Access to Schlemm's canal for canaloplasty: an intra-individual comparison of two dissection techniques.

Purpose: To compare a modified incision technique with classic scleral flap dissection for canaloplasty with canal expander regarding efficacy and safety.

Methods: In a prospective randomized pilot study of 32 eyes of 16 patients with primary open-angle glaucoma, access to Schlemm's canal was created by deep lamellar dissection (scleral flap excision, group 1) or by vertical cut-down incision (group 2). Following canal opening and viscodilation with microcannula and sodium hyaluronate, two Stegmann Canal Expanders were implanted, and the scleral flap or vertical incision, respectively, was closed watertight.

Flap-sparing canaloplasty: a modified approach to Schlemm's canal.

Purpose: To present a modified surgical technique for canaloplasty with the Stegmann Canal Expander obviating the need for lamellar scleral dissection.

Methods: After limbal peritomy of the conjunctiva, the sclera is not dissected in the classic lamellar fashion with superficial and deep scleral flaps but is successively 'scratched' down by radial incision until Schlemm's canal (SC) is opened (trench cut). Following canal opening and viscodilation with a microcannula and sodium hyaluronidate, one Stegmann Canal Expander is implanted on either side of the canal ostia and the scleral incision is closed watertight.

Pharmacokinetics, Safety and Efficacy of Maraviroc in Treatment-experienced Pediatric Patients Infected With CCR5-Tropic HIV-1.

Background: Maraviroc is a CC-chemokine receptor 5 antagonist approved to treat adults infected with CC-chemokine receptor 5-tropic (R5) HIV-1. Study A4001031 was conducted to evaluate the pharmacokinetics, safety and efficacy of maraviroc in combination with optimized background therapy in treatment-experienced pediatric patients infected with R5 HIV-1 and support registration of maraviroc for pediatric use.

Methods: This is an open-label, 2-stage, age-stratified, noncomparative multicenter study.

Canaloplasty with Stegmann Canal Expander for primary open-angle glaucoma: two-year clinical results.

Purpose: To examine longer-term postsurgical safety and efficacy of a new expander for Schlemm's canal.

Methods: In a non-comparative, prospective study, 42 White patients with medically uncontrolled primary open-angle glaucoma (POAG) underwent primary canaloplasty with >2-year follow-up. The bleb-independent procedure comprised catheter-assisted canaloplasty and implantation of two Stegmann Canal Expanders to maintain trabecular distension and canal patency over 180°.

Adherence to On-Time ART Drug Pick-Up and Its Association with CD4 Changes and Clinical Outcomes Amongst HIV Infected Adults on First-Line Antiretroviral Therapy in Nigerian Hospitals.

Medication adherence is a major determinant of antiretroviral treatment (ART) success. Promptness in medication refill pick-ups may give an indication of medication adherence. This study determined medication refill adherence among HIV positive patients on ART and its association with treatment outcomes in HIV treatment centers in Nigeria.

A New Expander for Schlemm Canal Surgery in Primary Open-angle Glaucoma-Interim Clinical Results.

Purpose: To evaluate a new canal expander in circumferential viscocanalostomy (canaloplasty) for whites with primary open-angle glaucoma (POAG).

Design: Prospective, single-center, noncomparative study.

Participants: Twenty-two eyes of 22 consecutive patients with medically uncontrolled POAG underwent primary viscocanalostomy and implantation of the Stegmann Canal Expander into Schlemm canal with a follow-up time of at least 1 year.

Evaluation of short message service and peer navigation to improve engagement in HIV care in South Africa: study protocol for a three-arm cluster randomized controlled trial.

Background: In countries with a high burden of HIV, such as South Africa, where the epidemic remains the world's largest, improving early uptake of and consistent adherence to antiretroviral therapy could bring substantial HIV prevention gains. However, patients are not linked to or retained in care at rates needed to curtail the epidemic. Two strategies that have demonstrated a potential to stem losses along the HIV care cascade in the sub-Saharan African context are use of text messaging or short message service (SMS) and peer-navigation services.

Need for improvements in clinical practice to retain patients in pre-antiretroviral therapy care: Data from rural clinics in North West Province, South Africa.

