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Abstract
The Bausch & Lomb Zyoptix system provides a customized approach to corneal sculpting resulting in improvements in best-corrected visual acuity and contrast sensitivity over that achieved in conventional laser in situ keratomileusis surgery.
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Bower SPC, Vogrin SJ, Morris K, Cox I, Murphy M, Kilpatrick CJ, Cook MJ. Amygdala volumetry in "imaging-negative" temporal lobe epilepsy. J Neurol Neurosurg Psychiatry 2003; 74:1245-9. [PMID: 12933928 PMCID: PMC1738652 DOI: 10.1136/jnnp.74.9.1245] [Citation(s) in RCA: 56] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVE Although amygdala abnormalities are sometimes suspected in "imaging-negative" patients with video EEG confirmed unilateral focal epilepsy suggestive of temporal lobe epilepsy (TLE), amygdala asymmetry is difficult to assess visually. This study examined a group of "imaging-negative" TLE patients, estimating amygdala volumes, to determine whether cryptic amygdala lesions might be detected. METHODS Review of video EEG monitoring data yielded 11 patients with EEG lateralised TLE and normal structural imaging. Amygdala volumes were estimated in this group, in 77 patients with pathologically verified hippocampal sclerosis (HS), and in 77 controls. RESULTS Seven of 11 "imaging-negative" cases had both significant amygdala asymmetry and amygdala enlargement, concordant with seizure lateralisation. Although significant amygdala asymmetry occurred in 35 of 77 HS patients, it was never attributable to an abnormally large ipsilateral amygdala. Compared with patients with HS, patients with amygdala enlargement were less likely to have suffered secondarily generalised seizures (p<0.05), and had an older age of seizure onset (p<0.01). CONCLUSION Abnormal amygdala enlargement is reported in seven cases of "imaging-negative" TLE. Such abnormalities are not observed in patients with HS. It is postulated that amygdala enlargement may be attributable to a developmental abnormality or low grade tumour. It is suggested that amygdala volumetry is indicated in the investigation and diagnosis of "imaging-negative" TLE.
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Shipman C, Pearce A, Addington-Hall J, Cox I, Richards S. Cancer services. Left to chance. THE HEALTH SERVICE JOURNAL 2001; 111:24-5. [PMID: 11432360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Abstract
Most primary care groups/trusts have cancer lead posts and have some involvement in planning and commissioning cancer services. Cancer is not a high priority in comparison to other national service frameworks and the transition to PCT status. PCG/Ts want help and information about developing cancer services but not all want this now. Most PCG/Ts have some involvement in cancer networks but information needs exist about their role and potential.
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Shipman C, Addington-Hall J, Barclay S, Briggs J, Cox I, Daniels L, Millar D. Educational opportunities in palliative care: what do general practitioners want? Palliat Med 2001; 15:191-6. [PMID: 11407190 DOI: 10.1191/026921601678576176] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
It is important to support general practitioners (GPs) in maintaining and developing their palliative care skills as most of the final year of a patient's life is spent at home under the care of the primary health care team. The training needs and uptake of GPs have been explored, but little is known about how GP educational preferences vary. The aim of this study was to explore the current educational preferences of GPs in different geographical locations as part of an evaluation of an educational intervention. The methods used included postal questionnaires sent to 1061 GPs. Results from 640 (60%) of GPs revealed that half (51%) wanted education in symptom control for non-cancer patients. More inner-city GPs wanted education in opiate prescribing (43%), controlling nausea and vomiting (45%), and using a syringe driver (38%) than their urban and rural colleagues (26%, 29% and 21%, respectively). Increased educational preference and increased difficulty in accessing information was associated with reduced confidence in symptom control. To maximize educational uptake it will be important for educational strategies to be developed and targeted according to variations in demand, and in particular to respond to the need for palliative care education in symptom control for patients suffering from advanced non-malignant disease.
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Williams D, Yoon GY, Porter J, Guirao A, Hofer H, Cox I. Visual Benefit of Correcting Higher Order Aberrations of the Eye. J Refract Surg 2000; 16:S554-9. [PMID: 11019871 DOI: 10.3928/1081-597x-20000901-12] [Citation(s) in RCA: 117] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
There is currently considerable debate concerning the visual impact of correcting the higher order aberrations of the eye. We describe new measurements of a large population of human eyes and compute the visual benefit of correcting higher order aberrations. We also describe the increase in contrast sensitivity when higher order aberrations are corrected with an adaptive optics system. All these results suggest that many, though not all, observers with normal vision would receive worthwhile improvements in spatial vision from customized vision correction, at least over a range of viewing distances and particularly when the pupils are large. Keratoconic patients or patients suffering from spherical aberration as a result of laser refractive surgery as it is presently performed would especially benefit. These results encourage the development of methods to correct higher order aberrations.
