Notes

Intumescent Fire Retardant Device associated with Lignosulfonate as being a Char Developing Adviser in Firm Polyurethane Foam.
PURPOSE To demonstrate disposable trabeculoplasty lens damage after routine selective laser trabeculoplasty (SLT) for primary open angle glaucoma (POAG). METHODS Disposable single-mirror laser lenses were used to perform SLT in 2 patients with POAG. Images of the single use mirrors were taken before and after treatment. RESULTS One lens showed heavy focal loss of reflectivity of its mirror with SLT settings of 0.8-0.9▒mJ x 97 shots on a patient with a lightly pigmented angle. Aiming beam splashing or loss was noted after most shots. The second lens showed much less damage with 0.6▒mJ x 90 shots in a heavily pigmented angle. CONCLUSION While single use gonio-lenses have gained popularity for their role in infection control and elimination of wear and tear of reusable lenses, our cases show that damage occurs to the silver mirror due to high laser fluence, interfering with proper aiming and possibly diminishing delivered energy and treatment efficacy.PURPOSE To evaluate the outcome of pericardium patch graft (Tutoplast®) as an adjuvant to either bleb repair or bleb reduction after nonpenetrating filtering surgery. METHOD Retrospective study, at a tertiary glaucoma center. Bleb revision with Tutoplast® positioning was performed either for bleb repair to treat early leaks or hypotony with maculopathy, either for bleb reduction to improve ocular pain, discomfort, burning, foreign body sensation, tearing and fluctuations of visual acuity. Intraocular pressure (IOP), best corrected visual acuity (BCVA), number of antiglaucoma medications, and postoperative complications were analyzed postoperatively at 1 week, 1 month, 3 months, 6 months, and compared to the pre-operative baseline. Surgical success was defined as achieving an intraocular pressure between 8 and 16▒mmHg. RESULTS 6-month data were available from 15 eyes of 15 patients; mean patient age was 69.6±11.7 (66.7% male). Bleb revision was necessary for 10 patients due to bleb dysesthesia (bleb reduction), and in 5 patients due to leaking filtering bleb (bleb repair). The success rate was 73.3% at 6 months, with a significant IOP increase from 4.9▒mmHg±2.2 pre-operatively to 12.7▒mmHg±3.5 at 6-month (P=0.0001), and a concomitant rise of BCVA from 0.5±0.3 to 0.6±0.3 (P=0.2871). In order to control IOP, antiglaucoma medications were needed for 3 patients (20%) at 6-month. Overall, 3 patients (20%) required additional bleb revision for persistent hypotony, and 1 patient underwent a subsequent glaucoma surgery (transscleral cyclodestruction). CONCLUSION Pericardium patch graft (Tutoplast®) is a safe and effective adjuvant for bleb revision due to bleb dysesthesia of leaking filtering bleb after nonpenetrating filtering surgery.INTRODUCTION Multimonth dispensing (MMD) of antiretroviral treatment (ART) aims to reduce patient-related barriers to access long-term treatment and improve health system efficiency. However, randomized evidence of its clinical effectiveness is lacking. We compared MMD within community ART groups (CARGs) vs. GBD-9 ic50 standard-of-care facility-based ART delivery in Zimbabwe. METHODS A three-arm, cluster-randomized, pragmatic non-inferiority trial was performed. Thirty healthcare facilities and associated CARGs were allocated to either ART collected three-monthly at facility (3MF, control); ART delivered three-monthly in CARGs (3MC); or ART delivered six-monthly in CARGs (6MC). Stable adults receiving ART ≥six months with baseline viral load (VL) less then 1000 copies/ml were eligible. Retention in ART care (primary outcome) and viral suppression (VS) 12 months after enrolment were compared, using regression models specified for clustering. ClinicalTrials.gov NCT03238846. RESULTS 4800 participants were recruited; 1919, 1335 and 1546 in arms 3MF, 3MC and 6MC, respectively. For retention, the pre-specified non-inferiority limit (-3.25%, risk difference [RD]) was met for comparisons between all arms, 3MC (94.8%) vs. 3MF (93.0%), adjusted RD=1.1% (95% CI -0.5% to 2.8%); 6MC (95.5%) vs. 3MF aRD=1.2% (95% CI -1.0% to 3.6%); and 6MC vs. 3MC aRD=0.1% (95% CI -2.4% to 2.6%). VL completion at 12 months was 49%, 45% and 8% in 3MF, 3MC and 6MC, respectively. VS in 3MC (99.7%) was high and not different to 3MF (99.1%), relative risk=1.0 (95% CI 1.0-1.0). VS was marginally reduced in 6MC (92.9%) vs. 3MF, relative risk=0.9 (95% CI 0.9-1.0). CONCLUSION Retention in CARGs receiving three and six-monthly MMD was noninferior versus standard-of-care facility-based ART delivery. VS in 3MC was high. VS in six-monthly CARGs requires further evaluation.BACKGROUND Our objective was to quantify the extent of anal cancer screening among men receiving HIV specialty care in Ontario, Canada and evaluate factors associated with screening. SETTING Cross-sectional questionnaire within a multi-site clinical HIV cohort. METHODS A questionnaire assessing knowledge and experience with HPV-associated diseases and their prevention was administered in 2016-2017 to 1677 men in the Ontario HIV Treatment Network Cohort Study. We used logistic regression to identify factors associated with having discussed screening with a healthcare provider and self-reported receipt of screening (digital anorectal exams [DARE]; anal cytology or anoscopy). Results reported as adjusted odds ratios (aOR) with 95% confidence intervals (CI). RESULTS 40% of men reported ever having had anal cytology/anoscopy, and 70% had ever had DARE. After accounting for differences in age, sexual orientation, years since HIV diagnosis, previous diagnosis with AIDS, knowing someone with HPV-associated cancer, comfort discussing anal health, education and income, the proportion screened differed by self-identified race. Compared to White men, Asian men were less likely to have discussed screening with a healthcare provider (aOR=0.48 95% CI0.29,0.80) or to have been screened by DARE (aOR=0.27 95% CI0.17,0.44) or anal cytology/anoscopy (aOR=0.51 95% CI0.31,0.83); and African, Caribbean or Black men (aOR=0.47 95% CI0.31,0.70) were less likely to have had DARE. Results were consistent when restricting the analyses to gay, bisexual and other men who have sex with men. CONCLUSION Our findings highlight the potential for disparities in anal cancer screening that need to be considered when developing guidelines and screening programs to reduce the burden of anal cancer among men living with HIV and ensure health equity.
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