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Нейромиелитное расстройство спектра в Германии. Анализ данных о частотности, распространенности, методах лечения и диагностическом совпадении с множественным склерозом.

Нейромиелитные расстройства спектра (NMOSD) являются редкими аутоиммунными заболеваниями центральной нервной системы. Оценки распространенности в мире сильно различаются, а данные по Германии являются ограниченными. ЦЕЛИ: Оценка распространенности, частотности, диагностических параметров, комордного кодирования с множественным склерозом (MS) и схем лечения в Германии. Мы проанализировали данные о претензиях в связи с медицинским страхованием в Германии (приблизительно) 9 million - лица; 2015-2022). Случаи НМОСБ были выявлены ICD-10-GM код G36.0. Была проведена оценка динамики, диагностических

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… Incident diagnoses were provided by neurologists in most cases (48%), followed by general practitioners in 28%, and in 8% by ophthalmologists ( Table 1 ). Table 1. … incident cases | | 20–39 years (%) | | 30 40–59 years (%) | | 42 60+ years (%) | | 27 Setting of incident NMOSD diagnosis (%) | | During hospitalization (%) | | 37 Outpatient setting (%) | | 63 Specialist group for incident diagnosis* | | Neurologist | | 48 General practitioner | | 28 Ophthalmologist …

Диагностическая точность межглазой разницы только в слое ячеек для определения оптического неврита при множественном склерозе.

ВВЕДЕНИЕ: Критерии Макдональда 2024 года для диагностики множественного склероза (МС) включают в себя оптическое нервы в качестве пятого региона для обеспечения распространения в космосе. Оптический нейрит (ON) может быть обнаружен с помощью оптической последовательности томографии (OCT) с использованием межглазой абсолютной или процентной разницы (IEAD, IEPD) в толщине ганглионного клеточного плексиформного слоя (GCIPL). ЦЕЛЬ: Сопоставление диагностической точности ГКИПЛ МЭАД/ЙЕДП с ГЦЛ и ИПЛ МЭАД/ЕИПД только для выявления истории ВН. МЕТОДЫ: Это перекрестное ретроспективное исследование охва

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… ON was confirmed by experienced neuro-ophthalmologists based on the following criteria: monocular, subacute loss of vision accompanied by (i) orbital pain worsening on eye movements, (ii) reduced contrast and color vision, and/or (iii) relative afferent pupillary defect (RAPD). … Optical coherence tomography OCT imaging was performed by experienced neuro-ophthalmologists at the Department of Ophthalmology and Optometry using the same spectral-domain OCT (Spectralis OCT, Heidelberg Engineering, Heidelberg, Germany; software Heidelberg eye explorer software version 5.4.8.0) without …

Belantamab mafodotin плюс венетоклакс в t()11;14)-положительное повторное или повторное несколько миелом – испытание BELI(E)VE

Множественная миелома (ММ) — широко неизлечимая злокачественная клетка B-клеток, которая в основном затрагивает пожилых людей. 10% от рака гематологов. Несмотря на достижения в области терапии, которые значительно увеличили средний показатель общего выживания (ОС), ММ по-прежнему является клинической проблемой с плохим прогнозом в отношении пациентов, отказывающихся от лечения в нескольких классах лекарственных препаратов. Существует острая потребность в новаторских и индивидуализированных методах лечения, в том числе для пациентов с транслокацией (см.11;14), подгруппу, характеризующуюся особо

The role of topical moxifloxacin, a new antibacterial in Europe, in the treatment of bacterial conjunctivitis.

This article discusses current practice in the treatment of conjunctivitis and how the use of topical moxifloxacin can increase therapeutic effectiveness, reduce treatment failures and, consequently, be cost effective and reduce the societal burden of the disorder. Current practice and effectiveness data were derived from the literature. Data on healthcare utilization as a result of treatment failure were collected by survey and the cost of treatment was defined using national costings. A decision-analytic model to assess cost effectiveness was developed and the impact on the healthcare budget

[Studies on clinical pathophysiology of pseudophakic/aphakic eyes--a journey of 4 decades].

