bluuebunny/crossref_metadata_2025 huggingface dataset:
An Emerging “Maternal Near‐Miss Syndrome”: Narratives of Women Who Almost Died During Pregnancy and Childbirth
Authors: Souza Joao P. , Cecatti Jose G. , Parpinelli Mary A. , Krupa Fabiana , Osis Maria J. D.
Published: May 2009

Background:
An improvement in maternal health conditions can only be achieved when a reduction in the number of deaths is accompanied by a reduction in the frequency of severe complications of pregnancy. The objective of this study was to investigate women's experiences related to the burden of severe maternal morbidity.
Methods:
This qualitative study is based on narratives of women who survived severe complications of pregnancy and who were admitted to the intensive care unit of a public university hospital in the city of Campinas, Brazil. A sample of 30 women was recruited between April 2007 and January 2008. Before hospital discharge, eligible women who agreed to participate responded to a semidirected interview. The interviews were recorded and the transcripts received a thematic analysis.
Results:
Two major themes were identified, one more closely related to the experience of a critical illness and the other to the experience of care. A complex set of reactions was found in the women who survived, indicating the occurrence of acute stress‐related disorders.
Conclusions:
On the basis of narratives of women who almost died during pregnancy and childbirth, we reported on an acute stress disorder that may be associated with the occurrence of severe maternal complications, which we named, the “maternal near‐miss syndrome.” The implementation of integrated care that encompasses the physical, psychological, social, and spiritual aspects of women's health may help to alleviate the burden that maternal complications impose on millions of women around the world.
GEITLERINEMA SPECIES (OSCILLATORIALES, CYANOBACTERIA) REVEALED BY CELLULAR MORPHOLOGY, ULTRASTRUCTURE, AND DNA SEQUENCING1
Authors: Do Carmo Bittencourt‐Oliveira Maria , Do Nascimento Moura Ariadne , De Oliveira Mariana Cabral , Sidnei Massola Jr. Nelson
Published: May 2009

Geitlerinema amphibium (C. Agardh ex Gomont) Anagn. and G. unigranulatum (Rama N. Singh) Komárek et M. T. P. Azevedo are morphologically close species with characteristics frequently overlapping. Ten strains of Geitlerinema (six of G. amphibium and four of G. unigranulatum) were analyzed by DNA sequencing and transmission electronic and optical microscopy. Among the investigated strains, the two species were not separated with respect to cellular dimensions, and cellular width was the most varying characteristic. The number and localization of granules, as well as other ultrastructural characteristics, did not provide a means to discriminate between the two species. The two species were not separated either by geography or environment. These results were further corroborated by the analysis of the cpcB‐cpcA intergenic spacer (PC‐IGS) sequences. Given the fact that morphology is very uniform, plus the coexistence of these populations in the same habitat, it would be nearly impossible to distinguish between them in nature. On the other hand, two of the analyzed strains were distinct from all others based on the PC‐IGS sequences, in spite of their morphological similarity. PC‐IGS sequences indicate that these two strains could be a different species of Geitlerinema. Using morphology, cell ultrastructure, and PC‐IGS sequences, it is not possible to distinguish G. amphibium and G. unigranulatum. Therefore, they should be treated as one species, G. unigranulatum as a synonym of G. amphibium.
Brugada‐Like Changes in the Peripheral Leads during Diagnostic Ajmaline Test in Patients with Suspected Brugada Syndrome
Authors: BATCHVAROV VELISLAV N. , GOVINDAN MALINI , CAMM A. JOHN , BEHR ELIJAH R.
Published: May 2009

Background: Although cases of Brugada‐type electrocardiographic (ECG) pattern in peripheral (limb) leads have been reported (“atypical” Brugada syndrome [BS]), their incidence in patients investigated for BS is unknown.

Methods: We retrospectively analyzed an ECG database collected during ajmaline test in 143 patients (89 men) with suspected BS. In 42 patients, 12‐lead ECGs were recorded, whereas in 101 patients, leads V1–V3 from the third intercostal space were also recorded. The presence of types 1, 2, and 3 Brugada pattern in each limb and precordial lead was noted and the PR, QRS, and QTc intervals were calculated.

Results: There were 114 (79.7%) negative and 29 (20.3%) positive tests. Type 1 pattern developed in ≥1 limb lead in six patients (4.2%) (3/29 with positive tests, 10.3%); all of them were male, symptomatic, and/or with family history of BS or sudden cardiac death. Their pre‐ and posttest QRS were significantly longer compared with the rest with positive (n = 26) or negative (n = 111) test (pretest: 129 ± 31 ms vs 101 ± 11 ms and 97 ± 12 ms, P < 0.001; posttest: 175 ± 44 ms vs 134 ± 14 ms and 131 ± 19 ms, P < 0.001). The posttest QTc was longer in patients with peripheral changes compared with the rest (507 ± 47 ms vs 453 ± 22 ms and 447 ± 24 ms, P < 0.001). The pretest QTc and pre‐ and posttest heart rate and PR intervals were not significantly different between the three groups.

Conclusions: Type 1 Brugada pattern in the peripheral leads was observed in 4.2% of patients during ajmaline test (10.3% of positive tests) and was associated with longer QRS and greater QTc prolongation compared with the rest of the patients.
Prevalence of a Brugada Pattern Electrocardiogram in an Urban Population in the United States
Authors: PATEL SANDEEP S. , ANEES SYED S. , FERRICK KEVIN J.
Published: May 2009

Objective: To determine the prevalence of a Brugada‐type pattern on routine electrocardiogram (ECG) in an urban population served by a tertiary medical center in the United States.

