bluuebunny/crossref_metadata_2025_split huggingface dataset:
Microbial cultures in open globe injuries in southern India
Authors: Gupta Arvind , Srinivasan Renuka , Kaliaperumal Subashini , Setia Sajita 
Published: May 2007

AbstractPurpose:  To determine the risk factors leading to positive intraocular culture in patients with open globe injury.Methods:  A prospective interventional study involving 110 eyes of 110 patients of more than 15 years of age, presenting with open globe injury, was undertaken. Emergency repair of the injured globe was done. Prolapsed intraocular tissue or aqueous humour was sent for microbial work up before repair. In endophthalmitis cases intravitreal antibiotics were given according to the antimicrobial sensitivity. Chi‐square and logistic regression analysis were used to determine the risk factors.Results:  Fifty‐six patients showed microbial contamination. Bacteria were cultured in 42 patients and fungi in 14 patients. Nineteen patients developed endophthalmitis, of which 18 patients showed microbial growth initially. In univariate analysis, initial visual acuity (<6/360, P = 0.002), presence of uveal tissue prolapse (P < 0.001), vitreous prolapse (P < 0.001) and length of laceration (>8 mm, P < 0.001) were significantly associated with positive microbial culture, however, in the multivariate stepwise logistic regression delay in surgical intervention (>72 h, P < 0.001), uveal tissue prolapse (P = 0.004) and corneosclearal laceration (>8 mm, P = 0.013) were associated with increased risk of positive microbial culture. Six patients had intraocular foreign body but were culture negative. Age, gender, site of injury and presence of cataract did not significantly affect the culture positivity.Conclusions:  Microbial contamination is a risk factor for the development for endophthalmitis. Despite the high frequency of microbial contamination, it develops only in few cases. Systemic antibiotics, virulence of the organism and host factors play a role in the manifestation of endophthalmitis. Prophylaxis with intraocular antibiotics should be strongly considered in cases with poor vision at presentation, larger corneoscleral laceration, delayed surgical intervention and uveal tissue or vitreous prolapse.
Prevalence of plateau iris syndrome in young patients with recurrent angle closure
Authors: Stieger Roland , Kniestedt Christoph , Sutter Florian , Bachmann Lucas M , Stuermer Joerg 
Published: May 2007

AbstractBackground:  To assess and describe the prevalence and clinical features associated with plateau iris syndrome (PIS) in young individuals with recurrent angle closure despite initial therapy.Methods:  Chart review of 137 relatively young individuals (aged < 60 years) with symptoms of angle closure between 1995 and 2005. A follow‐up period of 36 months after initial presentation was retrospectively analysed. Seventy‐six patients with recurrent angle closure symptoms were clinically reviewed using gonioscopy and ultrasound biomicroscopy.Results:  Based on chart analysis, 30 of 137 individuals were diagnosed with PIS (22%). After clinical review, 34 additional patients suffered from PIS as the underlying cause for persistent angle closure symptoms. The prevalence of PIS in our patient population with recurrent angle closure symptoms in spite of initial iridotomy or iridectomy was 54%.Conclusion:  Among angle closure in young individuals, PIS is not uncommon. The causative mechanism of PIS in young individuals is peripheral iris block, rather than pupillary block which is more often prevalent in older patients. For proper diagnosis and therapy, ultrasound biomicroscopy and gonioscopy should be performed on every young individual with angle closure symptoms.
Clinical outcomes of keratitis
Authors: Green Matthew D , Apel Andrew JG , Naduvilath Thomas , Stapleton Fiona J 
Published: May 2007

