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- 300IR 5-Grass pollen sublingual tablet offers relief from nasal symptoms in patients with allergic rhinitis. [JOURNAL ARTICLE]
- Am J Rhinol Allergy 2014 Oct 20.
300IR 5-grass pollen sublingual immunotherapy tablets have been approved for the treatment of allergic rhinitis (AR) with or without conjunctivitis in adults and children 5 years with grass pollen allergy. This study was designed to review data on nasal symptoms with 300IR 5-grass pollen sublingual tablets in adults and children.We reviewed data from four double-blind, placebo-controlled, randomized clinical trials. Two groups of patients who received a daily dose of either placebo or 300IR 5-grass pollen sublingual tablets starting 4 months before the expected start of the pollen season and continuing through the season were compared (analysis of covariance) for scores of sneezing, rhinorrhea, nasal pruritus, nasal congestion, total nasal symptom score (TNSS), and adult Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) scores.Data for 266 children (one pediatric trial) and 1036 adults (three trials) were analyzed. Compared with the placebo groups, mean TNSS in the 300IR groups was lower by 22% in children and 19-36% in adults. Among the four nasal symptoms, the lowest scores relative to placebo were for nasal congestion in children (31%) and adults (43%). Mean adult RQLQ scores were 21-31% lower in the 300IR group than in the placebo group.Allergen immunotherapy with 300IR 5-grass pollen sublingual tablets was consistently associated with AR symptom relief in adults and children and provided a clinically meaningful improvement in quality of life.
- Label-Free Biochemical Analytic Method for the Early Detection of Adenoviral Conjunctivitis using Human Tear Biofluids. [JOURNAL ARTICLE]
- Anal Chem 2014 Oct 21.
Cell culture and polymerase chain reaction are currently regarded as the gold standard for adenoviral conjunctivitis diagnosis. They maximize sensitivity and specificity, but require several days to three weeks to get the results. The aim of this study is to determine the potential of Raman spectroscopy as a stand-alone analytical tool for clinical diagnosis of adenoviral conjunctivitis using human tear fluids. A drop-coating deposition surface enhanced Raman scattering (DCD-SERS) method was identified as the most effective method of proteomic analysis in tear biofluids. The proposed DCD-SERS method (using a 2-µL sample) led to Raman spectra with high reproducibility, noise-independence, and uniformity. Additionally, the spectra were independent of the volume of biofluids used and detection zones, including the ring, middle, and central zone, with the exception of the outer layer of the ring zone. Assessments with an intensity ratio of 1242 to 1342 cm-1 achieved 100% sensitivity and 100% specificity in the central zone. Principal component analysis assessments achieved 0.9453 in the area under the receiver operating characteristic curve (AUC) as well as 93.3% sensitivity and 94.5% specificity in the central zone. Multi-Gaussian peak assessments showed that the differences between these two groups resulted from the reduction of the amide III α-helix structures of the proteins. The presence of adenovirus in tear fluids could be detected more accurately in the center of the sample than in the periphery. The DCD-SERS technique allowed for high chemical structure sensitivity without additional tagging or chemical modification, making it a good alternative for early clinical diagnosis of adenoviral conjunctivitis. Therefore, we are hopeful that the DCD-SERS method will be approved for use in ophthalmological clinics in the near future.
- Prevalence and Pattern of Eye Disorders among Commercial Motorcycle Riders in Ile-Ife, Osun state.Prevalence and Pattern of Eye Disorders among Commercial Motorcycle Riders in Ile-Ife, Osun state. [Journal Article]
- Niger Postgrad Med J 2014 Sep; 21(3):255-61.
To describe the prevalence and pattern of eye disorders existing among commercial motorcycle riders (CMRs) in Ile-Ife, Osun State. Materials, Subjects and Methods: A total of 1626 registered CMRs operated in 40 registered motorcycle assembly units in Ile-Ife. Using a multi- staged random sampling technique, a total of 322 riders were randomly selected from 10 units. Equal number of 322 was selected from the sample space as control. Structured questionnaires were administered and ocular examination carried out.SA total of 312 (96.9%) CMRs had normal vision (better than 6/18) in the better eye. The observed prevalence of subnormal visual acuity (<6/18-3/60) was 3.1% (10 CMRs) while prevalence of monocular vision was 2.8% (9 riders). Cataract and glaucoma were the major causes of visual impairment and blindness. The common ocular conditions seen were presbyopia (11.8%), allergic conjunctivitis (11.5%), glaucoma suspect (8.1%), pterygium (4.7%), pingueculum (4.0%), uncorrected refractive error (3.7%) and cataract (2.8%). It was also observed that the longer the years of riding experience of these riders, the higher the occurrence of pterygium with a significant statistical impact of p value of 0.009. Presbyopia was also the commonest disorder amongst the control group (11.2%).Presbyopia was the most common finding from the study while the commonest anterior segment disorder was pterygium which was an occupation- related ocular disorder. Causes of blindness seen were avoidable.