Methods: The investigators reviewed the ECG database at the Montefiore Medical Center, a tertiary teaching center in the Bronx, New York, over a 10‐year period. During this time, 653,006 ECG records in 162,590 patients were identified. The database was queried by applying standard diagnostic criteria in an attempt to identify records with apparent conduction delay and ST abnormality in leads V1–V3. Additional diagnostic criteria were then applied to identify records in an attempt to mimic Brugada‐like changes. A cardiac electrophysiologist reviewed records meeting these criteria to confirm the presence of a Brugada‐type pattern.

Results: In total, 16,067 patients (9.8%) were identified as having ECGs with right bundle branch block, incomplete right bundle branch block, or RSR′ in leads V1 and V2. After applying additional diagnostic criteria evaluating ST segment shift, 456 patients were identified as having a pattern potentially consistent with a Brugada‐type ECG. The presence of a Brugada‐type pattern was confirmed by physician overread in 20 patients (0.012%).

Conclusion: The Brugada‐type ECG pattern is infrequently seen in a large ethnically diverse urban US population. Further evaluation should be considered when this pattern is seen on routine ECG.
Esophageal Contour Changes during Cryoablation of Atrial Fibrillation
Authors: HERWEG BENGT , ALI RIAS , KHAN NADIM , ILERCIL ARZU , BAROLD S. S.
Published: May 2009

Background: We have observed contour changes of the barium‐filled esophagus during atrial fibrillation (AF) ablation with cryo‐energy delivered in direct proximity to the esophagus.

Objective: To evaluate the frequency, location, and severity of esophageal contour changes during cryo‐energy application close to the esophagus.

Methods: We retrospectively analyzed cine‐fluoroscopic images acquired during hybrid cryo‐radiofrequency AF ablation in 100 consecutive patients with cryo‐energy delivered only in direct proximity to the esophagus.

Results: Esophageal contour changes were observed in 28 (32%) of 89 patients (and 74 [6.2%] of 1,191 of all cryo applications). They were more frequent in the left common pulmonary vein (PV) (50%) and less so in the right common PV and the upper PVs (4–5%). The distance of the ablation catheter from the endoesophageal contour prior to cryo‐energy applications associated with contour changes was 1.8 ± 1.5 mm, which increased to 4.1 ± 1.6 mm at the time of peak contour change (P < 0.001). The esophageal contour deformation was 2.3 ± 0.9 mm. There were no apparent complications related to cryo‐energy application for 3–4 minutes, even if associated with contour changes.

Conclusion: Esophageal contour changes were observed in >6% of cryo applications in direct proximity to the esophagus (32% of patients) and were most frequent in the posterior aspect of the left common and right lower PV ostium when cryo‐energy was delivered at a distance of ≤5 mm from the esophageal contrast silhouette. No overt esophageal injury occurred. However, the safety of cryo‐energy application in direct proximity to the esophagus remains to be further confirmed.
Distribution of Successful Ablation Sites of Idiopathic Right Ventricular Outflow Tract Tachycardia
Authors: YAMASHINA YOSHIHIRO , YAGI TETSUO , NAMEKAWA AKIO , ISHIDA AKIHIKO , SATO HIROKAZU , NAKAGAWA TAKASHI , SAKURAMOTO MANJIROU , SATO EIJI , YAMBE TOMOYUKI
Published: May 2009

Background: There are few studies evaluating the distribution of successful ablation sites of idiopathic right ventricular outflow tract (RVOT) arrhythmias using a three‐dimensional electroanatomical mapping system. This study aims to clarify the favorite site of idiopathic RVOT arrhythmias through electroanatomical voltage mapping using the CARTO system (Biosense Webster, Diamond Bar, CA, USA).

Methods: A consecutive series of 72 patients (mean age 43.6 ± 16.2 years, 32 males) who underwent radiofrequency catheter ablation (RFCA) for a total of 82 morphologies of idiopathic RVOT arrhythmias were studied. Detailed three‐dimensional electroanatomical voltage maps of the RVOT were obtained using the CARTO system prior to the RFCA during sinus rhythm. The voltage on bipolar electrogram was defined as follows: amplitude < 0.5 mV as “low‐voltage zone,” amplitude between 0.5 and 1.5 mV as “transitional‐voltage zone,” and amplitude >1.5 mV as “high‐voltage zone.” Successful ablation sites were electroanatomically classified into each voltage zone.

Results: Successful ablation was acquired in 63 patients and 71 RVOT arrhythmias (63/72 patients: 87.5%, 71/82 RVOT arrhythmias: 86.5%). In the successful group, three arrhythmias (4.2%) were classified in the low‐voltage zone, 63 arrhythmias (88.7%) in the transitional‐voltage zone, and five arrhythmias (7.0%) in the high‐voltage zone.

Conclusions: This study indicates that the vast majority of successful ablation sites for idiopathic RVOT arrhythmias are located in the transitional‐voltage zone. Mapping of the transitional‐voltage zone may be an important landmark of RFCA for RVOT arrhythmia.
Assessment of Clockwise Cavotricuspid Isthmus Block Based on Conduction Times during Transient Entrainment: A Prospective Study
Authors: CASTELLANOS EDUARDO , ALMENDRAL JESÚS , PUCHOL ALBERTO , ARIAS MIGUEL A. , CUENA RAFAEL , VALVERDE IRENE , PACHÓN MARTA , PADIAL LUIS RODRÍGUEZ
Published: May 2009

Background:

In typical counterclockwise atrial flutter (AFL), the route of impulse propagation to anteroinferior right atrium (AIRA) during transient entrainment (TE) from the coronary sinus (CS) is expected to be similar to that during pacing from the same CS site during sinus rhythm (SR) when cavotricuspid isthmus (CTI) block has occurred. This could be used to identify CTI block during ablation procedures.

Methods:

Thirty‐six patients with AFL (cycle length [CL], 240 ± 25 ms) underwent CTI ablation during AFL. CS pacing was performed at a CL of 20 ms less than AFL CL before ablation (n = 36), and at several CL during SR with conduction through the CTI (n = 21) and after CTI block (n = 36).

