bluuebunny/crossref_metadata_2025_split huggingface dataset:
Unilateral Pseudophakia in Children Under 4 Years
Authors: Awner Steven , Buckley Edward G , DeVaro John M , Seaber Judy H 
Published: April 2021

ABSTRACT
Purpose: We examined the efficacy of intraocular lens implantation (IOL) in children younger than 4 years of age for unilateral aphakic visual rehabilitation.
Methods: Twenty-one patients underwent unilateral cataract extraction, IOL placement, posterior capsulotomy, and anterior vitrectomy between 1990 and 1994. Postoperative vision, refractive change, and complications were monitored prospectively. Two cataract subgroups were analyzed: 12 patients with infantile (congenital and developmental) cataracts, and nine patients with posttraumatic cataracts.
Results: Overall age at surgery averaged 26 months (range 9 to 44 months), with follow up of 5 to 55 months. Fifty-two percent achieved 20/40 or better vision: 42% in the infantile group and 67% in the traumatic group. IOL power averaged 22.6 diopters (D). The difference between predicted and actual postoperative refraction was less than 1 D in 70%. After 6 months, the average change in refraction was 0.50 D (21 patients). An increasing myopic shift of 1.10 D at 12 months (14 patients), 1.80 D at 18 months (nine patients), and 2.90 D after 24 months (eight patients) was noted. This trend was greater in the infantile group. Amblyopia treatment was implemented in 18 patients. Half have completed occlusion successfully, one third continue therapy, 17% are treatment failures, and 11% (two patients) were lost to follow up. Six patients required strabismus surgery; five had infantile cataracts. Postoperative complications occurred in four eyes, two infantile and two traumatic; they consisted of posttraumatic temporal IOL dislocation, corectopia, partial pupillary capture of an IOL, and partial pupillary membrane.
Conclusion: Primary IOL implantation is an effective way to rapidly achieve aphakic visual rehabilitation in preschool children. We continue to evaluate the longterm safety and effects of pediatric pseudophakia.
High Resolution, Dynamic, Magnetic Resonance Imaging in Complicated Strabismus
Authors: Shin Grace S , Demer Joseph L , Rosenbaum Arthur L 
Published: April 2021

ABSTRACT
Strabismus cases, especially after previous surgery or trauma to extraocular muscles, often present diagnostic challenges. Conventional clinical tests are helpful in some cases but may be inconclusive. High resolution, dynamic, orbital magnetic resonance imaging (MRI) may yield additional critical information about orbital and extraocular muscle anatomy and function. We report four complicated strabismus cases for which dynamic surface coil MRI helped formulate a precise diagnosis and the most appropriate surgical plan.
The Relationship Between Dissociated Vertical Divergence (DVD) and Head Tilts
Authors: Bechtel Robert T , Kushner Burton J , Morton Gail V 
Published: April 2021

ABSTRACT
Introduction: Dissociated vertical divergence (DVD) has been associated with manifest head tilts. Also, DVD has been described as demonstrating a characteristic response to forced head tilt by increasing the size of the DVD on contralateral tilt.
Methods: A series of 116 consecutive patients with DVD associated with infantile esotropia were examined according to a predetermined protocol between 1989 and 1994. Each patient was examined for a manifest head tilt. Also, the response of the DVD to forced ipsilateral and contralateral head tilt was analyzed. In addition, 100 consecutive patients with manifest head tilts were examined and the etiology of the tilt determined.
Results: A manifest head tilt was present in 35% (26/74) of patients with an ocular fixation preference and no prior vertical muscle surgery. None of the patients with alternating fixation and a history of no vertical muscle surgery manifested a head tilt. Most patients responded in the classically described manner by increasing the size of the DVD on forced contralateral tilt and decreasing the size of the DVD on ipsilateral tilt. Atypical responses were not related to the presence of oblique overaction. DVD was the etiology in 9 of 100 consecutive patients with a manifest head tilt.
Conclusions: Patients with DVD often manifest a head tilt. Most respond by increasing the size of the DVD on forced contralateral head tilt and decreasing on ipsilateral tilt. Atypical responses did not appear to be influenced by oblique overaction. DVD is a relatively frequent cause of manifest head tilts.
Randomized Comparison of Diode Laser Photocoagulation Versus Cryotherapy for Threshold Retinopathy of Prematurity: 3-year Outcome
Authors: White Janette E , Repka Michael X 
Published: April 2021

