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Peters IR, Helps CR, Lait PL, Harris C, Lee AC, Jones CA, Hall EJ, Day MJ. Detection of allelic variants of the canine IGHA gene by fluorescence resonance energy transfer melting temperature examination. J Immunol Methods 2005; 304:60-7. [PMID: 16140319 DOI: 10.1016/j.jim.2005.06.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2005] [Revised: 05/24/2005] [Accepted: 06/08/2005] [Indexed: 11/21/2022]
Abstract
The fluorescence resonance energy transfer (FRET) dual hybridisation probe system has been used for the detection of the accumulation of target DNA during real-time PCR and for the identification of nucleotide polymorphisms through examination of melt curves. This system involves the use of two oligonucleotide probes which are located close to each other and are complementary to an internal segment of a target DNA of interest. Four allelic variants of the gene encoding the hinge region of the immunoglobulin A (IgA) heavy chain (IGHA) have been so far identified in the dog and this variability is due to a combination of single nucleotide polymorphisms and insertion/deletion of nucleic acid motifs. An individual dog may be homozygous or heterozygous for these allelic variants. The purpose of this study was to develop a FRET-based dual probe melting temperature assay to identify the alleles present within an individual dog and to use this assay to determine the frequency of the four allelic variants in different breeds within the canine population. A single pair of oligonucleotide probes were designed that were able to discriminate between the four allelic variants in both homozygous and heterozygous individuals. The genotype of 96 DNA samples obtained from various purebreeds of dogs was determined using this FRET assay. The frequency of each allele differed between the breed groups. The results of this study indicate that it is possible to distinguish relatively complex gene polymorphisms using a single set of oligonucleotide probes. Furthermore, any future comparison of IGHA genotypes between normal and diseased dog populations must take into account the breed variation in allelic frequency.
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Harris JP, Atkinson EA, Lee AC, Nithi K, Fowler MS. Hemispace differences in the visual perception of size in left hemiParkinson's disease. Neuropsychologia 2003; 41:795-807. [PMID: 12631530 DOI: 10.1016/s0028-3932(02)00285-3] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The visual perception of size in different regions of external space was studied in Parkinson's disease (PD). A group of patients with worse left-sided symptoms (LPD) was compared with a group with worse right-sided symptoms (RPD) and with a group of age-matched controls on judgements of the relative height or width of two rectangles presented in different regions of external space. The relevant dimension of one rectangle (the 'standard') was held constant, while that of the other (the 'variable') was varied in a method of constant stimuli. The point of subjective equality (PSE) of rectangle width or height was obtained by probit analysis as the mean of the resulting psychometric function. When the standard was in left space, the PSE of the LPD group occurred when the variable was smaller, and when the standard was in right space, when the variable was larger. Similarly, when the standard rectangle was presented in upper space, and the variable in lower space, the PSE occurred when the variable was smaller, an effect which was similar in both left and right spaces. In all these experiments, the PSEs for both the controls and the RPD group did not differ significantly, and were close to a physical match, and the slopes of the psychometric functions were steeper in the controls than the patients, though not significantly so. The data suggest that objects appear smaller in the left and upper visual spaces in LPD, probably because of right hemisphere impairment.
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Lee AC, Robbins TW, Owen AM. Episodic memory meets working memory in the frontal lobe: functional neuroimaging studies of encoding and retrieval. CRITICAL REVIEWS IN NEUROBIOLOGY 2003; 14:165-97. [PMID: 12645957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
Recent functional-neuroimaging studies have provided a wealth of new information suggesting that regions of the prefrontal cortex play a role in episodic memory encoding and retrieval. This review seeks to evaluate the results of these studies in the context of one general model that has proposed that the left prefrontal cortex is preferentially involved in episodic memory encoding, whereas the right prefrontal cortex is preferentially involved in episodic memory retrieval, irrespective of the type (e.g., modality) of information being remembered. The origins of this framework are considered in some detail and then all relevant functional-neuroimaging studies are critically reviewed. The results of this review fail to provide support for the functional-asymmetry model, suggesting instead that episodic memory encoding and retrieval may actually involve similar regions of the lateral prefrontal cortex when all factors relating to the type of stimulus material (i.e., modality), are appropriately controlled.