Results:

TE with orthodromic activation of AIRA occurred in all 36 patients. Conduction time from CS to AIRA during TE (T‐entr, 199 ± 29 ms) was significantly longer than during pacing in SR (T‐CTI) at the same rate not only with CTI conduction (T‐CTI‐C, 135 ± 24 ms, P < 0.001), but also with CTI block (T‐CTI‐B, 186 ± 24 ms, P < 0.01). T‐entr did not correlate with T‐CTI‐C, but there was an excellent correlation between T‐entr and T‐CTI‐B (r = 0.874, P < 0.001). A “TE index” that corrected T‐CTI for individual T‐entr identified CTI block with 97% sensitivity and 91% specificity. T‐CTI at low rates differed from T‐CTI at high rates but correlated significantly with them.

Conclusion:

Comparison of conduction times during TE from the CS and during pacing from the same site and rate in SR can help to establish whether clockwise CTI block has been achieved in patients with typical AFL.
The Influence of Left Ventricle Diastolic Function on Natriuretic Peptides Levels in Patients with Atrial Fibrillation
Authors: BAKOWSKI DAWID , WOZAKOWSKA‐KAPLON BEATA , OPOLSKI GRZEGORZ
Published: May 2009

Background:

The diagnosis of the impaired left ventricle (LV) diastolic function during atrial fibrillation (AF) using traditional methods is very difficult. Natriuretic peptides seem to be useful for assessment of diastolic function in patients with AF.

Aim:

To evaluate the influence of LV diastolic dysfunction on natriuretic peptides concentrations and to assess the diagnostic value of atrial natriuretic peptide (ANP) and B‐type natriuretic peptide (BNP) in patients with AF and impaired LV diastolic function.

Methods:

The study included 42 patients (23 males, 19 females), aged 58.6 ± 8.2 years with nonvalvular persistent AF with preserved LV systolic function who were converted into sinus rhythm by DC cardioversion (CV) and maintained sinus rhythm for at least 30 days. Echocardiography (ECG), ANP, and BNP level measurements were taken at baseline 24 hours before CV and 24 hours and 30 days after CV. On the 30th day following CV in patients with sinus rhythm, Doppler ECG was performed to assess LV diastolic function.

Results:

Thirty days after CV, normal LV diastolic function in 15 patients and impaired diastolic function in 27 patients was diagnosed: 20 with impaired LV relaxation and seven with impaired LV compliance. During AF and 24 hours, and 30 days after sinus rhythm restoration, significantly higher ANP and BNP levels were observed in patients with LV diastolic dysfunction as compared to the subgroup with normal LV diastolic function. The average values of ANP during AF in patients with normal and impaired diastolic function were 167.3 ± 70.1 pg/mL and 298.7 ± 83.6 pg/mL, respectively (P < 0.001), and the average values of BNP in the above mentioned subgroups were 49.5 ± 14.7 pg/mL and 145.6 ± 49.6 pg/mL respectively (P < 0.001). While comparing the diagnostic value of both natriuretic peptides it was noted that BNP was a more specific and sensitive marker of impaired LV diastolic function. ANP value >220.7 pg/mL measured during AF identified patients with impaired LV diastolic function with 85% sensitivity and 90% specificity. BNP value >74.7 pg/mL proved 95% sensitive and 100% specific in the diagnosing of such a group.

Conclusions:

The increase of ANP/BNP concentration in patients with AF results not only from the presence of AF, but also reflects the impaired LV diastolic function. Natriuretic peptides, especially BNP, may be useful in diagnosing LV diastolic dysfunction in patients with AF.
Acute Evaluation of Transthoracic Impedance Vectors Using ICD Leads
Authors: GOTTFRIDSSON CHRISTER , DAUM DOUGLAS , KENNERGREN CHARLES , RAMUZAT AGNÈS , WILLEMS ROGER , EDVARDSSON NILS
Published: May 2009

Background:

Minute ventilation (MV) has been proven to be very useful in rate responsive pacing. The aim of this study was to evaluate the feasibility of using implantable cardioverter‐defibrillator (ICD) leads as part of the MV detection system.

Methods:

At implant in 10 patients, the transthoracic impedance was measured from tripolar ICD, tetrapolar ICD, and atrial lead vectors during normal, deep, and shallow voluntary respiration. MV and respiration rate (RespR) were simultaneously measured through a facemask with a pneumotachometer (Korr), and the correlations with impedance‐based measurements were calculated. Air sensitivity was the change in impedance per change in respiratory tidal volume, ohms (Ω)/liter (L), and the signal‐to‐noise ratio (SNR) was the ratio of the respiratory and cardiac contraction components.

Results:

The air sensitivity and SNR in tripolar ICD vector were 2.70 ± 2.73 Ω/L and 2.19 ± 1.31, respectively, and were not different from tetrapolar. The difference in RespR between tripolar ICD and Korr was 0.2 ± 1.91 breaths/minute. The regressed correlation coefficient between impedance MV and Korr MV was 0.86 ± 0.07 in tripolar ICD.

Conclusions:

The air sensitivity and SNR in tripolar and tetrapolar ICD lead vectors did not differ significantly and were in the range of the values in pacemaker leads currently used as MV sensors. The good correlations between impedance‐based and Korr‐based RespR and MV measurements imply that ICD leads may be used in MV sensor systems.
Ectopy in Patients with Permanent Pacemakers and Implantable Cardioverter‐Defibrillators Undergoing an MRI Scan
Authors: MOLLERUS MICHAEL , ALBIN GLENN , LIPINSKI MARGARET , LUCCA JILL
Published: May 2009

Background:

Recent series suggest that magnetic resonance imaging (MRI) scanning can be performed safely in select patients with pacemakers or implantable cardioverter‐defibrillators (ICDs). Limited data have been reported on ectopy during MRI scans in patients with pacemakers or ICDs. This study evaluated increased ectopy observed in patients with permanent pacemakers or ICDs undergoing MRI scanning of any landmark without peak specific absorption rate (SAR) limit.

