bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dry‐eye syndrome after allogeneic stem‐cell transplantation in children
Authors: Fahnehjelm Kristina Teär , Törnquist Alba‐Lucia , Winiarski Jacek 
Published: May 2008

Abstract.Purpose:  To report the prevalence of dry‐eye syndrome (DES) in children and young adults treated with allogeneic stem‐cell transplantation (SCT) during childhood; to relate DES to conditioning regimes, including total body irradiation (TBI) and chemotherapy, and to immunosuppressive drugs and graft‐versus‐host disease (GVHD).Methods:  This cross‐sectional study included 60 children/young adults transplanted because of leukaemia, various haematological disorders and inborn errors of metabolism between 1986 and 2004, with a follow‐up time of 7.0 years (median, range 2–18). Clinical assessments, performed at a median age of 15.6 years (range 5.5–23.5), included an inquiry form on dry‐eye symptoms, corneal status including fluorescein staining, ‘break‐up time’ (BUT) and Schirmer test.Results:  A total of 37 of 60 patients had DES defined as presence of corneal epithelial lesions with a pathological BUT and/or Schirmer test. Twenty‐nine had had staining <1–10% of the corneal surface while eight patients had staining ≥10–25% of the corneal surface. All 37 patients with objective signs of DES, graded and not graded, had significant associations to subjective symptoms of dry eyes including dry eyes, red eyes, ocular irritation, secretion and sensitivity to light. Frequent occasions (above median; n = 7) of high cyclosporine A trough levels above 250 ng/ml were associated significantly with DES (P = 0.002). However, there was no association between DES and conditioning with single‐dose (s‐TBI) or fractionated TBI (f‐TBI), busulfan or other chemotherapy. There were no associations between prolonged corticosteroid treatment or chronic GVHD and DES in the present study. DES was more common in patients with malignant diseases (P = 0.02). Malignant disease increased the risk of DES in girls but not in boys. Increased age at SCT increased the risk for DES in boys but not in girls (P = 0.02). Although severe keratitis occurred in three patients, nobody suffered corneal perforation.Conclusion:  DES with epithelial punctata keratopathy was common in children/young adults treated with SCT and more common if the patients were exposed to repeated high trough levels of cyclosporine A; however, DES was not associated with irradiation, corticosteroids or GVHD in the present study. Patients with objective DES also had subjective symptoms of dry eyes, which facilitate diagnosis. Girls with malignant diseases and boys who underwent SCT at later ages seem to demand higher attention and more frequent check‐ups regarding DES. Patients with diagnosed severe DES needed frequent and continuous ophthalmological care to maintain treatment motivation.
Ocular characteristics in 10 children with long‐chain 3‐hydroxyacyl‐CoA dehydrogenase deficiency: a cross‐sectional study with long‐term follow‐up
Authors: Fahnehjelm Kristina Teär , Holmström Gerd , Ying Liu , Haglind Charlotte Bieneck , Nordenström Anna , Halldin Maria , Alm Jan , Nemeth Antal , Von Döbeln Ulrika 
Published: May 2008

Abstract.Purpose:  To present long‐term ocular complications and electroretinographic (ERG) findings in children with long‐chain 3‐hydroxyacyl‐CoA dehydrogenase (LCHAD) deficiency – a life‐threatening metabolic disease – and the relation to age at diagnosis, treatment and other clinical parameters.Methods:  Ten children with LCHAD deficiency underwent repeated ophthalmological evaluations including ERG.Results:  All 10 children developed chorioretinal pathology. Regardless of age at diagnosis, initiation of treatment and age at examination, inter‐individual differences were present. Profound chorioretinal atrophy, severe visual impairment and progressive myopia had developed in two teenagers. Milder chorioretinopathy with or without subnormal visual acuity was present in all other children. ERG was pathological in seven children. The chorioretinopathy often started in the peripapillary or perimacular areas. In one patient, unilateral visual impairment was associated with fibrosis.Conclusion:  Early diagnosis and adequate therapy might delay but not prevent the progression of retinal complications. Late diagnosis with severe symptoms at diagnosis, neonatal hypoglycaemia and frequent decompensations may increase the progression rate of the chorioretinopathy.LCHAD deficiency, a potentially lethal disease, is sometimes difficult to diagnose. Unusual chorioretinal findings should alert the ophthalmologist to the long‐chain 3‐hydroxyacyl‐CoA dehydrogenase deficiency, especially if there is a history of neonatal hypoglycaemia or failure to thrive.
Atypical Microsporum canis variant in an immunosuppressed child
Authors: Anemüller Waltraud , Baumgartner Sabine , Brasch Jochen 
Published: May 2008

