INTRA-OCULAR PRESSURE CHANGES AF-TER B-BLOCKER EYE DROPS INSTILLA-TION AND BICYCLE ERGOMETER EXER-CISE

Purpose: To evaluate the additive IOP effect of physical aerobic exercise (bicycle ergometer), in healthy individuals, after the in- stillation of b-blockers. Material: 20 healthy individuals. Methods: The IOP was measured before and 2 hours after the instillation of eye drops (b-blockers) in the right eye (OD) of the individuals.. The IOP was measured again within 5 minutes after the completion of physical exercise on a bicycle ergometer (about 10 minutes of duration - till exhaustion). Results: The instillation of b-blocker eye drops in the right eye was followed by an IOP decrease after 2 hours. The IOP decreased further more after the performance of the bicycle ergometer exercise. Mean IOP before the instillation of b-blocker. right eyes: 16.25, left eyes: 16.15. Mean IOP after the instillation of b-blocker. right eyes: 12.35 (decrease ranged from 3 to 5 mm Hg), left eyes: 14.20.. The IOP lowering effect after the bicycle ergometer exercise for the right eyes ranged from 1 to 5 mmHg. Mean IOP 10.20.     

The Effect of Education and Self-monitoring of Blood Glucose on Glycosylated Hemoglobin in Type I Diabetes

ABSTRACT The influence on glycosylated hemoglobin (HbA₁) of formal education as compared with self-monitoring of blood glucose (SMBG) was studied in a randomized 18-month trial. All adult type I diabetics in a community were identified. Forty-one of these patients had had diabetes for 20 years or less. Thirty-seven patients were included in the study and finally randomized into four groups. Ten patients received individual formal education followed by SMBG, eight patients were instructed in SMBG without pre-education, nine patients were given only formal education and 10 patients made up a reference group. Education did not improve the mean HbA₁ values. SMBG resulted in a decrease by 2% in HbA₁ from 12 to 10% (p<0.05). The final HbA₁ level, however, did not differ significantly between any of the groups. SMBG was accepted by 80% of the patients. The liability to hypoglycemia was about equal in the four groups. It was concluded that SMBG, but not education, improved metabolic control to a certain degree.     

Pseudophakic inferior retinal detachment or detachment with inferior breaks: clinical outcome and recurrences after primary vitrectomy-gas

BACKGROUND: This study aims to evaluate the outcome of primary vitrectomy/gas for pseudophakic retinal detachment (RD) located inferiorly or associated to inferior breaks. PATIENTS AND METHODS: We performed a retrospective, non-randomised study comprising 18 pseudophakic RD eyes with inferior RD (group A) and 19 pseudophakic RD eyes with inferior breaks (group B) treated with primary vitrectomy and gas tamponade (SF (6) 20 %). Pre- and postoperative characteristics were analysed, focusing on RD recurrences. RESULTS: In group A, RD recurred in 2/18 eyes (11 %) and was associated to proliferative vitreoretinopathy (PVR) both at first intervention and on recurrence. In group B, RD recurred in 4/19 eyes (21 %). One eye presented PVR at first intervention and all at re-intervention. Anatomic reapplication was achieved after second vitrectomy/gas in 2/4 eyes of group B, whereas long-term silicon oil tamponade was needed in 2 eyes of each group. CONCLUSIONS: This series shows a high success rate of primary vitrectomy/gas in pseudophakic RD patients with inferior RD or detachment associated to inferior breaks. Recurrences after vitrectomy are most often related to the presence of PVR.     

Occult anterior-chamber metallic fragment post-phacoemulsification masquerading as chronic recalcitrant postoperative inflammation

PURPOSE: To report a case of an occult, metallic, anterior-chamber intraocular foreign body after uneventful phacoemulsification that was masquerading as chronic recalcitrant postoperative inflammation. DESIGN: Interventional case report. METHODS: A 73-year-old patient was referred to us for recalcitrant anterior-chamber inflammation after uneventful phacoemulsification; the patient presented with visual disturbances, anterior-chamber inflammation, and macular epiretinal membrane with concomitant cystoid macular edema. RESULTS: After meticulous evaluations and repeated clinical examinations, a metallic intraocular foreign body was discovered on the iris, which was surgically removed and analyzed. Chemical analysis revealed copper, aluminum, and zinc. Pars plana vitrectomy with epiretinal membrane and indocyanine-green-assisted internal limiting membrane peeling followed, with subsequent improvement of visual acuity. CONCLUSIONS: Intraocular foreign bodies should always be considered in the differential diagnosis of recalcitrant inflammation post-phacoemulsification. However, in the absence of intraocular inflammation, surgical removal of such particles is questionable.     

Bronchopulmonary dysplasia: radiographic appearance in middle childhood

Chest radiographs were compared for three groups of children 8-9 years old: 23 survivors of bronchopulmonary dysplasia (BPD), 33 survivors of hyaline membrane disease without BPD, and 35 survivors of premature birth without neonatal respiratory problems. Only four children in the second group and three in the third had abnormal lungs. Linear shadows, apparently representing strands of fibrosis or deep pleural fissuring, were seen more frequently (15 of 23) in the BPD group than in the others (P less than .0001). Seventeen children in the BPD group had definite pulmonary abnormalities, none of them severe. The anteroposterior dimension of the chest in survivors of BPD tended to be decreased (P less than .001 vs that of reported control subjects).     

Effects and mechanisms of PCB ecotoxicity in food chains: Algae  fish  seal  polar bear 1

Wildlife populations are adversely affected in polluted environments. Nevertheless, a cause‐and‐effect relationship between excessive exposure to chlorinated hydrocarbons and induction of pathologic disorders in animals, is difficult to demonstrate without verification from experiments following the rationale of Koch's postulates. Deleterious effects of chlorinated chemicals such as DDT on songbird reproduction, as demonstrated by the clutch size of eggs in a nest, however, is an example, where exposure and causation are apparent. With amelioration of DDT pollution, clutch size increases, and the cause‐and‐effect relationship is established. Similar examples of exposure to DDT and PCBs inducing reproductive disorders and endocrine disruption among marine mammals have been documented in industrialized nations of northern Europe and in the upper latitudes of the Northern Hemisphere. Population declines in ringed, grey and harbor seals are apparently due to a rapid decrease in their rates of reproduction¹. These latter observations are best interpreted in light of experiments conducted by Reijnders². Reijnders exposed harbor seals to relatively high dietary levels of PCBs and induced PCB‐blood‐lipids among seals to an average of 25 mg/kg compared to 10 mg/kg among controls. The treated seals had a significantly reduced reproductive rate. A relationship between increased PCB‐blood‐levels in vivo and the decrease in reproductive rates in this experiment is highly instructive for interpreting the decline of fertility in seal populations in polluted Baltic Sea waters. These linked observations are dependent upon demonstration of pathologic mechanisms associated with occlusion and stenosis of the uterine lumen among affected females in seal populations.

PCB congeners apparently disrupt endocrine‐system‐functions leading to, or associated with, increases in endometriosis, fetal abortion, glomerulonephropathies and osteoporosis. This observation is further highlighted by Reijnders experiment, which closely replicated the range of PCB concentrations found in seal populations living in a variety of PCB polluted waters.

Various PCB congeners differentially accumulate in brain, liver and adipose tissues in young and old seals. Further research of PCB toxic effects on organ systems of these animals and other species is thus indicated.

This report, then, examines the process of PCB bioaccumulation within the marine food chain from fish to seals, whales, other marine mammals and to polar bears. Environmental toxic pollutants affect animals within the food chain in different ways but ultimately they affect humans as well.