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Courtney CA, Lee AC, Wilson C, O'Dwyer PJ. Ventral hernia repair: a study of current practice. Hernia 2003; 7:44-6. [PMID: 12612798 DOI: 10.1007/s10029-002-0102-0] [Citation(s) in RCA: 59] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2002] [Accepted: 11/04/2002] [Indexed: 10/25/2022]
Abstract
Ventral wall hernias are common; despite this, there are no guidelines on the best surgical management. The aim of this study was to examine the types of repair in use for abdominal wall hernias in the West of Scotland over a 3-month period. Data were gathered on 120 patients. There were 60 incisional, 32 umbilical, and 28 epigastric hernias. The main indication for repair was pain (78%), while 12 patients (10%), presented acutely with incarceration or strangulation. The most common method of repair was sutured (55%), followed by mesh (29%) and Mayo repair (16%). There was no correlation between use of mesh and hernia size or whether repair was for a recurrent hernia. Surgical practice varies widely in the repair of ventral wall hernias. Clinical trials are required to establish the best method of repair for this common condition.
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Lee AC, Harris JP, Atkinson EA, Nithi K, Fowler MS. Dopamine and the representation of the upper visual field: evidence from vertical bisection errors in unilateral Parkinson's disease. Neuropsychologia 2002; 40:2023-9. [PMID: 12207999 DOI: 10.1016/s0028-3932(02)00055-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
It has been suggested that dopamine is an important neurotransmitter in the brain mechanisms which represent the upper visual field. This idea was tested with a vertical line bisection task in unilateral Parkinson's disease. Stimuli of a range of lengths were presented on a large screen in three positions (left, centre and right) and at two viewing distances (0.6 and 1.5m). The patients, who were compared with a group of normal age-matched controls, comprised 16 sufferers from predominantly unilateral disease, 8 with more severe left-sided symptoms (LPD) and 8 with more severe right-sided symptoms (RPD). The LPD group consistently set the bisecting cursor below the midpoint of the stimulus lines, and their bisection error became larger as the length of the line increased. In contrast, the controls set the cursor above the midpoint of the line, an error which also increased with line length. The settings of the RPD group were similar to those of the controls. The results suggest altitudinal neglect in left unilateral PD, and support the hypothesis of dopaminergic involvement in the coding of upper visual space, with the proviso that the perceptual component of this involves the right hemisphere in humans.
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Lee AC. The demand for children as a factor in fertility trends. POPULATION FORUM : MONTHLY NEWSLETTER OF THE COMMISSION ON POPULATION 2002:19-21. [PMID: 12342114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
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Lett JT, Cox AB, Keng PC, Lee AC, Su CM, Bergtold DS. Late degeneration in rabbit tissues after irradiation by heavy ions. LIFE SCIENCES AND SPACE RESEARCH 2002; 18:131-42. [PMID: 11968209 DOI: 10.1016/b978-0-08-024436-5.50018-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Abstract
In 1974, using the rabbit as a model, we began long-term experiments designed to help in the evaluation of the hazards to man from extended exposure to heavy ions in space. Such exposure would occur, for example, during the construction of solar power stations in stationary orbits or on round trips to Mars. Our experiments with 400 MeV/nucleon Ne ions and 570 MeV/nucleon Ar ions have shown that true late effects of a degenerative nature are manifested only years after irradiation. At the appropriate doses (the high end of the experimental dose range), the magnitudes of the late effects are comparable with those encountered in human patients given radiation therapy with neutrons. Such comparisons show that the rabbit experiments are applicable to man. Given that basis, the results from the low end of the experimental dose range lead to the conclusion that astronauts subjected to the radiation fluxes anticipated during flights of the above duration could experience late radiation effects one or more decades after exposure. Late degenerative changes will occur in tissues of the central nervous system, terminally differentiating systems and stem cell populations. The studies also indicate that individual tissues may be "prematurely aged" by radiation in the sense that the "life spans" of those tissues can be decreased without the appearance of malignancies.
