Meibomian gland function cannot be predicted by Meibography in patients symptomatic for dry eye

Purpose: The purpose of this study was to determine if meibography could predict meibomian gland (MG) function with regard to number of functional MGs and/or estimation of functional MG volume in patients symptomatic for dry eye. Methods: Patients (n=23) symptomatic for dry eye who met the inclusion criteria for the study were fully consented and enrolled. Inclusion criteria: willingness to participate in the study, over the age of 18, no lid abnormalities, no current ocular inflammation/disease, no ocular surgery within the last 6 months, no history of lid surgery. Symptoms were scored using the SPEED questionnaire. MG function and estimation of functional MG volume were performed with the Korb meibomian gland evaluator. Meibography was performed using the Modi Topographer and analyzed using the Phoenix software provided. Lower lids were examined in three equal sections: nasal (N), central (C) and temporal (T) for the number of functional MGs and their functional volume (volume was as 1 for minimal, 2 for moderate and 3 for copious), and for MG dropout. MG dropout was categorized according to the Pult Meiboscale. Results: Only data for right eyes are presented. The mean age and symptom score of the patients was 48.0±12.1 years (5 males; 18 females) and 8.9±5.0 respectively. The average number of functional glands per lid section was: N=2.7±1.7, C=2.2±2.0, T=0.2±0.5. The estimated functional gland volume per lid section was: N=5.0±3.9, C=3.2±3.2, T=0.3±1.1. The N and C lid sections had significantly more functional MGs and higher functional gland volume relative to the T section (p < 0.005). Conversely the amount of gland loss as determined by gland atrophy was significantly highest in the nasal section of the lid (p<0.0001) and drop out showed no apparent correlation with MG function or functional volume. Conclusions: There appears to be no relationship between the level of apparent drop out and the number of functional MGs and/or functional MG volume. These counterintuitive results strongly indicate that standard noncontact infrared meibography cannot be used to predict MG function in terms of number of functional glands and/or functional gland volume except in the case of total gland dropout, when the glands are completely absent

A new model of central lid margin apposition and tear film mixing in spontaneous blinking

PURPOSE: To investigate tear film spreading and central lid position in spontaneous blinks and to propose a model of the central lid position of the closed eye in such blinks. METHOD: In vivo: lid margin position and geometry of 15 subjects (9 female; median age=45 years) were evaluated by high-speed video and slit-lamp microscope video in consecutive spontaneous blinks. Upper lid (UL) tear meniscus (TM) depth was observed in the open and almost closed eye. Eyelid geometry, position and UL TM depth were analysed by Image-J Software. Lid margin thicknesses were measured with a Scheimpflug camera. In vitro: tear film spreading and lipid layer formation were simulated on a lubricated glass plate and videoed by high-speed camera (JVC, GZ-GX1BE, Japan). RESULTS: In vivo: the median central lid margin thickness was not significantly (p=0.258) different between UL (1.8mm) and LL (1.7mm) in the opened eye. During blinking, UL remained perpendicular to the corneal surface, while LL tilted in and thinned. A scaled model diagram was created and revealed an over-blink of the UL over the LL (>0.7mm) and a height offset of the posterior lid margin of >0.7mm. In vitro: the LL TM fused with the UL TM even before full lid touch due to capillary bridge building. CONCLUSIONS: The central UL overlaps the central LL during spontaneous blinking. This provides the appearance of complete closure. The space that results from the lack of lid margin apposition influences the fusion of the upper and lower TM and ultimately tear film mixing

Cutaneous Permeation of a Percutaneously Applied Glucocorticoid Using Plant-Based Anionic Phospholipids in Hydrogenated Vegetable Oil: A Preliminary Study

