bluuebunny/crossref_metadata_2025_split huggingface dataset:
Suprasellar arachnoid cyst resulting in the syndrome of inappropriate antidiuretic hormone secretion
Authors: Beier Alexandra D. , Cheshier Samuel H. , Chakraborty Aabir , Dirks Peter 
Published: November 2010

The syndrome of inappropriate antidiuretic hormone secretion (SIADH) is occasionally seen after hypothalamic injury or dysfunction, although it typically occurs in association with other endocrine disturbances. It is has never been described as a presenting feature of a suprasellar arachnoid cyst (SAC) in the pediatric population. The authors describe the case of an enlarging SAC resulting in SIADH as the only presenting feature, with an otherwise normal hypothalamic-pituitary axis.
An SAC was diagnosed in utero in this 5-month-old girl who had a normal functioning hypothalamic-pituitary axis on presentation. Because of cyst enlargement and hydrocephalus, the patient was scheduled for surgery; however, preoperative labs revealed SIADH. After stabilizing the serum sodium concentration with fluid restriction and the administration of 3% sodium chloride, the patient underwent endoscopic cyst fenestration. Postoperatively, she had complete resolution of the SIADH.
Syndrome of inappropriate antidiuretic hormone secretion as the presenting symptom of an SAC has not been previously described. In the aforementioned patient, the proposed mechanism for SIADH was enlargement of the suprasellar arachnoid cyst causing compression of the supraoptic and paraventricular nuclei and thus overstimulating the secretion of arginine vasopressin, which resulted in SIADH.
The association of SIADH with an SAC is reportable, as is the resolution of the SIADH via cyst fenestration. The authors suggest that SIADH is an uncommon presenting feature of SACs and that syndrome resolution is possible with cyst decompression.
Perineurioma of the sciatic nerve: a possible cause of idiopathic foot drop in children
Authors: Ferraresi Stefano , Garozzo Debora , Bianchini Ezio , Gasparotti Roberto 
Published: November 2010

The authors report on a loss of foot dorsiflexion in pediatric-age individuals and suggest that the possible cause could be a perineurioma of the sciatic nerve.
The authors describe 4 cases in which foot drop in the absence of sensory discomfort was the heralding sign of perineurioma of the sciatic nerve. Magnetic resonance imaging showed a focal enlargement of the sciatic nerve, but the tumor was confined only to its lateral compartment. Treatment in 2 cases involved excision of the affected segment and subsequent graft repair. The two other patients shared the same clinical, radiological, and surgical findings, but no nerve biopsy sample was obtained; the patients underwent only a tibialis posterior muscle transfer. Long-term recovery of nerve function never occurred.
Because tumor resection and nerve graft yield no functional results, a tendon transfer to restore walking may be the sole useful surgical procedure in these cases. Removal of the tumor may not be necessary because long-term follow-up confirms that perineuriomas are self-limiting and the final prognosis is favorable.
Establishing Construct Validity of a Stages-of-Change Algorithm for Physical Activity
Authors: Kosma Maria , Ellis Rebecca 
Published: November 2010

Purpose. Examine the construct validity of a modified stages-of-change (SOC) scale among adults with physical disabilities by investigating the relations among the transtheoretical model (TTM) constructs, physical activity (PA), and SOC. Additionally, the SOC algorithm was compared with previously recommended SOC scales. Design/Setting. Cross-sectional online survey. Subjects. 271 adults with physical disabilities ( x̄age = 49.25; 73.4% females). Measures. Standardized questionnaires for the TTM constructs and PA. Analyses/Results. Based on the multivariate analysis of variance, the hypothesized relations between the SOC and the TTM constructs were supported. According to the analysis of variance, PA levels increased almost linearly across the SOC. Precontemplators ( x̄ = 8.53 metabolic equivalent [MET]-h/d) had lower PA scores than contemplators ( x̄ = 14.27 MET-h/d) and preparators ( x̄ = 17.64 MET-h/d), who in turn had lower scores than those in action ( x̄ = 23.03 MET-h/d). Based on the direct discriminant function analysis, all TTM constructs were important predictors of the SOC (e.g., r = .85 for behavioral processes; r = .69 for self-efficacy; and r = .58 for cognitive processes). The most accurately predicted SOC were action (76.9%), precontemplation (70.6%), contemplation (44.6%), and preparation (14.9%), with an overall classification accuracy of 56.8%. The study participants were more evenly distributed across the SOC algorithm compared with previous studies. Conclusion. The construct validity of the SOC scale was supported. The scale differentiated almost linearly the levels of PA and most TTM constructs, and participants were well-represented across SOC. Health promoters should feel confident in using the proposed SOC scale and the TTM to implement stage-matched PA motivational programs.
The Impact of an Online Disease Management Program on Medical Costs among Health Plan Members
Authors: Schwartz Steven M. , Day Brian , Wildenhaus Kevin , Silberman Anna , Wang Chun , Silberman Jordan 
Published: November 2010