AbstractObjection:  To analyse the patient, clinical and microbiological variables associated with poor outcomes from keratitis in patients presenting to a major public hospital in Australia.Methods:  A retrospective audit of the records of all patients who had a corneal scraping in 5 years at Princess Alexandra Hospital (Brisbane, Australia) was carried out. The outcome of a patient's episode of keratitis was classified as poor if they had final visual acuity of 6/60 or worse; had vision loss during treatment; or a complication of keratitis; or needed surgical intervention.Results:  A final outcome was established in 207 cases during the 5‐year period. Final vision of 6/12 or better was found in 48% (100) of cases while a poor outcome was seen in 28% (58). Linear regression showed poor outcomes were directly associated with age (P < 0.001) and disease severity (P < 0.001). Univariate analysis indicated that poor outcomes were more likely in patients who had had prior ocular surgery (P = 0.005) or ocular surface disease (P = 0.01) and were also associated with presenting visual acuity of worse than 6/60 (P < 0.001) and isolation of Streptococcus pneumoniae (P = 0.002). While patients with traumatic keratitis, contact lens‐related keratitis or negative corneal cultures (P = 0.009) were more likely to have good outcomes. Multivariate analysis showed that the relative risk of a patient having a poor outcome was 4.3× (CI 2.0–9.5) if they had severe keratitis, 4.1× (CI 1.8–9.5) if they had keratitis related to ocular surface disease and 3.8× (CI 1.8–8.3) if they were over 50 years old.Conclusions:  An outcome of poor vision, vision loss during treatment, surgical intervention or complication of keratitis is more likely in patients with severe keratitis, keratitis related to prior ocular surface disease or older age.
Microbial keratitis following corneal transplantation
Authors: Das Sujata , Constantinou Marios , Ong Terrence , Taylor Hugh R 
Published: May 2007

AbstractPurpose:  To determine the predisposing risk factors and analyse the clinical and microbiological profiles of microbial keratitis following corneal transplantation.Methods:  A retrospective analysis was done of hospital records of all patients who presented with microbial keratitis in the corneal graft between July 2000 and June 2005 at the Corneal Unit of Royal Victorian Eye and Ear Hospital, Melbourne, Australia.Results:  Eighty‐one episodes of infection were identified in 62 patients over a 5‐year period. Thirteen patients had multiple episodes of infection. The mean age of the patients was 70 ± 16 years (range: 22–92 years). The median time interval between the graft and infection was 17 months (range: 6 days to 385 months). Twenty‐two (35%) episodes of primary infection were related to sutures. The associated predisposing risk factors were failed graft (40%), dry eye (18%), Herpes simplex keratitis (8%), and ocular surface disease (8%). Forty‐seven (76%) cases were culture positive for bacteria. Ten cases were positive for Herpes simplex virus (HSV) during presentation.Conclusion:  Failed graft is a long‐term risk factor for graft infection in addition to ocular surface disease and H. simplex keratitis. All the predisposing risk factors increase the risk of recurrent graft infection.
A rapidly advancing mediastinal mass – overcoming tracheobronchial obstruction
Authors: FROST IAN , ROSS‐RUSSELL ROB , BASS SAM , BURKE AMOS 
Published: May 2007

SummaryWe report the case of a 7‐year‐old boy who presented with rapidly advancing airway obstruction secondary to mediastinal T‐cell nonHodgkins lymphoma. His brisk deterioration required transfer to the pediatric intensive care unit and intubation of the trachea. Unforeseen unilateral bronchial involvement led to gas trapping and critical pulmonary hyperinflation. Endobronchial advancement of the tracheal tube beyond the bronchial obstruction relieved pulmonary hyperinflation but subsequent one lung ventilation was poorly tolerated. We report the manufacture of a proximal ‘Murphy’s eye’ which allowed ventilation of the contralateral lung to proceed. To the best of our knowledge this is the first time that this technique has been described in a pediatric patient.
Anesthesia management in a child with PHACE syndrome and agenesis of bilateral internal carotid arteries
Authors: JAVAULT AURÉLIA , METTON OLIVIER , RAISKY OLIVIER , BOMPARD DOMINIQUE , HACHEMI MOHAMED , GAMONDES DELPHINE , NINET JEAN , NEIDECKER JEAN , LEHOT JEAN‐JACQUES , CANNESSON MAXIME 
Published: May 2007

SummaryThis is the first case report of successful anesthesia management in a high‐risk neurological procedure in a patient with PHACE syndrome. PHACE syndrome is rare but an important clinical entity. Anesthesiologists should be aware of the neurological, otolaryngogical, and vascular risk associated with this syndrome.
Assessing parents preferences for the avoidance of undesirable anesthesia side effects in their children undergoing surgical procedures
Authors: WAGNER DEBORAH S. , YAP JOSE MARTIN , BRADLEY KATHRYN M. , VOEPEL‐LEWIS TERRI 
Published: May 2007

