bluuebunny/crossref_metadata_2025 huggingface dataset:
Ventilator-associated pneumonia in a tertiary care hospital in India: role of multi-drug resistant pathogens
Authors: Joseph Noyal Mariya , Sistla Sujatha , Dutta Tarun Kumar , Badhe Ashok Shankar , Rasitha Desdemona , Parija Subhash Chandra
Published: May 2010

Background: Ventilator-Associated Pneumonia (VAP) is the most frequent intensive-care-unit (ICU)-acquired infection. The aetiology of VAP varies with different patient populations and types of ICUs. Methodology: A prospective study was performed over a period of 15 months in a tertiary care hospital to determine the various aetiological agents causing VAP and the prevalence of multidrug resistant (MDR) pathogens. Combination disk method, Modified Hodge test, EDTA disk synergy (EDS) test and AmpC disk test were performed for the detection of extended spectrum beta-lactamases (ESBL), carbapenemases, metallo-beta-lactamases (MBL) and AmpC β-lactamases respectively. Results: Enterobacteriaceae, Haemophilus influenzae, Staphylococcus aureus, Streptococcus pneumoniae, Candida spp. were more common in early-onset VAP, while non-fermenters (Pseudomonas spp. and Acinetobacter spp.) were significantly associated with late-onset VAP (P value 0.0267, Chi-square value 4.91). Thirty-seven (78.7%) of the 47 VAP pathogens were multidrug resistant. ESBL was produced by 50% and 67% of Escherichia coli and Klebsiella pneumoniae respectively. MBL was produced by 20% of P. aeruginosa. AmpC beta-lactamases were produced by 33.3% and 60.7% of the Enterobacteriaceae and non-fermenters respectively. Of the S. aureus isolates, 43% were methicillin resistant. Prior antibiotic therapy and hospitalization of five days or more were independent risk factors for VAP by MDR pathogens. Conclusions: VAP is increasingly associated with MDR pathogens. Production of ESBL, AmpC beta-lactamases and metallo beta-lactamases were responsible for the multi-drug resistance of these pathogens.  Increasing prevalence of MDR pathogens in patients with late-onset VAP indicate that appropriate broad-spectrum antibiotics should be used to treat them.
Streptomyces bacteremia in a patient with actinomycotic mycetoma
Authors: Joseph Noyal Mariya , Harish Belgode Narasimha , Sistla Sujatha , Thappa Devinder Mohan , Parija Subhash Chandra
Published: May 2010

A 29-year-old woman presented with multiple painful swelling with discharging sinuses over the scalp. Histopathological examination of the biopsy tissue was suggestive of actinomycotic mycetoma. Streptomyces spp. was isolated from blood culture. The patient was successfully treated with trimethoprim-sulfamethoxazole and crystalline penicillin. This case is reported because of the rare occurrence of bacteremia by Streptomyces spp. secondary to subcutaneous actinomycotic mycetoma. Moreover, an interesting association between successive two pregnancies and occurrence of mycetoma of the scalp was observed in this case.
Prevalence and patient characteristics associated with pleural tuberculosis in Nigeria
Authors: Adewole Olufemi O. , Erhabor Greg E. , Ogunrombi Akinwumi B. , Awopeju Fehintola A.
Published: May 2010

Background: Tuberculosis is a leading cause of mortality worldwide, with a growing death rate. The pleural space is a common extrapulmonary site of involvement. The aim of this paper is to document prevalence and types of pleural involvement in pulmonary tuberculosis and patient characteristics associated with its occurrence. Methodology:  The study was conducted in a hospital outpatient clinic in which consecutive patients with pulmonary tuberculosis (PTB) or suspects were recruited and studied for the presence of co existing pleural disease or involvement (PD). Results:  Of 100 patients studied, eighty-two (82%) had PTB alone and six (6%) patients had PD. Pleural effusion was responsible for the majority of the cases, accounting for 67% of PD. There was no case of empyema. Mean age between patients with PTB and PTB/PD was similar.  On univariate analysis, patients with PD had a shorter duration of symptoms and increased reporting of fever (p value = .0.02) and were also different from those with only PTB in HIV seropositivity and sputum smear from AFB (p value = 0.02 and 0.00 respectively).  However, after adjustment for multiple comparisons using the Bonferroni test, the only significant difference between them was in the HIV seropositivity rate (p value < 0.012). Conclusion:  Less than one tenth of patients with PTB have co-existing and involvement of the pleural space. Pleural involvement is associated with HIV.
Does Salmonella Typhi primarily reside in the liver of chronic typhoid carriers?
Authors: Nath Gopal , Singh Yogesh K , Maurya Pushpa , Gulati Anil K , Srivastava Ramit C , Tripathi Sunil K
Published: May 2010

This item has no abstract. Follow the links below to access the full text.
The first Chikungunya case from Sonipat district near the national capital city of Delhi, India
Authors: Kumari Roop , Nand Parma , Mittal Veena , Lal Shiv , Saxena Vijay Kumar
Published: May 2010

This item has no abstract. Follow the links below to access the full text.
Family Caregiving to Hospitalized End-Of-Life and Acutely Ill Geriatric Patients
Authors: Cohen Chaim J. , Auslander Gail , Chen Yifat
Published: May 2010

