bluuebunny/crossref_metadata_2025 huggingface dataset:
Erythema induratum of Bazin and Poncet's disease – successful treatment with antitubercular drugs
Authors: Heinemann C , Kaatz M , Elsner P
Published: December 2004

Erythema induratum of Bazin (EIB) is considered a tuberculide reaction and consists of recurrent painful nodules predominantly on the calves. Clinically it has common features with diseases like nodular vasculitis, perniosis, polyarteritis nodosa and erythema nodosum. Poncet's disease is a reactive arthritis that may accompany tuberculosis. We report a case of a young woman in which the simultaneous occurrence of erythema induratum of Bazin and Poncet's disease led to a clinical picture very similar to Löfgren's syndrome. The final diagnosis was obtained by polymerase chain reaction detection of mycobacterial DNA in a skin biopsy. A systemic therapy with tuberculostatic drugs led to the disappearance of symptoms. The presented case shows the usefulness of polymerase chain reaction diagnostics in EIB patients without other clinical signs of tuberculosis and a confusing combination of symptoms, and further confirms the presence of mycobacterial DNA in EIB lesions.
Onycholysis and subungual haemorrhages secondary to systemic chemotherapy (paclitaxel)
Authors: Ghetti E , Piraccini BM , Tosti A
Published: December 2004

Paclitaxel is a chemotherapic agent of the taxane family used in treatment of malignant solid tumory. We report here the case of a 40‐year old woman referred to our clinic for nail changes involving all 20 digits and developed after 5 months of paclitaxel intake, due to a breast carcinoma.

Clinical examination revealed red‐brown discoloration of the nails associated with hematomas and onycholysis. The nail changes were very painful and the patient complained of discharge of bad‐smelling yellow brown opaque fluid from underneath the nail plate.

Hemorrhagic onycholysis and subungual abscesses are a possible side effect of taxane treatment that should be early recognized to prevent serious complications.
Ingrowing nails and carbon dioxide laser surgery
Authors: Andre P
Published: December 2004

Background Ingrown nails are common in young people, surgery is often required and recurrence rates are high.

Objective To evaluate the efficacy of CO2 laser surgery.

Methods Three hundred and two patients were operated with the CO2 laser under local anaesthesia.

Results They were evaluated one year later: nine cases (3%) recurred and we observed 15 cases (5%) of spicules.

Conclusion Ingrown nails are easily operated with the CO2 laser; bleeding is minimal, post‐operative pain is low, infection is rare, the wounds heal without exhudative drainage and cosmetic results are good.
Cutaneous melanoma extirpated with insufficient surgical margins
Authors: Serrano‐Ortega S , Ruiz‐Villaverde R , Blasco‐Melguizo J , Linares Solano J
Published: December 2004

A major controversy in the treatment of melanoma is the width of the surgical margin necessary for complete excision. We have reviewed the case histories of 1125 patients at the Melanoma Unit of the Dermatology Department of the San Cecilio Clinical Hospital in Granada from 1988 to 2000. The first aim was to verify whether there is a statistically significant correlation between occupied margins and other prognosis factors. We also analyse the situation after re‐excising the scar from the previous extirpation with a minimum margin of 1 cm.
Granuloma annulare associated with prostate carcinoma
Authors: Akyol M , Kiliçarslan H , Göze F , Emre S
Published: December 2004

Granuloma annulare occurs as an idiopathic and benign condition, although it may be associated with some neoplasms. We describe a 60‐year‐old man with granuloma annulare on dorsal hands who developed prostate carcinoma. To the best of our knowledge, this is the first case report of granuloma annulare with prostate carcinoma. Granuloma annulare, especially in older age groups, may be classified as a sign of various carcinomas.
Isolation of polymorphic microsatellite loci in Plantago major and P. intermedia
Authors: Squirrell J. , Wolff K.
Published: December 2004

Plantago major and P. intermedia are two closely related inbreeding species. The isolation of polymorphic codominant microsatellite markers will provide valuable tools to investigate the reproductive isolation and the evolution of the two species. The isolation of microsatellite loci was achieved using a membrane enrichment method. Primers were designed to microsatellite flanking sequences and were analysed using fluorescent labels. Results indicated that nine out of the 10 loci amplified in both species, and that all the loci were polymorphic. The amplification of the loci was tested in a variety of Plantago species and was shown to be limited.
Transferability and genome specificity of a new set of microsatellite primers among Brassica species of the U triangle
Authors: Lowe Andrew J. , Jones Alexandra E. , Raybould Alan F. , Trick Martin , Moule Carolyn L. , Edwards Keith J.
Published: December 2004

We present a new set of 12 highly polymorphic simple sequence repeat primer sequences for use with Brassica species. These new primers, and four from A.K.S. SzewcMcFadden and colleagues, were tested in four Brassica species (B. rapa, B. napus, B. oleracea and B. nigra). Most primers successfully amplified products within all species and were polymorphic. Due to the risk of gene flow from GM oilseed rape to its wild relatives, hybrid formation in the Brassicaceae is of great interest. We identify six primer pairs as specific to the A, B or C genomes that could be used to identify such hybrids.
Polymorphic microsatellite markers for stock identification in Japanese anchovy (Engraulis japonica)
Authors: Chiu Tai‐Sheng , Lee Yann‐Jium , Huang Shiao‐Wei , Yu Hon‐Tsen
Published: December 2004

