A Review of the Ahmed Glaucoma Valve Implant and Comparison with Other Surgical Operations

The Ahmed glaucoma valve (AGV) is a popular glaucoma drainage implant used for the control of intraocular pressure in patients with glaucoma. While in the past AGV implantation was reserved for glaucoma patients poorly controlled after one or more filtration procedures, mounting evidence has recently encouraged its use as a primary surgery in selected cases. AGV has been demonstrated to be safe and effective in reducing intraocular pressure in patients with primary or secondary refractory glaucoma. Compared to other glaucoma surgeries, AGV implantation has shown favorable efficacy and safety. The aim of this article is to review the results of studies directly comparing AGV with other surgical procedures in patients with glaucoma

Evaluating the effect of pupil dilation on spectral-domain optical coherence tomography measurements and their quality score

BACKGROUND: Spectral-domain optical coherence tomography (SD-OCT) provides fast scan speed and high scan resolution improving its diagnostic accuracy. The purpose of this study was to evaluate if SD-OCT measurements and their quality score are influenced by pupil dilation. METHODS: Retinal nerve fiber layer thickness (RNFL), ganglion cell complex (GCC) and optic nerve head (ONH) were measured in one eye of 57 glaucoma patients and 36 healthy subjects using spectral domain optical coherence tomography (SD-OCT) before and after pupil dilation. Comparisons were made between measurements and their quality score pre- and post dilation (Signal Strength Index, SSI). Overall RNFL, average GCC and ONH rim volume were considered in the analysis. RESULTS: No statistically significant differences were found between pre- and post-dilation measurements in both groups (glaucoma: RNFL 80 ± 15 μm vs 80 ± 16 μm, p = 0.87; GCC 81.35 ± 13.4 μm vs 81.10 ± 13.14 μm, p = 0.92; ONH 0.05 ± 0.11 mm(3) vs 0.04 ± 0.07 mm(3), p = 0.74; controls RNFL 99 ± 12 μm vs 98 ± 14 μm, p = 0.70; GCC 92.12 ± 6.7 μm vs 91.54 ± 7.05 μm, p = 0.72; ONH 0.11 ± 0.1 mm(3) vs 0.04 ± 0.07 mm(3), p = 0.36) nor between pre- and post-dilation quality score (glaucoma SSI RNFL 54.3 ± 10.3 vs 51.7 ± 18.1, p = 0.12; SSI GCC 58 ± 9.5 vs 57 ± 8.09, p = 0.55; SSI ONH 48.5 ± 7.6 vs 46.6 ± 7.2, p = 0.16; controls SSI RNFL 57 ± 10.3 vs 54 ± 9.31, p = 0.2; SSI GCC 60.9 ± 8.1 vs 58.8 ± 7.3, p = 0.3; SSI ONH 51.5 ± 8.9 vs 50.4 ± 8.3, p = 0.59). CONCLUSION: Pupil dilation doesn’t affect SD-OCT measurements and their quality score

Citicoline in Ophthalmological Neurodegenerative Disease: A Comprehensive Review

Cytidine 5'-diphosphocholine has been widely studied in systemic neurodegenerative diseases, like Alzheimer's disease, Parkinson's disease, and brain ischemia. The rationale for the use of citicoline in ophthalmological neurodegenerative diseases, including glaucoma, anterior ischemic optic neuropathy, and diabetic retinopathy, is founded on its multifactorial mechanism of action and the involvement in several metabolic pathways, including phospholipid homeostasis, mitochondrial dynamics, as well as cholinergic and dopaminergic transmission, all being involved in the complexity of the visual transmission. This narrative review is aimed at reporting both pre-clinical data regarding the involvement of citicoline in such metabolic pathways (including new insights about its role in the intracellular proteostasis through an interaction with the proteasome) and its effects on clinical psychophysical, electrophysiological, and morphological outcomes following its use in ophthalmological neurodegenerative diseases (including the results of the most recent prospective randomized clinical trials)

Contraception and post abortion services: Qualitative analysis of users' perspectives and experiences following Zika epidemic in Honduras

