Long-term efficacy and tolerability of TNFα inhibitors in the treatment of non-infectious ocular inflammation:an 8-year prospective surveillance study

BACKGROUND/AIM: To report the efficacy and tolerability of antitumour necrosis factor-alpha therapy (TNF inhibitors [TNFi]) in the management of non-infectious ocular inflammation, including uveitis and scleritis, in adult patients over an 8-year period. MATERIALS AND METHODS: This is a prospective cohort study of infliximab and adalimumab in the treatment of non-infectious ocular inflammatory disease. 43 of 85 adult patients on TNFi (34 infliximab, 9 adalimumab) for ≥1 year with non-infectious uveitis or scleritis were followed from 2006 to 2014. Clinical assessments, medication, adverse events and history of steroid rescues were collected at 6 monthly intervals. General quality of life (Short Form Health Survey (SF-36)) and visual quality of life (Vision-related quality of life Core Measure (VCM1)) were assessed annually. Outcome measures included rate of sustained remission, rate of relapse, systemic corticosteroid reduction, adverse events, and VCM1 and SF-36 scores. RESULTS: The median time on infliximab was 3.2 years (IQR 4.3) and on adalimumab was 2.4 years (IQR 1.8). Sustained remission was induced in 39 patients (91%) (0.5 per patient year) after a median of 1.2 years on a TNFi. 22 (51%) experienced one relapse, and 5 (12%) had two relapses. 23 (54%) had at least one adverse event; serious adverse events necessitating hospitalisation or cessation of medication occurred in four (9%) patients. 10 patients (23%) switched from the initiation of TNFi, at 1.7 years after starting, to another TNFi or another class of biologic therapy. CONCLUSION: TNFi treatment is associated with long-term drug-induced remission of ocular inflammation, visual stability and corticosteroid reduction. Adverse events were common and no new safety signals occurred. Relapse of inflammation occurs in half of the treated population

European lobster Homarus gammarus aquaculture: Technical developments, opportunities and requirements

The European lobster (Homarus gammarus) has been the subject of aquaculture and related research efforts for the last 150 years, due to both the wild fishery and cultural value of the species. Since the middle of the 20th century, increasing anthropogenic pressure has led to a severe decline in wild fish and shellfish stocks, including H. gammarus, with some fisheries yet to recover. H. gammarus is amongst the most exclusive and valuable European shellfish products, and whilst management measures have been implemented to safeguard stocks, H. gammarus aquaculture is an increasingly credible approach to help to secure a sustainable lobster supply. Historically, this has been achieved by relatively small-scale release of hatchery-reared juveniles during stock enhancement programmes. Until recently, commercial attempts at farming have not been viable, mainly due to cost-prohibitive technical challenges. At present, there are several promising approaches to overcome bottlenecks hampering commercialisation of lobster aquaculture. This review summarises new technical and husbandryinnovations in H. gammarus culture since the start of the 21st century, including technological innovations, husbandry and expansion of the stock enhancement (release) and farming (production) sectors. Additionally, likely directions for both sectors in the coming decades are summarised, knowledge gaps identified and the societal support required to achieve further potential are discussed

Surgical advances in tonsillectomy: report of a roundtable discussion

Professiona

Australian Law Dictionary

The Australian Law Dictionary is the best reference for those who want familiarity with, and knowledge of, Australian legal terms. Clear, relevant and well-pitched definitions explain the meaning of Australian legal terms and for those interested in contextualising these terms further and exploring legal concepts in more depth, more information and detailed in-text cross references are provided. With a focus on the Priestley 11, the Australian Law Dictionary has been built from the ground up and ‘mapped’ around 25 key legal subject areas to ensure comprehensive coverage of core legal content. This holistic approach to the development of the dictionary means readers are provided with a scaffold on to which to attach their knowledge. They are encouraged to learn the meaning of a particular term; link it with any related concepts; and to locate it within the larger body of law