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D Miller

Publications and source records attributed to D Miller.

At least 37 records · Page 2Linked to original sources
PubMed2003

Neutralizing antibodies during treatment of secondary progressive MS with interferon beta-1b.

OBJECTIVE: To investigate the relationship between neutralizing antibodies (NAB) and disease progression, relapses, and MR measures of MS. METHODS: Sequential serum samples from all 718 patients of the European Study Group in Interferon beta-1b in Secondary Progressive MS were analyzed to investigate relations between NAB and disease progression, relapses, and MR measures. RESULTS: This study showed no attenuating effect of NAB development on progression in disability. The effects of NAB on relapse rate showed substantial variation, depending on the statistical approach and definition of positivity, though analyses comparing low- and high-NAB+ periods with NAB- periods suggested a titer-related effect. MR T2 lesion volume changes from baseline were significantly higher for NAB+ patients but remained lower than for placebo patients. A substantial proportion of NAB+ patients became NAB-. No untoward effect of NAB development on safety was observed. CONCLUSION: These results support the conclusion that even though high NAB titers appear to have impact on treatment efficacy with respect to relapses, treatment decisions should be based primarily on clinical grounds.

Adult↗
PubMed2003

An ordered BAC contig map of the equine major histocompatibility complex.

A physical map of ordered bacterial artificial chromosome (BAC) clones was constructed to determine the genetic organization of the horse major histocompatibility complex. Human, cattle, pig, mouse, and rat MHC gene sequences were compared to identify highly conserved regions which served as source templates for the design of overgo primers. Thirty-five overgo probes were designed from 24 genes and used for hybridization screening of the equine USDA CHORI 241 BAC library. Two hundred thirty-eight BAC clones were assembled into two contigs spanning the horse MHC region. The first contig contains the MHC class II region and was reduced to a minimum tiling path of nine BAC clones that span approximately 800 kb and contain at least 20 genes. A minimum tiling path of a second contig containing the class III/I region is comprised of 14 BAC clones that span approximately 1.6 Mb and contain at least 34 genes. Fluorescence in situ hybridization (FISH) using representative clones from each of the three regions of the MHC localized the contigs onto ECA20q21 and oriented the regions relative to one another and the centromere. Dual-colored FISH revealed that the class I region is proximal to the centromere, the class II region is distal, and the class III region is located between class I and II. These data indicate that the equine MHC is a single gene-dense region similar in structure and organization to the human MHC and is not disrupted as in ruminants and pigs.

Animals↗
PubMed2003

Pattern reversal visual evoked potentials as a measure of visual pathway pathology in multiple sclerosis.

BACKGROUND: Pattern reversal visual evoked potentials (PRVEPs) have a well-documented role in diagnosis of multiple sclerosis (MS), but their value as a visual function surrogate remains controversial. METHODS: We evaluated PRVEP in 37 patients with MS who were participating in a long-term follow-up study following a phase III trial of interferon beta-1a (Avonex). Patients were examined to determine the Kurtzke Extended Disability Status Score (EDSS), multiple sclerosis functional composite (MSFC), contrast letter acuity (CLA), and had cranial MRI scans to determine whole brain atrophy (BPF). PRVEP was evaluated for P100 latency, amplitude, and waveform morphology. Two summary scores were created: for Score A, abnormal latencies, morphologies, and amplitudes of each individual eye were added; for Score B, abnormal latencies, morphologies, and amplitude ratio between eyes was determined. Sixteen patients in this group also had PRVEP at the time they enrolled in the clinical trial, eight years previously. RESULTS: At the follow-up exam, over 75% of patients had abnormal PVEP parameters while visual acuity (VA) was abnormal only in 59%. Increased PRVEP latency over the eight-year period correlated with deterioration assessed by EDSS (P = 0.006), BPF (P = 0.0001), and MSFC (P = 0.0041). Score A was significantly correlated with EDSS, BPF, CLA, cognitive function, and quality of life assessed with the Sickness Impact profile. No correlation was seen with the MSFC. CONCLUSIONS: The results indicate that PRVEP measures MS-related pathology, and can provide not only diagnostic but also prognostic information during evaluation of MS patients.