Purpose: It is important that, when corticosteroids are used therapeutically, concentrations be reduced as much as possible to mitigate potential adverse events and side effects. This preliminary study compares the permeation for the delivery of a corticosteroid in a 1% hydrocortisone-supplemented topical cream containing anionic polar phospholipids (APP) in hydrogenated vegetable oil (triglyceride) versus a market-leading 1% hydrocortisone in a mineral hydrocarbon-based skin cream. Methods: Using the Franz diffusion cell method with cadaveric skin, the permeation of a 1% hydrocortisone-supplemented cream containing APP (test preparation) was compared with a commercially available 1% hydrocortisone cream (control preparation). The principal APP in the test preparation were phosphatidylinositol, phosphatidylserine and phosphatidylglycerol. Permeation was determined at 4 and 8 h time intervals. Results: The permeation values for the 1% hydrocortisone supplemental APP cream (test preparation) were comparatively very high 1180 ng/cm2 at 4 h and 2173 ng/cm2 at 8 h, in contrast to the 1% hydrocortisone cream (control preparation) values of 13 ng/cm2 at 4 h and 98 ng/cm2 at 8 h. Permeation of skin cream increased significantly from 0 to 4 and 8 h, when comparing the APP test preparation with the control preparation (p &lt; 0.001). This translates, respectively, into the 90-fold greater and a 20-fold greater penetration of the test preparation APP cream over the 1% hydrocortisone cream at 4 h and 8 h time points. Conclusions: This preliminary study demonstrates the enhanced permeation of 1% hydrocortisone when applied topically to the skin in an APP skin cream vehicle. This enhanced permeation suggests the potential use of APP technology to deliver therapeutically effective hydrocortisone treatment to the skin at markedly reduced concentrations of steroid. As such, APP technology may offer an improved approach to the treatment of dermatoses associated with inflammatory diseases and conditions requiring prolonged topical corticosteroid therapy

Psychopharmacology 2003 Conference, 10-13 September 2003

List of abstracts and authors: 1. Comparative benefits of Atypical antipsychotics Diana P Morrison 2. Evidence-based management of depression in Schizophrenia Andre F Joubert 3. Second generation Antipsychotics: An African update Dave Swingler 4. The drug management of patients with HIV/Aids in the Mental Health Care setting: A therapeutic challenge Denise White 5. New developments in the treatment of Bipolar depression Jospeh R Calabrese 6. Dual action antidepressants: Faster onset, more remission, better value? Roger M Pinder 7. Antisocial personality disorder: A review Donald W Black 8. The South African study of stress and health: An overview David R Williams 9. Ugliness is in the eye of the beholder: Psychiatric apsects of body image disturbance David Castle 10. Over diagnosed or under recognized? Treating ADHD Dora Wynchank 11. The contagious effects of trauma and their impact on human service organisations Kerry Gibson 12. Temporal lobe epilepsy in adolescence - 'Understanding the narrative' Helen Clark 13. The effectiveness of treatment programs for Methaqualone (Mandrax) dependence Greg McCarthy, Nandi Siegfried, Bronwyn Myers 14. Community influence on alcohol and marijuana Alan J Flisher, Robyn Mallett, Gary King, Neo Morojele, Martie Muller, Carl Lombard 15. Psychiatric presentations of medical illness Sebastian Akalula 16. Imaging of brain function using Spect James Warwick 17. Selected neuropsychological test performances and SSRI usage Theophilus Lazarus 18. Comparative effectiveness and safety of antipsychotic treatments for outpatient Schizophrenia Frans Korb, Adel Sadak, Aly Akram, Sunar Birsoz, Abderrahmane Belaid 19. Evidence-based mental healthcare - What do you know, think, feel? Nandi Siegfried, George Swingler, Soraya Seedat, Martie Muller, Rachel Churchill, Dan Stein 20. Competitions Act - Anti-competitive health care practices Z Nthakwana 21. Unique approach to mental wellness by medical Schemes Petro Kempen 22. What happens to my medical aid contribution? Eugene Allers 23. Financial issues in a modern private practice Mike Edwards 24. Transcranial magnetic stimulation: Uses in brain function research and medical