Absence of muscle capillary basement membrane thickening and retinopathy in patients with myocardial infarction and impaired I.V. glucose tolerance

Summary We have investigated the possible contribution of an early capillaropathy to the increased incidence of myocardial infarction (MI) in patients who had impaired glucose tolerence (IGT) during an i.v. glucose tolerance test (IVGTT). In lieu of the myocardium, biopsies from the quadriceps femoris muscle were studied for muscle capillary basement membrane (MCBM) thickening. Fluorescence angiography was performed to detect capillary retinopathy. Plasma growth hormone (GH) concentrations were determined during IGT. Data were obtained from 14 male patients with MI and IGT on IVGTT. Nine healthy subjects served as controls. MCBM thickness was similar in patients and controls (1,107±55vs 1,067±88 ?). None of the patients had signs of capillary retinopathy, and plasma GH concentrations were not higher in the patients as compared to control subjects. It is concluded that, in patients with IGT on IVGTT, MCBM thickening is probably not a factor for the development of MI.     

Use of nonsterile instruments for examination for retinopathy of prematurity in the neonatal intensive care unit

OBJECTIVE: Use of nonsterile eyelid speculae and scleral depressors during screening examinations for retinopathy of prematurity (ROP) in the neonatal intensive care unit (NICU) violates existing infection control recommendations. The objective of this study was to characterize current instrument management and to estimate the prevalence of use of nonsterile instruments. STUDY DESIGN: NICU nurse managers were surveyed. Questionnaires were mailed to 735 NICUs from The United States Neonatologists and Perinatologists Directory. RESULTS: Of 300 surveys returned, 290 reported ROP examinations in their NICUs. Two hundred ten (72%) of 290 NICUs reported supplying instruments. Seventy-five (36%) of 210 NICUs supplying instruments reported a best practice on the basis of current guidelines. Twenty-six (9%) of 290 NICUs reported eye infections as a result of ROP examinations. Reported infection was more frequent (19%) among NICUs reporting reuse of instruments ( P =.019) and more frequent (17%) among NICUs in which ophthalmologists brought their own instruments ( P =.021). Only one (2%) NICU reporting best practice also reported eye infections ( P =.004). CONCLUSIONS: ROP instrument management is inconsistent within and between NICUs. Without the exclusive use of sterile instruments, an increased risk of nosocomial infection might exist. Greater attention to sterile instrument management is recommended.     

The effect of a growth hormone receptor antagonist drug on proliferative diabetic retinopathy

Objective

This study investigated whether the growth hormone receptor antagonist pegvisomant could produce regression of diabetic retinal neovascularization.

糖尿病视网膜病变患者家庭关怀度与治疗依从性关联研究

目的调查2型糖尿病合并视网膜病变患者家庭关怀度、视功能损伤程度（以矫正视力、视网膜病变为评价指标）与治疗依从性之间的关系,为完善糖尿病视网膜病变的临床治疗提供依据.方法对127例糖尿病视网膜病变患者分别进行矫正视力、视网膜病变检查,并采用APGAR家庭关怀度指数问卷和糖尿病治疗依从性问卷分别评定家庭关怀度和治疗依从性情况,并分析以上各项与糖尿病患者治疗依从性的关系.结果糖尿病视网膜病变患者家庭关怀度指数与正常对照组存在显著差异,家庭关怀度总分、家庭适应度、情感度、亲密度三个维度评分及视力损伤程度与治疗依从性呈显著相关性,视网膜病变与治疗依从性无显著相关性.结论家庭关怀度总分、适用度、情感度、亲密度与治疗依从性相关,糖尿病患者依从性与家庭支持呈正相关.     

糖尿病视网膜病变患者健康教育需求调查与对策

目的通过对糖尿病（DM）患者进行眼科健康教育的需求调查，制定护理对策，使糖尿病视网膜病变（DR）患者做到早诊断、早治疗，以保留健康的视力。方法对175例DR患者进行健康教育内容及需求调查，制定相应护理对策。结果175例DR患者中63例（36％）患者掌握有关DR的知识，接受过健康教育的患者视力明显好于未接受健康教育者。结论必要的DM教育，使患者正确认识DM，大力培养专科护士是减少DR发病的有力护理措施。     

早产儿视网膜病变发生率及危险因素分析

目的分析早产儿视网膜病变（ROP）的发生率及危险因素。方法对孕周〈36周，出生体质量〈2500g的208例早产儿生后4～6周行眼底检查，根据ROP国际诊断分期法进行诊断分级，探讨ROP与孕周、出生体质量、窒息、吸氧、母亲妊娠并发症、感染及贫血等因素的关系。结果208例早产儿中患有不同程度ROP者39例（其中ROPⅠ期24例，ROPⅡ期13例，ROPⅡ期2例），ROP发生率为18．8％。ROP病儿中住院期间有3例自愈，4例成功进行手术治疗，而大部分病例需出院后继续定期进行眼底检查。孕周、出生体质量、吸氧、母亲妊娠并发症、贫血及感染对ROP的发生具有明显影响。且孕周越短、出生体质量越小，ROP发生率越高。结论早产儿ROP的发生率较高，ROP的发生与孕周、出生体质量、吸氧、母亲妊娠并发症、贫血及感染等因素有关。     

Microaneurysms in diabetes mellitus

Summary The structural characteristics of and similarities between retinal, glomerular and conjunctival microaneurysms are detailed. Predisposing factors are reviewed. A combination of hypertriglyceridemia and local rheological factors such as venular stasis or capillary ischaemia frequently leads to the formation of microaneurysms. This combination of factors pertains to some extent in hypertension but more particularly in diabetes.This work is partly based on a thesis for M. D. submitted by the author to Glasgow University.     

Hubbard法评价视网膜血管改变与高血压冠状动脉狭窄的相关性

目的 探讨Hubbard法评价高血压患者视网膜血管改变与64层螺旋CT冠状动脉造影诊断冠状动脉狭窄的相关性。方法选取行双源64层螺旋CT冠状动脉造影检查的110例高血压患者,对其进行眼底照相,并采用Hubbard法对视网膜血管进行详细评价,测定视网膜动脉狭窄程度、动静脉交叉压迫征严重程度和视网膜动静脉直径比值。结果73例（66．4％）高血压患者被诊断为冠状动脉狭窄。冠状动脉狭窄组的视网膜动脉狭窄程度和动静脉交叉压迫征的严重度,均较对照组明显增加（P〈0.05）。冠状动脉狭窄患者,随着狭窄程度的增加,视网膜动脉狭窄程度、动静脉交叉压迫征的严重度均明显增加（P〈0．05）。冠状动脉狭窄者视网膜动脉直径和动静脉直径比值均明显小于对照组（P〈0．05）,而视网膜静脉直径并无明显变化（P〉0．05）。另外,冠状动脉狭窄患者,随着狭窄程度的增加,视网膜动脉直径与视网膜动静脉比值均明显缩小（P〈0．05）。视网膜动脉狭窄对冠状动脉狭窄程度的阳性预测率为76．62％,灵敏度为80．82％;视网膜动静脉交叉压迫征的阳性预测值为89．74％,特异性为89．19％。结论采用Hubbard法评价高血压患者视网膜血管的改变,可以很好地间接反映冠状动脉的狭窄程度。该视网膜血管评价方法,可以用于高血压患者的冠心病普查,并为进一步施行64层螺旋CT冠状动脉造影检查提供依据。