bluuebunny/crossref_metadata_2025_split huggingface dataset:
Re‐Conceptualizing the Hospital Labor Room: The PLACE (Pregnant and Laboring in an Ambient Clinical Environment) Pilot Trial
Authors: Hodnett Ellen D. , Stremler Robyn , Weston Julie A. , McKeever Patricia 
Published: May 2009

ABSTRACT: Background:
Nearly all hospitalized laboring women spend most of the time in bed. We made simple but radical modifications to a hospital labor room, which included the removal of the standard hospital bed and the addition of equipment to promote relaxation, mobility, and calm. We designed a pilot study, the objectives of which were to test the feasibility of a randomized trial and the acceptability of the modified labor room to women and their care providers.
Methods:
Women were assessed and invited to participate just before their admission to the labor and delivery suite. Sixty‐two women at two Toronto teaching hospitals were randomly allocated to either the standard labor room or the “ambient room.” Data about labor and birth events were abstracted from the medical records. Participants and their nurses and physicians completed questionnaires to elicit their views of their experiences with the labor rooms.
Results:
Women's and practitioners’ evaluations of the ambient room were generally very positive. Nineteen women (65.5%) in the ambient group, compared with 4 (13.3%) in the standard group, reported spending 50 percent or less of their hospital labor in the standard labor bed. Twelve women allocated to the ambient room had artificial oxytocin infusions, compared with 21 allocated to the standard room (X 2 = 4.73, p = 0.03).
Conclusion:
We conclude that the ambient labor room should be evaluated in an adequately powered randomized controlled trial. (BIRTH 36:2 June 2009)
Environmental Impact and Intensity of Processes in Selected Services Companies
Authors: Junnila Seppo 
Published: May 2009

SummaryThe study fills the gap in existing literature by comparing the economic costs and environmental impacts of processes in four services companies in Europe and the United States. Process‐based life cycle assessment (LCA) and the case study method are used to compare companies both on four global‐scale impacts and on environmental intensity (impacts per unit cost). The study builds on prior publications on the environmental contribution of processes. The processes include all the activities of the companies that result in an entry into the bookkeeping records. The results show that despite the substantial differences in organizational characteristics and line of business, all the cases had similar environmental contributions and intensity profiles. Wages, which accounted for over half of the costs, were assumed not to cause any environmental impacts. By contrast, the office premises, which generated less than 10% of the costs, caused around 50% of the environmental impacts. At a more general level, the results suggest that both the high environmental impact and the high intensity are attributed mostly to a few premises‐related processes in the services industry. The results also seem to imply that the companies could gain added value by using life cycle assessment in determining the significant environmental impacts of their operations.
Symptomatic and Asymptomatic Atrial Fibrillation after Pulmonary Vein Ablation and the Impact on Quality of Life
Authors: PONTOPPIDAN JACOB , NIELSEN JENS COSEDIS , POULSEN STEEN HVITFELDT , HANSEN PETER STEEN 
Published: May 2009

Background: The aim of this prospective study was to evaluate the recurrences of atrial fibrillation (AF) and flutter (AFL) after circumferential pulmonary vein ablation (CPVA) using repetitive long‐term Holter recordings, and to evaluate the change in quality of life (QoL), especially in patients with asymptomatic AF recurrences.
Methods: A total of 149 patients with AF were followed up with 7‐day Holter monitoring at 3, 6, and 12 months after CPVA. We calculated the burden of AF/AFL defined as the percentage of time in AF/AFL, and patients with documented arrhythmia were divided into isolated symptomatic episodes of arrhythmia, mixed symptomatic/asymptomatic arrhythmia, or isolated asymptomatic arrhythmia. The QoL was analyzed with SF‐36 questionnaires in patients with sinus rhythm after CPVA, and in patients with recurrence of symptomatic and asymptomatic arrhythmia, respectively.
Results: Asymptomatic arrhythmia was observed in 44% of the patients with documented arrhythmia at 12 months of follow‐up. In patients with persistent AF, 63% of the documented arrhythmia at 12 months of follow‐up was asymptomatic and often persistent. In the subgroup of patients with asymptomatic arrhythmia, the QoL improved significantly in the physical scores, in contrast to patients with symptomatic arrhythmia who had unchanged or worsened QoL scores.
Conclusions: Asymptomatic arrhythmia is very common after AF ablation. Our data indicate that these patients improve their physical component of the QoL significantly, which may be considered a palliative success of treatment. We suggest that patients with asymptomatic AF recurrences are carefully evaluated before considering reablation. Repetitive rhythm monitoring after AF ablation is very important considering the postablation management of anticoagulant therapy.
Ventricular Arrhythmia Inducibility Predicts Subsequent ICD Activation in Nonischemic Cardiomyopathy Patients: A DEFINITE Substudy
Authors: DAUBERT JAMES P. , WINTERS STEPHEN L. , SUBAČIUS HARIS , BERGER RONALD D. , ELLENBOGEN KENNETH A. , TAYLOR SARAH G. , SCHAECHTER ANDI , HOWARD ADAM , KADISH ALAN ,   for the Defibrillators In Nonischemic Cardiomyopathy Treatment Evaluation (DEFINITE) Investigators
Published: May 2009