ABSTRACT
Purpose: To report the structural and functional outcomes at a minimum of 3 years postmenstrual corrected age following laser- or cryoablation of threshold retinopathy of prematurity (ROP).
Methods: Nineteen patients were entered into a prospective, randomized treatment protocol, in which one eye received cryotherapy and the other received diode laser photocoagulation. Asymmetric eyes were randomly assigned. Two patients have died and five were not available for 3-year outcome exams.
Results: Seven males and five females with a mean birthweight of 638 g and a mean gestational age of 24.9 weeks were examined. Two patients had asymmetrical disease and received laser photocoagulation. Two discordant structural outcomes were present among the 10 symmetrical cases. The laser-treated eyes had the favorable outcome; the cryotherapy-treated eyes had the unfavorable outcome. The geometric mean visual acuity after laser photocoagulation was 20/52; after cryotherapy, it was 20/91 (P=O. 046). The mean refractive error was -6.60 diopters (D) after laser photocoagulation and -7.62 D after cryotherapy. Seven patients (58%) have developed strabismus.
Conclusions: Laser photocoagulation appears to have an outcome at least comparable to cryotherapy when the patients are examined 3 years following therapy. These data, Including visual acuity and refractive error, suggest that laser photocoagulation may have a minimal advantage over cryotherapy in the treatment of ROP.
Myopia Predicts Better Outcome in Persistent Hyperplastic Primary Vitreous
Authors: Cheung Jason C , Summers C Gail , Young Terri L 
Published: April 2021

ABSTRACT
Purpose: Persistent hyperplastic primary vitreous (PHPV) is a congenital disorder that presents with a spectrum of ocular anomalies, including cataracts, microphthalmia, and hyaloid vessel remnants. Severe visual loss due to secondary glaucoma and retinal detachment is common. This report evaluates the visual outcome of a variant of PHPV with myopia not associated with glaucoma.
Methods:The records of 23 consecutive patients with the diagnosis of PHPV (all unilateral) from October 1992 to August 1995 were reviewed. All but three patients had a cataract extraction procedure and all underwent amblyopia therapy. Eyes with a phakic myopic refractive error (Rx) or aphakic refractive correction ≤8.5 diopters (D) in the immediate postoperative period were designated as myopic.
Results: Six patients were in the myopic group (Group 1) and 17 in were the nonmyopic group (Group 2). The mean age of diagnosis was 21.1 months in Group 1 versus 2.0 months in Group 2, with a comparable follow-up period of 36 months. The mean preoperative Rx of Group 1 was -7.78 D. The mean aphakic Rx of Group 2 was +18.29 D. Average axial length measurement determined by echography was 22.46 mm in Group 1 and 14.03 mm in Group 2. The mean corneal diameter was 11.3 mm in Group 1 vs 8.9 mm in Group 2. In Group 2, seven eyes developed retinal detachment and four developed glaucoma. These complications did not develop in Group 1 during the follow-up period. Overall functional visual acuity was better in Group 1, with a median visual acuity at final follow up of 20/1 60, as compared with light perception for Group 2.
Conclusions: PHPV eyes with myopia were not detected as early as the typical PHPV eyes, primarily because of less media opacification and near-normal corneal diameters. These eyes showed a more favorable visual outcome as they were less likely to develop typical PHPV-related postoperative complications. Myopic PHPV eyes may require a different management approach.
Predictive Value of Regression and Theoretical IOL Formulas in Pediatric Intraocular Lens Implantation
Authors: Andreo Larry K , Wilson M Edward , Saunders Richard A 
Published: April 2021

