Notes

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une 2020, with a low of 51 in July, the lowest number since March 2020. Patients evaluated in this study did not have a longitudinal increase in HAPIs from March-July 2020 during the COVID-19 pandemic, despite similarities in illness severity between the two time points. Our experience has demonstrated the ability of our organizational leaders to learn quickly during crisis.
Minimally invasive glaucoma surgery (MIGS) is an emerging therapy for glaucoma. The Hydrus Microstent is a MIGS device that stents Schlemm's canal, thereby increasing aqueous drainage and lowering intraocular pressure (IOP). This article describes the use of the microstent in pseudophakic patients with medically refractory glaucoma, a patient population undocumented in the current literature.

We present a retrospective case series of 11 pseudophakic eyes using 3 or more pressure lowering medications daily for open-angle glaucoma who underwent Hydrus Microstent insertion. Patients were followed up at 1, 3, 6, 12, 24, 36, 48, and 60 months postoperatively and assessed for reductions in IOP and medication burden.

At intervals 12 and 24 months, medication burden reduced by 75.6% at both junctures, and IOP reduced by 43.8% and 34.1%. Complications included 4 hyphaemas and 1 corneal epithelial defect, each of which resolved.

This case series demonstrated effective pressure and medication reduction in medically refractory open-angle glaucoma patients using the Hydrus Microstent. Use of this device in this population is thus far undocumented in the literature and may represent an optimal therapeutic modality in the future.
This case series demonstrated effective pressure and medication reduction in medically refractory open-angle glaucoma patients using the Hydrus Microstent. Use of this device in this population is thus far undocumented in the literature and may represent an optimal therapeutic modality in the future.
An Ahmed glaucoma valve (AGV) tube in the ciliary sulcus (CS) is safer for the endothelium. At 4 years of follow-up, there was a significant decrease in endothelial cell count only with anterior chamber (AC) placement.

Corneal endothelium (CE) damage is one of the most feared long-term complications that can result from glaucoma drainage devices. Nonetheless, there is a lack of studies evaluating longitudinal changes in CE cells. This study aims to compare CE changes after AGV implantation in eyes with AC or CS tube placement.

This was a retrospective, nonrandomized, longitudinal study of pseudophakic eyes with open-angle glaucoma and medically uncontrolled intraocular pressure that received an AGV. Eyes with additional glaucoma surgeries performed during follow-up were excluded. The main outcome measure was endothelial cell density (ECD), which was evaluated 1 year±2 months and 4 years±2 months postoperatively. The average endothelial cell size (AS) and the distance from the tube tip to the cornea were also evaluated.

Twenty-six eyes from 26 patients, with a mean age of 73±10 years, were included. The tube was placed in the AC in 15 eyes and in the CS in 11 eyes. The eyes with tube placement in the AC showed a significant AS increase (P=0.007) and ECD decrease (P=0.034), whereas eyes with tube placement in the CS had no significant AS (P=0.575) or ECD (P=0.445) change. In the eyes with tube placement in the AC, there was no correlation between DTC and ECD (P=0.260) or AS (P=0.428) changes.

Tube placement in the AC seems to lead to significant CE cell loss over time, compared with tube placement in the CS.
Tube placement in the AC seems to lead to significant CE cell loss over time, compared with tube placement in the CS.
The FP8 glaucoma valve was demonstrated to be reasonably safe with reliable results in an advanced age patient population.

As life expectancy increases, a growing number of patients with glaucoma are of an advanced age. There are little to no data looking at glaucoma surgical treatment options in patients over the age of 85. Our study describes the safety and efficacy of the FP8 Ahmed glaucoma valve in this patient population.

This was a retrospective study of patients over 85 years of age undergoing FP8 Ahmed glaucoma valve implantation. Preoperative age, sex, intraocular pressure (IOP), and number of glaucoma medications were recorded. Primary outcome variables were IOP and number of medications. Secondary outcome variables included any intraoperative or postoperative complications.

Mean IOP preoperatively was 26 mm Hg on an average of 3 glaucoma medications (n=56). IOP was significantly reduced at all time points in follow-up for an overall reduction of 42% at 1 year and 46% at 2 years. Mean IOP at 1 year follow-up was 15 mm Hg and 14 mm Hg at 2 years follow-up. Glaucoma medications were reduced from a mean of 3 preoperatively to 2 postoperatively.

Implantation of an FP8 Ahmed glaucoma valve is a relatively safe procedure to achieve satisfactory IOP and decreased reliance on glaucoma medications in an advanced age population.
Implantation of an FP8 Ahmed glaucoma valve is a relatively safe procedure to achieve satisfactory IOP and decreased reliance on glaucoma medications in an advanced age population.
We describe standardization and simplification of classic trabeculectomy combined with manual small incision cataract surgery (MSICS) to effectively manage the 2 leading and often coexisting causes of blindness and vision impairment in resource-constrained areas.

The purpose of this study was to describe modifications to trabeculectomy combined with MSICS and report on the outcomes of this technique. The modifications consist of standardization and simplification of the surgical steps.

