Published: February 2014

PURPOSE:

To compare the effect of wavefront-guided (WFG) and wavefront-optimized (WFO) photorefractive keratectomy (PRK) on patient perceived quality of vision.

METHODS:

Seventy-one patients (142 eyes) were enrolled in this prospective, randomized, fellow eye controlled study. One eye was randomized to undergo WFG PRK treatment by the AMO Visx CustomVue S4 IR excimer laser system (Abbott Medical Optics, Inc., Santa Clara, CA) and the fellow eye received WFO PRK treatment by the Alcon Allegretto Wave Eye-Q 400 Hz excimer laser system (Alcon Laboratories, Inc., Fort Worth, TX). Patients answered questionnaires on their visual symptoms and quality of vision preoperatively and at 1, 3, 6, and 12 months after surgery.

RESULTS:

Patients in both groups reported better vision compared to baseline from 3 months onward (mean change in score of 1.56 to 2.51 in the WFO group and 1.54 to 2.28 in the WFG group,
P
⩽ .003). Both groups experienced less nighttime glare from 6 months onward (
P
⩽ .030). Halos, double vision, and visual clarity were initially worse (
P
⩽ .025) but not significantly different after 1 month. Haze and fluctuating vision resolved after 3 months. Visual symptoms were similar between the two groups at all times (
P
⩾ .059) except at 6 months, when patients felt their WFG eyes had more excellent vision (
P
= .029). A composite of all symptoms was also similar between the groups until 12 months when patients had fewer symptoms in their WFO eye (
P
= .044).

CONCLUSIONS:

One year after surgery, patient self-reported visual symptoms were not significantly different in eyes receiving WFG or WFO PRK. However, the average of all symptoms was lower in eyes receiving wavefront-optimized treatment.

[
J Refract Surg.
2014;30(1):6–12.]
Femtosecond Laser Versus Manual Clear Corneal Incision in Cataract Surgery
Authors: Mastropasqua Leonardo , Toto Lisa , Mastropasqua Alessandra , Vecchiarino Luca , Mastropasqua Rodolfo , Pedrotti Emilio , Di Nicola Marta
Published: February 2014

PURPOSE:

To compare functional and morphological outcomes of femtosecond laser clear corneal incision (CCI) versus manual CCI during cataract surgery.

METHODS:

Sixty eyes of 60 patients who underwent CCI during cataract surgery were randomized into two groups: femtosecond laser CCI (30 eyes) and manual CCI (30 eyes).

RESULTS:

There were no significant between-group differences in uncorrected distance visual acuity, corrected distance visual acuity, surgically induced astigmatism, and corneal aberrations. Keratometric astigmatism was significantly lower in the femtosecond laser CCI group compared to the manual CCI group at 30 and 180 days (
P
< .05). Central endothelial cell count was significantly higher in the femtosecond laser CCI group compared to the manual CCI group at 7 and 30 days postoperatively (
P
< .05). A lower increase of corneal thickness at the incision site was observed at 30 and 180 days postoperatively in the femtosecond laser CCI group compared to the manual CCI group (
P
< .05). In addition, femtosecond laser CCI showed a better morphology (lower percentage of endothelial and epithelial gaping and endothelial misalignment) compared to manual CCI at different time points. Total phacoemulsification time was significantly lower in the femtosecond laser CCI group (
P
< .05).

CONCLUSIONS:

The femtosecond laser procedure was safe, efficient, and less damaging, as evidenced by lower central endothelial cell loss, lower increase of corneal thickness at the incision site, and better tunnel morphology compared to the manual technique.

[
J Refract Surg.
2014;30(1):27–33.]
Optical Coherence Tomography Combined With Videokeratography to Differentiate Mild Keratoconus Subtypes
Authors: Rabinowitz Yaron S. , Li Xiaohui , Canedo Ana Laura Caiado , Ambrósio Renato , Bykhovskaya Yelena
Published: February 2014

PURPOSE:

To develop parameters using a combination of optical coherence tomography (OCT) and videokeratography to detect early keratoconus.

METHODS:

Videokeratography, wavefront analysis, and measured OCT indices were performed on 180 normal eyes, 46 eyes with moderate keratoconus, 54 eyes with early keratoconus, 7 eyes with forme fruste keratoconus, and 16 eyes with keratoconus “suspect” to determine the most sensitive parameters for separating these groups.