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Lee AC, Keshtgar MRS, Waddington WA, Ell PJ. The role of dynamic imaging in sentinel lymph node biopsy in breast cancer. Eur J Cancer 2002; 38:784-7. [PMID: 11937312 DOI: 10.1016/s0959-8049(01)00471-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The aim of this study was to evaluate the role of dynamic imaging in sentinel lymph node (SLN) biopsy in breast cancer. Patients with T1/T2, N0 invasive breast cancer underwent SLN localisation using intra-dermal injection of 15 MBq of 99mTc-nanocolloid. Gamma camera anterior-oblique dynamic imaging commenced simultaneously with tracer administration for 45 min, and was followed by anterior and lateral static imaging. Dynamic imaging data was reformatted into image files of different time-frames. Patterns of uptake were analysed using the sequences of dynamic frames and time-activity curve (TAC). SLN localisation was successful in 70/73 studies (96%) in 72 patients. Imaging information was present within the first 15 min of dynamic imaging in 67/70 studies (96%). Critical analysis of dynamic data helped to differentiate true SLN from secondary echelon nodes in eight studies and transient foci of radioactivity in six studies. In 17 studies, SLN contained metastatic disease. The detection of SLN metastasis was independent from the use of dynamic imaging. Dynamic imaging improves the interpretation of preoperative SLN imaging for breast cancer, but does not contribute significantly to the successful detection of SLN. Hence, preoperative dynamic imaging is not necessary in SLN biopsy for breast cancer.
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Lui WY, Lee AC, Que TL. Central venous catheter-associated Nocardia bacteremia. Clin Infect Dis 2001; 33:1613-4. [PMID: 11588709 DOI: 10.1086/323557] [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: 02/05/2023] Open
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Lee AC, Harris JP, Atkinson EA, Fowler MS. Disruption of estimation of body-scaled aperture width in Hemiparkinson's disease. Neuropsychologia 2001; 39:1097-104. [PMID: 11440762 DOI: 10.1016/s0028-3932(01)00032-x] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
A group of patients with left-sided symptoms of Parkinson's disease (LPD) was compared with a group of patients with right-sided symptoms (RPD) and with a group of healthy age-matched controls on body-scaled judgements of aperture width. Participants judged whether or not they would fit through a life-sized schematic doorway shown on a large screen. A staircase technique was used to find the door width for which 50% of the judgements were positive. The ratio between this measure and the width of the participant's body at the shoulders (the aperture to shoulder - A/S ratio) was calculated. The A/S ratio was approximately 1.5 in the LPD group, approximately 0.9 in the RPD group, and approximately 1.1 in the control group, suggesting that the visual representation of the doorway (or that of its relationship to perceived body-size) is compressed in LPD (and perhaps expanded in RPD). The A/S ratios were invariant with viewing distance (0.6 or 1.5 m), the contrast polarity of the display (white on dark, or vice versa) and the doorway surround (blank, or vertical or horizontal stripes). The findings are discussed with reference to the neural representation of external space and of the body, and to the motor problems of Parkinson's disease.