Background: Zika virus (ZIKV) infection during pregnancy has severe consequences on the new-born. The World Health Organization declared the Zika outbreak to be a Public Health Emergency of International Concern (PHEIC) in 2016. Health facilities in the regions most affected by Zika lacked the capacity to respond to the increased demand for contraception. The objectives were to explore healthcare users' perceptions regarding contraception, Zika prevention during pregnancy and post-abortion care (PAC) services in the context of a Zika outbreak in Tegucigalpa, Honduras, and to follow these services over time. Methods: This study was part of a broader implementation research study. We used qualitative research consistent with grounded theory approach. Semi-structured interviews and focus groups were performed with women and their partners who used contraceptive services or received PAC services. Data were collected in two stages from December 2017 to July 2018. Themes explored included contraception, Zika and PAC services. Results: Participants had positive attitude towards the use of contraceptive methods and demanded more information on safety, efficacy and on side effects. Health care services were inconsistent in the provision of information on Zika and contraception services. ZIKV vector transmission was known but fewer participants were aware of risk of sexual transmission of Zika. Barriers to access healthcare services included contraceptive and PAC services included distance to healthcare facilities, disorganized admission process, long waiting times and out-of-pocket expenditure to purchase medicines. Furthermore, poor quality, mistreatment and abuse of women seeking PAC was prevalent. Some positive changes were noted over time, such as improvements in infrastructure including improved privacy and cleanliness, removal of fees, requisite to bring clean water to hospital. Conclusions: Our results highlight the challenges and areas for improvement in policy and practice related to contraceptive services and PAC in the context of ZIKV infection. Public policies to prevent epidemics should focus more on providing proper sanitation; removing barriers to access and use of effective contraception as human rights priority. Zika epidemic has highlighted weaknesses in health systems that obstruct access to and use of sexual and reproductive health services. The study results call for increased efforts to improve access, especially for women of low socio-economic status and intervene at different levels to eradicate discrimination and improve equity in the provision of health care. Qualitative methods can capture the community perspectives and can provide useful information to develop interventions to improve services.Fil: Belizan, Maria. Instituto de Efectividad Clínica y Sanitaria; ArgentinaFil: Maradiaga, Edna. Facultad de Ciencias Médicas; HondurasFil: Roberti, Javier Eugenio. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; ArgentinaFil: Casco Aguilar, Maricela. Facultad de Ciencias Médicas; HondurasFil: Ortez, Alison F.. Facultad de Ciencias Médicas; HondurasFil: Avila Flores, Juan C.. Facultad de Ciencias Médicas; HondurasFil: González, Gloria. Hospital Escuela; HondurasFil: Bustillo, Carolina. Hospital Escuela; HondurasFil: Calderón, Alejandra. Centro de Salud Alonso Suazo; HondurasFil: Bock, Harry. No especifíca;Fil: Cafferata, María L.. Instituto de Efectividad Clínica y Sanitaria; ArgentinaFil: Tavares, Adriano B.. Organizacion Mundial de la Salud; ArgentinaFil: Alger, Jackeline. Facultad de Ciencias Médicas; HondurasFil: Ali, Moazzam. Organizacion Mundial de la Salud; Argentin

Detection of Central Visual Field Defects in Early Glaucomatous Eyes: comparison of Humphrey and Octopus perimetry

Purpose: To compare the detection rate of central visual field defect (CVFD) between the 30-degree Octopus G1 program (Dynamic strategy) and the HFA 10–2 SITA-Standard test in early glaucoma eyes not showing any CVFD on the HFA 24–2 SITA-Standard test. Methods: One eye of 41 early glaucoma patients without CVFD in the central 10 on HFA 24–2 test was tested with both the HFA 10–2 test and the Octopus G1 program 15 minutes apart, in random order. The primary outcome measure was the comparison of CVFD detection rates. Secondary outcome measures comprised the agreement in detecting CVFD, and the comparison of test durations and the numbers of depressed test points outside the central 10-degree area between the HFA 24–2 test and the Octopus G1 program. Results: The mean age of the population was 65.2±10.1 years, and the mean deviation with HFA 24–2 was -3.26±2.6 dB. The mean test duration was not significantly different between the tests (p = 0.13). A CVFD was present in 33 (80.4%) HFA 10–2 test and in 23 (56.0%) Octopus G1 tests (p = 0.002). The overall agreement between the HFA 10–2 and Octopus G1 examinations in classifying eyes as having or not having CVFD was moderate (Cohen’s kappa 0.47). The Octopus G1 program showed 69.6% sensitivity and 100% specificity to detect CVFD in eyes where the HFA 10–2 test revealed a CVFD. The number of depressed test points (p<5%) outside the central 10 area detected with the Octopus G1 program (19.68±10.6) was significantly higher than that detected with the HFA 24–2 program (11.95±5.5, p<0.001). Conclusion: Both HFA 10–2 and Octopus G1programs showed CVFD not present at HFA 24–2 test although the agreement was moderate. The use of a single Octopus G1 examination may represent a practical compromise for the assessment of both central and peripheral visual field up to 30 eccentricity without any additional testing and increasing the total investigation time

