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M Wand

Publications and source records attributed to M Wand.

At least 19 recordsLinked to original sources
PubMed2006

Multilevel modelling of the incidence of visceral leishmaniasis in Teresina, Brazil.

Epidemics of visceral leishmaniasis (VL) in major Brazilian cities are new phenomena since 1980. As determinants of transmission in urban settings probably operate at different geographic scales, and information is not available for each scale, a multilevel approach was used to examine the effect of canine infection and environmental and socio-economic factors on the spatial variability of incidence rates of VL in the city of Teresina. Details on an outbreak of greater than 1200 cases of VL in Teresina during 1993-1996 were available at two hierarchical levels: census tracts (socio-economic characteristics, incidence rates of human VL) and districts, which encompass census tracts (prevalence of canine infection). Remotely sensed data obtained by satellite generated environmental information at both levels. Data from census tracts and districts were analysed simultaneously by multilevel modelling. Poor socio-economic conditions and increased vegetation were associated with a high incidence of human VL. Increasing prevalence of canine infection also predicted a high incidence of human VL, as did high prevalence of canine infection before and during the epidemic. Poor socio-economic conditions had an amplifying effect on the association between canine infection and the incidence of human VL. Focusing interventions on areas with characteristics identified by multilevel analysis could be a cost-effective strategy for controlling VL. Because risk factors for infectious diseases operate simultaneously at several levels and ecological data usually are available at different geographical scales, multilevel modelling is a valuable tool for epidemiological investigation of disease transmission.

Animals↗
PubMed2001

Latanoprost and cystoid macular edema in high-risk aphakic or pseudophakic eyes.

PURPOSE: To determine the magnitude of the association between latanoprost use and cystoid macular edema (CME) in high-risk aphakic or pseudophakic eyes. SETTING: Single referral glaucoma practice. METHODS: In a referral glaucoma practice, 40 consecutive patients with glaucoma uncontrolled on maximally tolerated medications without latanoprost were studied. Seven eyes were aphakic, and 33 eyes were pseudophakic. All eyes had an absent or open posterior capsule, and 29 eyes had 1 or more additional risk factors for developing CME. Latanoprost 0.005%, 1 drop at bedtime, was added to the patients' current regimen. Patients were instructed to check their vision in the treated eye daily at home and to report any perceived decrease promptly. Patients without a change in vision or other side effects were reexamined 1 month after initiating latanoprost and every 3 months thereafter. If there was a greater than 1 line decrease in visual acuity, a retinal evaluation and fundus fluorescein angiography (FFA) were performed by a retina specialist. RESULTS: Two eyes had to discontinue latanoprost because of side effects before the 1 month visit. They were excluded from the analysis. At the 1 month follow-up, the mean intraocular pressure was 18.2 mm Hg +/- 6.5 (SD), a decrease from the pretreatment mean of 21.5 +/- 5.7 mm Hg. The visual acuity was within 1 line of baseline in 36 eyes and decreased by 2 lines in 2 eyes. In these 2 eyes, symptomatic CME was documented by FFA. The CME clinically resolved, with visual acuity returning to baseline after the latanoprost was discontinued and a nonsteroidal antiinflammatory drug started. There were no additional cases of CME after a mean follow-up of 5.7 months. CONCLUSION: Approximately 5% of high-risk eyes treated with latanoprost developed clinically symptomatic and angiographically documented CME. The temporal relationship between initiation of treatment and the decreased vision in our 2 cases suggests but does not establish a causal relationship between CME and latanoprost. With appropriate informed consent and attentive follow-up, clinicians should not be deterred from using this important glaucoma medication.

Aged↗
PubMed2001

Molecular identification using flow cytometry histograms and information theory.

Flow cytometry is a common technique for quantitatively measuring the expression of individual molecules on cells. The molecular expression is represented by a frequency histogram of fluorescence intensity. For flow cytometry to be used as a knowledge discovery tool to identify unknown molecules, histogram comparison is a major limitation. Many traditional comparison methods do not provide adequate assessment of histogram similarity and molecular relatedness. We have explored a new approach applying information theory to histogram comparison, and tested it with histograms from 14 antibodies over 3 cell types. The information theory approach was able to improve over traditional methods by recognizing various non-random correlations between histograms in addition to similarity and providing a quantitative assessment of similarity beyond hypothesis testing of identity.

Animals↗
PubMed2000

Long-term effect of Nd:YAG laser posterior capsulotomy on intraocular pressure.

