Efficacy of transpupillary thermotherapy (TTT) in the treatment of occult subfoveal choroidal neovascularization in age-related macular degeneration.

PURPOSE: To determine the efficacy of transpupillary thermotherapy (TTT) in the treatment of occult subfoveal choroidal neovascularization in patients with age-related macular degeneration (ARMD). METHODS: We conducted a retrospective review of patients with ARMD treated with TTT from June, 1999 through July, 2000 at a retina referral practice. TTT was delivered through a slit-lamp using a modified diode laser at 810 nm wavelength and a spot size of 3 mm delivered at one location for a minimum of 60 seconds duration. Re-treatment was performed at 2-month intervals if indicated. RESULTS: 81 eyes of 77 patients were included in the study. Vision improved greater than one line Snellen in 18 eyes (22%), vision was stable within one line Snellen in 38 (47%), and worsened greater than one line Snellen in 25 (31%). Patients had a mean follow-up of 9 months. The average number of treatments was 1.37 (range 1 to 4). Pretreatment vision was less than or equal to 20/200 in 54% of eyes. CONCLUSIONS: Transpupillary thermotherapy may stabilize visual acuity in a majority of patients with occult subfoveal choroidal neovascularization secondary to ARMD. Proof of therapeutic benefit is best determined by a randomized clinical trial that is currently underway (TTT4CNV).

Carbon monoxide poisoning in racing car drivers.

BACKGROUND: To determine if carbon monoxide (CO) exposure during competition racing is significant enough to cause post-racing symptoms among professional racing drivers. METHODS: Closed vehicle professional racing drivers were questioned after competition regarding symptoms consistent with heat exposure, dehydration, and carbon monoxide poisoning. All drivers, regardless of symptoms, underwent expired CO monitoring using a breath analyzer both before and after competition events. CO measurements were performed prior to any post-race interviews. Driver smoking history, laps at low speed (under caution), cockpit fire or damage to the exhaust system were also noted. An association between driver symptoms, track and vehicle condition, and increases in expired CO levels during racing was sought. RESULTS: Twenty-eight drivers completed the study. Each driver was tested both before and after each competition event, and some drivers were tested at different tracks. All of the tested drivers experienced an increase in carboxyhemoglobin concentrations during the competition event. Drivers who smoked had higher baseline levels than non-smokers, but were no more likely to have symptoms. The driver with the highest post-race CO level was exposed to a fire which completely destroyed the vehicle, but he complained of no symptoms after the race. Most drivers complained of post-race symptoms or appeared symptomatic, but no correlation could be shown between post-race CO levels and symptoms. CONCLUSIONS: There is a mild increase in driver CO levels during professional road racing competition, however, no correlation with CO level and driver symptomatology can be demonstrated. Carbon monoxide does not appear to be a significant cause of post-race driver symptoms such as fatigue, nausea, headache, and weakness.

Female United States Air Force (USAF) pilots: themes, challenges, and possible solutions.

BACKGROUND: Identification of stresses of mixed-gender squadrons, attention to the psychological concerns of pilots in combat, and recognition of the difficulties of balancing a career and family are important in today's United States Air Force (USAF). What qualities are desirable in male and female pilots in combat situations, how do men and women view their career and family goals, and how do men and women work together in day-to-day squadron activities versus deployment and combat situations? METHODS: A semi-structured clinical interview sought in formation about personal/family health, squadron relationships, and career/deployment stresses. The interview covered the effect of grounding for more than 30 d, motivation to fly, health decrements due to aircraft design, teamwork difficulties and blocks to success, career demands, combat and prisoner of war (POW) concerns, stress and coping styles, flying goals, and family/health concerns. There were 114 (64 male and 50 female) pilots who participated in the study. RESULTS: The majority of male pilots interviewed asserted that they would be more protective of a woman in combat than a man and were concerned about their reaction to a female POW. Many women were concerned about being used to exploit men in a POW camp. The majority of pilots believed women were well integrated into their squadrons. Those interviewed reported that the squadron members with the most difficulty dealing with women were older males, including enlisted crew and some commanders. CONCLUSION: The information gained from this study will assist the USAF in understanding and coping with the psychological stresses associated with combat, deployment, and mixed-gender squadrons.

An investigation of differences in attitudes between suicidal and nonsuicidal student ideators.

Suicidal activity among youths has increased dramatically in recent years, yet little objective research in non-hospital settings has been conducted. The present study analyzed attitudes of suicidal ideator and nonideator groups at elementary, middle, and high school levels. Responses to the Student Attitude Measure (S.A.M.) were analyzed with a multivariate analysis of variance. Ideators' attitudes were found to be significantly more negative than those of nonideators. Some grade level and gender differences also were revealed. The ability of this instrument to differentiate potentially suicidal youths from their nonsuicidal peers has the potential for providing schools with a critical proactive strategy.