bluuebunny/crossref_metadata_2025_split huggingface dataset:
Bacteria commonly isolated from keratitis specimens retain antibiotic susceptibility to fluoroquinolones and gentamicin plus cephalothin
Authors: Ly Cameron N , Pham Jeanette N , Badenoch Paul R , Bell Sydney M , Hawkins Glenn , Rafferty Dianne L , McClellan Kathleen A 
Published: February 2006

AbstractPurpose:  Patients presenting with presumed infective keratitis were studied to determine predisposing factors, the current susceptibilities of the bacterial isolates to a range of relevant antibiotics, the success rate of topical antibiotic treatment of keratitis and predictors of failure of topical therapy.Methods:  Corneal scrapings taken from patients who presented between January 2002 and December 2003 to the Sydney Eye Hospital Emergency Department with keratitis were cultured. The minimum inhibitory concentration of selected antibiotics was determined for each bacterial isolate using an agar dilution technique.Results:  One hundred and twelve consecutive patients presented with corneal ulcers. Forty‐seven of the 112 (42%) patients had a growth from the corneal scraping. Potential predisposing factors were identified in 64% of patients, most frequently contact lens wear (36% of patients). Coagulase‐negative staphylococci were the most common species isolated. Other common organisms isolated include Pseudomonas aeruginosa, Corynebacterium spp., Staphylococcus aureus and Streptococcus spp.Conclusions:  Most microorganisms isolated from patients with bacterial keratitis showed susceptibility to ciprofloxacin and aminoglycosides. Cephalothin plus aminoglycoside constituted an effective initial broad‐spectrum antibiotic combination. The success rate of topical antibiotic treatment of corneal abscess is 89%. Predictors of failure include older age group, medium or large ulcer, culture‐negative keratitis, hypopyon and poor visual acuity.
Wegener's granulomatosis presenting with painless bulbar‐conjunctival ulcer and central retinal artery occlusion
Authors: Toh Tze’Yo , Cooper Richard L , Parker Andrew , Vote Brendan J 
Published: February 2006

AbstractHerein an unusual case of Wegener's granulomatosis with a painless, bulbar‐conjunctival ulcer in the right eye is reported. Rapid disease progression occurred with central retinal artery occlusion in the fellow eye. Biopsy of the diseased conjunctiva confirmed the clinical diagnosis. The clinical and histopathological findings are discussed.
Limbal stem cells: the search for a marker
Authors: Chee Kevin YH , Kicic Anthony , Wiffen Steven J 
Published: February 2006

AbstractThe corneal epithelium is a self‐renewing tissue and must, by definition, have a resident basal cell population necessary for homeostasis and wound healing. There is a substantial body of evidence, both experimental and clinical, pointing to the basal cells of the limbus as the location of corneal epithelial stem cells. However, in the absence of a definitive marker of limbal stem cells, the evidence remains largely circumstantial. Many markers such as p63 and integrin α9 are preferentially localized to the limbus but cannot be regarded as stem cell‐specific. Other markers such as K3 and connexin 43 can be regarded as markers of corneal differentiation. The discovery of stem cell markers in other organ systems, such as the haematopoietic system, offers optimism that a marker of limbal stem cells will one day be found. Such a discovery will have far‐reaching implications for the study of ocular surface biology and stratified squamous epithelia in general.
Clinical Case Notes
Authors: Ansari Husam , Garibaldi Daniel C , Jun Albert S 
Published: February 2006

AbstractTwo patients, both with a history of major depressive disorder, presented with large bilateral corneal epithelial defects and ring‐shaped stromal opacities. Both were initially treated unsuccessfully with topical antibiotic therapy for presumed infectious keratitis. One patient eventually admitted to topical anaesthetic abuse. In the second patient, signs of topical anaesthetic abuse and Munchausen's syndrome became evident. Cessation of anaesthetic use resulted in rapid resolution of the corneal epithelial defects in both patients. Anaesthetic abuse keratopathy is often a manifestation of underlying psychiatric illness, and psychiatric intervention is a very important part of management. To the authors’ knowledge, this is the first report of ocular Munchausen's syndrome manifesting as anaesthetic abuse keratopathy.
Traumatic optic nerve avulsion and central retinal artery occlusion following rugby injury
Authors: Chong Colin CW , Chang Andrew A 
Published: February 2006

