Community and ambulatory pharmacy: evaluation of patient care services and billing patterns before implementation of Medicare part D.

Objective: To provide a summary of community and ambulatory pharmacy practice and billing patterns for medication therapy management services before implementation of Medicare Prescription Drug Improvement and Modernization Act of 2003 (MMA).

Design: Cross-sectional survey.

Setting: Ambulatory care and community pharmacy practice settings in the United States in January 2004.

Macular carotenoids and age-related maculopathy.

Lutein (L) and zeaxanthin (Z) are concentrated at the macula, where they are collectively known as macular pigment (MP), and where they are believed to play a major role in protecting retinal tissues against oxidative stress. Whilst the exact pathogenesis of age-related maculopathy (ARM) remains unknown, the disruption of cellular processes by oxidative stress may play an important role. Manipulation of dietary intake of L and Z has been shown to augment MP, thereby raising hopes that dietary supplementation with these carotenoids might prevent, delay, or modify the course of ARM.

The impact of new regulations on the incidence and severity of ocular injury sustained in hurling.

Aim: To prospectively evaluate, and compare, the incidence of hurling-related eye injuries in the South East of Ireland before and after implementation of new rules rendering the use of protective head gear and face masks compulsory for players aged 18 years or under.

Methods: Details relating to patients attending the regional ophthalmic department with injuries sustained during hurling were prospectively recorded between 1 October 2003 and 31 March 2006.

Results: Sixty players attended with hurling-related ocular injuries during the study period.

Buckle-related complications following surgical repair of retinal dialysis.

Aim: To describe buckle-related complications following surgical repair of retinal dialysis.

Methods: A retrospective study of 28 consecutive cryobuckle procedures for retinal detachments secondary to retinal dialysis is reported, with particular attention directed towards postoperative complications relating to the buckle. Stata 8 statistical software and Fisher's exact test were used to analyse the data.

Risk factors for age-related maculopathy are associated with a relative lack of macular pigment.

Macular pigment (MP) is composed of the two dietary carotenoids lutein (L) and zeaxanthin (Z), and is believed to protect against age-related maculopathy (ARM). This study was undertaken to investigate MP optical density with respect to risk factors for ARM, in 828 healthy subjects from an Irish population. MP optical density was measured psychophysically using heterochromatic flicker photometry, serum L and Z were quantified by HPLC, and dietary intake of L and Z was assessed using a validated food-frequency questionnaire.

Surgical and visual outcomes following exchange of opacified Hydroview intraocular lenses.

Aim: To report the clinical and surgical outcomes following exchange of opacified Hydroview intraocular lenses (IOLs), and to relate the final visual and anatomic results to clinical and surgical variables.

Methods: This is a prospective study of seventy-three eyes that underwent exchange of opacified Hydroview IOLs in Waterford Regional Hospital, Ireland. Preoperative, intraoperative and postoperative details were recorded.

Investigating parental preferences regarding the development and implementation of a parent-directed drug-related educational intervention: an exploratory study.

Strengthening parents' capacity to reduce children's risk of alcohol, tobacco and other drug-related harm is recognised as an important public health strategy in Australia, but engaging parents' involvement in these training programs is known to be challenging. This study utilised a self-complete questionnaire and structured small group discussions with parents in order to identify their needs in terms of communicating with their children about drinking alcohol and smoking cigarettes. It also investigated their preferences regarding the nature of a parent drug education intervention as well as strategies to recruit and actively engage them in parent-directed interventions.

Mutations in the gene encoding GlyT2 (SLC6A5) define a presynaptic component of human startle disease.

Hyperekplexia is a human neurological disorder characterized by an excessive startle response and is typically caused by missense and nonsense mutations in the gene encoding the inhibitory glycine receptor (GlyR) alpha1 subunit (GLRA1). Genetic heterogeneity has been confirmed in rare sporadic cases, with mutations affecting other postsynaptic glycinergic proteins including the GlyR beta subunit (GLRB), gephyrin (GPHN) and RhoGEF collybistin (ARHGEF9). However, many individuals diagnosed with sporadic hyperekplexia do not carry mutations in these genes.