RESULTS:

A combination of videokeratography and OCT indices (inferior-superior [I-S] value and minimum pachymetry) was statistically the most significant in separating the keratoconus groups from normal eyes (
P
< .001). Using a newly derived index, the minimum pachymetry divided by the I-S value (pachymetry/asymmetry [PA]/I-S index) with a cut-off of 100, 100% of early and forme fruste keratoconus could be identified as being abnormal with 7 normals misclassified (misclassification rate 2.7%). By adding keratoconus “suspect” to the analysis and an I-S value of 1.2 as a cut-off point, 5 “suspects” were classified as normal and 11 normals as abnormal (misclassification rate 7.8%). The PA/I-S index, with a cut-off point of 100, reduced this misclassification rate to 4.4%.

CONCLUSIONS:

These results suggest that OCT combined with videokeratography may be more useful for differentiating mild forms of keratoconus than videokeratography alone.

[
J Refract Surg.
2014;30(2):80–86.]
Primary Posterior Laser-Assisted Capsulotomy
Authors: Dick H. Burkhard , Schultz Tim
Published: February 2014

PURPOSE:

To describe new techniques for performing primary posterior laser-assisted capsulotomy (PLC) to prevent posterior capsule opacification after cataract surgery.

METHODS:

After lens and cortex removal, three different techniques were used to cut the posterior capsule with an image-guided (optical coherence tomography [OCT]) femtosecond laser. Technique 1: Prior to intra-ocular lens (IOL) implantation, the posterior capsule was carefully opened and elevated with ophthalmic viscosurgical device (OVD) whereas the anterior hyaloid surface remains intact. After sterile re-docking, the posterior capsule was cut and removed and followed by IOL implantation. Techniques 2 and 3: After IOL implantation, a thin layer of OVD was injected between the IOL optic and the posterior capsule. After sterile re-docking, Berger’s space and the posterior capsule were identified using OCT and the capsule was cut by the laser. The posterior capsule is located close to the anterior hyaloid membrane in Technique 2 and the posterior capsule is located between the posterior optic surface of the IOL and the anterior hyaloid in Technique 3.

RESULTS:

Technique 1 was performed in 50 PLC cases. All capsulotomies were easy to remove and no complications were observed. Techniques 2 and 3 were performed in 53 of 55 PLC cases. In 45 of these cases (82%), the posterior capsule was localized with open space between the IOL and Berger’s space. In all treated PLC cases, a 360° cut was successfully accomplished.

CONCLUSION:

The described techniques for PLC have the potential to prevent and solve posterior capsule opacification in routine cases.

[
J Refract Surg.
2014;30(2):128–133.]
Haptic Exploration in Elementary School Age Children
Authors: Coté Carol A.
Published: February 2014

Haptic exploration, or active touch, is a perceptual modality that has demonstrated therapeutic potential for elementary age children but is not commonly studied with this age group. The aim of this exploratory study was to discover the characteristics of haptic scanning that are associated with efficiency and accuracy in a shape matching task. The study tasks were designed to resemble common visual perception tests, but in a haptic form using wooden shapes. Children ages 6 years, 6 months to 9 years, 6 months (N = 25), and adults (N = 25) engaged in shape matching tasks that involved either cross-modal (haptic with vision) or unimodal (haptic only) exploration. Video recordings were analyzed and four types of haptic strategies were identified that were significantly related to both age and correctness of response: the simultaneous use of two hands was the highest level and the use of one hand was the lowest. The findings are discussed in terms of attention capacity and ability to use points of reference.
Hollywood Takes on Intellectual/Developmental Disability: Cinematic Representations of Occupational Participation
Authors: Renwick Rebecca , Schormans Ann Fudge , Shore Deborah
Published: February 2014

Adults with intellectual/developmental disability (IDD), and their occupational participation, are vastly under-represented in Hollywood films. Because films often provide individuals' only experience of people with IDD, cinematic representations can influence audience perceptions. Thus, films can help inform public perceptions about desired and appropriate occupational participation for people with IDD, potentially impacting their access to meaningful occupational participation and achievement of occupational potential. Accordingly, this research examined occupational portrayals of adults with IDD in contemporary Hollywood films. Occupational portrayals, as defined here, refer to representations of the dynamic process of the person participating in occupation(s) in a context. Grounded theory methods guided coding and analysis of qualitative data collected from eight contemporary films using an occupation-focused tool. Two major, striking themes emerging from the qualitative analysis—infantilization and simplification of participation in complex occupations (with three associated sub-themes)—are discussed. Implications of the findings and future research directions are considered.
Participation of Young Adults with High-Functioning Autism in Taiwan: A Pilot Study
Authors: Wang Hsin-Yen , Berg Christine
Published: February 2014

