Improving the benefits of HIV testing and referrals in large household surveys through active linkages to care: lessons and recommendations from the Namibia population-based HIV impact assessment (NAMPHIA), 2017.

In household-based surveys that include rapid HIV testing services (HTS), passive referral systems that give HIV-positive participants information about how and where to access ART but minimal follow-up support from survey staff may result in suboptimal linkage. In the 2017 Namibia Population-based HIV Impact Assessment (NAMPHIA), we piloted a system of active linkage to care and ART (ALCART) that utilized the infrastructure of existing community-based partner organizations (CBPOs). All HIV-positive participants age 15-64 years not on ART were given standard passive referrals to ART plus the option to participate in ALCART.

Mutational Signature Analysis Reveals NTHL1 Deficiency to Cause a Multi-tumor Phenotype.

Biallelic germline mutations affecting NTHL1 predispose carriers to adenomatous polyposis and colorectal cancer, but the complete phenotype is unknown. We describe 29 individuals carrying biallelic germline NTHL1 mutations from 17 families, of which 26 developed one (n = 10) or multiple (n = 16) malignancies in 14 different tissues. An unexpected high breast cancer incidence was observed in female carriers (60%).

How to make clinical decisions from statistics.

Best practice health care depends on clinicians understanding and applying the results of trials in clinical practice. These results are most often presented in the language of statistics, which can be bewildering and even misleading for those of us who have only a limited understanding of the terms used in reporting statistics. This communication provides a simple explanation of some of the more common types of trials and their descriptors, presented in a way that should allow clinicians to understand, assess and apply the results.

Prevalence and evolutionary origins of the del(GJB6-D13S1830) mutation in the DFNB1 locus in hearing-impaired subjects: a multicenter study.

Mutations in GJB2, the gene encoding connexin-26 at the DFNB1 locus on 13q12, are found in as many as 50% of subjects with autosomal recessive, nonsyndromic prelingual hearing impairment. However, genetic diagnosis is complicated by the fact that 10%-50% of affected subjects with GJB2 mutations carry only one mutant allele. Recently, a deletion truncating the GJB6 gene (encoding connexin-30), near GJB2 on 13q12, was shown to be the accompanying mutation in approximately 50% of these deaf GJB2 heterozygotes in a cohort of Spanish patients, thus becoming second only to 35delG at GJB2 as the most frequent mutation causing prelingual hearing impairment in Spain.

Acute macular neuroretinopathy.

Acute macular neuroretinopathy is an infrequently encountered condition in which there is a sudden mild central vision loss, photopsia and red-brown wedge-shaped lesions in the macular region with corresponding scotomata in the central visual fields. The condition may be associated with the use of oral contraceptives or with a recent febrile illness. It is self-limiting and non-recurrent.

Diabetic retinopathy: classification, description and optometric management.

BACKGROUND: Diabetes mellitus is an important cause of visual loss, which can be moderated by treatment at specific stages of diabetic retinopathy. Existing monitoring for retinopathy has been shown to fall short of ideal, resulting in unnecessary visual loss. Using appropriate guidelines, optometrists should be well-placed to contribute to the management of patients having diabetic eye disease.

Herpes zoster opthalmicus.

INTRODUCTION: Herpes zoster is a common disease which may cause serious ocular sequelae when it affects the trigeminal nerve. Although involvement of the nasociliary branch of the first division of the trigeminal nerve is well recognised to be associated with serious and direct ocular morbidity, the need for careful long-term follow-up of cases of frontal branch involvement is perhaps less well known. METHODS: The pathogenesis, epidemiology, risk factors, clinical course and treatment of herpes zoster are discussed with emphasis on trigeminal nerve involvement.

Clinical features of pseudoexfoliation of the lens capsule: suggested management.

BACKGROUND: Pseudoexfoliation of the lens capsule (PEX) is found in widely varying proportions across the population of regional groups. It is strongly associated with open angle glaucoma and to a lesser extent angle closure glaucoma. This association makes PEX a very important risk factor for glaucoma, which should be sought actively in all patients over 50 years of age who seek eye care.

Diagnosis and management of open angle glaucoma: suggested guidelines for optometrists.

OBJECTIVE: The aims of this review are to define open angle glaucoma, to outline its prevalence and its financial and personal costs, to discuss the difficulties encountered in establishing the diagnosis and monitoring treatment, and to suggest initial clinical guidelines for the comanagement of glaucoma between ophthalmologists and optometrists. METHODS: The literature was selectively reviewed to permit deductions that can be directed toward an effective comanagement strategy for patients with open angle glaucoma. CONCLUSIONS: Comanagement of patients having open angle glaucoma is a viable option, provided the opportunity for improved monitoring and better compliance is available.