Methods:

Fifty‐two patients with a total of 119 leads underwent a total of 59 MRI scans of any landmark using usual protocols with standard peak SAR settings for the scan. No patient was pacemaker dependent. All devices were programmed to single‐chamber demand mode (VVI) or dual‐chamber demand mode (DDI) with a lower rate of 40 bpm.
Both telemetry and pulse oximetry plethysmographic waveform were observed continuously throughout the scans for ectopy.

Results:

Increased ectopy was observed during seven scans. The ectopy in four scans was ventricular and had fixed coupling intervals of 1,500 and 3,000, and was likely due to device noise rejection behavior. The etiology of ectopy observed during the other three scans could not be determined. Ectopy could not be predicted by peak SAR, scan time duration, or landmark. No significant changes in pacing thresholds were seen postscan.

Conclusions:

The current series suggests that a minority of patients with implanted pacemakers may have MRI‐related ectopy. A significant proportion of this ectopy may arise from normal device behavior within the MRI environment.
Troponin Levels after Cardiac Electrophysiology Procedures: Review of the Literature
Authors: ALAITI MOHAMAD A. , MAROO ANJLI , EDEL THOMAS B.
Published: May 2009

Cardiac‐specific Troponins (cTn) I and T have become markers of choice for myocardial injury. We reviewed the literature in order to understand the expected postprocedure cTn rise after electrophysiology procedures. A total of 34 studies and 1,608 patients were included. After external monophasic cardioversion, seven of 442 patients (1.6%) had minimal increase in cTnI (0.1–0.9 ng/mL), and only one of 368 (0.3%) had increase in cTnT (0.11 ng/mL). After internal cardioversion, 17 of 105 (16%) had increase in cTnI (0.7–2.4 ng/mL) but only three (2.9%) were above the cutoff for myocardial infarction (MI) (1.5 ng/mL). During implantable cardioverter‐defibrillator (ICD) installation with a mean of 2–7 ICD shocks, 12 of 74 (16%) patients had cTnI ≥1.5 ng/mL (range 1.7–5.5 ng/mL) and 20 of 64 (32%) had cTnT ≥0.1 ng/mL (range 0.26–6.46 ng/mL) considered in the range of clinical MI. Radio frequency ablation (RFA) (n = 496) resulted in significant cTn elevation in 25–100% of patients with ventricular > atrial and linear > focal lesions. Average postprocedure peak cTnI ranged from 0.13 to 6 ng/mL (median: 2.36 ng/mL, max: 15 ng/mL) and cTnT 0.2 to 2.41 ng/mL (median: 0.44 ng/mL, max: 9 ng/mL). Early cTn peak at 2–8 hours was noted after RFA. External cardioversion should not cause a significant increase in cTn; RFA and ICD implantation with shocks often result in an increase in cTn. Interpretation of these markers can be difficult if acute coronary syndrome is suspected in the postprocedure period.
A Case of Reversible Ventricular Tachycardia and Complete Atrioventricular Block Associated with Primary Cardiac B‐Cell Lymphoma
Authors: TANAKA YASUAKI , YAMABE HIROSHIGE , YAMASAKI HIROSHI , TSUDA HIROYUKI , NAGAYOSHI YASUHIRO , KAWANO HIROAKI , KIMURA YOSHIHIRO , HOKAMURA YOICHI , OGAWA HISAO
Published: May 2009

We report a long‐term survival case of primary cardiac lymphoma with reversible ventricular tachycardia (VT) and complete atrioventricular block (C‐AVB). A 65‐year‐old man with VT was treated by oral amiodarone administration. Later, a dual‐chamber pacemaker was implanted because of C‐AVB. Then, he was readmitted, as he complained of fever and chest pain. Echocardiography showed an enlarged cardiac mass and thus an open‐chest biopsy was performed. He was then diagnosed with primary cardiac lymphoma. The chemotherapy and radiotherapy resulted in the disappearance of the mass. Complete remission has been maintained for 8 years after the therapy, and no VT or C‐AVB has been detected.
Catheter Ablation of Premature Ventricular Contractions Arising from the Mitral Annulus after Mitral Valvoplasty
Authors: YAMADA TAKUMI , McELDERRY H. THOMAS , DOPPALAPUDI HARISH , EPSTEIN ANDREW E. , PLUMB VANCE J. , KAY G. NEAL
Published: May 2009

A 57‐year‐old man undergoing mitral valvoplasty underwent catheter ablation of symptomatic premature ventricular contractions (PVCs) with a right bundle branch block and right inferior axis QRS morphology. Left ventriculography revealed a normal left ventricular function and visualized the anatomical relationships between the left ventricular outflow tract and the mitral annuloplasty ring. Electroanatomic mapping during the PVCs revealed a centrifugal activation pattern arising from the mitral annulus, and the PVCs were likely to be idiopathic. Successful radiofrequency ablation was achieved at the site close to the antero‐paraseptal end of the mitral annuloplasty ring, which was located adjacent to the fibrous trigone.
Past‐president's address: is geography (the discipline) sustainable without geography (the subject)?
Authors: SHARPE CHRIS
Published: May 2009

