bluuebunny/crossref_metadata_2025_split huggingface dataset:
An exploratory study of assertive community treatment for people with intellectual disability and psychiatric disorders: conceptual, clinical, and service issues
Authors: Martin G. , Costello H. , Leese M. , Slade M. , Bouras N. , Higgins S. , Holt G. 
Published: June 2005

AbstractBackground  Assertive community treatment (ACT) has been applied to a number of disorders in the adult population, such as schizophrenia, with some degree of success; its use in the treatment of people with intellectual disability (ID) and mental illness has received little attention. Despite the high costs of ID in health and social care, there has been very little evidence‐based practice for people with ID and mental illness, and it remains a neglected area of research.Aims  The aims of this study were an exploratory comparison of the effectiveness of an ACT model for the treatment of mental illness in people with ID (ACT‐ID) with a standard community treatment (SCT‐ID) approach.Method  A Randomized controlled trial design was adopted and allocation was made by stratified randomization by an independent statistician. The prognostic factors used in the randomization were gender and psychiatric diagnosis (psychosis vs. affective). Service users were randomly allocated to either ACT‐ID or SCT‐ID.Results  There were no statistically significant differences between ACT‐ID and SCT‐ID in terms of the level of unmet needs, carer burden, functioning and quality of life, but borderline evidence of a difference between treatment groups in quality of life in favour of SCT‐ID. Both SCT‐ID and ACT‐ID groups decreased level of unmet needs and carer burden, and increased functioning. SCT‐ID also led to a small increase in quality of life.
Antenatal therapeutic drug exposure and fetal/neonatal tumours: review of 89 cases
Authors: Satgé  , Sasco  , Little  
Published: June 2005

Summary.
Although case reports on the association between neonatal tumours and maternal therapeutic drug use during pregnancy are cited regularly, no systematic review has been published. In a systematic search of the literature on fetal and neonatal tumours, we identified 36 malignant and 54 benign tumours in 89 fetuses and neonates prenatally exposed to various drugs. Six associations with in utero exposure are noteworthy: (1) phenytoin and neuroblastoma, as already suspected; (2) antibiotics and leukaemias; (3) hormonal treatment and vascular tumours; (4) acetaminophen (paracetamol) and fusocellular sarcoma; (5) acetaminophen in combination with petroleum products and hepatoblastoma; and (6) dicyclomine hydrochloride and teratomas. In view of the high level of consumption of drugs by pregnant women and the rarity of neonatal tumours, a possible carcinogenic effect is difficult to establish. However, some associations already observed in older infants, children and adults after antenatal and postnatal exposure to the same drugs are of note. We suggest that these drugs may act as carcinogens or as co‐carcinogens in association with other physical and chemical agents and/or a particular genetic background. We therefore feel it is important to encourage the systematic collection, registration and publication of case reports on this subject. The hypotheses generated thereby could then be tested by formal epidemiological studies.
Smoking during pregnancy and babbling abilities of the 8‐month‐old infant
Authors: Obel  , Henriksen  , Hedegaard  , Secher  , Østergaard  
Published: June 2005

Summary.
Animal experiments suggest that the fetal brain is sensitive to nicotine. Although much attention has been given to the relation between cigarette smoking during pregnancy and neurodevelopment in children, this remains controversial. Our study describes the relationship between maternal cigarette smoking during pregnancy and babbling abilities of the 8‐month‐old infant. In a longitudinal cohort, information was collected at the 16th week of gestation, at delivery and when the infant was about 8 months old. At this age babbling abilities of the infant were evaluated by a health visitor during a home visit. Singleton infants without any disability born at Aarhus University Hospital, Denmark, 1991–92 and still living in the Community of Aarhus at the age of 8 months were eligible (n = 2302). Complete follow‐up was obtained for 1871 children (81.3%). A dose–response‐like relationship between number of cigarettes smoked per day during pregnancy and babbling abilities was found after controlling for potential confounders. Smoking 10 or more cigarettes per day during pregnancy almost doubled the risk (odds ratio [OR] = 2.0, 95% confidence interval [CI] 1.1–3.6) of the infant being a non‐babbler at the examination at 8 months. Among children who were breast fed for less than 4 months this risk was even higher (OR = 2.7, CI 1.3–5.8).
Dense membrane formation after combined phacoemulsification–trabeculectomy surgery
Authors: Chan Colin CK , Goldberg Ivan 
Published: June 2005

