Publications by authors named "Jeremy Hoffman"

The urban heat island effect exacerbates independent climate change-induced shifts toward longer, stronger, and more frequent heat extremes. Environmental inequity, driven by a history of racially motivated urban planning policies, has led particular demographics to bear the worst impacts of urban heat exposure and thus also climate change. These impacts cause adverse health outcomes in the form of heat emergencies.

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Article Synopsis
  • Laboratory confirmation through PCR testing is essential for diagnosing and managing herpes simplex virus (HSV) keratitis, though previous sensitivity rates were low.
  • An educational intervention targeting swab technique for sample collection was implemented, leading to a retrospective review of keratitis cases before and after the program.
  • The findings showed a significant increase in lab-confirmed HSV diagnoses post-intervention, indicating that improved swabbing techniques enhanced the sensitivity of PCR testing for HSV-1 in keratitis.
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Purpose: The aims of this study were to quantify the incidence of Acanthamoeba keratitis (AK) in the United Kingdom and investigate risk factors and management parameters.

Methods: This was a prospective population-based study from January to December 2015 through the British Ophthalmic Surveillance Unit. Data were collected on demographics, clinical features, and management.

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Purpose: The purpose of this study was to develop a protocol to prepare buffered chlorhexidine (CHX) eye drops (0.2% w/v) in the United Kingdom that can be reproduced at a production facility in Uganda. Buffered CHX eye drops can prevent CHX degradation and improve ocular tolerability during the treatment of fungal keratitis.

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Filamentous fungal infections of the cornea known as filamentous fungal keratitis (FK) are challenging to treat. Topical natamycin 5% is usually first-line treatment following the results of several landmark clinical trials. However, even when treated intensively, infections may progress to corneal perforation.

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Clinically diagnosing fungal keratitis (FK) is challenging; diagnosis can be assisted by investigations including in vivo confocal microscopy (IVCM), smear microscopy, and culture. The aim of this study was to estimate the sensitivity in detecting fungal keratitis (FK) using IVCM, smear microscopy, and culture in a setting with a high prevalence of FK. In this cross-sectional study nested within a prospective cohort study, consecutive microbial keratitis (MK) patients attending a tertiary-referral eye hospital in south-eastern Nepal between June 2019 and November 2020 were recruited.

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Background: The aim of this study was to describe the health-seeking journey for patients with microbial keratitis (MK) in Nepal and identify factors associated with delay.

Methods: Prospective cohort study where MK patients attending a large, tertiary-referral eye hospital in south-eastern Nepal between June 2019 and November 2020 were recruited. We collected demographic details, clinical history, and examination findings.

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In the United States, heat kills more people on average than any other weather-related hazard, thus the mitigation of heat-related impacts remains a significant issue within emergency management and public health communities. Research indicates the use of community cooling centers as an effective way to reduce vulnerability and adverse heat impacts. Using the Commonwealth of Virginia as a study location, this research evaluates the placement of cooling centers and assesses emergency managers' understanding of heat-related issues.

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Fungal corneal infection (keratitis) is a common clinical problem in South Asia. However, it is often challenging to distinguish this from other aetiologies, such as bacteria or acanthamoeba. In this prospective study, we investigated clinical and epidemiological features that can predict the microbial aetiology of microbial keratitis in Nepal.

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Background: A new coronavirus causes COVID-19, a developing respiratory illness. Unfortunately, there is little information assessing healthcare workers' understanding of technology and preventative strategies during the Nepalese epidemic. Researchers from other subspecialties uncovered some mythical thoughts.

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Purpose: To investigate if topical chlorhexidine 0.2%, which is low cost and easy to formulate, is noninferior to topical natamycin 5% for the treatment of filamentous fungal keratitis.

Design: Randomized controlled, single-masked, noninferiority clinical trial.

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Aims: To evaluate the sensitivity and specificity of polymerase chain reaction (PCR), in vivo confocal microscopy (IVCM) and culture for microbial keratitis (MK) diagnosis.

Methods: Retrospective review of PCR, IVCM and culture results for MK diagnosis at Moorfields Eye Hospital between August 2013 and December 2014.

Results: PCR results were available for 259 MK patients with concurrent culture for 203/259 and IVCM for 149/259.

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Objective: Fungal keratitis is a major ophthalmic public health problem, particularly in low-income and middle-income countries. The options for treating fungal keratitis are limited. Our study aimed to describe the outcomes of using chlorhexidine 0.

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Background: Nepal was under a severe lockdown for several months in 2020 due to the COVID-19 pandemic. There were concerns regarding misinformation circulating on social media. This study aimed to analyse the knowledge and awareness of COVID-19 amongst eye care professionals in Nepal during the first wave of the pandemic.

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Objective Or Purpose: To develop and test a patient-reported outcome measure for assessing health-related quality of life (HRQOL) in surgically amenable epiphora.

Design: Questionnaire development and validation study.

Participants: 201 patients with a cause of epiphora amenable to surgical intervention, recruited across three independent centres.

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Mycotic or fungal keratitis (FK) is a sight-threatening disease, caused by infection of the cornea by filamentous fungi or yeasts. In tropical, low and middle-income countries, it accounts for the majority of cases of microbial keratitis (MK). Filamentous fungi, in particular spp.

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Objectives: To understand the incidence, causes, management and outcomes of intentional (assault) and unintentional severe ocular chemical injuries (SOCI) at an urban tertiary referral centre in the UK.

Design: Retrospective observational study.

Setting: A London tertiary referral ophthalmic centre, Moorfields Eye Hospital.

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Introduction: Fungal infections of the cornea, fungal keratitis (FK), are challenging to treat. Current topical antifungals are not always effective and are often unavailable, particularly in low-income and middle-income countries where most cases occur. Topical natamycin 5% is usually first-line treatment, however, even when treated intensively, infections may progress to perforation of the eye in around a quarter of cases.

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Importance: In vivo confocal microscopy (IVCM) provides high-resolution images of the ocular surface and has been validated in trachomatous conjunctival scarring.

Background: This study used IVCM to identify parameters associated with clinical scarring progression.

Design: Prospective cohort study.

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