Hypertensive phase and early complications after Ahmed glaucoma valve implantation with intraoperative subtenon triamcinolone acetonide

Objective: To evaluate intraoperative subtenon triamcinolone acetonide (TA) as an adjunct to Ahmed glaucoma valve (AGV) implantation. Design: Retrospective comparative case series. Participants: Forty-two consecutive cases of uncontrolled glaucoma undergoing AGV implantation: 19 eyes receiving intraoperative subtenon TA and 23 eyes that did not receive TA. Methods: A retrospective chart review was performed on consecutive pseudophakic adult patients with uncontrolled glaucoma undergoing AGV with and without intraoperative subtenon TA injection by a single surgeon. Clinical data were collected from 42 eyes and analyzed for the first 6 months after surgery. Main outcome measures Primary outcomes included intraocular pressure (IOP) and number of glaucoma medications prior to and after AGV implantation. The hypertensive phase (HP) was defined as an IOP measurement of greater than 21 mmHg (with or without medications) during the 6-month postoperative period that was not a result of tube obstruction, retraction, or malfunction. Postoperative complications and visual acuity were analyzed as secondary outcome measures. Results: Five out of 19 (26%) TA cases and 12 out of 23 (52%) non-TA cases developed the HP (P=0.027). Mean IOP (14.2±4.6 in TA cases versus [vs] 14.7±5.0 mmHg in non-TA cases; P=0.78), and number of glaucoma medications needed (1.8±1.3 in TA cases vs 1.6±1.1 in the comparison group; P=0.65) were similar between both groups at 6 months. Although rates of serious complications did not differ between the groups (13% in the TA group vs 16% in the non-TA group), early tube erosion (n=1) and bacterial endophthalmitis (n=1) were noted with TA but not in the non-TA group. Conclusions: Subtenon TA injection during AGV implantation may decrease the occurrence of the HP but does not alter the ultimate IOP outcome and may pose increased risk of serious complications within the first 6 months of surgery

Latanoprost with high precision, piezo-print microdose delivery for IOP lowering: clinical results of the PG21 study of 0.4 µg daily microdose.

Background:Topical high-precision piezo-print delivery of microdoses of latanoprost achieved significant IOP reduction consistent with the eyedropper effect but with a 75% reduced exposure to drugs and preservatives. Prostaglandin analogs are a mainstay glaucoma therapy. However, conventional eyedroppers deliver 30-50 µL drops that greatly exceed the physiologic 7-µL ocular tear film capacity. Eyedropper overdosing floods the eye with excess drug compounds and preservatives, resulting in ocular surface toxicity, periorbitopathy, and other well-characterized ocular side effects. Piezoelectric high-precision microdosing provides targeted delivery that can reduce exposure to both drug and preservatives compared to conventional eyedropper delivery, with the potential to deliver similar biologic effect. Methods:Both eyes (N=60) of 30 healthy volunteers received single 8-µL microdoses of 0.005% latanoprost (0.4 µg; µRx-latanoprost) on the morning of Days 1 and 2 using a high-precision, piezo-print horizontal delivery system. Diurnal IOP was measured before and 2 days after microdosing. Main efficacy outcomes were diurnal IOP change after µRx-latanoprost microdosing and accurate microdosing success rates, and the primary safety outcome was adverse event (AE) incidence. Results:µRx-latanoprost reduced baseline IOP by 26% and 30% at 1 and 2 days postadministration, respectively. Successful topical dosing was achieved in 100% of technician-assisted deliveries. All patients successfully self-administered microdoses after receiving training. Microdose administration was well tolerated and did not result in any AEs. Conclusion:Microdosing of 0.4 µg of µRx-latanoprost achieved significant IOP reduction. Lower ocular exposure with topical prostaglandin analog microdosing can enable new therapeutic opportunities for optimizing glaucoma treatment. Microdosing may also be beneficial in reducing ocular side effects associated with excessive drug product and preservatives often used to treat chronic ocular diseases such as glaucoma

