Aza Compounds ; analysis ; Heterocyclic Compounds ; analysis ; Sensitivity and Specificity ; Spectrophotometry, Ultraviolet ; methods ; Workplace

PURPOSE: Relapsing polychondritis is an uncommon systemic autoimmune disorder which is characterized by recurrent and often progressive inflammatory episodes involving multiple organ systems, including the ophthalmic, otorhinolaryngeal, respiratory, musculoskeletal, renal, cardiovascular, and dermatologic systems. The most common ocular manifestations are episcleritis and scleritis. Uveitis, especially the nongranulomatous type, has been reported in 3% to 22% of relapsing polychondritis cases. We report uncommon hypopyon uveitis as an ophthalmic finding associated with relapsing polychondritis. CASE SUMMARY: A 56-year-old woman with known relapsing polychondritis presented with ocular pain and redness in the right eye which had developed two months before and was managed for scleritis. However, she developed blurred vision, and hypopyon and vitreous opacity was found. The patient presented to our clinic and we diagnosed her with hypopyon uveitis associated with relapsing polychondritis. The patient was started on systemic steroid therapy consisting of 1% prednisolone acetate, 0.5% moxifloxacin, and 0.5% tobramycin in the right eye. Hypopyon disappeared 8 days following the initiation of treatment, and all symptoms had resolved after 14 days.
Aza Compounds ; Eye ; Female ; Humans ; Middle Aged ; Polychondritis, Relapsing ; Prednisolone ; Quinolines ; Scleritis ; Tobramycin ; Uveitis ; Vision, Ocular

PURPOSE: To report the clinical results of moxifloxacin mixed augmented amniotic membrane transplantation (AMT) in 2 patients with perforating infectious keratitis. CASE SUMMARY: Moxifloxacin mixed augmented amniotic membrane transplantations were performed in 2 patients with rapidly deteriorating deep perforated bacterial keratitis. All patients preserved their eyesight. Complete re-epithelization over the amniotic membrane were observed within a month. The corneal surfaces were healed with opacity, and there were no active infectious infiltrations or recurrences for 3 months after application. CONCLUSIONS: Moxifloxacin mixed augmented AMT has proven to be successful both tectonically and physiologically for cases with perforating active bacterial keratitis.
Amnion ; Aza Compounds ; Corneal Perforation ; Corneal Ulcer ; Fibrin Tissue Adhesive ; Humans ; Keratitis ; Quinolines ; Recurrence ; Transplants

PURPOSE: To report a case of fusarium keratitis treated with only moxifloxacin 0.5% ophthalmic solution (Vigamox(R), Alcon Laboratories, Inc., Ft Worth, TX, USA). CASE SUMMARY: A 37-year-old healthy male patient experienced a right eye injury due to grain 7 days prior to presentation at our hospital with visual disturbance and ocular pain. A 2.7 x 4.3 mm sized corneal epithelial defect with irregular featherlike midstromal infiltration was observed, and slit lamp examination revealed a dry, rough texture. Thus a smear and culture were performed. Moxifloxacin 0.5% ophthalmic solution (Vigamox(R)) and lubricant were applied for treatment. Three days after using the eye solution, all clinical features improved. Seven days later, Fusarium species was identified in culture. CONCLUSIONS: As standard treatment for Fusarium, the authors of the present study used an antifungal agent. Although hyphae were detected in culture, the use of only moxifloxacin 0.5% ophthalmic solution (Vigamox(R)) result in a satisfactory result and improvement in clinical features.
Adult ; Aza Compounds ; Edible Grain ; Eye ; Eye Injuries ; Fusarium ; Humans ; Hyphae ; Keratitis ; Male ; Quinolines

The prevention of and the controlling of symptoms, reductions in the frequency of exacerbations, and disease severity are central to the pharmacologic therapy of chronic obstructive pulmonary disease (COPD). COPD patients are inclined to be older, have more comorbidities, and use polypharmacy as a result. Long-acting inhaled muscarinic antagonists (LAMAs) is a preferred treatment modality. However, the cardiovascular (CV) safety of anti-cholinergics, including LAMA, has been an issue. In contrast, the results of the UPLIFT trial and a pooled analysis of data from 30 trials of tiotropium illustrates the association of tiotropium with reductions in the risk of all cause mortality, CV mortality and CV events. And, the UPLIFT trial provides clues regarding the additive advantages of tiotropium in COPD patients who already are using long-acting inhaled beta2 agonists and inhaled corticosteroids. Following the contribution of tiotropium as a first LAMA, new LAMAs such as aclidinium and glycopyrrolate (NVA-237) seem to be emerging.
Adrenal Cortex Hormones ; Cholinergic Antagonists ; Comorbidity ; Glycopyrrolate ; Humans ; Muscarinic Antagonists ; Polypharmacy ; Pulmonary Disease, Chronic Obstructive ; Scopolamine Derivatives ; Tiotropium Bromide