Purpose. This study evaluated the economic impact of an online disease management program within a broader population health management strategy. Design. A retrospective, quasi-experimental, cohort design evaluated program participants and a matched cohort of nonparticipants on 2003–2007 claims data in a mixed model. Sample. The study was conducted through Highmark Inc, Blue Cross Blue Shield, covering 4.8 million members in five regions of Pennsylvania. Overall, 413 online self-management program participants were compared with a matched cohort of 360 nonparticipants. Measures. The costs and claims data were measured per person per calendar year. Total payments were aggregated from inpatient, outpatient, professional services, and pharmacy payments. The costs of the online program were estimated on a per-participant basis. All dollars were adjusted to 2008 values. Intervention. The online intervention, implemented in 2006, was a commercially available, tailored program for chronic condition self management, nested within the Blues on CallSM condition management strategy. Analysis. General linear modeling (with covariate adjustment) was used. Data trends were also explored using second-order polynomial regressions. Results. Health care costs per person per year were $757 less than predicted for participants relative to matched nonparticipants, yielding a return on investment of $9.89 for every dollar spent on the program. Conclusions. This online intervention showed a favorable and cost-effective impact on health care cost.
Assessment of Central Corneal Thickness Using OCT, Ultrasound, Optical Low Coherence Reflectometry and Scheimpflug Pachymetry
Authors: Beutelspacher Sven C. , Serbecic Nermin , Scheuerle Alexander F. 
Published: October 2010

Purpose Accurate measurement of central corneal thickness (CCT) is essential in refractive surgery and advanced glaucoma diagnostics. The gold standard for pachymetry is full-contact ultrasound-based pachymetry. As this method is associated with potential sources of error, noncontact methods have been introduced. The aim of this study was to compare CCT results measured using 4 different techniques. Methods In this analysis of 20 patients (40 eyes) at the University Eye Hospital Heidelberg, Germany, we compared a slit-lamp-mounted optical coherence tomography (OCT) system (SL-OCT, Heidelberg Engineering, Heidelberg, Germany), conventional ultrasound pachymetry (IOPac, Heidelberg Engineering), optical low coherence reflectometry (OLCR, Haag-Streit, Germany), and scanning-slit pachymetry (Orbscan). Results Comparison among the 4 groups did not show significant differences, except the comparison of OLCR to Orbscan; the mean was significantly different (p=0.0247) and the Orbscan detected slightly thicker values than the other methods. Conclusions Orbscan, SL-OCT, and OLCR provide non-touch technology, without the need for local anesthesia, and limiting the risk of infection or artifacts. Extreme care must be used interpreting the results obtained from Orbscan, as this technique may overestimate the CCT significantly.
Reproducibility of Ocular Biometry with a New Noncontact Optical Low-Coherence Reflectometer in Children
Authors: Şahin Aísun , Gürsoy Hüseyin , Başmak Hikmet , Yildirim Nilgün , Usalp Zuhat , Çolak Ertuğrul 
Published: October 2010

Purpose TO evaluate the reproducibility of Lenstar in the pediatric population. Methods Three consecutive measurements per eye by 2 ophthalmologists with a total of 6 measurements per eye were performed using Lenstar. Axial length (AL), central corneal thickness (CCT), anterior chamber depth (ACD), lens thickness (LT), and corneal curvatures (K1 and K2) were measured for right and left eyes in 154 school-age children. Right and left eyes were analyzed separately. Each optical parameter obtained by 2 examiners was compared by paired samples t test. Intraobserver and interobserver correlation coefficients (r) were calculated for each variable. Significance was attributed when p<0.05. Results Measurements could be performed in 152 of the children included. The mean measurements were not different statistically except for left AL (23.22±0.81 vs 23.21 ±0.82 mm; p=0.014), left CCT (548.5±32.3 vs 548.0±32.7 μm; p=0.013), and right ACD (3.19±0.25 vs 3.19±0.25 mm; p=0.033). Intraobserver r values were all above 0.957 except for left LT (r=0.786) for examiner 2. Interobserver r values were all above 0.979. Conclusions Although statistical significance was obtained in some variables, they were clinically negligible. The intraobserver and interobserver relation coefficients were very high for all optical parameters including the r value for left LT for examiner 2 (r=0.786). Lenstar is a highly reproducible, user independent, and tolerable instrument for ocular biometry in the pediatric population, with no anesthesia or discomfort.
Prophylactic Intravitreal Bevacizumab for Diabetic Macular Edema (thickening) after Cataract Surgery: Prospective Randomized Study
Authors: Fard Masoud Aghsaei , Abyane Alireza Yazdanei , Malihi Mehrdad 
Published: October 2010