SummaryA 10‐year old boy with X‐chromosomal adrenoleukodystrophy presented with scaly patches on the scalp and diffuse effluvium. He was on immunosuppressive therapy because of a chronic graft‐versus‐host‐reaction after allogenic bone marrow transplantation. At home he had been in contact with cats, rabbits and guinea pigs. Through Wood light and KOH examination, we confirmed the diagnosis of tinea capitis and started antimycotic therapy.The morphology of the culture first suggested Epidermophyton floccosum, Trichophyton mentagrophytes var. nodulare or Trichophyton tonsurans as possible causes for this infection. Further studies, however, revealed an atypical form of Microsporum canis infection.
Determinants of treatment goals and satisfaction of patients with atopic eczema
Authors: Schmitt Jochen , Csötönyi Friederike , Bauer Andrea , Meurer Michael 
Published: May 2008

Summary Background: Despite the high prevalence, morbidity, and economic burden of atopic eczema,data on patients' treatment goals and treatment satisfaction are missing. Methods: A cross‐sectional study was performed with standardized survey of all adult patients treated between 01/2004 and 03/2006 in the atopic eczema outpatient unit of the Department of Dermatology, TU Dresden, Germany. Assessed were disease‐specific characteristics (age at onset, treatment, disease severity, quality of life impact), and aspects of health services research (treatment goals, patients' self‐treatment competence, treatment satisfaction). Treatment satisfaction was assessed on a 100 mm visual analog scale with 0 reflecting “very dissatisfied”, and 100 “highly satisfied”. Based on an a priori model we analyzed the impact of sociodemographic and disease‐specific factors on treatment satisfaction (primary endpoint) using multivariate regression modeling. Results: Of the 267 patients asked to participate, 226 (85 %) agreed. Mean treatment satisfaction was 59.6 (± 30.8). Age and sex were not significantly associated with treatment satisfaction. Professional competence of the treating physician was the most important determinant of treatment satisfaction, followed by physician's sensitivity, disease severity, education about the condition, and patient's competence to adjust treatment to disease activity. Reduction of itching and burning, as well as complete clearing of all skin changes, were the most important treatment goals. Conclusions: For adult patients with atopic eczema the impression of professional competence of the treating physician has highest priority. Disease severity only explains 20 % of the total variance of treatment satisfaction. Comprehensive information about the condition and reinforcement of patients' treatment competence should be better integrated in clinical practice.
House ofMirrors: Textual Variation and theMirror for Magistrates
Authors: Human Elizabeth M. A. 
Published: May 2008

AbstractLily B. Campbell's 1938 edition has decisively shaped current scholarship on theMirror for Magistrates, a sixteenth/seventeenth‐century poem taking as its subject British history. Though sixteen texts calling themselves theMirror for Magistrates(or some variation thereon) were published between 1554/5 and 1620, under the leadership of several editors (William Baldwin, John Higgins, Thomas Blenerhasset, and Richard Niccols), Campbell focuses on the earlier versions, selectively including the 1554/5–1587 editions (the material edited by or connected to Baldwin), and excluding the seventeenth‐century texts entirely. My essay endeavors first to illuminate this complex textual history, and to suggest that a reckoning with theMirrorwhole opens on to some crucial concerns for the literary history of the period, such as the role of the printer in producing the text, the uses of history in public discourse, and the status of the author in the late sixteenth and early seventeenth centuries.
‘a mixed Parenthesis’: John Donne'sLetters to Severall Persons of Honour
Authors: Hester M. Thomas 
Published: May 2008