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Lee AC, Harris JP, Atkinson EA, Fowler MS. Evidence from a line bisection task for visuospatial neglect in left hemiparkinson's disease. Vision Res 2001; 41:2677-86. [PMID: 11520513 DOI: 10.1016/s0042-6989(01)00129-8] [Citation(s) in RCA: 56] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The perception of extrapersonal space in Parkinson's disease was examined with two line bisection tasks. One was a conventional pencil and paper test, the line bisection section of the Behavioural Inattention Test. In the other, the stimuli were displayed on a large (2x2.4 m) screen and varied in length (48-480 mm) and also in location on the screen (left, centre and right). They were presented at two viewing distances (0.6 and 1.5 m). Subjects remotely adjusted the position of a cursor until it appeared to bisect the stimulus line, using two push-buttons, one in each hand. The PD participants (n=18) had a marked asymmetry of motor symptoms. They were divided into two groups, those with predominantly left-sided motor symptoms (LPD, n=9), and those with predominantly right-sided motor symptoms (RPD, n=9). The control group (n=9) were all right-handed. No significant differences between the groups were found on the BIT bisection task. In contrast, when the stimuli were presented on the screen, LPD subjects showed a significant rightward bias in their settings of the cursor, particularly for lines on the left and centre of the screen, which was greater, the longer the stimulus line. The RPD group bisected lines slightly to the left, in common with the control group (pseudo-neglect). In a second experiment, Parkinsonian subjects repeated this task, but with the buttons reversed between the hands, so that the cursor was moved to the left by the right hand, and vice versa, but the pattern of results was the same as in the first experiment. The data suggest a small but reliable neglect in left hemiparkinson's disease, which is contralateral to the non-dominant (and probably worse affected) hemisphere. The dissociation between the response and the bisection error suggests a visuospatial impairment in LPD.
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Chan GC, Leung YL, Shing MM, Luk CW, Ling SC, Lee AC. Does a "false negative" MIBG scan predict a better outcome in neuroblastoma patients? MEDICAL AND PEDIATRIC ONCOLOGY 2001; 37:155. [PMID: 11496360 DOI: 10.1002/mpo.1190] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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Abstract
A retrospective audit was carried out to assess patient outcome in relation to the timing of feeding after pyloromyotomy for hypertrophic pyloric stenosis. Fifty-two patients received the first feed within 8 hours of surgery and 49 patients were fed between 13 and 20 hours post-operatively. Seventy-seven per cent of patients in the early group vomited compared to 53% in the late group. Sixty-one per cent of patients in the early group produced large vomits compared to 29% in the late feeding group. However, time to establish feeding and post-operative stay were comparable in both groups. We recommend feeding to be delayed for 12 hours after pyloromyotomy unless the patient is distressed because of hunger in which case the parents are warned of the increased risk of vomiting.
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Quintana-Murci L, Krausz C, Heyer E, Gromoll J, Seifer I, Barton DE, Barrett T, Skakkebaek NE, Rajpert-De Meyts E, Mitchell M, Lee AC, Jobling MA, McElreavey K. The relationship between Y chromosome DNA haplotypes and Y chromosome deletions leading to male infertility. Hum Genet 2001; 108:55-8. [PMID: 11214908 DOI: 10.1007/s004390000424] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Microdeletions on the short arm of the Y chromosome have defined three non-overlapping regions (AZFa, b, c) recurrently deleted among infertile males. These regions contain several genes or gene families involved in male germ-cell development and maintenance. Even though a meiotic origin for these microdeletions is assumed, the mechanisms and causes leading to microdeletion formation are largely unknown. In order to assess whether some Y chromosome groups (or haplogroups) are predisposed to, or protected against, deletion formation during male meiosis, we have defined and compared Y chromosome haplogroup distribution in a group of infertile/subfertile males harbouring Yq deletions and in a relevant Northwestern European control population. Our analyses suggest that Y chromosome deletion formation is, at least in the study populations, a stochastic event independent of the Y chromosome background on which they arise and may be caused by other genetic and/or environmental factors.