SummaryBackground:  Willingness to pay (WTP) surveys have proven to be useful tools in determining patient preferences though relatively few pediatric studies have utilized them. Studies in the adult surgical population have used such methods to assess patients’ perspectives regarding the avoidance of anesthesia side effects or outcomes. The purpose of this survey was to assess parental preferences, using a relative WTP model, for the avoidance of anesthesia side effects in their children undergoing surgery.Methods:  The survey was distributed to 150 parents of children who were undergoing surgery. Parents were asked to rank order (1 = most unwanted to 7 = least troublesome) six stated potential anesthesia side effects and to allocate a fixed dollar percentage of a $100 toward prevention of each. A total of 142 surveys were returned (95% response rate).Results:  Parents ranked vomiting as the least desirable side effect for their child (rank order = 1.9) and pain as second (rank order = 2.14). However, parents allocated $33.48 to prevent pain compared with $28.89 for vomiting as a relative dollar amount.Conclusions:  This study suggests that targeting management toward the prevention of these adverse outcomes may improve parental satisfaction with anesthesia care of their children.
Sequential clot strength analyses following diclofenac in pediatric adenotonsillectomy
Authors: HEANEY MAIREAD , LOONEY YVONNE , MCKINSTRY CALEB , O’HARE BRENDAN 
Published: May 2007

SummaryBackground:  Tonsillectomy is a common pediatric surgical procedure resulting in significant postoperative pain. There is ongoing controversy as to the most satisfactory analgesic regimen. Nonsteroidal antiinflammatory drugs (NSAIDs) are an alternative to opioids in this setting. NSAID use in tonsillectomy has been shown to be opioid sparing in the recovery period and to have similar analgesic effects to opioids in pediatric patients. Because of their nonspecific action on the enzyme cyclo‐oxygenase there is potential for increased bleeding which has led many practitioners to avoid NSAIDs completely in this patient population potentially resulting in suboptimal pain control.Our aim in this study was to assess the effect of preoperatively administered diclofenac on the blood clot strength in children undergoing (adeno‐) tonsillectomy.Methods:  Twenty patients undergoing (adeno‐) tonsillectomy were recruited into this prospective observational study. All patients received 2 mg·kg−1 of diclofenac rectally immediately preoperatively. Blood was taken for thromboelastograph analysis pre‐diclofenac and 1 and 4 h post‐diclofenac administration.Results:  There was a statistically significant increase in maximal clot strength (MA) at 1 and 4 h after diclofenac. Similarly there was a statistically significant reduction in time to initial fibrin formation (R time) post‐diclofenac. There was no primary or secondary hemorrhage.Conclusions:  Diclofenac when given preoperatively does not adversely affect clot strength in the immediate postoperative period when the risk of primary hemorrhage is greatest.
Anesthesia for Fucosidosis
Authors: ABDALLAH CLAUDE , HANNALLAH RAAFAT , MCGILL WILLIS 
Published: May 2007

SummaryFucosidosis is an extremely rare, autosomal recessive lysosomal storage disease, characterized by a deficiency of the lysosomal hydrolase alpha fucosidase. We report a case of a 6‐year‐old child, diagnosed with fucosidosis type 2, who presented for dental rehabilitation under general anesthesia. Anesthesia was uneventful. Features of fucosidosis are discussed
Altered ‘active’ antireflux mechanism in primary vesico‐ureteric reflux: a morphological and manometric study
Authors: Arena Salvatore , Fazzari Carmine , Arena Francesco , Scuderi Maria G. , Romeo Carmelo , Nicòtina Piero A. , Di Benedetto Vincenzo 
Published: May 2007