ABSTRACT
Purpose: Intraocular lenses (IOLs) are being implanted in children with greater frequency and in a wider age range. The accuracy of available regression and theoretical formulas in predicting correct IOL power for pediatric eyes, however, has not been reported.
Methods: We reviewed medical records of 47 consecutive pediatric IOL implantations after cataract extraction that met inclusion criteria. Age at surgery ranged from 2 months to 16 years, with measured axial lengths of the eye between 18.6 and 26.7 mm. For the purpose of this study, the 2-month postoperative refraction was considered the post-IOL refractive outcome. Using preoperative globe axial length, corneal curvature, IOL power, and the A constant for the lens provided by the manufacturer, we employed the four common IOL power formulas (one regression formula [SRK-II] and three theoretical formulas [SRK-T, Holladay, and Hoffer Q]) to predict refractive outcome.
Results: The average difference between predicted and actual postoperative refractive error ranged from 1.2 to 1.4 diopters (D) for all formulas. Predicted postoperative refraction was less than the actual in 89 calculations and greater in 99. No significant differences in predictive accuracy were found in any of the axial length groups (group 1 P=0.79, group 2 P=0.42, and group 3 P=O. 86). All formulas were slightly less accurate in group 3 patients (shortest eyes). In this group, the Hoffer Q formula had the lowest error (1.4 D) and the SRK-II had the highest error (1.8 D). The difference was not statistically significant (P=.86).
Conclusions: In our pediatric study eyes, all four IOL power calculation formulas predicted mean refractive outcome within 1.4 D. Theoretical formulas did not outperform the regression formula.
Long-term Outcome of Neonatal Macular Hemorrhage
Authors: Zwaan Johan , Cardenas Rick , O'Connor Patrick S 
Published: April 2021

ABSTRACT
Background:We studied long-term visual acuity in children who had macular hemorrhages at birth.
Methods: Of 1 1 involved children, seven had eye examinations at about age 10. Two were contacted by telephone; two were lost to follow up.
Results: Of the seven examined children, six had normal visual acuities. One had reduced vision in the eye with the macular hemorrhage, possibly related to deprivation amblyopia secondary to slow resorption of the hemorrhage. The two patients contacted by telephone reported normal vision.
Conclusion: Although macular hemorrhages generally resolve without any lasting damage, the outcome may be less favorable In some patients.
Deletion 3q in Two Patients With Blepharophimosis-ptosis-epicanthus Inversus Syndrome (BPES)
Authors: Costa Teresa , Pashby Robert , Huggins Marlene , Teshima Ikuko E 
Published: April 2021

ABSTRACT
Background: Blepharophimosis-ptosis-epicanthus inversus syndrome (BPES) is an autosomal dominant condition mapped to chromosome 3q23. There are several reports of chromosomal abnormalities involving this region with a resultant phenotype that includes BPES.
Method: We reassessed two unrelated boys ages 3 and 5 with BPES and associated nonocular abnormalities. Karyotype, which had been previously reported as normal, was repeated using high-resolution banding techniques, to look specifically at 3q23. Clinical findings were tabulated and compared with previously reported cases.
Results: Both patients proved to have interstitial deletions of chromosome 3, the first Involving bands q22.2q25.1 and the second q22.2q24. The first patient exhibited prenatal and postnatal growth retardation, with global developmental delay, while the second patient had normal growth and development except for speech delay. Both had dysmorphic facies with BPES, flat philtrum, a thin upper Hp, and small chin. In addition, the first boy had an inguinal hernia and hypospadius; the second boy had abnormal auricles and metatarsus adductus.The eight cases of interstitial deletions of 3q2 and six rearrangements involving this region have a remarkably similar phenotype.
Conclusions: Deletion of 3q23 is a recognizable contiguous gene syndrome. Microdeletions of 3q23 should be ruled out in any sporadic case of BPES especially if there are associated nonocular abnormalities.
Congenital Cataract Surgery in Children With Cataract as an Isolated Defect and in Children With a Systemic Syndrome: A Comparative Study
Authors: Spierer Abraham , Desatnik Howard , Rosner Mordechai , Blumenthal Michael 
Published: April 2021