Evoked Potentials, Visual↗
PubMed2003

Thrombocytopaenia in canine babesiosis and its clinical usefulness.

Canine babesiosis is a common cause of thrombocytopaenia but there are few formal studies that have investigated this haematological finding in dogs. Thrombocyte counts from full blood counts were retrospectively analysed for the years 1996-2002. Thrombocyte counts and mean platelet volumes of dogs with babesiosis were compared with those of dogs, seen over the same period of time, that did not have babesiosis. There were 1162 cases in the Babesiosis group and 10 808 in the Non-babesiosis group. A frequency distribution of the thrombocyte counts showed a trimodal distribution in the Non-babesiosis group compared to a bimodal distribution in the Babesiosis group, with a strong positive skewness. The modes for the frequency distributions were 10, 40, 300 and 10, 35 x 10(9)/l thrombocytes, respectively. The median thrombocyte count in the Babesiosis group was 14 x 10(9)/l and 282 x 10(9)/l in the Non-babesiosis group. There was a statistically significant difference in the median thrombocyte count between the Babesiosis group and the Non-babesiosis group. In the Babesiosis group, 99% of the thrombocyte counts were below the lower reference range value (250 x 10(9)/l) and 62% of thrombocyte counts were below 25 x 10(9)/l. The mean platelet volume (11.1 fl) for the Babesiosis group was greater than the reference range (6-10 fl) and significantly larger than in the Non-babesiosis group (median 9.7 fl). Thrombocyte counts greater than 110 and 250 x 10(9)/l had a predictive value that the dog was not suffering from babesiosis of 99.3% and 99.8%, respectively. There was a statistically significant difference between the thrombocyte counts of dogs with babesiosis when grouped by parasitaemia scores. The mechanisms of the thrombocytopaenia are not fully understood, and multiple mechanisms, including concomitant thrombocytopaenia-inducing diseases such as ehrlichiosis, probably result in this haematological finding. Babesiosis in the South African canine population is associated with thrombocytopaenia in nearly all patients and is severe in the majority of them. In the absence of thrombocytopaenia, babesiosis is an unlikely diagnosis.

Analysis of Variance↗
PubMed2002

Eight-year follow-up study of brain atrophy in patients with MS.

OBJECTIVE: To characterize whole-brain atrophy in relapsing-remitting MS (RRMS) patients over an 8-year period. The specific goals of this study were to determine if brain atrophy is related to subsequent disability status and to identify MRI correlates of atrophy progression. METHODS: A follow-up study was conducted to reassess patients from a phase III trial of interferon beta-1a (IFNbeta-1a) 8 years after randomization. Clinical and MRI data from 172 patients followed over 2 years in the original trial were used as baseline data. Follow-up data were obtained on 160 patients, including 134 patients with follow-up MRI examinations. Brain atrophy was estimated by automated calculation of brain parenchymal fraction. The relation between atrophy during the original trial and disability status at follow-up was determined. Correlations were also determined between lesion measurements from the original trial and the brain parenchymal fraction at follow-up. RESULTS: Brain atrophy was correlated with subsequent disability status. Atrophy rate during the original trial was the most significant MRI predictor of disability status at follow-up. Brain atrophy at follow-up was related to lesion volumes measured during the original trial. CONCLUSIONS: The relation between atrophy progression and subsequent neurologic disability status suggests that atrophy progression during RRMS is clinically relevant. Therefore, atrophy progression may be a useful marker for disease progression in clinical trials. The relation between lesions and subsequent atrophy indicates that brain atrophy may be related to focal tissue damage at earlier points in time, but important predisposing or other factors contributing to atrophy remain undefined.