OBJECTIVETo immunolocate c‐kit‐positive interstitial cells of Cajal (ICCs, known to be responsible for pacemaker activity in human ureters, coordinating ureteric motility) in the intramural ureter of patients with different grades of vesico‐ureteric reflux (VUR), to assess the ureteric histology and correlate these findings with manometric patterns.PATIENTS AND METHODSThe VU junction (VUJ) represents the boundary between the low‐pressure of the upper and high pressure of the lower urinary tract, protecting the upper tract from VUR using active and passive antireflux mechanisms. The contraction of the longitudinal muscle coat of the VUJ possibly functions as an ‘active’ antireflux system, but previous manometric findings on refluxing ureteric units (RUs) have shown altered patterns. In all, 32 RU ends were stained using both picro‐Mallory and Sirius Red techniques; in a parallel immunohistochemical procedure, using mast cell tryptase and CD117 antibodies (to identify ICCs), they were compared with eight control ureteric ends. Ureteric manometry of the VUJ was also done during ureteric reimplantation.RESULTSThe histochemical and immunohistochemical results in the RUs showed a replacement of the altered smooth muscle fascicles by collagenous stroma and significant loss of ICCs in RU ends, both correlated with the grade of VUR. Ureteric manometry showed significant impairment of basal and maximum pressure in RUs, correlated, respectively, with histological lesions and loss of ICCs.CONCLUSIONDeficiency of the longitudinal muscle coat probably leads to dysfunction and insufficiency of the ostial valve mechanism, with subsequent impairment of the active valve mechanism. Histological, histochemical and immunohistochemical changes support the alterations of ureteric peristalsis in RUs.
Repeated botulinum‐A toxin injections in the treatment of myelodysplastic children and patients with spinal cord injuries with neurogenic bladder dysfunction
Authors: Akbar Michael , Abel Rainer , Seyler Thorsten M. , Gerner Hans J. , Möhring Klaus 
Published: May 2007

Authors from Germany describe the use of botulinum toxin in the treatment of myelodysplastic children and found it to be safe and effective. They found that repeat treatments are as effective as the first one, with no evidence of tachyphylaxis, antibody formation or detrusor fibrosis.OBJECTIVESTo examine the effects of repeated detrusor injections of botulinum‐A toxin (BTX) for possible changes in bladder function, muscular structure of the detrusor, increase in BTX tolerance (tachyphylaxis) and side‐effects, as BTX is a new treatment alternative for patients with a neurogenic bladder condition that is difficult to treat and refractory to anticholinergic medication.PATIENTS AND METHODSBetween 2000 and 2005, 19 patients with myelodysplasia (MDP) and 25 spinal cord‐injured (SCI) patients were treated with repeated suburothelial BTX injections (Dysport®, Ipsen‐Pharma, Ettlingen, Germany) or injections into the intramural detrusor. The follow‐up was ≥ 3 years (range 3–5, median 4.5).RESULTSDetrusor compliance, bladder capacity, and detrusor pressure at maximum filling improved significantly (P < 0.001) compared to baseline after each BTX injection. There was prolonged efficacy of each BTX administration and all repeated injections in the paediatric and adult patients with neurogenic bladder dysfunction over a median follow‐up of 4.5 years. There was no evidence for drug tolerance or changes in the morphological appearance of the bladder. Safety was good: no complications were associated with the injection procedure itself. Early in the treatment programme, three patients who received a dose of 1000 units Dysport showed systemic side‐effects and generalized muscle weakness. These resolved without intervention and did not recur after reducing the adult dose to 750 units (paediatric dose 20 units/kg, not >400 units), which seems to be the optimum for good efficacy with an adequate safety margin.CONCLUSIONBTX injection is a safe and effective treatment for neurogenic detrusor hyperreflexia. Repeat treatments are as effective as the first: there was no indication of a lack of efficacy due to tachyphylaxis, antibody formation, or fibrosis of the detrusor muscle in this sample.
Low nuclear ErbB3 predicts biochemical recurrence in patients with prostate cancer
Authors: Koumakpayi Ismaël H. , Diallo Jean‐Simon , Le Page Cécile , Lessard Laurent , Filali‐Mouhim Abdelali , Bégin Louis R. , Mes‐Masson Anne‐Marie , Saad Fred 
Published: May 2007