Japanese anchovy (Engraulis japonica) is a migratory marine fish of high economic significance in Taiwan. The adult Japanese anchovies migrate from the East China sea to spawn in coastal waters of Taiwan; the larvae then drift back to the East China Sea to complete their life cycle. We developed six highly polymorphic microsatellites for E. Japonica (expected heterozygosity ranging from 0.751 to 0.971) and these microsatellites can be used as genetic markers for identifying stocks to establish regulations in fishing management. Moreover, the markers will be useful in inferring the stock origins and migration routes in the future.
Microsatellite primers for three Western AtlanticFarfantepenaeusprawn species
Authors: Maggioni R. , Rogers Alex D.
Published: December 2004

Microsatellite loci were identified for three closely related penaeid species,Farfantepenaeus subtilis,F. paulensisandF. sp., from genomic libraries enriched for CA repeats. Seven out of nine highly polymorphic loci detected were amplified across all three species. Between four and 64 alleles were recorded per locus (average = 36). The average observed heterozygosity ranged from 0.094 to 0.897 (mean = 0.613), while the expected heterozygosity ranged from 0.091 to 0.985 (mean = 0.822).
New microsatellites primers for plaice, Pleuronectes platessa L. (Teleostei: Pleuronectidae)
Authors: Hoarau G. , Cook D. , Stam W. T. , Olsen J. L.
Published: December 2004

Seven microsatellite loci were developed for Pleuronectes platessa, a commercially important flatfish found throughout northern European waters. The number of alleles per locus ranged from 11 to 33 and heterozygosities from 0.74 to 0.96. Cross‐reactivity was tested against six other flatfish species. Significant amplification was found in all species from one to all seven of the loci.
Isolation and characterization of microsatellite markers from the Hypoptychus dybowskii (Pisces, Gasterosteiformes)
Authors: Munehara Hiroyuki , Nagai Noriko , Narimatsu Yoji
Published: December 2004

Hypoptychus dybowskii (Gasterosteiformes) exhibits allopaternal care frequently caused by various types of male reproductive tactics (sneaking, egg desertion and taking over). In order to understand this interesting reproductive system, we isolated microsatellites loci from H. dybowskii. Five microsatellites showed 2–10 alleles and expected heterozygosities ranged from 0.15 to 0.84. These were not significant deviations from Hardy–Weinberg expectations. These results suggest that these novel polymorphic loci should be useful for parentage analysis of H. dybowskii.
Polymorphic microsatellites in white rhinoceros
Authors: Florescu A. , Davila J. A. , Scott C. , Fernando P. , Kellner K. , Morales J. C. , Melnick D. , Boag P. T. , Van Coeverden De Groot P.
Published: December 2004

The southern white rhinoceros (Ceratotherium simum simum) has suffered severe reductions in population size over the last 150 years as a result of overhunting. We optimized 10 southern white rhinoceros microsatellite loci and tested them on 30 individuals from the largest remaining population of this species. Five of the 10 loci were polymorphic with mean expected heterozygosity of 0.578, mean polymorphic information content of 0.481 and mean number of alleles 2.8. Although these data suggest low genetic variability in C. s. simum, an accurate comparison of variability awaits results of ongoing broad‐scale microsatellite surveys in this family.
Isolation and characterization of microsatellite loci in the ground beetle Carabus problematicus (Coleoptera, Carabidae)
Authors: Gaublomme Eva , Dhuyvetter Hilde , Verdyck Peter , Mondor‐Genson Guenaelle , Rasplus Jean‐Yves , Desender Konjev
Published: December 2004

Six microsatellite loci were isolated from the ground beetle Carabus problematicus. The polymorphism ranged from two to 17 alleles and observed and expected heterozygosities ranged from 0.137 to 0.676 and 0.147 to 0.710, respectively.
Isolation and characterization of microsatellite DNA markers in the malaria vector Anopheles sacharovi
Authors: Guillemin M.‐L. , Severini C. , Berthomieu A. , Raymond M. , Weill M.
Published: December 2004

The mosquito Anopheles sacharovi, a member of the A. maculipennis complex, is an important malaria vector in the Middle East. Here we describe the isolation of 15 microsatellite polymorphic loci from the A. sacharovi genome, displaying a high among‐individual diversity (0.30–0.92) in a sample from Turkey. Seven loci displayed a significant departure from Hardy–Weinberg proportions, suggesting a substantial frequency of null alleles. The remaining eight loci are good candidates for further genetic studies in this species.
Isolation and characterization of microsatellites in the Asian walking catfish Clarias macrocephalus
Authors: Sukmanomon S. , Poompuang S. , Nakajima M.
Published: December 2004

Microsatellite loci were characterized in the walking catfish, Clarias macrocephalus, random clones from a small genomic library using a (GT)15 probe. Primers for DNA amplifications using polymerase chain reaction (PCR) were designed and synthesized for 23 loci. Twelve loci were polymorphic, with the number of alleles ranging from two to 13 alleles per locus. Developed microsatellite primers should prove useful for population studies and genetic mapping of the walking catfish.
Five new microsatellite markers for Northern pike (Esox lucius)
Authors: Launey Sophie , Krieg Francine , Morin Julie , Laroche Jean
Published: December 2004

