bluuebunny/crossref_metadata_2025_split huggingface dataset:
Low vision rehabilitation in patients with age‐related macular degeneration at a tertiary eye care centre in southern India
Authors: Khan Sarfaraz A , Das Taraprasad , Kumar Sharmila Mohan , Nutheti Rishita 
Published: March 2003

Abstract Purpose: To evaluate the specific needs and types of low vision devices (LVDs) in patients with age‐related macular degeneration (AMD) so as to use the residual vision effectively. Methods: One hundred consecutive patients with diagnosis of AMD were evaluated to ascertain the degree of visual disability. Different LVDs were used to suit the specific needs of individual patients. The distribution of LVDs for distance and near and other rehabilitation measures were stratified for vision ≥6/18 and <6/18. Statistical analysis was performed using χ2 test/Fisher's exact test and paired t‐test. Results: The percentage of patients with visual acuity <6/18 reduced from 72.2% (26/36) to 47.2% (17/36) with the use of standard spectacles (P = 0.03). Similarly, the percentage of patients with visual acuity <6/18 reduced from 85.7% (6/7) to 14.3% (1/7) with the use of a telescope (P = 0.029). The optical devices for near tasks included spectacle magnifiers (n = 59), stand magnifiers (n = 19), and hand magnifiers (n = 18). With these LVDs, the near vision improved from 0.13 (decimal notations) to 0.39 (P < 0.001). Eighty‐six patients were given at least one of the LVDs and 20% were prescribed more than one near device (bifocals, spectacle magnifiers, hand magnifiers, stand magnifiers). Additionally, patients also needed counselling (n = 89) and training on eccentric viewing (n = 39), coin identification (n = 45), and independent mobility (n = 41). Conclusion: The overall management of a patient with AMD must include counselling, prescription of appropriate LVDs and training to utilize the residual vision to its fullest advantage. This is expected to improve the patient's quality of life.
Analysis of the Arg345Trp disease‐associated allele of the EFEMP1 gene in individuals with early onset drusen or familial age‐related macular degeneration
Authors: Guymer Robyn H , McNeil Robyn , Cain Melinda , Tomlin Belinda , Allen Penelope J , Dip Chi Luu , Baird Paul N 
Published: March 2003

Abstract Background: A single base change within the EFEMP1 gene has been associated with malattia leventinese and Doyne honeycomb retinal dystrophy, two dominantly inherited macular diseases with early onset drusen. The aim of this study was to determine whether the same disease allele was also associated with other forms of early onset drusen or familial cases of age‐related macular degeneration. Methods: Thirteen index cases of early onset drusen together with 15 other family members were examined. In addition, 54 familial cases of age‐related macular degeneration were examined. Blood was taken for DNA analysis and screened for the Arg345Trp disease‐associated allele of the EFEMP1 gene. Twenty‐four cases of malattia leventinese or Doyne honeycomb retinal dystrophy were also screened as positive controls. Another 150 ethnicity‐ and age‐matched individuals acted as controls. Results: The Arg345Trp disease‐associated allele in the EFEMP1 gene was confirmed in individuals with malattia leventinese and Doyne honeycomb retinal dystrophy. However, involvement of this allele was not evident in either early onset drusen or familial age‐related macular degeneration. Conclusions: The Arg345Trp disease‐associated allele of the EFEMP1 gene does not appear to be associated with cases of early onset drusen that fall outside the diagnosis of malattia leventinese or Doyne honeycomb retinal dys­trophy, nor does it appear to play a role in familial age‐related macular degeneration. These findings do not exclude the involvement of other alleles of the EFEMP1 gene in either phenotype. The genetic mechanisms involved in the hetero­geneous group of early onset drusen remain to be elucidated but should lead to insights into the genetic causes of macular diseases.
Penetration of oral and topical ciprofloxacin into the aqueous humour
Authors: Ghazi‐Nouri Seyed M , Lochhead Jonathan , Mearza Ali A , Qureshi Muhammad A , Thompson Graham M , Cowdrey Geoff , Firth Maria , Moss Raymond , Karim Abdul‐Kadir , Firth Gary 
Published: March 2003