Data obtained from adult patients who underwent described surgical technique at rural eye care centers across 3 Indian states between January 2018 and May 2019 were analyzed retrospectively. check details Complete success was intraocular pressure between 6 and 18 mm Hg without supplementary medication. Qualified success allowed up to 3 topical medication(s). Data are presented as median (first and third quartiles).

We analyzed data of 70 eyes of 70 patients. Ophthalmology fellows performed 27 (38.5%) surgeries, whereas an experiencedlity, especially in the underserved regions of the world.
Deep sclerectomy with intrascleral collagen implant (DSCI) was less effective in lowering intraocular pressure (IOP) than with suprachoroidal implantation. Further studies are needed to establish the potency and safety of deep sclerectomy with suprachoroidal collagen implant (DSSCI).

The purpose of this study was to analyze the safety and IOP-lowering effect of DSSCI in comparison with DSCI.

Geneva University Hospitals, Geneva, Switzerland.

This is a prospective, randomized, controlled study involving 13 patients (26 phakic eyes) with bilateral medically uncontrolled primary or secondary open-angle glaucoma. Bilateral deep sclerectomy was performed with each patient being randomly assigned to receive a collagen implant in the intrascleral space in one eye, and a suprachoroidal collagen implant in the other. Follow-up visits were performed at day 1; at week 1; and at months 6, 9, 12, 18, 30, 48, 54, and 60.

Mean preoperative IOP was 24.1±4.2 mm Hg for DSCI group and 25.3±5.3 mm Hg for DSSCI group (P=0.1). The mean postoperative IOP was 14.8±4.0 mm Hg (DSCI) versus 9.8±3.7 mm Hg (DSSCI) at month 60 (P=0.01). Mean preoperative best-corrected visual acuity for the DSCI group was 0.76±0.22 and 0.74±0.23 for the DSSCI group (P=0.001), while the mean postoperative best-corrected visual acuity was 0.82±0.17 (DSCI) and 0.80±0.17 (DSSCI) at month 60 (P=0.004).

DSSCI demonstrated a greater IOP-lowering effect than deep sclerectomy with intrascleral implantation. The safety profile of both methods was similar. More patients with a longer follow-up are required to comprehensively assess the safety and efficacy of this new approach.
DSSCI demonstrated a greater IOP-lowering effect than deep sclerectomy with intrascleral implantation. The safety profile of both methods was similar. More patients with a longer follow-up are required to comprehensively assess the safety and efficacy of this new approach.
Yogic pranayama and diaphragmatic breathing are potential adjunctive therapies for patients with glaucoma; however, they are not substitutes for medicine or eye drops.

Currently, medical or surgical lowering of intraocular pressure is the only therapeutic approach for treating primary open-angle glaucoma. Intraocular pressure maintenance is influenced by autonomic activity (sympathetic and parasympathetic). "Yogic pranayama" and "diaphragmatic breathing" are exercises that can affect autonomic activity by stimulating a wakeful hypometabolic state of parasympathetic dominance. We aimed to assess the effect of yogic pranayama and diaphragmatic breathing on intraocular pressure to determine whether it can be recommended for individuals with established glaucoma in combination with glaucoma medication as an adjuvant therapy.

In this prospective, randomized trial, 90 patients with primary open-angle glaucoma (180 eyes, age above 40 y) were assigned to either the control or yogic pranayama and diaphragmatic breathing exercise group. In the latter group, yogic pranayama and diaphragmatic breathing were practiced daily for 6 months. We measured the intraocular pressure at presentation and subsequently after 1, 3, and 6 months.

Compared with the wait-list group, the yogic pranayama and diaphragmatic breathing exercise group had significantly lowered intraocular pressure (right eye 20.85±3.39 to 14.90±2.86 mm Hg; left eye 20.30±4.12 to 14.25±3.85 mm Hg; P<0.001).

Yogic pranayama and diaphragmatic breathing exercises can reduce intraocular pressure in patients with primary open-angle glaucoma and can therefore be recommended as an adjuvant therapy.
Yogic pranayama and diaphragmatic breathing exercises can reduce intraocular pressure in patients with primary open-angle glaucoma and can therefore be recommended as an adjuvant therapy.Family caregivers provide long-term, complex care in home settings where most persons with dementia (PWD) live. These men/women caregivers differ in responses and approaches to caring problems. Following our review of the research literature and needs assessment from caregivers of PWD (group 1), a comparison revealed key caregiver gender differences in caring problems and approaches. We developed and implemented a Web-based Educational Modules (WBEMs) project focused on gender-based differences to offer unique support for men/women caregivers who face these problems. Other caregiver evaluators (group 2) agreed the WBEMs were well designed with clear, credible, informative content. Evaluators' suggestions for larger font size and navigation directions were incorporated in module improvements. Six modules were eventually placed on an established university-sponsored caregivers' website. WBEMs have potential to reestablish well-being for caregivers of PWD. Home healthcare nurses and other healthcare providers can use, adapt, or create additional modules to meet the needs of and support for caregivers and patients living in community settings.
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