The article examines family caregiving to hospitalized older adults at the end of life (EOL). The stress process model was used to compare family caregiving in an EOL patient population (
n
= 50) with family caregiving in an acutely ill elderly population (
n
= 50) in a single Israeli hospital. A convenience sample of family caregivers was interviewed in the hospital using a structured questionnaire. Differences between the two groups were examined using contingency tables,
t
tests, and discriminant multivariate analysis. Findings show that family caregivers of EOL patients carry out fewer caregiving tasks and report a greater sense of overload and captivity. On the other hand, they attend to the patient for more days, mobilize more social network support, and report a comparable sense of reward and growth. These findings are discussed in the context of active versus passive caregiving and the significance of nursing support for family caregivers of EOL patients.
Rediscovering the Art of Healing Connection by Creating the Tree of Life Poster: A Pilot Program for Hospitalized Older Adults
Authors: Pipe Teri Britt , Mishark Kenneth , Hansen Reverend Patrick , Hentz Joseph G. , Hartsell Zachary
Published: May 2010

The goal of this project was to provide a way for hospital staff to form meaningful therapeutic relationships with patients in the fast-paced hospital environment. Watson's Theory of Human Caring was the framework guiding the project. The Lifestory intervention was a Tree of Life poster depicting sources of encouragement and enjoyment, special memories, life lessons, family, and roots. Preintervention and postintervention measures included quality of life (QOL) and spirituality scales with established psychometrics. A one-sample
t
test was used to analyze data. Mean age of participants (
n
= 15) was 73.8. Ten (67%) patients reported the intervention positively affected their QOL. Improvements were noted in overall QOL (
p
= 0.05), as well as emotional (
p
= 0.005), physical (
p
= 0.02,) and spiritual well-being, as measured by the Expanded Version of the Functional Assessment of Chronic Illness Therapy—Spiritual Well-Being Scale (
p
= 0.02). This simple Lifestory intervention was feasible and associated with improvement in several QOL dimensions in hospitalized older adults.
Sleep Disturbances in Dementia: What They Are and What To Do
Authors: Rose Karen M. , Lorenz Rebecca
Published: May 2010

Approximately one quarter of adults with dementia experience sleep disturbances. The purpose of this article is to (a) describe and define sleep disturbances in individuals with dementia, (b) describe techniques to assess for sleep disturbances in individuals with dementia, and (c) provide nursing interventions to improve sleep in this patient population. Typical presentations of sleep disturbances in individuals with dementia are described, along with medications that may interfere with sleep. Suggestions for nursing measures that can be implemented to enhance sleep are also presented. Nurses have numerous nonpharmacological options to assist with the regulation of sleep-wake rhythms in individuals with dementia.
Developing a Statewide Medication Technician Pilot Program in Nursing Homes
Authors: Randolph Pamela K. , Scott-Cawiezell Jill
Published: May 2010

In times of fiscal constraints, nursing homes are seeking to maximize use of licensed staff through delegation of low-risk tasks to unlicensed personnel. Between 2004 and 2008, the Arizona State Board of Nursing developed and conducted a pilot program to determine the impact on patient health and safety of licensed nurses delegating medication administration to trained certified nursing assistants. There were no differences in patterns of medication errors before and after the introduction of medication technicians, and structured interviews revealed that participants viewed the role favorably, with reported increased role satisfaction on the part of delegating nurses. Efforts are underway to extend the program statewide.
A Multicomponent Exercise Program for Institutionalized Older Adults
Authors: Justine Maria , Hamid Tengku Aizan
Published: May 2010

This study examined the effects of a multicomponent exercise program on depression and quality of life in institutionalized older adults. A quasi-experimental pretest-posttest design was used. Participants were recruited from a publicly funded shelter home in Seremban, Negeri Sembilan Malaysia. The experimental group consisted of 23 volunteers 60 or older who performed 60 minutes of supervised exercise three times per week for 12 weeks. The control group consisted of 20 volunteers who continued with a sedentary lifestyle. At 12 weeks, the exercise group demonstrated an improvement in quality of life by 10.74% (
p
> 0.05) but not depression (−1.6%,
p
> 0.05). The control group demonstrated a decrease in both quality of life by 11.26% (
p
> 0.05) and level of depression by 17.7% (
p
> 0.05). This study suggests a multicomponent exercise program is a feasible intervention to improve quality of life in institutionalized older adults.
Agreeableness and Activity Engagement in Nursing Home Residents with Dementia
Authors: Hill Nikki L. , Kolanowski Ann , Kürüm Esra
Published: May 2010

Residents with dementia are the least likely to be engaged in the nursing home and often spend most of their time doing nothing at all. However, resident participation in meaningful activities is important to promote both physical and psychological health. Tailoring activities to individual functional abilities and personality preferences improves both the time and level of participation. This pilot study used an analysis of covariance procedure to test the relationship between the personality trait of agreeableness and engagement when activities are ideally tailored to ability and interest. No significant difference was found between the high and low agreeableness groups, indicating that residents were more engaged when activities were individually tailored, regardless of their agreeableness level. Although low agreeableness may pose a challenge when implementing activities for people with dementia, the results of this study suggest that tailoring activities to functional ability and interest may overcome the effects.
Someone to Talk to: The Nurse and the Depressed or Suicidal Older Patient
Authors: Plawecki Lawrence H. , Amrhein David W.
Published: May 2010

Depression and suicide are two major mental health problems affecting older adults, this country's fastest growing population. As such, more nurses must become educated on assessing their geriatric patients for the signs and symptoms of each. These subjects are very difficult to breach and often are not discussed unless rapport has been established through nurses' use of positive, therapeutic communication. When confronted, professional nurses are placed in the difficult situation between maintaining the patient's privacy or confidentiality, respecting their federally protected health information, and the duty to care for the patient. Open discussion between the nurse and other members of the treatment team is vital to identifying the issue and providing older patients with the mental health care they require.
Conducting Root Cause Analysis with Nursing Students: Best Practice in Nursing Education
Authors: Lambton Judith , Mahlmeister Laura
Published: May 2010