We commonly define geography as the ‘integrative’ discipline, but there is more rhetoric than reality in the notion that our discipline has a coherent view of the world. Academic geography is dominated by increasingly esoteric topical specialties, and too often practiced as if it didn't exist outside the universities. By ignoring the popular conception of what geography is, we foster a dangerous opposition between geography as a popular subject and geography as a discipline. I argue that the survival of the discipline requires a collective rediscovery of a common core, which could be built around ‘regional’ geography—not the outmoded capes, bays and main export regional geography of the past, but one informed by modern theory, and attending to causal structures rooted in current realities. Our introductory courses are the best place to demonstrate a renewed commitment to a holistic geography grounded in an understanding of the world. Eclectic, curiosity‐driven research is also essential to the survival of the discipline, but disciplinary diversity is a strength only if it is grounded in an identifiable core. Excessive pluralism and intellectual arrogance may lead to ‘disciplinocide’.
Critical GIScience in Canada in the new millennium
Authors: SCHUURMAN NADINE
Published: May 2009

Critical GIS (CGIS) is an approach to evaluating GIS technology that draws upon multiple intellectual tool kits—from geography, social theory and computing science. While its roots are in the battles between human geographers and GIScientists in the 1990s, CGIS has emerged as an independent, constructive approach to enhancing the power and appeal of GIS. CGIS is also beginning to gain acceptance as a legitimate component of the broad tent that is GIScience. This short article reviews the emergence of CGIS, discusses its influence on the discipline of GIScience and finally explores the state of CGIS in Canada.
Empiètements et stratégies géo‐légales: le cas de la coupe en mosaïque en bordure des parcs nationaux du Québec
Authors: FOREST PATRICK
Published: May 2009

Depuis les années 1980, la province du Québec a créé de nombreux parcs, devenus parcs nationaux en 2002, afin d'assurer la conservation et la protection des territoires représentatifs de ses régions naturelles. Certains d'entre eux sont contigus à des portions de forêts publiques où se déroulent des activités industrielles d'exploitation forestière. Or, depuis 2003, les industriels sont tenus d'intégrer la coupe en mosaïque à leurs activités. Ce type de coupe requiert la préservation de forêts résiduelles (non‐coupées) d'une superficie au moins équivalente à celle des aires de coupe. En 2004, les industriels se voient autorisés à situer ces forêts résiduelles à l'intérieur des frontières des parcs nationaux. Reposant sur l'approche interdisciplinaire de la géographie du droit, notre étude entend développer le concept d'empiètement, mais aussi les stratégies géo‐légales qui sous‐tendent ce dernier, au continuum du public‐et‐du‐privé. Pour ce faire, nous avons recours à une méthodologie conciliant les méthodes juridiques et qualitatives afin d'étudier trois parcs nationaux où il y a localisation de forêts résiduelles à l'intérieur des limites de ces parcs. Notre étude entend démontrer que ces forêts résiduelles, situées à l'intérieur des parcs nationaux, constituent des empiètements résultant de stratégies géo‐légales mises en œuvre par le ministère des Ressources naturelles et de la Faune et les compagnies forestières.
Source water protection in a landscape of ‘New Era’ deregulation
Authors: PATRICK ROBERT J.
Published: May 2009

The concept of source water protection (SWP) has gained prominence in the water resource literature. SWP consists of watershed and groundwater management for the protection of drinking water supplies. The logic behind SWP is that it is easier, cheaper and safer to protect a drinking water source from contamination than it is to remediate after contamination. SWP is largely a regulatory activity, requiring provincial government policy commitments. This research investigates the degree to which recent provincial deregulation plays a role in constraining SWP implementation at the local water utility level. The research was undertaken in British Columbia (BC) where, after 2001, the provincial government advanced widespread ‘New Era’ deregulation of social and environmental legislation. The apparent contradiction between government deregulation and government commitment to safe drinking water is interrogated. Data were collected using semi‐structured interviews and document review in the Okanagan Basin. This article reveals that New Era deregulation initiatives have constrained local efforts to implement SWP on the ground. This article recommends that a single provincial agency should oversee drinking water in BC and that greater attention be given to regional governance for drinking water management in the Okanagan Basin.
Settler colonialism and the nuclear family
Authors: PHILLIPS RICHARD
Published: May 2009

Colonial societies revolved around nuclear families. Though they often seemed natural, universal and inevitable, colonial nuclear families were in fact produced through a series of laws and customs that regulated sex and marriage. These legal, social and cultural practices conspired to make the family an adaptable and formidable social institution, both a pillar and a beneficiary of colonization. Hegemonic but not universal, family members were privileged over other members of colonial societies, who not only survived on the margins and in the shadows of colonialism, but also played crucial roles in resettlement societies.
Applied Spatial Data Analysis with R. by BIVAND, R. S., PEBESMA, E. J., and GOMEZ‐RUBIO, V.
Authors: Ver Hoef Jay M.
Published: May 2009

Applied Spatial Data Analysis with R

(R. S. Bivand, E. J. Pebesma, and V. Gomez‐Rubio)

Jay M. Ver Hoef

Bayesian Disease Mapping: Hierarchical Modeling in Spatial Epidemiology

(A. B. Lawson)

J. Law

Disease Surveillance: A Public Health Informatics Approach

(J. S. Lombardo and D. L. Buckeridge, editors)

Iris Pigeot

Survival Analysis for Epidemiologic and Medical Research

(S. Selvin)

M. G. Valsecchi

Survival and Event History Analysis: A Process Point of View

(O. O. Aalen, O. Borgan, and H. K. Gjessing)

Patricia Grambsch

Nonlinear Dimensionality Reduction

(J. A. Lee and M. Verleysen)

Haonan Wang

Model Selection and Model Averaging

(G. Claeskens and N. L. Hjort)

Thomas M. Loughin

Meta‐Analysis of Binary Data Using Profile Likelihood

(D. Böhning, R. Kuhnert, and S. Rattanasiri)

Eloise Kaizar

Wavelet Methods in Statistics with R

(G. P. Nason)

Jeffrey S. Morris

Adaptive Design Theory and Implementation Using SAS and R

(M. Chang)

