bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Design of the Multicenter Study of Light Reduction in Retinopathy of Prematurity (LIGHT-ROP)
Authors: Anonymous  
Published: April 2021

ABSTRACT
Background: The LICHT-ROP Study was a multicenter, prospective, randomized, controlled, clinical trial designed to determine if a reduction in ambient light exposure to premature infants' eyes would reduce the incidence of retinopathy of prematurity (ROP). Previous clinical reports were contradictory and had one or more methodological flaws.
Methods: The LICHT-ROP trial was designed in rigorous fashion to include randomization to treatment or control groups, masking of examiners, an adequate sample size of high-risk infants, a universal ROP classification system, a reliable and reproducible ophthalmologic examination protocol, a controlled method of light reduction, and monitoring of light levels in the nursery. The multicenter trial was conducted at three centers in Buffalo, Dallas, and San Antonio, with a separate coordinating center in Houston. The trial also utilized a separate data and safety monitoring committee.
Conclusion: The design of the LICHT-ROP study represents the most rigorous and largest clinical trial to date. It has demonstrated that light reduction does not reduce the incidence of confirmed ROP in high risk infants.
Journal of Pediatrie Ophthalmology and Strabismus 7999;36:257-263.
Triage, Education, and Group Meetings: Efficient Use of the Interdisciplinary Team with Chronic Psychiatric Outpatients
Authors: Rosenthal Renate H , Thomas Norma S , Vandiveer Carol A 
Published: April 2021

ABSTRACT
The caseload of chronic patients of a large mental health outpatient clinic was triaged into medication groups with educational and socialization emphasis. Organization, division of staff responsibilities, and longitudinal clinic responses are described, and advantages and pitfalls of the group format are presented.
A Group Self-Care Approach to Stress Management
Authors: Garrison John , Scott Patricia A 
Published: April 2021

ABSTRACT
A procedure is described for teaching patients the use of relaxation as a coping skill. The procedure, called Stress Management Training, combines Progressive Relaxation and Clinical Meditation into a standardized but flexible seven-session protocol. The technique has been used to treat a variety of stress-related medical and psychological problems. The training consists of three components. The first is giving the patient a cognitive understanding of stress and relaxation. The second, teaching the patient to relax by controlling the muscle tension and sympathetic nervous system activity. The third, teaching the patient to generalize the relaxation skill to real-life stress situations. Patients are also instructed in the relationship between stress, basic health practices, and physical health status.
Talking About Sex - With Less Anxiety
Authors: Anderson Mary Lynn 
Published: April 2021

ABSTRACT
Nurses have both the opportunity and the responsibility to discuss the client's sexual concerns as part of the provision of wholistic health care, yet anxiety often inhibits this discussion. The client may feel anxious in response to changes in social norms and confusion as to the acceptability of his sexuality when hospitalized. Other factors may contribute to the client's inability to communicate about sexual concerns in a specific and forthright manner. The nurse must create a setting that reinstates protective social norms and clarifies the purpose of her professional interest in sexual health care issues. Counseling techniques that decrease the client's anxiety should be used. The nurse must deal with her own anxiety related to role confusion, inadequate knowledge base and lack of support systems. Role clarification, educational opportunities and the creation of a supportive system are necessary challenges for the practicing nurse who chooses to provide sexual health care.
The Professionalization of Psychiatric Nursing: From Doctors' Handmaidens to Empowered Professionals
Authors: Boling Anita 
Published: April 2021

ABSTRACT
The professionalization of psychiatric nursing in the United States has been subject to political, economic, and theoretical influences, and prominent individuals such as Florence Nightingale and Hildegard Peplau have caused changes over time. Throughout history, professional and societal beliefs about mental illness have affected the nature of psychiatric nursing. In colonial times, people with mental illnesses were considered to be either possessed by demons or inferior and treated as animals. Today, psychobiological causes of mental illnesses are better understood, and treatment is aimed at adjusting disordered physiology and implementing psychosocial interventions. Care of people with mental illnesses has echoed this shift with increasing professionalization of psychiatric nurses. Attention to the lessons of history can help psychiatric nurses identify current societal influences, act on them according to their own vision, and further increase their professionalism.
Call for Information for Assessment of Refractive Keratoplasty Procedures
Authors: Goldstone Donald 
Published: April 2021