This article describes a novel approach that allows students to actively participate in a root cause analysis, whether the error was committed in the clinical setting or in the simulation setting. This process can develop student awareness of the responsibility and professional duty to participate in creating a safer patient environment.
Headed in the “Write” Direction: Nursing Student Publication and Health Promotion in the Community
Authors: McMillan Libba Reed , Raines Kimberly
Published: May 2010

Effective writing is vital to nursing practice. As educators, we sought to incorporate a meaningful writing assignment as part of a junior-level professional development course. We used innovative methods that support the missions of higher education in general and nursing education in particular while promoting healthful living and establishing the community-as-client. In addition to fostering health education and health promotion, this writing assignment served to enhance students’ writing skills and provide them with an opportunity to have their work published. The venue for publication was
The Auburn Villager
, a weekly local newspaper with a circulation of 6,000 within the local community in East Alabama. The writing assignment was a tremendous success on many levels. Foremost among the positive outcomes was student pride in experiencing publication of their creative work. In addition, students reported a feeling of satisfaction that the assignment had both practical and educational utility.
A University and Health Care Organization Partnership to Prepare Nurses for Evidence-Based Practice
Authors: Missal Bernita , Schafer Beth Kaiser , Halm Margo A. , Schaffer Marjorie A.
Published: May 2010

This article describes a partnership model between a university and health care organizations for teaching graduate nursing research from a framework of evidence-based practice. Nurses from health care organizations identified topics for graduate students to search the literature and synthesize evidence for guiding nursing practice. Nurse educators mentored graduate students in conducting critical appraisals of the literature. Students learned how to search for the evidence, summarize the existing research findings, and translate the findings into practice recommendations. Through presenting and discussing their findings with key stakeholders, students learned how nurses planned to integrate the evidence into practice. Nurses used the evidence-based results to improve their practice in the two partner hospitals. The partnership stimulated action for further inquiry into best practices.
Palliative Care and African American Women Living with HIV
Authors: DeMarco Rosanna F.
Published: May 2010

It is challenging to develop and assess skills in a classroom setting, for graduate students particularly, in the area of quality improvement project plans that are real, relevant, and sensitive in a unique health care context. Although understanding significant issues related to palliative care needs of U.S. citizens through the interpretation of those who publish in this area is extremely helpful to students, it does not allow for an experience uniquely situated in realities faced by those living with life-threatening and chronic illness or in a time frame that is current. Graduate students in a Health Resources and Services Administration-funded program of study completed a secondary data analysis of digitally recorded conversations of African American women living with human immunodeficiency virus or acquired immune deficiency syndrome to identify consumer-driven palliative care needs and create possible quality improvement program solutions. This exercise supports the World Health Organization’s advice to become palliative care leaders through engagement in clients’ realities.
Decreased Contrast Sensitivity in Children and Adolescents with Type 1 Diabetes Mellitus
Authors: Georgakopoulos Constantine D. , Eliopoulou Maria I. , Exarchou Artemis M. , Tzimis Vasileios , Pharmakakis Nikolaos M. , Spiliotis Bessie E.
Published: May 2010

Purpose:

To evaluate contrast sensitivity in children and adolescents with diabetes mellitus without evidence of diabetic retinopathy.

Methods:

Sixty patients with insulin-dependent diabetes mellitus (age range: 8 to 18 years) were studied. Their contrast sensitivity scores were obtained using the CSV-1000 device (Vector Vision, Dayton, OH) for four spatial frequencies and were compared with v scores of 45 age-matched and gender-matched “healthy” patients. Contrast sensitivity values were also correlated to patient’s age, duration of disease, and metabolic control of diabetes mellitus.

Results:

The patients with insulin-dependent diabetes mellitus had a significant contrast sensitivity score reduction at all spatial frequencies tested. Glycosylated hemoglobin levels were inversely related to the contrast sensitivity thresholds. No significant correlation was found between the contrast sensitivity scores and the patient’s age or duration of disease.

Conclusion:

Contrast sensitivity defects are detected in patients with insulin-dependent diabetes mellitus. These defects may represent an early dysfunction of the retina, visual pathway, or both in patients with insulin-dependent diabetes mellitus who do not show any signs of diabetic retinopathy.
Binocular Function in Pseudophakic Children
Authors: Ing Malcolm R.
Published: May 2010

Purpose:
The author reports the results of visual and binocular tests performed on patients who had primary insertion of intraocular lenses following the removal of cataracts in their childhood.

Methods:
Monocular and binocular tests were performed on 21 patients using the same equipment for sensory testing for binocularity on all patients before the history was abstracted from the clinical records. These patients were selected from a consecutive series and observed for a minimum of 5 years by their surgeons.

Results:
The mean age at surgery performed on the first eye was 6.3 years. The mean age at the date of the author’s examination was 16.5 years and the mean length of follow-up was 10.3 years. All but 2 patients had motor alignment within 8 prism diopters of orthotropia at near. Fusion and some stereopsis was found in 15 patients, but only 4 of these demonstrated fine (60 seconds of arc or better) stereoacuity. Patients with fine versus gross stereoacuity were compared and found to be similar in type of cataract, age at first surgery, interval between surgeries, length of follow-up, and refraction, but different in the quality of best-corrected visual acuity.

Conclusion:
Although satisfactory motor alignment, fusion, and some stereopsis is present in the majority of patients, fine stereoacuity is uncommon in pseudophakic children.
Dilation and Probing of Schlemm’s Canal and Viscocanalostomy in Pediatric Glaucoma
Authors: Kay Jeffrey S. , Mitchell Robert , Miller Joseph
Published: May 2010

Purpose:
To describe the authors’ experience using a novel surgical technique for treatment of childhood glaucoma.