AbstractThis paper is part of the secondLiterature Compasspanel cluster arising fromThe Texas A&M John Donne Collection: A Symposium and Exhibition. [Correction added after online publication 24 October 2008: ‘This paper introduces the secondLiterature Compasspanel cluster’ changed to ‘This paper is part of the secondLiterature Compasspanel cluster’.] Comprising an introduction by Gary Stringer and three of the papers presented at the symposium, this cluster seeks to examine the current state of Donne Studies and aims to provide a snapshot of the field. The symposium was held April 6–7, 2006.The cluster is made up of the following articles:‘Introduction to the Second Donne Cluster: Three Papers fromThe Texas A&M John Donne Collection: A Symposium and Exhibition’, Gary A. Stringer,Literature Compass5 (2008), DOI:10.1111/j.1741-4113.2008.00551.x.‘Donne into Print: The Seventeenth‐Century Collected Editions of Donne's Poetry’, Ted‐Larry Pebworth,Literature Compass5 (2008), DOI:10.1111/j.1741-4113.2008.00552.x.‘“a mixed Parenthesis”: John Donne'sLetters to Severall Persons of Honour’, M. Thomas Hester,Literature Compass5 (2008), DOI:10.1111/j.1741-4113.2008.00553.x.‘What We Think About Donne: A History of Donne Criticism in Twenty Minutes’, Paul A. Parrish,Literature Compass5 (2008), DOI:10.1111/j.1741-4113.2008.00554.x.***This 1651 (rpt. 1654) edition of 129 letters composed by John Donne (1572–1631) presents the witty poet and preacher in many of his most significant styles and roles; ‘conveyors of me to you’, he called them. Despite the ‘tampering’ of many of the letters by its editor or collector, the letters yet maintain an overall impression of the ‘vitality of mind’ and ‘purposeful mental recourse’ for which this Renaissance poet and preacher was known. Attacks on the corruption of the court are balanced in the volume overall by its many meditative considerations; the portrait here of Donne the family man and loving father and husband is set beside the clever writer who declared friendship to be his ‘second religion’; and these revealing insights into his public and private self are balanced by letters affirming his life‐long assertion that ‘There is no Vertue, but Religion’. Letters about the ongoing religious conflicts in Europe are followed often by newsless letters he called ‘ghosts’ and ‘apparitions’, both examples of his epistolary art expressed in those dexterous conceits that characterize his vibrant poetry and prose. This varied collection of Donne's letters seems often, that is, to be framed to illustrate his understanding of that ancient and Renaissance adage,Stylus virum arguit: ‘Style argues the man’.
The Poetics of Place and Space: Wordsworth, Norman Nicholson and the Lake District
Authors: Cooper David 
Published: May 2008

AbstractThis article draws upon the ‘spatial turn’ in critical practice to open up thinking about Romantic and post‐Romantic representations of geo‐specific space. The opening section maps out the philosophical foundations for spatial literary criticism by tracing two main strands of spatial theory: one which emerges out of Heideggerian phenomenology; and the other which is based on the Marxist cultural analysis of Henri Lefebvre. The article then highlights some ways in which these spatial theories have been used to offer new readings of Romantic texts. The second half of the essay roots this spatial thinking by focusing on literary representations of the Lake District. It shows how notions of boundary and boundedness are central to Wordsworth's spatial configuration of his native region; alongside this, it indicates how Wordsworth's mapping of the area has influenced later constructions of the landscape as a ‘social space’. The final section points towards further thinking by briefly examining the work of the twentieth‐century Cumbrian writer, Norman Nicholson (1914–87), and highlighting the tensions in his development of a site‐specific, post‐Romantic poetics of place and space.
The Quest for Utopia in the Eighteenth Century
Authors: Pohl Nicole 
Published: May 2008

AbstractThis article reviews critical scholarship on eighteenth‐century utopias and utopianism over the last ten years. It suggests that, in the light of current debates about Enlightenment discourses, eighteenth‐century utopias and utopianism reflect accurately the multitude of discourses on gender, sexuality, colonialism and politics that make the Enlightenment so contentious.
John Skelton and the New Fifteenth Century
Authors: Tonry Kathleen 
Published: May 2008