We examined current challenges with patient engagement in HIV prevention and care in South Africa by assessing the procedures of eight public health clinics in the North West Province. Procedures consisted of (1) an inventory/audit of the HIV Counseling and Testing, pre-antiretroviral therapy (pre-ART), and antiretroviral therapy (ART) patient registers; (2) extraction of data from a convenience sample of 39 HIV-positive patient files; and (3) 13 key informant interviews with clinic staff to characterize retention and re-engagement practices for patients. Incomplete registers revealed little evidence of follow-up services, particularly for pre-ART patients.

Novel device for expanding Schlemm's canal: a morphological study: Implantation of the Stegmann Canal Expander following viscodilation of Schlemm's canal resulted in permanent expansion of the canal lumen and distension of the trabecular meshwork without complications.

This study was performed to assess any changes in Schlemm's canal (SC) in human autopsy eyes possibly resulting from the injection of a viscoelastic substance and implantation of a new device (the Stegmann Canal Expander, SCE) into SC. After the surgical procedure, eyes were fixed, dissected into quartered segments and examined using light and scanning electron microscopy. Tissue sections displayed a marked dilation of SC and of the collector channels compared with untreated control sections.

Long-term results of up to 12 years of over 700 cases of viscocanalostomy for open-angle glaucoma.

Purpose: To study the safety and long-term efficacy of classic viscocanalostomy in patients with open-angle glaucoma (OAG) in different populations.

Methods: A total of 726 eyes of 726 patients from Europe or South Africa with primary OAG (POAG) and pseudoexfoliative glaucoma (PXFG) were included in this retrospective multicentre study. Complete (qualified) success was defined as an intraocular pressure (IOP) equal to or lower than 21, 18 and 16 mmHg without (with or without) medications, respectively.

Pregnancy outcomes and birth defects from an antiretroviral drug safety study of women in South Africa and Zambia.

Objective: To evaluate the safety of combination antiretroviral therapy (ART) in conception and pregnancy in different health systems.

Design: A pilot ART registry to measure the prevalence of birth defects and adverse pregnancy outcomes in South Africa and Zambia.

Methods: HIV-infected pregnant women on ART prior to conception were enrolled until delivery, and their infants were followed until 1 year old.

Thrombocytopenia and thrombosis: a double-edged sword.

Severe thrombocytopenia with bleeding associated with a life-threatening thrombotic manifestation in the setting of antiphospholipid syndrome is a major diagnostic and therapeutic challenge for the clinician. Hemorrhage is a less common complication than thrombosis in patients with APS, although severe thrombocytopenia can sometimes result in bleeding. There are no evidence-based guidelines regarding the management of a patient with severe thrombocytopenia associated with a major thrombotic manifestation.

Canaloplasty for primary open-angle glaucoma: long-term outcome.

Background/aims: To study the safety and effectiveness of 360° viscodilation and tensioning of Schlemm canal (canaloplasty) in black African patients with primary open-angle glaucoma (POAG).

Methods: Sixty randomly selected eyes of 60 consecutive patients with POAG were included in this prospective study. Canaloplasty comprised 360° catheterisation of Schlemm's canal by means of a flexible microcatheter with distension of the canal by a tensioning 10-0 polypropylene suture.

Comparing two tensioning suture sizes for 360 degrees viscocanalostomy (canaloplasty): a randomised controlled trial.

Purpose: To compare the safety and efficacy of two polypropylene (Prolene) sutures for tensioning of the inner wall of Schlemm's canal (SC) in black African patients with primary open-angle glaucoma (POAG) undergoing canaloplasty.

Methods: In a prospective randomised trial of 90 patients, canaloplasty was performed with a flexible microcatheter (iTrack-250A) and sodium hyaluronidate 1.4% (Healon GV).

Clinical evaluation of the aqueous outflow system in primary open-angle glaucoma for canaloplasty.

Purpose: To assess the aqueous outflow pathway in primary open-angle glaucoma (POAG) through provocative gonioscopy and channelography with a flexible microcatheter and fluorescein tracer during canaloplasty.

Methods: One eye each was randomly selected from 28 consecutive black African POAG patients undergoing canaloplasty. Provocative gonioscopy was performed at the beginning of surgery, and blood reflux from collector channels into Schlemm's canal (SC) was semiquantitatively evaluated.

Capsular opacification after vitreous-sparing cataract surgery in children.