OBJECTIVE: To study the long-term effect of Nd:YAG capsulotomy on intraocular pressure (IOP). METHODS: We reviewed the records of patients with bilateral pseudophakia who received Nd:YAG capsulotomy in only 1 eye. Using the Wilcoxon rank sum test, we compared the mean change in IOP in eyes before and after capsulotomy with that of the noncapsulotomy eyes at corresponding time intervals. Using multiple regression tests, we analyzed the factors significantly associated with postcapsulotomy long-term IOP increases. RESULTS: The study included 100 patients who were followed up for a median of 1.5 years after capsulotomy. The mean +/- SD age of the study group was 76+/-7 years, and 37 patients had glaucoma. The changes in IOP in the eyes treated with capsulotomy were significantly higher than those in noncapsulotomy eyes at each time interval following capsulotomy. The long-term IOP increase was significantly associated with the IOP increase measured 1 hour after the capsulotomy (P =. 001). Patients with glaucoma were more likely to require long-term additional glaucoma medication than were nonglaucoma patients to require initial glaucoma therapy after the capsulotomy (P =.002). CONCLUSION: After Nd:YAG capsulotomy, long-term IOP is often elevated above precapsulotomy baselines, especially in glaucoma patients or patients who experience a significant IOP increase within hours after the capsulotomy.

Aged↗
PubMed2000

A comparison of dorzolamide-timolol combination versus the concomitant drugs.

PURPOSE: To compare the intraocular pressure (IOP) lowering effect of fixed combination dorzolamide 2% and timolol 0.5% therapy to that of concomitant administration of a topical beta-blocker and dorzolamide. METHODS: Seventy-four consecutive glaucoma patients were changed from a regimen including a topical beta-blocker and dorzolamide to the fixed combination dorzolamide-timolol in 1 eye, with the other eye used as the control. The average IOP readings before and 1 month after the change were compared. RESULTS: The mean baseline IOP in the entire study population was 19.4 +/- 4.2 mm Hg in the study eyes and 16.9 +/- 4.2 mm Hg in the control eyes. Four weeks after the medication change, the mean IOP was 17.3 +/- 3.9 mm Hg in the study eyes (P <.001) and 16.1 +/- 4.1 mm Hg in the control eyes (P =.02). The difference between the mean IOP change of 2.1 mm Hg in the study eyes and 0.8 mm Hg in the control eyes was found to be statistically significant (P =.01). CONCLUSION: These findings suggest that the fixed combination dorzolamide-timolol therapy achieves additional lowering of the intraocular pressure compared with the concomitant administration of a beta-blocker and dorzolamide.

Adrenergic beta-Antagonists↗
PubMed2000

Visually significant cystoid macular edema in pseudophakic and aphakic patients with glaucoma receiving latanoprost.

PURPOSE: To investigate the incidence of visually significant cystoid macular edema associated with the use of latanoprost in patients with glaucoma after cataract surgery. PATIENTS AND METHODS: This is a multicenter, retrospective study of 185 patients, of whom 173 were pseudophakic (212 eyes) and 12 were aphakic (13 eyes), who were treated for glaucoma with latanoprost 0.005%. The posterior lens capsule was intact in 125 eyes, open or absent as a result of surgery in 25 eyes, and status-post-yttrium-aluminum-garnet capsulotomy in 75 eyes. Visual acuity was documented before and after initiating latanoprost therapy, and patients with a reduction of two or more lines on the Snellen chart were examined by fluorescein angiography for cystoid macular edema. RESULTS: Visual reduction was documented in four (2.16%) patients. Three of the four patients had cystoid macular edema, and the fourth was thought to have lost a central island of vision from glaucoma. The three patients with cystoid macular edema all had ruptured posterior capsules, requiring anterior vitrectomy, and one had a previous episode of cystoid macular edema 3 years before starting latanoprost therapy. CONCLUSION: These findings suggest that visually significant cystoid macular edema associated with latanoprost therapy in pseudophakic or aphakic patients is uncommon. If there is a cause-and-effect relationship between latanoprost therapy and clinically significant cystoid macular edema, the incidence appears to be low.

Adolescent↗
PubMed2000

Exhaled nitric oxide in patients with asthma: association with NOS1 genotype.

