Graft Rejection ; Humans ; Kidney Transplantation ; mortality ; statistics & numerical data ; Patient Care

BACKGROUND: Burn injury and its subsequent multisystem effects are commonly encountered by acute care practitioners. Resuscitation is the major component of initial burn care and must be managed to restore and preserve vital organ function. Later complications of burn injury are dominated by infection. Burn centers are often called to manage problems related to thermal injury, including lightning and electrical injuries. METHODS: A selected review is provided of key management concepts as well as of recent reports published by the American Burn Association. RESULTS: The burn-injured patient is easily and frequently over resuscitated, with ensuing complications that include delayed wound healing and respiratory compromise. A feedback protocol designed to limit the occurrence of excessive resuscitation has been proposed, but no new “gold standard” for resuscitation has replaced the venerated Parkland formula. While new medical therapies have been proposed for patients sustaining inhalation injury, a paradigm-shifting standard of medical therapy has not emerged. Renal failure as a specific contributor to adverse outcome in burns has been reinforced by recent data. Of special problems addressed in burn centers, electrical injuries pose multisystem physiologic challenges and do not fit typical scoring systems. CONCLUSION: Recent reports emphasize the dangers of over resuscitation in the setting of burn injury. No new medical therapy for inhalation injury has been generally adopted, but new standards for description of burn-related infections have been presented. The value of the burn center in care of the problems of electrical exposure, both manmade and natural, is demonstrated in recent reports.
Burn Units ; Burns* ; Humans ; Inhalation ; Lightning ; Renal Insufficiency ; Resuscitation ; Smoke Inhalation Injury ; Wound Healing

Health ; Environment

OBJECTIVE: To determine the reduction in intraocular pressure (IOP) of multiple selective laser trabeculoplasty (SLT) in eyes with open-angle glaucoma (OAG) and ocular hypertension (OHT). METHODS: Forty-nine OAG eyes that received multiple SLTs were retrospectivel]j studied. The first and second SLT treated 180 degrees and the third treat! 180 to 360 degrees of the trabecular meshwork. Main outcome (response rate)] was IOP reduction of a3 mm Hg from baseline at 6 months after each SLT.Only patients followed up for at least 6 months were included. CONCLUSION: Multiple selective SLT successfully lowers IOP. A second SLT lowered IO1 by 19 percent from baseline IOP after 6 months and a third by 47 percent after another f months. Eyes with baseline IOP >21 mm Hg had greater IOP reduction; higher response rates for each SLT compared to those with baseline IOP ? 21 mm Hg.
ARGON ; TRABECULECTOMY ; GLAUCOMA ; INTRAOCULAR PRESSURE ; GLAUCOMA, OPEN-ANGLE

The findings of a seroepidemiological study into the prevalence of Toxoplasma gondii infection amongst normal blood donors and patients infected with HIV (human immunodeficiency virus) are presented. Of the total 301 participants, 181 were HIV antibody positive and 120 blood donors were HIV antibody negative. We used a prevalidated questionnaire, enzyme-linked immunosorbent assay (ELISA) and the Epi Info version 3.2 software plus SPSS version 10 for data analysis. The results showed an overall antibody prevalence rate of 53% in the population and a significantly higher infection rate amongst HIV-positive patients: odds ratio 2.14 (95% CI 1.30-3.53), p = 0.001. The study further showed that exposure to cats and highlands origin were independent risk factors. This study has demonstrated that in light of the current HIV/AIDS (acquired immune deficiency syndrome) epidemic, opportunistic infections such as toxoplasmosis will be a cause of considerable morbidity and mortality. It is therefore important that clinicians and public health practitioners fit these findings into overall management strategies to help control toxoplasmosis.