Adjuvants, Immunologic↗
PubMed2002

Use of intravenous amiodarone for postoperative junctional ectopic tachycardia in children.

To assess the efficacy and safety of intravenous (IV) amiodarone for the treatment of postoperative junctional ectopic tachycardia (JET) in children, we retrospectively reviewed 11 patients treated with IV amiodarone for JET between 1/92 and 2/00. Data included heart rate and hemodynamics pre- and post-amiodarone, drug dosage, duration of therapy, and effect. Success was defined as reversion to sinus rhythm or slowing to a hemodynamically stable rate. The mean heart rate prior to amiodarone was 203 bpm, and the mean systolic blood pressure was 64 mmHg. Mean IV amiodarone loading dose was 8.2 +/- 4.0 mg/kg, followed by an infusion in 7 patients at a dose of 12.9 +/- 3.9 mg/kg/day for a duration of 74.3 +/- 46.9 hours. At 1 hour post-load, mean heart rate was 147 bpm and mean systolic blood pressure was 88 mmHg for the group. Three patients were in sinus rhythm, 4 in intermittent sinus rhythm with accelerated junctional rhythm, and 4 patients solely accelerated junctional rhythm. Control of JET persisted in 9 patients. Of the two patients requiring additional treatment, both had received a 5 mg/kg load and neither was on an infusion. Five patients were paced at some point following amiodarone: four to improve hemodynamics and one for late sinus bradycardia. Side effects included hypotension with loading (1) and late sinus bradycardia (1). One patient was discharged on oral amiodarone. Intravenous amiodarone given in doses of 10 mg/kg in two 5 mg/kg increments, followed by an infusion of 10-15 mg/kg/day for 48-72 hours, appears to be safe and effective for postoperative JET in patients who fail conventional therapy or who are hemodynamically unstable. Long-term oral therapy is usually not necessary.

Amiodarone↗
PubMed2002

Interventions for relieving the pain and discomfort of screening mammography.

BACKGROUND: Pain of mammography is recognised as a significant deterrent to breast screening and therefore may effect the success or failure of any screening programme. OBJECTIVES: To review research of interventions related to any aspect of breast screening to reduce or relieve the pain and discomfort of screening mammography. SEARCH STRATEGY: The Cochrane Breast Cancer Group conducted a search of their specialised register in the Cochrane Library. In addition a wide variety of databases and websites were searched using keywords 'mammography' and 'pain', along with handsearching selected journals. Information was requested from a wide range of interested people and organisations. SELECTION CRITERIA: Randomised controlled trials and non-randomised trials with a comparison group were considered. Studies had to include assessment of both pain and quality of mammograms. DATA COLLECTION AND ANALYSIS: Identified studies were independently reviewed by two reviewers to determine if they met the inclusion criteria. Additional information was sought from investigators as necessary. Each study was reviewed for quality, including concealment of the allocation sequence, generation of the allocation sequence, comparability between groups at the baseline, inclusion of all randomised participants in the analysis and blinding after allocation. MAIN RESULTS: Three RCTs were identified for inclusion. A well designed study found that patient controlled breast compression gave a significant reduction in discomfort. However, the quality of mammograms was only maintained if the technologist controlled the first compression. Another study involved the technologist reducing compression force for one view. This study was poorly designed and showed no significant differences. The result was the same in a well designed study of the use of acetoaminophen as a premedication. The differences in interventions, and the inconsistency in measures and validation of pain scales and assessment of quality of mammograms, mean that the results of the studies cannot be combined. REVIEWER'S CONCLUSIONS: The only intervention suggesting significant reduction in the pain and discomfort was of patient controlled compression. Further research is required to determine if these findings can be replicated. Reducing technologist applied compression force did not result in significant reduction in pain suggesting that more than actual compression force is involved in pain and discomfort. However, the poor design of this study could have influenced the results. Premedication with acetoaminophen has no effect on the pain of mammography. More research into interventions to reduce the pain of mammography is needed if this is to continue as the preferred screening method in the detection of breast cancer.

