Effect of mulches on hydrologic and erosional processes, soil moisture and crop yield, in highly crusting tropical semi-arid soils, Baringo, Kenya

ThesisThesis, University of Toronto, 199

Pancorneal contact lens with a toric edge: a new concept in keratoconus

PURPOSE To investigate whether fitting a patient with keratoconus to a pancorneal toric rigid gas-permeable (RGP) contact lens leads to a change in corneal compression and improves the best-corrected visual acuity (BCVA) and keratometry values. METHODS Thirty eyes with keratoconus were fitted with a newly designed pancorneal toric RGP contact lens. Each patient was examined at the time of enrollment and after having used the new contact lens for at least 2 months. Corneal topography was performed both times. RESULTS A change in corneal compression was noticed in 23 eyes (77%). Following the use of the pancorneal toric RGP contact lens, the average BCVA improved significantly (p=0.007), with a mean BCVA of 0.63 (SD 0.15) before and 0.70 (SD 0.18) after using the toric contact lens. No significant changes were seen in the mean vertical and horizontal K-values or the mean E-values. CONCLUSIONS While no significant measurable differences in K- and E-values were observed, fitting of a pancorneal toric RGP contact lens in keratoconus led to a marked improvement in visual acuity and a visible change in corneal compression

Interferon Therapy for HCV-Associated Glomerulonephritis: Meta-Analysis of Controlled Trials

A relationship between hepatitis C virus (HCV) infection and chronic glomerulonephritis (GN) has been asserted on the grounds of epidemiological and experimental data. Although this suggests a role for an antiviral approach to HCV-associated GN instead of the more conventional immunosuppressive (or supportive) therapy, the optimal management of HCV related glomerulonephritis remains controversial. To compare antiviral with immunosuppressive therapy for HCV-associated GN. Meta-analysis of controlled clinical trials (CCTs) of the two treatments (antiviral versus immunosuppressive) of HCV-associated GN. We used the fixed or random effects model of DerSimonian and Laird, with heterogeneity and sensitivity analyses. The rate of proteinuria and serum creatinine decrease after therapy for HCV-associated GN were regarded as the most reliable outcome end-points. We identified six studies involving 145 unique patients with HCV-associated GN. Pooling of study results demonstrated that proteinuria decreased more commonly after IFN than corticosteroid therapy (OR 1.92 (95% CI, 0.39; 9.57), NS), P-test for heterogeneity, 0.06 (I2=52.9%). In a sensitivity analysis including only CCTs using standard IFN-doses, OR was 3.86 (95% CI, 1.44; 10.33, (P=0.007)), P-test for heterogeneity, 0.18 (I2=35.9%). No improvement of serum creatinine after IFN compared to immunosuppressive therapy was noted (OR, 0.59 (95% CI, 0.21; 1.65), NS), P-test for heterogeneity, 0.76 (I2=0%). Only three CCTs gave information on the rate of proteinuria decrease over follow-up (OR, 5.08 (95% CI, 0.69; 37.31), NS). A few major side effects were noted after IFN administration. Our meta-analysis indicates that standard IFN-doses were more effective than immunosuppressive therapy in lowering proteinuria of patients with HCV-related glomerulonephritis. However, no significant improvement in serum creatinine was seen by IFN or steroid therapy across the studies. Also, information on proteinuria recurrence after the completion of antiviral therapy was not sufficient. Prospective, randomized trials based on combined antiviral therapy (pegylated IFN plus ribavirin) with adequate dose and follow-up are required to assess the efficacy and safety of antiviral treatment of HCV-associated glomerulonephritis

Risk factors for Nontuberculous Mycobacteria Infections in Solid Organ Transplant recipients: a multinational case-control study.

Risk factors for nontuberculous mycobacteria (NTM) infections after solid organ transplant (SOT) are not well characterized. Here we aimed to describe these factors. Retrospective, multinational, 1:2 matched case-control study that included SOT recipients ≥12 years old diagnosed with NTM infection from January 1, 2008, to December 31, 2018. Controls were matched on transplanted organ, NTM treatment center, and post-transplant survival greater than or equal to the time to NTM diagnosis. Logistic regression on matched pairs was used to assess associations between risk factors and NTM infections. Analyses included 85 cases and 169 controls; (59% male, 88% white, median age at time of SOT of 54 years (IQR 40-62)). NTM infection occurred in kidney (42%), lung (35%), heart and liver (11% each), and pancreas transplant recipients (1%). Time from transplant to infection was 21.6 months (IQR 5.3-55.2). Most underlying comorbidities were evenly distributed between groups; however, cases were older at the time of NTM diagnosis, more frequently on systemic corticosteroids and had a lower lymphocyte count (all P < 0.05). In the multivariable model, older age at transplant (adjusted odds ratio [aOR] 1.04; 95 confidence interval [CI] 1.01-1.07), hospital admission within 90 days (aOR, 3.14; [1.41-6.98]), receipt of antifungals (aOR, 5.35; [1.7-16.91]), and lymphocyte-specific antibodies (aOR, 7.73, [1.07-56.14]), were associated with NTM infection. Risk of NTM infection in SOT recipients was associated with older age at SOT, prior hospital admission, receipt of antifungals or lymphocyte-specific antibodies. NTM infection should be considered in SOT patients with these risk factors