This pilot study aimed to investigate the activity participation of young adults with high-functioning autism (HFA) living in Taiwan. Eleven young adults with HFA, their caring adults, and 11 matched typically developing youth were recruited across Taiwan. The Adolescent and Young Adult Participation Sort-Taiwanese version (AYAPS-T) was administered to all three groups to compare the activity participation. In addition, youth with HFA identified activities in which they desired to participate and barriers hindering their participation. The results of this study suggest that youth with H FA had lower participation rates in activities across different domains than their typically developing peers. Youth with HFA were able to identify the activities they desired to do and the barriers hindering their participation. No significant differences in participation were found between the results reported by the caring adults and youth with HFA. Occupational therapy practitioners may work on eliminating the personal and environmental barriers that impede participation as youth with HFA transition out of secondary school.
Social Activity Decreases Risk of Placement in a Long-Term Care Facility for a Prospective Sample of Community-Dwelling Older Adults
Authors: Miller Lyndsey M. , Dieckmann Nathan F. , Mattek Nora C. , Lyons Karen S. , Kaye Jeffrey A.
Published: February 2014

The purpose of this study was to determine the role of modifiable factors in the risk of long-term care (LTC) placement. Using data from a cohort of community-residing older adults (
N
= 189), a secondary analysis was conducted of the contribution of social activity, sleep disturbances, and depressive symptoms to the risk of LTC placement. Analyses controlled for cognitive and functional impairment, age, and medical conditions. Within 5 years, 20% of participants were placed in a LTC facility. Each unit increase in social activity was associated with a 24% decrease in the risk of placement (odds ratio [OR] = 0.763,
p
= 0.001, 95% confidence interval [CI] [0.65, 0.89]). Cognitive impairment (OR = 3.05,
p
= 0.017, 95% CI [1.23, 7.59]), medical conditions (OR = 1.22,
p
= 0.039, 95% CI [1.01, 1.47]), and age (OR = 1.101,
p
= 0.030, 95% CI [1.01, 1.20]) were also significant individual predictors of placement. Although many of the strongest risk factors for placement are not modifiable, older adults who engage in more social activity outside the home may be able to delay transition from independent living.

[Res Gerontol Nurs. 2014; 7(3):106–112.]
Results and Lessons Learned from a Nurse Practitioner-Guided Dementia Care Intervention for Primary Care Patients and Their Family Caregivers
Authors: Fortinsky Richard H. , Delaney Colleen , Harel Ofer , Pasquale Karen , Schjavland Elena , Lynch John , Kleppinger Alison , Crumb Suzanne
Published: February 2014

Older adults with dementia care needs often visit primary care physicians (PCPs), but PCP dementia care limitations are widely documented. This study tested the value of employing a nurse practitioner (NP) with geropsychiatric expertise to augment PCP care for newly and recently diagnosed patients and family caregivers. Twenty-one dyads received the NP intervention; 10 dyads were controls. Outcomes included patient neuropsychiatric symptom and quality of life changes, and caregiver depression, burden, and self-efficacy changes. Intervention acceptability by patients, caregivers, and PCPs was determined. No outcome differences were found; however, the NP intervention was deemed highly satisfactory by all stakeholders. Patients experienced no significant cognitive decline during the 12-month study period, helping explain why outcomes did not change. Given widespread acceptability, future tests of this PCP-enhancing intervention should include patients with more progressive cognitive decline at study entry. NPs with geropsychiatric expertise are ideal interventionists for this rapidly growing target population.