Methods:
Medical records of 24 consecutive patients and 39 eyes that underwent dilation and probing of Schlemm’s canal and viscocanalostomy between September 2002 and June 2008 were reviewed. Surgical success was defined as an intraocular pressure (IOP) of less than 23 mm Hg with or without glaucoma medication and without further surgical intervention.

Results:
Mean age at surgery was 66 ± 66 months, with a mean preoperative IOP of 40.4 ± 10.2 mm Hg. Surgical success was achieved in 27 of 39 eyes (69%) with an average follow-up of 22 months. In patients without history of previous surgery and the diagnosis of primary congenital or juvenile glaucoma, surgical success was achieved in 17 of 19 eyes (89%) with an average follow-up of 20 months. There were no serious surgical complications associated with this procedure.

Conclusion:
Goniosurgery with dilation and probing of Schlemm’s canal in combination with viscocanalostomy appears to be a safe and effective surgical modality to lower IOP. The procedure appears to be most effective in surgically naïve primary congenital and juvenile glaucoma.
Physical Characteristics of Ocular Structures in Chinese Children With Emmetropia
Authors: Zhang Zhen-Yong , Chu Ren-Yuan , Zhang Xing-Ru , Zhou Xing-Tao , Hoffman Matthew R. , Dai Jin-Hui
Published: May 2010

Purpose:
To evaluate whether accommodation has effects on eye elongation.

Methods:
Two hundred seventy-three eyes with a refractive error between +1.0 and −0.5 diopters were divided into three groups: pre-school children, grade-school children, and middle-school children. Ocular structures were measured using autorefraction and A-scan ultrasonography.

Results:
There was a negative correlation between age and corneal power (r = −0.227, P = .0001), lens thickness (r = −0.263, P = .00001), and Gullstrand lens power (r = −0.452, P << .0001). There was a positive correlation between age and axial length (r = −0.432, P << .0001) and vitreous chamber depth (r = 0.505, P << .0001). Mean corneal power (P < .001) and lens power (P < .001) were significantly greater in pre-school children than in grade-school children, whereas axial length (P < .001) and vitreous chamber depth (P < .001) were greater in grade-school children. Mean lens thickness (P = .01) and lens power (P = .07) were higher in grade-school children than in middle-school children, whereas axial length (P = .024) and vitreous chamber depth (P < .001) were higher in middle-school children.

Conclusion:
Ocular structures may play different roles in maintaining emmetropia. Accommodation during near work and its potential attendant hyperopic defocus could potentially drive eye elongation.
Corneal Infiltrates After Corneal Collagen Cross-Linking
Authors: Mangioris George F. , Papadopoulou Domniki N. , Balidis Miltiadis O. , Poulas Jordan L. , Papadopoulos Nikolaos Th. , Seiler Theo
Published: May 2010

Purpose:

To present a case of advancing keratoconus treated with corneal collagen cross-linking (CXL) with ultraviolet A (UVA) light and riboflavin complicated with sterile infiltrates.

Methods:

The patient’s cornea was de-epithelialized and CXL was performed with application of riboflavin and exposure to UVA light (370 nm, 3 mW/cm
2
) for 30 minutes.

Results:

Early in the postoperative period, the patient presented with 11 deep stromal infiltrates of 1 to 2 mm with clear demarked edges in a circle near the limbus with some clear cornea. Corneal cultures were negative. Treatment consisted of antibiotic ofloxacin and tobramycin four times daily, and dexamethasone drops six times daily. After 2 months, scars remained evident.

Conclusions:

This complication has not been reported previously and may be an individual hypersensitivity reaction to the riboflavin or UVA light in the anterior stroma.
Refractive Surgical Correction of Presbyopia with the AcuFocus Small Aperture Corneal Inlay: Two-Year Follow-Up
Authors: Seyeddain Orang , Riha Wolfgang , Hohensinn Melchior , Nix Gerhard , Dexl Alois K. , Grabner Günther
Published: May 2010

Purpose:

To evaluate the safety and efficacy of the AcuFocus Corneal Inlay 7000 (ACI 7000) implanted in emmetropic presbyopic patients for the improvement of near and intermediate vision over 2-year follow-up.

Methods:

This prospective, non-randomized, non-comparative study included 32 naturally emmetropic presbyopic patients. The intracorneal inlay was implanted in the non-dominant eye over the pupil by creating a superior-hinged flap with the IntraLase 60-kHz femtosecond laser (Abbott Medical Optics). Inlay centration was over the line of sight. Minimum postoperative follow-up was 24 months.

Results:

After mean follow-up of 24.2±0.8 months (range: 24 to 26 months), 96.9% of patients read J3 or better in the implanted eye. Mean binocular uncorrected near visual acuity improved from J6 preoperatively to J1 after 24 months. Mean binocular uncorrected intermediate visual acuity (UIVA) was 20/20 at 1 month and remained 20/20 throughout 24-month follow-up, with 71.9% of eyes reaching UIVA of 20/20 or better. At 24 months, mean uncorrected distance visual acuity was 20/20 in the implanted eye and 20/16 binocularly. No inlay was explanted during the study. Two decentered inlays were recentered after 6 months because of in-sufficient increase in near and intermediate visual acuity. Both patients’ near and intermediate visual acuity improved significantly after recentration.