OBJECTIVE: The study aimed to evaluate efficacy of tiotropium as add-on therapy on top of standard regimens for uncontrolled asthma, specifically in terms of FEV1, morning and evening PEF, reduction in exacerbations, rescue medication use, and quality of life improvement.
METHODS: A search was done for eligible trials after which validity screen and data extraction was performed. Results were presented as mean differences, standard errors, and 95% confidence intervals, and graphically as forest plots. Estimates were pooled using the random effects model with I2 and Chi2 tests used to assess heterogeneity. Adverse events were reported as dichotomous variables.
RESULTS: Four studies were included totaling 1617 participants. The tiotropium group had statistically significant improvement in FEV1 (95% Cl, 0.14 [0.09, 0.19], p<0.00001), morning (95% Cl, 20.03 [11.71, 28.35], p<0.00001) with trend towards benefit in reduction of rescue medications (95% Cl, 0.12 [-0.17,0.4],p=0.42) and quality of life improvements (95% Cl, 0.1 [-0.05,0.25], p=0.20). Homogeneity (I2= 0%, Chi2= 0.47-3.22) was found across studies.
CONCLUSION: Tiotropium is associated with significant improvement in pulmonary function among patients with uncontrolled asthma, with possible benefit in reduction of rescue medications and quality of life improvement.

Human ; Male ; Female ; Adult ; Asthma ; Bronchodilator Agents ; Confidence Intervals ; Quality Of Life ; Respiratory Physiological Phenomena ; Scopolamine Derivatives ; Tiotropium Bromide ; Meta-analysis

PURPOSE: To report a case of corneal ulcer caused by Achromobacter xylosoxidans in a farmer. CASE SUMMARY: A previously healthy 68-year-old man presented with unilateral redness and irritation after his eye was grazed by a cow's tail. The patient had previously been treated in a local clinic for four days without improvement. Bacterial staining, culture, and an antibiotic sensitivity test were performed from a corneal scrape. The cultures revealed growth of A. xylosoxidans. The patient was treated with moxifloxacin and ceftazidime eyedrops. After three months of treatment, the infection was resolved with mild scarring. CONCLUSIONS: Although it is a rare pathogen, A. xylosoxidans should be considered as a potential pathogen in patients presenting with corneal ulceration due to trauma from an object contaminated by soil or animal feces and having a slowly progressive disease and localized infiltrate but showing Gram-negative bacilli on smear examination.
Achromobacter ; Achromobacter denitrificans ; Aged ; Animals ; Aza Compounds ; Ceftazidime ; Corneal Ulcer ; Eye ; Feces ; Humans ; Keratitis ; Ophthalmic Solutions ; Quinolines ; Soil ; Tail

BACKGROUND: According to the notion of the immunoregulatory functions of moxifloxacin (MFX), the effect of MFX on the neutrophilic respiratory burst in conjunction with the expression of cytosolic phospholipase A2 (cPLA2) was investigated. METHODS: The effects and possible mechanisms of MFX on neutrophilic respiratory burst in oleic acid (OA)-induced acutely injured rats lung and OA-stimulated, isolated murine neutrophils were probed, associated with the expression of cytosolic phospholipase A2 in vivo and in vitro. RESULTS: In the OA-induced acutely-injured lungs, neutrophils were accumulated, which was attenuated by MFX. The parameters denoting a neutrophilic respiratory burst, such as nitro blue tetrazolium reaction, cytochrome-c reduction, neutrophil aggregation, H2O2 production in neutrophils revealed increased neutrophilic respiratory burst by OA, and MFX decreased all of these parameters. In addition, the enhanced expression of cPLA2 in the lung and isolated murine neutrophils by OA were decreased by MFX. CONCLUSION: MFX suppresses the OA-induced neutrophilic respiratory burst by the suppression of cPLA2 in neutrophils.
Animals ; Aza Compounds ; Cytosol ; Lung ; Neutrophils ; Oleic Acid ; Phospholipases ; Phospholipases A2 ; Phospholipases A2, Cytosolic ; Quinolines ; Rats ; Respiratory Burst

OBJECTIVE: To determine the safety of intracamerally injected preservative-free 0.5% moxifloxacin/0.1% dexamethasone fixed-dose combination on the corneal endothelium in a rabbit model and compare it to intracamerally injected preservative-free 0.5% moxifloxacin.