AbstractOptic nerve avulsion (ONA) secondary to finger gouging is a rare complication. A case is reported of a 14‐year‐old boy who had an acute loss of vision after being poked in his left eye during a game of rugby union. He was later diagnosed with ONA, and this was associated with central retinal artery occlusion, which was rarely reported in the literature. His progress was complicated by a delayed onset of neovascular glaucoma. This is the first report of ONA secondary to a rugby injury and highlights the need for clinicians to be aware of the potential for loss of sight from gouging.
The Snug Seton: short and medium term results of slow fistulotomy for idiopathic anal fistulae
Authors: Hammond T. M. , Knowles C. H. , Porrett T. , Lunniss P. J. 
Published: February 2006

AbstractObjective  To assess the short and intermediate outcomes of a modification of the traditional cutting seton technique, using a ‘snug’ silastic seton, to treat idiopathic anal fistulae.Patients and methods  Between August 1997 and December 2002, 35 patients with idiopathic fistulae (4 female; age 26–76 years) underwent insertion of a ‘snugly’ tied 1 mm silastic seton (silicone nerve vessel retractor, Medasil ®), as definitive treatment. Short‐term assessment was performed by case note review. Patients were subsequently invited to participate in a medium‐term review.Results  Twenty‐nine patients' notes (3 female) were available for short‐term analysis. Fistulae were classified as intersphincteric (9) and transsphincteric (20). The seton spontaneously cut out in 15/29 (52%) after a median of 24 weeks. In 14 patients the seton enclosed residual tissue (< 5 mm) required division as a day case procedure, at a median of 35 weeks. All fistulae healed but 10/29 (34%) patients (1 female; 8 transsphincteric) experienced minor incontinence. Sixteen patients participated in a medium‐term review at a median of 42 months; 7 had experienced early continence disturbance. No patient suffered recurrence, but minor incontinence persisted in 4/16 (25%) patients (0 females; 3 transsphincteric). All patients were at least ‘satisfied’ with the outcome.Conclusion  In the short and medium term, the ‘snug’ seton is a safe and effective addition to the fistula surgeon's armamentarium.
A five‐year audit of anal cancer in Wales
Authors: Karandikar S. S. , Borley A. , Crosby T. , Williams G. , Reynolds S. , Radcliffe A. G. 
Published: February 2006

AbstractObjectives  A retrospective audit has been undertaken of Squamous (epidermoid) type of anal cancer diagnosed and treated in the principality of Wales over a five‐year period (1995–99) with follow‐up until 2005. The referral pattern, distribution, presenting symptoms, predisposing conditions, clinical findings and staging modalities were documented. The surgical and oncological treatment together with their outcome was analysed.Methods  Patients were identified from the Welsh Cancer Registry and the pathology databases of the 17 acute hospitals in Wales. Data was collected from the clinical and oncology case notes onto a purpose designed Microsoft access database.Results  There was a wide variation in data quality from the individual units. Twenty‐six anal cancers were diagnosed per year in the region. Median age was 69 years. Ten percent had documented perianal Human Papilloma Virus related disease. Radiology was inconsistently used for staging. Eighty percent were referred for an oncology opinion; 50% had chemo‐radiotherapy with a curative intent. The over‐all Stoma rate was 35% and of these 18% had an abdomino perineal resection. The overall five‐year survival was 45%.Conclusions  This is a unique regional audit of anal cancer. Improvements need to be made in documentation particularly of staging, treatment, pathology reporting and outcome. This study concurs that Human Papilloma Virus appears to predispose to Squamous anal cancer. Radiological staging needs to be standardized according to best clinical practice. As recommended by NICE all patients should be referred to a multidisciplinary anal cancer team, which can provide individual treatment plans. Increased specialization could mean specialist regional MDTs for anal cancer.
Prediction of response to sibutramine therapy in obese non‐diabetic and diabetic patients
Authors: Finer N. , Ryan D. H. , Renz C. L. , Hewkin A. C. 
Published: February 2006