My prime years as an ophthalmologist began as intraocular lenses (IOLs) were just entering into the developmental stage, and I took on as my mission to contribute to perfecting safe and reproducible cataract/IOL implantation surgery. Identifying surgical and/or IOL-related complications consumed time; however, these complications soon became predictable and even preventable with the use of sensitive biological parameters and preclinical evaluation. This was a simple goal for me to pursue my studies on cataract/IOL implantation surgery. I discuss in this review article, based on my previous res

Ocular complications with the use of radium-223: a case series.

BackgroundRadium-223 is used for the treatment of osseous metastases in castrate-resistant prostate cancer, and has been shown to increase time to the first skeletal-related event, reduce the rate of hospitalization, and improve quality of life. It is well tolerated, with hematologic toxicity as the main adverse event. Thus far, no ocular complication has been reported in the literature after initial administration of radium-223 with a single case reported of ocular complications after a patient's second course of radium-223.Case presentationsWe present three cases of ocular complications afte

Face-down positioning or posturing after pars plana vitrectomy for macula-involving rhegmatogenous retinal detachments.

BACKGROUND: A macula-involving rhegmatogenous retinal detachment (RRD) is one of the most common ophthalmic surgical emergencies and causes significant visual morbidity. Pars plana vitrectomy (PPV) with gas tamponade is often performed to repair primary macula-involving RRDs with a high rate of anatomical retinal reattachment. It has been advocated by some ophthalmologists that face-down positioning after PPV and gas tamponade helps reduce postoperative retinal displacement. Retinal displacement can cause metamorphopsia and binocular diplopia. OBJECTIVES: The primary objective of this review …

Aetiologies, neuroradiological features, and risk factors for mortality and long-term neurosequelae of febrile coma in Malawian children: a prospective cohort study.

BACKGROUND: Children in febrile coma in Africa are frequently hospitalised, with poorer outcomes than those in high-income settings. Cerebral malaria is historically the most common cause of febrile coma. Due to limited diagnostic and radiological resources and a decrease in malaria prevalence, there might be under-recognition of non-malarial coma. However, prospective data are scarce. We aimed to determine causes, neuroradiological features, risk factors for mortality, and neurosequelae of children in febrile coma in Malawi. METHODS: In this prospective cohort study, we enrolled children in

Characterization of Belantamab Mafodotin-Induced Corneal Changes in Patients With Multiple Myeloma.

IMPORTANCE: Ocular surface events are a class effect of microtubule-inhibitor payload-containing antibody-drug conjugates (ADCs); the mechanism underlying these events has not been fully elucidated. OBJECTIVE: To characterize corneal epithelial changes in patients with relapsed or refractory multiple myeloma (RRMM) treated with belantamab mafodotin, a maleimidocaproyl monomethyl auristatin-F (MMAF)-containing ADC. DESIGN, SETTING, AND PARTICIPANTS: This multicenter, phase 3b case series study was conducted in the US from March 26, 2020, to November 21, 2022, among adults with RRMM. Data were

Ассоциация увеита с педиатрическими аутоиммунными заболеваниями на основе исследования TriNetX.

Расследовать риск увеита среди таких пациентов. В ретроспективном когортном исследовании использовалась база данных TriNetX и были приняты на работу педиатрические аутоиммунные пациенты, диагностированные в период с января 1st 2004 и декабрь 31st 2022. Неавтоиммунная группа была произвольно выбрана пациентами-контролями в разбивке по полу, возрасту и индексу года. Главным результатом этого является появление новых увеитов. 175,328 Пациенты педиатрии с аутоиммунными заболеваниями (средний возраст) 10.7 +/- 5.1 годы; 55.8% - женщины; 66.2% Белый) и 175,328 Пациенты педиатрии без аутоиммунных заб

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… We recognize the significant clinical value of examining this issue from a non-ophthalmologist perspective. … This provides non-ophthalmologists with a clearer understanding and allows them to detect warning signs earlier and refer pediatric patients with these conditions for specialist evaluation in a timely manner. …

The role of belantamab mafodotin for patients with relapsed and/or refractory multiple myeloma.

