One of the main immune-mediated diseases that lead to avoidable blindness is non-infectious uveitis. Glucocorticoids are the first-line therapy choice for noninfectious uveitis;however, biologics are also showing prom...One of the main immune-mediated diseases that lead to avoidable blindness is non-infectious uveitis. Glucocorticoids are the first-line therapy choice for noninfectious uveitis;however, biologics are also showing promise in the management of this condition. The description of glucocorticoid and biologic usage in non-infectious uveitis is the main topic of this paper.展开更多
Background Non-infectious endophthalmitis was reported to occur after cataract surgery or intravitreal injections. This study reported a series of patients having non-infectious endophthalmitis after pars plana vitrec...Background Non-infectious endophthalmitis was reported to occur after cataract surgery or intravitreal injections. This study reported a series of patients having non-infectious endophthalmitis after pars plana vitrectomy in the same two operation rooms during the same period to estimate the risk factors for non-infectious endophthalmitis after vitrectomy. Methods Medical records of patients who presented with severe non-infectious endophthalmitis following vitrectomy between May 13 and June 8, 2011, were reviewed. The presenting symptoms and signs were collected, including visual acuity, intraocular pressure, cornea and anterior chamber activity. The treatments and results of microbiology examination were also recorded and analyzed. Results Ten patients were identified with severe non-infectious endophthalmitis, presenting 1 day after pars plana vitrectomy. Three eyes （30%） had previous intraocular surgeries, four （40%） had proliferative diabetic retinopathy, and one （10%） got pars plana vitrectomy combinded with phacoemulsification and intraocular lens implantation. All the patients were initially treated with topical and/or oral steroids. Only two patients had intravenous antibiotics because of the atypical presentation. One eye had paracentesis because of high intraocular pressure and the aqueous sample was sent for microbiological examination. The culture of the aqueous, air in the operation room, the swab from hand of surgeons, infusion fluid, and vitrectomy effluent were all negative for bacteria and fungi. The inflammation regressed rapidly after the initial treatment. Conclusions Intraocular surgery history, poor general health status, longer operation time, and more surgical procedures are the risk factors for non-infectious endophthalmitis after vitrectomy. It responds well to steroids.展开更多
Human-induced inputs of nitrogen(N)and phosphorus(P)into the biosphere have reached unprecedented levels,particularly N,leading to an escalating global anthropogenic N:P ratio.This ratio has emerged as a significant d...Human-induced inputs of nitrogen(N)and phosphorus(P)into the biosphere have reached unprecedented levels,particularly N,leading to an escalating global anthropogenic N:P ratio.This ratio has emerged as a significant driver of environmental change,impacting organisms,ecosystems,and global food security.However,the implications of this ratio for human health have been largely overlooked and remain uncertain.This article aims to fill this knowledge gap by exploring the potential effects of N:P ratios on both non-infectious and infectious diseases.Preliminary data emphasize the importance of investigating the influence of N:P ratios on human health,suggesting a potential role in the rise of non-infectious diseases,such as cancer,as well as the proliferation of infectious diseases,including Zika and malaria.These findings highlight the urgent need for increased attention from the scientific community and policymakers regarding the complex impacts of the human-induced biospheric N:P ratio.It is crucial to investigate and understand the underlying mechanisms and drivers behind these effects.Furthermore,there is significant potential for improving human health through the manipulation of N:P ratios and the availability of N and P.This applies not only to medical treatments but also to innovative fertilizer management strategies.These avenues present promising opportunities to address the challenges associated with human health in an ever-changing world.展开更多
Intraocular inflammation is an important cause of blindness both in the developing and developed world. Corticosteroids play a pivotal role in the treatment of intraocular inflammation. Lately, therapy by immuno-suppr...Intraocular inflammation is an important cause of blindness both in the developing and developed world. Corticosteroids play a pivotal role in the treatment of intraocular inflammation. Lately, therapy by immuno-suppression has taken the center stage for patients with severe intraocular infammation. However, the side effects of immunosuppressive drugs are oncogenic, in-fectious, and hematological. Recently, biologic response modifiers specifically targeting suppression of the im-mune effector responses have revolutionized the treat-ment of intraocular infammation. Anti-tumour necrosis factor agents are etanercept, infiximab, and adalimum-ab. Newer drugs include certolizumab and golimumab. Infiximab has been found to be superior to corticoste-roids in treating retinal vasculitis. Anti-interlenkin thera-pies include rituximab, daclizumab, anakinra, tocilizum-ab and secukinumab. Rituximab has been proven to be quite effective. Other biologics used are interferons and abatacept. However, there are several limitations and side effects associated with their use.展开更多