Purpose TO determine the role of intravitreal bevacizumab injected at the time of cataract surgery on postoperative increase of retinal thickness in patients with diabetic retinopathy. Methods Patients were randomized to a standardized procedure of phacoemulsification with intraocular lens implantation alone (control group; 30 eyes) or to receive 1.25 mg intravitreal bevacizumab at the end of surgery (IVB group; 31 eyes). Efficacy measures included best-corrected visual acuity (BCVA) testing, optical coherence tomography (OCT), and ophthalmoscopic examination at each postoperative visit during a 6-month follow-up. Results There were no significant differences in central macular thickness, BCVA, or systemic condition between the control and IVB groups at baseline. One month after surgery, the control group showed a significant increase in central macular thickness, whereas the bevacizumab group did not show an increase. After 6 months, there was no significant difference in macular thickness and postoperative visual acuity between the 2 groups. Conclusions Intravitreal administration of 1.25 mg bevacizumab at the time of cataract surgery is effective just for the short term and 6-month results are the same as the control group.
National Survey of Day-Case Vitreoretinal Surgery in the United Kingdom
Authors: Hussain Rumana , Matare Taurai , Zambarakji Hadi 
Published: October 2010

Introduction Day-case surgery has become uniformly accepted in ophthalmology for most procedures but not for complex, lengthy ones, including vitreoretinal surgery. There is a need for uniform practice that is not only financially and resource efficient, but also convenient for patients. Purpose TO describe current practice patterns of day-case vitreoretinal (DCVR) surgery in the United Kingdom. Methods A 16-part e-mail questionnaire was sent to UK vitreoretinal consultants, with day-case surgery defined as patients admitted and discharged following surgery on the same day. The questionnaire was sent to all consultant members of the Britain and Eire Association of Vitreoretinal Surgeons using the e-mail address beavrs@yahoogroups.com to increase the response rate. Results The overall response rate was 41%. Of 55 responders, 9% do not undertake DCVR surgery, but 61% perform DCVR surgery in >75% of patients. Of all undertaking DCVR surgery, 85% of responders discharge patients home and 13% to a hostel. A total of 76% of responders use local/sub-Tenon anesthesia in >50% of patients undergoing DCVR surgery. A total of 15% of responders were not in favor of DCVR surgery. Common reasons for not undertaking DCVR surgery were significant traveling distances for patients, patient choice, and the need for support during posturing. Conclusions The practice of DCVR surgery across the United Kingdom is variable and is influenced by local factors, patient factors, and surgeon views. There is a lack of guidelines to help decision-making. Common standards are required to maximize clinical outcomes and patient satisfaction, as well as reduce the cost burden of hospital admissions.
Experimental Femtosecond Laser-Assisted Nanosurgery of Anterior Lens Capsule
Authors: Toropygin Sergey G. , Krause Matthias , Akkaya Asim , Riemann Iris , Seitz Berthold , Mestres Pedro , Ruprecht Klaus W. , Troeber Leonie , Gatzioufas Zisis , König Karsten 
Published: October 2010

Purpose TO investigate femtosecond laser-assisted nanosurgery of the anterior lens capsule in a prospective in vitro study. Methods Eight anterior lens capsules obtained during conventional phaco surgery were irradiated with a nonamplified 80-MHz near-infrared 800-nm titanium:sapphire femtosecond laser. Line intratissue laser cuts were examined by femtosecond multiphoton laser scanning microscopy (MLSM) and transmission electron microscopy (TEM). Results Speed parameters of the laser beam, laser ablation time, and pulse power determined the width of the lesions, which ranged from 220±40 nm (SD) to 1.49±0.15 μm. Both MLSM and TEM revealed minimal collateral alterations in the tissue surrounding the laser cuts. Conclusions Nonamplified near-infrared femtosecond laser pulses at low pulse energies may be a promising strategy for precise noncontact nanosurgery of the anterior lens capsule with minimal collateral damage to surrounding tissue. High-resolution MLSM offers 3-dimensional, noninvasive, non-destructive imaging at submicrometer resolution within seconds before and after ablation.
Interface Corneal Stromal Irregularities after Flap Creation using Femtosecond Laser
Authors: Kymionis George D. , Kounis George A. , Grentzelos Michael A. , Panagopoulou Sophia I. , Kandarakis Stylianos A. , Krasia Maria S. 
Published: October 2010

