scholarly journals History of the Development of the Treatment of Keratoconus

Author(s):  
Ramez Barbara ◽  
Lamis Abdelaziz

ABSTRACT Keratoconus (from Greek meaning horn-shaped cornea) is a degenerative, ectatic disease of the cornea, causing corneal thinning and remodelling into a more conical shape.1 Symptoms include blurring of vision, and a gradual decline in visual acuity.1 It is usually bilateral, but can affect each eye at different severities.1 There are various treatment modalities, both surgical and nonsurgical, both simple and more invasive. Here, we review the history of the development and advances of the wide range of treatment options, since it was first recognized in 1748 up until now. How to cite this article Abdelaziz L, Barbara R. History of the Development of the Treatment of Keratoconus. Int J Kerat Ect Cor Dis 2013;2(1):31-33.

2020 ◽  
Vol 8 (4) ◽  
pp. 87-97
Author(s):  
Iga Dudek ◽  
Danuta Hajduga ◽  
Cezary Sieńko ◽  
Amr Maani ◽  
Elżbieta Sitarz ◽  
...  

Abstract Purpose of the Review Alcohol abuse causes a wide range of disorders that affect the nervous system. These include confusion, cerebellar ataxia, peripheral neuropathy, and cognitive impairment. Chronic and excessive alcohol consumption is the primary cause of peripheral neuropathy. It is worth noting that peripheral neuropathy has no reliable treatment due to the poor understanding of its pathology. Recent Findings Coasting is a major feature of alcoholic neuropathy, largely due to chronic alcohol abuse. Its major features are hyperalgesia, allodynia, and burning pain. Even though much research was done in this area, still we do not have a full understanding of the mechanism of alcoholic neuropathy. However, some theories have been proposed. These include direct or indirect effects of alcohol metabolites, impaired axonal transport, suppressed excitatory nerve pathway activity, or imbalance in neurotransmitters. Activation of spinal cord microglia, mGlu5 spinal cord receptors, and hypothalamic-pituitary-adrenal axis also seem to be implicated in the pathophysiology of this alcoholic neuropathy. The goal of treatment is to impede further damage to the peripheral nerves while also restoring their normal physiology. Alcohol abstinence, intake of balanced diets, and treatment with medications are suggested including benfotiamine, alpha-lipoic acid, acetyl-l-carnitine, vitamin E, methylcobalamin, myo-inositol, N-acetylcysteine, capsaicin, tricyclic antidepressants, or antiepileptic drugs. Summary This review focuses on the many pathways that play a role in the onset and development of alcohol-induced neuropathy, as well as present the possible treatment strategies of this disorder, providing insights into a further search of new treatment modalities.


2020 ◽  
Vol 26 ◽  
Author(s):  
Arif Kalkanli ◽  
Hakan Akdere ◽  
Gökhan Cevik ◽  
Emre Salabas ◽  
Nusret Can Cilesiz ◽  
...  

Background: Medical treatments are used either alone or in combination with assisted reproductive techniques for treatment of infertile patients with hypergonadotropic hypogonadism. A wide range of treatment options such as gonadotropins, aromatase inhibitors (AIs), selective estrogen receptor modulators (SERMs) and their combination are available as options. Objective: The aim of this review was to evaluate treatment options for the infertile men with hypergonadotropic hypogonadism. Methods: A literature search of MEDLINE (1980-2019) was conducted using the terms ‘hypogonadism’, ‘male infertility’, ‘gonadotropins’, ‘SERMs’ and ‘AIs’. Pathologies leading to hypergonadotropic hypogonadism and treatment modalities such as gonadotropins, SERMs, AIs and surgical treatment were discussed. Results: FSH increases spontaneous pregnancy rates but level of evidence was proven to be low for live birth rates. AIs are valid treatment options for patients with low T/E2 ratio as they significantly increase sperm concentrations. SERMs are recommended for infertile males with a sperm concentration between 10-20 millions. Varicocele was reported to increase testosterone levels of hypogonadic infertile males. Conclusion: Medical treatment modalities such as gonadotropins, SERMs, AIs and combination of these therapies has been showed to have some effect in improvement of fertility but is not mainstream of the treatment.


