25th RCOphth Congress, President's Session paper:25 years of progress in medical retina

The quarter century since the foundation of the Royal College of Ophthalmologists has coincided with immense change in the subspecialty of medical retina, which has moved from being the province of a few dedicated enthusiasts to being an integral, core part of ophthalmology in every eye department. In age-related macular degeneration, there has been a move away from targeted, destructive laser therapy, dependent on fluorescein angiography to intravitreal injection therapy of anti-growth factor agents, largely guided by optical coherence tomography. As a result of these changes, ophthalmologists have witnessed a marked improvement in visual outcomes for their patients with wet age-related macular degeneration (AMD), while at the same time developing and enacting entirely novel ways of delivering care. In the field of diabetic retinopathy, this period also saw advances in laser technology and a move away from highly destructive laser photocoagulation treatment to gentler retinal laser treatments. The introduction of intravitreal therapies, both steroids and anti-growth factor agents, has further advanced the treatment of diabetic macular oedema. This era has also seen in the United Kingdom the introduction of a coordinated national diabetic retinopathy screening programme, which offers an increasing hope that the burden of blindness from diabetic eye disease can be lessened. Exciting future advances in retinal imaging, genetics, and pharmacology will allow us to further improve outcomes for our patients and for ophthalmologists specialising in medical retina, the future looks very exciting but increasingly busy

Drug discovery in ophthalmology: past success, present challenges, and future opportunities

BACKGROUND: Drug discovery has undergone major transformations in the last century, progressing from the recognition and refinement of natural products with therapeutic benefit, to the systematic screening of molecular libraries on whole organisms or cell lines and more recently to a more target-based approach driven by greater knowledge of the physiological and pathological pathways involved. Despite this evolution increasing challenges within the drug discovery industry are causing escalating rates of failure of development pipelines. DISCUSSION: We review the challenges facing the drug discovery industry, and discuss what attempts are being made to increase the productivity of drug development, including a refocusing on the study of the basic biology of the disease, and an embracing of the concept of ‘translational research’. We consider what ophthalmic drug discovery can learn from the sector in general and discuss strategies to overcome the present limitations. This includes advances in the understanding of the pathogenesis of disease; improvements in animal models of human disease; improvements in ophthalmic drug delivery and attempts at patient stratification within clinical trials. SUMMARY: As we look to the future, we argue that investment in ophthalmic drug development must continue to cover the whole translational spectrum (from ‘bench to bedside and back again’) with recognition that both biological discovery and clinical understanding will drive drug discovery, providing safe and effective therapies for ocular disease

Dose inseminante utilizada na fertilização artificial de ovócito de piracanjuba (Brycon orbignyanus)

A piracanjuba (Brycon orbignyanus Valenciennes, 1849) é uma espécie de peixe migratória, ameaçada de extinção. O objetivo do presente estudo foi determinar a dose inseminante na fertilização artificial de ovócitos de piracanjuba. Para isso, utilizou-se delineamento em blocos casualizados, com quatro tratamentos e três repetições. Três casais de piracanjuba, selecionados dos tanques de reprodutores da Estação Ambiental de Itutinga (EAI - CEMIG), no período de piracema 2006/2007, receberam aplicação de hormônio extrato bruto de hipófise de carpa (EBHC) para obtenção dos gametas. Adotaram-se quatro tratamentos diferentes para a fertilização de 0,1 grama de ovócitos: 10µL, 20µL, 30µL e 40µL de sêmen. As amostras foram ativadas com 5 mL de água do próprio tanque e, em seguida, levadas para incubadoras, dotadas de renovação constante de água, à temperatura de 28ºC. Após 8 e 16 horas, analisaram-se as taxas de fertilização (ovos viáveis) e de eclosão dos ovos, respectivamente. Os resultados obtidos foram comparados pelo teste de Tukey a 5%. As relações sêmen-ovócitos testadas não alteraram as taxas de fertilização e eclosão (P>0,05). O número de espermatozoides-ovócitos, variando de 10,4 x10(5) a 41,6 x10(5), foi eficiente para obtenção de boas taxas de fertilidade

Community-associated versus healthcare-associated methicillin-resistant Staphylococcus aureus bacteraemia: A 10-year retrospective review

The objective was to compare the epidemiology and outcome of healthcare- (HA-) and community-associated (CA-) MRSA bacteraemia. A 10-year retrospective study of MRSA bacteraemia was carried out. Episodes were classified according to established criteria. Molecular typing was performed on a subset of isolates. Of 197 MRSA bacteraemia episodes, 178 (90.4%) were classified as HA-MRSA and 19 (9.6%) as CA-MRSA. All-cause 7- and 30-day mortality rates were similar in the HA and CA-MRSA bacteraemia groups; however, 1-year mortality was higher in the HA-MRSA bacteraemia group (48.3% vs 21.1% [p?=?0.023]). Thirty-day all-cause mortality was significantly lower if empiric antimicrobial therapy included agent(s) to which the isolate tested susceptible, compared with patients receiving "inactive" therapy (19% vs 35.1% [p?=?0.011]). The majority of MRSA bacteraemia episodes were caused by clones known to circulate in the community. All-cause mortality is as high in HA- as in CA-MRSA bacteraemia. Thirty-day mortality was significantly reduced if the patient received an antibiotic with activity against the MRSA isolate. © 2008 Springer-Verlag