[Res Gerontol Nurs. 2014; 7(3):126–137.]
Nurse and Patient Interaction Behaviors’ Effects on Nursing Care Quality for Mechanically Ventilated Older Adults in the ICU
Authors: Nilsen Marci L. , Sereika Susan M. , Hoffman Leslie A. , Barnato Amber , Donovan Heidi , Happ Mary Beth
Published: February 2014

The study purposes were to (a) describe interaction behaviors and factors that may effect communication and (b) explore associations between interaction behaviors and nursing care quality indicators among 38 mechanically ventilated patients (age ≥60 years) and their intensive care unit nurses (
n
= 24). Behaviors were measured by rating videorecorded observations from the Study of Patient-Nurse Effectiveness with Communication Strategies (SPEACS). Characteristics and quality indicators were obtained from the SPEACS dataset and medical chart abstraction. All positive behaviors occurred at least once. Significant (
p
< 0.05) associations were observed between (a) positive nurse and positive patient behaviors, (b) patient unaided augmentative and alternative communication (AAC) strategies and positive nurse behaviors, (c) individual patient unaided AAC strategies and individual nurse positive behaviors, (d) positive nurse behaviors and pain management, and (e) positive patient behaviors and sedation level. Findings provide evidence that nurse and patient behaviors effect communication and may be associated with nursing care quality.

[Res Gerontol Nurs. 2014; 7(3):113–125.]
Re-evaluating Our Perspective on Retinal Artery Occlusion from Carotid Dissection: A Report of Three Cases and Review of the Literature
Authors: Patel Mrinali , Shah Gaurav , Davies John B. , Mittra Robert A. , Eliott Dean
Published: February 2014

BACKGROUND AND OBJECTIVE:

Retinal artery occlusion from carotid dissection is rare and classically considered a post-traumatic phenomenon occurring in young patients and associated with additional symptoms of dissection such as neck pain, headache, or focal neurological deficits.

PATIENTS AND METHODS:

The authors report three cases of retinal artery occlusion due to carotid artery dissection and briefly review the literature.

RESULTS:

Antecedent trauma or neck injury was reported in only 42% (five of 12) of previously reported cases and in none of the three cases presented here. All three patients in this series initially denied symptoms such as headache or neck pain; however, one patient’s wife later recalled her husband experiencing minor neck soreness several days prior to visual loss. In 17% (two of 12) of previously reported cases, no additional symptoms of carotid dissection were reported.

CONCLUSION:

These cases highlight the importance of considering carotid dissection in young patients with retinal artery occlusion, even in the absence of a report of recent trauma or associated symptoms such as pain.

[
Ophthalmic Surg Lasers Imaging Retina.
2013;44:555–650.]
Surgical Technique: Hand-Over-Hand Retrieval of a Posteriorly Dislocated DSAEK Graft in an Eye With an Iris Reconstruction Lens
Authors: Wells John A. , Aldave Anthony J. , Tsui Irena
Published: February 2014

Descemet’s stripping automated endothelial keratoplasty (DSAEK) has become the preferred surgical treatment for corneal endothelial pathologies. An intraoperative complication of DSAEK is posterior dislocation of the donor graft into the vitreous cavity. As the number of performed DSAEK procedures grows each year, the possibility of encountering a posteriorly dislocated donor graft increases. The authors report a case of intraoperative graft dislocation and a novel hand-over-hand retrieval method from the retinal surface. The hand-over-hand method provides an added surgical strategy for rescuing grafts that have fallen into the vitreous cavity.

[
Ophthalmic Surg Lasers Imaging Retina.
2013;44:569–571.]
Serum Erythropoietin, Insulin-like Growth Factor 1, and Vascular Endothelial Growth Factor in Etiopathogenesis of Retinopathy of Prematurity
Authors: Yenice Ozlem , Çerman Eren , Ashour Ahmet , Firat Ridvan , Haklar Goncagul , Sirikci Onder , Akman Ipek , Kazokoglu Haluk
Published: February 2014

BACKGROUND AND OBJECTIVE:

The role of growth factors in the pathogenesis of retinopathy of prematurity (ROP) is known. To better understand this issue, the authors investigated vascular endothelial growth factor (VEGF), insulin-like growth factor 1 (IGF-1), and erythropoietin (EPO) levels in the cord blood of premature newborns.

PATIENTS AND METHODS:

IGF-1, VEGF, and EPO levels were measured in cord blood samples obtained from 93 infants less than 32 weeks of gestational age at birth, and their predictive value in the development of ROP was investigated.

RESULTS:

The mean birth age and mean birth weight were 32.2 ± 1.5 weeks and 1,678 ± 326 g, respectively, in infants without ROP and 29.6 ± 2.3 weeks and 1,384 ± 343 g, respectively, in infants with ROP. Multivariate logistic regression analysis showed that only the gestational age and the serum VEGF at birth were independently associated with the risk of developing ROP (
P
= .002, Exp[B] = 0.514, CI = 95%: 0.341–0.775;
P
= .028, Exp[B] = 0.999, CI = 95%: 0.997–1.00).