Background:  Early weight loss is generally considered to predict long‐term weight outcome in obese patients, and this is reflected in prescribing guidelines for antiobesity drugs. For example, the current prescribing guidelines for the antiobesity drug, sibutramine, indicate that if patients have not lost 2 kg (or 4 lb) in the first 4 weeks of treatment with sibutramine 10 mg, the physician should re‐evaluate the therapy, which may result in increasing the dose to 15 mg or discontinuation. This regimen may deny treatment to a large group of patients who might otherwise benefit, particularly patients with type 2 diabetes who often find it more difficult to lose weight than non‐diabetic obese individuals.Materials:  We have re‐analysed pooled data from seven randomized, controlled studies of sibutramine‐induced weight loss and maintenance in which patients (n = 928; 75% female) had taken sibutramine 10 or 15 mg continuously for 12 months, in order to determine the predictors of success in weight loss (defined as loss of at least 5% of initial body weight at Month 12) in both diabetic and non‐diabetic patients. Sensitivity and specificity analyses were used to calculate optimal predictive values.Results:  In both diabetic and non‐diabetic patients, weight loss of 4 kg at 3 months was identified as the optimal predictor for achieving at least 5% weight loss at 12 months. This target was associated with the best average values for sensitivity, specificity and accuracy, as well as high positive (78% vs. 84% for non‐diabetics and 76% vs. 85% for diabetics, compared to existing guidelines target of 2 kg after 1 month treatment) and negative predictive values (63% vs. 71% for non‐diabetics; 52% vs. 70% for diabetics).Conclusion:  Sibutramine, in conjunction with diet and exercise, should be continued for at least 3 months (providing there are no adverse effects) to determine whether or not patients are likely to achieve a clinically valid outcome at 1 year. This highlights the need to ensure that regulatory restrictions reflect the needs of clinical practice.
Tissue‐specific regulation of malonyl‐CoA decarboxylase activity in OLETF rats
Authors: Kim H. J. , Zhao Z. S. , Lee Y. J. , Shim W. S. , Kim S. K. , Ahn C. W. , Park C. W. , Lee H. C. , Cha B. S. 
Published: February 2006

Aim:  The intracellular concentration of malonyl‐CoA, a key regulator of fatty acid oxidation, is determined both from its synthesis by acetyl‐CoA carboxylase and from its degradation by malonyl‐CoA decarboxylase (MCD). The aim of our study was to investigate the activity and mRNA expression of MCD under insulin resistance and after treatment with insulin sensitizers in different tissues.Methods:  We treated 18‐week Otusuka Long‐Evans Tokushima Fatty (OLETF) rats with pioglitazone (10 mg/kg/day) or metformin (300 mg/kg/day) for 8 weeks and determined the activity and mRNA expression of MCD in diabetic OLETF and non‐diabetic Long‐Evans Tokushima Otsuka (LETO) rats in myocardial and skeletal muscles, and in liver.Results:  The MCD activities of myocardial and skeletal muscles were remarkably reduced in OLETF rats compared with LETO rats (995 ± 114 vs. 2012 ± 359, 58 ± 11 vs. 167 ± 40 pmol/min/mg protein; p = 0.005 and p = 0.010). Surprisingly, after pioglitazone treatment, not after metformin, the MCD activities of myocardial and skeletal muscles (1906 ± 320 and 259 ± 44 pmol/min/mg protein) increased up to the levels in LETO rats. MCD mRNA expression in OLETF rats was also reduced in myocardial and skeletal muscles vs. LETO rats (p = 0.049 and p = 0.008) and was unchanged by pioglitazone or metformin treatment. In the liver, MCD activity and mRNA expression were similar in OLETF and LETO rats.Conclusion:  Pioglitazone treatment restored MCD activity to non‐diabetic level and improved the restrained fatty acid metabolism in myocardial and skeletal muscles caused by insulin‐resistant diabetic status.
Subnormal energy expenditure: a putative causal factor in the weight gain induced by treatment of hyperthyroidism
Authors: Jacobsen R. , Lundsgaard C. , Lorenzen J. , Toubro S. , Perrild H. , Krog‐Mikkelsen I. , Astrup A. 
Published: February 2006