Abstract Aims: To investigate the penetration of ciprofloxacin via different modes of administration into the aqueous humour using capillary zone electrophoresis and to determine its prophylactic role in ophthalmic surgery. Methods: A prospective study was conducted of 84 patients, divided into two groups, undergoing routine cataract surgery and intraocular lens implantation. Forty patients received 750 mg ciprofloxacin orally the evening before and on the morning of surgery 12 h apart. Forty‐four patients received one drop of 0.3% topical ciprofloxacin 90 and 30 min prior to surgery. At the commencement of surgery 0.1−0.2 mL of aqueous fluid was sampled from the anterior chamber and assayed for ciprofloxacin concentration using capillary‐zone electrophoresis. Results: The concentration of ciprofloxacin in the group receiving topical doses was less than 0.1 µg/mL, which is well below the minimum inhibitory concentration for cipro­floxacin inhibiting 90% (MIC90) of strains of Staphylococcus epidermidis (0.4 µg/mL). The mean concentration of ciprofloxacin in the aqueous humour of the oral group was 0.26 µg/mL with a standard deviation of 0.12 µg/mL (range 0.09−0.67 µg/mL) with only 12.5% achieving levels higher than MIC90 for S. epidermidis. Conclusion: The topical ciprofloxacin 0.3% as given in this study achieved poor aqueous humour concentration. Oral ciprofloxacin given in this regime should not on its own be considered adequate prophylaxis in intraocular surgery. Capillary zone electrophoresis can be used as an alternative tool to the existing high‐pressure liquid chromatography methods for analysing ciprofloxacin level in the aqueous humour.
Endoscopic 13C‐urea breath test
Authors: Urita Yoshihisa , Miki Kazumasa 
Published: March 2003

Background: Several modifications of the 13C‐urea breath test (UBT) for the diagnosis of Helicobacter pylori infection have been published. A new modification of UBT is described with the aim of avoiding the influence of urease activities from the commensal organisms other than H. pylori upon 13CO2 excretion in the breath. Methods: The new modified UBT was performed in 295 consecutive patients undergoing esophagogastroscopy. After the collection of a baseline breath sample, an endoscopy was carried out. A baseline gastric gas sample was collected through a biopsy channel, and 20 mL of sterile water containing 100 mg of 13C‐urea was sprayed onto the gastric mucosa. The scope was drawn after spraying the 13C‐urea solution and collecting a gastric gas sample. Breath samples were collected 5, 10, 20 and 30 min after the spraying of 13C‐urea. Results: The mean ± SD value of gastric gas samples for excess δ13CO2 in H. pylori‐positive patients was 1036.7 ± 1309.0‰, and 6.0 ± 23.3‰ in H. pylori‐negative patients. The cut‐off point as determined by receiver operator characteristic (ROC) curves for the gastric gas samples was 10‰. The sensitivity and specificity for this new method were 95.4% and 92.5%, respectively. Conclusion: The method of endoscopically collecting 13CO2 gas in the stomach, which is not affected by the metabolism or by the absorption of 13C, provides an accurate and sensitive means for the detection of H. pylori.
Endoscopic Evaluation of Rectal Mucosal Reddening in Patients with Liver Cirrhosis
Authors: Motoyama Hirotaka , Ueki Junichi , Baba Yasuyuki , Asakura Hitoshi 
Published: March 2003

Background:
Colonic mucosal lesions observed in patients with portal hypertension have been reported as portal hypertensive colopathy. We studied the rectal mucosa in patients with liver cirrhosis to evaluate the prevalence of mucosal reddening which looks like gastric red spots in the portal hypertensive gastropathy and to determine whether there is a correlation between this lesion and portal hypertension or the severity of liver disease.Methods:
Seventy‐two patients with liver cirrhosis and 50 control subjects were examined. Colonoscopy was performed to evaluate the presence of mucosal reddening in the rectum. We investigated the relations between rectal mucosal reddening and esophageal varices, portal hypertensive gastropathy and the severity of liver cirrhosis.Results:
Rectal mucosal reddening was observed in eight of 72 patients with liver cirrhosis but in none of the 50 control subjects; its prevalence in cirrhosis patients was significantly higher than that in the control subjects (P < 0.05). Cirrhosis patients with esophageal varices were more likely to have rectal mucosal reddening than cirrhosis patients without esophageal varices (P < 0.05). In addition, the occurrence of rectal mucosal reddening correlated with the severity of cirrhosis, based on Child–Pugh's classification (P < 0.05).Conclusion:
We have shown that rectal mucosal reddening develops in patients with liver cirrhosis and is associated with the existence of esophageal varices and the severity of liver cirrhosis. These results suggest the possibility that portal hypertension and impaired liver function may play an important role in the pathogenesis of rectal mucosal reddening in patients with cirrhosis.
Three‐dimensional endoscopic ultrasonography for the assessment of early gastric carcinoma invasion: could it provide diagnostic innovations?
Authors: SABET EMAN A. , OKAI TAKASHI , MINAMOTO TOSHINARI , MAI MASAYOSHI , SAWABU NORIO 
Published: March 2003

