Photodynamic Therapy in Macular Diseases of Asian Populations: When East Meets West

Purpose

We reviewed the indications, safety, and efficacy of photodynamic therapy with verteporfin in various macular diseases and vasculopathies, which are common in Asian populations, and compared the outcomes of photodynamic therapy in Asian patients with the outcomes in Caucasian patients.

Methods

Relevant clinical and laboratory original articles, case reports, and review articles that have been published in the literature between January 1999 and October 2004 were searched in Medline. The potential differences in the response to photodynamic therapy between Asian and Caucasian patients were evaluated. Articles in foreign languages with English abstracts were included.

Results

Macular diseases commonly seen in Asian populations, including choroidal neovascularization (CNV) of age-related macular degeneration, secondary to pathologic myopia or from an idiopathic cause, and choroidal vasculopathies such as central serous chorioretinopathy and polypoidal choroidal vasculopathy were included in the review. The results were tabulated and the differences with Caucasian populations were compared and highlighted.

Conclusion

Photodynamic therapy has been found to be an effective and noninvasive treatment for various subfoveal CNV and choroidal vasculopathies of the macula. Diverse behavior in different ethnic groups is observed. Jpn J Ophthalmol 2006;50:161–169 © Japanese Ophthalmological Society 2006     

Maternal mortality in the Maltese Islands

Maternal mortality statistics from the Maltese Islands since 1935 are reviewed to show that there has been a marked decrease in maternal mortality rates. This decrease is probably related to reductions in family size and improvements in the perinatal care of mothers. Hypertensive disease is now the most important cause of maternal mortality.     

An ethnobotanical study of medicinal plants used by the Nandi people in Kenya

ETHNOPHARMACOLOGICAL RELEVANCE: The study of local knowledge about natural resources is becoming increasingly important in defining strategies and actions for conservation or recuperation of residual forests. AIMS OF THE STUDY: This study therefore sought to collect information from local populations concerning the use of Nandi Forest medicinal plants; verify the sources of medicinal plants used and determine the relative importance of the species surveyed. MATERIALS AND METHODS: Data was obtained using semi-structured forms to record the interviewee's personal information and topics related to the medicinal use of specific plants. A total of 40 medicinal plants used locally for the treatment and/or control of human ailments were collected through interviews conducted with selected traditional doctors and professional healers. RESULTS: This study demonstrated that local people tend to agree with each other in terms of the plants use and that leaf material form the major component of plant parts exploited. The other harvested materials consist of stem bark, the roots and the whole plant, though at a lower intensity for making liquid concoctions from different plants. Majority of the remedies were prepared from a single species. In most cases, the mode of administration was oral. In the forest, some of the plants collected were scarce. This scarcity was attributed to indiscriminate logging, overexploitation, poor harvesting methods and current agricultural trends. CONCLUSION: Conservation procedures and creation of awareness were identified as the main remedies to the current situation.     

Plant Thorn Synovitis

Five children with an inflammatory monarthritis due to penetration of the joint by plant thorns are presented. The clinical presentation was that of a transient acute synovitis followed by a relatively asymptomatic period, and later by chronic arthritis often after the thorn injury was forgotten. Histopathology demonstrated a granulomatous synovitis. Polarized light microscopy facilitated identification of the plant tissue within the synovium. Conservative medical therapy was ineffective, but surgical excision of the affected synovium resulted in normal joint function. The differential diagnosis of monarthritis in children is extensive, and awareness of this condition is necessary to elicit a comprehensive history and to avoid delay in treatment.     

The 2001 Bethesda System: terminology for reporting results of cervical cytology

Diane Solomon, MD; Diane Davey, MD; Robert Kurman, MD; Ann Moriarty, MD; Dennis O'Connor, MD; Marianne Prey, MD; Stephen Raab, MD; Mark Sherman, MD; David Wilbur, MD; Thomas Wright, Jr, MD; Nancy Young, MD; for the Forum Group Members and the Bethesda 2001 Workshop

JAMA. 2002;287:2114-2119.

Objectives  The Bethesda 2001 Workshop was convened to evaluate and update the 1991 Bethesda System terminology for reporting the results of cervical cytology. A primary objective was to develop a new approach to broaden participation in the consensus process.

Participants  Forum groups composed of 6 to 10 individuals were responsible for developing recommendations for discussion at the workshop. Each forum group included at least 1 cytopathologist, cytotechnologist, clinician, and international representative to ensure a broad range of views and interests. More than 400 cytopathologists, cytotechnologists, histopathologists, family practitioners, gynecologists, public health physicians, epidemiologists, patient advocates, and attorneys participated in the workshop, which was convened by the National Cancer Institute and cosponsored by 44 professional societies. More than 20 countries were represented.

Evidence  Literature review, expert opinion, and input from an Internet bulletin board were all considered in developing recommendations. The strength of evidence of the scientific data was considered of paramount importance.

Consensus Process  Bethesda 2001 was a year-long iterative review process. An Internet bulletin board was used for discussion of issues and drafts of recommendations. More than 1000 comments were posted to the bulletin board over the course of 6 months. The Bethesda Workshop, held April 30-May 2, 2001, was open to the public. Postworkshop recommendations were posted on the bulletin board for a last round of critical review prior to finalizing the terminology.

Conclusions  Bethesda 2001 was developed with broad participation in the consensus process. The 2001 Bethesda System terminology reflects important advances in biological understanding of cervical neoplasia and cervical screening technology.