Conclusions:

The ACI 7000 seems to provide a safe and effective treatment for presbyopia over follow-up of 2 years.
Evaluation of the Calhoun Vision UV Light Adjustable Lens Implanted Following Cataract Removal
Authors: Hengerer Fritz H. , Conrad-Hengerer Ina , Buchner Sabine E. , Dick H. Burkhard
Published: May 2010

Purpose:

To evaluate the effectiveness of a silicone intraocular lens (IOL) that can be adjusted following implantation using ultraviolet (UV) irradiation.

Methods:

Prospective clinical trial of 40 patients (40 eyes) with visually significant cataract. Participants underwent small-incision phacoemulsification followed by implantation of a light-adjustable, silicone IOL (Light Adjustable Lens [LAL], Calhoun Vision). All patients were required to wear UV-protective eyewear at all times, until final lock-in. Pre- and postoperative clinical parameters included distance visual acuity and manifest refraction.

Results:

At average 2 weeks postoperative (range: 10 to 21 days), patients were seen and refracted to determine type and magnitude of refractive error needing correction. All patients required an initial adjustment of the LAL, whereas 28 required a second UV treatment and none required a third adjustment. At 4 months postoperative, mean refraction was 0.04±0.37 diopters (D) (range: −0.88 to 0.50 D), mean sphere was 0.24±0.40 D (range: −0.50 to 0.75 D), and mean cylinder was 0.41±0.25 D (range: 1.00 to 0.0 D). Eighty-one percent of eyes gained 2 or more lines of corrected distance visual acuity.

Conclusions:

The adjustment and lock-in procedures were well tolerated by patients. The Calhoun Vision LAL is a promising technology with the potential to eliminate postoperative refractive surprises of up to 2.00 D of refractive and cylindrical error following implantation.
Comparison of Optical Performance in Eyes Implanted with Aspheric Foldable, Spherical Foldable, and Rigid PMMA IOLs
Authors: van Gaalen Kim W. , Jansonius Nomdo M. , Koopmans Steven A. , Kooijman Aart C.
Published: May 2010

Purpose:

To compare the optical performance of rigid spherical polymethylmethacrylate (PMMA), foldable spherical, and foldable aspheric intraocular lenses (IOLs).

Methods:

Measurements were obtained monocularly from pseudophakic patients with a PMMA IOL (Ophtec PC265y or Rayner 105U), spherical AcrySof MA30 IOL (Alcon Laboratories Inc), or aspheric Tecnis ZA9003 IOL (Abbott Medical Optics). Contrast sensitivity was measured using the Holladay automated contrast sensitivity test with 5.0-mm artificial pupil at 3 and 6 cycles per degree at optimal focus and at several defocus levels. The myopic shift (shift of the optimal focus toward more myopic values at lower spatial frequencies) and depth of focus were determined. Wavefront aberrations were assessed with a Hartmann-Shack wavefront analyzer; straylight was measured using the C-Quant meter (Oculus Optikgeräte GmbH).

Results:

Nine patients with a spherical rigid PMMA IOL, 19 patients with a spherical foldable IOL, and 24 patients with an aspheric foldable IOL met the inclusion criteria. Eyes with an aspheric IOL showed less spherical aberration than eyes with other IOLs; no differences were found in overall higher order aberrations. No differences in contrast sensitivity at optimal focus and in straylight were found among the IOLs. Eyes with a PMMA IOL showed a larger depth of focus compared to eyes with an aspheric IOL. Eyes with an aspheric IOL had a smaller myopic shift than eyes with other IOLs.

Conclusions:

Optical performance differences among the IOLs in this study are small, concurring with similar higher order aberrations found in the three groups. Reduction in myopic shift appears to be the most obvious effect of aspheric IOLs.
Long-Term Ophthalmological Follow-Up of Children with Parinaud Syndrome
Authors: Goldenberg-Cohen Nitza , Haber Jordana , Ron Yonina , Kornreich Liora , Toledano Helen , Snir Moshe , Cohen Ian J. , Michowiz Shalom
Published: May 2010

Background and Objective:

To assess the long-term ophthalmological outcome of Parinaud syndrome.

Patients and Methods:

The files of 6 children with tumor-related Parinaud syndrome diagnosed and observed from 2000 to 2007 were reviewed. All had papilledema indicating increased intracranial pressure.

Results:

Mean presentation-to-diagnosis delay was 3.6 weeks. Treatment consisted of surgical shunting and complete or partial resection with adjuvant chemotherapy (n = 4) and radiation (n = 3). Visual acuity remained stable or improved in 8 of 9 eyes with 20/30 visual acuity at diagnosis; improved bilaterally in 1 patient from 20/100 to 20/25; and deteriorated bilaterally in 1 patient from 20/30 and 20/200 to counting fingers and hand motions, respectively. The most improvement was achieved within 4 months. Findings at follow-up (mean: 4.2 years) included up gaze limitation (minimal in 2 patients), abnormal convergence, convergence retraction nystagmus, and light-near dissociation. One child had bilateral optic atrophy.

Conclusion:

Children with tumor-related Parinaud syndrome tend to have subtle but measurable residual ophthalmological findings years after diagnosis and treatment.
Choroidal Metastases Fundus Autofluorescence Imaging: Correlation to Clinical, OCT, and Fluorescein Angiographic Findings
Authors: Natesh Sribhargava , Chin Kimberly J. , Finger Paul T.
Published: May 2010

Background and Objective:

To correlate fundus autofluorescence (FAF) characteristics of metastatic choroidal tumors with optical coherence tomography/scanning laser ophthalmoscope (OCT/SLO).

Patients and Methods:

A retrospective review of 10 choroidal metastases in 9 patients.