CONTEXT: Pregabalin has shown efficacy in the treatment of multiple chronic pain syndromes.
OBJECTIVES: The objective was to evaluate the overall safety and tolerability of pregabalin in the treatment of a several neuropathic pain syndromes in a naturalistic setting using a flexible dosage regimen.
METHODS: Patients aged >- 18 years with neuropathic pain of various etiologies participated in an open-label, non-comparative study at 95 sites in the Philippines. Treatment included pregabalin for 4 weeks, with upward dosage titration to 600 mg/day at investigator discretion. Efficacy was rated with an 11-point pain visual analog scale (VAS). Physicians and patients rated pregabalin on treatment satisfaction, efficacy and safety using a Clinical Global Impression (CGI) rating scale. Descriptive statistics were used for quantitative variables and categorical frequency counts for qualitative variables.
RESULTS: The efficacy analysis (intent-to-treat) included 1603 patients. Mean VAS pain score improved from baseline (7.2 +- 1.6) to 3.8 +- 1.8 at second visit and 2.3 +- 1.4 at last visit. Physicians' and patients' impression of pregabalin regarding treatment satisfaction, efficacy and safety using a CGI rating scale showed> 75% who gave a rating of excellent at second visit gave the same rating at final visit. Adverse events (AEs) were generally mild to moderate, with dizziness and somnolence most frequently reported.
DISCUSSION: Improvement in mean VAS pain scores as well as physicians' and patients' overall satisfaction with tolerability and efficacy support the usefulness of pregabalin in the treatment of various neuropathic pain syndromes in Asian patients.
WHAT'S KNOWN? Pregabalin is effective for the treatment of chronic pain syndromes, including painful diabetic peripheral neuropathy, postherpetic neuralgia, spinal cord injury and fibromyalgia.
WHAT'S NEW? This open-label, non-comparative study demonstrates safety, tolerability and efficacy for neuropathic pain syndromes in Asian patients.

Human ; Male ; Female ; Aged ; Middle Aged ; Adult ; Adolescent ; Neuralgia, Postherpetic ; Pregabalin ; Dizziness ; Fibromyalgia ; Chronic Pain ; Neuralgia ; Pain Measurement ; Diabetic Neuropathies ; Spinal Cord Injuries

52 consecutive patients with in-the-bag modified J-loop lenses had posterior capsulectomy performed with Neodymium:YAG Laser. 3 mm openings were made. There was a shift toward both myopia and hypermetropia following this procedure but only 5 shifted enough to warrant a change of glasses at the six months level whereas at the one month level the change was not significant enough in any of the patients to replace lenses fitted prior to YAG laser capsulectomy.
Cataract ; Eyeglasses ; Glass ; Humans ; Hyperopia ; Lasers, Solid-State ; Myopia

The intercapsular cataract extraction using the Anis Dry Technique offered the greatest protection to the corneal endothelium. This clinically manifested itself by a much clearer cornea the morning after surgery, as well as a much quieter eye. However intercapsular phacoemuslfication and intercapsular automated irrigation/aspiration likewise produced very good results with great protection to the endothelial cells of the cornea.
Cataract Extraction* ; Cataract* ; Cornea ; Endothelial Cells* ; Endothelium, Corneal

This study investigated the development of a novel approach to surface characterization of drug poly-morphism and the extension of the capabilities of this method to perform ‘real time’ in situ measure-ments. This was achieved using diffuse reflectance visible (DRV) spectroscopy and dye deposition, using the pH sensitive dye, thymol blue (TB). Two polymorphs, SFN-β and SFN-γ, of the drug substance sul-fanilamide (SFN) were examined. The interaction of adsorbed dye with polymorphs showed different behavior, and thus reported different DRV spectra. Consideration of the acid/base properties of the morphological forms of the drug molecule provided a rationalization of the mechanism of differential coloration by indicator dyes. The kinetics of the polymorphic transformation of SFN polymorphs was monitored using treatment with TB dye and DRV spectroscopy. The thermally-induced transformation fitted a first-order solid-state kinetic model (R2 ? 0.992), giving a rate constant of 2.43 ? 10 ? 2 s ? 1.