Objectives:

We evaluated whether electrophysiologic (EP) inducibility predicts the subsequent occurrence of spontaneous ventricular tachycardia (VT) or ventricular fibrillation (VF) in the Defibrillators in Nonischemic Cardiomyopathy Treatment Evaluation (DEFINITE) trial.
Background:

Inducibility of ventricular arrhythmias has been widely used as a risk marker to select implantable cardioverter defibrillator (ICD) candidates, but is believed not to be predictive in nonischemic cardiomyopathy patients.
Methods:

In DEFINITE, patients randomized to the ICD arm, but not the conventional arm, underwent noninvasive EP testing via the ICD shortly after ICD implantation using up to three extrastimuli at three cycle lengths plus burst pacing. Inducibility was defined as monomorphic or polymorphic VT or VF lasting 15 seconds. Patients were followed for a median of 29 ± 14 months (interquartile range = 2–41). An independent committee, blinded to inducibility status, characterized the rhythm triggering ICD shocks.
Results:

Inducibility, found in 29 of 204 patients (VT in 13, VF in 16), was associated with diabetes (41.4% vs 20.6%, P = 0.014) and a slightly higher ejection fraction (23.2 ± 5.9 vs 20.5 ± 5.7, P = 0.021). In follow‐up, 34.5% of the inducible group (10 of 29) experienced ICD therapy for VT or VF or arrhythmic death versus 12.0% (21 of 175) noninducible patients (hazard ratio = 2.60, P = 0.014).
Conclusions:

In DEFINITE patients, inducibility of either VT or VF was associated with an increased likelihood of subsequent ICD therapy for VT or VF, and should be one factor considered in risk stratifying nonischemic cardiomyopathy patients.
Persisting corneal oedema following intracapsular cataract extraction
Authors: Baggesen Kirsten , Ehlers Niels 
Published: May 2009

ABSTRACT.Purpose: The purpose of this study was to reveal the frequency of persisting corneal oedema following intracapsular cataract extraction and at the same time to examine whether the survival rate after penetrating keratoplasty due to this diagnosis differs from the survival rate following penetrating keratoplasty due to primary Fuchs' endothelial dystrophy.Methods and Material: A series of 2455 eyes underwent intracapsular cataract extraction between January 1, 1986 and December 31, 1988, at the Department of Ophthalmology, Århus University Hospital. The medical files were examined to study the frequency of persisting corneal oedema. Patients with persisting corneal oedema were offered penetrating keratoplasty and the survival rate following this procedure was calculated.Results: The frequency of pseudophakic persisting corneal oedema was 5.3% in the group of patients who underwent intracapsular cataract extraction. The survival of the following corneal transplantation was 54% after 2 years of follow‐up. This is a low survival rate compared to the survival rate in primary Fuchs' endothelial dystrophy, but there is a similarity to this disease in a development of a slowly progressive oedema in 17% compared to 13% in primary Fuchs' endothelial dystrophy.Conclusion: 5.3% of a group of patients who underwent intracapsular cataract extraction developed persisting corneal oedema within a 5 to 7‐year follow‐up period. When these patients underwent penetrating keratoplasty the survival rate of the graft was 54% after 2 years of follow‐up.
In vitro evidence for UV‐protection of the eye by the corneal epithelium mediated by the cytoplasmic protein, RNA, and ascorbate
Authors: Ringvold Amund 
Published: May 2009