Monthly consistency of macular pigment optical density and serum concentrations of lutein and zeaxanthin.

Purpose: This study was undertaken to assess serial month-to-month consistency of macular pigment (MP) optical density and serum concentrations of lutein (L) and zeaxanthin (Z). Four healthy subjects aged between 23 and 51 years volunteered to participate in this study.

Methods: MP optical density (measured psychophysically using heterochromatic flicker photometry [HFP]), and serum concentrations of L and Z (quantified using high-performance liquid chromatography [HPLC]), were recorded every month for 24 consecutive months.

Macular pigment and ocular biometry.

This study is designed to investigate the relationship between macular pigment optical density (MPOD) and ocular biometric parameters. The following details were recorded for 180 healthy subjects: demographic profile; best-corrected visual acuity; refractive status; ocular biometric parameters [axial length (AL), anterior chamber depth (ACD), lens thickness (LT) and vitreous chamber depth (VCD)]; ocular dominance; MPOD; serum lutein (L) and zeaxanthin (Z). The mean MPOD (+/-SD) was 0.

Transconjunctival sutureless vitrectomy: initial experience and surgical tips.

Objectives: We report the operative details and surgical outcomes of 39 consecutive transconjunctival sutureless vitrectomies using the TSV 25 system.

Methods: We retrospectively reviewed the medical records of 35 patients (39 eyes) who underwent surgery using TSV 25 at the Department of Ophthalmology, Waterford Regional Hospital between March 2003 and February 2005. Preoperative, intraoperative and postoperative details were recorded and analysed.

Age and sex profile of patients having cataract surgery between 1986 and 2003.

Purpose: To investigate the age and sex profile of patients having cataract surgery by 2 consulting ophthalmic surgeons over an 18-year period.

Setting: Waterford Regional Hospital, Waterford, Republic of Ireland.

Methods: Operating theater logbooks were reviewed, and all patients having cataract surgery between January 1986 and December 2003 in Waterford Regional Hospital were identified.

Central retinal thickness is positively correlated with macular pigment optical density.

Macular pigment (MP) has been suggested to have a protective role in age-related macular degeneration by reducing the amount of oxidative stress on the retina. MP levels peak at the foveal center, where it is found predominantly in the receptor axon and inner plexiform layers of the retina. The purpose of this study was to investigate the relationship between central retinal thickness and macular pigment optical density in a group of healthy subjects.

Visual experiences during vitreous surgery under regional anesthesia: a multicenter study.

Purpose: To investigate patients' subjective intraoperative visual experiences during vitreous surgery performed under regional anesthesia, to ascertain if patients were frightened by their visual experiences, and to determine the risk factors associated with a frightening visual experience.

Design: Multicenter, prospective study.

Methods: Sixty-five patients who had vitreous surgery under regional (retrobulbar or peribulbar) anesthesia in five centers in Ireland, Singapore, and Hong Kong were interviewed within 2 hours of their operation using a standardized questionnaire.

Heritability of macular pigment: a twin study.

Purpose: Several studies have reported higher levels of macular pigment (MP) in association with reduced risk for age-related macular degeneration (ARMD), a disease to which there is a genetic predisposition. A classic twin study was performed to determine the heritability of MP in the healthy eye.

Methods: One hundred fifty twin pairs (76 monozygotic [MZ] and 74 dizygotic [DZ]), aged 18 to 50 years, participated.

Macular pigment levels following successful macular hole surgery.

Aim: Macular pigment (MP) is composed of two hydroxycarotenoids contained within the photoreceptors and the axons of the central neurosensory retina, with peak concentrations in the Henle layer. A full thickness macular hole (FTMH) is characterised by absence of all retinal layers in an area centred at the former centre of the fovea. The authors report the results of a study designed to investigate MP levels in patients following successful FTMH surgery, using Raman spectroscopy, and to correlate these findings with functional and topographic outcomes.