Five new microsatellite markers were isolated from Northern pike (Esox lucius), a freshwater fish widely distributed in both Northern Europe and Northern America. Characterization in 30 individuals from a population from France revealed four to seven alleles and an expected heterozygosity of 0.243–0.642. No departure from Hardy–Weinberg equilibrium nor linkage disequilibrium were found. The level of polymorphism was higher than previously reported in the literature for pike populations from Northern America and Northern Europe, but with different microsatellite loci.
A set of cross‐species amplifying microsatellite markers developed from DNA sequence databanks in Picea (Pinaceae)
Authors: Besnard G. , Acheré V. , Faivre Rampant P. , Favre J. M. , Jeandroz S.
Published: December 2004

Seven codominant genetic markers (of which six are located in gene untranslated transcribed regions) were developed from Picea DNA sequences available in databanks. Primers were designed to specifically amplify by polymerase chain reaction tri‐, di‐ or mononucleotide repeated motifs. They provided single locus length polymorphism on a representative sample of 93 Picea abies individuals. The usefulness of each locus in mapping, population genetics or gene flow studies was assessed. A weak geographical genetic differentiation was revealed. The loci were also amplified in P. glauca, P. engelmannii and P. omorika demonstrating potential transferability across Picea species.
Isolation of Psoroptes scab mite microsatellite markers (Acari: Psoroptidae)
Authors: Evans Lucie M. , Dawson Deborah A. , Wall Richard , Burke Terry , Stevens Jamie
Published: December 2004

Nine microsatellite markers have been isolated from the scab mite, Psoroptes ovis. These markers have been tested for polymorphism in individual Psoroptes mites originating from two hosts, the European rabbit, Oryctolagus cuniculus, and sheep, Ovis aries. No definitive picture of Psoroptes species’ status or interrelationships exists. This study provides the basis for a new molecular system to elucidate the systematics of groupings within the genus Psoroptes, allowing us to clarify the population dynamics and epidemiology of the mites causing sheep scab world wide.
Isolation and characterization of sequence‐tagged microsatellite sites markers in chickpea (Cicer arietinum L.)
Authors: Sethy Niroj K. , Shokeen Bhumika , Bhatia Sabhyata
Published: December 2004

In this study we report the isolation of microsatellite sequences and their conversion to sequence‐tagged microsatellite sites (STMS) markers in chickpea (Cicer arietinum L.). Thirteen putative recombinants isolated from a chickpea genomic library were sequenced, and used to design 10 STMS primer pairs. These were utilized to analyse the genetic polymorphism in 15 C. arietinum varieties and two wild varieties, C. echinospermum and C. reticulatum. All the primer pairs amplified polymorphic loci ranging from four to seven alleles per locus. The observed heterozygosity ranged from 0 to 0.6667. Most of the STMS markers also amplified corresponding loci in the wild relatives suggesting conservation of these markers in the genus. Hence, these polymorphic markers will be useful for the evaluation of genetic diversity and molecular mapping in chickpea.
Microsatellites from Clarias batrachus and their polymorphism in seven additional catfish species
Authors: Yue G. H. , Kovacs B. , Orban L.
Published: December 2004

We isolated 18 novel microsatellite loci from the walking catfish (Clarias batrachus), and examined their cross‐amplification in seven additional catfish species from three families. Sixteen of the 18 microsatellites were polymorphic in the source species (allele number: 2–10/locus and expected heterozygosity: 0.30–0.87). Moreover, nine of these 18 primer pairs cross‐amplified specific and polymorphic products from the genome of at least six of the seven other catfish species tested. However, the success rate of cross‐species amplification varied from locus to locus, indicating that cross‐species amplification of microsatellites is locus‐dependent.
Brood sex ratio determination by flow cytometry in ants
Authors: Aron Serge , De Menten Ludivine , Van Bockstaele Dirk
Published: December 2004

Sex ratio variations during brood development have important implications for the study of sex allocation in haplodiploid insects. So far, few studies have addressed this question because of the difficulty to determine the sex of the brood. We used flow cytometry to differentiate haploid males from diploid females in the ant Linepithema humile. Our data show that flow cytometry can be used successfully to distinguish between male and female brood on the basis of their DNA content, from the very first larval stage. Moreover, we show that flow cytometry allows sex brood determination in other ant species, as well as in nonsocial Hymenoptera.
Isolation and characterization of microsatellite loci in Schizolobium parahyba (Leguminosae)
Authors: Kamau E. M. , Mayes S. , Barrett J. A.
Published: December 2004

Primer sequences for 16 microsatellite loci were developed from Schizolobium parahyba, a tropical tree species. Twelve loci were found to be polymorphic after screening diversity in individuals from Belize. A total of 39 alleles were found at nine loci. The markers are invaluable tools for studying the population genetics and mating system of the species.
Fluorescent dUTP helps characterize 10 novel tetranucleotide microsatellites from an enriched salamander (Ambystoma texanum) genomic library
Authors: Williams Rod N. , DeWoody J. Andrew
Published: December 2004

Ten tetranucleotide microsatellite loci were isolated and characterized from Indiana (USA) populations of the smallmouth salamander, Ambystoma texanum. As opposed to individually labelling primers that were not yet known to be polymorphic, we used fluorescent dUTP to assess genetic variability and found it to be very effective. Allelic diversity ranged from two to 18 alleles per locus and observed heterozygosity ranged from 0.17 to 0.91 among roughly 25 individuals. One of the 10 markers also amplified and was polymorphic in the tiger salamander (A. tigrinum).
Characterization of microsatellite loci in White‐chinned Petrel (Procellaria aequinoctialis) and cross‐amplification in six other procellariiform species
Authors: Techow N. M. S. M. , O'Ryan C.
Published: December 2004