Belantamab mafodotin (belamaf) is a first-in-class anti-B-cell maturation antigen (BCMA) antibody-drug conjugate (ADC) that recently gained regulatory approval for the treatment of relapsed and/or refractory multiple myeloma (RRMM) patients who have received at least four prior therapies including an anti-CD38 monoclonal antibody (mAb), a proteasome inhibitor (PI), and an immunomodulatory drug (IMiD). As the first BCMA-targeted therapy to be approved in multiple myeloma along with its "off-the-shelf" outpatient administration, belamaf addresses a significant unmet need in RRMM that is refracto

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… Belamaf should be avoided in patients with pre-existing corneal epithelial disease, and contact lenses should not be worn unless recommended by an ophthalmologist. … Given the unique and frequent corneal ocular AEs reported with belamaf, a multidisciplinary team of oncologists and eye care specialists (general ophthalmologists, optometrists, and/or corneal specialists) is needed to safely treat patients with belamaf. …

Relapsing polychondritis: state of the art on clinical practice guidelines.

Due to the rarity of relapsing polychondritis (RP), many unmet needs remain in the management of RP. Here, we present a systematic review of clinical practice guidelines (CPGs) published for RP, as well as a list of the most striking unmet needs for this rare disease. We carried out a systematic search in PubMed and Embase based on controlled terms (medical subject headings and Emtree) and keywords of the disease and publication type (CPGs). The systematic literature review identified 20 citations, among which no CPGs could be identified. We identified 11 main areas with unmet needs in the fie

Health and aging in elderly farmers: the AMI cohort.

BackgroundThe health of the agricultural population has been previously explored, particularly in relation to the farming exposures and among professionally active individuals. However, few studies specifically focused on health and aging among elders retired from agriculture. Yet, this population faces the long-term effects of occupational exposures and multiple difficulties related to living and aging in rural area (limited access to shops, services, and practitioners). However, these difficulties may be counter-balanced by advantages related to healthier lifestyle, richer social support and

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… Beyond the epidemiological approach, we paid from the very beginning of the research, a specific attention to the development of a multidisciplinary approach, involving epidemiologists, neurologists, neuropsychologists, psychologists, geriatricians, ophthalmologists, pharmaco-epidemiologists, demographists … Finally, self-reported ocular diseases and visual impairment (self-reported and assessed using a reading test commonly used by French ophthalmologists (Parinaud test) or its equivalent for the illiterate (Rossano and Weiss test)), hearing impairment (deafness or self-reported difficulty following conversations …

Multidisciplinary Management of Morbidities Associated with Chronic Graft-Versus-Host Disease.

Chronic graft-versus-host disease (cGVHD) represents a common long-term complication after allogeneic hematopoietic stem cell transplantation (HSCT). It imposes a significant morbidity burden and is the leading cause of non-relapse mortality among long-term HSCT survivors. cGVHD can manifest in nearly any organ, severely affecting the quality of life of a transplant survivor. While the mainstay of treatment has remained systemic immunosuppression with glucocorticoids, progress has been made within the last few years with approvals of three oral agents to treat steroid-refractory cGVHD: ibrutin

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… Thus, in addition to routine eye examinations, any particular concern of ocular involvement of cGVHD should prompt early referral to an ophthalmologist with experience in ocular GVHD for a thorough evaluation with slit lamp exam and other specialized clinical tests as indicated, such as with corneal … Ophthalmologists versed in GVHD also supervise the use of topical therapies, such as with lubricants and anti-inflammatory drops (e.g., corticosteroid, tacrolimus, cyclosporine), scleral lenses, and procedural interventions which are the mainstay of ocular cGVHD management, as systemic therapy rarely …

Adverse events associated with chimeric antigen receptor T-cell therapy in ophthalmology: a narrative review.