An increased concentration of nitric oxide (NO) in exhaled air (FENO) is now recognized as a critical component of the asthmatic phenotype. When we identified patients with asthma on the basis of a standard case definition alone, we found that they were remarkably heterogeneous with respect to their FENO. However, when we included genotype at a prominent asthma candidate gene (i.e., NOS1) in the case definition, and determined the number of AAT repeats in intron 20, we identified a remarkably homogeneous cohort of patients with respect to FENO. Both mean FENO (p = 0.00008) and variability around the mean (p = 0.000002) were significantly lower in asthmatic individuals with a high number (> or = 12) of AAT repeats at this locus than in those with fewer repeats. These data provide a biologically tenable link between genotype at a candidate gene in a region of linkage, NOS1, and an important component of the asthmatic phenotype, FENO. We show that addition of NOS1 genotype to the case definition of asthma allows the identification of a uniform cohort of patients, with respect to FENO, that would have been indistinguishable by other physiologic criteria. Our isolation of this homogeneous cohort of patients ties together the well-established associations among asthma, increased concentrations of NO in the exhaled air of asthmatic individuals, and variations of trinucleotide repeat sequences as identified in several neurologic conditions.

Adult↗
PubMed1999

Latanoprost and herpes simplex keratitis.

PURPOSE: To report three cases in which herpes simplex keratitis developed after initiation of latanoprost therapy. METHODS: Case report. RESULTS: One patient with a history of herpes simplex keratitis had recurrence of herpes simplex keratitis with latanoprost treatment, resolution when latanoprost was stopped, and another recurrence when rechallenged with latanoprost. A second patient with a history of herpes simplex keratitis had bilateral recurrence with initiation of latanoprost; antiviral therapy could not eradicate herpes simplex keratitis until the latanoprost was discontinued. The third patient with latanoprost-associated herpes simplex keratitis cleared with the discontinuation of latanoprost and start of antiviral therapy; reinstitution of latanoprost with prophylactic antiviral medication kept the cornea clear, but as soon as the antiviral suppression was discontinued, herpes simplex keratitis reappeared. CONCLUSION: Latanoprost, among its diverse pharmacologic effects, may mediate inflammation in the eye. Prostaglandins may be a final common pathway for stimulating recurrence of herpes simplex keratitis. Clinicians should be aware of this possible association.

Aged↗
PubMed1999

Latanoprost in glaucoma associated with Sturge-Weber syndrome: benefits and side-effects.

PURPOSE: This study was conducted to evaluate the ocular hypotensive efficacy, safety, and side effects of latanoprost 0.005% administered as adjunctive therapy in patients with Sturge-Weber syndrome (SWS) and glaucoma. METHODS: Commercially available latanoprost 0.005% was added as a single drop once daily to other antiglaucoma medications. Intraocular pressure (IOP) was measured at 1, 3, and 6 months of treatment. A successful response was defined as a reduction of at least 20% in IOP at the final follow-up evaluation without additional medical or surgical therapy and no adverse events related to latanoprost. RESULTS: 18 eyes of 18 patients with SWS and glaucoma were enrolled from 9 clinical centers. Mean baseline IOP was 28.4 +/- 7.1 mmHg (range, 17-42 mmHg). Using Kaplan-Meier analysis, a successful response to latanoprost was observed in 3 of 18 (16.7%) patients at the 6-month interval. Seven (38.9%) patients required surgery; three (16.7%) patients required additional medical therapy, seven (38.9%) patients had no change in therapy. One (5.6%) patient discontinued latanoprost treatment because of intolerable conjunctival hyperemia. Two successfully treated patients had significantly greater episcleral vessel engorgement after initiation of latanoprost therapy. CONCLUSION: Patients with SWS and glaucoma respond poorly to adjunctive latanoprost therapy and often require additional medical or surgical intervention. Increased episcleral vascular engorgement might result in greater operative risks should filtration surgery become necessary in these patients.

Adolescent↗
PubMed1997

Latanoprost for uncontrolled glaucoma in a compassionate case protocol.

PURPOSE: To evaluate the ocular hypotensive response of latanoprost 0.005% administered as adjunctive therapy in patients with glaucoma who were receiving maximal tolerated medical therapy. METHODS: Consecutive patients entering a latanoprost compassionate clinical trial were enrolled at two sites. Latanoprost 0.005% was administered as a single drop between 6 and 8 PM, and all other medications were continued. Intraocular pressure was measured between 2 and 4 PM. Responders were defined as having a reduction in intraocular pressure of at least 20% from baseline. RESULTS: In 160 eyes of 160 patients, mean baseline intraocular pressure +/- SD was 23.3 +/- 6.9 mm Hg. Intraocular pressure was significantly reduced compared with baseline measurements (P < .01) with mean intraocular pressure measurement reductions of 4.1 +/- 5.2, 4.0 +/- 6.3, and 3.7 +/- 4.2 mm Hg at the 1-, 3-, and 6-month intervals, respectively. A reduction in intraocular pressure of at least 20% was observed in 64 (44.4%) of 144 patients, 46 (43.0%) of 107 patients, and 10 (32.3%) of 31 patients at the 1-, 3-, and 6-month visits, respectively. A 40% reduction in intraocular pressure was observed in 18 (12.5%) of 144 and nine (8.4%) of 107 patients at 1 and 3 months, respectively. Mean reduction in intraocular pressure was similar in the miotic and nonmiotic groups (P > .4 at all intervals). Eight patients (5.0%) developed ocular allergy or irritation necessitating cessation of latanoprost therapy. CONCLUSION: Latanoprost 0.005% may provide significant further intraocular pressure reduction in patients already receiving maximal tolerated medical therapy.