The Office of Health Technology Assessment (OHTA) of the National Center for Health Services Research (NCHSR) and Health Care Technology Assessment has the direct responsibility to conduct technology evaluations and make Public Health Service coverage recommendations in response to requests from agencies administering Federally-financed health programs. One such agency is the Health Care Financing Administration (HCFA). These requests may originate in the public or private sector. Requests frequently originate when claims for reimbursement are filed. For example, in the case of refractive surgery, the source of inquiry regarding reimbursement from HCFA was a medical optics firm and several ophthalmologists. HCFA subsequently asked the OHTA to assess the status of refractive surgery. OHTA announced the impending assessment in the Federal Register, soliciting public input. The Office also conducts a literature search and obtains information from such groups as clinical specialty organizations and manufacturer's associations. Scientific findings as well as specific recommendations are obtained from other Federal agencies. In the case of refractive surgery, for instance, the National Eye Institute will provide scientific advice on the technology.
OHTA assessments represent comprehensive evaluations of the safety, clinical effectiveness, and the appropriate use of the technology. While the OHTA performs evaluations that may take into account cost-effectiveness, social, ethical, and economic impacts, the primary concern of OHTA, in making its coverage recommendations, are the safety and clinical effectiveness of the technology. AU pertinent information, from controlled clinical trials to qualified medical opinion, are summarized and analyzed to determine if they are valid and significant. From this evaluation appropriate judgments and conclusions are formulated about the technology's safety and effectiveness.
Based on the information received, OHTA suggests how HCFA should deal with the reimbursement question. OHTA may recommend that a technology be covered, not covered, or covered with certain restrictions or guidelines. OHTA provides HCFA with a written coverage recommendation and the completed assessment report. HCFA has final responsibility for making decisions on what diagnostic and therapeutic techniques and procedures will be covered.
NCHSR publishes and disseminates the OHTA assessment reports to the public. Health Technology Assessment Reports concerning ophthalmology include:
* Computer Enhanced Perimetry, 1983
* Nd:YAG Laser for Posterior Capsulotomies, 1984
* Laser Trabeculoplasty for Open Angle Glaucoma, 1984.
Keratotomy Model of Pseudomonas Keratitis: Gentamicin Chemotherapy
Authors: Brockman E Britt , Tarantino Paul A , Hobden Jeffery A , Hill James M , O'Callaghan Richard J , Kaufman Herbert E , Insler Michael S 
Published: April 2021

ABSTRACT
Background: Chemotherapy of bacterial keratitis requires frequent application of antibiotic drops. Collagen shields containing antibiotics could reduce the need for frequent antibiotic application. To determine the effect of gentamicin-containing collagen shields and gentamicin drops on Pseudomonas keratitis, a new keratotomy model of infection was employed.

Methods: Model-contact lenses (58% water content) presoaked in 1% bovine serum albumin and exposed to 10
p 8
colony forming units per mL of Pseudomonas aeruginosa strain 27853, were found to reproducibly retain 5.9 (log base 10) colony-forming units. Rabbit corneas were scarified centrally with two perpendicular intersecting diamond knife cuts (5 mm × 5 mm × 0.2 mm), and bacteria-impregnated contact lenses were positioned and held in place for 24 hours with partial tarsorrhaphies. Treatment-Fourteen hours after lens removal (38 hours after infection), corneas were treated for 8 hours with collagen shields hydrated in saline (control), or shields impregnated with 800 µg gentamicin during manufacture, or one drop every 30 minutes of fortified gentamicin drops (14 mg/mL). The rabbits were killed and corneas collected for bacterial enumeration after 8 hours of treatment (46 hours after infection).