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Abstract
OBJECTIVES To describe the practice patterns of licensed massage therapists (LMTs). DESIGN Cross-sectional survey. SUBJECTS One hundred and twenty-six (126) massage practices randomly selected from the Greater Boston Area yellow pages. OUTCOMES MEASURES Practitioner demographics, training, practice characteristics, and fees. RESULTS The response rate was 65%. Most respondents were Caucasian (95%) and female (80%). Their mean age was 41 years old. Half held a college degree; on average, practitioners received 1000 hours of training in massage therapy. The majority were in group practices (59%) and saw an average of 20 patients per week. The typical visit lasted 50-60 minutes; the cost was $60 and rarely covered by insurance (5%). Half of respondents offered sliding scales to patients, but only 11% accepted Medicaid patients. Respondents reported less than 1 visit per week from pediatric and adolescent patients (<21 years old). CONCLUSIONS Most LMTs are female and Caucasian. The costs of massage therapy are almost entirely paid out-of-pocket by patients (95%). LMTs infrequently care for children.
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Girkin CA, Emdadi A, Sample PA, Blumenthal EZ, Lee AC, Zangwill LM, Weinreb RN. Short-wavelength automated perimetry and standard perimetry in the detection of progressive optic disc cupping. ARCHIVES OF OPHTHALMOLOGY (CHICAGO, ILL. : 1960) 2000; 118:1231-6. [PMID: 10980768 DOI: 10.1001/archopht.118.9.1231] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVE To compare progression in short-wavelength automated perimetry (SWAP) and white-on-white (standard) perimetry in eyes with progressive glaucomatous changes of the optic disc detected by serial stereophotographs. METHODS Forty-seven glaucoma patients with at least 2 disc stereophotographs more than 2 years apart, along with standard perimetry and SWAP examinations within 6 months of each disc photo of the same eye, were included in the study. The mean follow-up time was 4.1 years (range, 2.0-8.9 years). Baseline and follow-up stereophotographs were then graded and compared for the presence of progression. Progression in standard perimetry and SWAP, using the Advanced Glaucoma Intervention Study scoring system and a clinical scoring system, was compared between eyes with progressive change on stereophotographs and those without. RESULTS Twenty-two of 47 eyes showed progressive change by stereophotographs. There was a statistically significant difference in the mean change in Advanced Glaucoma Intervention Study scores for both standard perimetry (P<.004) and SWAP (P<.001) between the progressed and nonprogressed groups. The sensitivity, specificity, and area under the receiver operator characteristic curve were higher using SWAP than standard perimetry when evaluated by either algorithm. This was statistically significant only in the area under the receiver operator characteristic curve for the Advanced Glaucoma Intervention Study scoring system (P =.04). CONCLUSIONS Short-wavelength automated perimetry identified more patients than standard perimetry as having progressive glaucomatous changes of the optic disc. Compared with standard perimetry, SWAP may improve the detection of progressive glaucoma. Arch Ophthalmol. 2000;118:1231-1236
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Lee AC, Wong YC, Fung SH, Kwong NS, Tsui KY, Ramsay AD. Congenital sacrococcygeal primitive neuroectodermal tumor. MEDICAL AND PEDIATRIC ONCOLOGY 2000; 34:448-50. [PMID: 10842257 DOI: 10.1002/(sici)1096-911x(200006)34:6<448::aid-mpo15>3.0.co;2-e] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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Lee AC, Robbins TW, Pickard JD, Owen AM. Asymmetric frontal activation during episodic memory: the effects of stimulus type on encoding and retrieval. Neuropsychologia 2000; 38:677-92. [PMID: 10689044 DOI: 10.1016/s0028-3932(99)00094-9] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Recent functional neuroimaging studies have suggested that the left prefrontal cortex is preferentially involved in the encoding of episodic memory whilst the right prefrontal cortex is preferentially involved in the retrieval of episodic memory, irrespective of the type (e.g. modality) of information being remembered. In the present PET activation study, a 2 x 2 design was employed to investigate the relationship between encoding and retrieval of verbal and non-verbal material in episodic memory. Accordingly, seven healthy volunteers were scanned whilst encoding and then recalling stimuli which either emphasised visual or verbal processes. When encoding and retrieval tasks were compared directly, significantly greater prefrontal activation was observed in the encoding conditions, regardless of modality, although these changes were bilaterally distributed. In contrast when the verbal and visual memory tasks were compared directly, the former was associated with rCBF changes that were predominantly located in the left lateral frontal cortex whilst the latter was associated with rCBF changes that were predominantly located in the right lateral frontal cortex. These results suggest that encoding and retrieval may actually involve similar regions of the lateral prefrontal cortex when all factors relating to the type of stimulus material (i.e. modality), are appropriately controlled.