Acetaminophen↗
PubMed2002

Vulvar squamous cell carcinoma in young women: a clinicopathologic study of 21 cases.

OBJECTIVES: Invasive squamous cell carcinoma (ISCC) of the vulva occurs most often in older women and the clinical, pathological, and immunohistochemical features of vulvar ISCC in young women are poorly characterized. The aim of this study was to examine clinical and pathological features of ISCC presenting in women younger than 40 years of age. METHODS: Patients younger than 40 years of age who presented with vulvar ISCC were identified in the population-based tumor registry of the British Columbia Cancer Agency (BCCA) for the period 1970-1998. Clinical data and follow-up were obtained. The pathologic material was reviewed and morphologic features assessed. Immunohistochemical staining for MIB-1 and p53 proteins was done and the presence of human papillomavirus (HPV) DNA was assessed by microdissection/PCR. RESULTS: Twenty-one cases, accounting for 5% of all cases of vulvar ISCC encountered at BCCA during this period, were identified, with patient's ages ranging from 17 to 39 years (mean 33). The number of cases of vulvar ISCC in young women, as a percentage of all cases of vulvar ISCC, increased significantly over the study period. Lichen sclerosus was seen in 3 cases. Vulvar intraepithelial neoplasia (VIN) was present in 20 of 21 cases and was multifocal in 4 of them. VIN was subclassified as warty in 7 cases, mixed warty and basaloid in 6, basaloid in 4, and differentiated in 3. There was MIB-1 immunostaining throughout the full thickness of warty and basaloid VIN. Only basal cells stained for MIB-1 in differentiated VIN. Increased p53 expression was present in only 2 cases; both were differentiated-type VIN. HPV DNA was detected in 17 of 20 cases. The tumors were staged as follows: stage IA, 3 cases; stage IB, 13 cases; stage II, 3 cases; stage III, 2 cases. Depth of invasion ranged from <1 to 8.5 mm. The definitive surgical procedure was vulvectomy with lymph node dissection in 14 cases, wide local excision in 6, and excisional biopsy in 1. Clinical follow-up of 1 to 28 years (median, 5 years) showed that 5 patients had local recurrence and 2 died of disease. Of the 21 patients in this study, 1 had concurrent HIV infection and 1 patient with Crohn's disease was treated with corticosteroids; the remaining patients had no clinical evidence of depressed immune function. CONCLUSIONS: The incidence of vulvar ISCC in young women has increased over time; this increase cannot be accounted for by ISCC in immunocompromised patients. The overall disease outcome was excellent, with 2 of 21 patients dead of disease. Most tumors were associated with HPV, but cases of ISCC in the absence of HPV, and associated with differentiated VIN, were encountered. p53 staining of the basal layer can aid in recognition of differentiated VIN while MIB-1 staining within the upper layers of the squamous epithelium is consistently present in warty and basaloid VIN, but not in differentiated VIN.

Adolescent↗
PubMed2002

The effect of Helicobacter pylori infection on levels of DNA damage in gastric epithelial cells.

BACKGROUND: Helicobacter pylori infection leads to an increased risk of developing gastric cancer. The mechanism through which this occurs is not known. We aimed to determine the effect of H. pylori and gastritis on levels of DNA damage in gastric epithelial cells. METHODS: Epithelial cells were isolated from antral biopsies from 111 patients. DNA damage was determined using single cell gel electrophoresis and the proportion of cells with damage calculated before and 6 weeks after eradication of H. pylori. Cell suspensions generated by sequential digestions of the same biopsies were assayed to determine the effect of cell position within the gastric pit on DNA damage. RESULTS: DNA damage was significantly higher in normal gastric mucosa than in H. pylori gastritis [median (interquartile range) 65% (58.5-75.8), n = 18 and 21% (11.9-29.8), n = 65, respectively, p <.001]. Intermediate levels were found in reactive gastritis [55.5% (41.3-71.7), n = 13] and H. pylori negative chronic gastritis [50.5% (36.3-60.0), n = 15]. DNA damage rose 6 weeks after successful eradication of H. pylori[to 39.5% (26.3-51.0), p =.007] but was still lower than in normal mucosa. Chronic inflammation was the most important histological factor that determined DNA damage. DNA damage fell with increasing digestion times (r = -.92 and -.88 for normal mucosa and H. pylori gastritis, respectively). CONCLUSIONS: Lower levels of DNA damage in cells isolated from H. pylori infected gastric biopsies may be a reflection of increased cell turnover in H. pylori gastritis. The investigation of mature gastric epithelial cells for DNA damage is unlikely to elucidate the mechanisms underlying gastric carcinogenesis.