Results: Model-Slit-lamp examination and microbiologic confirmation showed uniformity of keratitis in all eyes. Treatment-Corneas treated with saline (controls) contained 6.4 (log base 10) Pseudomonas. Corneas treated with gentamicin-impregnated collagen shields (total drug = 800 µg) and fortified gentamicin drops (total drug = 21 mg) showed a reduction in viable bacteria of 2 logs and 6 logs, respectively, relative to the control.
Conclusions: In this new model of Pseudomonas keratitis, the amount of gentamicin introduced into collagen shields during manufacture effectively reduced bacterial growth in infected rabbit corneas. However, larger amounts of drug applied as fortified drops on a frequent dosing schedule were more effective by a factor of three. Treatment of keratitis with antibiotic-impregnated collagen shields may reduce the need for very frequent application of topical drops, but may be more effective with topical drop supplementation to increase the amount of drug available over the course of therapy. Refract Corneal Surg 1992;8:39-43.)
Circular and Interrupted Suture Technique for Correction of Hyperopia Following Radial Keratotomy
Authors: Lyle W Andrew , Jin Jia-Chi 
Published: April 2021

ABSTRACT
Background: Hyperopia is a possible complication following radial keratotomy. In this article, we describe a circular and interrupted corneal compression suture technique for the correction of hyperopia induced by radial keratotomy.
Methods: A retrospective study was performed to evaluate the effectiveness of this procedure in nine consecutive patients.
Results: The procedure achieved an average of -1.70 diopters change in spherical equivalent refraction. This accounted for an overall correction of 68% of the hyperopia caused by radial keratotomy after a minimum 3-month follow up. Seven of nine eyes (78%) were within 1.00 D of emmetropia after surgery. Uncorrected visual acuity of 20/40 or better was present in only two eyes (22%) preoperatively, and nine eyes (100%), after the corneal suturing procedure. The mean improvement of uncorrected visual acuity was 4.0 Snellen lines (P = .0004). All patients were pleased with their visual outcomes.
Conclusions: We found that this technique is an easy, safe, and reasonably successful treatment for radial keratotomy overcorrection. (Refract Corneal Surg 1992;8:80-83.)
Delayed Sterile Keratitis Following Radial Keratotomy Successfully Treated With Conjunctival Flap
Authors: Mackman Gary 
Published: April 2021

ABSTRACT
Background: A case of sterile keratitis involving three adjacent incisions and intervening stroma occurring 5 years after an eight-incision radial keratotomy is reported.
Methods: Multiple cultures showed no pathogens. Treatment with antibiotics, lubricants, patching, and bandage contact lenses failed to improve the condition. A conjunctival bridge flap was therefore performed.
Results: Total resolution of the keratitis occurred rapidly after performing the conjunctival bridge flap.
Conclusions: Delayed keratitis following radial keratotomy has been reported in the past. Treatment in these cases has primarily been corneal transplantation. The present case presents an alternative treatment, conjunctival bridge flap, which was successful in this case of sterile keratitis following radial keratotomy. (Refract Corneal Surg 1992;8:122-124.)
Patient Preference-Contact Lens or Radial Keratotomy?
Authors: Haverbeke Luc 
Published: April 2021

ABSTRACT
BACKGROUND: Past clinical experience has suggested that patients are more satisfied after radial keratotomy than when wearing contact lenses.
METHODS: One- hundred patients who had worn contact lenses prior to receiving radial keratotomy compared subjectively these two methods for correcting myopia. The postoperative follow up ranged from 3 months to 13 years.
RESULTS: The vast majority (93%) preferred radial keratotomy to the handling of contact lenses.
CONCLUSIONS: The desire to be independent of optical correction is a sufficient indication for refractive surgery. [Refract Corneal Surg 1992;8:315-318.)
Clinical Strategies for Excimer Laser Therapeutic Keratectomy
Authors: Talamo Jonathan H , Steinert Roger F , Puliafito Carmen A 
Published: April 2021