ABSTRACT
Purpose: To compare visual acuity outcome in two groups of children who underwent congenital cataract surgery. The first group is one in which an isolated cataract occurred; the second group is one in which cataract occurred in conjunction with a systemic disease.
Methods: A review of 46 charts: 36 children (50 eyes) with congenital cataract as an isolated defect, and 10 children (16 eyes) with cataract as part of a systemic disease.
Results: One third of the eyes with isolated cataract had postoperative visual acuity better than 6/12, although none of the patients in the syndrome group had visual acuity better than 6/12. This difference was statistically significant (p=0.01). Of the various ocular pathologies associated with congenital cataract, only nystagmus was found to be more prevalent in the syndrome group (40%) as compared with the isolated cataract group (11%) (p=0.05). Surgery was performed during the first 2 years of life in 54% of the eyes in the isolated cataract group, and in 87% of the eyes in the syndrome group (p=0.01). There was no difference in the prevalence of the postoperative complications between the two groups.
Conclusion: Children who underwent congenital cataract surgery developed poorer visual acuity if the cataract was a part of a systemic disease as compared with children without a systemic syndrome.
Möbius' Syndrome: Features and Etiology
Authors: Ghabrial Rafat , Versace Patrick , Kourt Georgina , Lipson Anthony , Martin Frank 
Published: April 2021

ABSTRACT
Purpose: To review the clinical features and possible aetiology of all cases of Möbius' syndrome presented at the Royal Alexandra Hospital for Children in Sydney, Australia, from 1963 through 1995.
Methods: All charts of patients suffering from Möbius' syndrome were reviewed, and each patient was thoroughly assessed by a geneticist and a pediatrie ophthalmologist.
Results: Patterns of systemic and ocular clinical features became evident. Of 23 patients in the series, 10 (43%) had a history significant events in utero.
Conclusions: All patients suffering from Möbius' syndrome require thorough assessment by a multidisciplinary team including a geneticist or pediatrician and a pediatrie ophthalmologist. Significant vascular events of pregnancy may explain some cases of fetal vascular disruption to the brainstem.
changes in attitudes about mental illness among nursing students following a psychiatric affiliation
Authors: Creech Stephen K 
Published: April 2021

ABSTRACT
The purpose of this study was to determine changes in nursing students' attitudes about mental illness following a twelve-week psychiatric affiliation program in a state mental hospital. Data were collected by means of two combined opinions about mental illness scales - Cohen and Struening's factor analytically-derived Opinions About Mental Illness (OMI) questionnaire and Ellsworth's empirically-derived Opinions About Mental illness Scale. The sample consisted of 95 student nurses from three diploma schools of nursing. The subjects were administered the instrument at the beginning and end of their psychiatric affiliation. Following the affiliation, student nurses' attitudes about mental illness changed significantly in a favorable direction on the following attitudinal dimensions: Authoritarianism, Mental Hygiene Ideology, Social Res trie tiveness, Interpersonal Etiology, Non traditionalism, and Restrictive Control. Although significant changes were not found on Benevolence and Protective Benevolence, there was a trend toward favorable changes on both attitudinal dimensions.
Identification of Typologies Derived from Child Behaviors in the Hospital as Predictors of Psychological Upset
Authors: Cormier Patricia P 
Published: April 2021

ABSTRACT
This study proposed to measure objectively the behaviors of children in the hospital setting in order to combine the data on the particular aspects of behaviors or symptoms into global measures or typologies of psychological upset. It attempts to offer a good, single measure for predicting behavior of children in psychological upset.
Thirty-one subjects in this study, observed in the hospital setting, are clustered together to identify typologies derived from child behaviors in the hospital. These children were divided into three factors which correspond with the three stages of hospitalization: Factor I typified Stage III - Denial; Factor II typified Stage II - Despair; and Factor III typified Stage I - Protest.
The study offers direction to objectively and systematically evaluate the effects of hospitalization on children. It also suggests that observational ratings of child behaviors in the hospital may be accurate predictors of the degree of psychological upset a child is experiencing at a certain point in time. It also has particular implications for strategies which hospital staff could employ when they observe particular stages that children manifest.
Identity Operations and Family Treatment
Authors: Lantz James E , Treece Nancy 
Published: April 2021

ABSTRACT
This article outlines the concept of the identity operation and how family system processes and individual identity operations reciprocally interact within the family group. A case report illustrates use of the identity operations concept in family treatment, and demonstrates its usefulness to the clinical practitioner. The identity operations concept as a bridge between the understanding family and individual levels of human existence is explored.
Geropsychiatric Nursing: ESSENTIAL Curriculum Content
Authors: Hoeffer Beverly 
Published: April 2021