Ocular injury in hurling.

Objectives: To describe the clinical characteristics of ocular injuries sustained in hurling in the south of Ireland and to investigate reasons for non-use of protective headgear and eye wear.

Methods: Retrospective review of the case notes of 310 patients who attended Cork University Hospital or Waterford Regional Hospital between 1 January 1994 and 31 December 2002 with ocular injuries sustained during a hurling match. A confidential questionnaire on reasons for non-use of protective headgear and eye wear was completed by 130 players.

Quality improvement: the pursuit of excellence.

Sherbrooke Community Centre, a registered Eden Alternative home, has implemented structures and processes to support ongoing quality improvement (QI). A comprehensive QI program supports Sherbrooke's commitment to excellence. The organization's QI program is based on the Board of Directors' strategic plan and the core directions of the strategic plan are reflected in the QI standards.

Impacts of recreation trails on exotic and ruderal species distribution in grassland areas along the Colorado Front Range.

This study examines the establishment patterns of exotic and ruderal species along trail corridors in grassland areas of the Colorado Front Range. The effects of trail presence, trail age, and trail traffic levels on exotic and ruderal species establishment are explored to ascertain the potential impacts of trails on surrounding vegetation. Established trails exhibited a greater presence of exotic and ruderal species along the immediate trailside, showing that disturbed trailsides tend to encourage the growth of these species over time.

Investigation and management of an epidemic of Hydroview intraocular lens opacification.

Background: Opacification of Hydroview posterior chamber intraocular lenses had been prescribed, but many aspects of this complication remain unknown, including its aetiology, clinical features, pathogenesis, prognosis and treatment. This paper describes an epidemic of Hydroview intraocular lens (IOL) opacification.

Methods: Subjects in whom the Hydroview IOL was implanted were recalled for evaluation of its transparency, assessment of contrast sensitivity (CS) [VCTS (Vistech CO, Dayton, Ohio, USA)] and visual acuity (LogMAR), and analysis of medical and surgical data.

Refractive lens exchange in high myopia: long term follow up.

Aim: To establish long term outcomes and incidence of complications following refractive lens exchange (RLE) for the correction of high myopia.

Methods: Operative and postoperative records of 62 cases of small incision phacoemulsification RLE performed in 37 patients over an 11 year period, by a single surgeon, were reviewed. In addition, patients were recalled for a follow up examination, which included dilated retinal examination with scleral indentation.

A novel index for predicting intraocular pressure reduction following cataract surgery.

Aim: The results of a study designed to investigate the predictive value of preoperative anterior chamber depth (ACD) and intraocular pressure (IOP) are reported. The relation between these factors and their effect on the reduction in IOP following phacoemulsification cataract surgery was also studied.

Methods: The ACD and IOP were prospectively measured in 103 non-glaucomatous eyes of 103 patients who underwent uneventful phacoemulsification and posterior chamber intraocular lens (PCIOL) implantation.

Decreased warfarin effect after initiation of high-protein, low-carbohydrate diets.

Objective: To report 2 cases of decreased international normalized ratio (INR) after initiation of a high-protein, low-carbohydrate diet.

Case Summaries: Case 1. A 67-year-old white woman had been receiving warfarin for 3 years for venous thromboembolism.

Measurement of macular pigment: Raman spectroscopy versus heterochromatic flicker photometry.

Purpose: There are several techniques for measuring macular pigment (MP) in vivo, of which Raman spectroscopy (RS) is a recently developed objective

Method: This study reports the reproducibility, test-retest variability, and validity of RS MP readings, by comparing them with heterochromatic flicker photometry (HFP).

Methods: MP was measured with HFP and RS in 120 healthy subjects, and the latter technique was also used on two separate occasions in a sample of 20 subjects to investigate the intersessional variability of readings. Intrasessional reproducibility of RS MP measurements was also calculated.