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Lee AC, Li DH, Kemper KJ. Chiropractic care for children. ARCHIVES OF PEDIATRICS & ADOLESCENT MEDICINE 2000; 154:401-7. [PMID: 10768681 DOI: 10.1001/archpedi.154.4.401] [Citation(s) in RCA: 76] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVE To describe the practice characteristics and pediatric care of chiropractors. STUDY DESIGN Cross-sectional, descriptive survey. SETTING Chiropractic practices in the Boston, Mass, metropolitan area. PARTICIPANTS One hundred fifty licensed chiropractors. MAIN OUTCOME MEASURES Demographics, practice characteristics, and fee structure. Practitioners were also asked about their approach to childhood immunizations and a clinical scenario. Data were analyzed using simple descriptive statistics. RESULTS Ninety (60%) chiropractors responded. All were white and 65% were men. Respondents had on average 122 patient visits weekly, of which 13 (11%) were from children and adolescents. Typical visit frequency ranged from 1 to 3 times weekly. Average visit fees were $82 and $38 (initial and follow-up) and 49% of the fees were covered by insurance. Seventy percent of the respondents recommended herbs and dietary supplements. For pediatric care, 30% reported actively recommending childhood immunizations; presented with a hypothetical 2-week-old neonate with a fever, 17% would treat the patient themselves rather than immediately refer the patient to a doctor of medicine, doctor of osteopathy, or an emergency facility. CONCLUSIONS Children and adolescents constitute a substantial number of patients in chiropractics. An estimated 420000 pediatric chiropractic visits were made in the Boston metropolitan area in 1998, costing approximately $14 million. Pediatric chiropractic care is often inconsistent with recommended medical guidelines. National studies are needed to assess the safety, efficacy, and cost of chiropractic care for children.
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Abstract
A case is reported of septic arthritis in a child with human immunodeficiency virus-negative hemophilia A associated with a Staphylococcus aureus catheter-associated septicemia. The infection occurred in relation to the use of a totally implantable central venous catheter. The organism was eventually eradicated with antibiotics injected via the catheter. With increasing use of such catheters in the hemophilic population, clinicians should be alerted to the possibility of septic arthritis for prompt diagnosis and treatment.
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Blumenthal EZ, Sample PA, Zangwill L, Lee AC, Kono Y, Weinreb RN. Comparison of long-term variability for standard and short-wavelength automated perimetry in stable glaucoma patients. Am J Ophthalmol 2000; 129:309-13. [PMID: 10704545 DOI: 10.1016/s0002-9394(99)00432-8] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
PURPOSE To quantify and compare, on a point-by-point basis, the long-term variability of standard and short-wavelength automated perimetry in a group of stable glaucoma patients. METHODS From a group of 53 glaucoma patients experienced in visual field testing, we identified one eye, randomly chosen, from each of 25 glaucoma patients whose condition was found to be stable, based on both standard and short-wavelength automated perimetry visual field criteria. On each of three visits during a period of up to 3 months, each patient performed one standard and one short-wavelength automated perimetry 24-2 visual field in a random order on a Humphrey visual field analyzer. The long-term variability (also referred to as test-retest variability) was defined as the SD of the three threshold decibel values at each test location. The long-term variability for each test point (mean +/- SD) was determined separately for both standard visual fields and short-wavelength automated perimetry. RESULTS With all 52 test locations of the 24-2 field averaged, the global long-term variability, mean (+/- SD) for standard visual fields and short-wavelength automated perimetry was 2.37 +/- 2.03 dB (95% confidence interval, 2.26-2.48 dB) and 2.92 +/- 2.03 dB (95% confidence interval, 2.81-3.03 dB), respectively (P <.0001). In 16 of the 52 visual field locations, long-term variability on short-wavelength automated perimetry was significantly higher than long-term variability on standard visual fields. In addition, the long-term variability increased with greater distance from the point of fixation for both standard visual fields and short-wavelength automated perimetry. The long-term variability decreased closer to fixation, more for standard visual fields than for short-wavelength automated perimetry. CONCLUSIONS In a group of stable glaucoma patients, mean long-term variability was 0.55 dB higher for short-wavelength automated perimetry than for standard visual fields. This needs to be taken into consideration when serial visual fields are evaluated for change.
