5 research outputs found
Optic Neuropathy Caused by Allergic Fungal Sinusitis
To describe a case of allergic fungal sinusitis presenting with optic neuropathy and to discuss the diagnostic treatment plan as it presents to the ophthalmologist
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Ocular infections caused by Providencia rettgeri
To report a series of patients with ocular infections caused by the rarely described gram-negative bacterium, Providencia rettgeri.
Retrospective case series.
Five patients with ocular infections who grew P. rettgeri after culture (2 keratitis, 1 dacryocystitis, 1 conjunctivitis, 1 conjunctivitis/endophthalmitis).
Microbiology culture results positive for P. rettgeri were cross-referenced to identify the patients with ocular infections. Medical records of these patients were carefully reviewed.
Descriptive analysis of each patient's history, potential risk factors, and clinical outcome.
Five eyes in 2 institutions were found to be culture positive for the gram-negative bacterium P. rettgeri. The organism may cause keratitis, dacryocystitis, conjunctivitis, and endophthalmitis. Possible risk factors include a compromised ocular surface and coexisting medical morbidity, including urinary tract infections, recent hospitalizations, and an immunocompromised state. Culture and sensitivity profiles should guide treatment; resistant strains are being identified.
Infections caused by P. rettgeri, although rare, are responsible for ocular morbidity. This report describes patient attributes, risk factors, and outcomes that will be helpful to ophthalmologists treating ocular infections. P. rettgeri should be acknowledged as a source of ocular infection
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Long-term Follow-up of Conjunctival and Corneal Intraepithelial Neoplasia Treated with Topical Interferon Alfa-2b
To evaluate the long-term recurrence rate (>1 year) of conjunctival and corneal intraepithelial neoplasia (CIN) treated with topical interferon alfa-2b.
Retrospective, noncomparative, interventional case series.
Twenty-eight eyes of 26 patients from 2 institutions, treated between April 1997 and June 2005, with CIN lesions utilized topical interferon alfa-2b drops 4 times daily until clinical resolution was achieved.
Patients' charts and clinical photographs were reviewed, and data were analyzed.
All eyes were monitored for the possibility of recurrence with a minimum of 1-year follow-up from the time of documented clinical resolution.
Complete clinical resolution of the CIN lesions was achieved in 27 of the 28 eyes treated (96.4%). One of the 28 eyes treated (3.6%) had only a partial response to treatment. For the 27 eyes with complete response, resolution occurred after a median of 2.0 months (range, 10 days–15 months). Eyes were treated for a median of 3.2 months (range, 1–15). Median follow-up after clinical resolution (tumor-free period) was 42.4 months (range, 14–89). One eye of the 27 analyzed (3.7%) experienced a recurrence. Side effects of treatment were limited to mild conjunctival hyperemia and follicular conjunctivitis in 3 patients (12%). In all cases, there was total resolution of the side effects within 1 month after cessation of the medication.
In this group of patients with CIN lesions observed for >1 year, topical interferon alfa-2b was effective in treating lesions with minimal self-limited side effects
Floor-Rise Strategy Training in Older Adults
To determine the effect of a 2-week (six-session) training intervention to improve the ability of disabled older adults to rise from the floor. DESIGN: Prospective intervention trial. SETTING: Congregate housing in Michigan. PARTICIPANTS: Subjects aged 65 and older who admitted to requiring assistance (such as from a person, equipment, or device) in performing at least one of the following mobility-related activities of daily living: transferring, walking, bathing, and toileting. INTERVENTION: Participants were randomly allocated to individual training (n = 17, mean age 81) in strategies to rise from the floor (using for example, certain key intermediate body positions) or a control chair-based flexibility intervention (n = 18, mean age 80). MEASUREMENTS: At baseline and postintervention, residents were queried regarding their rise difficulty (difficulty scale) and symptoms (symptoms scale) associated with the rise and were tested in their ability to perform timed floor-rise tasks. These tasks varied in starting position (supine vs all fours) and in use of a support to assist in rising (no support, use of an end table, use of a chair). RESULTS: Using baseline performance as the covariate, by analysis of covariance (ANCOVA), the training group showed a significant ( P < .05) improvement in mean number of rise tasks completed (baseline mean 6.6, postintervention mean 7.3) versus essentially no improvement in the controls. Similarly, by ANCOVA, the training group (compared with controls) showed a significant ( P < .05) improvement on the difficulty and symptoms scales. There was no intervention effect for rise time. CONCLUSIONS: A short-term, strategy-based intervention improved floor-rise ability and perceived difficulty and symptoms associated with the rise. This approach, focusing on key intermediate body positions, may be useful in training floor-rise skills, particularly in older adults at risk for falls.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/66412/1/j.1532-5415.2002.50463.x.pd
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Expert Performance in Visual Differentiation of Bacterial and Fungal Keratitis
This study quantifies the performance of an international cohort of cornea specialists in image-based differentiation of bacterial and fungal keratitis, identifying significant regional variation and establishing a reference standard for comparison against machine learning models