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In recent years, there has been a paradigm shift in glaucoma surgical procedures. Glaucoma drainage implant (GDI) surgeries are being performed much more commonly. Thus, it is important for surgeons to be cognisant of potential complications and their management. Exposure of a GDI is a well‐known complication, and prompt recognition and treatment are required to prevent endophthalmitis, a potentially blinding condition. In this review, we discuss the mechanisms and risk factors for GDI exposure, highlight important considerations for repair, and discuss repair techniques, with the aim of improving patient outcomes and minimising the risk of re‐exposure. [ABSTRACT FROM AUTHOR]

Context: Studies find surgery superior to medications in the treatment of primary aldosteronism (PA). It would be ideal to compare surgical and medical therapy in patients with unilateral PA only, who have the option between these treatment modalities. However, this is challenging as most patients with unilateral PA on adrenal vein sampling (AVS) undergo surgery. Objective: To compare outcomes of surgery and medications in patients with confirmed or likely unilateral PA. Design: Retrospective cohort study of 274 patients with PA managed at two referral centres from 2000 to 2019. Patients: 154 patients identified with unilateral PA using AVS and a validated clinical prediction model were treated with surgical (n = 86) or medical (n = 68) therapy. Measurements: Primary outcome was a composite incident cardiovascular event comprising acute myocardial infarction, coronary revascularization, stroke, atrial fibrillation or congestive cardiac failure. Secondary outcomes were clinical and biochemical control. Results: Cardiovascular outcomes were comparable, with the surgery group having an adjusted hazard ratio of 0.93 (95% CI: 0.32–2.67), p =.89. Both treatments improved clinical and biochemical control, but surgery resulted in better systolic blood pressure, 133.0 ± 11.7 mmHg versus 137.9 ± 14.6 mmHg, p =.02, and lower defined daily dosages of antihypertensive medications, 1.0 (IQR 0.0–2.0) versus 2.6 (IQR 0.8–4.3), p <.001. In addition, 12 of 86 patients in the surgery group failed medical therapy before opting for surgery. Conclusion: In patients with unilateral PA who can tolerate medications, medical therapy improves clinical and biochemical control, and may offer similar cardiovascular protection. However, surgery reduces pill burden, may cure hypertension and is recommended for unilateral PA. [ABSTRACT FROM AUTHOR]

Importance Argon laser peripheral iridoplasty (ALPI) could be effective in widening residual angle closure following laser peripheral iridotomy (LPI). Background: We investigated changes in angle parameters following ALPI and its safety profile in this study. Design Retrospective, observational case series. Participants: The records from a single centre, of 36 patients (60 eyes) who underwent ALPI, for residual angle closure following LPI, were reviewed. Methods: We analysed anterior chamber parameters in anterior segment optical coherence tomography (ASOCT) images using customized software pre‐ and post‐ALPI. Paired t‐test was used to compare changes. Main Outcome Measures: ASOCT parameters analysed included angle opening distance (AOD 500 and 750), trabecular iris surface area (TISA 500 and 750), anterior chamber width (ACW), anterior chamber volume (ACV), angle recess area (ARA), anterior chamber area (ACA), anterior chamber depth (ACD) and lens vault (LV). Results: There was a mean increase in AOD 500 (0.05 vs. 0.16 mm, P < 0.001), AOD 750 (0.15 vs. 0.27 mm, P < 0.001), TISA 500 (0.010 vs. 0.038 mm2, P < 0.001), TISA 750 (0.039 vs. 0.102 mm2, P < 0.001), ACV (89.76 vs. 102.25 mm3, P = 0.01), ARA 500 (0.015 vs. 0.033 mm2, P < 0.001) and ARA 750 (0.044 vs. 0.088 mm2, P < 0.001). There was no significant change in ACW, ACD, ACA and LV. Mean intraocular pressure (IOP) decreased post‐ALPI (17.2 vs. 15.7 mmHg, P = 0.002). The mean follow‐up duration was 2.1 years (range 0.5–5 years). Conclusions and Relevance: ALPI results in changes to the angle morphology and lowered IOP in eyes with residual angle closure. Our findings suggest a possible role for ALPI in eyes with residual angle closure following peripheral iridotomy. [ABSTRACT FROM AUTHOR]

Orbital vascular lesions account for 7% of orbital diseases.[[1]] Distinctions have been made between vascular tumours propagating by cellular hyperplasia and vascular malformations occurring from localized defects during morphogenesis. An orbital computed tomography (CT) scan identified a homogenous well-circumscribed mass not extending into surrounding bony structures (Fig. c,d). A facial CT scan revealed a hyperdense lesion to the right of her nasal bridge. MRI features include isointense T2-weighted and hypointense T1-weighted images in comparison with muscle.[7] Other techniques, such as biphasic CT angiography protocols and time-resolved MRI sequences, may further demonstrate characteristic features.[8]. [Extracted from the article]

Fish allergy is common in countries where consumption is high. Asian nations are amongst the world’s largest consumers of fish but the allergen profiles of tropical fish are unknown. This study sought to evaluate the allergenicity of four commonly consumed tropical fish, the threadfin ( Polynemus indicus), Indian anchovy ( Stolephorus indicus), pomfret ( Pampus chinensis) and tengirri ( Scomberomorus guttatus). Immunoglobulin E (IgE) cross-reactivity with parvalbumin of cod fish (Gad c 1), the major fish allergen, was also studied. Detection of tropical fish and cod specific-IgE was performed by UniCap assay, and skin prick tests were also carried out. The IgE-binding components of tropical fish were identified using IgE immunoblot techniques, and cross-reactivity with Gad c 1 was assessed by ELISA inhibition and IgE immunoblot inhibition. Clinically, nine of 10 patients studied were allergic to multiple fish. All patients exhibited detectable specific-IgE to cod fish (10 of 10 skin prick test positive, eight of 10 UniCap assay positive) despite lack of previous exposure. The major allergen of the four tropical fish was the 12-kDa parvalbumin. IgE cross-reactivity of these allergens to Gad c 1 was observed to be moderate to high in the tropical fish studied. Parvalbumins are the major allergens in commonly consumed tropical fish. They are cross-reactive with each other as well as with Gad c 1. Commercial tests for cod fish appear to be sufficient for the detection of tropical fish specific-IgE. [ABSTRACT FROM AUTHOR]