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Lee AC, Kemper KJ. Homeopathy and naturopathy: practice characteristics and pediatric care. ARCHIVES OF PEDIATRICS & ADOLESCENT MEDICINE 2000; 154:75-80. [PMID: 10632255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
OBJECTIVE To describe the practice characteristics and pediatric care of homeopathic practitioners (HPs) and naturopathic doctors (NDs). DESIGN Cross-sectional, descriptive survey. SETTING Homeopathic and naturopathic practices in Massachusetts. PARTICIPANTS Homeopathic practitioners (N = 42) and NDs (N = 23) identified from the yellow pages, regional and national society membership lists, schools, magazine advertisements, and by word-of-mouth. The response rate was 55% (23/42) for HPs and 65% (15/23) for NDs. MAIN OUTCOME MEASURES Demographics, practice characteristics, fee structure, and amount of pediatric care. Practitioners were asked for their approach to childhood immunizations and to treating a febrile neonate. Data were analyzed using simple descriptive statistics. RESULTS Almost all respondents were white. Among the HPs, 13 (57%) were licensed medical doctors. Naturopathic doctors and HPs reported having an average of only 25 to 40 patient visits per week, but children and adolescents accounted for up to one third of these visits. Nearly all reported treating children, but fewer than half of the practitioners reported any formal pediatric training. Initial patient visits typically lasted more than 1 hour and cost $140 to $150. Follow-up visits were scheduled every 4 to 6 weeks and lasted more than 30 minutes on average. Insurance covered less than one third of the patient visits, and sliding scale payments were offered by less than half of the respondents. Most practitioners reported that they did not actively recommend immunizations and fewer than half of the nonphysician practitioners reported that they would refer a 2-week-old neonate with a fever to a medical doctor or emergency medical facility. CONCLUSIONS Many patients using homeopathy and naturopathy are children. Visits to these providers are frequent and fees are primarily paid out-of-pocket. Failure on the part of these providers to recommend immunizations or recognize potentially serious illnesses is cause for concern.
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Agboola IO, Lee AC. Computer and information technology access for deaf individuals in developed and developing countries. JOURNAL OF DEAF STUDIES AND DEAF EDUCATION 2000; 5:286-289. [PMID: 15454507 DOI: 10.1093/deafed/5.3.286] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
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Abstract
PURPOSE To determine the efficacy of a nonendoscopic brow/forehead lift. METHODS Case series of 12 patients. Small scalp and upper eyelid blepharoplasty incisions were used to elevate the brows/forehead and perform protractor myectomy. RESULTS All patients achieved an aesthetically pleasing eyebrow and forehead lift with reduction of vertical and horizontal glabellar creases. Complications included one patient who experienced prolonged ecchymosis after corrugator muscle resection and one patient who had asymmetric lid folds after surgery. The length of follow-up ranged from 9 to 35 months. CONCLUSIONS The small incision nonendoscopic browlift technique provides a useful alternative to the endoscopic approach.
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