Histopathological evaluation of ocular tissues is important in differentiating between infectious and autoimmune disease. Inflammation, necrosis and keratolysis are common to most forms of keratitis. ...Histopathology can be of great help in identifying the causative organism, establishing a final diagnosis and/or managing the patient with herpes simplex virus keratitis, mycotic keratitis, acanthamoeba keratitis or microsporidia keratoconjunctivitis. Important pathogenetic knowledge with therapeutic relevance has been gained from histopathological studies in nummular keratitis after epidemic keratoconjunctivitis and atopic keratoconjunctivitis.
Dry eye disease (DED) is a common disorder, accounting for up to 35% of the general population. Therefore, we hypothesized that laryngopharyngeal reflux (LPR), inducing refluxate rising into airways, ...may involve the ocular surface and may either induce or worsen DED.
To investigate the prevalence and relevance of suspected LPR in DED patients and subjects with refractive problems (RP) without DED, they were defined as non-dry eye group (NEG) in clinical practice.
This retrospective study included consecutive patients evaluated because of dry eye-like symptoms at eight tertiary ophthalmological clinics. Parameters included reflux symptom index (RSI), ocular surface disease index (OSDI), symptom assessment in dry eye (SANDE) for frequency and severity, Schirmer test, tear break-up time (BUT), and Oxford grading.
The study included 245 subjects (72.5% females; mean age 56.3 years), 152 DED patients, and 93 sex- and age-matched NEG subjects. Pathological RSI (score>13) was detected in 80 subjects (32.6%); 68 (85%) with DED and 12 (15%) CG (OR = 8; p < .0001). In NEG, pathological RSI was associated with higher SANDE (Frequency and Severity), OSDI, and Schirmer scores (OR = 16.36; 14.51; 12.54; and 7.22, respectively. In DED patients, pathological RSI was associated with higher OSDI values (OR = 8.75).
Patients with DED are at eight times higher risk for having pathological RSI than NEG patients. Moreover, pathological RSI was associated with more severe ocular symptoms both in DED and non-DED patients. The role of LPR in definite DED patients remains to be clarified, but this condition deserves to be investigated in managing patients with DED symptoms.
Celotno besedilo
Dostopno za:
DOBA, IJS, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
Background Overdose deaths continue to rise within the United States, despite effective treatments such as buprenorphine and methadone for opioid use disorder (OUD). Mobile medical units with the ...ability to dispense buprenorphine have been developed to engage patients and eliminate barriers to accessing OUD treatment. This study reports survey responses of patients of a mobile medical unit dispensing buprenorphine in areas of Chicago, IL with high overdose rates. Methods All patients who were dispensed buprenorphine via the mobile medical unit were invited to participate in a 7-item anonymous survey between May 24, 2023, and August 25, 2023. The survey included 5-point satisfaction scale, multiple-choice, and open-ended questions. Outcomes included satisfaction with buprenorphine dispensing from the mobile medical unit, satisfaction with filling buprenorphine at a pharmacy in the past, barriers experienced at pharmacies when filling buprenorphine, and whether the client would have started treatment that day if the mobile medical unit had not been present. Satisfaction scale and multiple-choice question responses were assessed using descriptive statistics. Wilcoxon signed-rank test was used to compare median satisfaction levels between receiving buprenorphine from the mobile medical unit versus filling a buprenorphine prescription at a community pharmacy. Open-ended questions were analyzed qualitatively using inductive thematic analysis. Results 106 unique patients were dispensed buprenorphine from the mobile unit during the study period. Of these patients, 54 (51%) completed the survey. Respondents reported high satisfaction with the buprenorphine dispensing process as a part of a mobile medical unit. Of those who had previously filled buprenorphine at a pharmacy, 83% reported at least one barrier, with delays in prescription dispensing from a community pharmacy, lack of transportation to/from the pharmacy, and opioid withdrawal symptoms being the most common barriers. 87% reported they would not have started buprenorphine that same day if the mobile medical unit had not been present. Nearly half of survey participants reported having taken buprenorphine that was not prescribed to them. Qualitative analysis of open-ended survey responses noted the importance of convenient accessibility, comprehensive care, and a non-judgmental environment. Conclusions Mobile medical units that dispense buprenorphine are an innovative model to reach patients with OUD who have significant treatment access barriers. This study found that patients who experienced barriers to accessing buprenorphine from a pharmacy were highly satisfied with the mobile medical unit's buprenorphine dispensing process. Programs seeking to develop mobile buprenorphine dispensing programs should consider patient priorities of accessibility, comprehensive care, and welcoming, non-judgmental environments. Keywords: Opioid use disorder, Buprenorphine, Mobile medical unit, Low-threshold, Harm reduction
The authors report the first results of a GaAs/AlGaAs buried-heterostructure vertical-cavity surface-emitting laser (VCSEL) with semi-insulating Ga sub(0.51)In sub(0.49)P:Fe (SI-GaInP:Fe) as the ...burying layer. Regrowth of SI-GalnP:Fe around 15 mu m diameter and 8 mu m tall VCSEL mesas was carried out by hydride vapour phase epitaxy (HVPE). Linder room temperature continuous wave (CW) operation, the device exhibited a threshold current of 3.5 mA, a differential quantum efficiency of 33% and a light output power of 4.2 mW. CW operation at temperatures up to 97degreesC is also demonstrated.