intervention Alan St Clair Gibson 25. The Neurochemistry of dreams: Implications for Psychiatry Mark Solms 26. Tenascin-R expression in the Central Nervvous system of lower vertebrates Ruth Jarvis, N-. Hsu, P. Pesheva and D.M. Lang 25. Localisation of the Nogo-A receptor in Neronal Lipid rafts Edward Nyatia, D.M. Lang 26. Characterising an animal model for early life trauma using time dependent sensitisation Joachim D.K. Uys, Willie M.U. Daniels, Dan J. Stein 27. Tolmetin affords protection against Quinoclinic acid induced Neurotoxixity in Rat brain Amichand Dairam, S Daya 28. Acetaminophen and aspirin inhibit superoxide anion generation and Lipid Peroxidation, and protect against 1-Methyl-4Phenyl Pyridinim-induced Dopaminergic Neurotoxicity in rats H. Maharaj, D.S. Maharaj, K. S. Saravanan, K.P. Mohanakumar, S. Daya 29. Can exercise provide Neuroprotection in a rat model for Parkinson's disease? M Mabandla, L Kellaway, A St Clair Gibson, M Lambert, V Russell 30. Treatment of rapid cycling Bipolar disorder Joseph R. Calabrese 31. Depression as a Neurodegenerative Disorder: The need for achieving remission Roger M Pinder 32. Side-effects induced by modern antidepressants- Overview and management Franco Colin 33. The Placebo response in antidepressant clinical trials Robin Emsley 34. Impulse control disorders: An overview Donald W. Black 35. Post traumatic stress disorder: The Wits trauma clinic experience Ugash Subramaney 36. Post traumatic stress disorder among recently diagnosed patients with HIV in South Africa Soraya Seedat, Bo Olley, D J Stein 37. Improving outcome in Schizophrenia Diana P Morrison 38. Reviewing post Graduate training Cliff W Allwood 39. Ethics in HIV Research Keimanthro Moodley 40. Improving and maintaining ethical standrads in Psychiatric research Tuviah Zabow ============================================================= Posters: Neurosciences section (Presenting author only) 1. Blunted Acth response correlates with altered Neurotransmitter function in maternally separatedrats W M U Daniels 2. A mechanism for zinc toxicity in Neuroblastoma cells W M U Daniels 3. The effects of Hypericum Perforatum, Quercetin, and Fluoxetine on receptor densities in the Rat Brain L Heiderman 4. Trichotillomania and obsessive-compulsive disorder: Clinical and genetic comparisons within a South African population S M J Hemmings 5. Expression of Nogo-A in the amphibian central nervous system N. J. Hsu 6. Biochemical model for inflammation of the brain: The role of iron, transferring and toxiferring in Lipid Peroxidation S J Van Rensburg 7. Improvement in Alzheimer's disease patients with antioxidant supplementation over 15 months S J Van Rensburg 8. The Placebo effect - Is it all in the mind? S J Van Rensburg 9. Very low serum iron concentrations in elderly patients with active Carcinoma S J van Rensburg 10. Melatonin affords protection against Rotenone-induced Neurotoxicity R John 11. Effect of enriched environment on Ca uptake via NMDA receptors into barrel cortex slices of spontaneously Hypertensiverats M Lehohla 12. Effects of Methylpenidate in a rat model for Attention Deficit Hyperactivity Disorder G. L. S. Lelaka 13. 6-Hydroxymelatonin converts Fe (III) to Fe(II) and reduces iron-induced Lipid Peroxidation D S Maharaj 14. Metrofinate Potentiates Quinolinic Acid and Potassium Cyanide induced Neurotoxicity A Ramsunder 15. The effect of chronic Intra-Amylgdala CRF injections on rat behaviour and HPA-Axis function L Richter 16. Effect of Glutamate in the Prefrontal Cortex of a rat model for Attention-Deficit Hyperactivity Disorder V Russell 17. An investigation into the relationship between Corticosterone and Neuron Cell death P J Van Vuuren ============================================================= 41. Blunted Acth response correlates with altered Neurotransmitter function in maternally separated Rats W M U Daniels, C Y Pietersen, M E Carstens, D J Stein 42. A mechanism for Zinc Toxicity in NeuroBlastoma Cells W M U Daniels, J Hendricks, R Salie, S J Van Rensburg 43. The effects of Hypericum Perforatum, Quercetin and Fluoxetine on receptor densities in the rat brain L Heideman and S Daya 44. Trichotillomania and obsessive-compulsive disorder: Clinical and genetic comparisons withn a South African population S M J Hemmings, C J Kinnear, C Lochner, H Moolman-Smook, D J H Niehaus, V Corfield, D J Stein 45. Expression of Nogo-A in the amphibian central nervous system N. J. Hsu, R Jarvis, D. M. Lang 46. Biochemical model for inflammation of the brain: The role of iron, transferring and Toxiferring in Lipid Peroxidation S J Van Rensburg, R T Erasmus, J M van Zyl, D Hon, W M U Daniels, F C V Potocnik, M J Kotze, N J De Villiers, P R Hurly 47. Improvement in Alzheimer's Disease patients with antioxidant supplementation over 15 months S J van Rensburg, F C V Potocnik, J M Van Zyl, B J Van der Walt, D Hon, A Roos, E Rienhardt, R T Erasmus 48. The Placebo effect - Is it all in the mind? S J van Rensburg, R A  Emsley, C M Smuts, M Kidd, S Van der Merwe, C C Myburgh, P Oosthuizen, H Bleeker 49. Very low serum Iron concentrations in elderly patients with active Carcinoma S J van Rensburg, R Erasmus, D Hon, C Bouwens 50. Melatonin affords protection against Rotenone-induced Neurotoxicity R John, S Daya 51. Effect of enriched environment on Ca uptake via NMDA Receptors into barrel Cortex slices of spontaneously Hypertensive rats M Lehohla, V Russell, L Kellaway 52. Effects of Methylpenidate in a rat model for Attention-Deficit Hyperactivity Disorder G. L. S. Lelaka, V. A. Russel, L. A. Kellaway 53. 6-Hydroxymelatonin converts Fe (III) to Fe (II) and reduces iron-induced Lipid Peroxidation D S Maharaj, S Daya 54. Metrofinate Potentiates Quinolinic Acid and Potassium Cyanide induced Neurotoxicity A Ramsunder, S Daya 55. The effect of chronic Intra-Amygdala CRF injections on rat behaviour and HPA-Axis function L Richter, W Daniels, D J Stein 56. Effect of Glutamate in the Prefrontal Cortex of a rat model for Attention-Deficit Hyperactivity Disorder V Russell, M Lehohla, L Kellaway 57. An investigation into the relationship between Corticosterone and Neuron cell death P J Van Vuuren, J Hendricks, W M U Daniels ============================================================= Posters: Psychiatry Section 1. Descriptive study of Tardive Dyskinesia in a South African Xhosa population S Brink 2. Alcohol drinking problems at three urban High Schools in Umtata O Alonso Betancourt 3. Childhood and adolescent sexual abuse - Demographic, traumatic and clinical signposts P D Carey 4. Inositol in the treatment of Obsessive Compulsive Disorder P D Carey 5. A review of factors associated with Suicidal behaviour in children and adolescents admitted to Tygerberg Hospital T Du Plessis 6. Psychological and physical outcomes fo elective abortion; Local Anaesthesia vs Intravenous Sedation T Ericksen 7. Mental health literacy of Human Resource Practitioners in South Africa C J Hugo 8. The importance of a specialized clinic for the care of patients with first episodes of psychosis N Keyter 9. Self-report vs Urinary drug screening in Schizophrenia: A pilot study L Koen 10. The effect of aggression on the use of Psychotropics in Schizophrenia: A naturalistic study H Lategan 11. Factor analysis of obsessive-compulsive spectrum disorders in patients with obssessive-compulsive disorder: Clinical and Genetic correlates C Lochner 12. Experiences in obsessive-compulsive Disorder and Trichotillomania: Role of childhood trauma C Lochner 13. Delusional systems in Xhosa Schizophrenia Sibpairs J E Muller 14. OCD Heteogeneity reflected by lack of Genealogically determined founder effect D J H Niehaus 15. The efficacy and tolerbaility of low-dose vs standard dose Haloperidol in first episode Psychosis. A randomised, double-blind study P P Oosthuizen 16. Treatment with low-dose Haloperidol does not protect against Tardive Dyskinesia P P Oosthuizen 17. Do healthcare funders discriminate against members on the grounds of mental illness? O Scholtz 18. Treatment strategies in patients with Clozaopine-resistant Schizophrenia at Stikland Hospital: A critical evaluation of one option A Schulte 19. Early coadministration of Clonazepam with Paroxetine for generalized social anxiety disorder S Seedat 20. Trauma exposure and post-traumatic stress symptoms in adolescents: A schools' survey in Cape Town (South Africa) and Nairobi (Kenya) S Seedat 21. The QTC