OBJECTIVETo further evaluate the association between the cytoplasmic or nuclear localization of ErbB3 with biochemical recurrence (BCR) in patients with prostate cancer and positive surgical margins, as there is a greater risk of BCR for such patients after radical prostatectomy (RP).PATIENTS AND METHODSWe recently noted that ErbB3, which is normally associated with the plasma membrane, can translocate to the nucleus, an event which appears to be associated with disease progression. We evaluated ErbB3 expression and localization using immunohistochemistry on tissue samples from 55 patients with positive surgical margins after RP; 30 of these 55 (55%) had BCR after 3 years of follow‐up. The relationship between ErbB3 nuclear localization and BCR (prostate‐specific antigen, PSA, >0.3 ng/mL) after RP was analysed by Kaplan‐Meier survival analysis and Cox regression models.RESULTSThe BCR‐free survival probability at 3 years was 0.65 and 0.35 for positive and negative nuclear ErbB3, respectively (Kaplan‐Meier, P = 0.029). Patients negative for nuclear ErbB3 had a 2.47‐fold increase in BCR frequency in a univariate Cox model (P = 0.008) and it remained an independent prognostic marker when combined with clinical prognostic variables in a multivariate model (P = 0.023).CONCLUSIONLow nuclear localization of ErbB3 is a predictor of BCR in patients with prostate cancer and positive surgical margins after RP.
Elective management of transitional cell carcinoma of the distal ureter: can kidney‐sparing surgery be advised?
Authors: Giannarini Gianluca , Schumacher Martin C. , Thalmann George N. , Bitton Alain , Fleischmann Achim , Studer Urs E. 
Published: May 2007

OBJECTIVETo determine the long‐term oncological outcome of patients with primary transitional cell carcinoma (TCC) of the distal ureter electively treated with either kidney‐sparing surgery (KSS) or radical nephroureterectomy (RNU) in a retrospective, non‐randomized, single‐centre study.PATIENTS AND METHODSOf 43 consecutive patients with a primary solitary distal ureter TCC, 19 had KSS, consisting of distal ureter resection with bladder cuff excision and ureter reimplantation, and 24 had RNU with bladder cuff excision.RESULTSThe median (range) age at surgery was 69 (31–86) years for the KSS group and 73 (59–87) years for the RNU group, patients in the latter having worse hydronephrotic kidneys. The median (range) follow‐up was 58 (3–260) months. A recurrent bladder tumour was diagnosed after a median of 15 months in five of the 19 patients treated by KSS and after a median of 5.5 months in eight of the 24 treated by RNU. Five of the 19 patients treated by KSS and six of the 24 treated by RNU died from metastatic disease despite chemotherapy. Recurrence‐free, cancer‐specific and overall survival were comparable in the two groups. In two patients (11%) treated by KSS an ipsilateral upper urinary tract TCC recurred after 42 and 105 months, respectively.CONCLUSIONTreatment by distal ureteric resection is feasible in patients with primary TCC of the distal ureter. The long‐term oncological outcome seems to be comparable with that of patients treated by RNU. Furthermore, kidney preservation is advantageous if adjuvant or salvage chemotherapy is required.
Body size and host range co‐determine the altitudinal distribution of Neotropical tephritid flies
Authors: Kubota Umberto , Loyola Rafael D. , Almeida Adriana M. , Carvalho Débora A. , Lewinsohn Thomas M. 
Published: May 2007

ABSTRACTAim We addressed the following questions: (1) Does tephritid body size tend to increase in species found at higher elevations, as predicted by Bergmann's rule? (2) Do tephritids conform to Rapoport's rule, so that species found at higher elevations tend to have broader altitudinal ranges? (3) More generally, how do body size and host range jointly affect the patterns of altitudinal distribution among Neotropical tephritid flies?Location The Mantiqueira mountain range, south‐eastern Brazil, at sites ranging fromc. 700 to 2500 m a.s.l.Methods At each site we collected flower heads of all Asteraceae species to rear out endophagous immatures (from January to June in 1998 and 1999). We used structural equation models (SEM) to evaluate jointly the relationships between body size, host range and altitudinal distribution (range and mid‐point).Results Neotropical tephritid body size showed a negative relationship with altitudinal distribution. SE modelling showed no significant direct effect of body size on altitudinal range; however, it had significant indirect negative effects through host range and altitudinal mid‐point. The SE model was a good predictor of observed correlations and accounted for 84% of the variation in tephritid altitudinal range.Main conclusions The altitudinal range of flower‐head‐feeding tephritids is related to host range and is indirectly affected by body size via host range and altitudinal mid‐point. As predicted by Rapoport's rule, tephritids that occur at higher elevations also present wider altitudinal ranges. Bergmann's rule does not apply to Neotropical tephritids along a tropical elevational gradient, but rather its converse was found. Body size may determine host range by imposing a restriction upon large individuals using small flower heads. Host species turnover along the altitudinal gradient may be the main factor explaining the strong relationship between host range and insect elevational distribution.