Six polymorphic dinucleotide microsatellite loci were isolated and characterized from the White‐chinned Petrel Procellaria aequinoctialis, using a degenerate primer and PCR‐based technique to construct and screen an enriched genomic library. Preliminary data on three populations show heterozygosity levels ranging from 0.22 to 0.67 and allele numbers from three to nine. Preliminary data also suggest genetic distance between these three populations (FST 0.088). Cross‐species amplification of these six microsatellite loci and one further locus were tested in six other procellariiform species of the genus Procellaria, Macronectes, Thalassarche and Diomedea.
EST and random genomic nuclear microsatellite markers for Streptocarpus
Authors: Hughes M. , Möller M. , Bellstedt D. U. , Edwards T. J. , Woodhead M.
Published: December 2004

Microsatellite markers have been developed from standard enriched genomic libraries and a cDNA library for the genus Streptocarpus. Out of 15 loci derived from ESTs (expressed sequence tags), four gave working primer pairs, with expected heterozygosities (HE) ranging from 0.42 to 0.86. Out of 89 genomic library derived loci, 6 gave working primer pairs, with HE ranging from 0.63 to 0.93.
Development of polymorphic microsatellite loci for North American river otters (Lontra canadensis) and amplification in related Mustelids
Authors: Beheler Amanda S. , Fike Jennifer A. , Murfitt Lisa M. , Rhodes Olin E. , Serfass Thomas S.
Published: December 2004

In order to complement ecological research on native and reintroduced populations of the North American river otter (Lontra canadensis), we developed 10 polymorphic microsatellite loci that would permit us to evaluate population genetic structure and conduct fecal DNA analyses. The number of alleles per locus ranged from 3 to 14 and observed heterozygosity ranged from 0.23 to 0.68. Preliminary screening revealed that primers were polymorphic in a subset of other Mustelids.
distruct: a program for the graphical display of population structure
Authors: Rosenberg Noah A.
Published: December 2004

In analysis of multilocus genotypes from structured populations, individual coefficients of membership in subpopulations are often estimated using programs such as structure. distruct provides a general method for visualizing these estimated membership coefficients. Subpopulations are represented as colours, and individuals are depicted as bars partitioned into coloured segments that correspond to membership coefficients in the subgroups. distruct, available at http://www.cmb.usc.edu/~noahr/distruct.html, can also be used to display subpopulation assignment probabilities when individuals are assumed to have ancestry in only one group.
Isolation of 10 microsatellite markers for mongoose lemurs (Eulemur mongoz)
Authors: Pastorini J. , Fernando P. , Melnick D. J. , Forstner M. R. J.
Published: December 2004

We present here 10 new microsatellite markers for the mongoose lemur (Eulemur mongoz), nine of which were isolated from E. mongoz and one from Lemur catta. At least 60 individuals were genotyped for each of the 10 loci. Mendelian inheritance at each locus was tested by genotyping five captive families with known pedigrees. All loci were polymorphic and demonstrated simple Mendelian inheritance. The microsatellite markers presented here will be useful for genetic surveys of wild E. mongoz, to gain insights into the genetic background of the captive population, and to aid in the conservation of the species’ genetic diversity.
Microsatellite loci isolated from the Caribbean coral, Montastraea annularis
Authors: Severance E. G. , Szmant A. M. , A. Karl S.
Published: December 2004

We report the isolation and characterization of seven microsatellite loci from the Caribbean reef‐building coral, Montastraea annularis. All loci are polymorphic with allele numbers ranging from five to 31 and observed heterozygosities from 0.17 to 0.89. These loci can be used in assessing gene flow patterns and diversity of this stony coral species both for local coral reef management purposes as well as for elucidating population connectivity within the greater Caribbean basin. These markers should also be applicable to other species of Montastraea and for resolving taxonomic relationships within the M. annularis species complex.
Development of microsatellite markers in the toxic dinoflagellate Alexandrium tamarense (Dinophyceae)
Authors: Nagai S. , Lian C. , Hamaguchi M. , Matsuyama Y. , Itakura S. , Hogetsu T.
Published: December 2004

Outbreaks of paralytic shellfish poisoning caused by the toxic dinoflagellate Alexandrium tamarense (Dinophyceae) are currently a serious problem from an economic and food hygiene point of view throughout the world. We isolated 13 polymorphic microsatellite loci from this species. These loci provided microsatellite markers with high polymorphism ranging from four to 15 alleles per locus and gene diversity between 0.632 and 0.974. The markers are available for more detailed investigations of genetic structure and gene flow of A. tamarense populations.
Polymorphic microsatellite loci in the black‐and‐gold chromis, Neoglyphidodon nigroris (Teleostei: Pomacentridae)
Authors: Watts Phillip C. , Veltsos Paris , Soffa Benjamin J. , Gill Andrew B. , Kemp Stephen J.
Published: December 2004