Adolescent↗
PubMed2002

Embryo quality and IVF treatment outcomes may correlate with different sperm comet assay parameters.

BACKGROUND: Standard semen parameters have proven poor at predicting the outcomes of IVF treatment cycles. As recent studies suggest that the male genome may play an important role in early embryogenesis, this study attempts to correlate the level of sperm DNA damage in fresh semen and prepared sperm with the outcomes of conventional IVF treatment cycles. METHODS: Forty patients embarking on IVF treatment were recruited into this prospective observational study. Both fresh semen and PureSperm-prepared sperm were processed using a modified comet assay 3-6 months prior to the patients' IVF treatment cycles. Comet head DNA (mean and integrated head density) and tail DNA parameters (length and moment) were measured separately. RESULTS: Significant correlations between total sperm concentration and between comet length, moment, mean head density with embryo quality were detected in fresh semen and prepared sperm. Surprisingly, no significant correlations between head and tail parameters were detected. CONCLUSIONS: Comet head and tail DNA parameters appear to be potentially useful as predictors of embryo quality and IVF outcomes, especially in couples with unexplained subfertility. The lack of correlation between head and tail parameters may be due to a different mechanism of DNA damage within these two compartments.

Adult↗
PubMed2002

Isolation, characterization and expression of the human Factor In the Germline alpha (FIGLA) gene in ovarian follicles and oocytes.

The Factor In the Germline alpha (FIGalpha) transcription factor regulates expression of the zona pellucida proteins ZP1, ZP2 and ZP3 and is essential for folliculogenesis in the mouse. Using the published mouse Figla sequence, BLAST searches identified a human chromosome 2 BAC clone with high sequence identity. Using PCR primers derived from this clone, amplicons derived from ovarian follicles and mature oocytes revealed 100% identity with the appropriate human BAC clone, the expected homology with the mouse Figla gene sequence, and homology on translation with the FIGalpha protein identified in the Japanese rice fish, medaka (Oryzias latipes). PCR expression profiling of this transcript revealed FIGLA mRNA expression in cDNA derived from ovarian follicles (5/5 samples from the primordial through to the secondary stage) mature oocytes (6/9 samples), and less frequently in preimplantation embryos (2/7 samples). Subsequent BLAST searches revealed the predicted full length coding sequence of the human FIGalpha protein which demonstrates 68 and 25% similarity overall to mouse and medaka proteins respectively, with 96 and 57% identity respectively within the basic helix-loop-helix region. This confirms our identification of the human homologue for this gene which maps to chromosome 2p12. Further work is required to understand its role in normal human oocyte development and the potential involvement in human infertility.

Alternative Splicing↗
PubMed2001

Use of the Multiple Sclerosis Functional Composite to predict disability in relapsing MS.