Purpose TO report a case of interface corneal stromal irregularities after flap creation with the advanced IntraLase femtosecond (150 Hz) laser system (Abbott Medical Optics, Inc.). Methods Case report. Results An 18-year-old man underwent bilateral laser in situ keratomileusis (LASIK) using the IntraLase femtosecond laser to create 110–μm flaps. The procedure was uneventful in the left eye. In the right eye, after flap lifting a central irregular stromal interface was noted. The created flap was thicker than expected (139 μm) as measured intraoperatively with ultrasound pachymetry. The excimer laser ablation procedure was performed and the flap was repositioned. On the first postoperative day and during the 6-month follow-up period, uncorrected distance visual acuity was 20/20 in both eyes. Conclusions Interface corneal stromal irregularities may occur after femtosecond corneal flap creation during LASIK.
Evaluation of Corneal Biomechanical Properties with the Reichert Ocular Response Analyzer
Authors: Detry-Morel Michèle , Jamart Jacques , Pourjavan Saveh 
Published: October 2010

Purpose TO compare corneal hysteresis (CH) and corneal resistance factor (CRF) measured with the Ocular Response Analyzer (ORA) in patients with primary open-angle glaucoma (POAG), patients with ocular hypertension (OHT), and normal subjects (NL); and to assess correlations of CH and CRF with corneal-compensated intraocular pressure (IOPcc), Goldmann applanation tonometry (GAT), glaucoma type, central corneal thickness (CCT), previous filtering procedure, and antiglaucoma medications. Methods A total of 108 POAG, 22 OHT, and 24 NL were enrolled in this observational study Goldmann applanation tonometry and ORA were performed in a randomized sequence followed by pachymetry One eye per subject was selected at random for analysis. Chi-square, Wilcoxon, and Kruskal-Wallis tests were used for comparison and Spearman coefficient for assessing correlations. Results Mean CH and CRF were significantly lower in POAG than in OHT and NL. Ocular Response Analyzer IOPcc overestimated IOP compared to GAT only in POAG. This difference increased with higher GAT. Goldmann applanation tonometry and IOPcc were correlated. Corneal hysteresis was negatively correlated with age in POAG. Corneal resistance factor and CH were positively correlated with CCT in POAG and OHT. Unlike CRF, CH was not correlated with GAT in POAG and OHT. Corneal-compensated intraocular pressure was not correlated with CCT. Difference between GAT and IOPcc was not CCT dependent. Corneal hysteresis and CRF were comparable in POAG and NTG, un-changed after filtering procedure. Corneal hysteresis was not altered by topical medications. Corneal resistance factor was significantly lower in treated eyes and those receiving prostaglandin analogues with no correlation with the treatment duration. Conclusions Patients with glaucoma seem to have distinctive corneal biomechanical properties compared to OHT and NL. They may be influenced by many other unknown subparameters.
Polypoidal Choroidal Vasculopathy and Macroaneurysm: Respective Roles of Scanning Laser Ophthalmoscopy-Indocyanine Green Angiography and Optical Coherence Tomography
Authors: Coscas Florence , Coscas Gabriel , Souïed Eric 
Published: October 2010

Purpose TO report on a patient with exudative age-related macular degeneration, polypoidal choroidal vasculopathy, and macroaneurysm. Methods Scanning laser ophthalmoscopy (SLO)-indocyanine green angiography (ICGA) demonstrated the coexistence of several lesions in the same patient. Optical coherence tomography (OCT) combined with ICGA defined the nature of the lesions and the severity of the exudative phenomena. Results The eye tracking system ensured precise follow-up of the course of the lesions on both ICGA and spectral domain (SD) OCT. Image correlation provided a precise diagnosis, defining the indications for local and systemic therapy. Conclusions In this patient with multiple lesions, only correlation of clinical examinations and SLO-ICG and SD-OCT imaging allowed a complete assessment with the proposal of a coherent and effective treatment plan.
Refractive Lens Exchange with Acri.LISA Bifocal Intraocular Lens Implantation
Authors: Alfonso José F. , Fernández-Vega Luis , Baamonde Begoña , Orti Susana , Montés-Micó Robert 
Published: October 2010