Background: This study aimed to evaluate a three‐dimensional endoscopic ultrasonographic (3‐D EUS) system in the assessment of the tumor invasion depth of early gastric carcinoma.Methods: Sixty‐nine macroscopically early cancer lesions in 67 patients were recruited in an in vivo study. The surgically resected gastric specimens of 30 of them
were re‐examined in an ex vivo study. An Olympus 3‐D EUS imaging system was employed in both studies. Diagnostic accuracy for tumor invasion depth was evaluated and compared with histopathological sections stained by H&E and Masson’s trichrome stain. Reconstructed surface‐rendering images were evaluated and compared with the endoscopic and macroscopic findings.Results: Three‐dimensional EUS allowed rapid tomographic assessment of the lesions in both the in vivo and ex vivo studies. The accuracy of 3‐D EUS for the assessment
of tumor invasion depth was 87% in the in vivo study. The accuracy
rate was significantly lower (P = 0.03) for the cancer lesions associated
with ulcer fibrosis (74%) than for those with no fibrosis (97%).
In the 30 subjects who underwent both studies, the accuracy rates were higher in
the ex vivo than the in vivo study (94%vs 77%
for all the lesions, and 93%vs 74% for cancers associated
with fibrosis), but were not statistically significant. The rates of good surface‐rendering
images were 64% and 94% in the in vivo and ex vivo
studies, respectively. The differences were attributed to the clearer dual‐plane
reconstruction images obtained in the ex vivo study in absence of motion artifacts.Conclusions: Three‐dimensional EUS is a promising imaging technique for the assessment of tumor invasion depth of early gastric cancer.
Efficacy of short‐course lansoprazole with clarithromycin and amoxicillin in the eradication of Helicobacter pylori in South‐East Asian patients: 5‐day t.d.s. versus 7‐day b.d. treatment regimens
Authors: Goh KL , Cheah PL , Tan YM , Rosmawati M , Ong KT , Lo YL , Chin SC 
Published: March 2003

OBJECTIVE: To determine and compare the efficacy of 5‐day t.d.s and 7‐day b.d. treatment regimens comprising lansoprazole, clarithromycin and amoxicillin in the eradication of Helicobacter pylori. METHODS: Patients with unequivocal evidence of H. pylori infection based on histology and rapid urease tests of both antrum and corpus biopsies were recruited for the study. The study was a randomized, investigator‐blind, comparative study. Patients received either 500 mg clarithromycin t.d.s. and 500 mg amoxicillin t.d.s. for 5 days (LAC5) or 500 mg clarithromycin b.d. and 500 mg amoxicillin b.d. for 7 days (LAC7) together with 30 mg lansoprazole (both groups) daily for either 5 or 7 days, depending on the treatment group. Patients were assessed for the successful eradication of H. pylori, defined as the absence of bacteria based on histology and urease tests on both antral and corporeal biopsies, carried out at least 4 weeks after completion of the therapy. RESULTS: One hundred and eight patients were recruited for the study. In the LAC5 treatment group, four patients failed to return for follow up and in the LAC7 group, two failed to return for follow up and two were not compliant with medications. Eradication rates based on an intention‐to‐treat analysis were: 46/54 for LAC5 (85.2%; 95% CI = 72.9–93.4) and 47/54 for LAC7 (87.0%; 95% CI = 75.1–94.6). Based on a per protocol analysis, the rates were: 46/50 for LAC5 (92.0%; 95% CI = 80.8–97.8) and 47/50 for LAC7 (94.0%; 95% CI = 83.5–98.7). Both treatment regimens were convenient for patients and except for two patients in the LAC7 group, all patients reported taking 100% of all prescribed medications. The side‐effects encountered were uniformly mild and no patient discontinued treatment because of intolerance to medications. The most common side‐effects were altered taste (LAC5 64.7%; LAC7 78.8%). Diarrhea, nausea and anorexia were reported in a minority of patients. CONCLUSIONS: Both the LAC5 t.d.s. and the LAC7 b.d. treatment regimens were well tolerated by patients and were highly effective in the eradication of H. pylori.
Effect of albumin infusion on preventing the deterioration of renal function in patients with spontaneous bacterial peritonitis
Authors: XUE Hui Ping , LIN Bing , MO Jian Zhong , LI Ji Qiang 
Published: March 2003

