Incidence and outcome of endophthalmitis over a 13-year period

Objective: The aim of the study was to assess the functional results and long-term visual prognosis in patients treated for acute endophthalmitis (AE).Design: Observational clinical series.Participants: Evaluation of 120 eyes of 114 patients with AE treated between 1991 and 2004.Methods: This retrospective institutional analysis included 120 eyes of 114 patients (52 male, 68 female) with AE and a minimum follow-up of half a year. The patients had a mean follow-up of 23 months (6-135 months) and a mean age of 61 years (8 months-94 years) at the time of treatment. Treatment included intraocular injection of antibiotics alone (n = 18, 15%) and vitrectomy combined with intraocular and topical postoperative antibiotics (n = 85, 70%).Results: The most frequent complications were vitreous or retinal hemorrhages (n = 17, 14%), retinal detachment (n = 17, 14%), choroidal detachment (n = 3, 3%), secondary glaucoma (n = 7, 6%), and recurrent endophthalmitis (n = 3, 3%). Four eyes had to be enucleated because of recurrent and uncontrollable infection. Positive microbiological results were achieved in 67 of 88 specimens (76%). The most common isolate was Staphylococcus. At the end of follow-up, visual acuity was reduced (more than 2 lines) in 18 eyes (15%), stable in 22 (18%), and improved (more than 2 lines) in 72 eyes (60%).Conclusions: AE is a rare but severe disease with a potentially deleterious outcome in affected eyes. In our series, 78% of all eyes had stable or improved postoperative visual acuity following various treatment regimens, depending on the severity of each case.     

Vitrectomy for macular detachment associated with optic nerve pits

Objective. To describe the pathogenic mechanism for a central retinal detachment in eyes with a pit of the optic disc. Design. Three patients with macular detachment associated with optic nerve head pits were prospectively controlled following pars plana vitrectomy. Methods. Three cases of macular detachment associated with congenital optic nerve pit were treated with pars plana vitrectomy and air-fluid exchange and sulphur hexafloride (SF6) gas injection. During vitrectomy posterior hyaloid removal caused visible traction on the elevated retina, when the hyaloid detached. Removing the posterior hyaloid resulted in reattachment of the macular and an increase in the visual acuity without laser treatment. Conclusion. We recommend the removal of the posterior hyaloid face during pars plana vitrectomy in patients with central macular detachment associated with a pit of the optic disc.The study was presented in part at the XIXth meeting of the Club Jules Gonin, Versailles, France, September 11, 1994.     

Evaluation of mimetic expression of schizophrenic and depressed patients by the psychiatrist]

Facial videos of schizophrenic and depressive patients and of healthy controls when watching both funny and horror films and during emotionally positive or negative interviews were rated by psychiatrists (experts) and students (novices). The observers' task was to rate joy, fear, sadness, and expressivity on a 7-point unipolar intensity scale. The soundless facial videos were presented to each observer for exactly 2.5 min. The observer groups did not differ significantly in their ratings except for sadness. Psychiatrists consistently rated expressed sadness as less intense than students. Facial expressivity and joy were rated as less intense in both patient groups in comparison with healthy controls. Depressives expressed significantly more sadness.     

Nosologic specificity of psychopathologic findings in schizophrenic and depressed patients]

Different expert-rating scales (GAS, BPRS, SANS, Ham-D) were applied to assess the psychopathological findings in 40 schizophrenic and 40 depressive patients (classified according to DSM III-R guidelines). The data demonstrated that the schizophrenic sample did not display acute psychotic or negative symptoms as a specific symptomatology, and that depressive mood was not a specific symptom of the depressive sample. Hence, these types of research tools should mainly be used as a global measurement for determining the severity of psychiatric disorders, or for monitoring the progress of individual patients in order to illustrate disparate psychopathological qualities in nosologically different groups.     

A new permanent magnet for removal of intra-ocular ferromagnetic foreign bodies

The permanent-magnet (Sm-Co-Magnet) is described with a length of 35 mm and a diameter of 18 gauge. This magnet enables a controlled atraumatic removal of small or even larger intraocular ferromagnetic foreign bodies.     

A school-based intervention program to prevent adolescent smoking.

Research has shown that tobacco use usually begins in early adolescence, results in an increase in future health problems, and ultimately affects national health care costs. Despite the messages about the dangers of smoking, young people continue to smoke. A school-based tobacco education program designed to produce a more favorable attitude about the positive effects of not smoking and increase knowledge of the hazards of smoking was implemented for 6th graders in a parochial middle school. After the intervention, there was a significant increase in knowledge about tobacco but no change in attitudes regarding the use of tobacco. The results have implications for school nurses who design and teach programs to prevent tobacco use.     

Manifestation of intolerance to cow's milk protein in mucoviscidosis with the symptom triad of hypoproteinemia, edema and anemia

The symptom complex--hypoproteinemia, edema and anemia--occurs in approximately 5 percent of CF-patients during the first 6 months of life. Since milk is the only nutritional source in this age group, a hypocaloric nutrition respectively marginaly low protein intake may contribute to these symptoms in case of an exocrine pancreatic insufficiency. Even if breast milk and soy bean formulas can advance the disease it must be mentioned that relapses of the symptom triad had never occurred under pancreatic enzyme supplementation independently of the source of milk being fed. A cow's milk protein intolerance and coincidental exocrine pancreatic insufficiency lead to the symptom complex in an infant in spite of an adequate caloric and protein intake. This case revealed again that sweat electrolyte tests are unreliable during the acute period of disease, sweat tests were positive when the presenting symptoms were resolved. The case demonstrates that repeated sweat chloride tests are mandatory during an asymptomatic phase of disease besides the exclusion of a renal or cardiac origin of the symptom complex. An early postnatal diagnosis of CF and immediate initiation of pancreatic enzyme and fat soluble vitamin supplementation could prevent such courses of disease.