Effect of oral donepezil on intraocular pressure in normotensive Alzheimer patients.

Donepezil, a selective acetylcholinesterase (AChE) inhibitor, has been shown to reduce intraocular pressure (IOP) in ocular normotensive rabbit eyes. The aim of this investigation was to evaluate the effect of oral donepezil on IOP and pupil diameter after mid-term oral treatment in normotensive persons. Thirty-two newly diagnosed Alzheimer patients with normal IOP and no further antiglaucomatous treatment were included in the study.

Anhedonia and emotional numbing in combat veterans with PTSD.

We explored relationships between anhedonia and posttraumatic stress disorder (PTSD) symptom clusters, including their role in predicting psychiatric comorbidity. Our measure of anhedonia was derived from an examination of the latent structure of the Beck Depression Inventory. We found evidence for a two-factor solution, leading to anhedonia and undifferentiated, global depressive symptoms scales.

Social anxiety disorder in veterans affairs primary care clinics.

To examine the prevalence and correlates of social anxiety disorder (SAD) in veterans, 733 veterans from four VA primary care clinics were evaluated using self-report questionnaires, telephone interviews, and a 12-month retrospective review of primary care charts. We also tested the concordance between primary care providers' detection of anxiety problems and diagnoses of SAD from psychiatric interviews. For the multi-site sample, 3.

Telehealth service delivery for persons with alcoholism.

Videoconferencing at a bandwidth of 384 kbit/s was used in open sessions for subjects with alcohol use disorders (AUD). Study participants received eight sessions of group therapy over a four-week period from an accredited addictions counsellor. Outcome assessment included self-report measures, a qualitative interview and a chart review.

Subthreshold PTSD in primary care: prevalence, psychiatric disorders, healthcare use, and functional status.

The purpose of this study is to determine the prevalence of subthreshold posttraumatic stress disorder (PTSD) and its association with specific traumas, other psychiatric diagnoses, healthcare use, and functional status among 669 veterans in four VA Medical Centers. A cross-sectional, epidemiological design incorporating self-report measures, structured interviews, and chart reviews was used to obtain relevant information for analyses. Comparisons across three trauma-exposed groups (PTSD, subthreshold PTSD, no PTSD) revealed that veterans in the subthreshold PTSD group did not use mental health services more often than those in the no PTSD group despite the presence of additional mental health diagnoses and worse functional status.

Müllerectomy for upper eyelid retraction and lagophthalmos due to facial nerve palsy.

Background: Facial nerve palsy often results in symptoms of ocular irritation due to inadequate eyelid closure. Weakened protractor function results in relative upper eyelid retraction and contributes to lagophthalmos.

Objective: To evaluate the role of müllerectomy in the comprehensive surgical treatment of ocular exposure due to facial nerve palsy.

Consumers' perceptions of negative experiences and "sanctuary harm" in psychiatric settings.

Objective: Recent studies show a high prevalence of trauma symptoms among people with serious mental illness who are treated in public-sector mental health systems. Unfortunately, growing evidence suggests that many consumers have had traumatic or harmful experiences while being treated in various psychiatric settings. This study explores consumers' perceptions of such harmful inpatient experiences, events that the authors place under the rubric of "sanctuary harm.

Patients' reports of traumatic or harmful experiences within the psychiatric setting.

Objective: This study examined the frequency and associated distress of potentially traumatic or harmful experiences occurring within psychiatric settings among persons with severe mental illness who were served by a public-sector mental health system.

Methods: Participants were 142 randomly selected adult psychiatric patients who were recruited through a day hospital program. Participants completed a battery of self-report measures to assess traumatic and harmful events that occurred during the course of their mental health care, lifetime trauma exposure, and symptoms of posttraumatic stress disorder.

Trauma-related mental health needs and service utilization among female veterans.

Women constitute a growing segment of the military veteran population and researchers have begun to examine the extent to which their mental health needs are appropriately addressed within the Veterans Affairs (VA) healthcare system. Existing research documents high rates of both military and non-military trauma among female veterans; however, little has been done to examine the extent to which female veterans exposed to trauma receive treatment for trauma-related problems such as posttraumatic stress disorder (PTSD) and substance abuse within the VA system. This article reviews the literature documenting a high rate of trauma exposure among female veterans and examines evidence that trauma-related mental health problems, such as PTSD and substance-use problems, are under-diagnosed and under-treated among female veterans in VA healthcare settings.

Patient satisfaction among combat veterans receiving specialty PTSD treatment.

Background: Despite the difficulties with successfully developing effective treatments for posttraumatic stress disorder (PTSD), very little research has been conducted on veterans' perceptions of satisfaction with the treatments they receive through the VA.

Objective: Our objective was to evaluate combat veterans' satisfaction with Veterans Affairs (VA) services and to evaluate the reliability and preliminary validity of a measure of patient satisfaction, the Charleston Psychiatric Outpatient Satisfaction Scale-VA PTSD Version, which was originally designed for general psychiatric outpatients.

Method: Fifty-one combat veterans currently receiving specialty mental health care at a VA outpatient PTSD clinic were asked to complete two instruments designed to assess their satisfaction with services provided within the VA mental health and primary care clinics.

Documented combat exposure of US veterans seeking treatment for combat-related post-traumatic stress disorder.

Background: There are concerns regarding the validity of combat exposure reports of veterans seeking treatment for combat-related post-traumatic stress disorder (PTSD) within US Veterans Affairs Medical Centers.