OBJECTIVE: To determine whether plasma volume expansion with albumin could prevent impairment of renal function and reduce mortality in cirrhotic patients with either acute spontaneous bacterial peritonitis (SBP) or patients complicated with SBP. METHODS: A total of 112 patients was randomly allocated to two groups: 56 patients were allocated to be treated with ceftriaxone and 56 patients were allocated to treatment with ceftriaxone plus intra‐venous albumin in 3 weeks. Serum creatinine and blood urea nitrogen levels were monitored. RESULTS: Of the 56 patients (group 2) treated with ceftriaxone and albumin,
five patients had renal impairment. Of the 56 patients (group 1) treated with ceftriaxone
alone, 19 had renal impairment. The incidence of renal impairment was significantly
lower in patients treated with ceftriaxone and albumin (5/56; 10%) than in
patients treated with ceftriaxone alone (19/56; 34%; P = 0.002). In
addition, in‐hospital mortality in group 2 was 10% (5/56), but was 33%
(17/56) in group 1. Thus, in‐hospital mortality was significantly reduced from 33%
(17/56) in patients treated with ceftriaxone to 10% (5/56) in patients treated
with ceftriaxone and albumin (P = 0.01). CONCLUSIONS: The addition of intravenous albumin to an antibiotic regimen reduces the incidence of renal impairment and mortality in cirrhotic patients with SBP.
Arterial stiffness index: A new evaluation for arterial stiffness in elderly patients with essential hypertension
Authors: Kaibe Masaharu , Ohishi Mitsuru , Komai Norio , Ito Norihisa , Katsuya Tomohiro , Rakugi Hiromi , Ogihara Toshio 
Published: March 2003

Background:  Arterial stiffness is one of the predictors of cardiovascular event. Arterial stiffness is commonly measured by pulse wave velocity between the carotid and femoral arteries. Recently the arterial stiffness index which is measured by computerized oscillometry at the upper arm was developed. As this procedure is a convenient means of measuring pulse wave velocity, we considered it suitable to evaluate arterial stiffness in elderly patients. We evaluated this arterial stiffness index and compared it with other methods of evaluating arterial stiffness in hypertensive patients, including the elderly.Methods:  Forty‐two patients with essential hypertension, including 26 subjects over 60 years old were enrolled. We evaluated the arterial stiffness index by computerized oscillometry, and also evaluated arterial stiffness between the carotid‐femoral artery and the brachial‐tibial artery, the second derivative of photoplethysmogram, the forearm vasodilator response to reactive hyperemia by strain‐gauge plethysmography.Results:  Arterial stiffness index was positively correlated with pulse wave velocity between the carotid‐femoral artery (P < 0.0001; r = 0.579), the heart‐carotid artery (r = 0.454) and right brachial‐tibial artery (r = 0.549). It was also correlated with b/a (r = 0.474) and d/a (r = 0.568) by a second derivative of photoplethysmogram, but not correlated with a reactive vasodilator response. In elderly patients, arterial stiffness index was also correlated with carotid‐femoral pulse wave velocity (P < 0.05; r = 0.456) but not correlated with a vasodilator response to reactive hyperemia.Conclusion:  These data suggest that arterial stiffness index is correlated to common pulse wave velocity between the carotid and femoral arteries, so this index might be useful to evaluate arterial stiffness in hypertensive patients including the elderly.
Why barium enemas fail to identify colorectal cancers
Authors: McDonald Sharyn , Lyall Patrick , Israel Lincoln , Coates Richard , Frizelle Frank 
Published: March 2003