AbstractA case is reported of formation of a dense intraocular membrane following combined phacoemulsification–trabeculectomy surgery. The membrane might have originated from a loose piece of pigment epithelium or might have resulted from dense pigment deposition on a postoperative pupillary membrane. Postoperative membranes have been reported particularly after combined procedures. A combination of intensive topical dexamethasone, homatropine and a Nd:YAG laser was used to speed resolution of the membrane.
Unusual cause for non‐detection of retained metallic foreign body on ocular ultrasonography
Authors: Prakash Gunjan , Venkatesh Pradeep , Garg Satpal 
Published: June 2005

AbstractUltrasound biomicroscopy has become a valuable adjunct in the evaluationof occult ocular foreign bodies. An unusual cause for non‐detectionof a metallic retained intraocular foreign body is described. Inthis case, the usual ‘shadowing’ was not discernibleas the foreign body was lying just over the optic disc.
Choroidal neovascularization after accidental macular damage by laser
Authors: Nehemy MárcioB , Torqueti‐Costa Leonardo , Magalhães Érika P , Vasconcelos‐Santos Daniel Vítor , Vasconcelos AdoJório 
Published: June 2005

AbstractA 30‐year‐old male physics professor was examined 2 months afterbeing accidentally hit by a laser beam in his left eye. He complainedof abrupt vision loss and central scotoma after the laser accident,with stabilization of the vision thereafter. At presentation, hepresented best‐corrected visual acuity of 6/18 in the lefteye. Fundoscopy disclosed a slightly elevated foveal brownish lesion,surrounded by a subtle subretinal haemorrhage. Fluorescein angiographydemonstrated a hyperfluorescent foveal lesion with stainingand a slight leakage in the late phase, characterizing a fibrovascularchoroidal neovascularization (CNV). Optical coherence tomography showeda discrete increase in retinal thickness and a subretinalfibrotic CNV. Visual acuity remained stable during the follow up(4 months). CNV after laser injury is rare. The evolutionof this case suggests that CNV, after an accidental laser injury,in a healthy macula of a young patient might have a self‐limitedcourse and a relatively good prognosis.
Bilateral benign lymphoid hyperplasia of the conjunctiva in a paediatric patient
Authors: Kim Peter , Macken Peter L , Palfreeman Simon , Rawlinson William D , Martin Frank 
Published: June 2005

AbstractA 14‐year‐old boy presented with a 6‐month history of bilateral slowly enlarging conjunctival lesions. There was no associated ocular or systemic symptomatology. Examination revealed bilateral salmon‐coloured nodular lesions of the bulbar conjunctiva. The remainder of his ophthalmic and general examinations were normal. Extensive investigation excluded regional or systemic involvement. Excision biopsy of the lesions showed a predominantly mature B lymphocyte infiltrate with immunohistochemistry and flow cytometry consistent with reactive lymphoid hyperplasia. Polymerase chain reaction testing for Epstein–Barr virus was negative. At 2 years follow‐up, the patient remained healthy and there was no evidence of recurrence. Benign lymphoid hyperplasia of the conjunctiva with bilateral involvement is extremely rare in children. Only a few case reports have been documented in the literature.
Suprachoroidal haemorrhage following Nd:YAG laser posterior capsulotomy
Authors: Chan Wing C , McGimpsey Stuart J , Murphy Martin F , Best Richard M 
Published: June 2005

AbstractNd:YAG laser posterior capsulotomy is the commonest procedurefor posterior capsule thickening following cataract surgery. Complicationsfollowing this laser surgery are relatively few, and this is ordinarilya safe and effective procedure. Herein a case is described of suprachoroidalhaemorrhage following Nd:YAG laser posterior capsulotomy. To thebest of the authors' knowledge, this is the first report of this complication.Patients undergoing this procedure should be warned of this rarebut potentially devastating complication.
Effects of pars plana vitrectomy on retrobulbar haemodynamics in diabetic retinopathy
Authors: Sullu Yuksel , Hamidova Reyhan , Beden Umit , Yakupov Kamuran , Canbaz Sevgi , Danaci Murat 
Published: June 2005

