Tear Osmolarity and Dry Eye Symptoms in Women Using Oral Contraception and Contact Lenses

Purpose—To examine the relationship between oral contraceptive pill (OCP) use, contact lens wear, and dry eye signs and symptoms in healthy young females. Methods—Fifty-two women using OCPs and forty-five women not using any form of hormonal contraception were enrolled. Medical, menstrual, and contact lens histories were obtained and dry eye symptoms were assessed using the Ocular Surface Disease Index (OSDI) and Symptom Assessment iN Dry Eye (SANDE) questionnaires. Tear osmolarity testing was performed using the TearLab™ Osmolarity System. Results—Mean age of all subjects was 26.0 ± 3.7 years. There were no significant differences in any of the measurements between the follicular and luteal phases. While SANDE scores were significantly higher in subjects with OCP and recent contact lens use (p\u3c0.01), there were no significant differences in OSDI and tear osmolarity amongst the same subject groups. Subjects who reported both OCP and recent contact lens use had significantly higher OSDI and SANDE scores (p=0.015 and p\u3c0.001, respectively). Conclusions—There were no differences between the phases of the menstrual cycle. Tear osmolarity was not affected by OCP or contact lens use in young females. However, the combination of OCP use and contact lens wear may increase the severity of dry eye symptoms

Effects of Omega-3 Supplementation on Exploratory Outcomes in the Dry Eye Assessment and Management Study.

We report results from a multicenter, randomized clinical trial (N=535) of the effect of ω-3 supplementation, relative to placebo, on exploratory and minimally invasive outcome measures for moderate to severe dry eye disease

n-3 Fatty Acid Supplementation for the Treatment of Dry Eye Disease.

BackgroundDry eye disease is a common chronic condition that is characterized by ocular discomfort and visual disturbances that decrease quality of life. Many clinicians recommend the use of supplements of n-3 fatty acids (often called omega-3 fatty acids) to relieve symptoms.MethodsIn a multicenter, double-blind clinical trial, we randomly assigned patients with moderate-to-severe dry eye disease to receive a daily oral dose of 3000 mg of fish-derived n-3 eicosapentaenoic and docosahexaenoic acids (active supplement group) or an olive oil placebo (placebo group). The primary outcome was the mean change from baseline in the score on the Ocular Surface Disease Index (OSDI; scores range from 0 to 100, with higher scores indicating greater symptom severity), which was based on the mean of scores obtained at 6 and 12 months. Secondary outcomes included mean changes per eye in the conjunctival staining score (ranging from 0 to 6) and the corneal staining score (ranging from 0 to 15), with higher scores indicating more severe damage to the ocular surface, as well as mean changes in the tear break-up time (seconds between a blink and gaps in the tear film) and the result on Schirmer's test (length of wetting of paper strips placed on the lower eyelid), with lower values indicating more severe signs.ResultsA total of 349 patients were assigned to the active supplement group and 186 to the placebo group; the primary analysis included 329 and 170 patients, respectively. The mean change in the OSDI score was not significantly different between the active supplement group and the placebo group (-13.9 points and -12.5 points, respectively; mean difference in change after imputation of missing data, -1.9 points; 95% confidence interval [CI], -5.0 to 1.1; P=0.21). This result was consistent across prespecified subgroups. There were no significant differences between the active supplement group and the placebo group in mean changes from baseline in the conjunctival staining score (mean difference in change, 0.0 points; 95% CI, -0.2 to 0.1), corneal staining score (0.1 point; 95% CI, -0.2 to 0.4), tear break-up time (0.2 seconds; 95% CI, -0.1 to 0.5), and result on Schirmer's test (0.0 mm; 95% CI, -0.8 to 0.9). At 12 months, the rate of adherence to treatment in the active supplement group was 85.2%, according to the level of n-3 fatty acids in red cells. Rates of adverse events were similar in the two trial groups.ConclusionsAmong patients with dry eye disease, those who were randomly assigned to receive supplements containing 3000 mg of n-3 fatty acids for 12 months did not have significantly better outcomes than those who were assigned to receive placebo. (Funded by the National Eye Institute, National Institutes of Health; DREAM ClinicalTrials.gov number, NCT02128763 .)