ABSTRACT
BACKGROUND: Surgical therapy for superficial corneal scars, dystrophies, or surface irregularities with the 193 nm excimer laser shows great promise. Depending upon the character of the pathology to be treated, different surgical strategies are required.
METHODS: Treatment strategies for three patients with diverse corneal pathology are presented. Focal surface irregularities are treated with small laser spot sizes leaving the epithelium intact. Smooth, uniformly distributed subepithelial anterior stromal pathology is best removed with a large spot size through intact epithelium. When scattered scarring of variable thickness is present, selective epithelial debridement permits improved exposure of irregularities in Bowman's layer and the anterior stroma.
RESULTS: Guidelines for selective debridement of epithelium and protection of adjacent and underlying stroma with moderate viscosity solutions enhances the surgeons's ability to obtain a smooth and clear surface while minimizing corneal thinning. Even with these strategies and use of piano disc ablation, net hyperopic shift generally occurs with broad large area therapeutic ablation.
CONCLUSIONS: Superficial corneal opacities and irregularities can be surgically treated with the excimer laser as an alternative to the more invasive procedure of lamellar keratoplasty. Treatment failures can then go on to lamellar keratoplasty while successfully treated patients are more rapidly rehabilitated at lower total cost than a lamellar graft. Refinement of treatment strategies to minimize the hyperopic shift and facilitate masking around irregularities will further improve the results. Refract Corneal Surg 1992;8:319-324.)
Modified Surgical Technique for Repeated Epikeratophakia Surgery in Aphakic Eyes
Authors: Busin Massimo , Cusumano Andrea 
Published: April 2021

ABSTRACT
BACKGROUND: Incomplete epithelial removal from the peripheral keratectomy at the time of repeat epikeratophakia surgery can lead to interface downgrowth and consequent failure, as observed in the case reported herein. We present a modification of the standard surgical technique aimed at avoiding such complication.
METHODS: A 69-year-old white female underwent a third aphakic epikeratophakia modified to reduce the risk of epithelial interface downgrowth, which had caused a previous failure. The aphakic tissue lens, 8.5 mm in diameter, was sutured into a corneal pocket obtained at a deeper level, inside the peripheral keratectomy used for the previous two procedures.
RESULTS: Useful visual acuity (20/60) was obtained and the refractive outcome remained stable up to 1 year postoperatively. Epithelial interface downgrowth did not recur.
CONCLUSIONS: Despite the possible risk of perforation while undermining the recipient cornea at a deeper level, the modified technique might offer a more effective method of preventing epithelial downgrowth after repeat epikeratophakia surgery. [Refract Corneal Surg 1992;8:382384).
Combined Epikeratoplasty and Homoplastic Keratophakia for Correction of Aphakia: Double Curve Effect
Authors: Burillon Carole , Durand Luc , Gourraud Anne 
Published: April 2021

ABSTRACT
BACKGROUND: Having used the nonfreeze Barraquer-Krumeich-Swinger set for refractive lamellar keratoplasty since January 1987, the authors found the results of this procedure to be disappointing for correction of aphakia. Insufficient refractive gains for epikeratoplasty ( + 39% of initial refraction at 12-month follow up) persuaded the authors to look for a more effective refractive corneal surgery technique for correcting aphakia.
METHODS: We describe a new technique consisting of the insertion of a plano-convex homoplastic donor cornea meniscus between the patient's cornea and a hypermetropic epikeratoplasty. A nonfreeze Barraquer-Krumeich-Swinger set was used to fashion the two donor lenticules. This double surgery, called the "double curve effect," because it uses two convex surfaces to increase the converging power of the cornea, has been performed in 15 eyes.
RESULTS: We report the results of 10 eyes with a 6-month follow up. The average refractive gain was + 11.75 D, 90% of the needed correction. But there was a loss of approximately 46% of best spectacle-corrected visual acuity.
CONCLUSION: Three problems should be emphasized: the existence of two interfaces, the difficulty of perfectly centering the two lenticules, and the inäuced irregulär astigmatism. Despite these problems which can reduce the level of best spectacle-corrected visual acuity, the double curve effect may offer an effective solution for treating certain cases of unilateral aphakia. [Refract Cornea! Surg. 1993;9;2J4-218.)
Design and Development of a New 193-Nanometer Excimer Laser Surgical System
Authors: Förster Werner , Beck Rasmus , Busse Holger 
Published: April 2021