Aims:  To examine the causes of weight gain occurring as an adverse effect of treatment of hyperthyroidism.Methods:  We measured 24‐h energy expenditure (EE), body composition and spontaneous physical activity (SPA) in eight patients before and 1 year after treatment of hyperthyroidism was initiated, and eight controls.Results:  One year after initiation of treatment thyrotropin was normalized, thyroid hormones had fallen to the lower end of the reference range and fat mass had increased by 3.5 kg (p < 0.001). Twenty‐four hour EE adjusted for fat‐free mass (FFM) was 15% higher in hyperthyroid patients before treatment than in controls (p = 0.003), and treatment decreased 24‐h EE by 1.9 MJ/day (p = 0.001). After treatment, 24‐h EE, adjusted for FFM, was similar to the controls. Multiple regression analyses showed that the suppressed EE could partly be attributed to an iatrogenic suppression of thyroid hormones, resulting in lower sleeping EE. Twenty‐four hour SPA was normal in the hyperthyroid state, but decreased after treatment by 21% (p = 0.045), to a level not significantly different, but still below that of the controls.Conclusions:  The study suggests that weight gain during treatment of hyperthyroidism might be due to subnormal levels of EE and SPA caused by a suppression of the thyroid hormone to a level in the lower end of the normal range.
The analyst's body as tuning fork: embodied resonance in countertransference
Authors: Stone Martin 
Published: February 2006

Abstract:  This paper examines the phenomenon of embodied countertransference: where the analyst experiences a somatic reaction rather than the more common countertransference responses of thoughts, feelings, images, fantasies and dreams. Discussion of clinical material considers neurotic and syntonic aspects. The analogy is made of resonance with a tuning fork. Several questions are posed: Why does countertransference resonate in the bodies of some analysts but not all? Why do those analysts who are sensitive to this, experience it with some patients but not with others? And what are the conditions which are conducive to producing somatic responses?It proposes that somatic reactions are more likely to occur when a number of conditions come together: when working with patients exhibiting borderline, psychotic or severe narcissistic elements; where there has been early severe childhood trauma; and where there is fear of expressing strong emotions directly. In addition another theoretical factor is proposed, namely the typology of the analyst.
The developmental/emergent model of archetype, its implications and its application to shamanism
Authors: Merchant John 
Published: February 2006

Abstract:  This paper addresses the ongoing debate in the JAP to do with archetype theory and supports an emergent/developmental model which sees archetypal imagery as an emergent phenomenon arising out of neural bio‐structures laid down in early infant life as a result of developmental experience.This model is supported by the current findings of those developmental biologists who adhere to Developmental Systems Theory. The themes of Developmental Systems Theory are examined and corroborative parallels are drawn with the model. A number of implications follows: the model has substantial explanatory power and leads to a new perspective on innatism; it implies an archetype‐environment nexus; it collapses the nature‐nurture debate in relation to archetype theory; it collapses the ‘sacred heritage’ approach to archetypes and it removes the conceptual division between the collective and personal unconscious.This developmental/emergent perspective is then applied to the shaman archetype, using ethnographic records of the Sakha (Yakut) Siberian tribe. The material supports the hypothesis that the shamanic complex is laid down in early infancy by a combination of events which cause emotional ruptures in the mother‐infant dyad. Siberian shamanism is then understood to arise out of developmental experience and not from the constellation of an autochthonous archetype.
The Columbia Cooperative Aging Program: An Interdisciplinary and Interdepartmental Approach to Geriatric Education for Medical Interns
Authors: Maurer Mathew S. , Costley Alex W. , Miller Patricia A. , McCabe Sigrid , Dubin Shelly , Cheng Huai , Varela‐Burstein Ellyn , Lam Binh , Irvine Craig , Page Kerrianne P. , Ridge Gerald , Gurland, MD Barry 
Published: February 2006

Although there is a critical need to prepare physicians to care for the growing population of older adults, many academic medical centers lack the geriatric‐trained faculty and dedicated resources needed to support comprehensive residency training programs in geriatrics. Because of this challenge at Columbia University, the Columbia Cooperative Aging Program was developed to foster geriatric training for medical interns. For approximately 60 interns each year completing their month‐long geriatric rotations, an integral part of this training now involves conducting comprehensive assessments with “well” older people, supervised by an interdisciplinary team of preceptors from various disciplines, including cardiology, internal medicine, occupational therapy, geriatric nursing, psychiatry, education, public health, social work, and medical anthropology.Interns explore individual behaviors and social supports that promote health in older people; older people's strengths, vulnerabilities, and risk for functional decline; and strategies for maintaining quality of life and independence. In addition, a structured “narrative medicine” writing assignment is used to promote the interns' reflections on the assessment process, the data gathered, and their clinical reasoning throughout. Preliminary measures of the program's effect have shown significant improvements in attitudes toward, and knowledge of, older adults as patients, as well as in interns' self‐assessed clinical skills. For academic medical centers, where certified geriatric providers are scarce, this approach may be an effective model for fostering residency geriatric education among interns.
Abdominal Obesity Is an Independent Risk Factor for Chronic Heart Failure in Older People
Authors: Nicklas Barbara J. , Cesari Matteo , Penninx Brenda W.J.H. , Kritchevsky Stephen B. , Ding Jingzhong , Newman Anne , Kitzman Dalane W. , Kanaya Alka M. , Pahor Marco , Harris Tamara B. 
Published: February 2006