OBJECTIVE: To determine whether the MS Functional Composite (MSFC) can predict future disease progression in patients with relapsing remitting MS (RR-MS). BACKGROUND: The MSFC was recommended by the Clinical Outcomes Assessment Task Force of the National MS Society as a new clinical outcome measure for clinical trials. The MSFC, which contains a test of walking speed, arm dexterity, and cognitive function, is expressed as a single score on a continuous scale. It was thought to offer improved reliability and responsiveness compared with traditional clinical MS outcome measures. The predictive value of MSFC scores in RR-MS has not been determined. METHODS: The authors conducted a follow-up study of patients with RR-MS who participated in a phase III study of interferon beta-1a (AVONEX) to determine the predictive value of MSFC scores. MSFC scores were constructed from data obtained during the phase III trial. Patients were evaluated by neurologic and MRI examinations after an average interval of 8.1 years from the start of the clinical trial. The relationships between MSFC scores during the clinical trial and follow-up status were determined. RESULTS: MSFC scores from the phase III clinical trial strongly predicted clinical and MRI status at the follow-up visit. Baseline MSFC scores, and change in MSFC score over 2 years correlated with both disability status and the severity of whole brain atrophy at follow-up. There were also significant correlations between MSFC scores during the clinical trial and patient-reported quality of life at follow-up. The correlation with whole brain atrophy at follow-up was stronger for baseline MSFC than for baseline EDSS. CONCLUSION: MSFC scores in patients with RR-MS predict the level of disability and extent of brain atrophy 6 to 8 years later. MSFC scores may prove useful to assign prognosis, monitor patients during early stages of MS, and to assess treatment effects.

Adult↗
PubMed2001

Stereoselective and regioselective reaction of cyclic ortho esters with phenols.

Cyclic ortho esters undergo stereoselective and regioselective reaction with phenols when treated with BF(3) x OEt(2) at low temperatures. Attack of the phenol on the ortho ester occurs at an open carbon para to electron-donating groups on the phenol ("C-addition") or at the phenolic hydroxyl group ("O-addition") depending on the nature of the cation formed from reaction of the ortho ester and BF(3) x OEt(2). Products resulting from O-addition undergo reversion to a mixture of starting phenol, C-addition product, and O-addition product if treated with BF(3) x OEt(2) at room temperature, but C-addition products are stable under the same conditions. X-ray structural analysis of the C-addition compound indicates that its stereochemistry is opposite to that observed in reaction of similar ortho esters with chloride from TMSCl. However, the stereochemistry of the reaction can be rationalized by the ability of the ortho ester to isomerize via an intermediate benzylic cation and examination of the preferred trajectory of attack of the nucleophile on the intermediate oxonium ion.

Journal Article↗
PubMed2001

Spontaneous regression of stage IV clear cell carcinoma of the endometrium in a patient with essential thrombocytosis.

OBJECTIVE: The aim of this study was to document a case of advanced stage clear cell carcinoma of the endometrium which underwent spontaneous regression (SR) and comment on the possible contribution of the patient's thrombocytosis. CASE REPORT: A 73-year-old woman with essential thrombocytosis presented with vaginal bleeding. Imaging demonstrated a complex uterine mass, a 4-cm infrarenal mass, and a 5-cm subumbilical mass. Biopsy of the subumbilical mass revealed adenocarcinoma, and endometrial curettage revealed extensively necrotic clear cell endometrial carcinoma. At hysterectomy 5 weeks later, the infrarenal and subumbilical masses were not identified. The endometrial tumor was almost completely necrotic. She received no adjuvant therapy and remains disease-free 6 years later. Interestingly, her platelet-lowering agent (hydroxyurea) was discontinued shortly before, and her platelet count was significantly elevated at the time of her presentation with endometrial carcinoma. CONCLUSION: This report documents a rare case of SR of advanced endometrial carcinoma, and we speculate that increased circulating platelets were a major contributing factor.

Adenocarcinoma, Clear Cell↗
PubMed2001

Trophic barriers to fertilizer Cd bioaccumulation through the food chain: a case study using a plant--insect predator pathway.