Background: The aim of this study was to evaluate different methods of intraocular lens (IOL) implantation and posterior capsule management in the absence of vitrectomy with respect to visual axis opacification (VAO) in children.

Patients And Methods: Seventy-three eyes of African children undergoing cataract extraction and IOL implantation between 1998 and 2001 were evaluated. In all eyes, the IOL haptics were placed in the bag and the vitreous was preserved.

Channelography: imaging of the aqueous outflow pathway with flexible microcatheter and fluorescein in canaloplasty.

Background: The aim of this study is to present a new approach to visualize the aqueous outflow system during glaucoma surgery using a flexible microcatheter and fluorescein, called channelography.

Patients And Methods: Schlemm's canal was unroofed in a standard non-penetrating dissection technique in patients undergoing canaloplasty. A flexible microcatheter (iTrack 250A) was introduced into the canal and advanced 360 degrees .

Protonation constant of monoaza-12-crown-4 ether and stability constants with selected metal ions in aqueous solution in the presence of an excess of sodium ion: a potentiometric and differential pulse polarographic study at fixed ligand to metal ratio and varied pH.

The ligand monoaza-12-crown-4 ether (A12C4) was studied in aqueous solution at 298 K and an ionic strength of 0.5 mol dm(-3) in the presence of an excess of sodium ion (0.5 mol dm(-3) NaNO(3)).

Proliferative verrucous leukoplakia and field cancerization: report of a case.

Proliferative verrucous leukoplakia (PVL) is a multi-focal oral pre-malignant lesion, proliferative in nature, with a tendency to recur despite adequate therapy, and a high rate of malignant transformation. The field cancerization phenomenon may explain the characteristic behaviour of PVL. A case of PVL is presented and the field cancerization concept is discussed.

Diagnosis of fallopian tube patency.

Objectives: To evaluate and compare the diagnostic value of hysterosalpingography (HSG) and laparoscopic chromopertubation (LCP), in the diagnosis of fallopian tube patency.

Design: A comparative prospective study.

Setting: The infertility clinic of the Department of Obstetrics and Gynaecology, Ga-Rankuwa hospital (Medical University of Southern Africa), Pretoria, South Africa.

Complex oral manifestations of an HIV-seropositive patient.

A complex manifestation of characteristic oral lesions occurring simultaneously in an HIV-seropositive patient is presented. Necrotizing ulcerative gingivitis (NUG), necrotizing ulcerative periodontitis (NUP), oral-facial herpes infection, pseudomembranous candidiasis and atypical oral ulceration are discussed. In spite of extremely low CD4+ T-cell counts of 3 x 10(6)/L and lack of anti-retroviral therapy, an AIDS patient responded favourably to standard periodontal therapy.

Acute hepatitis and atovaquone/proguanil.

A 31-year-old healthy man developed acute hepatitis after receiving atovaquone (250 mg) and proguanil (100 mg) for malaria prophylaxis daily for 25 days. Although atovaquone/proguanil is generally well-tolerated, this case highlights the hepatotoxic potential with considerable morbidity and should alert physicians to this harmful side effect.

Clade-related amphotericin B resistance among South African Candida albicans isolates.

Molecular epidemiology revealed 5 distinct clades among clinical isolates of Candida albicans, using DNA fingerprinting with the complex Ca3 probe. Certain clades were found to be highly enriched in particular geographical areas (e.g.

Penetrating eye injuries in South African children: aetiology and visual outcome.

Purpose: To assess the aetiology, prognosis, and visual outcome of penetrating eye injuries in South African children.

Methods: In all, 100 consecutive patients, aged 16 years and under, with penetrating ocular injuries undergoing surgery between January 2001 and November 2002 were prospectively evaluated.

Results: Most children (66%) were injured during play.

Posterior vertical capsulotomy with optic entrapment of the intraocular lens in congenital cataracts--prevention of capsule opacification.

Purpose: To present a modified surgical technique for preventing posterior capsule opacification (PCO) in children with congenital cataracts and to evaluate its long-term efficacy.

Setting: Department of Ophthalmology, Medical University of Southern Africa, Medunsa, South Africa.

Methods: Anterior and posterior vertical capsulotomy, with optic entrapment of the intraocular lens (IOL) by maintaining the anterior hyaloid, was performed in 68 cataractous eyes of children aged 2 months to 8 years (mean 3 years, 1 month).