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Cox I. Insurance medicine. JOURNAL OF THE ROYAL COLLEGE OF PHYSICIANS OF LONDON 2000; 34:394-6. [PMID: 11005081 PMCID: PMC9665491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
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Shipman C, Addington-Hall J, Barclay S, Briggs J, Cox I, Daniels L, Millar D. Providing palliative care in primary care: how satisfied are GPs and district nurses with current out-of-hours arrangements? Br J Gen Pract 2000; 50:477-8. [PMID: 10962787 PMCID: PMC1313727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023] Open
Abstract
The complex needs of palliative care patients require an informed, expert, and swift response from out-of-hours general medical services, particularly if hospital admission is to be avoided. Few general practitioners (GPs) reported routinely handing over information on their palliative care patients, particularly to GP co-operatives. District nurses and inner-city GPs were least satisfied with aspects of out-of-hours care. Most responders wanted 24-hour availability of specialist palliative care. This indicates a need to develop and evaluate out-of-hours palliative care procedures and protocols, particularly for GP co-operatives, and to improve inter-agency collaboration.
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Cox I, Haworth P. Cardiac disease in guinea pigs. Vet Rec 2000; 146:620. [PMID: 10870771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
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Cox I, Stevens S. Care of ophthalmic surgical instruments. COMMUNITY EYE HEALTH 2000; 13:40-1. [PMID: 17491960 PMCID: PMC1705974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
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Atherton DJ, Cox I, Hann I. Intravenous iron (III) hydroxide-sucrose complex for anaemia in epidermolysis bullosa. Br J Dermatol 1999; 140:773. [PMID: 10233353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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Musso P, Cox I, Vidano E, Zambon D, Panteghini M. Cardiac troponin elevations in chronic renal failure: prevalence and clinical significance. Clin Biochem 1999; 32:125-30. [PMID: 10211629 DOI: 10.1016/s0009-9120(98)00089-7] [Citation(s) in RCA: 65] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES The aim of the study was investigate the prevalence of abnormal values of cardiac troponin T (cTnT) and cardiac troponin I (cTnI) in patients with chronic renal failure (CRF) and their clinical significance. DESIGN AND METHODS We investigated the concentrations of cTnT and cTnI in 49 CRF patients without heart disease or diabetes. Cardiac TnT values were measured with a second generation immunoassay and cTnI with two immunoassays with different analytical sensitivity. All CRF patients underwent regular clinical follow-up over a 18-month period. RESULTS No patients with CRF had elevated values of cTnI when measured with one assay and only 2 patients displayed minimally elevated values with the second assay. In contrast, 23 CRF patients (47%) displayed cTnT concentrations elevated above the upper reference limit. The elevated cTnT values observed were below the values detected in acute myocardial infarction and were not associated with adverse cardiac events during follow-up. CONCLUSIONS Mildly elevated cTnT concentrations are common in patients with CRF and do not appear to be associated with adverse coronary events.
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Orr D, Cox I. Kenya eye safari. West J Med 1998. [DOI: 10.1136/bmj.316.7125.156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Rigby K, Cox I, Black G. Cooperativeness and bully/victim problems among Australian schoolchildren. THE JOURNAL OF SOCIAL PSYCHOLOGY 1997; 137:357-68. [PMID: 9200972 DOI: 10.1080/00224549709595446] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The relationship was examined between the self-reported cooperativeness of Australian secondary-school students and their involvement in peer abuse at school, both as bullies and as victims. An 18-item Likert-type measure, the Cooperativeness Scale, was developed, and its reliability and concurrent validity were supported by the results of its application to two samples of Australian students (N = 176 and N = 763, respectively) attending different coeducational secondary schools, the first in a predominantly middle-class area and the second in a lower class socioeconomic area. At both schools, girls scored higher in cooperativeness than boys. Students at the second school also anonymously completed multiple measures of the extent of their involvement during the current year in bullying, victimization, or both. As predicted, correlations and multiple regression analyses supported the hypothesis that relatively low levels of cooperativeness were characteristic, not only of both boys and girls who engaged in bullying, but also, to a lesser extent, of those who were frequently victimized by their peers at school.
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Rigby K, Cox I. The contribution of bullying at school and low self-esteem to acts of delinquency among Australian teenagers. PERSONALITY AND INDIVIDUAL DIFFERENCES 1996. [DOI: 10.1016/0191-8869(96)00105-5] [Citation(s) in RCA: 54] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Kaski JC, Chen L, Crook R, Cox I, Tousoulis D, Chester MR. Coronary stenosis progression differs in patients with stable angina pectoris with and without a previous history of unstable angina. Eur Heart J 1996; 17:1488-94. [PMID: 8909904 DOI: 10.1093/oxfordjournals.eurheartj.a014711] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
OBJECTIVES To compare the evolution of stenoses responsible for acute coronary events with those not associated with acute coronary syndromes. METHODS AND RESULTS We prospectively studied angiographic stenosis progression in 190 stable angina patients, with single vessel disease, who were awaiting non-urgent coronary angioplasty. Sixty four patients had a previous history of unstable angina (Group 1) and 126 patients had no history of unstable angina (Group 2). Culprit stenoses were classified as "complex' or "smooth'. At restudy, 8 +/- 4 months after the first angiogram, 12 of 63 culprit stenoses in Group 1 had progressed and seven of 125 in Group 2 (19% vs 6%, P = 0.0044). Thirteen of 68 complex culprit stenoses had progressed, compared with only 6 of 120 smooth culprit stenoses (19% vs 5%, P = 0.003). Coronary events occurred in 12 Group 1 patients and nine Group 2 patients (P = 0.02). CONCLUSIONS In patients with stable angina, stenoses associated with previous episodes of unstable angina are more likely to progress than stenoses not associated with previous unstable angina. Unstable coronary atherosclerotic plaques, even those that have been clinically stable for more than 3 months, may retain the potential for rapid progression to total occlusion.