Un état de coexistence du soja transgénique et conventionnel au Paraná, Brésil

document consultable au : http://economierurale.revues.org/index2881.html Cette version a corrigé des erreurs dans le tableau 4, et a ajusté les commentaires correspondant, mais sans changement du fond de l'articleInternational audienceIn Brazil, soybean production has increased with an annual growth of 7.2% since 1996. The adoption of transgenic soybean, rendered tolerant to glyphosate herbicide, has contributed to this remarkable increase. After the presentation of soybean production in Brazil, this article introduces the results of a survey conducted to capture the use of transgenic soybean, during the 200708 campaign in Paraná, one of the main producing States. The survey indicates that producers may show no, partial or total adoption of glyphosate-tolerant varieties of transgenic soybean. The allocation of transgenic soybean to most weedy plots is one reason of the coexistence of transgenic and non-transgenic soybean within the same farm holding. The continuation of the observed coexistence depends particularly on the evolution of royalties on transgenic soybean, and on the measures to ensure the non-transgenic purity of conventional soybean seeds.Au Brésil, la production de soja a progressé avec une croissance annuelle de 7,2 % depuis 1996. La culture des variétés de soja transgéniques tolérantes à l'herbicide glyphosate a concouru à cette importante progression. Après avoir présenté le contexte de production du soja au Brésil, l'article présente les résultats d'une enquête sur l'utilisation du soja transgénique, se rapportant à la campagne 2007/2008 dans le Paraná, l'un des principaux États brésiliens producteurs de soja. Cette enquête indique que, selon les exploitations agricoles, l'adoption du soja transgénique peut être nulle, partielle ou totale. L'utilisation du soja transgénique en fonction de l'état d'infestation des parcelles par les mauvaises herbes est une raison de la production simultanée des deux types de soja dans une même exploitation. La poursuite de cette coexistence dépend notamment de l'évolution des royalties appliquées au soja transgénique et des dispositions prises pour assurer la pureté des semences de soja conventionnel

Impacts of The Radiation Environment At L2 On Bolometers Onboard The Herschel Space Observatory

We present the effects of cosmic rays on the detectors onboard the Herschel satellite. We describe in particular the glitches observed on the two types of cryogenic far- infrared bolometer inside the two instruments PACS and SPIRE. The glitch rates are also reported since the launch together with the SREM radiation monitors aboard Herschel and Planck spacecrafts. Both have been injected around the Lagrangian point L2 on May 2009. This allows probing the radiation environment around this orbit. The impacts on the observation are finally summarized.Comment: 8 pages, 13 figures, 2 images, Author Keywords: Bolometers, Infrared detectors, cryogenics, radiation effects, submillimeter wave technology IEEE Terms: Bolometers, Detectors, Instruments, Picture archiving and communication systems, Protons, Silicon, Space vehicles; Radiation and Its Effects on Components and Systems (RADECS), 2011 12th European Conference. Conference location: Sevilla. Date of Conference: 19-23 Sept. 2011. Session H: Radiation Environment: Space, Atmospheric and Terrestrial (PH2

Regulation of intraocular pressure by soluble and membrane guanylate cyclases and their role in glaucoma

Glaucoma is a progressive optic neuropathy characterized by visual field defects that ultimately lead to irreversible blindness (Alward, 2000; Anderson et al., 2006). By the year 2020, an estimated 80 million people will have glaucoma, 11 million of which will be bilaterally blind. Primary open-angle glaucoma (POAG) is the most common type of glaucoma. Elevated intraocular pressure (IOP) is currently the only risk factor amenable to treatment. How IOP is regulated and can be modulated remains a topic of active investigation. Available therapies, mostly geared toward lowering IOP, offer incomplete protection, and POAG often goes undetected until irreparable damage has been done, highlighting the need for novel therapeutic approaches, drug targets, and biomarkers (Heijl et al., 2002; Quigley, 2011). In this review, the role of soluble (nitric oxide (NO)-activated) and membrane-bound, natriuretic peptide (NP)-activated guanylate cyclases that generate the secondary signaling molecule cyclic guanosine monophosphate (cGMP) in the regulation of IOP and in the pathophysiology of POAG will be discussed

Glaucoma Screening in the Haitian Afro-Caribbean Population of South Florida

Objective: To evaluate the presence of clinical signs consistent with suspected glaucoma in Haitian Afro-Caribbean individuals residing in South Florida who do not receive regular eye examinations. Design: Retrospective, cross-sectional study. Methods: SETTING: Community health center in the Little Haiti district of Miami, Florida. PATIENT POPULATION: We reviewed medical records and screening forms from five health screenings between October 2011 to October 2013 of 939 Afro-Caribbean individuals older than 18 years, who were never diagnosed with glaucoma or had an eye examination within the last ten years. PROCEDURES: Measurements of distance visual acuity (VA), intraocular eye pressure (IOP), central corneal thickness (CCT), cup-to-disc ratio (CDR), frequency doubling technology (FDT) perimeter visual field (VF). Main Outcome Measures: Proportion of glaucoma suspects, based on IOP greater than or equal to 24 mm Hg or CDR greater than or equal to 0.7 in either eye, and determinants of CDR and IOP. Results: One hundred ninety-one (25.5%) of 750 patients were identified as glaucoma suspects. Glaucoma suspects were common in both the youngest and oldest age groups (70 years, 25.0%; 95% CI, 21.8–28.2) and higher in men than women less than 70 years; the reverse was true after 70 years. Among all patients, mean IOP was 19.2±4.5 mmHg, mean CDR was 0.37±0.17, and mean CCT was 532±37.1 µm. In multiple linear stepwise regression analysis, determinates of increased CDR included increasing age (P = 0.004), lack of insurance (P = 0.019), and higher IOP (P<0.001), while increasing CDR (P<0.001) and thicker CCT (P<0.001) were associated with higher IOP. Conclusions: This first glaucoma survey in a U.S. Haitian Afro-Caribbean population indicates glaucoma suspect status is high across all age groups, and suggests glaucoma monitoring in people less than 40 years of age is indicated in this population