CONCLUSION:

Serum VEGF levels at birth were lower in infants who later developed ROP. This may have a predictive value for ROP and contribute to the pathogenesis, because affected infants may be more susceptible to extrauterine hyperoxic insult.

[
Ophthalmic Surg Lasers Imaging Retina.
2013;44:549–554.]
Small Hyperreflective Intraretinal Material Observable on Spectral-Domain Optical Coherence Tomography in High Myopia
Authors: Mititelu Mihai , Ram Radha , Gill Manjot K.
Published: February 2014

With the rapid adoption of spectral-domain optical coherence tomography (SD-OCT) in clinical practice and recent advances in technology, SD-OCT has become an important tool for detecting and managing retinal pathology. The diagnosis of degenerative changes in pathologic myopia can sometimes be difficult and delayed, as the clinical presentation may be subtle. In this series, SD-OCT proved useful in the detection of small hyperreflective intraretinal material in cases in which retinal changes are minimally visible and may explain visual changes that may not have been otherwise elucidated. The results show that SD-OCT in conjunction with clinical examination may provide useful information in the management of patients with pathologic myopia.

[
Ophthalmic Surg Lasers Imaging Retina.
2013;44:606–609.]
A Pre-Retinal Arterial Loop Causing a Branch Retinal Artery Occlusion
Authors: Datoo O’Keefe Ghazala A. , Sadda SriniVas R.
Published: February 2014

Pre-retinal arterial loops are usually incidental findings during examinations in healthy individuals. They are rarely associated with arterial occlusion, with only nine previously reported cases in the literature. The authors report a case of a pre-retinal arterial loop associated with a branch retinal artery occlusion in a myopic young man. They also report the first documented optical coherence tomography scan through the loop causing the branch retinal artery occlusion.

[
Ophthalmic Surg Lasers Imaging Retina
. 2014;45:66–68.]
Differential Flow Rate of Commercially Available Triamcinolone With and Without Preservative Through Small-Gauge Needles
Authors: Cabrera Mariana , Gonzalez Alex , Albini Thomas A. , Rowaan Cornelis , Aguilar Mariela , Lee William , Fortun Jorge A. , Moshfeghi Andrew A. , Flynn Harry W , Parel Jean-Marie A.
Published: February 2014

OBJECTIVE:

To compare the flow rate through different gauge needles of triamcinolone acetonide with benzyl alcohol (TABA) versus preservative-free triamcinolone acetonide injectable suspension (TAIS).

MATERIALS AND METHODS:

Experimental injections of 1 mL of TABA or TAIS were performed through a 27-, 30-, or 32-gauge needle. A piezoelectric pressure transducer connected to a personal computer was placed between the syringe and needle to record the force-time relationship and assess the flow rate (mL/s). Measurements were performed in triplicate.

RESULTS:

Flow rates were similar between preparations using a 27-gauge needle. Using a 30-gauge needle, the flow rate was 0.058 mL/s for TABA and 0.178 mL/s for TAIS. Using a 32-gauge needle, no flow was sustained by TABA, whereas the flow rate of TAIS was 0.114 mL/s (
P
< .05).

CONCLUSION:

TAIS can be injected through a 32-gauge needle without the risk of obstruction. Occlusions were seen with TABA using the 30- and 32-gauge needles.

[
Ophthalmic Surg Lasers Imaging Retina.
2014;45:54–57.]
Occult Wooden Posterior Segment Intraocular Foreign Body
Authors: Desai Ankit , Parihar Rohit , Mathews Joanne , Akduman Levent
Published: February 2014

BACKGROUND AND OBJECTIVE:

To evaluate B-scan and computed tomographic appearance of a wooden intraocular foreign body within the posterior segment.

MATERIALS AND METHODS:

The authors report a case of a patient with an occult retained foreign body. To identify why the object was elusive, an in vitro study was conducted using computed tomography (CT) and B-scan on five human cadaveric eyes with known foreign bodies implanted into the vitreous cavity.

RESULTS:

Posterior segment metal and glass produced comet tail artifacts on B-scan, whereas stone, wood, and plastic produced shadowing artifacts. There was difficulty in identifying wood within the posterior chamber via CT. However, stone and plastic were easily detectable but difficult to identify without Hounsfield units.