Purpose TO assess efficacy, safety, and predictability after refractive lens exchange (RLE) in patients who had bilateral implantation of an Acri.LISA 366D diffractive bifocal intraocular lens (IOL). Methods Sixty-six eyes of 33 consecutive patients were examined after RLE who had bilateral implantation of an Acri.LISA bifocal 366D IOL. Eyes were divided into myopic and hyperopic groups. Monocular uncorrected distance visual acuity, best-corrected distance visual acuity (BCVA), uncorrected distance near visual acuity, and best distance-corrected near visual acuity (BCNVA) were recorded preoperatively and 6 months after surgery. Results Efficacy indexes were 0.73 for myopic and 0.85 for hyperopic eyes at 6 months postoperatively. For the myopic group, 2 eyes lost 1 line, 4 eyes gained 1 line, and 6 eyes gained ≥2 lines; for the hyperopic group, 11 eyes lost 1 line, 8 eyes gained 1 line, and 7 eyes gained 2 lines. Safety indexes were 1.07 and 1.03 for myopic and hyperopic eyes, respectively. Safety indexes at near were 1.03 for myopic and 1.00 for hyperopic eyes. Efficacy indexes at near were 1.00 for myopic and 0.99 for hyperopic eyes. Conclusions Bilateral implantation of an Acri.LISA 366D bifocal IOL after RLE is an effective procedure for correcting ametropia and presbyopia.
Posterior Hyaloid Peeling in Advanced Stages of Aggressive Posterior ROP
Authors: Ecsedy Monika , Recsan Zsuzsa 
Published: October 2010

Purpose TO evaluate the indications and timing of surgical intervention on eyes with aggressive posterior retinopathy of prematurity (ROP). Methods Retrospective review of a consecutive case series of 9 eyes of 7 children, with aggressive posterior ROP, who underwent early lens-sparing vitrectomy. Preoperative retinal and vitreal features, intraoperative and postoperative complications, postoperative anatomic status, and fixation behavior 1 year after surgery were investigated. Results Vitreous hemorrhage and recurrence of plus disease with retinal detachment were the main indications for surgery. Vitrectomy was performed from the 37th to the 44th postmenstrual week (mean 40th week). In 7 eyes, vitrectomy could stop the disease progression. In all of these cases, posterior hyaloid could be peeled together with the proliferative tissue. Conclusions Lens-sparing vitrectomy with posterior hyaloid peeling at early postmenstrual ages (37–40 postmenstrual weeks) seems to be advantageous in infants with aggressive posterior ROP. The formation of a gliotic membrane growing ahead to the posterior surface of the lens resulted in unfavorable outcomes in our cases.
The Efficacy of Vertical Rectus Transposition and Its Modalities in Patients with Abducens Nerve Palsy
Authors: Nowakowska Olimpia , Loba Piotr , Broniarczyk-Loba Anna 
Published: October 2010

Purpose Patients with VIth nerve palsy that does not resolve within 6 months should undergo surgery. The most common procedure used in such cases is transposition of a whole or a part of a vertical rectus muscle combined or not with a resection of the lateral rectus muscle. Commonly, a simultaneous recession of medial rectus muscle with or without prior injection of botulinum toxin is performed. The aim of our study was to evaluate the results of vertical rectus transposition performed in patients with abducens nerve palsy. Methods Nine cases of abducens nerve palsy ware retrospectively analyzed. All patients underwent full ophthalmic and orthoptic examination before and after surgery. All patients underwent vertical rectus muscle transposition to the lateral rectus insertion in the affected eye. Additional procedures included Jensen procedure, botulinum toxin injection, resection of the lateral rectus, recession of the medial rectus on the same side with or without adjustable sutures, and Foster modification of lateral rectus posterior fixation. Results In all cases, we found a varying degree of postoperative improvement. There was a significant reduction in the strabismus angle for distance and near, increase in abduction of the affected eye, and broadening of the field of binocular single vision. Conclusions The vertical rectus muscle transposition technique is a safe and successful method of treatment in abducens nerve palsy. Its use together with additional procedures and modifications allows one to achieve orthophoria, improvement of abduction, and larger field of binocular single vision.