2020 ◽  
Vol 5 (1) ◽  
pp. e000337
Author(s):  
Daniel Pilger ◽  
Christoph von Sonnleithner ◽  
Eckart Bertelmann

BackgroundConjunctival defects can be repaired with several mucosal tissues. The simplicity of harvesting oral mucosa and its wide availability makes it the preferred graft tissue for all indications requiring mucosal grafting. Through analysing the postsurgical outcomes and rate of revisions, this study explores the suitability of oral mucosa grafts, depending on the initial diagnosis.MethodsWe reviewed all the files of patients with a history of oral mucosal graft surgery, performed at our clinic between 2012 and 2018, focusing on complications and revision rates.ResultsIn total, we analysed 173 oral mucosa grafts in 131 patients. The most common initial diagnosis was tumour resection, followed by surgical complications, postenucleation socket syndrome, trauma and ocular surface disorders. Complication and revision rates depended highly on the initial diagnosis. Revision rates were highest if the initial diagnosis included ocular surface disorders or chemical trauma.ConclusionsOral mucosa grafting (OMG) is the most effective treatment for a wide range of ocular conditions involving conjunctival defects. Conjunctival defects that result from trauma or cicatricial surface diseases seem less suitable for OMG and may benefit from alternative graft tissue or treatment options.


SLEEP ◽  
2019 ◽  
Vol 42 (10) ◽  
Author(s):  
Brian John Curtis ◽  
Liza H Ashbrook ◽  
Terry Young ◽  
Laurel A Finn ◽  
Ying-Hui Fu ◽  
...  

Abstract Study Objectives Report the first prevalence estimates of advanced sleep phase (ASP), familial advanced sleep phase (FASP), and advanced sleep–wake phase disorder (ASWPD). This can guide clinicians on the utility of screening for extreme chronotypes both for clinical decision-making and to flag prospective participants in the study of the genetics and biology of FASP. Methods Data on morning or evening sleep schedule preference (chronotype) were collected from 2422 new patients presenting to a North American sleep center over 9.8 years. FASP was determined using a severity criterion that has previously identified dominant circadian mutations in humans. All patients were personally seen and evaluated by one of the authors (C.R.J.). Results Our results demonstrate an ASP prevalence of 0.33%, an FASP prevalence of 0.21%, and an ASWPD prevalence of at least 0.04%. Most cases of young-onset ASP were familial. Conclusions Among patients presenting to a sleep clinic, conservatively 1 out of every 300 patients will have ASP, 1 out of every 475 will have FASP, and 1 out of every 2500 will have ASWPD. This supports obtaining a routine circadian history and, for those with extreme chronotypes, obtaining a family history of circadian preference. This can optimize treatment for evening sleepiness and early morning awakening and lead to additional circadian gene discovery. We hope these findings will lead to improved treatment options for a wide range of sleep and medical disorders in the future.


2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Mahmut Oğuz Ulusoy ◽  
Sertaç Argun Kıvanç ◽  
Mehmet Atakan ◽  
Berna Akova-Budak

Purpose.There are several etiological factors that cause epiphora, and treatment differs according to the cause. We aimed to evaluate the etiology of epiphora and the treatment modalities of the affected patients.Materials and Methods.Data of patients who were referred to ophthalmology clinics for epiphora were retrospectively analyzed. All patients were evaluated for epiphora etiology, treatment modalities, and duration of complaints, after complete ophthalmologic examination.Results.This study consisted of 163 patients with a mean age of 64.61 ± 16.52 years (range 1–92 years). Lacrimal system disease (48.4% [79/163]) was the most common cause, followed by ocular surface disease (dry eye/blepharitis) (38.7% [63/163]). Among the patients included in this study, 69% (113/163) did not receive any treatment, whereas only 1.8% (3/163) were treated surgically. About 4.3% of the patients (7/163) had a complaint for more than 5 years (p=0.012) and six of these had chronic dacryocystitis and one had ectropion.Conclusion.Epiphora not only has a negative impact on patients’ comfort, but also puts them at risk for probable intraocular operations in the future. Therefore, the wide range of its etiology must be taken into consideration and adequate etiology-specific treatment options must be applied.