Results:

All tumors were amelanotic, although 8 exhibited surface pigmentation. FAF imaging revealed hyperautofluorescence in areas of focal pigmentation and subretinal fluid with hypoautofluorescent margins (n = 5) corresponding to OCT evidence of retinal pigment epithelial (RPE) thickening and subretinal fluid. Loss of RPE was FAF imaging hypoautofluorescent. FAF images changed with tumor growth. OCT best revealed elevation of the RPE and retina, RPE thickening and folds, and retinal detachment.

Conclusion:

FAF imaging best defined surface characteristics and tumor margins. FAF imaging hyperautofluorescence correlated to focal hyperpigmentation, subretinal fluid, and advancing tumor edges. OCT better demonstrated intraretinal findings (atrophy, subretinal fluid, and increased and lost RPE). This study shows that FAF imaging and OCT reveal unique tumor characteristics of choroidal metastasis.
Anatomic and Visual Outcomes of Vitrectomy for Lamellar Macular Holes
Authors: Witkin Andre J. , Castro Leonardo C. , Reichel Elias , Rogers Adam H. , Baumal Caroline R. , Duker Jay S.
Published: May 2010

Background and Objective:

To assess anatomic and visual outcomes after pars plana vitrectomy for lamellar macular holes.

Patients and Methods:

Charts of 746 patients who had vitrectomy surgery with membrane peel were reviewed. Preoperative diagnosis of lamellar macular hole was based on optical coherence tomography (OCT) appearance; 16 eyes of 16 patients met the inclusion criteria.

Results:

Mean acuity was 20/158 preoperatively and 20/118 postoperatively (
P
= .408). Central macular thickness was 377.06 μm preoperatively and 245.7 μm postoperatively (
P
= .002). Two eyes (13%) developed full-thickness macular holes postoperatively. Six eyes (38%) continued to have a lamellar macular defect on OCT postoperatively.

Conclusion:

Despite postoperative anatomic improvement in many patients and an overall decrease in foveal thickness on OCT, this retrospective series suggests that vitrectomy for lamellar holes may not improve visual acuity.
Loss of Retinal Pigment Epithelium Associated With Bilateral Diffuse Uveal Melanocytic Proliferation
Authors: Kiratli Hayyam , Erkan Kadriye
Published: May 2010

A 69-year-old woman was evaluated for poor visual acuity in both eyes despite recent cataract extractions. She had bilateral distinct melanocytic lesions in the posterior uvea and retinal pigment epithelial loss over these lesions and over normal-appearing choroid. Fluorescein angiography showed patchy areas of mottled hypofluorescence and hyperfluorescence. Optical coherence tomography demonstrated focal deposition of material over atrophic retinal pigment epithelium. Electroretinography showed decreased a- and b-wave amplitudes under scotopic and photopic conditions. The diagnosis of bilateral diffuse uveal melanocytic proliferation immediately led to the discovery of bronchogenic carcinoma and the patient died 10 days later. This case study suggests that different paraneoplastic stimuli may be operational over the retinal pigment epithelium and uveal melanocytes and that certain features of bilateral diffuse uveal melanocytic proliferation and cancer-associated retinopathy may coexist.
Presencia y visibilidad web de las universidades públicas españolas
Authors: Orduña-Malea Enrique , Serrano-Cobos Jorge , Ontalba-Ruipérez Jose Antonio , Lloret-Romero Nuria
Published: May 2010

Se estudia la evolución del tamaño y visibilidad de los dominios web de las universidades públicas españolas desde enero hasta junio de 2009 en función de diversos buscadores web (Google, Yahoo!, Live/Bing y Exalead). Asimismo, se proponen el factor de representatividad relativa media en tamaño (Rs) y el factor de representatividad relativa media en visibilidad (Rv) como indicadores para conocer la importancia de un dominio, en número de documentos y de enlaces externos respectivamente, durante un intervalo temporal, con el propósito de ser aplicados en el diseño y construcción de rankings de universidades basados en técnicas cibermétricas. Los resultados confirman que las diferencias de tamaño entre los dominios académicos web son muy grandes según el buscador utilizado, por lo que el uso de un único buscador no permite conocer de forma fiable el tamaño real de un dominio web. Además, el empleo de valores combinados a partir de la media obtenida en cada buscador no ofrece resultados fiables, dada la varianza de datos obtenida entre buscadores así como los diferentes índices obtenidos de Rs. Las diferencias en visibilidad son menores aunque igualmente significativas. Se comprueba que los indicadores Rs y Rv proporcionan información útil y coherente acerca del grado de evolución de las universidades en la Web durante un intervalo temporal determinado. Se obtiene asimismo una correlación positiva entre estos dos indicadores tanto en Yahoo! como en Exalead, que confirma la relación entre el tamaño documental de un dominio académico web y el número de enlaces que recibe a lo largo del tiempo.
La participación española en los programas europeos: análisis estructural del área de salud del 6.º Programa Marco
Authors: Ortega José Luis , Aguillo Isidro F.
Published: May 2010

El objetivo de este trabajo es describir la participación española en el área temática de salud del 6.º Programa Marco. Para ello se pretende realizar un análisis estructural de la red de colaboraciones entre las diversas entidades que participan en tales proyectos además de una descripción al nivel regional, sectorial e individual del grado de participación y retorno obtenido. Los resultados muestran que la participación española se apoya en el sector administración, de ámbito estatal, concretamente en el CSIC, el CNIO, los hospitales y las universidades. Se concluye que España presenta una posición periférica en el área temática de salud, cuya participación se sustenta básicamente en el CSIC.
Spatial dynamics of Fabiana imbricata shrublands in northwestern Patagonia in relation to natural fires
Authors: Oddi F. J. , Dudinszky N. , Ghermandi L.
Published: May 2010