This article delineates the essential curriculum content for geropsychiatric nursing. Although content at the baccalaureate and doctoral levels of education are addressed, the discussion focuses primarily on master's level curriculum content, because of the consensus that preparation for advanced practice in specialized areas of nursing occurs at this level.
Gerontologie and nursing literature is reviewed for suggested core content in geropsychiatric nursing at the graduate level, graduate programs offering geropsychiatric nursing are surveyed, and forces that shape the development of curricula in geropsychiatric nursing are identified.
Risperidone: Clinical Issues in Treatment
Authors: Littrell Kimberly , Schultz Richard E 
Published: April 2021

On December 29, 1993, the Food And Drug Administration approved the new antipsychotic agent risperidone (Risperdal) for use in the United States. Risperidone is the first of a new class of antipsychotic agents known as serotonin/dopamine antagonists. It is only the second new antipsychotic medication to be introduced in this country during the past two decades. Early efficacy studies show that risperidone has marked superiority in reducing both positive and negative symptoms over placebos and haloperidol.
Risperidone does not produce the blood dyscrasias associated with clozapine and possesses a relatively dean adverse reaction profile. Maximum therapeutic responses have been observed with doses of 4 mg to 8 mg; higher dosages have resulted in extrapyramidal symptoms without added benefits.
Putting Feeding Back Into the Hands of Patients
Authors: Ford Ginger 
Published: April 2021

At the Behavioral Health Unit of Baton Rouge General Medical Center, the author and registered dietitians of the Clinical Nutrition Department developed "utensil-less" diets for patients with acute psychiatric conditions.
Initially, the diet was developed for patients with dementia; however, the staff quickly realized that the diet would be appropriate for patients with many acute psychiatric disorders, or for those patients with physical limitations.
The "Dementia Diet" includes five nutritionally balanced, small meals each day, consisting of finger foods such as sandwiches, vegetable sticks, fruit slices, and other items that patients can eat on their own without feeding assistance or utensils (Figure).
After introducing the diet on the Behavioral Health Unit, the staff found that 7 of 10 patients on the diet improved their food intake and gained weight.
Not only were nutritional needs met, but mealtimes became more enjoyable for the patients, families, and staff (Table).
Unit safety advanced, and most importantly, quality of life and self-esteem were cultivated by helping adult patients regain some of their independence associated with meal times.
Cognitive-Behavioral THERAPY
Authors: Romana Maria S 
Published: April 2021

Treating Individuals with Dual Diagnoses
ABSTRACT
Because deinstitutionalization of individuals with mental retardation/developmental disability and mental illness has become the standard of practice, many practitioners are now faced with the challenge of serving the needs of this specialized population. The existence of mental illness in individuals with mental retardation has been well established in the literature, but there are relatively few studies involving therapeutic interventions in this client population. However, there is a theoretical framework that guides practice and measures the effectiveness of interventions with this specialized population.
This article presents a case study exploring the application of cognitive-behavioral therapy to a client with mental retardation and mental illness. The theoretical framework, major concepts, and key assumptions of the theory will be reviewed, as well as treatment outcomes.
Refractive Versus Keratometric Astigmatism Postkeratoplasty
Authors: Judge David , Gordon Lance , Vander Zwaag Roger , Wood Thomas O 
Published: April 2021

ABSTRACT: In patients who had undergone penetrating keratoplasty, we compared the relationship between keratometric astigmatism and actual refractive cylinder required for visual correction in 115 eyes postoperatively. The average time from surgery to refraction was 49.5 months and from surgery to keratometry 50.3 months. Sixty-five eyes retaining their running 10-0 nylon sutures had an average of 5.43 diopters of keratometric cylinder and 2.95 D of refractive cylinder. The difference was highly statistically significant (P < .001). This significant difference was true in eyes with keratoconus and Fuchs' endothelial dystrophy.
In 50 eyes with all sutures removed, the average keratometry reading revealed 4.27 D of astigmatism while the cylindrical refraction required in spectacles averaged 3.70 D. The difference was not statistically significant (P = .018). The significant difference between astigmatism as measured by keratometry and by refraction in eyes with the sutures still in place should be taken into consideration when using suture removal or adjusting techniques after keratoplasty. [Refractive and Corneal Surgery 1990;6:174-178.]