Introduction: Senegal has pioneered the implementation of peritoneal dialysis (PD) in West Africa, practicing it since 2004. Non-infectious complications are a significant cause of failure of this technique and the tr...Introduction: Senegal has pioneered the implementation of peritoneal dialysis (PD) in West Africa, practicing it since 2004. Non-infectious complications are a significant cause of failure of this technique and the transfer of patients to haemodialysis. The aim of this study was to determine the prevalence and the different types of non-infectious complications in our context. Patients and Methods: This was a 5-year, descriptive, retrospective study of patients on chronic peritoneal dialysis for more than 3 months. Results: During the study period, 75 patients were included. The prevalence of non-infectious complications was 88%, including 45.3% mechanical complications and 76% metabolic complications. Catheter migration was the most common mechanical complication (55.9%), followed by catheter blockage (23.5%). Metabolic complications were dominated by hypoalbuminemia (76.3%). Dyslipidaemia and hypokalaemia affected more than 50% of patients, occurring in 59.3% and 56.9% of cases, respectively. Conclusion: In our study, non-infectious complications related to PD were frequent and varied. They remain a significant cause of technical failure. Mechanical complications are often the cause of permanent transfer to haemodialysis.展开更多
Our increase in knowledge of the pathophysiology of non-infectious uveitis(NIU)and other immune-mediated diseases has been mirrored over the last two decades by the expansion of therapeutic options in the realm of imm...Our increase in knowledge of the pathophysiology of non-infectious uveitis(NIU)and other immune-mediated diseases has been mirrored over the last two decades by the expansion of therapeutic options in the realm of immunosuppressive medications.Principal among these advances is the emergence of biologics,which offer the promise of targeted therapy and the hope of reduced toxicity when compared to corticosteroids and“standard”immunosuppression.Among the biologics,monoclonal antibodies blocking tumor necrosis factor alpha(TNF-α)have been shown to be a very effective therapeutic target for uveitis and many associated systemic inflammatory diseases.Multiple TNF blockers have shown benefit for uveitis,and in 2016,adalimumab became the first biologic and non-corticosteroid immunosuppressive to obtain Food and Drug Administration(FDA)approval in the treatment of NIU.Although effective,TNF blockers are not universally so,and safety concerns such as infection and demyelinating disease must be carefully considered and ruled out prior to their use,especially in patients with intermediate uveitis with which multiple sclerosis is a known association.Ongoing study has identified novel targets for regulation in the treatment of immune-mediated and inflammatory diseases.Interferons,interleukin and Janus kinase inhibitors in addition to antibodies targeting T cell and B cell activation highlight the expanding field of treatment modalities in NIU.Ongoing study will be required to better determine the safety and efficacy of biologics in the armamentarium of immunosuppressive treatments for NIU.展开更多
文摘One of the main immune-mediated diseases that lead to avoidable blindness is non-infectious uveitis. Glucocorticoids are the first-line therapy choice for noninfectious uveitis;however, biologics are also showing promise in the management of this condition. The description of glucocorticoid and biologic usage in non-infectious uveitis is the main topic of this paper.
文摘Background Non-infectious endophthalmitis was reported to occur after cataract surgery or intravitreal injections. This study reported a series of patients having non-infectious endophthalmitis after pars plana vitrectomy in the same two operation rooms during the same period to estimate the risk factors for non-infectious endophthalmitis after vitrectomy. Methods Medical records of patients who presented with severe non-infectious endophthalmitis following vitrectomy between May 13 and June 8, 2011, were reviewed. The presenting symptoms and signs were collected, including visual acuity, intraocular pressure, cornea and anterior chamber activity. The treatments and results of microbiology examination were also recorded and analyzed. Results Ten patients were identified with severe non-infectious endophthalmitis, presenting 1 day after pars plana vitrectomy. Three eyes （30%） had previous intraocular surgeries, four （40%） had proliferative diabetic retinopathy, and one （10%） got pars plana vitrectomy combinded with phacoemulsification and intraocular lens implantation. All the patients were initially treated with topical and/or oral steroids. Only two patients had intravenous antibiotics because of the atypical presentation. One eye had paracentesis because of high intraocular pressure and the aqueous sample was sent for microbiological examination. The culture of the aqueous, air in the operation room, the swab from hand of surgeons, infusion fluid, and vitrectomy effluent were all negative for bacteria and fungi. The inflammation regressed rapidly after the initial treatment. Conclusions Intraocular surgery history, poor general health status, longer operation time, and more surgical procedures are the risk factors for non-infectious endophthalmitis after vitrectomy. It responds well to steroids.