AbstractBackground:  The purpose of the present study was to determine the effects of pars plana vitrectomy on retrobulbar haemodynamics in patients with proliferative diabetic retinopathy (PDR).Methods:  Colour Doppler imaging was used for measurement of blood flow velocities and resistive index of the ophthalmic artery (OA), posterior ciliary arteries (PCA) and central retinal artery (CRA) in 14 eyes of 14 patients with PDR before pars plana vitrectomy and at the 1 and 6 months after operation. The patients were also treated by laser photocoagulation before or during surgery. Twenty age‐ and sex‐matched healthy subjects were used as control group.Results:  Mean peak systolic velocity and the end diastolic velocity of the CRA in the patients with PDR were lower and the mean resistive index was higher than in those of the control group (P < 0.05). The mean end diastolic velocity of OA in the patients was lower and the mean resistive index was higher than in the control group (P < 0.05). The peak systolic velocity of the OA and the end diastolic velocity of the CRA were significantly increased (P = 0.043 and P = 0.018, respectively) and the mean resistive index of the CRA was significantly decreased after pars plana vitrectomy (P = 0.043). No significant changes were detected among preoperative and postoperative values of peak systolic velocity, end diastolic velocity, and resistive index of the PCA and the mean velocity of the central retinal vein (P > 0.05).Conclusions:  The blood flow velocities of OA and CRA are decreased but the resistive index is increased significantly in patients with PDR. Pars plana vitrectomy in patients with PDR may decrease resistive index and improve blood flow in the CRA.
A Simple Gait‐Stabilizing Device Reduces Outdoor Falls and Nonserious Injurious Falls in Fall‐Prone Older People During the Winter
Authors: McKiernan Fergus Eoin 
Published: June 2005

Objectives: To determine whether Yaktrax Walker (YW), a nonmedical gait‐stabilizing device, prevents outdoor falls and injurious falls in fall‐prone older people during the winter.Design: Prospective, randomized, interventional trial.Setting: Community‐based, northern United States, winter, outdoors.Participants: Ambulatory, community‐dwelling, fall‐prone people aged 65 and older.Intervention: Participants were randomized to wear YW or their usual winter footwear (UWF) outdoors during the winter of 2003/2004.Measurements: The number of indoor and outdoor slips, falls, and injurious falls was recorded daily in a fall diary. Winter footwear satisfaction survey was completed after study completion.Results:
One hundred nine subjects completed 10,724 diary days. Mean age was 74.2. There were 93 indoor slips, 13 indoor falls, 714 outdoor slips, and 62 outdoor falls. The tendency for both groups to slip/fall indoors was comparable. The relative risk (RR) of outdoor slip for YW was 0.50 (P<.04) for all diary days and 0.61 (P=.14) when only days walked on snow and ice was the exposure variable. The RR of outdoor fall for YW was 0.42 (P<.03) when only days walked on snow and ice was the exposure variable. RR of injurious falls per day walked on snow and ice for YW was 0.13 (P<.02). Twelve of 19 outdoor falls occurred when YW subjects were not wearing their assigned device. No serious injury or fracture occurred in either group. The number needed to treat for the YW to prevent one nonserious injurious fall in one winter was six.Conclusion: YW may reduce the risk of outdoor winter falls, and of nonserious injurious falls, in older community‐dwelling people with a history of previous falls.
Medication Safety in Older Adults: Home‐Based Practice Patterns
Authors: Metlay Joshua P. , Cohen Abigail , Polsky Dan , Kimmel Stephen E. , Koppel Ross , Hennessy Sean 
Published: June 2005

Objectives: To identify the current state of medication‐taking practices of community‐dwelling older adults on high‐risk medications.Design: Telephone survey of older adults filling prescriptions for warfarin, digoxin, or phenytoin from May 2, 2002, through June 30, 2003.Setting: The Pennsylvania Pharmacy Assistance Contract for the Elderly (PACE) Program, a state‐run program providing prescription drug coverage for poor older adults.Participants: PACE members.Measurements: Patients self‐reported sources of information on current medications as well as home‐based practices for organizing medication regimens.Results: Four thousand nine hundred fifty‐five PACE members were interviewed. Thirty‐two percent of the sample reported that they had not received any specific instructions about their medications, 35% reported that they received instructions from their primary care provider, and 46% indicated they received them from a pharmacist. Fifty‐four percent of participants indicated that they used a pillbox for organizing their medications. Older adults prescribed warfarin were more likely to report receiving instructions than those prescribed digoxin or phenytoin.Conclusion: A substantial proportion of older adults on high‐risk medications do not recall receiving instructions for the use of their medications and do not take advantage of existing systems for organizing medication regimens. Improved patient education and delivery of medication organization systems are immediate opportunities to potentially reduce the risk of medication errors in older people.
Heterocyclics and Selective Serotonin Reuptake Inhibitors in the Treatment and Prevention of Poststroke Depression
Authors: Bhogal Sanjit K. , Teasell Robert , Foley Norine , Speechley Mark 
Published: June 2005