Feifang Hu

Ecological Models and Data in R

(B. M. Bolker)

Rachel M. Fewster

Applied Multiway Data Analysis

(P. M. Kroonenberg)

Renato Coppi

Brief Reports by the Editor

Sampling of Populations: Methods and Applications, 4th edition

(P. S. Levy and S. Lemeshow)

Applied Survival Analysis: Regression Modeling of Time‐to‐Event Data, 2nd edition

(D. W. Hosmer, S. Lemeshow, and S. May)

SAS for Data Analysis: Intermediate Statistical Methods

(M. G. Marasinghe and W. J. Kennedy)

Advances in Mathematical and Statistical Modeling

(B. C. Arnold, N. Balakrishnan, J. M. Sarabia, and R. Mínguez, editors)

An Introduction to Generalized Linear Models, 3rd edition

(A. J. Dobson and A. G. Barnett)

Design and Analysis of Bioavailability and Bioequivalence Studies, 3rd edition

(S.‐C. Chow and J.‐P. Liu)
Corneoscleral discs excised from enucleated and non‐enucleated eyes are equally suitable for transplantation
Authors: Garweg Justus , Hagenah Michael , Engelmann Katrin , Böhnke Matthias
Published: May 2009

Purpose: To assess whether the biological quality of corneoscleral tissue dissected in situ is, after organ culture, comparable to that harvested after enucleation.

Methods: Corneoscleral discs were prepared from 23 donor eyes, either after enucleation, under laminar flow conditions (right eyes; group 1) or by direct excision in situ (left eyes; group 2). Endothelial cell counts were made and the degree of tissue contamination assessed both prior to and upon termination of organ culture.

Results: Microbial growth was found in 12/22 conjunctival swabs collected from group 1 eyes and in 14/22 of those obtained from group 2 globes (p = 0.76). Bacterial growth was detected in four primary culture media, two from each group, at low colony densities. No significant difference in endothelial cell counts were encountered between the two groups, either immediately after dissection [group 1: 2940±308 (2100–3500) c/mm2; group 2: 2947±345 (2200–3700) c/mm2; p = 0.945] or upon termination of organ culture [group 1: 2646±321 (1895–3200); group 2: 2723 ± 312 (2100–3650); p = 0.413]. Conclusion: Dissection of corneoscleral discs in situ may serve as an alternative to the conventional technique if consent is obtained to remove only the cornea. The risk of contamination is no higher and endothelial cell viability no lower than in tissue derived from enucleated globes, provided that the excision is performed by a skilled surgeon and a rigorous disinfection protocol is instigated.
Comparative study on the effects of different growth factors on migration of bovine corneal endothelial cells during wound healing
Authors: Thalmann‐Goetsch A. , Engelmann K. , Bednarz J.
Published: May 2009

Purpose: In a comparative study we investigated the effects of epidermal growth factor, acidic and basic fibroblast growth factor, transforming growth factor‐β1, and vascular endothelial growth factor on proliferation and migration of cultured bovine corneal endothelial cells during wound healing.

Methods: Cell proliferation was determined by incorporation of 5‐bromo‐2′‐deoxy‐uridine and by cell counting. To investigate cell migration, we established a method to produce identically shaped cell‐free areas in monolayers of cultured cells and documented the wound‐healing process.

Results: Concerning the five tested growth factors, only epidermal growth factor as well as basic and acidic fibroblast growth factor stimulated DNA synthesis, cell proliferation, and migration during wound healing. Vascular endothelial growth factor stimulated migration during wound healing without influencing DNA synthesis or cell proliferation.

Conclusion: Whereas epidermal growth factor and the basic and acidic forms of fibroblast growth factor enhance proliferation as well as migration during wound healing, vascular endothelial growth factor seems to be a stimulatory agent specific for corneal endothelial cell migration.
Ocular hypotensive effect of pilocarpine before and after argon laser trabeculoplasty
Authors: Teus Miguel A. , Castejón Miguel A. , Calvo Miguel A. , Fagúndez Maria A.
Published: May 2009

Purpose: The purpose of this study was to compare the hypotensive response of human glaucomatous eyes to 1% pilocarpine solution before and after argon laser trabeculoplasty.

Methods: We designed a prospective, ‘repeated measures’ study comparing the ocular hypotensive effect of acutely administered 1% pilocarpine solution in 30 medically uncontrolled glaucomatous eyes, before and after argon laser trabeculoplasty.

Results: The pilocarpine‐induced IOP decrease was 3.6 ± 0.59 mmHg before argon laser trabeculoplasty, and 1.8 ± 0.53 mmHg after laser therapy. In both instances, the pilocarpine hypotensive effect was significantly correlated with pretreatment IOP (p = 0.02, r = 0.41 before argon laser trabeculoplasty, and p = 0.003, r = 0.52 after argon laser trabeculoplasty). We built a ‘repeated measurements ANCOVA’ model, and found no statistically significant difference between the pilocarpine IOP lowering effect before and after argon laser trabeculoplasty (p = 0.4).