基金Grants TED2021-132627B-I00 and PID2022-140808NB-I00 funded by MCIN,AEI/10.13039/501100011033by the European Union NextGenerationEU/PRTR,and grant CIVP20A6621 from the Fundacion Ramon Areces.
文摘Human-induced inputs of nitrogen(N)and phosphorus(P)into the biosphere have reached unprecedented levels,particularly N,leading to an escalating global anthropogenic N:P ratio.This ratio has emerged as a significant driver of environmental change,impacting organisms,ecosystems,and global food security.However,the implications of this ratio for human health have been largely overlooked and remain uncertain.This article aims to fill this knowledge gap by exploring the potential effects of N:P ratios on both non-infectious and infectious diseases.Preliminary data emphasize the importance of investigating the influence of N:P ratios on human health,suggesting a potential role in the rise of non-infectious diseases,such as cancer,as well as the proliferation of infectious diseases,including Zika and malaria.These findings highlight the urgent need for increased attention from the scientific community and policymakers regarding the complex impacts of the human-induced biospheric N:P ratio.It is crucial to investigate and understand the underlying mechanisms and drivers behind these effects.Furthermore,there is significant potential for improving human health through the manipulation of N:P ratios and the availability of N and P.This applies not only to medical treatments but also to innovative fertilizer management strategies.These avenues present promising opportunities to address the challenges associated with human health in an ever-changing world.
文摘Intraocular inflammation is an important cause of blindness both in the developing and developed world. Corticosteroids play a pivotal role in the treatment of intraocular inflammation. Lately, therapy by immuno-suppression has taken the center stage for patients with severe intraocular infammation. However, the side effects of immunosuppressive drugs are oncogenic, in-fectious, and hematological. Recently, biologic response modifiers specifically targeting suppression of the im-mune effector responses have revolutionized the treat-ment of intraocular infammation. Anti-tumour necrosis factor agents are etanercept, infiximab, and adalimum-ab. Newer drugs include certolizumab and golimumab. Infiximab has been found to be superior to corticoste-roids in treating retinal vasculitis. Anti-interlenkin thera-pies include rituximab, daclizumab, anakinra, tocilizum-ab and secukinumab. Rituximab has been proven to be quite effective. Other biologics used are interferons and abatacept. However, there are several limitations and side effects associated with their use.
文摘Introduction: Senegal has pioneered the implementation of peritoneal dialysis (PD) in West Africa, practicing it since 2004. Non-infectious complications are a significant cause of failure of this technique and the transfer of patients to haemodialysis. The aim of this study was to determine the prevalence and the different types of non-infectious complications in our context. Patients and Methods: This was a 5-year, descriptive, retrospective study of patients on chronic peritoneal dialysis for more than 3 months. Results: During the study period, 75 patients were included. The prevalence of non-infectious complications was 88%, including 45.3% mechanical complications and 76% metabolic complications. Catheter migration was the most common mechanical complication (55.9%), followed by catheter blockage (23.5%). Metabolic complications were dominated by hypoalbuminemia (76.3%). Dyslipidaemia and hypokalaemia affected more than 50% of patients, occurring in 59.3% and 56.9% of cases, respectively. Conclusion: In our study, non-infectious complications related to PD were frequent and varied. They remain a significant cause of technical failure. Mechanical complications are often the cause of permanent transfer to haemodialysis.
文摘Our increase in knowledge of the pathophysiology of non-infectious uveitis(NIU)and other immune-mediated diseases has been mirrored over the last two decades by the expansion of therapeutic options in the realm of immunosuppressive medications.Principal among these advances is the emergence of biologics,which offer the promise of targeted therapy and the hope of reduced toxicity when compared to corticosteroids and“standard”immunosuppression.Among the biologics,monoclonal antibodies blocking tumor necrosis factor alpha(TNF-α)have been shown to be a very effective therapeutic target for uveitis and many associated systemic inflammatory diseases.Multiple TNF blockers have shown benefit for uveitis,and in 2016,adalimumab became the first biologic and non-corticosteroid immunosuppressive to obtain Food and Drug Administration(FDA)approval in the treatment of NIU.Although effective,TNF blockers are not universally so,and safety concerns such as infection and demyelinating disease must be carefully considered and ruled out prior to their use,especially in patients with intermediate uveitis with which multiple sclerosis is a known association.Ongoing study has identified novel targets for regulation in the treatment of immune-mediated and inflammatory diseases.Interferons,interleukin and Janus kinase inhibitors in addition to antibodies targeting T cell and B cell activation highlight the expanding field of treatment modalities in NIU.Ongoing study will be required to better determine the safety and efficacy of biologics in the armamentarium of immunosuppressive treatments for NIU.