ABSTRACT.Purpose: (1) To evaluate the effect of ribonucleic acid (RNA) and ascorbate on UV‐absorption and their impact on ultraviolet‐induced (UV) fluorescence from various proteins, and (2) to compare RNA and DNA reduction of protein fluorescence. These informations will be useful for later work on the UV‐filtering effect of the corneal epithelium.Method: Spectrophotometry and spectrofluorimetry.Results: (1) RNA and ascorbate caused a significant UV‐absorption and reduced the fluorescence from various water‐soluble proteins, the degree of reduction varying independently from one protein to the other. (2) RNA and DNA showed protein fluorescence reduction of roughly the same order.Conclusion: The results are discussed both in the context of UV‐protection of the cell nucleus in general, and the possible UV‐filtering effect for the eye of bovine corneal epithelium.
Influence of lens autofluorescence on retinal nerve fiber layer evaluation
Authors: Siik S. , Airaksinen P. J. , Tuulonen A. , Nieminen H. 
Published: May 2009

ABSTRACT.Background: Yellow‐brown coloration of the human lens increases with age and is associated with increasing lens autofluorescence. This may interfere with retinal image through scatter and absorption.Patients and Methods: We measured the lens autofluorescence (AF) of 30 eyes of 30 healthy subjects and evaluated their retinal nerve fiber layer (RNFL) visibility from fundus photographs. These otherwise healthy eyes showed a varying degree of yellow‐brown coloration of the lens. Lens fluorometry was carried out with a previously described technique using blue‐green AF range (495 nm/520 nm). RNFL photographs were taken with a Canon CF‐60 ZA wide angle camera with blue (495 nm) interference filter and low‐sensitivity, high resolution black‐and‐white film.Results and Conclusion: Lens yellowing expressed here by means of lens autofluorescence measurements, was statistically significantly (r = ‐ 0.53, p = 0.0008) correlated with the RNFL visibility score. In stepwise regression analysis adding age to the model including only the maximum AF did not reduce the residual standard deviation statistically significantly (p = 0.1). This suggests that lens yellowing has an effect on RNFL visibility and may be an important confounding factor in clinical RNFL evaluation.
A new scoring system for comparing the results of high‐pass resolution perimetry and differential light sensitivity perimetry in glaucoma patients
Authors: Kono Yoshiki , Yamamoto Tetsuya , Kitazawa Yoshiaki 
Published: May 2009

ABSTRACT.Using a new standard, we compared the visual field defects detected by high‐pass resolution perimetry (HRP) and differential light sensitivity (DLS) perimetry in 61 eyes of 61 open‐angle glaucoma patients. Abnormal test points were determined using probability plot analysis of HRP and total deviation probability maps of the Humphrey Field Analyzer. To evaluate the agreement between the two tests, we developed a new scoring system. Thirty‐three eyes, 23 eyes, and 5 eyes had good, fair, and poor agreement, respectively. In relation to Aulhorn's stage classification, the more advanced the glaucomatous stage, the more increased the percentages of good agreement. These results suggest that the distribution and severity of visual field defects demonstrated by HRP agree closely with those found using DLS perimetry in glaucomatous eyes, especially those with advanced visual field changes.
Residual symptoms and signs after untreated acute optic neuritis
Authors: Frederiksen J. L. , Sørensen T. L. , Sellebjerg F. T. 
Published: May 2009

ABSTRACT.Purpose: To study the symptoms and signs one year after optic neuritis.Methods: Seventy population‐based untreated patients, (44F, 26M; median age 35 years, range 14–48 years) were eligible for study, but the 11 bilateral cases were excluded. Among 59 patients participating in a one‐year follow‐up of the visual function, 58 answered a questionnaire.Results: At follow‐up 59% of the patients complained of visual impairment, though 49% of these patients had a Snellen visual acuity of 6/9 or better. The affected eyes showed decreased visual acuity in 34%, decreased contrast sensitivity in 63%, an abnormal score in 40% with the Lanthony D‐15 desaturated panel, and in 13% with the Ishihara test, prolonged latencies of VEP in 58%, and decreased amplitudes of VEP in 41%.Conclusions: All tests except for VEP correlated significantly to the degree of per‐cieved visual impairment. Subjective visual complaints and more sensitive tests than visual acuity should be used to evaluate the visual function following optic neuritis.
Quality of life among patients with glaucoma in Sweden
Authors: Wändell Per E. , Lundström M. , Brorsson B. , Åberg H. 
Published: May 2009