Adolescent↗
PubMed1997

Supraciliary effusions and ciliary body thickening after scleral buckling procedures.

PURPOSE: The purpose of the study was to use ultrasound biomicroscopy to identify and quantity changes in anterior segment parameters after scleral buckling procedures. METHODS: Ultrasound biomicroscopy was used to examine 15 patients with retinal detachment within 1 week before and after surgery. Quantitative measurements were performed of anterior chamber depth, supraciliary effusion depth, ciliary body thickness, and angle opening. RESULTS: Supraciliary fluid was present after surgery in 12 patients (80%). Average supraciliary fluid depth was 0.16 +/- 0.13 mm. Ciliary body thickness measurements at a point 2-mm posterior to the scleral spur increased after surgery in all patients an average of 0.15 +/- 0.10 mm. There was a strong correlation between ciliary fluid levels and change in ciliary body thickness (r = 0.742, P < 0.01). Anterior chamber depth decreased after surgery in 14 patients (93%). A decrease of angle opening of greater than 5 degrees was noted in 11 patients (73%). In all of these 11 patients, the ciliary body and iris root were considered to be rotated anteriorly. Six (55%) of 11 of these patients showed anterior bowing of the iris, indicating pupillary block. Complete angle closure occurred over one to three quadrants in three patients, but none of these patients had complete angle closure or glaucoma. CONCLUSIONS: Supraciliary effusions and ciliary body thickening are common after scleral buckling procedures and can produce conditions conducive to angle closure. Angle narrowing occurs through a combination of direct anterior iris rotation and induced pupillary block.

Anterior Chamber↗
PubMed1996

Combined phacoemulsification, intraocular lens implant, and trabeculectomy with intraoperative mitomycin-C: comparison between 3.2- and 6.0-mm incisions.

PURPOSE: To compare surgical results between 3.2- and 6.0-mm incisions in combined phacoemulsification, intraocular lens implant, and trabeculectomy with intraoperative mitomycin-C. METHODS: Fifty-seven consecutive eyes of 45 patients in a referral practice underwent combined phacoemulsification, intraocular lens implant, and trabeculectomy with intraoperative mitomycin-C. The first 24 eyes had a 6.0-mm incision and the next 33 eyes had a 3.2-mm incision; the procedures were otherwise identical. The postoperative intraocular pressures, number of antiglaucoma medications, presence of filtration blebs, visual acuity, and complications at 1 day, 1 week, 1 month, and 1 year were subjected to multivariate analysis. RESULTS: There were no statistical differences in the intraocular pressure control, number of antiglaucoma medications, or presence of filtration bleb between the two groups at any of the postoperative visits. Visual acuity was significantly better (p = 0.02) for the 3.2-mm incision group throughout the evaluation period. CONCLUSIONS: Both large- and small-incision phacoemulsification, intraocular lens implant, and trabeculectomy with intraoperative Mitomycin-C provide good intermediate range (1 year) postoperative IOP in eyes with coexisting cataract and glaucoma. In addition, small-incision surgery results in earlier and better visual rehabilitation than large-incision surgery.

Aged↗
PubMed1995

Laser iridotomy.

Explore the source record for details and available documents.

Glaucoma, Angle-Closure↗
PubMed1992

Argon laser gonioplasty for synechial angle closure.

Six eyes of five patients with synechial angle closure were treated with argon laser gonioplasty. The angle closure had persisted for weeks to many years. In each eye, most of the synechial angle closure (60% to 100%) was anatomically opened. The mean decrease in intraocular pressure was 5.5 mm Hg (range, 2 to 12 mm Hg). Previous reports have suggested that argon laser gonioplasty is successful only if the angle closure is of recent onset. I believe that argon laser gonioplasty can be attempted in virtually all cases of synechial angle closure regardless of its duration. I found the single-mirrored goniolens to be the most useful lens for this procedure. It permitted visualization of the angle, direct application of the laser burns on the synechial closure, and simultaneous compression gonioscopy if necessary.

Aged↗