AbstractJohn Skelton's writing career took place roughly between 1488 and 1528, years that straddle two centuries and, most awkwardly, two epochs. Perhaps because of that awkwardness he has been a poet marginalized in our literary histories and critical discourse until quite recently. This overview essay suggests that to re‐engage Skelton is to test alternative literary histories that think beyond the fifteenth century as a merely transitional moment and that put into play methodologies flexible enough to accommodate inter‐related notions of aesthetics and context. This essay traces Skelton's critical tradition as a series of perspectives on the poet's own nimble engagements with form and history. The first section follows the story of formalist and historicist approaches to Skelton working in tension up until the last part of the twentieth century. The second section explores the interventions of the new Skelton scholars. The third and final sections speculate briefly about fresh directions in Skelton scholarship, noticing that many of the themes and questions raised around Skelton over the past century remain open for more extensive development.
Vacuum‐assisted closure therapy for deep sternal wound infections: the impact of learning curve on survival and predictors for late mortality
Authors: Sjögren Johan , Mokhtari Arash , Gustafsson Ronny , Malmsjö Malin , Nilsson Johan , Ingemansson Richard 
Published: May 2008

AbstractThe aim of this study was to evaluate the possible learning curve effects on survival during the introduction of vacuum‐assisted closure (VAC) therapy in patients with deep sternal wound infection (DSWI). Furthermore, predictors of late mortality were analysed and causes of late death were examined. Fifty‐three patients (early Group, n = 26, January 1999 to July 2001 versus late group, n = 27, August 2001 to March 2003) were all treated with VAC for DSWI. A follow‐up was carried out in September 2006. Multivariate analyses were used to evaluate the predictors of late mortality. The 90‐day mortality was 0% in both groups. The survival rates at 5 years were 69·2 ± 9·1% (early group) versus 58·5 ± 11·7% (late group), P = ns (non significant). The time interval from cardiac surgery to diagnosis of DSWI and prolonged VAC therapy were identified as independent predictors of late mortality. Our concept for VAC therapy in DSWI seems to be readily introduced in clinical practice. There was no difference in survival between our initial cases and later cases. Late diagnosis and prolonged wound therapy were identified as predictors for late mortality.
Non healing leg ulcers and the nurse–patient relationship. Part 1: the patient’s perspective
Authors: Morgan Philip A , Moffatt Christine J 
Published: May 2008

AbstractThis paper reports on a study that explored the relationship between patients with non healing leg ulcers and the nurses providing their care in a community setting. Qualitative data were collected from five patients whose leg ulcers were healing and who had been identified as experiencing difficulty with adhering to treatment. Single semi‐structured interviews were used and participants were asked to share key events in their care prompted by the question ‘how are you coping with your leg ulcer?’ Striving to maintain balance by developing strategies to cope with the physical effects of an unhealed ulcer as well as ensuring the care they received met their unique needs was central to the experience of participants. From the participant’s perspective, however, nurses often showed little understanding of the complex issues patients were grappling with. Patients, in viewing nurse behaviour, often concluded that leg ulceration was an insignificant problem that nurses had little interest in. The need to establish and to maintain a trusting therapeutic relationship with patients is essential if they are to feel they matter, that they are important as individuals and that their suffering can be eased by sensitive collaboration.
The impact of Manuka honey dressings on the surface pH of chronic wounds
Authors: Gethin Georgina T , Cowman Seamus , Conroy Ronan M 
Published: May 2008