Background:  The aim of the present study was to determine the cause and clinicopathological factors associated with the failure of barium enemas to detect colorectal cancers.Methods:  A histopathological database was used to identify all patients with a diagnosis of colorectal cancer between 1991 and 1995. These records were matched with the records from patients who underwent barium enema examinations between 1990 and 1995. Those patients who had a colorectal cancer histologically diagnosed within 24 months of a barium enema in which no car­cinoma was seen, were identified. Where possible the radiology was reviewed. Failure to identify a carcinoma was then attributed to either simple failure, technical, interpretive or perceptive difficulties.Results:  There were 967 patients with colorectal cancers treated in Christchurch Hospital during the study period 1991–1995. Matching of these patient details with all barium enema records revealed 313 patients who had barium enemas and histologically proven colorectal cancer. There were 21 (6.7%) patients in whom a carcinoma was missed. Of these, 18 had a barium enema within 8 months of surgery, and three were performed outside this timespan (15, 18 and 28 months, respectively). On review, 11 carcinomas could not be identified (nine due to technical error: poor coating (n = 1), overlapping loops (n = 3), single‐contrast enema (n = 4), faecal residue (n = 1)); and seven could be seen on review of the films (two interpretation errors, one technical and perceptive error, and four perceptive errors). In three cases films could not be found for review. In 16 of the 21 missed lesions the patient had a double‐contrast barium enema (DCBE) while five patients had single‐contrast barium enema (SCBE). The site and stage of missed tumours is presented.Conclusions:  The most common reason for missed tumours was technical. The percentage of missed tumours in each region of the bowel correlates with the known incidence of tumours in each region and with a normal Dukes stage distribution, except in the caecum where the number of missed lesions was higher than expected.
Risks to feet in the top end: Outcomes of diabetic foot complications
Authors: O’Rourke Ian , Heard Sam , Treacy John , Gruen Russell , Whitbread Cherie 
Published: March 2003

Background: The foot complications of diabetes are severe, disabling, costly and common in the Northern Territory. An understanding of the pathogenesis, the disease spectrum and treatment efficacy, however, is poor. The patterns of disease are documented in the present study; factors associated with good and poor outcomes are identified; and improved management strategies are proposed. Methods: All patients presenting to the High Risk Foot Service at Royal Darwin Hospital between March 1997 and March 2000 were included in the present study, and details regarding the status of their feet, their demographics, their treatment and their outcomes were recorded prospectively. Logistic regression analysis was undertaken to determine associations between factors of interest and outcomes of healing and amputation. Results: One hundred and twenty‐six patients were recorded, 41% of whom had neuropathic ulcers and 63% of whom had severe disease at presentation. Two types of diabetic foot pathology were recognized that are not usually classified: acute injury without neuropathy (10%) and deep soft tissue infection alone (9%).Thirty‐seven percent and 23% of patients required minor and major amputations, respectively. The total number of hospital bed‐days was 5813. Total contact casting was associated with good healing rates in 16 patients. Major amputation was associated with ischaemia, severe disease at presentation and increasing age. Conclusions: Patterns of diabetic foot disease which are not commonly recognized are described in the present study; the severity and cost of the problem are documented; and some factors which lead to poor outcome, such as late presentation, are identified. Attention should be paid, through a multidisciplinary team, to timely referral from primary care, patient education, total contact casts and appropriate revascularization.
Retropharyngeal abscess in children
Authors: Dawes Laughlin C. , Bova Ronaldo , Carter Peter 
Published: March 2003

Background:  Retropharyngeal abscess (RPA) is an uncommon, potentially fatal condition found more frequently in children than adults. Prompt diagnosis and surgical management of this condition is imperative to prevent complications including airway obstruction and mediastinitis. Few studies have been dedicated to paediatric retropharyngeal abscess.Methods:  A retrospective analysis of 21 cases of retropharyngeal abscess at the Sydney Children's Hospital over a 12‐year period was performed.Results:  There were 12 boys and nine girls involved in the analysis. Their ages ranged from 3 months to 12 years. Common ­presenting symptoms and signs included fever, dysphagia, neck swelling and torticollis. Respiratory compromise was present in 29% of the children at presentation. Foreign body ingestion accounted for 10% of cases. Seventeen cases were managed with surgical drainage. Surgical approaches adopted included transoral (70%), external cervical approach (20%) and a combined approach in 10%. There was no mortality. Mediastinitis occurred in two patients, one of whom also had recurrent laryngeal nerve palsy. No other serious complications occurred.Conclusion:  Retropharyngeal abscess should be considered in all children presenting with neck pain and dysphagia. Prompt diagnosis and institution of appropriate medical and surgical therapy is imperative to prevent complications such as airway obstruction. The management of this condition should occur in a paediatric institution with appropriate medical, surgical and intensive care ­facilities.