OBJECTIVES: To examine whether total and abdominal adiposity are risk factors for the development of chronic heart failure (CHF) in older men and women.DESIGN: Prospective, longitudinal cohort: The Health, Aging and Body Composition study.SETTING: Memphis, Tennessee, and Pittsburgh, Pennsylvania, metropolitan areas.PARTICIPANTS: Three thousand seventy‐five well‐functioning community‐dwelling older adults aged 70 to 79.MEASUREMENTS: Body composition using dual energy X‐ray absorptiometry, visceral adipose tissue area using computed tomography, adjudicated CHF.RESULTS: Of the remaining (640 participants excluded from original group of 3,075) 2,435 participants (1,081 men, 1,354 women) without coronary heart disease or CHF at baseline, there were 166 confirmed diagnoses of CHF during the median±standard deviation (SD) follow‐up of 6.1±1.4 years. After adjustment for age, race, sex, site, education, smoking, and chronic obstructive pulmonary disorder, all adiposity variables (body mass index (BMI), adipose tissue mass, percentage body fat, waist‐to‐thigh ratio, waist circumference, and visceral and subcutaneous abdominal adipose tissue) were significant predictors of the development of CHF. In a model that included waist circumference and BMI, waist circumference was associated with incident CHF (hazard ratio (HR)=1.27, 95% confidence interval (CI)=1.04–1.54 per SD increase, P=.02), but BMI was not (HR=1.08, 95% CI=0.86–1.35). When waist circumference and percentage fat were included together, both variables were significant predictors of CHF (waist: HR=1.17, 95% CI=1.00–1.36 per SD increase, P=.05; percentage fat: HR=1.47, 95% CI=1.16–1.87 per SD increase, P=.002). Stepwise adjustment for inflammation, hypertension, insulin resistance, and diabetes mellitus did not decrease the relative risk of a greater waist circumference for the development of CHF (all HR=1.27–1.32, 95% CI=1.02–1.61 per SD increase).CONCLUSION: Abdominal body fat distribution may be a stronger risk factor for CHF than overall obesity.
Executive Dysfunction in Homebound Older People with Diabetes Mellitus
Authors: Qiao Qiu Wei , Lyn Price Lori , Hibberd Patricia , Buell Jennifer , Collins Lauren , Leins Drew , Mkaya Mwamburi David , Rosenberg Irwin , Smaldone Lauren , Scott Tammy M. , Siegel Richard D. , Summergrad Paul , Sun Xiaoyan , Wagner Carey , Wang Lixia , Yee Jacqueline , Tucker Katherine L. , Folstein Marshal 
Published: February 2006

OBJECTIVES: To describe patterns of cognitive deficits and activities of daily living (ADLs) in older people with diabetes mellitus.DESIGN: Cross‐sectional, population‐based study.SETTING: Three homecare agency areas in Boston, Massachusetts.PARTICIPANTS: Two hundred ninety‐one homebound people aged 60 and older; 40% with diabetes mellitus.MEASUREMENTS: Demographic data; evidence of diabetes mellitus and other diseases; Mini‐Mental State Examination and tests of memory and executive function; ADLs.RESULTS: Executive and visuospatial functions were more impaired in individuals with diabetes mellitus than in those without, as assessed using Block Design (mean score±standard deviation 17.1±8.6 vs 20.5±9.6, P=.003) and Trails B (median seconds to accomplish the task: 255 vs 201, P=.03). For memory, word retention score was lower in those with diabetes mellitus than without (39.1±28.9 vs 48.0±29.7, P=.01), but the other memory tests did not show a difference between these two subgroups. More individuals with diabetes mellitus suffered from depressive symptoms than those without (55% vs 42%, P=.03). The ADL scores of those with diabetes mellitus were higher than those without.CONCLUSION: The pattern of cognitive deficits in people with diabetes mellitus suggests frontal‐subcortical dysfunction, as seen in microvascular disease of the brain. The impairment in ADLs may be associated with this executive dysfunction, which cerebral microvascular disease in diabetes mellitus may cause.