ABSTRACT.Purpose: To assess the health‐related quality of life (HRQOL) in an unselected sample of patients with glaucoma.Methods: The HRQOL was studied in a cross‐sectional survey in 270 patients from two departments of ophthalmology in different parts of Sweden by using the Swedish Health‐Related Quality of Life Survey, a generic HRQOL‐instrument adapted from the Medical Outcomes Study.Results: Compared to a random Standard Population Sample, the glaucoma patients showed lower mean score only in the scale of ‘Pain’ (p<0.05, effect size 0.17), but higher mean score in ‘Sexual functioning’ (p<0.01, effect size 0.35). Significant factors correlated to a lower score on HRQOL‐scales were decreased visual acuity and visual field, and comorbidity of cardiovascular and non‐vascular systemic diseases. Regarding the topical medications, beta‐blockers with or without miotic agents had no negative impact on the HRQOL.Conclusion: Our findings indicate that health‐related quality of life in glaucoma patients in general is good, especially when vision is intact, and that topical beta‐blockers do not have any negative influence.
Fluorometric evaluation of panretinal photocoagulation in diabetic subjects
Authors: Knudsen L. L. , Olsen T. , Nielsen‐Kudsk F. 
Published: May 2009

ABSTRACTThe effect of panretinal photocoagulation on the blood‐retinal barrier was examined by long‐term kinetic vitreous fluorophotometry in eight insulin treated diabetic subjects, before and one month after unilateral panretinal photocoagulation. The fluorophotometric investigations revealed an increased permeability‐index following this treatment. A further analysis based upon a two‐compartment fluorescein kinetic model revealed a decreased penetration rate constant together with increased zero‐time concentration coefficients for fluorescein following panretinal photocoagulation. No alterations were observed in kinetic parameters in the group of untreated eyes. This points towards a delayed but increased fluorescein penetration to the vitreous following panretinal photocoagulation, probably indicating an increased net flux of fluorescein across the entire retina. In patients with unilateral proliferative retinopathy the permeability‐index obtained from eyes with classified proliferative retinopathy was 18.1%, whereas the permeability‐index from eyes without proliferative retinopathy was 15.4%. This relatively small difference seems to indicate that the main part of vitreous fluorescence comes from an increased penetration across the entire retina, whereas a direct leakage from the proliferations themselves is less in magnitude. This increased retinal penetration might possibly be caused by affected transport processes for fluorescein within the retina.
Value of intraoperative keratometry in predicting outcome of radial keratotomy
Authors: Olsen Hanne , Ehlers Niels , Hjortdal Jesper Ø. 
Published: May 2009

ABSTRACTPurpose: To investigate whether the immediate change in corneal power during radial keratotomy correlates with the long‐term postoperative change in subjective refraction, and thereby being predictive for refractive outcome.Methods: Manual keratometry was performed on 45 consecutively operated eyes of 45 young persons with myopia of 5 dioptres and less and immediately after radial keratotomy. Automated keratometry and subjective spherical equivalent refraction were investigated during a follow‐up period of 6 months and correlated to the intraoperative keratometric measurements.Results: On average, the majority of the change in corneal curvature after radial keratotomy took place within 1 min. There was no correlation between the intraoperative curvature change and the changes in curvature measured up to 6 months after surgery. There was a weak significant positive correlation between intraoperative curvature change and the change in subjective refraction at 6 months after surgery (R = 0.48, p<0.01). The prediction error in estimating subjective refractive changes from intraoperative keratometry changes was, however, similar in patients who had bilateral radial keratotomy. Inclusion of such fellow‐eye information together with the age of the patient in a multiple linear regression analysis increased the correlation coefficient from 0.48 to 0.75.Conclusions: The change in central corneal curvature takes place within minutes after corneal incision. As a single parameter, intraoperative keratometry cannot be used for titrating surgery. Information from the results of first eye radial keratotomy surgery with intraoperative keratometry is, however, predictive for radial keratotomy in the second eye. These findings suggest that a large source to refractive variability after radial keratotomy is related to individual patient factors, such as corneal biomechanics and wound healing.
Photorefractive keratectomy for low myopia at 6 mm treatment diameter
Authors: Hamberg‐Nyström Heléne L. , Fagerholm Per P. , Tengroth Björn T. 
Published: May 2009