AbstractChronic non healing wounds have an elevated alkaline environment. The acidic pH of Manuka honey makes it a potential treatment for lowering wound pH, but the duration of effect is unknown. Lowering wound pH can potentially reduce protease activity, increase fibroblast activity and increase oxygen release consequently aiding wound healing. The aim of this study was to analyse the changes in surface pH and size of non healing ulcers following application of Manuka honey dressing after 2 weeks. The study was an open label, non randomised prospective study. Patients presenting consecutively with non healing chronic superficial ulcers, determined by aetiology and no reduction in wound size in previous 3 weeks. Single pH measurements recorded using Blueline 27 glass surface electrode and R 315 pH meter set (Reagecon/Alkem, Co. Clare Ireland). Area determined using Visitrak (Smith & Nephew, Mull, UK) digital planimetry. Apinate® (Manuka honey) (Comvita, Slough, UK) applied to wounds for 2 weeks after which wounds re‐evaluated. Eight males and nine females with 20 ulcers (3 bilateral) were included: venous, 50% (n = 10); mixed aetiology, 35% (n = 7); arterial, 10% (n = 2) and pressure ulcer, 5% (n = 1). Reduction in wound pH after 2 weeks was statistically significant (P < 0·001). Wounds with pH ≥ 8·0 did not decrease in size and wounds with pH ≤ 7·6 had a 30% decrease in size. A reduction in 0·1 pH unit was associated with an 8·1% reduction in wound size (P < 0·012). The use of Manuka honey dressings was associated with a statistically significant decrease in wound pH and a reduction in wound size. Elevated pH readings at the start were associated with minimal reduction in size. Surface wound pH measurements may contribute to objective wound assessments, but further research is necessary to determine its exact contribution.
Wound healing in radiated skin: pathophysiology and treatment options
Authors: Olascoaga Andrea , Vilar‐Compte Diana , Poitevin‐Chacón Adela , Contreras‐Ruiz Jose 
Published: May 2008

AbstractUlcers in radiated skin continue to be a challenge for health care practitioners. Healing impairment in the setting of radiation‐damaged tissue will most of the time lead to chronic wounds that reduce the patient’s quality of life. In this review, we present an update of the pathophysiology of tissue damage caused by radiation that leads to chronic ulceration. We also explore the evidence available on the different prevention and treatment modalities that have been reported in the literature. The evidence for most preventive measures is inconclusive; however, sucralfate and amifostine seem to be the adequate recommendations for prophylaxis. As for treatment of ulcerated patients, the strongest level of evidence found was for the use of pentoxifylline, but proper trials are still scarce to be considered standard adjuvant therapy. Hyperbaric oxygen, cytokines and other growth factors and surgical interventions have shown some benefit in case reports and case series only. Other therapies show promise based on their mechanism of action but need to be tested in human studies and clinical trials.
Hip fracture and pressure ulcers – the Pan‐European Pressure Ulcer Study – intrinsic and extrinsic risk factors*
Authors: Lindholm Christina , Sterner Eila , Romanelli Marco , Pina Elaine , Torra y Bou Joan , Hietanen Helvi , Iivanainen Ansa , Gunningberg Lena , Hommel Ami , Klang Birgitta , Dealey Carol 
Published: May 2008

AbstractPressure ulcers (PU) in patients with hip fracture remain a problem. Incidence of between 8·8% and 55% have been reported. There are few studies focusing on the specific patient‐, surgery‐ and care‐related risk indicators in this group. The aims of the study were

to investigate prevalence and incidence of PU upon arrival and at discharge from hospital and to identify potential intrinsic and extrinsic risk factors for development of PU in patients admitted for hip fracture surgery.
to illuminate potential differences in patient logistics, surgery, PU prevalence and incidence and care between Northern and Southern Europe. Consecutive patients with hip fracture in six countries, Sweden, Finland, UK (North) and Spain, Italy and Portugal (South), were included. The patients were followed from Accident and Emergency Department and until discharge or 7 days. Prevalence, PU at discharge and incidence were investigated, and intrinsic and extrinsic risk indicators, including waiting time for surgery and duration of surgery were recorded. Of the 635 patients, 10% had PU upon arrival and 22% at discharge (26% North and 16% South). The majority of ulcers were grade 1 and none was grade 4. Cervical fractures were more common in the North and trochanteric in the South. Waiting time for surgery and duration of surgery were significantly longer in the South. Traction was more common in the South and perioperative warming in the North. Risk factors of statistical significance correlated to PU at discharge were age ≥71 (P = 0·020), dehydration (P = 0·005), moist skin (P = 0·004) and total Braden score (P = 0·050) as well as subscores for friction (P = 0·020), nutrition (P = 0·020) and sensory perception (P = 0·040). Comorbid conditions of statistical significance for development of PU were diabetes (P = 0·005) and pulmonary disease (P = 0·006). Waiting time for surgery, duration of surgery, warming or non warming perioperatively, type of anaesthesia, traction and type of fracture were not significantly correlated with development of PU.