Abstract. Fire is a critical disturbance in the structuring and functioning of most Mediterranean ecosystems. In northwestern Patagonia, vegetation patterns are strongly influenced by fire and environmental heterogeneity. Dendroecology, together with satellite imagery and GIS, have been demonstrated to be useful tools in studies that relate to fire effects with patches, patterns and species dynamics at landscape scale. Such studies can be approached from landscape ecology, which has evolved in the last years supported by the development of remote sensing and GIS technologies. This study evaluates the spatial dynamic of F. imbricata in response to fire using remote sensing, GIS and dendrochronology techniques, at landscape scale. Two sites were evaluated and one of them was affected by fire in the year 1999. The digital processing images (using the NBR spectral index) and the dendroecological analysis verified this. A fire, occurring in 1978, was also detected by the analysis of F. imbricata growth rings. The relation between F. imbricata shrubland dynamics and spatial configuration with fire, land topography and hydrography was established in the study area.
Assessment of Mitochondrial Dysfunction Arising from Treatment with Hepatotoxicants
Authors: King Adrienne L. , Bailey Shannon M.
Published: May 2010

Mitochondrial dysfunction from toxicants is recognized as a causative factor in the development of numerous liver diseases including steatohepatitis, cirrhosis, and cancer. Toxicant‐mediated damage to mitochondria result in depressed ATP production, inability to maintain proper cellular calcium homeostasis, and increased reactive oxygen species production. These disruptions contribute to hepatocellular death and lead to liver pathology. Herein, we describe a series of basic and advanced methodologies that can be incorporated into research projects aimed to understand the role of mitochondrial dysfunction in toxicant‐induced hepatotoxicity. Protocols are provided for isolation of liver mitochondria, assessment of respiratory function, measurement of mitochondrial calcium uptake, and reactive oxygen species production, as well as characterization of the mitochondrial protein thiol proteome using 2D gel electrophoresis. Data obtained from these methods can be integrated into a logical and mechanistic framework to advance understanding of the role of mitochondrial dysfunction in the pathogenesis of toxicant‐induced liver diseases. Curr. Protoc. Toxicol. 44:14.8.1‐14.8.29. © 2010 by John Wiley & Sons, Inc.
Growth and Maintenance of Baby Hamster Kidney (BHK) Cells
Authors: Hernandez Raquel , Brown Dennis T.
Published: May 2010

The BHK21 cell line was established in 1961 from the kidneys of 5 Syrian hamsters from litter number 21. Since this time, this cell line has been a laboratory standard for the growth of countless viruses and the study of many biological processes. The specific use for the growth of Sindbis virus is described, although it may apply to many types of viruses. Curr. Protoc. Microbiol. 17:A.4H.1‐A.4H.7. © 2010 by John Wiley & Sons, Inc.
Growth and Maintenance of Mosquito Cell Lines
Authors: Hernandez Raquel , Brown Dennis T.
Published: May 2010

Mosquito cells (Aedes albopictus) are among the most common insect cells emerging as new sources of cell cultures to use in basic research and in the pharmaceutical industry. They adapt well to growth in suspension; can be used in bioreactors for the production of expressed proteins, virus, and virus‐like particles; can be used in studies requiring lower growth temperatures than mammalian cells (28°C or below); and (because they are cholesterol auxotrophs) can be adapted to grow in dilipidated or serum‐free medium for experiments requiring these conditions. Procedures applicable to the laboratory maintenance of mosquito cell lines are described. Curr. Protoc. Microbiol. 17:A.4J.1‐A.4J.8. © 2010 by John Wiley & Sons, Inc.
Sunlight robbery: A critique of public health policy on vitamin D in the UK
Authors: Gillie Oliver
Published: May 2010

The British Isles have a very cloudy climate and as a result receive fewer hours of clear sunlight than most other industrial regions. The majority of people in these islands have low blood levels of vitamin D [25(OH)D] all year round. Few food products are fortified with vitamin D in the UK and the government does not recommend any vitamin D supplement for most adults in the UK. Diseases associated with vitamin D insufficiency such as cancer, heart disease, diabetes (types 1 and 2) and multiple sclerosis are more frequent in the UK, and particularly in Scotland, than in many other European countries and some, such as multiple sclerosis and diabetes (types 1 and 2), are increasing in incidence. Present knowledge suggests that the risk of some chronic diseases could be reduced if vitamin D intake or sun exposure of the population were increased. Yet policy and public health recommendations of the UK government and its agencies (e.g.the Health Protection Agency, the Food Standards Agency) and of Cancer Research UK have failed to take full account of established and putative benefits of vitamin D and/or sunshine. The epidemic of chronic disease in the UK, which is associated with and caused at least in part by vitamin D insufficiency, has not been adequately recognized by these agencies, and too often measures taken by them have been misguided, inappropriate or ineffective.
Vitamin D deficiency and pregnancy: From preconception to birth
Authors: Lewis Sharon , Lucas Robyn M. , Halliday Jane , Ponsonby Anne‐Louise
Published: May 2010