Objectives: To review the best current evidence on heterocyclic and serotonin‐reuptake inhibitor (SSRI) treatments of poststroke depression (PSD).Design: A literature review using multiple databases was conducted to identify randomized, controlled trials of the treatment or prevention of PSD. Odds ratios were used to test for significant treatment response between the treatment arms for dichotomous outcomes. Continuous outcome measures were evaluated using weighted mean difference and 95% confidence intervals.Setting: Literature review.Participants: Patients with stroke enrolled in the study of PSD of each selected article.Measurements: Frequency of patients with and without depression; frequency of patients who responded to treatment.Results: Nine articles were reviewed. Six investigated use of antidepressant therapy on treatment of PSD, and three examined the prevention of PSD. There was evidence to suggest that patients responded to treatment with antidepressants and significantly improved on depression scales, but treatment, especially with heterocyclic antidepressants, led to a significant number of dropouts due to side effects. There were insufficient data to pool the results of the prevention‐based studies.Conclusion: Treatment with heterocyclic antidepressants and SSRIs appears to be a viable option for PSD, but their absolute or relative efficacy has yet to be fully established. The effectiveness of early initiation of antidepressants in the prevention of PSD is not clear.
Caregiver‐Specific Outcomes in Antidementia Clinical Drug Trials: A Systematic Review and Meta‐Analysis
Authors: Lingler Jennifer Hagerty , Martire Lynn M. , Schulz Richard 
Published: June 2005

Objectives: To describe the range of caregiver‐specific outcomes and approaches to their study within antidementia drug trials and to quantify the effect of cholinesterase inhibitors on burden and active time use of caregivers of persons with Alzheimer's disease (AD).Design: Systematic review of English‐language publications and unpublished reports of antidementia clinical drug trials that included caregiver‐specific outcomes. Study characteristics and methodological quality were summarized. Random effects meta‐analyses were conducted for the outcomes of caregiver burden and active time use.Setting: Community.Participants: Informal caregivers of participants in clinical trials of antidementia drugs.Measurements: Burden, time use, psychological well‐being, healthcare costs, and ease of use of or satisfaction with intervention.Results: Seventeen studies involving 4,744 subjects were identified. Four trials (n=1,594) met criteria for inclusion in the burden analysis, and six trials (n=2,286) met criteria for inclusion in the time‐use analysis. Most investigations involved drugs now approved by the Food and Drug Administration for the treatment of AD; donepezil was the most frequently studied intervention in the set of studies. Methodological quality varied across trials. The weighted average effect sizes were Cohen's d=0.18 (95% confidence interval (CI)=0.04–0.32) and d=0.15 (95% CI=0.07–0.24) for the outcomes of caregiver burden and time use, respectively.Conclusion: Cholinesterase inhibitors have a small beneficial effect on burden and active time use among caregivers of persons with AD. Recommendations to enhance the quality and interpretability of AD clinical trials that involve caregiver‐specific outcomes are presented.
Foot Musculoskeletal Disorders, Pain, and Foot‐Related Functional Limitation in Older Persons
Authors: Badlissi Fadi , Dunn Julie E. , Link Carol L. , Keysor Julie J. , McKinlay John B. , Felson David T. 
Published: June 2005