There is no exact explanation for the increase in allergic diseases that occurred since the last two decades. An increased allergen exposure and/or a decreased bacterial load cannot explain the phenomenon completely. Other causal factors that rose at the beginning of the 1980s must be taken into consideration. Important changes at that time in our management of children were the worldwide switch from aspirin to paracetamol, the introduction of broad-spectrum antibiotics such as cephalosporins and the advice to avoid dust and pets in newborns from allergic families. General application of these new approaches, in itself or in combination, might be responsible, at least in part, for the increase of allergic diseases in children. [ABSTRACT FROM AUTHOR]

Johar A, Lim D, Mad Arif SA, Hawarden D, Du Toit G, Weinberg E, Motala C, Fieggen G, Yeang HY, Potter PC. Low prevalence of latex sensitivity in South African spina bifida children in Cape Town.Pediatr Allergy Immunol 2005.© 2005 Blackwell MunksgaardSpina bifida children have a high prevalence of latex allergy in studies reported from Europe and the USA. This study investigated the prevalence of latex allergy in a cohort of 24 spina bifida children at the Red Cross Children's Hospital from Cape Town, South Africa. The children were investigated using a detailed questionnaire, skin prick tests (ALK-Abello), ImmunoCap RASTs, Western blotting and ELISA, using the purified latex proteins Hev b1 and Hev b3 and whole latex preparation. A low overall prevalence of latex sensitization of 16.7% was found in the children. Children who were sensitive reacted to water insoluble to Hev b1 and Hev b3 proteins. The low prevalence of latex sensitization in the South African children may not be entirely explained by stringent latex avoidance. The children were from a low socioeconomic social status and‘hygiene’ and other factors should be considered. [ABSTRACT FROM AUTHOR]

Tan TN, Lim DL, Lee BW, Van Bever HP. Prevalence of allergy-related symptoms in Singaporean children in the second year of life.Pediatr Allergy Immunol 2005.© 2005 Blackwell MunksgaardThis study describes the cross-sectional prevalence of symptoms associated with eczema (chronic itchy rash), asthma (wheeze), and allergic rhinitis (rhinoconjunctivitis) in 1026 subjects between 18.5 and 23 months old (median age is 21 months) in Singapore. The first 2 yr cumulative prevalence of chronic itchy rash, wheeze, and rhinoconjunctivitis were 22.1% (n = 227), 22.9% (n = 235), and 8.4% (n = 86) respectively. In total, 42.2% (414 of 979) reported ever having any of these symptoms. Eczema, although prevalent, was diagnosed only in 34.4% (n = 78) of children with chronic itchy rash. Children with this eczematous rash were also more prone to wheeze (cOR = 2.0, 95% CI: 1.2–3.0) and rhinoconjunctivitis (cOR = 2.0, 95% CI: 1.4–2.8). Similarly, subjects who reported rhinoconjunctivitis and chronic itchy rash were 2.4 times (95% CI: 1.6–3.6) and 1.4 times (95% CI: 1.0–2.0) more at risk of wheezing respectively. Family history of allergy was a significant risk factor for chronic itchy rash (aOR = 1.8, 95% CI: 1.3–2.4) and wheeze (aOR = 1.7, 95% CI: 1.3–2.4). Thus, symptoms related to allergy were already prevalent during the second year of life. Significant proportions of these symptoms are likely to be due to true atopy as strong relationship with familial history and comorbidity with other potential allergic symptoms were observed. [ABSTRACT FROM AUTHOR]

Soluble N-ethylmaleimide sensitive factor attachment protein receptors (SNAREs) are critical proteins in membrane fusion, in both regulated and constitutive vesicular traffic. In addition, proteins that interact with the SNAREs are thought to regulate fusion. Vesicle-associated membrane protein-2 (VAMP-2) is a SNARE protein involved in insulin-dependent glucose transporter 4 (GLUT4) traffic. VAMP-2 is required for productive GLUT4 incorporation into the plasma membrane. VAMP-associated protein of 33 kDa (VAP-33) is an integral membrane protein that binds VAMPs in vitro, and is hypothesized to be a regulator of VAMPs. In L6 skeletal myoblasts, which display insulin-dependent traffic of GLUT4, we show that VAP-33 colocalized significantly with VAMP-2 using indirect confocal immunofluorescence and biochemical cosegregation. Overexpression of wild-type VAP-33 in L6 myoblasts attenuated the insulin-dependent incorporation of myc-tagged GLUT4 into the plasma membrane, and this response was restored by co-overexpression of VAMP-2 linked to green fluorescent protein. Antibodies to VAP-33 microinjected into 3T3-L1 adipocytes abrogated the insulin-stimulated translocation of GLUT4 to the plasma membrane, as measured in adhered plasma membrane lawns. Immunopurified VAMP-2-containing compartments from L6 myotubes and 3T3-L1 adipocytes showed significant levels of VAP-33. We propose that VAP-33 may be a regulator of VAMP-2 availability for GLUT4 traffic and other vesicle fusion events. [ABSTRACT FROM AUTHOR]