CONCLUSION:

CT provides quick imaging of suspected posterior segment foreign bodies; however, B-scan ultrasonography may prove more useful than CT in detecting wooden foreign bodies.

[
Ophthalmic Surg Lasers Imaging Retina
. 2014;45:58–61.]
Unilateral Choroidal Neovascular Membrane as a Herald Lesion for Crohn’s Disease
Authors: Thomas Benjamin J. , Emanuelli Andres A. , Berrocal Audina M.
Published: February 2014

Crohn’s disease is a diffuse inflammatory disease primarily affecting the gastrointestinal tract but with associated ophthalmologic complications that often appear after the initial diagnosis. The authors report a case in which the appearance of a choroidal neovascular membrane prior to the final diagnosis of Crohn’s disease suggests its role as an advance lesion heralding an inflammatory state. A 13-year-old boy was referred for evaluation of a clinically isolated, unilateral choroidal neovascular membrane, which stabilized after treatment with intravitreal bevacizumab. Two years later, the patient was diagnosed with Crohn’s disease. Choroidal neovascular membranes, reported previously as a complication of Crohn’s disease following diagnosis, may be a precursor lesion.

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Ophthalmic Surg Lasers Imaging Retina
. 2014;45:62–65.]
Cone Photoreceptor Abnormalities Correlate With Vision Loss in a Case of Acute Posterior Multifocal Placoid Pigment Epitheliopathy
Authors: Hong In Hwan , Park Sung Pyo , Chen Ching Lung , Kim Hyoung Kyun , Tsang Stephen H. , Chang Stanley
Published: February 2014

The authors report adaptive optics scanning laser ophthalmoscopy (AO-SLO) findings in a case of acute posterior multifocal placoid pigment epitheliopathy. The right eye showed an island of coarse, hyperreflective speckles surrounded by a dark annulus lacking cone cells, which were associated with reduced MP1 sensitivity and abnormal findings in other imaging modalities. Although dark lesions were also detected in the left eye, the correlated spectral-domain optical coherence tomography images were normal. AO-SLO allowed for the direct observation of retinal disruptions and the ability of this technology to detect abnormalities in the left eye demonstrates a superior ability for in-depth retinal imaging.

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Ophthalmic Surg Lasers Imaging Retina
. 2014;45:74–78.]
Retinal Imaging in Perimacular Degenerative Retinoschisis
Authors: Weng Christina Y. , Flynn Harry W.
Published: February 2014

Macula-threatening degenerative retinoschisis is a rare clinical problem. In the current report, imaging of three patients with asymptomatic and nonprogressive retinoschisis is presented. The visual and anatomic findings have remained stable during follow-up.

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Ophthalmic Surg Lasers Imaging Retina
. 2014;45:79–82.]
Disseminated Histoplasmic Multifocal Choroiditis in AIDS
Authors: Espinoza Juan V. , Lasave Andres F. , Guzman-Blanco Manuel , Arevalo Fernando A. , Arevalo J. Fernando
Published: February 2014

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Ophthalmic Surg Lasers Imaging Retina
. 2014;45:179–180.]
Bilateral Choroidal Excavation in Best Vitelliform Macular Dystrophy
Authors: Parodi Maurizio Battaglia , Zucchiatti Ilaria , Fasce Francesco , Bandello Francesco
Published: February 2014

Focal choroidal excavation (FCE) has recently been described as one or more localized areas of choroidal excavation on spectral-domain optical coherence tomography (SD-OCT). The authors describe a case of bilateral FCE in Best vitelliform macular dystrophy (VMD). SD-OCT revealed FCE in both eyes characterized by interruption of the internal segment–outer segment junction and the presence of subretinal hyporeflective space. This is the first report describing bilateral FCE in a distinct macular disorder and specifically with VMD. Future investigations are warranted to ascertain the involvement of other macular dystrophies with atrophic evolution and the impact of FCE on the clinical course.