La doppia pena delle donne detenute: considerazioni sul contesto italiano

Nel primo capitolo si cercheranno di approfondire quali siano le ragioni e le motivazioni che sin dall’antichità spingono le donne a delinquere. Si restituiranno in modo sintetico le principali prospettive teoriche sulla criminalità femminile e si presenterà un excursus sulla storia della detenzione femminile. In questa parte del lavoro, si dedicherà spazio anche ad un approfondimento quantitativo sulle donne detenute in Italia, per tipologia di reato e collocazione nei vari istituti penitenziari. Nel secondo capitolo, invece, il focus si sposta sulle donne detenute madri. Verranno prese in esame i bisogni specifici di questa categoria di detenute, le implicazioni etiche e le profonde contraddizioni della normativa. Una doppia pena? Se la maternità incarna, ancora oggi, l’onestà e la virtù femminile, con il reato si tradisce l’essere madre e la perdita dei figli è la punizione per aver varcato il Rubicone del femminile. Le colpe dei padri non ricadono sui figli, ma quelle delle madri sì, colpevolizzando così le donne, ben due volte. Infine, nel terzo capitolo, in linea di coerenza con le parti precedenti del lavoro, si restituiscono i risultati di un approfondimento empirico di tipo qualitativo che ha inteso valorizzare le narrazioni di testimoni privilegiate, donne con una o più esperienze di detenzione

Potential for biocontrol of Pleurotus ostreatus green mould disease by Aureobasidium pullulans De Bary (Arnaud)

Pleurotus ostreatus, commonly known as “oyster mushroom”, is an edible fungus economically important worldwide. The green mould, caused by Trichoderma pleuroti and T. pleuroticola, is a very important fungal disease, and it is commonly controlled by the use of fungicides. The yeast-like fungus Aureobasidium pullulans is a biocontrol agent naturally found throughout a wide range of habitats. The effect of A. pullulans L1 and L8 strains on P. ostreatus, T. pleuroti and T. pleuroticola was studied in in vitro assays. Both yeast strains resulted compatible with P. ostreatus growth, and effective in reducing the T. pleuroticola and T. pleuroti colony growth. The inhibitory effect of L1 and L8 was similar in the majority of the Trichoderma-A. pullulans combinations on agar plates. Both strains were more efficient than Trichoderma in substrate colonization, and produced volatile and nonvolatile metabolites which reduced Trichoderma growth. When the activity of L1 and L8 was tested against the green mould disease of P. ostreatus under controlled conditions similar to those of a mushroom farm, only L8 was effective in controlling the disease. It showed an effect similar to that of the fungicide prochloraz against T. pleuroticola, the less aggressive pathogen, and lower than that of the fungicide against T. pleuroti, the most aggressive. The antagonism was the result of mechanisms like antibiosis and competition for space and nutrients, whereas the direct attachment of A. pullulans with hyphae of the pathogens did not play a role

Biocontrol ability of Trichoderma harzianum strain T22 against Fusarium wilt disease on water-stressed lettuce plants

The control ability of Trichoderma harzianum strain T22 against Fusarium wilt of lettuce caused by Fusarium oxysporum f.sp. lactucae strain 365.07 was studied through mesocosm assays under extreme soil water content available for plants (-0.5 and -0.03 MPa).T22 was applied to nursery substrate at seeding, and to mesocosm soil at transplant of seedlings artficially infected by the pathogen. T22 decreased disease severity in comparison to infected controls by 57 and 78% in dry and wet conditions, respectively. Plant biomass was increased by T22 under both moisture levels. T22 colony growth, spore germination and antagonism to the pathogen were investigated under different water potential ( -0.03, -0.1, -0.5, -1.0, -2.0, -7.0 and -14.0 MPa) on minimal agar medium. All these parameters were influenced by water potential. However, they were similar at the same MPa values tested in the mesocosm assays.Our results provide evidence that T. harzianum strain T22 could be effective to control wilt disease caused by F. oxysporum f.sp. lactucae strain 365.07 under extreme soil moisture regimes already present in Italy, and susceptible to become more frequent in the near future

Potential for biocontrol of Pleurotus ostreatus green mould disease by Aureobasidium pullulans De Bary (Arnaud)

Pleurotus ostreatus, commonly known as \u201coyster mushroom\u201d, is an edible fungus economically important worldwide. The green mould, caused by Trichoderma pleuroti and T. pleuroticola, is a very important fungal disease, and it is commonly controlled by the use of fungicides. The yeast-like fungus Aureobasidium pullulans is a biocontrol agent naturally found throughout a wide range of habitats. The effect of A. pullulans L1 and L8 strains on P. ostreatus, T. pleuroti and T. pleuroticola was studied in in vitro assays. Both yeast strains resulted compatible with P. ostreatus growth, and effective in reducing the T. pleuroticola and T. pleuroti colony growth. The inhibitory effect of L1 and L8 was similar in the majority of the Trichoderma-A. pullulans combinations on agar plates. Both strains were more efficient than Trichoderma in substrate colonization, and produced volatile and nonvolatile metabolites which reduced Trichoderma growth. When the activity of L1 and L8 was tested against the green mould disease of P. ostreatus under controlled conditions similar to those of a mushroom farm, only L8 was effective in controlling the disease. It showed an effect similar to that of the fungicide prochloraz against T. pleuroticola, the less aggressive pathogen, and lower than that of the fungicide against T. pleuroti, the most aggressive. The antagonism was the result of mechanisms like antibiosis and competition for space and nutrients, whereas the direct attachment of A. pullulans with hyphae of the pathogens did not play a role