Flavour-dependent radiative correction to neutrino-neutrino refraction

In the framework of the Standard Model we calculate the flavour non-universal correction for neutrino refraction in a neutrino background and verify a similar previous result for the case of ordinary-matter background. The dominant term arises at loop level and involves tau leptons circulating in the loop. These O(G_F m_tau^2) corrections to the tree-level potential provide the dominant refractive difference between nu_mu and nu_tau unless the medium contains mu or tau leptons. Our results affect the flavour evolution of dense neutrino gases and may be of interest for collective three-flavour oscillations of supernova neutrinos. We spell out explicitly how these non-universal neutrino-neutrino interactions enter the flavour oscillation equations.Comment: 15 pages, 6 figures; updated reference lis

Private governance in royalty collection: Effectiveness and limitations in tracing GM soybean in Brazil

Ce papier analyse l'émergence d'une innovation institutionnelle en accompagnement de la diffusion du soja génétiquement modifié au Brésil. Il en découle une gouvernance plutôt efficace par la création d'une situation gagnant-gagnant pour les acteurs impliqués, au moins à court terme, tant que la coexistence avec les variétés conventionnelles peut demeurer. Cette coexistence est menacée surtout du fait d'une absence de prime de marché pour le soja conventionnel.OGM; soja; Brésil; innovation institutionnelle; redevance d'emploi; coexistence

Reliable intraocular pressure measurement using automated radio-wave telemetry

Purpose To present an autonomous intraocular pressure (IOP) measurement technique using a wireless implantable transducer (WIT) and a motion sensor. Methods: The WIT optical aid was implanted within the ciliary sulcus of a normotensive rabbit eye after extracapsular clear lens extraction. An autonomous wireless data system (AWDS) comprising of a WIT and an external antenna aided by a motion sensor provided continuous IOP readings. The sensitivity of the technique was determined by the ability to detect IOP changes resulting from the administration of latanoprost 0.005% or dorzolamide 2%, while the reliability was determined by the agreement between baseline and vehicle (saline) IOP. Results: On average, 12 diurnal and 205 nocturnal IOP measurements were performed with latanoprost, and 26 diurnal and 205 nocturnal measurements with dorzolamide. No difference was found between mean baseline IOP (13.08±2.2 mmHg) and mean vehicle IOP (13.27±2.1 mmHg) (P=0.45), suggesting good measurement reliability. Both antiglaucoma medications caused significant IOP reduction compared to baseline; latanoprost reduced mean IOP by 10% (1.3±3.54 mmHg; P<0.001), and dorzolamide by 5% (0.62±2.22 mmHg; P<0.001). Use of latanoprost resulted in an overall twofold higher IOP reduction compared to dorzolamide (P<0.001). Repeatability was ±1.8 mmHg, assessed by the variability of consecutive IOP measurements performed in a short period of time (≤1 minute), during which the IOP is not expected to change. Conclusion: IOP measurements in conscious rabbits obtained without the need for human interactions using the AWDS are feasible and provide reproducible results

Towards modifying the genetic predisposition for glaucoma: An overview of the contribution and interaction of genetic and environmental factors

Glaucoma, the leading cause of irreversible blindness worldwide, is a complex human disease, with both genetic and environmental determinants. The availability of large-scale, population-based cohorts and biobanks, combining genotyping and detailed phenotyping, has greatly accelerated research into the aetiology of glaucoma in recent years. Hypothesis-free genome-wide association studies have furthered our understanding of the complex genetic architecture underpinning the disease, while epidemiological studies have provided advances in the identification and characterisation of environmental risk factors. It is increasingly recognised that the combined effects of genetic and environmental factors may confer a disease risk that reflects a departure from the simple additive effect of the two. These gene-environment interactions have been implicated in a host of complex human diseases, including glaucoma, and have several important diagnostic and therapeutic implications for future clinical practice. Importantly, the ability to modify the risk associated with a particular genetic makeup promises to lead to personalised recommendations for glaucoma prevention, as well as novel treatment approaches in years to come. Here we provide an overview of genetic and environmental risk factors for glaucoma, as well as reviewing the evidence and discussing the implications of gene-environment interactions for the disease