Conclusion: Argon laser trabeculoplasty does not modify the IOP lowering effect of 1% pilocarpine solution.
Comparison of optic disc measurements by Heidelberg Retina Tomograph and manual planimetric techniques
Authors: Vihanninjoki Kyösti , Tuulonen Anja , Burk Reinhard O. W. , Airaksinen P. Juhani
Published: May 2009

The inner edge of the scleral ring is used as a reference plane for manual, computer assisted optic disc measurements. As it is possible to identify this level with the Heidelberg Retina Tomograph, our aim was to compare manual measurements to those taken with the Heidelberg Retina Tomograph. The material of this pilot study consisted of 12 eyes of 12 patients with early glaucomatous optic disc, retinal nerve fiber layer and/or visual field abnormalities. Measurements of the optic disc and neuroretinal rim area were obtained using our manual planimetric techniques, and the Heidelberg Retina Tomograph. The mean optic disc areas measured smaller with the Heidelberg Retina Tomograph than with the manual techniques (average difference 0.13 mm2; p<0.05). The neuroretinal rim area measurements and cup‐to‐disc area ratio using manual and Heidelberg Retina Tomograph techniques did not differ statistically significantly from each other. With the scleral ring as a reference plane, comparable optic disc measurements can be obtained with manual and laser techniques.
The HNK‐1 epitope in the pseudophakic and aphakic eye and secondary cataract
Authors: Uusitalo Marita , Kivelä Tero
Published: May 2009

Purpose: To search for changes in the presence and distribution of the cell‐adhesion‐related HNK‐1 carbohydrate epitope after cataract extraction. Methods: Twenty‐five pseudophakic and two aphakic human autopsy eyes and, for comparison, one anterior subcapsular cataract obtained at surgery were studied with monoclonal antibodies (MAbs) HNK‐1 and NC‐1 to the HNK‐1 epitope using the avidin‐biotinylated peroxidase complex method. Results: MAbs to the HNK‐1 epitope constantly immunolabelled the inner connective tissue layer of the ciliary body in all pseudophakic and aphakic eyes studied. The distribution of the immunoreaction was similar to that reported for normal eyes. They also labelled the extracellular matrix in each of 18 plaques of secondary cataract on the posterior capsule, in each of 13 plaques at the rim of the capsular bag, and in the anterior subcapsular cataract. Bladder cells in each of 16 Soemmering's rings remained unlabelled.

Conclusion: The distribution of the HNK‐1 epitope in the ciliary body does not appreciably change after cataract extraction, although the accommodative demand of the eye is altered. Its presence in an anterior subcapsular cataract suggests that the epitope may be locally produced by lens epithelial cells also in secondary cataract. The epitope is associated with cell adhesion and migration, both of which may play a role in the pathogenesis of secondary cataract.
Influence of laser coagulation therapy on untreated fellow‐eyes in severe nonproliferative diabetic retinopathy ‐ spectrometric results
Authors: Augsten R. , Königsdörffer E. , Gläser K. , Schweitzer D. , Strobel J.
Published: May 2009

Purpose: The aim was to examine the influence of laser treatment on untreated fellow‐eyes.

Methods: The effectiveness of the laser photocoagulation was investigated in 24 patients with type II diabetes mellitus and severe nonproliferative diabetic retinopathy. Using a spectrometric technique, the measurements in the macula were performed one day before laser coagulation and on the day directly following laser treatment. Further investigations took place 14 days and 6 weeks later. Results: One day after coagulation, the reflection of the untreated fellow‐eyes was found to be significantly increased between 530 and 600 nm, compared to the same eyes before coagulation. However, 14 days and 6 weeks after laser treatment alterations in the untreated eyes were no longer detectable. Conclusion: The choroidal blood volume seems to be decreased not only in coagulated eyes, but also in untreated fellow‐eyes, and, presumedly, the choroidal blood flow is improved. Considering the short duration of these effects, a therapeutic consequence is not supposed.
Comparison of surgical results of responders and non‐responders to the prism adaptation test in intermittent exotropia
Authors: Ohtsuki Hiroshi , Hasebe Satoshi , Okano Masaki , Furuse Takashi
Published: May 2009

The data for 94 consecutive patients with intermittent exotropia of basic type, ranging from 20 to 40 prism diopters (Δ), who preoperatively wore neutralizing prisms for 3 to 5 days, were studied retrospectively. The surgery in 43 patients in whom the amount of increase of angle was 4 Δ or less was based on the original angle (Group A), while that in 51 patients in whom the magnitude of increase was 5Δ or more was based on the increased angle of deviation (Group B). Patients with initial deviation less than 30 Δ and patients younger than 7 years of age showed an increase of deviation with prism correction. There were no significant differences in surgical results between the two groups at 1 year, and at 3 years; although at 3 years satisfactory motor alignment and binocular function for single vision at distance was higher in Group B than that in Group A.
Myopia in children born premature or with low birth weight
Authors: Saw Seang‐Mei , Chew Sek‐Jin
Published: May 2009

Purpose: To evaluate the association of myopia or astigmatism in children without retinopathy of prematurity (ROP) born premature or with low birth weight. Methods: This cross‐sectional study was conducted in Singapore where 527 children from three kindergartens aged 2 to 7 years without a history of ROP were recruited. Information on birth weight and gestational age at birth was obtained from a personal booklet and the refractive error in spherical equivalents was measured using distance photoretinoscopy. The data was analysed with univariate analysis and logistic regression models.

Results: There was no difference in the prevalence of myopia in children born premature or with low birth weight. There was also no difference in astigmatism in children born premature or with low birth weight.

Conclusion: This study shows no relationship between astigmatism or myopia with prematurity or low birth weight in children born without retinopathy of prematurity.
Cataract patients in a defined Swedish population 1986–1990
Authors: Ninn‐Pedersen K.
Published: May 2009

Purpose: Cataract surgery is often followed by a certain amount of astigmatism that changes in the postoperative period. However, there are large variations in both size and changes of the postoperative astigmatism. I have analysed the variations and the influence of different explanatory variables on the postoperative astigmatism.

Methods: Data for all patients undergoing cataract surgery from 1986 up to and including 1990 in the Lund Health Care District were prospectively recorded. Except for cases operated on with both keratoplasty and cataract, all cases were included in the study. The different explanatory variables considered included sex, age, preoperative axial length, preoperative average keratometry, preoperative intraocular pressure, glaucoma history, diabetes history, uveitis history (including both anterior and posterior uveitis), and a history of rheumatoid arthritis. Results: Besides age and sex, several variables significantly influenced the development of size and/or change in the postoperative astigmatism. They were preoperative astigmatism (polar value), preoperative intraocular pressure, and whether or not the cataract patient had an insulin dependent diabetes. Phacoemulsification as extraction mode, the location of the incision, complications at surgery, and whether or not a sphincterotomy was performed also influenced the two parameters of astigmatism. It was also important whether or not the operation was performed by a high volume surgeon.