METHODS: This experimental study included twenty eyes from ten albino rabbits. The eyes were assessed for baseline corneal clarity and anterior chamber (AC) inflammation using slit-lamp biomicroscopy. A specular microscope measured the corneal endothelial cell density (ECC) and corneal thickness (CT). Intracameral injections of 0.1 mL 0.5% moxifloxacin ophthalmic solution were administered to the 10 right eyes (IPFM group) and 0.1 mL of 0.5% moxifloxacin/0.1% dexamethasone fixed-dose preparation were administered to the 10 left eyes (IPFMDex group). In both groups, ECC, CT, corneal clarity, and AC inflammation at Day 1 (one day post-injection) and Day 7 (seven days post-injection) were compared with Day 0 (baseline). The IPFMDex group was also compared with the IPFM group at Days 0, 1, and 7. The endothelial cells of harvested corneas from both groups at Day 1 and 7 were stained with trypan blue and alizarin red, and compared for endothelial cell damage (ECD). Data were analyzed using paired and independent sample t-tests.

RESULTS: In both the IPFM and IPFMDex groups, ECC and CT at Day 1 (IPFM: ECC p=0.07, CT p=0.76; IPFMDex: ECC p=0.41, CT p=0.94) and Day 7 (IPFM: ECC p=0.95, CT p=0.28; IPFMDex: ECC p=0.29, CT p=0.34) were not different from Day 0 (baseline). No significant difference in ECC, CT, and ECD were found between the IPFM and IPFMDex groups at Day 1 (ECC p=0.82, CT p=0.36, ECD p=0.96) and Day 7 (ECC p=0.95, CT p=0.22, ECD p=0.61). Throughout the study, the cornea in both groups were clear and showed no signs of AC inflammation.

CONCLUSION: Intracameral injection of preservative-free moxifloxacin/dexamethasone fixed-dose formulation was safe on the rabbit corneal endothelium and was no different from preservative-free moxifloxacin.

Animal ; Endothelium, Corneal ; Moxifloxacin ; Alizarin ; Dexamethasone ; Slit Lamp ; Aza Compounds ; Anterior Chamber ; Cornea ; Anthraquinones ; Endothelial Cells ; Inflammation ; Ophthalmic Solutions

BACKGROUND: A combination of salmeterol and fluticasone propionate (SFC) and tiotropium bromide (TIO) is commonly prescribed for COPD patients but there is little data on their effectiveness, particularly in COPD patients with bronchial hyperresponsiveness. This study compared the spirometric improvement based on the change in FEV1, FEV1/FVC, and IC as well as the clinical outcomes of the therapeutic strategies with SFC and TIO versus the individual components in patients with severe COPD and bronchial hyperresponsiveness. METHODS: This study examined the spirometric data and clinical outcomes of 214 patients with COPD and hyperresponsiveness, who were divided into three groups according to the therapeutic regimen (TIO only, SFC only, and a triple therapy regimen). RESULTS: All regimen groups showed early improvement in the FEV1 and IC (at 3- and 6 months after treatment). However, long-term beneficial effects were observed only in the SFC group (at 24 months after treatment). However, these beneficial effects decreased after a 36-month follow up. In all spirometric results, the 12-, 24-, and 36-months data showed a similar degree of improvement in the three groups. The triple therapy group showed higher St. George's Respiratory Questionnaire scores and lower acute exacerbations and hospitalization. CONCLUSION: SFC can be a more important component in the pharmacological treatment of severe COPD patients with hyperresponsiveness than TIO, particularly in the spirometric and clinical outcomes.
Albuterol ; Androstadienes ; Diethylpropion ; Drug Therapy, Combination ; Follow-Up Studies ; Hospitalization ; Humans ; Pulmonary Disease, Chronic Obstructive ; Surveys and Questionnaires ; Scopolamine Derivatives ; Treatment Outcome ; Fluticasone ; Tiotropium Bromide ; Salmeterol Xinafoate