2015 ◽  
Vol 7 (1) ◽  
Author(s):  
Ora Bitterman-Deutsch ◽  
Leonid Kogan ◽  
Faris Nasser

Hyaluronic acid (HA) fillers in cosmetic medicine have been considered relatively safe, though fillers used in European countries and throughout the world are not necessarily approved by the Food and Drug Administration. As their use continues to expand worldwide, physicians in a wide range of medical specialties are authorized to perform HA injections, including general medicine practitioners and even dentists. An increasing number of reports have appeared regarding side effects to these products. It is now known that reactions to Hyaluronic acid are related not only to technical faults of the injections, but also to immune responses, including delayed hypersensitivity and granulomatous reactions. Herein, we describe five cases treated by a variety of treatment modalities, all with delayed reactions to different brands of hyaluronic acid fillers. As there is currently no standardization of treatment options of adverse effects, these cases accentuate the debate regarding the approach to the individual patient and the possible need for pre-testing in patients with an atopic tendency.


2007 ◽  
Vol 114 (2) ◽  
pp. 99-108 ◽  
Author(s):  
Michael R. Loebinger ◽  
Susana Aguilar ◽  
Sam M. Janes

There has been increasing excitement over the last few years with the suggestion that exogenous stem cells may offer new treatment options for a wide range of diseases. Within respiratory medicine, these cells have been shown to have the ability to differentiate and function as both airway and lung parenchyma epithelial cells in both in vitro and increasingly in vivo experiments. The hypothesis is that these cells may actively seek out damaged tissue to assist in the local repair, and the hope is that their use will open up new cellular and genetic treatment modalities. Such is the promise of these cells that they are being rushed from the benchside to the bedside with the commencement of early clinical trials. However, important questions over their use remain and the field is presently littered with controversy and uncertainty. This review evaluates the progress made and the pitfalls encountered to date, and critically assesses the evidence for the use of stem cells in lung disease.


2016 ◽  
Vol 7 ◽  
pp. CMTIM.S39404 ◽  
Author(s):  
Robert B. Lewis ◽  
Bryan A. Reyes ◽  
Michael S. Khazzam

This article reviews the assessment and management of the pathology of the long head of the biceps tendon, a disease commonly encountered by primary care physicians and orthopedic surgeons. We include a discussion of relevant anatomy, function, pathoanatomy, natural history of the disease, diagnostic methods, and treatment options. Recent literature on the function of the long head of the bicep (LHB) is reviewed. Literature on our evolving understanding of the pathoanatomy behind LHB tendinopathy is discussed. We also discuss the effectiveness of current diagnostic and treatment modalities.


2016 ◽  
Vol 7 (1) ◽  
pp. 77-85 ◽  
Author(s):  
Patrick Pavwoski ◽  
Anita Valanju Shelgikar

AbstractPurpose of review:Obstructive sleep apnea (OSA) is a global problem with implications for general health and quality of life, and is often encountered in patients with neurologic disease. This review outlines treatment modalities to consider for management of OSA in patients with neurologic disease.Recent findings:New advances in positive airway pressure (PAP) devices, oral appliances, and surgical interventions offer a wide range of treatment options for patients with OSA.Summary:PAP therapy remains the gold standard treatment for OSA. Other treatment modalities may be considered for OSA patients who decline or cannot tolerate PAP therapy. Some OSA patients may benefit from multimodal treatment.


2017 ◽  
Vol 21 (5) ◽  
pp. 460-463 ◽  
Author(s):  
Anna E. Kinio ◽  
Michael A. Sawchuk ◽  
Melanie Pratt

Background: Rosai Dorfman disease (RDD) is a rare disorder that typically presents with bilateral cervical lymphadenopathy and follows a benign course. Objective: We present a case of late-onset atypical primary cutaneous RDD that is resistant to treatment modalities described in the literature. Methods: Case report. Results: An 84-year-old woman presented with a 7-year history of cutaneous lesions histologically consistent with RDD. She later failed initial treatments of acitretin and thalidomide. Conclusion: Physicians must be aware of unusual presentations of RDD. Also, further treatment options must be explored for patients resistant to classical management of RDD.


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