- A Sialic Acid Binding Site in a Human Picornavirus. [JOURNAL ARTICLE]
- PLoS Pathog 2014 Oct; 10(10):e1004401.
The picornaviruses coxsackievirus A24 variant (CVA24v) and enterovirus 70 (EV70) cause continued outbreaks and pandemics of acute hemorrhagic conjunctivitis (AHC), a highly contagious eye disease against which neither vaccines nor antiviral drugs are currently available. Moreover, these viruses can cause symptoms in the cornea, upper respiratory tract, and neurological impairments such as acute flaccid paralysis. EV70 and CVA24v are both known to use 5-N-acetylneuraminic acid (Neu5Ac) for cell attachment, thus providing a putative link between the glycan receptor specificity and cell tropism and disease. We report the structures of an intact human picornavirus in complex with a range of glycans terminating in Neu5Ac. We determined the structure of the CVA24v to 1.40 Å resolution, screened different glycans bearing Neu5Ac for CVA24v binding, and structurally characterized interactions with candidate glycan receptors. Biochemical studies verified the relevance of the binding site and demonstrated a preference of CVA24v for α2,6-linked glycans. This preference can be rationalized by molecular dynamics simulations that show that α2,6-linked glycans can establish more contacts with the viral capsid. Our results form an excellent platform for the design of antiviral compounds to prevent AHC.
- Ophthalmic Rosacea: Case Report in a Child and Treatment Recommendations. [JOURNAL ARTICLE]
- Pediatr Dermatol 2014 Oct 16.
We report a rare case of rosacea with ocular involvement in a child that remitted with prolonged anti-inflammatory oral tetracycline therapy and provide general expert recommendations. A 14-year-old girl presented with discrete papules and pustules on both cheeks with blepharitis and conjunctivitis. Ophthalmologic examination confirmed bilateral severe blepharitis, as well as a corneal infiltrate in the right eye with additional neovascularization. The diagnosis of rosacea with ocular involvement was made. In addition to the existing antibiotic and anti-inflammatory topical eye therapy, systemic treatment with minocycline 50 mg twice a day was started. After marked improvement, the dose was reduced to 50 mg once a day. After further amelioration, treatment was switched to maintenance therapy with 40 mg of prolonged-release doxycycline. Three years after a 12-month course of anti-inflammatory therapy, the patient remained recurrence free.
- Optic nerve injury in a patient with chronic allergic conjunctivitis. [Journal Article]
- Case Rep Neurol Med 2014.:928486.
Manipulation of the optic nerve can lead to irreversible vision changes. We present a patient with a past medical history of skin allergy and allergic conjunctivitis (AC) who presented with insidious unexplained unilateral vision loss. Physical exam revealed significant blepharospasm, mild lid edema, bulbar conjunctival hyperemia, afferent pupillary defect, and slight papillary hypertrophy. Slit lamp examination demonstrated superior and inferior conjunctival scarring as well as superior corneal scarring but no signs of external trauma or neurological damage were noted. Conjunctival cultures and cytologic evaluation demonstrated significant eosinophilic infiltration. Subsequent ophthalmoscopic examination revealed optic nerve atrophy. Upon further questioning, the patient admitted to vigorous itching of the affected eye for many months. Given the presenting symptoms, history, and negative ophthalmological workup, it was determined that the optic nerve atrophy was likely secondary to digital pressure from vigorous itching. Although AC can be a significant source of decreased vision via corneal ulceration, no reported cases have ever described AC-induced vision loss of this degree from vigorous itching and chronic pressure leading to optic nerve damage. Despite being self-limiting in nature, allergic conjunctivitis should be properly managed as extreme cases can result in mechanical compression of the optic nerve and compromise vision.
- Evaluation of tularemia cases focusing on the oculoglandular form. [Journal Article]
- J Infect Dev Ctries 2014; 8(10):1277-84.
Tularemia is a zoonotic disease caused by Francisella tularensis. The oculoglandular form is one of the rarest forms. In this study, evaluated tularemia patients, focusing on the ocular form and the efficacy of early antibiotic therapy.During a tularemia outbreak, the epidemiological and clinical findings, laboratory assays, and drugs used for the treatment of 48 patients were recorded prospectively. The diagnosis of tularemia was confirmed with microagglutination test (MAT) as well as clinical findings.The mean age of the subject was 48.6 years; 23 (47.9%) of them were female. Thirty-six (81.25%) patients had clinical presentation compatible with oropharyngeal tularemia, seven (14.58%) with oculoglandular tularemia, and two (4.1%) with ulceroglandular tularemia. The most common symptoms were fever (91.6%) and sore throat (81.2%), and the most common findings were lymphadenopathy (91.6%) and tonsillopharyngitis (81.2%). In the oculoglandular form, fever, lymphadenopathy, periorbital edema, conjunctival injection, and chemosis were found. The most distinctive ophthalmic feature was follicular conjunctivitis and conjunctival epithelial defects. Forty-five cases had positive serological results with MAT. All the patients were treated with antibiotics considered effective against F. tularensis, and topical antimicrobial treatment was given to the patients with oculoglandular tularemia. Twenty-six (54.16%) patients, who were admitted within three weeks of the onset of symptoms, recovered without sequel.During tularemia outbreaks, ocular involvement should be considered carefully. The early administration of appropriate treatment will be more effective in resolving the infection and preventing complications. Along with systemic antibiotic therapy, topical treatment will help recovery.