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Ophthalmic Surg Lasers Imaging Retina
. 2014;45:e8–e10.]
A TNF-α–CCL20–CCR6 Axis Regulates Nod1-Induced B Cell Responses
Authors: Paradis Maude , Mindt Barbara C. , Duerr Claudia U. , Rojas Olga L. , Ng Dennis , Boulianne Bryant , McCarthy Doug D. , Yu Mingxi Dennis , Summers deLuca Leslie E. , Ward Lesley A. , Waldron James B. , Philpott Dana J. , Gommerman Jennifer L. , Fritz Jörg H.
Published: February 2014

Innate immune responses provoke the accumulation of leukocytes at sites of inflammation. In addition to monocytes and granulocytes, B cells also participate in antimicrobial innate immune responses; however, the mechanisms for accumulation of B cells to sites of inflammation are not well understood. To study B cell accumulation following systemic inflammation, we used a model synthetic ligand that stimulates a specific pattern recognition molecule, nucleotide-binding oligomerization domain–containing protein 1 (Nod1). Upon exposure to Nod1 agonists, both B cells and neutrophils rapidly accumulate within the spleen, and dendritic cells migrate into the periarterial lymphoid sheath. Nod1 stimulation led to a marked increase in several chemokines within the spleen, including CXCL13, CCL2, and CCL20. Whereas the lymphotoxin pathway was critical for the induction of the B cell chemoattractant CXCL13 in response to Nod1 agonists, B cell accumulation within the spleen following Nod1-induced systemic inflammation was independent of the lymphotoxin pathway. In contrast, a CCR6/CCL20 chemokine loop instructed rapid increase of B cells in the spleen in response to systemic administration of Nod1 agonists in a TNF-α–dependent manner. Moreover, CCR6 was required to regulate Nod1-mediated B cell responses. These results reveal a novel mechanism of B cells during inflammation and shed light on how B cells participate in innate immune responses to microbial stimulation.
In Vivo Characterization of Alveolar and Interstitial Lung Macrophages in Rhesus Macaques: Implications for Understanding Lung Disease in Humans
Authors: Cai Yanhui , Sugimoto Chie , Arainga Mariluz , Alvarez Xavier , Didier Elizabeth S. , Kuroda Marcelo J.
Published: February 2014

Alveolar macrophages (AMs) obtained by bronchoalveolar lavage (BAL) are commonly used to study lung macrophage-mediated immune responses. Questions remain, however, about whether AMs fully represent macrophage function in the lung. This study was performed to determine the contribution of interstitial macrophages (IMs) of lung tissue to pulmonary immunity and that are not present in BAL sampling. In vivo BrdU injection was performed to evaluate the kinetics and monocyte/tissue macrophage turnover in Indian rhesus macaques (Macaca mulatta). Lung macrophage phenotype and cell turnover were analyzed by flow cytometry and immunohistochemistry. AMs and IMs in lungs of rhesus macaques composed ∼70% of immune response cells in the lung. AMs represented a larger proportion of macrophages, ∼75–80%, and exhibited minimal turnover. Conversely, IMs exhibited higher turnover rates that were similar to those of blood monocytes during steady-state homeostasis. IMs also exhibited higher staining for TUNEL, suggesting a continuous transition of blood monocytes replacing IMs undergoing apoptosis. Although AMs appear static in steady-state homeostasis, increased influx of new AMs derived from monocytes/IMs was observed after BAL procedure. Moreover, ex vivo IFN-γ plus LPS treatment significantly increased intracellular expression of TNF-α in IMs, but not in AMs. These findings indicate that the longer-lived AMs obtained from BAL may not represent the entire pulmonary spectrum of macrophage responses, and shorter-lived IMs may function as the critical mucosal macrophage subset in the lung that helps to maintain homeostasis and protect against continuous pathogen exposure from the environment.
Phosphatase Holoenzyme PP1/GADD34 Negatively Regulates TLR Response by Inhibiting TAK1 Serine 412 Phosphorylation
Authors: Gu Meidi , Ouyang Chuan , Lin Wenlong , Zhang Ting , Cao Xuetao , Xia Zongping , Wang Xiaojian
Published: February 2014