ABSTRACT
BACKGROUND: The 193 -nanometer excimer laser is used for photoablative reprofiling of the cornea to correct refraction errors and to treat corneal pathologies. To use the unique properties of the excimer laser, some technical features should be provided by the excimer laser system. A new excimer laser system is presented.
METHODS: The instrument has a fluence sensor for precise measurement of the actual fluence just before surgery, a new delivery system including an integrator system to homogenize the laser beam, a steelband with apertures and a zoom optic to get the desired form of central reprofiling, and an alignment system to reduce the possibility to decenter the optical zone.
RESULTS: The fluence before surgery can be measured very precisely with the fluence sensor. The ablation zone size is at least 8 mm fn diameter with a homogenous laser beam profile resulting in a smooth surface of the treated material. Different forms of ablations can be created using the steelband with different forms of apertures. The center of the ablation zone can be found using the alignment system.
CONCLUSION: The new excimer laser system fulfills some important technical features for optimal use of the excimer laser in corneal surgery. (Refract Corneal Surg 1993;9:293-299.)
Effect of Topical Interferon-Alpha 2b on Corneal Haze After Excimer Laser Photorefractive Keratectomy in Rabbits
Authors: Monet Nigel , Gillies Mark C , Crouch Roger , Maloof Anthony 
Published: April 2021

ABSTRACT
BACKGROUND: Anterior corneal stromal keratocytes are activated by excimer laser photorefractive keratectomy resulting in haze with healing of the ablated area. In some eyes, this causes a visible haze or scar on the cornea, and an unpredictable regression of the myopic correction following refractive ablations.
METHODS: Following a 6.00-diopter excimer laser photorefractive keratectomy to both eyes, 16 rabbits were treated for 5 weeks with interferonalpha 2b drops four times a day to one eye only. Eight of these rabbits were treated with dexamethasone drops four times a day to both eyes. Using a standard grading scale for haze, the corneas were examined and the haze graded weekly.
RESULTS: The observed corneal haze was significantly reduced in the treated eyes by the application of topical interferon-alpha 2b drops (P=. 004), and topical dexamethasone drops (?<.00?). Topical dexamethasone also produced less haze in combination with interferon-alpha 2b than when used alone (p= .035). There was continuing resolution of the corneal haze in those rabbits observed for 7 weeks after the cessation of the drops. Topical interferon-alpha therapy was not toxic to the rabbit eye and was not associated with delayed reepithelialization after the laser procedure.
CONCLUSION: Topical interferon-alpha 2b appears to reduce the corneal haze produced by excimer laser photorefractive keratectomy in rabbits. Refract Corneal Surg. 1993;9:443-451.)
RÉSUMÉ
INTRODUCTION: Les kératocytes dans Ie stroma antérieur sont activés par la kératectomie photorefractive au laser excimer, ce qui produit une brume légère pendant la cicatrisation. Cette brume légère entraine une cicatrice visible et un effet/éfractif non-prévisible en certain cas.
MÉTHODES: Seize lapins furent traités 4 fois par jour pendant 5 semaines avec les gouttes d'interferon-alpha 2b sur un oeil uniquement, suivant une kératectomie photo-réfractive de 6 dioptries sur les deux yeux. Huit de ces lapins furent traités avec les gouttes de dexamethasone 4 fois par jour sur les deux yeux. Les cornées furent examinées et la brume légère fut classifiée une fois par semaine, utilisant une échelle standardisée.
RÉSULTATS: Nous avons observé significativement moins de brume chez les yeux traités par !'interferon -alpha 2b (p= 0,004), et ceux traités par les gouttes de dexamethasone (0,001). La dexamethasone a produit moins de brume légère combinée avec G interferon -alpha 2b qu'en usage seule (p =0,035). La brume légère disparait progressivement pendant les 7 semaines après l'arrêt des gouttes. L'utilisation de l'interferon-alpha 2b n'a pas montré d'effet toxique sur l'oeil du lapin et n'a pas entraîné de délai dans i'epithélialisation en postopératoire.