Patterns of emergency department visits for disorders of the eye and ocular adnexa

OBJECTIVE: To characterize the magnitude and patterns of visits to the emergency department (ED) for problems related to the eye and ocular adnexa. METHODS: The National Hospital Ambulatory Medical Care Survey was used to obtain information on ED visits in the United States for conditions of the eye and ocular adnexa in 1993. Patients were identified by International Classification of Diseases, Ninth Revision, Clinical Modification, codes. National projections were based on a staged probability design. RESULTS: There were 2.32 million projected ED visits for problems of the eye and ocular adnexa in 1993. Forty-nine percent of visits were for injuries, two thirds of which occurred in males. Thirty-five percent of injuries occurred in the home and 18% occurred in the workplace. Only 3% of patients required hospitalization. Most patients had private insurance, but substantial variations in coverage existed for patients who used the ED for injury- vs non-injury-related care. CONCLUSIONS: Emergency departments in the United States provide a large amount of eye care, much of which is for conditions other than trauma. Differences in insurance coverage for injury- and non-injury-related eye care indicate that factors other than medical urgency are involved in the decision to use ED services. Further studies are needed to determine the cost-effectiveness and quality of ocular-related ED visits.     

Reference performance and positive and negative thought disorder: A follow-up study of manics and schizophrenics.

Manic (n?=?22) and schizophrenic (n?=?28) patients were examined with clinical and linguistic measures of language performance at an acute admission and at a follow-up. It was found that the frequency of incompetent references and the severity of negative thought disorder were stable independent traits of schizophrenics. Furthermore, low levels of verbal productivity, indexed both clinically and linguistically, predicted the likelihood that schizophrenic subjects would be psychotic at follow-up. The language performance of manic patients was not temporally stable, although high levels of reference failures at index predicted psychosis at follow-up. These results are evaluated in terms of their implications for differentiating state-specific aspects of speech competence from potential vulnerability markers in these two types of patients. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Self-directed versus other-directed affect as a consequence of prejudice-related discrepancies.

Personal standards for responding toward gay males and affective reactions to discrepancies were examined for low prejudiced (LP) and high prejudiced (HP) Ss in 2 studies. These standards and discrepancies involved responses varying in controllability and acceptability. Results indicated that LP Ss experienced negative self-directed affect in connection with transgressions from their nonprejudiced and well-internalized standards, regardless of the type of response. HP Ss' personal standards were quite nonprejudiced and well internalized for relatively controllable and unacceptable prejudiced responses. Nevertheless, HP Ss' transgressions from their standards produced negative affect directed toward others but not toward the self, regardless of the type of response. The findings supported E. T. Higgins's (1987) argument that the standpoint of standards determines affective reactions to discrepancies. Apparently, LP Ss' standards are based on the own standpoint, but HP Ss' standards are based on the other standpoint. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The influence of ante-mortem treatment on relationship between pH and tenderness of beef

Longissimus lumborum et thoracis muscles from 150 cattle comprising Czech Pied breed bulls and cows were used to investigate the relationship between pH value and beef tenderness as influenced by housing before slaughter and by the hanging mode of carcasses. The pH value was measured in the loin at the end of the slaughter-line (pH(0)) and after cooling of carcasses (pH(24),pH(48)). The texture of raw meat was measured 72h post-mortem by the Warner-Bratzler shear method; the shear force was related to pH. Curvilinear relationships with coefficients of correlation r=0.64 (P<0.05) for bulls individually housed and r=0.83 for bulls housed in groups between the shear force and the pH value 24h p.m. were found with maximal shear force (the most tough meat) in the range of pH(24) from 6.2 to 6.4. Lower correlations (r=0.72 and r=0.54) between pH(24) and meat tenderness were found in the case of cows individually housed and housed in groups, respectively. No significant relationships were found between texture and pH measured at the end of the slaughter-line (r=0.59 for bulls and r=0.65 for cows) and 48h post-mortem (r=0.64 for bulls and r=0.50 for cows). The mode of housing of cattle before slaughter influenced the properties of beef significantly. Meat of bulls housed in groups before slaughter was less tender (the shear force was higher) than meat of bulls individually housed. It could be explained by higher depletion of glycogen before slaughter and thus insufficient pH decline. Generally, the meat of cows was more tender than of bulls irrespective of housing. No significant differences were found between the left and right halves of carcasses. Thus the mode of hanging had no influence on beef tenderness.     