Conclusion: In this material, the most important predisposing factors for rapid changes in the postoperative astigmatism were large preoperative astigmatism (polar value), young age, low preoperative intraocular pressure, if an ECCE were chosen as the extraction type, and the surgeon. The same variables and, in addition, if the location of the incision was anterior to the limbus were the most important explanatory variables in generating an early, large with‐the‐rule astigmatism.
The impact of cataract surgery on low vision patients
Authors: Mönestam Eva , Wachtmeister Lillemor
Published: May 2009

Purpose: To assess the impact of cataract surgery on low vision patients.

Methods: Self‐estimated ability to perform visually demanding tasks before and after cataract surgery and expectations and satisfaction with the surgery were analysed in all low‐vision patients (n = 52), who during a one‐year period underwent surgery at Norrlands University Hospital in Umea, Sweden. Self‐administered questionnaires were used and the records of the patients were studied.

Results: The majority (81%) of the low vision patients reported an improved ability to perform visually demanding tasks after surgery. The number of patients who were unable to read newspaper‐size print decreased significantly, from 44% to 21% after surgery. The subjectively improved visual ability as well as the augmentation of VA of the operated eye were both significantly related to satisfaction with the outcome of surgery.

Conclusion: Most low‐vision patients with significant cataract benefit from surgery, both subjectively by increased ability to perform visually demanding tasks as well as by an improved visual acuity. Particularly patients with loss of peripheral visual fields subjectively gain in orientation ability. It is important to reduce unreasonable expectations about the outcome of the surgery.
Practice styles and preferences of Danish cataract surgeons ‐ 1997 survey
Authors: Hansen Tom Eggert
Published: May 2009

A survey of the practice styles and preferences of cataract surgeons, who are members of the Danish Ophthalmological Society with address in Denmark was performed in January 1997. Only ophthalmologists performing cataract surgery were asked to return the questionnaire. Ninety responses were received by the cut‐off day, representing 26 640 cataract operations per year. The data were compared to similar questionnaires analysing the 1995 and 1996 practice styles and preferences in Denmark, and similar data from the US and Japan.
Surgical outcome of phacoemulsification combined with trabeculectomy in 243 eyes
Authors: Peräsalo Ritva , Flink Timo , Lehtosalo Juha , Ralli Reijo , Sulonen Jukka
Published: May 2009

This study was conducted to determine how phaco‐emulsification combined with trabeculectomy influenced intraocular pressure and need for glaucoma medication postoperatively. A retrospective analysis was undertaken of results relating to 243 eyes of 195 patients who had undergone phaco‐emulsification combined with trabeculectomy. Pre‐operative intraocular pressure decreased from a mean of 22.0 mmHg to 12.5 mmHg one week postoperatively with an average change of 9.5 mmHg. One month postoperatively, 70% of patients were without glaucoma medication. Visual acuity had improved in 80% of eyes. Phacoemulsification combined with trabeculectomy resulted in excellent glaucoma control, good visual recovery and a need for fewer glaucoma drugs.
Blindness in glaucoma patients
Authors: Blomdahl S. , Calissendorff B. M. , Tengroth B. , Wallin Ö.
Published: May 2009

In order to determine the risk for bilateral blindness from glaucoma and to which extent other diseases are responsible for the disability, the registers of low vision clinics were surveyed. All registered patients still alive in 1991 with the diagnosis of glaucoma were included. Eighteen hundred and ninety‐five patients fullfilled these criteria. Blindness was defined as bilateral visual acuity ≤ 0.1. The majority of the patients (68%) had a visual acuity better than 0.1. The remaining 590 patients had a visual acuity ≤ 0.1. In this latter group glaucoma was the reason for the low visual acuity in 20%, glaucoma in combination with other eye diseases in 35% and other eye diseases in 44%. Macular degeneration and cataracts were the main causes of the low vision in the latter group. The prevalence of glaucoma blindness in the Stockholm region was found to be 0.007% for glaucoma and 0.020% for glaucoma in combination with other eye diseases.
Experience with a broth culture technique for diagnosis of bacterial keratitis
Authors: Schønheyder Henrik Carl , Pedersen Jan Kjær , Nasser Kristian
Published: May 2009

Purpose: To determine if a broth culture technique is a practical means for bacteriological investigation of keratitis.

Material and methods: Twenty‐seven eyes of 27 patients with a clinical diagnosis of bacterial keratitis were included in a prospective and non‐comparative study at a Danish referral hospital. A corneal scrape was inoculated directly into broth medium which was transferred to the diagnostic laboratory for incubation and subculture.

Results: Culture was negative in 4 patients, and 19 of the remaining 23 patients had a pure growth of either Pseudomonas aeruginosa (n = 8), Staphylococcus aureus (n = 2), Streptococcus pneumoniae (n = 2), Haemophilus influenzae bio‐type III (n = 1), Moraxella species (n = 1), Corynebacterium species (n = 1), or coagulase‐negative staphylococci (n = 4). In 4 patients there was a mixed Gram‐positive growth. There was no association between microbiological findings and previous topical antibiotic therapy. Contamination and lack of quantitative assessment of growth proved not to be a problem.

Conclusions: By broth culture technique we identified a definite pathogen (P. aeruginosa, S. aureus or S. pneumoniae) in 44% of patients (95% binomial confidence limits: 25–65%). The technique may replace the standard technique of direct plate culture under circumstances where it is difficult to keep a supply of fresh media or transport inoculated plates.