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- [Lymphangioma of the orbitopalpebral area]. [English Abstract, Journal Article]
- Cesk Slov Oftalmol 2014; 70(4):152-9.
The authors refer about five patients with different types of lymphangioma, who were followed-up at the Department of Ophthalmology, Faculty Hospital Královské Vinohrady (Kings Vinegards), Charles University, Prague, Czech Republic, E.U., during the period 1995 - 2013; the follow-up period lasted from 5 to 17 years. The lymphangioma of the orbitopalpebral area is discussed according to the evaluation of the tumor development, histological verification, treatment, and its results.In four boys, the first signs of tumor were eyeball protrusion (exophthalmos) and bleeding into the conjunctiva or palpebral skin before the age of 5 years. In all four patients, the histological confirmation of the orbital lymphangioma was performed in the beginning of the disease. In three cases, it was the orbital type, and the fourth one was frontal type with bilateral orbital lymphangiomatosis. In one girl, there were present conjunctival changes only, appearing as one-sided hyperplastic changes. For these changes, she was followed-up since her 13 years of age under the false diagnosis of chronic conjunctivitis. The definite histological confirmation of only conjunctival lymphangioma was done from the diagnostic probatory biopsy not until ten years of symptoms and unsatisfactory treatment.In the girl with superficial conjunctival lymphangioma and in the patient with lymphangiomatosis, the follow-up was recommended only. In two patients with extraconal type of orbital tumor, the total or sub-total resection was performed. In the years of the follow-up, the remission of the disease was observed. In the patient with mostly intraconal type of the tumor, causing decrease of the visual acuity according to the optic nerve neuropathy and macular cystoid edema, the focused actinotherapy by means of linear accelerator treatment with the dose of 30 Gy after previous evacuation of chocolate cysts under ultrasound control. The regression of the tumor and normalized visual functions lasted for 17 years.As method of treatment of extraconal lymphangiomas, it seems, it is its resection, and in the intraconal localization of the tumor it is the focused actinotherapy by means of linear accelerator.Key words: orbital lymphangioma, conjunctival lymphangioma, lymphangiomatosis, tumor resection, linear accelerator actinotherapy.
- [Eponym 'Reiter' should better no longer be used]. [English Abstract, Journal Article]
- Ned Tijdschr Geneeskd 2014; 158(0):A7367.
From 1977 onwards international appeals have been made to use the descriptive term 'reactive arthritis' instead of the eponym 'Reiter' in medical literature. However, contrary to English publications the Dutch medical literature is not showing any obvious decline in the use of this eponym. As well as the fact that Reiter was not the first to describe the triad of arthritis, urethritis and conjunctivitis, he also was responsible for lethal medical experiments conducted in concentration camps during World War II. Since these two facts do not warrant eponymous regard for Reiter, the author proposes that this eponym no longer be used in Dutch medical vocabulary and that the descriptive term be used instead.
- Subcutaneous immunotherapy in Northern Israel: efficacy and safety. [Journal Article]
- Isr Med Assoc J 2014 Sep; 16(9):539-43.
The efficacy of subcutaneous immunotherapy for the treatment of allergic rhinitis, allergic conjunctivitis, allergic asthma and stinging insect hypersensitivity has been demonstrated in several studies.To investigate the effectiveness and side effects of immunotherapy in Israel and the relationship between local and systemic side effects.This retrospective study was based on patient records and a computerized database for drug dispensing over a 5 year period. Success was rated as partial or complete. Side effects were classified as local or systemic. Systemic side effects were further classified according to severity, as mild (cutaneous), moderate (respiratory symptoms), or severe (cardiovascular).Of the 135 patients on aero-allergen immunotherapy who reached maintenance, 120 (88.9%) exhibited complete or partial improvement and 15 (11.1%) did not improve. All of the 44 patients on hymenoptera immunotherapy reached effective maintenance doses. The mean percent side effects calculated per treatment (injection) were 2.49 for local and 1.58 for a systemic reaction during the build-up phase, and 1.13 and 1.12 during the maintenance phase, respectively. Rates of systemic reactions were 1.3% for cutaneous, 1.14% for respiratory and 0.97% for cardiovascular reactions during the build-up phase, and 1.11%, 0.53%, and 0.51% during the maintenance phase, respectively. The odds of systemic reactions were significantly higher in patients with local reactions both in the build-up phase (P = 0.03) and in the maintenance phase (P = 0.0003). The number of annual medications dispensed per patient decreased from 31.5 to 26.0 during the first year after reaching maintenance, and to 22.5 in the second year. Pharmaceutical costs were 67% lower 1 year after the start of the maintenance phase, compared to the year before the start of immunotherapy, and 63% lower in the second year (P = NS).Immunotherapy was effective and safe. Recognizing the benefits and safety of immunotherapy by physicians and health authorities is necessary to provide better care for allergic patients.