► Use of scanning transmission electron microscopy-high angle annular dark field (STEM-HAADF) to quantify composition modulation. ► Quantification of composition modulation in InxGa1−xP layer. ► ...Absolute variation in Indium content in InxGa1−xP layer of 4.25%. ► The compositional variation of the compound affects the Eg, causing negative effects on the overall efficiency of the device.
Multijunction solar cell efficiency is highly sensitive to structural and chemical variations. These variations can be quantified at nm scale in InGaP/InGaAs/Ge multijunctions using transmission electron microscopy modes, e.g. diffraction contrast (DC-CTEM) and high angle annular dark field (STEM-HAADF). These studies determined the structure and the composition modulation of InGaP layers with sensitivity below 1% of In composition. To quantify the In-related variation, STEM-HAADF profiles are compared to numerically simulated ones. The fit with the experimental contrast shows local variations of 4.25%In for distances below 30nm.
Acute bacterial conjunctivitis is a common health-care issue for the general practitioner and the ophthalmologist. Signs and symptoms usually allow a correct diagnosis without conjunctival swab. ...Primary microbiological investigations are recommended in newborns, immunocompromised patients and cases of hyperacute conjunctivitis. Of concern are methicillin-resistant Staphylococcus aureus strains which have been isolated with increasing frequency in the last few years. Studies have demonstrated the faster clinical and microbiological cure of acute bacterial conjunctivitis with topical antibiotics. However, the development of resistance of the typical germs to all of the antibiotic groups is alarming and should influence therapeutic behaviour. Fluoroquinolones show good activity in the treatment of acute bacterial conjunctivitis but should be saved for severe infections due to its broad spectrum of activity. Antibiotics such as gentamycin, tobramycin, and azithromycin should be preferred. Considering the high spontaneous healing rate of acute conjunctivitis, delayed topical antibiotics in case of persistence after 3-4 days, or treatment without antibiotics using artificial tears and eye bathings may be considered. Additive anti-inflammatory drugs are generally not recommended. Chronic-recurrent follicular conjunctivitis necessitates testing for Chlamydia, and in case of a positive result, systemic antibiotic treatment of patient and sexual partner.
In vivo confocal microcopy is a fascinating technique to obtain rapidly and non-invasively histological/cytological sections of the ocular surface, and observe long-term changes. It allows ...classification of corneal findings, facilitates the diagnosis of conjunctival lesions, and has broadened our understanding of lid margin disease. To correctly interpret in vivo confocal scans, profound knowledge of microscopic anatomy and histopathology are crucial. To reduce inter-observer variability and allow comparison of scientific studies, in vivo confocal-histopathological correlations have to be investigated, and standards for the interpretation of in vivo confocal microscopic findings must be established. In suspicious lesions of the ocular surface an excisional biopsy and histopathological examination are still the gold standard.
Purpose
The objective of this study was to compare the efficacy and safety of a polyethylene glycol/propylene glycol based eye drop (PEG/PG; Systane® Ultra) to an ...osmoprotective‐carboxymethylcellulose based eye drop (CMC/O; Optive®) in patients with dry eye.
Methods
This was a multicenter, observer masked, parallel‐design study, subjects were randomized to PEG/PG or CMC/O QID for 35 days (Phase 1) and then as needed for 55 days (Phase 2). Eligible subjects were diagnosed with dry eye and exhibited signs and symptoms at screening. Supportive efficacy assessments included the total ocular staining score (TOSS) score change from baseline to Day 90 (15‐point Oxford scale).
Results
Demographic characteristics were similar between the PEG/PG (n = 46) and CMC/O groups (n = 48). The efficacy of PEG/PG was similar to CMC/O at Day 90 (LS mean treatment difference in TOSS score change from baseline to Day 90 of −0.10 units in favor of PEG/PG). In addition, ocular surface staining associated with dry eye decreased following treatment with PEG/PG with a mean TOSS score change from baseline at Day 90 of −2.7 units. No treatment‐related serious adverse events were reported. Five subjects discontinued due to treatment‐related AEs (2 PEG/PG and 3 CMC/O subjects).
Conclusions
PEG/PG based drop demonstrated comparable efficacy to the CMC/O based drop after 90 days treatment with a favorable safety profile in patients with dry eye.
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