Chimeric antigen receptors are synthetically produced receptors engineered to engage with target cells with high specificity. These cells are created by inserting an artificial T-cell receptor into an immunoglobulin's antigen-binding region, allowing the cells to combine and target specific antigens. The use of chimeric antigen receptor (CAR) T-cell therapy has been a remarkable achievement in the field of immunotherapy, particularly in the treatment of ophthalmic tumors like retinoblastoma and uveal melanoma. However, there are some documented side effects, such as cytokine release syndrome (

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… Therefore, it is crucial for ophthalmologists and oncologists to understand the potential ocular toxicities associated with this therapy. Recognizing the appropriate time to refer patients for an ophthalmic examination is essential in effectively managing these potential side effects 13 . … Ophthalmic manifestations of acute leukaemias: the ophthalmologist’s role . Eye (Lond) . 2004 ; 18 : 663 – 672 . 15002029 10.1038/sj.eye.6701308 32 Rafei H Kantarjian HM Jabbour EJ . Recent advances in the treatment of acute lymphoblastic leukemia. …

Effect of softperm lens wear on corneal thickness and topography: a comparison between keratoconic and normal corneae.

PURPOSE: Complications related to contact lens-induced anoxia in the keratoconic eye are well documented, but the underlying mechanisms are poorly understood. This study compared topographical changes in corneal thickness and anterior corneal radius following SoftPerm (Ciba Vision, Atlanta, GA) (rigid-and-soft combination) lens wear in a group of keratoconic and normal individuals. METHODS: Video keratoscopic (VKS) (EyeSys, Houston, TX) and ultrasonographic pachometry measurements were taken at nine ocular locations, at central, mid-peripheral, and peripheral corneal areas of keratoconic and

Recurrent methicillin-resistant Staphylococcus aureus wound ulcer after clear-cornea cataract surgery.

PURPOSE: To present a case of recurrent, methicillin-resistant Staphylococcus aureus (MRSA) wound ulcer after clear-cornea cataract surgery. METHODS: Case report. RESULTS: An 82-year-old man underwent an uncomplicated phacoemulsification procedure with posterior-chamber intraocular lens (PCIOL) implantation. Two weeks after surgery, a corneal ulcer was present at the wound site. Corneal tissue sample cultures produced methicillin-resistant Staphylococcus aureus. The ulcer responded to high-dose vancomycin but recurred twice as vancomycin was tapered. Lamellar keratectomy with conjunctival fl

Therapeutic keratoplasty for infectious keratitis: a review of the literature.

PURPOSE: This article provides a review of the literature on various aspects of therapeutic keratoplasty, including indications, techniques, complications and outcome, and its application in cases of infectious keratitis. METHODS: Various articles on therapeutic keratoplasty (including English- and non-English-language publications) were analyzed. Selection of the articles was based on a Medline search for articles using the key words therapeutic keratoplasty, penetrating keratoplasty, therapeutic keratoplasty for infectious keratitis, non-healing corneal ulcer, microbial keratitis, and perfo

Visual performance of a multi-zone bifocal and a progressive multifocal contact lens.

PURPOSE: This study measured the relative visual performance of two planned-replacement soft contact lenses for presbyopic correction: a multi-zone bifocal (ACUVUE, Johnson & Johnson Vision Care, Jacksonville, FL) contact lens and a progressive multifocal (Focus Progressives, CIBA Vision, Duluth, GA) contact lens. METHODS: This was a randomized, double-masked, non-dispensing cross-over study. Visual performance was evaluated by log of minimal angle of resolution (LogMAR) measurement of visual acuity (VA) under a representative range of luminances (distance 250 candela[cd]/m2 and 2.5 cd/m2, ne

Bacterial keratitis and inflammatory corneal reactions: possible relations to contact lens oxygen transmissibility: the Harold A. Stein Lectureship 2001.

PURPOSE: Conventional contact lenses, particularly when used for extended wear (EW), are still associated with a high incidence of microbial keratitis and inflammatory reactions. This article discusses the possible relationship of such complications to contact lens oxygen transmissibility (Dk/t). METHODS: The literature, including our own work, is reviewed in regard to the binding of bacteria to the corneal epithelium and receptors likely to be associated with such binding, as well as the incidence of microbial keratitis and inflammatory reactions, in relation to conventional, lower Dk/t cont