- [Epidemics of conjunctivitis caused by avian influenza virus and molecular basis for its ocular tropism]. [English Abstract, Journal Article]
- Zhonghua Yan Ke Za Zhi 2014 Jul; 50(7):550-2.
Avian influenza virus (AIV) has caused several outbreaks in humans, leading to disasters to human beings. The outbreak of H7N9 avian influenza in China in 2003 re-attracted our close attention to this disease. More and more evidences demonstrated that eye is one of invasion portals of AIV, leading to conjunctivitis. The current studies showed that only subtypes H7 and H5 could cause severe systemic infections. Abundant distribution of α-2, 3 siliac acid receptor in conjunctiva and cornea as well as specific activiation of NF-κB signal transduction pathway by subtype H7 virus may contribute to the ocular tropism of the virus. These studies suggest that avian influenza conjunctivitis should be considered as a differential diagnosis during influenza epidemic seasons, and eyes should be well protected for disease control personnel when handling avian influenza epidemics. This review focused on AIV conjunctivitis and the molecular basis of ocular tropism.
- Dacryocystitis following a nasolacrimal duct obstruction caused by an ectopic intranasal tooth in a dog. [JOURNAL ARTICLE]
- Vet Ophthalmol 2014 Oct 14.
To describe a nasolacrimal duct (NLD) obstruction secondary to an ectopic tooth in a 5-year-old male Border collie. The dog was presented with a 1-month history of mucopurulent discharge from the left eye (OS) preceded by a lifelong history of epiphora OS. Treatment with neomycin/polymyxin B/dexamethasone ophthalmic solution had not improved the clinical signs, and the NLD was not patent when irrigated by the referring veterinarian.A complete ophthalmologic examination was performed followed by dacryocystorhinography and computed tomography (CT).The ophthalmologic examination revealed marked mucopurulent discharge, mild conjunctivitis, slightly elevated STT measurements, and a negative Jones test OS. Both nasolacrimal puncta OS could be cannulated without resistance for approximately 1.5 cm. Upon irrigation, copious amounts of mucopurulent discharge were exited through the corresponding punctum, while no fluid could be detected at the nares. Dacryocystorhinography was performed. Radiographs revealed an ectopic left canine tooth within the left nasal cavity. A cystic dilation of the NLD was observed proximal to the ectopic tooth. Computed tomography was performed to determine the exact position of the tooth and possible involvement of adjacent structures; CT confirmed the previous imaging findings. Treatment with systemic antibiotics, NSAIDs, and ofloxacin ophthalmic solution led to resolution of the clinical signs within several days. Surgery was declined by the owner.This is the first case report describing a blocked NLD due to an ectopic tooth in a dog. Ectopic teeth should be included as a differential diagnosis in cases of dacryocystitis and chronic epiphora in dogs.
- Dexamethasone/Povidone Eye Drops versus Artificial Tears for Treatment of Presumed Viral Conjunctivitis: A Randomized Clinical Trial. [JOURNAL ARTICLE]
- Curr Eye Res 2014 Oct 13.:1-8.
Abstract Purpose: To determine whether topical dexamethasone 0.1%/povidone-iodine 0.4% reduces the duration of presumed viral conjunctivitis better than artificial tears and whether the treatment relieves the symptoms of this disease. Methods: Randomized, masked and controlled trial. One-hundred twenty-two patients with a clinical diagnosis of presumed viral conjunctivitis were randomized to either the treatment group or the control group. Physicians and patients were masked to the treatment. Swabs were taken from the conjunctival fornix for adenovirus PCR analyses. Patients in the treatment group received topical dexamethasone 0.1%/povidone-iodine 0.4% eye drops four times daily, and patients in the placebo group received artificial tears four times daily, both for seven days. Symptoms were recorded on the day of recruitment and at the time of a follow-up examination 5, 10 and 30 d later. The main outcome was duration of the disease. The others outcomes were overall discomfort, itching, foreign body sensation, tearing, redness, eyelid swelling, side effects of the eye drops, intraocular pressure and the incidence of subepithelial corneal infiltrates. Results: There was no statistically significant difference between the treatment group and the control group in terms of the patients' symptoms, intraocular pressure and incidence of subepithelial cornea infiltrates during the entire follow-up period. Patients of the treatment group reported more stinging (p < 0.001) and a shorter conjunctivitis duration (9.4 ± 4.6 d in the dexamethasone 0.1%/povidone-iodine 0.4% group versus 11.8 ± 4.9 d in the artificial tears group, p = 0.009). Conclusions: The use of topical dexamethasone 0.1%/povidone-iodine 0.4% eye drops four times daily appears to reduce the duration of conjunctivitis, although it causes more stinging than artificial tears.