Vitamin D is important for bone health, as well as an increasing number of other health outcomes. Here we discuss the evidence relating to vitamin D in pregnancy, from preconception to the perinatal period. During pregnancy extra calcium required for fetal skeletal growth is attained by both maternal bone resorption and increased absorption from dietary sources, necessitating increased maternal vitamin D. Many women have low vitamin D status during pregnancy and may require supplementation, although optimal serum levels and intake required to achieve those levels is not yet well defined. Evidence from animal studies, with some supportive human evidence, suggests that fertility may be impaired in mothers with low vitamin D. During pregnancy, maintaining vitamin D and calcium levels may decrease the risks of pre‐eclampsia, while gestational diabetes mellitus appears to be more common in those with low vitamin D status, although there is insufficient evidence of causality. The evidence in relation to increased risks of bacterial vaginosis and caesarean section similarly requires confirmation in carefully designed observational and experimental studies. This review outlines the emerging evidence that maternal vitamin D status during pregnancy is important for the health of the mother and offspring across a range of possible health outcomes.
Leuchtstäbe und Goldkästchen
Authors: Schiecht Sabine
Published: May 2010

Von individuellen Partikeln zu komplexen hochgeordneten Architekturen reicht mittlerweile die Produktpalette der Verfahren zum Aufbau anorganischer Nanostrukturen. Abmessungen und Morphologien der Objekte lassen sich durch oberflächenaktive Additive oder Template steuern ‐ nun gilt es, das Anwendungspotential dieser Systeme auszuloten.
Virale Ionenkanäle: Bildung, Modelling, Drug Targeting
Authors: Fischer Wolfgang B.
Published: May 2010

Viren manipulieren den Stoffwechsel einer infizierten Zelle zu ihren Gunsten. Dafür nutzen sie kleine Proteine, die Ionenkanäle bilden. Doch wie lagern sich diese Proteine zu funktionellen, membrandurchspannenden Einheiten zusammen? Leitfähigkeitsmessungen und Computersimulation sind zwei der vielen Methoden, die dazu beitragen, die Vorgänge zu verstehen und letztlich neue antivirale Wirkstoffe zu entwerfen.
Affen, die lieben Verwandten
Authors: Groß Michael
Published: May 2010

Die kürzlich im Entwurf publizierte Genomsequenz des Schimpansen liefert uns vor allem Informationen über die am weitesten verbreitete Affenart, Homo sapiens.
Sport = Reach im Testlauf
Authors: Claus Frank , Kühr Ann‐Katrin
Published: May 2010

Sport, ein Planspiel, sollte die Praktikabilität der Stoffregistrierung im Rahmen des Reach‐Systems zeigen. Noch fehlen Ideen für effizientere Abläufe im Verfahren.
Fragmentscreening mit NMR‐Spektroskopie
Authors: Schade Markus
Published: May 2010

NMR‐Fragmentscreening kann wichtige Beiträge zur Leitstrukturfindung und ‐optimierung leisten. Die Methode eignet sich besonders für Zielproteine mit flachen Bindetaschen und ist dort hilfreich, wo die Selektivität von Leitstrukturen zu verbessern ist oder neue, passgenaue Molekülbausteine für fokussierte Bibliotheken gesucht werden.
Procedural Performance in Gastrointestinal Endoscopy: Live and Simulated
Authors: Sarker Sudip K. , Albrani Tark , Zaman Atiquaz , Kumar Isis
Published: May 2010

Background

The purpose of the present study was to compare the use of a human and a computer‐based technical skills assessment tool in live and simulated gastrointestinal endoscopies performed by consultants and trainees.

Methods

Validated human‐based Likert scales were used individually for generic and specific technical skills for two procedures. Two observers assessed each procedure independently and blindly. Computer‐based assessment tools were also used, assessing aspects of the mucosa as well as various procedural times. The two tools were then compared.

Results

A total of 210 live and simulated endoscopies (107 esophagogastroduodenoscopy [OGD], 103 sigmoidoscopy) were performed by 18 consultants and 37 trainees. Mean inter‐rater reliability using Cronbach alpha was good for the human‐based tool (range: p = 0.62–0.75). Construct validity was good for the human‐based tool (analysis of variance [ANOVA] range: p = 0.000–0.002) but not for the computer‐based tool (ANOVA range: p = 0.263–0.701).

Conclusions

This human‐based technical skills assessment tool of gastrointestinal endoscopies seems to have face, content, concurrent, and construct validities compared to computer‐based assessment parameters. The tool has the possibility of being used in training, self‐appraisal, and revalidation.
Hematopoiesis in the thymidine kinase 2 deficient mouse model of mitochondrial DNA depletion syndrome
Authors: Zhou Xiaoshan , Johansson Magnus , Solaroli Nicola , Rozell Björn , Grandien Alf , Karlsson Anna
Published: May 2010

Mitochondria are important for normal blood‐cell development, and several diseases linked to mitochondrial DNA (mtDNA) show hematological manifestations. We recently generated a mouse strain deficient in expression of the mitochondrial pyrimidine nucleoside kinase thymidine kinase 2 (Tk2), showing that these mice exhibit progressive mtDNA depletion in multiple organs. We used this mouse strain as a model for mtDNA depletion syndromes to investigate the effects of mtDNA depletion on hematopoiesis. MtDNA levels in spleen from the Tk2‐deficient mice were decreased 50%, but in contrast to all other investigated organs, both thymus and peripheral blood leukocytes showed normal mtDNA levels. Analysis of peripheral blood and cell populations in spleen, thymus, and bone marrow showed normal findings in the Tk2‐deficient mice. The total rates of thymidine phosphorylation—which also include phosphorylation catalyzed by cytosolic Tk 1—in both spleen and thymus from wild‐type mice were >50‐fold higher than in liver, brain, and muscle. In summary, our data show that blood cells are less dependent on mitochondrial Tk2 compared with several other tissues and that these cells can synthesize deoxyribonucleotides required for mtDNA replication by alternative pathways such as phosphorylation of thymidine by cytosolic Tk1.