Randomized, Controlled Trial of Therapy Interruption in Chronic HIV-1 Infection

BACKGROUND: Approaches to limiting exposure to antiretroviral therapy (ART) drugs are an active area of HIV therapy research. Here we present longitudinal follow-up of a randomized, open-label, single-center study of the immune, viral, and safety outcomes of structured therapy interruptions (TIs) in patients with chronically suppressed HIV-1 infection as compared to equal follow-up of patients on continuous therapy and including a final therapy interruption in both arms. METHODS AND FINDINGS: Forty-two chronically HIV-infected patients on suppressive ART with CD4 counts higher than 400 were randomized 1:1 to either (1) three successive fixed TIs of 2, 4, and 6 wk, with intervening resumption of therapy with resuppression for 4 wk before subsequent interruption, or (2) 40 wk of continuous therapy, with a final open-ended TI in both treatment groups. Main outcome was analysis of the time to viral rebound (>5,000 copies/ml) during the open-ended TI. Secondary outcomes included study-defined safety criteria, viral resistance, therapy failure, and retention of immune reconstitution. There was no difference between the groups in time to viral rebound during the open-ended TI (continuous therapy/single TI, median [interquartile range] = 4 [1–8] wk, n = 21; repeated TI, median [interquartile range] = 5 [4–8] wk, n = 21; p = 0.36). No differences in study-related adverse events, viral set point at 12 or 20 wk of open-ended interruption, viral resistance or therapy failure, retention of CD4 T cell numbers on ART, or retention of lymphoproliferative recall antigen responses were noted between groups. Importantly, resistance detected shortly after initial viremia following the open-ended TI did not result in a lack of resuppression to less than 50 copies/ml after reinitiation of the same drug regimen. CONCLUSION: Cycles of 2- to 6-wk time-fixed TIs in patients with suppressed HIV infection failed to confer a clinically significant benefit with regard to viral suppression off ART. Also, secondary analysis showed no difference between the two strategies in terms of safety, retention of immune reconstitution, and clinical therapy failure. Based on these findings, we suggest that further clinical research on the long-term consequences of TI strategies to decrease drug exposure is warranted

The Risk of Intraocular Pressure Elevation in Pediatric Noninfectious Uveitis

To characterize the risk and risk factors for intraocular pressure (IOP) elevation in pediatric non-infectious uveitis

A regenerative iron catholyte for a microbial fuel cell

Microbial fuel cells are devices that convert biochemical energy into useable electricity. This project uses Thiobacillus ferrooxidans, a chemolithoautotrophic obligate acidophile, to create a regenerative ferric/ferrous catholyte for the fuel cell. T. ferrooxidans gets its energy by oxidizing Fe2+ to Fe3+. We hypothesized that Fe3+ can then accept electrons from the anode and be converted back to Fe2+. The fuel cell did show a slight increase in current and voltage with the addition of bacteria, but the more significant increase appeared to come from the oxidation of Fe2+ by oxygen

Computational sequence analysis of a plastid-localized enzyme in plants

1-deoxy-D-xylulose-5 phosphate synthase (DXPS), a key regulatory enzyme in the nonmevalonate branch of the terpenoid biosynthetic pathway, is located in plastids. Sequence analysis of the DXPS and DXPS-like genes and signal sequences from multiple plant species included primary structure sequence alignments, common secondary structure features, and predicted hydrophobicity regions. The functional protein was found to be highly conserved, however the inferred gene trees did not resemble classical species trees. Although conservation of the signal sequence was not significant, there was similarity between hydrophobicity plots

Presence of Fatty Infiltration in Extraocular Muscles of Patients Undergoing Strabismus Surgery

Histopathology of extra-ocular muscles (EOMs) of both healthy and strabismic eyes reveal presence of lipid-like droplets, collagen proliferation, and abnormal arrangements and sizes of contractile elements. The significance of these changes and phenotypic correlation has not been previously studied. Our objective was to study the significance of fatty infiltration in resected muscles of patients with strabismus

Hydrodynamics of the inner canals of Venice.

The canals of Venice are in need of constant maintenance because of sediment accumulation on canal floors. This accumulation of sediment results in problems for the city. Canals become too shallow to allow boat passage, sewer pipes clog which cause them to burst and accelerate wall damage to buildings, and health risks increase because of the presence of raw sewage. A complete characterization of the water flow through the canals is necessary for the creation of an effective schedule that will prevent severe damage caused by sediment. For this reason, a sedimentation model is being developed by the Institute for the Study of the Dynamics of Great Masses that is co-sponsored by Insula S.p.A. and UNESCO-ROSTE, the sponsors of this project. Our goal was to measure the maximum flow velocity that will be used to verify the sedimentation model, and be combined with other canal data for the purpose of developing an improved canal maintenance schedule. Maximum velocity data were obtained and used to calculate the Flushing Index, a number that measures the relative flushing ability of water flow through a canal. This number was then compared to sediment accumulation data. We observed that those canal segments with higher flushing indices had lower levels of sediment accumulation than those canals with lower Flushing Indices. This information will be useful in determining which canal segments will require more frequent sediment removal, allowing an effective long-term maintenance schedule to be developed that will minimize the problems caused by sediment accumulation

Presence of Intercellular Fat in Extraocular Muscles of Patients Undergoing Strabismus Surgery

Histopathology of extra-ocular muscles of both healthy and strabismic eyes reveal presence of lipid-like droplets, collagen proliferation, and abnormal arrangements and sizes of contractile elements.1-4 The significance of these changes is unknown and phenotypic correlation is lacking in the literature. Our goal is to study the significance of fatty infiltration in resected muscles of patients with strabismus