We describe 15 polymorphic dinucleotide microsatellite loci in the black‐and‐gold chromis, Neoglyphidodon nigroris (Cuvier: Teleostei: Pomacentridae). Microsatellites were isolated from a partial genomic library that was enriched for CA repeat motifs. The 15 loci yielded between two and 23 alleles per locus in a sample of 16 fish from two forereef sites off the island of Hoga, Wakatobi National Park, Indonesia. Observed and expected heterozygosities varied from 0.13 to 1.00 and 0.24 to 0.98, respectively. These markers should allow us to discriminate between closely related individuals and also to assess the connectedness of populations of N. nigroris that inhabit different reefs.
Microsatellite DNA markers for population‐genetic studies of Atlantic bluefin tuna (Thunnus thynnus thynnus) and other species of genus Thunnus
Authors: Clark T. B. , Ma L. , Saillant E. , Gold J. R.
Published: December 2004

Twenty‐five microsatellites from Atlantic bluefin tuna (Thunnus thynnus thynnus) were characterized. All 25 microsatellites were polymorphic; the number of alleles among up to 56 individuals surveyed ranged from two to 23. Atlantic bluefin tuna are highly exploited and major questions remain as to stock structure and abundance in the eastern and western North Atlantic. The microsatellites will be useful in testing stock‐structure hypotheses and in generating estimates of effective population size. The polymerase chain reaction primer sets developed also amplified identifiable alleles in three other species of genus Thunnus: T. albacares (yellowfin tuna), T. alalunga (albacore tuna) and T. obesus (bigeye tuna).
Evolution of accommodative function and development of ocular movements in children
Authors: Jiménez R. , González M. D. , Pérez M. A. , García J. A.
Published: December 2004

The evolution of the accommodative function and development of ocular movement are evaluated in a non‐clinical paediatric population (1056 subjects) aged 6–12 years, providing means for each age in the optometric tests that evaluate the accommodative amplitude, accommodative facility, accommodative response (lag), and saccadic movements. A comparison of these values between ages (anova) established three distinct trends in the behaviour of these parameters. The accommodative amplitude, measured by modified dynamic retinoscopy, and the evaluation of the saccadic movements by the development of ocular movements [developmental eye movement (DEM)] test showed continuous change with age. The values for monocular and binocular accommodative facility, measured by ±2.00 D flippers, indicated the need to divide the population into two age groups (6–7 and 8–12 years). Finally, the means of accommodative response, measured by monocular estimation model (MEM) retinoscopy, and the direct observation of saccadic movement revealed no significant differences between ages, establishing a single mean reference value for the age group studied.
The projected increase in glaucoma due to an ageing population
Authors: Tuck Maurice W. , Crick Ronald Pitts
Published: December 2004

The number of cases of primary open angle glaucoma (POAG) in England and Wales is estimated to increase by a third over the 20 years to 2021, and then continue upwards at a similar pace to 2031. The estimates are based on official population projections, organised by 5‐year age groups, together with an age‐specific prevalence curve for POAG derived from the results of 11 epidemiological prevalence surveys. To cope with additional pressures, a thorough reappraisal of the present system for detection, referral, diagnosis, treatment and monitoring of the disease is likely to be required.
Barriers to accessing low vision services
Authors: Pollard Tamara L. , Simpson John A. , Lamoureux Ecosse L. , Keeffe Jill E.
Published: December 2004

Aim: To investigate barriers to accessing low vision services in Australia.

Methods: Adults with a vision impairment (<6/12 in the better eye and/or significant visual field defect), who were current patients at the Royal Victorian Eye and Ear Hospital (RVEEH), were interviewed. The questions investigated self‐perceived vision difficulties, duration of vision loss and satisfaction with vision and also examined issues of awareness of low vision services and referral to services. Focus groups were also conducted with vision impaired (<6/12 in the better eye) patients from the RVEEH, listeners of the Radio for the Print Handicapped and peer workers at Vision Australia Foundation. The discussions were recorded and transcribed.

Results: The questionnaire revealed that referral to low vision services was associated with a greater degree of vision loss (p = 0.002) and a greater self‐perception of low vision (p = 0.005) but that referral was not associated with satisfaction (p = 0.144) or difficulties related to vision (p = 0.169). Participants with mild and moderate vision impairment each reported similar levels of difficulties with daily activities and satisfaction with their vision (p > 0.05). However, there was a significant difference in the level of difficulties experienced with daily activities between those with mild‐moderate and severe vision impairment (p < 0.05). The participants of the focus groups identified barriers to accessing low vision services related to awareness of services among the general public and eye care professionals, understanding of low vision and the services available, acceptance of low vision, the referral process, and transport.