The objective of this study was to assess the uptake and subsequent transfer of Cd and Zn from a soil amended with a single application (150 kg P ha(-1)) of triple super phosphate fertilizer to wheat plants, aphids, and a predator and biocontrol agent of aphids, lacewings. The fertilizer amended soil and wheat plants grown on this soil had elevated concentrations of Cd compared to the controls, but similar concentrations of Zn. Aphids feeding on wheat plants on the fertilized soil had between three and seven times the concentrations of Cd and Zn observed in aphids feeding on the control plants. However, the lacewings showed no significant accumulation of Cd or Zn, and no differences in larval performance were recorded. Changes in the availability of Cd and Zn in the soils and the transfer through the plant-insect pathway were monitored using isotope dilution, by labeling the soils with carrier-free (109)Cd and (65)Zn. Decreases in the specific activities for Cd in the plants and aphids were observed for the fertilized soils compared to the controls, suggesting an increase in bioavailable Cd. On the fertilized soils the Cd:Zn ratio of the phloem-feeding aphids (0.008) was significantly less than the host plants (0.025), indicating a reduced relative uptake of Cd and a possible barrier for Cd along the soil--plant--herbivorous insect pathway--reducing uptake by phloem feeders and subsequently their predators.

Animals↗
PubMed2001

Pseudomonas aeruginosa in vitro corneal isolate sensitivity to ofloxacin, ciprofloxacin, and trovafloxacin: a comparative study.

PURPOSE: To compare sensitivity of Pseudomonas aeruginosa corneal isolates to ofloxacin, ciprofloxacin, and trovafloxacin. METHODS: Sensitivities of P. aeruginosa corneal isolates to each antibiotic from the periods 1985 to 1987 (n = 32) and 1995 to 1999 (n = 85) were evaluated in vitro with E tests (AB Biodisk; Remel, Lenexa, Kansas). RESULTS: Overall, the percent of P. aeruginosa corneal isolates sensitive in vitro to ofloxacin (106/117, 90.6%) was significantly less than to ciprofloxacin (113/117, 96.6%, P =.016) and trovafloxacin (113/117, 96.6%, P =.016). We observed trends of decreasing sensitivity to ciprofloxacin and trovafloxacin, which were not statistically significant. Sensitivity to ofloxacin remained unchanged; however, sensitivity to ofloxacin was always less than sensitivity to ciprofloxacin and trovafloxacin. CONCLUSION: Although in vitro susceptibilities may not correlate with in vivo efficacy, our data suggest that ciprofloxacin and trovafloxacin are superior to ofloxacin in the treatment of P. aeruginosa keratitis.

Anti-Infective Agents↗
PubMed2001

Endophthalmitis caused by Moraxella species.

PURPOSE: To report the incidence, clinical presentation, antibiotic sensitivities, and treatment outcomes for endophthalmitis caused by Moraxella species. METHODS: Consecutive interventional case series. Medical records were reviewed of all patients treated at Bascom Palmer Eye Institute between 1991 and 2000 for endophthalmitis caused by Moraxella species. RESULTS: Moraxella species were recovered from 9 patients (10 eyes), or 1.3% (10 of 757) of all culture-proven bacterial endophthalmitis cases; Moraxella catarrhalis was recovered from 7 eyes and Moraxella osloensis from 3. Endophthalmitis was delayed-onset (5 months to 10 years postoperatively) and bleb-associated in 9 eyes and trauma-related in 1. All isolates were sensitive to ceftazidime, ciprofloxacin, and the aminoglycosides, and they were resistant to vancomycin; resistance to ampicillin and trimethoprim/sulfa was 11%. Although presenting vision was hand motion or worse in 7 of 10 eyes, all but 3 regained baseline visual acuity (including two eyes in which the post-treatment course was complicated by retinal detachment and one eye with coexistent traumatic injuries). CONCLUSION: Endophthalmitis caused by Moraxella species is usually delayed-onset and bleb-associated. Although patients usually present with a profound decrease in vision, the organisms are sensitive to most antibiotics and, unlike most series of delayed-onset bleb-associated endophthalmitis, visual outcomes are generally good unless coexistent ocular morbidities exist.

Adult↗