- Acute Increase of Children's Conjunctivitis Clinic Visits by Asian Dust Storms Exposure - A Spatiotemporal Study in Taipei, Taiwan. [JOURNAL ARTICLE]
- PLoS One 2014; 9(10):e109175.
Adverse health impacts of Asian dust storms (ADS) have been widely investigated and discussed in respiratory disease, but no study has examined the association between ADS events and their impact on eye diseases, especially in children. The impact of ADS events on the incidence of children's conjunctivitis is examined by analyzing the data from children's clinic visits registered in the 41 districts of Taipei area in Taiwan during the period 2002-2007. The structural additive regression modeling approach was used to assess the association between ADS events and clinic visits for conjunctivitis in children with consideration of day-of-the-week effects, temperature, and air quality levels. This study identifies an acute increase in the relative rate for children's conjunctivitis clinic visits during ADS periods with 1.48% (95% CI = 0.79, 2.17) for preschool children (aged <6 years old) and 9.48% (95% CI = 9.03, 9.93) for schoolchildren (aged ≥6 years old), respectively. The relative rates during post-ADS periods were still statistically significant, but much lower than those during ADS periods. The spatial analysis presents geographic heterogeneity of children's conjunctivitis clinic visits where higher relative rates were more likely observed in the most populated districts Compared to previous ADS studies related to respiratory diseases, our results reveals significantly acute impacts on children's conjunctivitis during ADS periods, and much influence on schoolchildren. Vulnerable areas were also identified in high density population.
- Chlamydia trachomatis related knowledge and practices in medical practioners--a survey. [Journal Article]
- Int J Emerg Ment Health 2014; 16(1):237-40.
Chlamydia trachomatis is a frequently encountered condition by general physicians, urologists and infectious diseases specialists. It can affect both genders and causes significant morbidity if not treated properly and promptly. In addition, it can cause ophthalmia neonatorum, which manifests as neonatal conjunctivitis in the newborns.The data was collected from fourteen tertiary care hospitals in two provinces of Pakistan during the time period of four months (September-December 2013). Inclusion criteria included all medical practitioners working at those hospitals and there were no limitations of age and gender to participate. The participants were approached through email which included a self administered questionnaire. Written consent was obtained from the participants and the study was approved by the ethical committee of all selected hospital.Overall 130 participants participated with a response rate of 65%. Females were 52.3% and males were 47.7%. In the study 17.7% of male and 29.4% of female participants proclaimed that they referred a patient to an infectious disease specialist in case the diagnosis of Chlamydia was dubious. 72.5% of the male and 55.8% of the female medical practitioners indicated that they yield detailed sexual history from the patients with Chlamydia. Regarding inquiring about the drugs history from the patient at risk of STDs, 22.6% male and 35.3% of female participants informed that they took a detailed drug history. Only 1.5% of the female medical practitioners notified Chlamydia to the partner of diseased patient themselves (provider referral). 24% male and 17.6% female participants had an understanding regarding the definite test of diagnosis for sexually transmitted Chlamydia.More sexual health skills development is required in medical practitioners working in Pakistan. The major deficient areas are sexual and drug history taking, management of sexually transmitted diseases and partner notification.
- Inflammatory manifestations of HTLV-1 and their therapeutic options. [Journal Article]
- Expert Rev Clin Immunol 2014 Nov; 10(11):1531-46.
Human T lymphotropic virus type 1 (HTLV-1) is one of the most intriguing retroviruses infecting humans. Most commonly, infection remains undetected, since it does not cause obvious harm, yet in 4-9% of patients, this infection can be devastating, causing adult T-cell leukemia/lymphoma and/or HTLV-1 associated myelopathy/tropical spastic paraparesis (HAM/TSP). This review concentrates on all inflammatory aspects of HTLV-1 infection: HAM/TSP, HTLV-1 associated uveitis, HTLV-1 associated conjunctivitis, sicca syndrome and interstitial keratitis, HTLV-1 associated Sjögren's syndrome, Hashimoto's thyroiditis and Graves' disease, HTLV-1 associated pulmonary disease, infective dermatitis associated with HTLV-1, HTLV-1 associated inflammatory myositis and HTLV-1 associated arthritis. With the exception of HAM/TSP treatment, studies of these conditions are sparse and even for HAM/TSP, the level of evidence is limited. While control or elimination of infection remains a goal, most therapy beyond symptomatic management is directed at the immune response to HTLV-1.
- 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.