Conclusion: In addition to the expected difficulties with lack of awareness of services by people with low vision, many people do not understand what the services provide and do not identify themselves as having low vision. Knowledge of these barriers, from the perspective of people with low vision, can now be used to guide the development and content of future health‐promotion campaigns.
Sensitivity and specificity of two glaucoma case‐finding strategies for optometrists
Authors: Ieong A. , Murdoch I. , Cousens S. , Healey P. , Theodossiades J.
Published: December 2004

Current best practice for primary open‐angle glaucoma case‐finding comprises history‐taking, disc examination, intraocular pressure measurement and suprathreshold visual field analysis (SVFA). An alternative case‐finding technique was formulated replacing SVFA with computerised quantitative disc assessment, using the Heidelberg retinal tomograph II (HRT II). Each approach was adopted by four optometrists who screened 29 POAG and 37 normal patients. Average sensitivities and specificities were similar in the two groups [sensitivity 71% (SVFA) vs 69% (HRT II); specificity 94% both groups]. Our inclusion of pre‐perimetric glaucoma cases limited the sensitivity of the optometrists in this study. There was evidence to suggest that the optometrists tended to miss early changes at the optic disc such as disc haemorrhage, nerve fibre layer defects and subtle neuroretinal thinning.
Contact lens fitting following unsuccessful refractive surgery
Authors: Hau Scott C. H. , Ehrlich Daniel P.
Published: December 2004

A retrospective review of case notes of consecutive patients referred to a contact lens clinic after unsuccessful refractive surgery was carried out to determine the success of contact lens fitting. The main outcome variables in determining success were visual improvement, contact lens tolerance, fitting characteristics and wearing time. Thirteen eyes were fitted with conventional rigid gas permeable (CRGP), 10 with soft and 19 with reverse geometry rigid gas permeable contact lenses (RVG). The mean spectacle visual acuity (VA) was 6/9 (20/30) [range: 6/24 (20/80) to 6/5 (20/15)] and the mean VA after contact lens fitting was 6/6 (20/20) [range: 6/18 (20/60) to 6/5 (20/15)]. Of the 42 eyes, the contact lens VA was better than spectacle acuity in 25 (59.5%) eyes, equal in 14 (33.3%) and worse in three (7.1%). A total of 33 (78.6%) eyes were still wearing their lenses at the last visit. Contact lenses can be a valuable method of managing poor VA after refractive surgery.
Binocular interaction and performance of visual tasks
Authors: Justo Maria S. , Bermudez Maria A. , Perez Rogelio , Gonzalez Francisco
Published: December 2004

Binocular vision implies the fusion of the right and left retinal images to perceive a single image. For this, interocular interaction is required. We measured the reaction times to carry out a visual fixation task in order to determine whether binocular interaction influences performance. Several combinations of test and distraction stimuli were monocularly and binocularly presented to one monkey and three human subjects. The overall median reaction times were 340 ms for the animal and 308, 342 and 381 for human subjects 1, 2 and 3 respectively. Reaction time was shorter when the test stimulus was presented binocularly. Moreover, we observed that the presence of a distraction stimulus increased the reaction time and that a correlated distraction stimulus had a greater influence on this increase than an uncorrelated distraction stimulus. These findings indicate that with binocular vision a more rapid performance of a visual task occurs.
Position statement on the role of health care assistants who are involved in direct patient care activities within critical care areas
Authors:   The British Association of Critical Care Nurses
Published: December 2004

Intensive care has developed as a speciality since the 1950s, and during this time, there have been major technological advances in health care provision, leading to a rapid expansion of all areas of critical care

The ongoing problem in recruiting qualified nurses in general has affected, and continues to be a problem for, all aspects of critical care areas

During the past decade, nursing practice has evolved, as qualified nurses have expanded their own scope of practice to develop a more responsive approach to the complex care needs of the critically ill patient

The aim of this paper is to present the British Association of Critical Care Nurses (BACCN) position statement on the role of health care assistants involved in direct patient care activities, and to address some of the key work used to inform the development of the position statement
Immediate follow‐up after ICU discharge: establishment of a service and initial experiences
Authors: Strahan Eunice , McCormick Joanna , Uprichard Edith , Nixon Sandra , Lavery Gavin
Published: December 2004

Follow‐up of patients discharged from the intensive care unit (ICU) is recommended as a means of service evaluation (Department of Health (2000). Comprehensive Critical Care: a Review of Adult Critical Care Services), in order to monitor the quality of the services provided

Without patient follow‐up, ICU staff have only ‘death’ or ‘discharge alive from hospital’ as clinical outcomes from which to judge practice performance, and limited evidence exists on which to base decisions about improvements to critical care practice (Audit Commission (1999). Critical to Success – the Place of Efficient and Effective Critical Care Services Within the Acute Hospital  )

To address these issues the Regional Intensive Care Unit (RICU) obtained information from patient assessment/interview on problems experienced by patients within 8–9 days (mean), following discharge from RICU

A nurse‐administered questionnaire was used to identify functional outcomes, nutrition and psychological issues such as anxiety and sleep disturbances

Benefits of patient follow‐up introduced and planned include:

patient diaries for long‐term patients

input from clinical psychologist

review of sedation used in RICU
Change in Muscle Strength Explains Accelerated Decline of Physical Function in Older Women With High Interleukin‐6 Serum Levels
Authors: Ferrucci Luigi , Penninx Brenda W. J. H. , Volpato Stefano , Harris Tamara B. , Bandeen‐Roche Karen , Balfour Jennifer , Leveille Suzanne G. , Fried Linda P. , Md Jack M. Guralnik
Published: December 2004

OBJECTIVES:To test whether accelerated sarcopenia in older persons with high interleukin (IL)‐6 serum levels plays a role in the prospective association between inflammation and disability found in many studies.

DESIGN:Cohort study of older women with moderate to severe disability.

PARTICIPANTS:Six hundred twenty older women from the Women's Health and Aging Study in whom information on baseline IL‐6 serum level was available.