EXTRACTION OF URANYL IONS BY SYNERGISTIC MIXTURES OF THENOYLTRIFLUOROACETONE AND MACROCYCLIC DONORS

A linear polyether, 1, 13-bis[8-qulnoly]-l,4,7,10,13-pentaoxa-trldecane (K-5) and an aza-crown ether, 4,13-didodecyl-1,7,10,16-tetraoxadiazacyclooctadecane (K22DD) when combined with thenoyltrlfluoroacetone (HTTA) have been shown to exhibit a synergistic effect on the extraction of uranyl ion. The effects of the addition to the organic phase of K-5, K22DD, and tert-butylcyclohexyl-15-crown-5 (15-C-5) on the extraction of UO₂ ⁺² by HTTA in chloroform from 0.5 M NaNO₃ at 25°C have been measured. The results indicate the extraction is enhanced by the formation of an adduct, UO₂(TTA)₂S for K-5 and K22DD. No enhancement of the extraction was seen with the crown ether. The organic phase stability constants for both K-5 and K22DD were evaluated and found to be similar in magnitude. These results suggest that the major factor in the formation of the synergistic adduct is the presence of the nitrogen atom in the synergist.     

Improving Antibody-Tubulysin Conjugates through Linker Chemistry and Site-Specific Conjugation

Tubulysins have emerged in recent years as a compelling drug class for delivery to tumor cells via antibodies. The ability of this drug class to exert bystander activity while retaining potency against multidrug-resistant cell lines differentiates them from other microtubule-disrupting agents. Tubulysin M, a synthetic analogue, has proven to be active and well tolerated as an antibody-drug conjugate (ADC) payload, but has the liability of being susceptible to acetate hydrolysis at the C11 position, leading to attenuated potency. In this work, we examine the ability of the drug-linker and conjugation site to preserve acetate stability. Our findings show that, in contrast to a more conventional protease-cleavable dipeptide linker, the β-glucuronidase-cleavable glucuronide linker protects against acetate hydrolysis and improves ADC activity in vivo. In addition, site-specific conjugation can positively impact both acetate stability and in vivo activity. Together, these findings provide the basis for a highly optimized delivery strategy for tubulysin M.     

Rapidly progressive herpetic retinal necrosis: a blinding disease characteristic of advanced AIDS

Eleven patients with rapidly progressive herpetic retinal necrosis (RPHRN) complicating AIDS were investigated retrospectively to study the disease spectrum, systemic involvement, and therapy. The mean CD4 cell count was 24/microL. There was a characteristic disease pattern with rapid progression, 82% bilaterality, relative resistance to intravenous antiviral therapy, and 70% retinal detachment. Varicella-zoster virus was the probable cause in 10 patients (detected by polymerase chain reaction in two eyes investigated), and herpes simplex virus was the probable cause in one. Cutaneous zoster occurred previously in 73% but was not concurrent. Seventy-three percent had central nervous system disease, possibly virus-related. RPHRN may be a local herpetic recrudescence in an immune-privileged site with transneural spread. Only four of 20 affected eyes retained useful vision. Poor ocular bioavailability, retinal ischemia, acquired drug resistance, and strain pathogenicity may underlie treatment failure. Acyclovir therapy appears relatively ineffective. Combined intravenous and intravitreal therapy with foscarnet and ganciclovir may be the best current management. Research advances are needed urgently.     

Microscopic examination of surgical margins of intraocular tumors excised en bloc

Microscopic examination of the surgical margins of an en bloc resection of an intraocular tumor is difficult because of the small size of the specimen. A technique to study the surgical margins of en bloc resections is described that minimizes gross handling of the tissue in the laboratory. Step sections at 1/8-mm intervals along the anteroposterior axis of the eye provide sufficient sampling to detect involvement of the surgical margin. They also allow easy anatomic reconstruction of the tumor with glass slides.     

Extended mnemonic instruction with learning disabled students.

Divided 64 learning disabled (LD) 6th-, 7th-, and 8th-grade students into 24 instructional groups that were assigned at random to mnemonic and control conditions. Instructional groups were administered 3 daily lessons on dinosaurs in counterbalanced order. The lessons involved vocabulary on dinosaurs, attributes of dinosaurs, and reasons for dinosaur extinction. Mnemonic groups were taught the information using keyword and pegword techniques. Control instructional groups were taught the same information using the principles of direct instruction, including teacher-directed questioning, choral group responding, fast instructional pacing, and cumulative review. A test was given after each lesson on that lesson's content. On the 4th day, all Ss were given production and identification tests on the content of all 3 lessons. Results indicate that mnemonic groups outperformed control groups on the immediate and delayed tests. In addition, control Ss' responses revealed significantly more intralist intrusions than did those of mnemonic Ss. No meaningful trend across days of instruction was observed for either condition. Findings suggest that mnemonic instruction is a versatile and effective instructional technique for LD students. (23 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)