Aims: To verify combat exposure history for a relevant sample through objective historical data.

Method: Archival records were reviewed from the US National Military Personnel Records Center for 100 consecutive veterans reporting Vietnam combat in a Veterans Affairs PTSD clinic.

Tocotrienol inhibits proliferation of human Tenon's fibroblasts in vitro: a comparative study with vitamin E forms and mitomycin C.

Purpose: To evaluate the potential of the vitamin E compound alpha-tocotrienol as antifibrotic agent in vitro.

Methods: Using human Tenon's capsule fibroblast cultures, the antiproliferative and cytotoxic effects of the different vitamin E forms alpha-tocopherol, alpha-tocopheryl acetate, alpha-tocopheryl succinate and alpha-tocotrienol were compared with those of mitomycin C. To mimic subconjunctival and regular oral application in vivo, exposure time of serum-stimulated and serum-restimulated fibroblasts (SF and RF, respectively) to vitamin E forms was set at 6 days.

Mutations in PIP5K3 are associated with François-Neetens mouchetée fleck corneal dystrophy.

François-Neetens fleck corneal dystrophy (CFD) is a rare, autosomal dominant corneal dystrophy characterized by numerous small white flecks scattered in all layers of the stroma. Linkage analysis localized CFD to a 24-cM (18-Mb) interval of chromosome 2q35 flanked by D2S2289 and D2S126 and containing PIP5K3. PIP5K3 is a member of the phosphoinositide 3-kinase family and regulates the sorting and traffic of peripheral endosomes that contain lysosomally directed fluid phase cargo, by controlling the morphogenesis and function of multivesicular bodies.

Remote psychotherapy for terminally ill cancer patients.

We conducted a feasibility study of remote psychotherapy in 10 terminally ill cancer patients with diagnoses of adjustment disorder or major depression. Subjects received six sessions of individual cognitive therapy with the same therapist. Sessions alternated between face-to-face sessions and remote sessions delivered by analogue videophone.

Prevalence of posttraumatic stress disorder in Veterans Affairs primary care clinics.

Although posttraumatic stress disorder (PTSD) is relatively common in community epidemiologic surveys (5-6% for men, 10-12% for women), and psychiatric patients with PTSD are known to have poor functioning and high levels of psychiatric comorbidity, there are no studies that address PTSD prevalence, functioning, and burden in primary care settings. This article reports on (1) the prevalence of PTSD using Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition diagnostic criteria in Veterans Affairs (VA) primary care settings, (2) associated sociodemographic characteristics and comorbidities, (3) functional status related to PTSD, (4) the extent to which PTSD was recognized by providers and (5) health services use patterns (including specialty mental health) of PTSD patients. Patients were randomly selected from those who had an outpatient visit in FY 1999 at one of four VA hospitals; 888 patients consented (74.

Topical caspofungin for treatment of keratitis caused by Candida albicans in a rabbit model.

Candida albicans is the most frequent cause of fungal keratitis in temperate regions. Caspofungin has potent activity against Candida spp. in a variety of clinical settings.

Horizontal eyelid movement on eyelid closure.

Purpose: When performing ptosis surgery, a suture is placed between the levator and the tarsal plate at the point of the desired peak. This placement is done while the patient's eye is closed, but its effects are observed with the patient's eye open. Unaccounted-for horizontal eyelid movement on eyelid closing may therefore adversely affect the desired outcome.

Efficacy and efficiency of a new involutional ptosis correction procedure compared to a traditional aponeurotic approach.

Purpose: This was a retrospective study to compare the efficacy and efficiency of a new small anterior incision, minimal dissection ptosis procedure with that of a traditional anterior aponeurotic approach for the correction of aponeurotic ptosis.

Methods: The results of a chart and photograph review of 36 patients with 49 ptotic eyelids who had ptosis correction by a small-incision, minimal dissection procedure were compared with those of 36 patients with 49 ptotic eyelids who had ptosis correction by a traditional aponeurotic approach.

Results: The successful correction of the eyelid height and the rate of recommendation for reoperation were not significantly different for the 49 lids corrected in each arm of the study.

Collaborative care needs and preferences of primary care patients with multimorbidity.

OBJECTIVE To explore the collaborative care needs and preferences in primary care patients with multiple chronic illnesses. DESIGN Focus groups utilizing a series of open-ended questions elicited self-identified problems, experiences in communicating with providers, self-management needs, and preferences for monitoring and follow-up. Responses were organized and interpreted in light of the essential elements of collaborative care for chronic illness.

Telepsychiatry treatment outcome research methodology: efficacy versus effectiveness.

The use of videoconferencing technology to provide mental health services (telepsychiatry) offers hope for addressing longstanding problems regarding work force shortages and access to care, especially in remote or rural areas. However, data on treatment outcomes (i.e.

Efficacy and efficiency of a small-incision, minimal dissection procedure versus a traditional approach for correcting aponeurotic ptosis.

Objective: To compare the efficacy and efficiency of a new small anterior incision, minimal dissection ptosis procedure with that of a traditional anterior aponeurotic approach for the correction of aponeurotic ptosis.

Design: Retrospective, comparative, interventional case series.

Participants: Seventy-two patients with aponeurotic ptosis who had undergone ptosis correction surgery by 1 surgeon: 36 patients (49 ptotic eyelids) who had ptosis correction by a small-incision, minimal dissection procedure and 36 patients (49 ptotic eyelids) who had ptosis correction by a traditional aponeurotic approach.