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Heenan S, Ignotus P, Cox I, Ward D, Joseph AE. Case report: percutaneous biopsy of a right atrial angiosarcoma under ultrasound guidance. Clin Radiol 1996; 51:591-2. [PMID: 8761400 DOI: 10.1016/s0009-9260(96)80143-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
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Tirman PF, Feller JF, Palmer WE, Carroll KW, Steinbach LS, Cox I. The Buford complex--a variation of normal shoulder anatomy: MR arthrographic imaging features. AJR Am J Roentgenol 1996; 166:869-73. [PMID: 8610565 DOI: 10.2214/ajr.166.4.8610565] [Citation(s) in RCA: 74] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
OBJECTIVE The purpose of this study was to show the MR arthrographic imaging features of a normal anatomic variation of the shoulder: the absence of the anterior superior labrum and the presence of a "cordlike" middle glenohumeral ligament,which together are known as the Buford complex. MATERIALS AND METHODS We retrospectively analyzed the MR arthrographic examinations of 10 patients with arthroscopically proven Buford complexes. RESULTS MR arthrographic examinations showed an absent anterior superior labrum and an associated cordlike middle glenohumeral ligament in all patients. No contiguous tear of the superior labrum or anterior inferior labrum was evident. Originally, this variation was mistakenly diagnosed as a labral avulsion in two of the 10 patients. Also, a differential diagnosis of a superior labral tear was mistakenly offered for four patients. CONCLUSION An absent anterior superior labrum and an associated cordlike middle glenohumeral ligament represent the normal variation that is known as the Buford complex rather than an avulsed labrum. This normal variation may be mistaken for a detached labrum.
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Roberts TP, Kucharczyk J, Cox I, Moseley ME, Prayer L, Dillon W, Bleyl K, Harnish P. Sprodiamide-injection-enhanced magnetic resonance imaging of cerebral perfusion. Phase I clinical trial results. Invest Radiol 1994; 29 Suppl 2:S24-6. [PMID: 7928245 DOI: 10.1097/00004424-199406001-00009] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
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Cox I, Apollonio A, Erickson P. The effect of add power on simultaneous vision, monocentric, bifocal, soft lens visual performance. ACTA ACUST UNITED AC 1993. [DOI: 10.1016/0892-8967(93)90050-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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47
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Cox I, Fonn D. Interference filters to eliminate the surface reflex and improve contrast during fluorescein photography. ACTA ACUST UNITED AC 1991. [DOI: 10.1016/0892-8967(91)90004-j] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Cox I, Holden BA. Soft contact lens-induced longitudinal spherical aberration and its effect on contrast sensitivity. Optom Vis Sci 1990; 67:679-83. [PMID: 2234826 DOI: 10.1097/00006324-199009000-00004] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Some investigators have suggested that the poor quality of vision which some spherical, single vision, soft lens-wearing patients report may be a result of spherical aberration induced in the ocular system when a soft lens is placed on the eye. In this study, the longitudinal spherical aberration of spherical soft lenses, both on and off the eye, was calculated using an aspheric corneal model and two-dimensional ray tracing program. Specifically designed front-surface aspheric, soft lenses were produced which demonstrated levels of in-air power variation similar to that calculated for similar-parameter spherically surface lenses. The effect of these lenses on the visual performance of nine subjects was assessed by measuring changes in contrast sensitivity and high contrast visual acuity through 3- and 6-mm artificial pupils. Significant losses of contrast sensitivity were recorded for the spherically aberrated lenses with the 6-mm pupil but not with the 3-mm pupil. High contrast acuity was not affected by any of the aberrated lenses with either the 3- or 6-mm pupils. Theoretical calculations and the contrast sensitivity results indicate that negatively powered lenses produce significantly less spherical aberration in situ than positively powered lenses. Because the majority of the prepresbyopic soft lens-wearing population have low to moderate amounts of myopia, it would appear that soft lens-induced spherical aberration is unlikely to be responsible for the reduction in visual performance which some patients report when corrected with single vision soft lenses.
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Cox I, Holden BA. Can vision loss be used as a quantitative assessment of corneal edema? ACTA ACUST UNITED AC 1990. [DOI: 10.1016/0892-8967(90)90004-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Cox I, Zantos SG, Orsborn GN. The overnight corneal swelling response of non-wear, daily wear, and extended wear soft lens patients. ACTA ACUST UNITED AC 1990. [DOI: 10.1016/0892-8967(90)90031-a] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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