effects of Thioridazine when used as a second line Anti-psychotic ( at Stikland Hospital) C Seller 22. Brain imaging and substance related disorders D J Stein 23. Gender differences in trauma exposure & post traumatic stress disorder in a clinic sample S Suliman 24. Assessing the prevalence of anxiety and depressive symptoms among clinica at Tygerbeg Academic Hospital and controls H Van der Bijl 25. Pharmacological challenge with a serotonin ID Agonist in alcohol dependence B Vythilingum 26. The treatment of ADHD in adults W Verbeeck ============================================================= 58. Descriptive study of Tardive Dyskinesia in a South African Xhosa population S Brink, D J H Niehaus, L Koen, J E Muller 59. Alcohol drinking problems at three Urban High Schools in Umtata O Alonso Betancourt, M Morales Herrera 60. Childhood and adolescent sexual abuse - Demographic, traumatic and clinical signposts P D Carey, J Walker, S Seedat, D J Stein 61. Inositol in the treatment of obsessive compulsive Disorder P D Carey, S Seedat, D J Stein 62. A review of factors associated with suicidal behaviour in children and adolescents admitted to Tygerberg Hospital T Du Plessis, S M Hawkridge, F H Theron, S A Du Plessis 63. Psychological and physical outcomes of elective abortion: Local anaestheisa vs Intravenous sedation T Ericksen, S Seedat, P Labuschagne, D J Stein 64. Mental health literacy of Human resource practitioners in South Africa C J Hugo, H D Vos, D J Stein 65. The importance of a specialized clinic for the care of patients with first episodes of psychosis N Keyter, P P Oosthuizen, R A Emsley, H J Turner 66. Self-reort vs urinary drug screening in Schizophrenia: A pilot study L Koen, D J H Niehaus, J E Muller, C Seller, N Keyter 67. The effect of aggression on the use of Psychotropics in Schizophrenia: A naturalistic study H Lategan, L Koen, D J H Niehaus 68. Factor analysis of obsessive-compulsive spectrum disorders in patients with obsessive-compulsive Disorder: Clinical and genetic correlates C Lochner, D J H Niehaus, S M J Hemmings, C J Kinnear, V A Corfield, J C Moolman-Smook, D J Stein 69. Experiences in obsessive-compulsive disorder and Trichotillomania: Role of childhood trauma C Lochner, S Seedat, P D Carey, D J Stein 70. Delusional systems in Xhosa Schizophrenia Sibpairs J E Muller, D J H Niehaus, L Koen, C Seller, N Keyter, C Laurent, R A Emsley 71. OCD Heteogeneity reflected by lack of Genealogically determined founder effect D J H Niehaus, L Endeman, I Bosman, S Hemmings, C Lochner, L Koen, H Moolman-Smook, V A Corfield, D J Stein 72. The efficacy and tolerability of low-dose vs standard dose Haloperidol in first episode Psychosis. A randomised, double-blind study P P Oosthuizen, R A Emsley, H J Turner, N Keyter 73. Treatment with low-dose Haloperidol does not protect against Tardive Dyskinesia P P Oosthuizen, R A Emsley, H J Turner, N Keyter 74. Do healthcare funders discriminate against members on the grounds of mental illness? O Scholtz, P P Oosthuizen, C Hugo, B Richards 75. Treatment strategies in patients with Clozapine resistant Schizophrenia at Stikland Hospital: A critical evaluation of one option A Schulte, D J H Niehaus, L Koen, J E Muller, P P Oosthuizen, R A Emsley 76. Early coadministration of Clonazepam with Paroxetine for generalised Social Anxiety Disorder S Seedat, M B Stein 77. Trauma exposure and post-traumatic stress symptoms in adolescents: A schools' survey in Cape Town (South Africa) and Nairobi (Kenya) S Seedat, C Nyamap, F Njenga, B Vythilingum, D J Stein 78. The QTC effects of Thioridazine when used as a second line Antipsychotic (at Stikland Hospital) C Seller, P P Oosthuizen 79. Brain imaging and substance related disorders D J Stein 80. Gender differences in trauma exposure & post traumatic stress disorder in a clinic sample S Suliman, S Seedat, F Gxama, J Walker, W Rossouw 81. Assessing the prevalence of anxiety and depressive symptoms among clinicians at Tygerberg Academic Hospital and controls H Van der Bijl, P P Oosthuizen 82. Pharmacological challenge with a Serotonin ID agonist in alcohol dependence B Vythilingum, C Wessels, S Maritz, W P Pienaar, D J Stein 83. The treatment of ADHD in adults W Verbeec