Objectives: To examine whether common musculoskeletal disorders of feet are associated with pain and foot‐related functional limitation.Design: A cross‐sectional study using stratified random sampling.Setting: A residential community.Participants: Ethnically diverse sample of elderly persons (n=784).Measurements: Foot disorders (hallux valgus/bunion, pes planus (flat foot), pes cavus (high arch), hammertoe, mallet toe, claw toe, overlapping toes, bunionette, and plantar fasciitis), foot pain, the foot health functional status (FHFS, range 0–100, 100=no problems) scale, and walk time score (range 0–4, 4=fastest).Results: Most commonly assessed musculoskeletal disorders, including hallux valgus and toe deformities, were not associated with pain or function limitation. Plantar fasciitis and, to a lesser extent, pes cavus were associated with worse FHFS scores; foot pain partially explained this association. Neither foot disorders nor foot pain were significantly associated with slower walk times.Conclusion: Many foot disorders had little relationship with foot pain or function and may not require clinical attention when asymptomatic. Risk factors and preventive and therapeutic interventions for plantar fasciitis require further longitudinal investigation.
A Comparative Study of the Use of Four Fall Risk Assessment Tools on Acute Medical Wards
Authors: Vassallo Michael , Stockdale Rachel , Sharma Jagdish C. , Briggs Roger , Allen Stephen 
Published: June 2005

Objectives: To compare the effectiveness of four falls risk assessment tools (STRATIFY, Downton, Tullamore, and Tinetti) by using them simultaneously in the same environment.Design: Prospective, open, observational study.Setting: Two acute medical wards admitting predominantly older patients.Participants: One hundred thirty‐five patients, 86 female, mean age±standard deviation 83.8±8.01 (range 56–100).Measurements: A single clinician prospectively completed the four falls risk assessment tools. The extent of completion and time to complete each tool was recorded. Patients were followed until discharge, noting the occurrence of falls. The sensitivity, specificity, negative predictive accuracy, positive predictive accuracy, and total predictive accuracy were calculated.Results: The number of patients that the STRATIFY correctly identified (n=90) was significantly higher than the Downton (n=46; P<.001), Tullamore (n=66; P=.005), or Tinetti (n=52; P<.001) tools, but the STRATIFY had the poorest sensitivity (68.2%). The STRATIFY was also the only tool that could be fully completed in all patients (n=135), compared with the Downton (n=130; P=.06), Tullamore (n=130; P=.06), and Tinetti (n=17; P<.001). The time required to complete the STRATIFY tool (average 3.85 minutes) was significantly less than for the Downton (6.34 minutes; P<.001), Tinetti (7.4 minutes; P<.001), and Tullamore (6.25 minutes; P<.001). The Kaplan‐Meier test showed that the STRATIFY (log rank P=.001) and Tullamore tools (log rank P<.001) were effective at predicting falls over the first week of admission. The Downton (log rank P=.46) and Tinetti tools (log rank P=.41) did not demonstrate this characteristic.Conclusion: Significant differences were identified in the performance and complexity between the four risk assessment tools studied. The STRATIFY tool was the shortest and easiest to complete and had the highest predictive value but the lowest sensitivity.
Genetic Influences Underlying Self‐Rated Health in Older Female Twins
Authors: Leinonen Raija , Kaprio Jaakko , Jylhä Marja , Tolvanen Asko , Koskenvuo Markku , Heikkinen Eino , Rantanen Taina 
Published: June 2005

Objectives:To examine the genetic and environmental sources of variation in self‐rated health (SRH) in older female twins and to explore the roles of morbidity, functional limitation, and psychological well‐being as mediators of genetic and environmental effects on SRH.Design:Cross‐sectional analysis of twin data.Setting:Research laboratory.Participants:One hundred two monozygotic and 115 dizygotic female twin pairs aged 63 to 76.Measurements:SRH was categorized as good, average, or poor. Morbidity was described using a physician‐assessed disease‐severity scale together with information about the presence of diabetes mellitus and cancer. Maximal walking speed measured over 10 m was used to assess physical functional limitation; the Mini‐Mental State Examination and the Center for Epidemiologic Studies Depression Scale were used to characterize psychological well‐being. The contributions of genetic and environmental (defined as familial (shared by siblings) or nonshared (unique to each sibling)) effects were assessed using univariate and multivariate structural equation modeling of twin data.Results:SRH did not have its own specific genetic effect but shared a genetic component in common with the genetic components underlying liability to disease severity, maximal walking speed, and depressive symptoms. It accounted for 64% of the variation in SRH, with environmental effects accounting for the remaining variation.Conclusion:The current results suggest that there are no specific genetic effects on SRH but rather that genetic influences on SRH are mediated through genetic influences affecting chronic diseases, functional limitation, and mood.