MEASUREMENTS:Self‐report of functional status, objective measures of walking performance, and knee extensor strength were assessed at baseline and over six semiannual follow‐up visits. Potential confounders were baseline age, race, body mass index, smoking, depression, and medical conditions.

RESULTS:At baseline, women with high IL‐6 were more often disabled and had lower walking speed. After adjusting for confounders, women in the highest IL‐6 tertile (IL‐6>3.10 pg/mL) were at higher risk of developing incident mobility disability (risk ratio (RR) = 1.50, 95% confidence interval (CI) = 1.01–2.27), disability in activities of daily living (RR = 1.41, 95% CI = 1.01–1.98), and severe limitation in walking (RR = 1.61, 95% CI = 1.09–2.38) and experienced steeper declines in walking speed (P< .001) than women in the lowest IL‐6 tertile (IL‐6 ≤1.78 pg/mL). Decline in knee extensor strength was also steeper, but differences across IL‐6 tertiles were not significant. After adjusting for change over time in knee extensor strength, the association between high IL‐6 and accelerated decline of physical function was no longer statistically significant.

CONCLUSIONS:Older women with high IL‐6 serum levels have a higher risk of developing physical disability and experience a steeper decline in walking ability than those with lower levels, which are partially explained by a parallel decline in muscle strength.
Subcortical Vascular Disease and Functional Decline: A 6‐Year Predictor Study
Authors: Bennett Hayley P. , Corbett Alastair J. , Gaden Susan , Grayson David A. , Kril Jillian J. , Broe G. Anthony
Published: December 2004

OBJECTIVES: To identify predictors of activity of daily living (ADL) and instrumental activity of daily living (IADL) decline in a population with subcortical vascular dementia (SVD) and to evaluate potential mechanism of decline.

DESIGN: Longitudinal.

SETTING: Hospital‐based.

PARTICIPANTS: Computed tomographic (CT) scanning identified 77 participants as having subcortical infarction.

MEASUREMENTS: Participants were neurologically, neuropsychologically, behaviorally, and functionally assessed four times over 5.82 years. Baseline data were grouped into four modules: basic demographic and risk factor, CT scan, neurological and other clinical, and neuropsychological and behavioral. Multivariate analysis determined predictors of decline in ADLs and IADLs.

RESULTS: Predictors of ADL decline were age, alcohol consumption, coordination, snout reflex, and performance on a neuropsychological test (Block Design). Predictors of IADL decline were predominantly cognitive and included the presence of paratonia and performance on the two neuropsychological tests (attention and memory tasks).

CONCLUSION: These findings suggest that cognitive impairments are most likely to have an effect on IADL function, because the skills involved are complex and involve integrative activity, whereas physical and cognitive impairments combined are likely to compromise ADL function, given the more basic and physical nature of the functions involved. These findings indicate that in people with SVD, both ADL and IADL status should be monitored, because, for many, decline in function over time is likely, and thus the provision of appropriate support required.
Attitudinal Barriers to Effective Treatment of Persistent Pain in Nursing Home Residents
Authors: Weiner Debra K. , Rudy Thomas E.
Published: December 2004

OBJECTIVES: To systematically explore nursing home (NH) resident and staff attitudes that serve as barriers to detection and management of persistent pain.

DESIGN: Survey.

SETTING: Six community‐based and one Veterans Affairs long‐term care facility

PARTICIPANTS: Seventy‐five NH nurses, 75 certified nursing assistants (CNAs), and 75 communicative NH residents who reported some pain or discomfort “every day or almost every day.”

MEASUREMENTS: Three structured pain attitudes questionnaires (one each for NH residents, CNAs, and nurses) that incorporated constructs gleaned from a comprehensive literature review were designed. One‐week test‐retest reliability was calculated on a subsample of 25 residents, 19 CNAs, and 26 nurses. Attitudinal differences between the three groups were evaluated using multivariate analysis of variance (MANOVA).

RESULTS: Of 12 constructs evaluated, 10 had fair to excellent reliability indices (residents 0.46–0.80; CNAs 0.57–0.76; nurses 0.62–0.94). Of these 10 reliable constructs, MANOVA indicated significant overall attitude differences between the three groups. Follow‐up analyses indicated that attitudes endorsed most strongly by residents were that chronic pain does not change, belief in external pathology over pain reports, fear of addiction, and fear of dependence. CNAs attitudes endorsed most strongly were lack of time and complaints unheard. The nurse attitude endorsed most strongly was complaints unheard.

CONCLUSIONS: These findings suggest that, if residents' fears regarding addiction, worsening dependence, and the immutable nature of persistent pain were quelled, and if CNAs could feel that adequate time is available for pain assessment, perhaps improved pain management in the NH would result.
Cytokines and Cognition—The Case for A Head‐to‐Toe Inflammatory Paradigm
Authors: Wilson Craig J. , Finch Caleb E. , Cohen Harvey J.
Published: December 2004