The molecular mechanisms that fine tune TLRs responses need to be fully elucidated. Protein phosphatase-1 (PP1) has been shown to be important in cell death and differentiation. However, the roles of PP1 in TLR-triggered immune response remain unclear. In this study, we demonstrate that PP1 inhibits the activation of the MAPK and NF-κB pathway and the production of TNF-α, IL-6 in macrophages triggered by TLR3, TLR4, and TLR9 in a phosphatase-dependent manner. Conversely, PP1 knockdown increases TLRs-triggered signaling and proinflammatory cytokine production. Tautomycetin, a specific inhibitor of PP1, aggravates LPS-induced endotoxin shock in mice. We further demonstrate that PP1 negatively regulates TLR-triggered signaling by targeting TGF-β–activated kinase 1 (TAK1) serine 412 (Ser412) phosphorylation, which is required for activation of TAK1-mediated IL-1R and TLR signaling. Mutation of TAK1 Serine 412 to alanine (S412A) significantly inhibits TLR/IL-1R–triggered NF-κB and MAPK activation and induction of proinflammatory cytokines in macrophage and murine embryonic fibroblast cells. DNA damage-inducible protein 34 (GADD34) specifies PP1 to dephosphorylate TAK1 at Ser412. GADD34 depletion abolished the interaction between TAK1 and PP1, and it relieved PP1 overexpression-induced inhibition of TLRs signaling and proinflammatory cytokine production. In addition, knockdown of GADD34 significantly promotes TLR-induced TAK1 Ser412 phosphorylation, downstream NF-κB and MAPK activation, and proinflammatory cytokine production. Therefore, PP1, as a physiologic inhibitor, together with its regulatory subunit GADD34, tightly controls TLR-induced TAK1 Ser412 phosphorylation, preventing excessive activation of TLRs and protecting the host from overwhelmed inflammatory immune responses.
Inhibition of Batrachochytrium dendrobatidis Caused by Bacteria Isolated from the Skin of Boreal Toads, Anaxyrus (Bufo) boreas boreas, from Grand Teton National Park, Wyoming, USA
Authors: Park Shawna T. , Collingwood Amanda M. , St-Hilaire Sophie , Sheridan Peter P.
Published: February 2014

The chytrid fungus Batrachochytrium dendrobatidis is a significant cause of the worldwide decline in amphibian populations; however, various amphibian species are capable of coexisting with B. dendrobatidis. Among them are boreal toads ( Anaxyrus ( Bufo) boreas boreas) located in Grand Teton National Park (GTNP) in Wyoming, USA. The purpose of this study was to identify cultivable bacterial isolates from the skin microbiota of boreal toads from GTNP and determine if they were capable of inhibiting B. dendrobatidis in vitro, and therefore might be a factor in the toad's coexistence with this pathogen. Isolates from 6 of 21 genera tested were found to inhibit the growth of B. dendrobatidis. These bacteria represent diverse lineages such as the Gammaproteobacteria, the Betaproteobacteria, and the Bacteroidetes/Chlorobium groups. We propose that these bacteria compete via microbial antagonism with B. dendrobatidis.
Are early foliar fungicide applications on durum wheat grown in southeast Saskatchewan beneficial in increasing grain productivity?
Authors: Fernandez M. R. , May W. E. , Chalmers S. , Savard M. E. , Singh A. K.
Published: February 2014

Fernandez, M. R., May, W. E., Chalmers, S., Savard, M. E. and Singh, A. K. 2014. Are early foliar fungicide applications on durum wheat grown in southeast Saskatchewan beneficial in increasing grain productivity? Can. J. Plant. Sci. 94: 891–903. Producers have expressed interest in applying fungicides early in the development of durum wheat to reduce disease severity and increase grain yield. To address this issue, a field trial was conducted in southeast Saskatchewan (2004–2006) to determine the impacts of single and double foliar fungicide (tebuconazole) applications at various growth stages on leaf spotting, Fusarium head blight/Fusarium-damaged kernels, deoxynivalenol concentration, dark kernel discolouration, and grain traits of durum wheat. In most cases, application at stem elongation was not effective in reducing Fusarium diseases, or improving yield and grain characteristics. Application at flag leaf emergence was more effective, but for the most part, application at anthesis resulted in the most consistent reduction in disease levels, and improvement in test weight. Double fungicide applications (stem elongation or flag leaf emergence, and anthesis) were not more effective in disease control than a single application at anthesis. Grain yield did not differ significantly among any of the treatments. In contrast to Fusarium diseases and leaf spotting, fungicide applications at stem elongation and/or flag leaf emergence resulted in increased kernel weight and percentage dark kernel discolouration, which was significant in 2005 (10.53–10.60% total kernel discolouration in the stem and flag leaf treatments vs. 6.13% for the untreated control). In one or more years, kernel weight was negatively associated with Fusarium disease variables and leaf spotting, but positively associated with kernel discolouration. We conclude that under variable environmental conditions in Saskatchewan, early preventative fungicide use on durum wheat should not be recommended as a strategy to improve productivity, and might even result in increases in dark kernel discolouration and grain downgrading.