ABSTRACTPurpose: The aim of the retrospective study was to evaluate the algorithms and the surgical performance of two excimer lasers; the VISX 20/20 and the Summit Omnimed.Methods: Twenty patients were treated with the VISX‐laser and 20 with the Summit‐laser. The indications were myopia between ‐1 to ‐6 diopters which also allowed correction of astigmatism up to ‐ 2 in the VISX patients group. The treatment diameter was 6 mm and the follow‐up time was 12 months. The parameters studied were visual acuity uncorrected and corrected, contrast sensitivity in light, dark and glare, endothelial cell count, corneal topography, and subjective estimation of dark vision problems.Results: Both groups showed the same median refraction, ‐ 0.3 diopters. All the Summit patients had uncorrected visual acuity of 0.7 or better. In the VISX group 17 patients saw ≥ 0.7 uncorrected and all patients saw 0.5 or better s.c. The remaining result parameters showed no statistical differences between the two groups.Conclusion: The study does not lend conclusive support for any difference between the results obtained by the two lasers.
A comparative study of polyacrylic acid (Viscotears®) liquid gel versus polyvinylalcohol in the treatment of dry eyes
Authors: Brodwall J. , Alme G. , Gedde‐Dahl S. , Smith J. , Lilliedahl N. P. , Kunz P. A. , Sunderraj P. 
Published: May 2009

ABSTRACTWe conducted a prospective, randomised, single‐masked study comparing the safety and efficacy of polyacrylic acid 0.2% (PAA) and polyvinylalcohol 1.4% (PVA) in 85 patients (PAA 43, PVA 42) with dry eyes. The two groups were similar in patient demographics and study parameters at baseline. With treatment, the reduction in total symptoms (gritty or foreign body sensation, burning sensation, dry eye sensation, photophobia, others) and signs (conjunctival hyperaemia, ciliary injection, corneal and conjunctival epithelial staining) score on PAA was significantly greater than that on PVA at both two and four weeks. The daily frequency of instillation of PAA was significantly less than that of PVA on 16 of the 27 (59%) study days. For overall local tolerance there was a significant preference for PAA compared to PVA by both patients and doctors. Only one patient on each treatment had an adverse event and neither was serious. PAA (Viscotears®) was as safe as, but better tolerated and more effective than PVA in the treatment of dry eye conditions.
Anthrax as the cause of preseptal cellulitis
Authors: Çelebi Serdal , Çelebi Harika , Çeliker Ülkü Ö , Kandemir Baran , Alagöz Gürsoy , Esmerligil Serhan 
Published: May 2009

ABSTRACTAnthrax is an infectious disease caused by Bacillus anthracis. It is primarily a disease of domestic animals such as cattle, goats, and sheep; but humans can rarely be infected by contact with infected animals or contaminated animal products. Our case is a 4–year‐old boy who was initially diagnosed as preseptal cellulitis, but later he showed the characteristic anthrax lesions with a black necrotic eschar. Scrapings from the necrotic tissue showed gram positive rods and culture grew Bacillus anthracis. The patient responded to intravenous administration of penicillin G, and the lesions resolved, leaving a scar on the right upper eyelid. Eyelid involvement of anthrax is rarely seen in clinical practice, but should be considered in differential diagnosis.
Silicone oil removal: Results, risks and complications
Authors: Scholda Christoph , Egger Stefan , Lakits Adalbert , Haddad Raja 
Published: May 2009

ABSTRACT.Purpose: We studied the results and complications of silicone oil removal applying basic criteria for the selection of eyes.Methods: The criteria for oil removal: 1. Completely attached retina for at least 4 weeks, 2. Absence of tractions and active proliferations, 3. Preoperative vision weeks, 2. Absence of tractions and active proliferations, 3. Preoperative vision > 0.01. The oil was removed from 90 of 261 oil filled eyes (removal rate: 34.5%). 83 eyes were included in the further study. Follow‐up: 1.3–62.5 months (mean 15.7).Results: Visual acuity improved (≥ 1 line) in 40 of the 83 eyes (48.2%), remained unchanged in 22 eyes (26.5%) and deteriorated (≥ 1 line) in 21 eyes (25.3%). Complications: reproliferations (42.2%), retinal detachment (20.5%), pressure rises (27.7%), lens opacification (36.7%), severe keratopathy (8.4%).Conclusion: Silicone oil removal has a distinct rate of complications, despite pre‐operative selection of eyes with a better prognosis. Reduction of reproliferations and weighing of risk and benefit could improve the results.