The brain is not only immunologically active of its own accord, but also has complex peripheral immune interactions. Given the central role of cytokines in neuroimmmunoendocrine processes, it is hypothesized that these molecules influence cognition via diverse mechanisms. Peripheral cytokines penetrate the blood‐brain barrier directly via active transport mechanisms or indirectly via vagal nerve stimulation. Peripheral administration of certain cytokines as biological response modifiers produces adverse cognitive effects in animals and humans. There is abundant evidence that inflammatory mechanisms within the central nervous system (CNS) contribute to cognitive impairment via cytokine‐mediated interactions between neurons and glial cells. Cytokines mediate cellular mechanisms subserving cognition (e.g., cholinergic and dopaminergic pathways) and can modulate neuronal and glial cell function to facilitate neuronal regeneration or neurodegeneration. As such, there is a growing appreciation of the role of cytokine‐mediated inflammatory processes in neurodegenerative diseases such as Alzheimer's disease and vascular dementia. Consistent with their involvement as mediators of bidirectional communication between the CNS and the peripheral immune system, cytokines play a key role in the hypothalamic‐pituitary‐adrenal axis activation seen in stress and depression. In addition, complex cognitive systems such as those that underlie religious beliefs, can modulate the effects of stress on the immune system. Indirect means by which peripheral or central cytokine dysregulation could affect cognition include impaired sleep regulation, micronutrient deficiency induced by appetite suppression, and an array of endocrine interactions. Given the multiple levels at which cytokines are capable of influencing cognition it is plausible that peripheral cytokine dysregulation with advancing age interacts with cognitive aging.
The Effect of Do‐Not‐Resuscitate Orders on Physician Decision‐Making
Authors: Beach Mary Catherine , Morrison R. Sean
Published: December 2004

The effect of do‐not‐resuscitate (DNR) orders on physicians' decisions to provide life‐prolonging treatments other than cardiopulmonary resuscitation (CPR) for patients near the end of life was explored using a cross‐sectional mailed survey. Each survey presented three patient scenarios followed by 10 treatment decisions. Participants were residents and attending physicians who were randomly assigned surveys in which all patient scenarios included or did not include a DNR order.

Response to three case scenarios when a DNR order was present or absent were measured. Response from 241 of 463 physicians (52%) was received. Physicians agreed or strongly agreed to initiate fewer interventions when a DNR order was present versus absent (4.2 vs 5.0 (P = .008) in the first scenario; 6.5 vs 7.1 (P = .004) in the second scenario; and 5.7 vs 6.2 (P = .037) in the third scenario). In all three scenarios, patients with DNR orders were significantly less likely to be transferred to an intensive care unit, to be intubated, or to receive CPR. In some scenarios, the presence of a DNR order was associated with a decreased willingness to draw blood cultures (91% vs 98%, P = .038), central line placement (68% vs 80%, P = .030), or blood transfusion (75% vs 87%, P = .015). The presence of a DNR order may affect physicians' willingness to order a variety of treatments not related to CPR. Patients with DNR orders may choose to forgo other life‐prolonging treatments, but physicians should elicit additional information about patients' treatment goals to inform these decisions.
Advanced Practice Nursing in the Care of Frail Older Adults
Authors: Bourbonniere Meg , Evans Lois K.
Published: December 2004

Models of care for frail older adults have increasingly used advanced practice nurses (APNs) to achieve outcomes. Knowledge of the common APN functions and skills that contribute to the success of these models could better inform education and evidence‐based practice and guide further research, but published investigations associated with models of gerontologic care neither describe fully these functions and skills nor link the activities of the APN with specific outcomes. Using examples primarily from the University of Pennsylvania School of Nursing, this paper identifies, describes, and analyzes common functions and skills of APNs in published gerontologic care models; examines the strength of the evidence for the effect of APNs on outcomes of care; and identifies areas for further study.
A Randomized, Controlled Trial of Quadriceps Resistance Exercise and Vitamin D in Frail Older People: The Frailty Interventions Trial in Elderly Subjects (FITNESS)
Authors: Latham Nancy K. , Anderson Craig S. , Lee Arier , Bennett Derrick A. , Moseley Anne , Cameron Ian D. , For The Fitness Collaborative Group
Published: December 2004

OBJECTIVES:  To determine the effectiveness of vitamin D and home‐based quadriceps resistance exercise on reducing falls and improving the physical health of frail older people after hospital discharge.

DESIGN:   Multicenter, randomized, controlled trial with a factorial design.

SETTING:   Five hospitals in Auckland, New Zealand, and Sydney, Australia.

PARTICIPANTS:   Two hundred forty‐three frail older people.

INTERVENTIONS:   Patients were randomized to receive a single dose of vitamin D (calciferol, 300,000 IU) or placebo tablets and 10 weeks of high‐intensity home‐based quadriceps resistance exercise or frequency‐matched visits.

MEASUREMENTS:   The primary endpoints were physical health according to the short‐form health survey at 3 months and falls over 6 months. Physical performance and self‐rated function were secondary endpoints. Assessments took place in the participants' homes at 3 and 6 months after randomization and were performed by blinded assessors.

RESULTS:   There was no effect of either intervention on physical health or falls, but patients in the exercise group were at increased risk of musculoskeletal injury (risk ratio = 3.6, 95% confidence interval = 1.5–8.0). Vitamin D supplementation did not improve physical performance, even in those who were vitamin D deficient (<12 ng/mL) at baseline.

CONCLUSION:   Neither vitamin D supplementation nor a home‐based program of high‐intensity quadriceps resistance exercise improved rehabilitation outcomes in frail older people after hospitalization. There was no effect of vitamin D on physical performance, and the exercises increased the risk of musculoskeletal injury. These findings do not support the routine use of these interventions at these dosages in the rehabilitation of frail older people. J Am Geriatr Soc 51:291–299, 2003.