Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0086543 (cataract)
 29,165 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Side effects have to be monitored carefully in all patients receiving drugs profoundly affecting their metabolism. Corticosteroids produce the well-known Cushing's syndrome. Children rarely develop gastric ulcers or disturbances of haemostasis. If steroids are administered for more than one year, the eyes have to be examined for signs of cataract. Rarely, the pseudotumor cerebri syndrome (increased intracranial pressure) may be observed. A monitoring schedule adapted from adult medicine for paediatric purposes is proposed in the text. Nowadays, mostly combinations of cytotoxic drugs are used. Often, doses are as high as the patient can tolerate them. Effects of these drugs are especially marked upon rapidly proliferating tissues such as the haematopoietic system and gastrointestinal mucosa. Immunosuppression may have very serious consequences. Infections caused by organisms usually considered as little pathogenic (e.g., pneumocystis carinii) may become deleterious; some infections may remain concealed or produce fever as the only symptom. Particular side effects of certain cytotoxic drugs are described in the text. Many therapeutic regimens are now standardized, as are monitoring schedules. Frequency and nature of the necessary controls depend upon the disease treated and the kind of therapy applied, as well as on its intensity. Both hospital and family doctors are indispensable for this surveillance; they must remain in close contact with each other.
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PMID:[Monitoring of side effects in patients treated with corticosteroids of cytotoxic drugs (author's transl)]. 32 Apr 59

Infections due to Ps. aeruginosa are a problem in the tropics as in other parts of the world. Over a four year period, 15 patients attending University College Hospital, Ibadan, were proved to have septicaemia due to this organism and 13 patients died rapidly as a direct result of the infection. The two patients who survived the acute episode had received immediate treatment with at least one antibiotic active against Ps. aeruginosa: a third patient, who received immediate appropriate antibiotic therapy, was already suffering from aplastic anaemia and died rapidly despite treatment. The remaining patients received inappropriate antibiotic therapy because pseudomonas infection was not suspected at the time the diagnosis of septicaemia was made. Patients most at risk appear to be the very young and those with pre-existing malignant or other conditions affecting the defence mechanisms of the body: it is suggested that routine initial management of such patients should include a blood culture, followed by immediate treatment with an antibiotic combination that includes at least one agent likely to be active against Ps. aeruginosa. The development of medical services can lead to the introduction of ophthalmic or other operations on tissues that are highly susceptible to infection before facilities are provided for the maintenance of a pathogen-free environment. Following an outbreak of eye infection after cataract extractions, carried out in an old and unsatisfactory theatre, wide-spread room contamination was demonstrated with the same strains of Ps. aeruginosa that had been responsible for the clinical infections. Chemical disinfection of the theatre floor failed to eliminate the organisms, although other experiments suggested that the drying effect of air-conditioning would be successful in this respect. The wisdom of introducing such operations before the provision of adequate facilities is seriously questioned.
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PMID:Serious infections due to Pseudomonas aeruginosa. 82 57

Intraocular lenses removed because of recurrent episodes of intraocular inflammation showed bacteria adhering to the prosthesis. Infections localized to areas around intraocular lenses have been reported in the literature. Two such infections and an in vitro study of bacterial adherence to implant surfaces are reported. Adherent bacteria were found to be more numerous on the polypropylene haptic than on the polymethylmethacrylate optic in both in vitro and in vivo cases. We suggest that the intraocular lens becomes contaminated with commensal organisms of low virulence during insertion into the eye, and that these organisms are the source of the inflammatory episodes. Experiments show that lenses as supplied are sterile and that in vitro bacteria adhere preferentially to the haptic.
J Cataract Refract Surg 1989 May
PMID:Bacterial adhesion to intraocular lenses. 273 31

Twenty seven cases of actionomycotic mycetoma caused either by Actinomadura madurae or Actinomadura pelletierii have been described. Infection by A. madurae has been more common than A. pelletierii. Left foot in A. madurae and right foot in A. pelletierii infections were involved more commonly in adult males, whereas right foot of the females was frequently affected in A. madurae infection. Large, soft, white grains in A. madurae and small, firm, red grains in A. pelletierii were consistently seen. Deep hematoxylin stained grains with scalloped margin and prominent eosinophilic club in A. madurae and such deep stained grains with smooth margin and horizontal cracks appearing as portions of a spherical mass in A. pelletierri were diagnostic. Large numbers of plasma cells and Russel bodies were also characteristic of A. madurae infection. Both the grains were stainable with Von Kossa method for calcium. Bone changes were similar in both the infections. Oral tetracycline produced soft tissue and bone resolution to almost normalcy in those who regularly consumed the drug any time from 2 to 6 years. Mild glucose intolerance, facial hyperpigmentation and urticaria were the side effects observed in a few. Two patients developed cataract following tetracycline therapy. The value of medical therapy with oral tetracycline in Actionomadura mycetomas is emphasized.
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PMID:A clinico-pathological study of actinomycotic mycetomas caused by Actinomadura madurae and Actinomadura pelletierii. 357 38

From 1981-1982, 750 clinical specimens from patients who developed postoperative infections were processed in the ocular microbiology laboratory. Bacterial cultures were positive in 71.0%, fungal in 1.3% and another 1.4% yielded both. The remaining 26.3% were sterile. Infections were due chiefly to Gram positive organisms (63.6%); only 6.4% were due to Gram negative bacteria while 0.9% were due to both. Staphylococcus aureus (52.0%) was the most common isolate, followed by S epidermidis (37.2%). Pseudomonas aeruginosa and Acinetobacter calcoaceticus were the next frequent pathogens. Aspergillus was the most common fungus among the fungal isolates. The highest number of infections followed cataract extraction and keratoplasty. A vast majority of postoperative infections seem to be occurring with hospital acquired strains. Cloxacillin seems to be the most effective remedy for treating staphylococcal infections and polymyxin B for infections due to Pseudomonas. Chloramphenicol appears to be as effective as gentamicin for treating all infections.
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PMID:Postoperative ocular infections: an analysis of laboratory data on 750 cases. 643 98

Spiroplasma mirum (suckling mouse cataract agent) was studied in an epithelial cell line AG-4676, derived from rabbit eye lens. Rabbit eye lens is a natural target tissue of S. mirum infection. The organism grew rapidly in this cell line, reaching titers of 10(7) to 10(9) color change units per ml at 7 days after infection. This is the same level as that achieved in SP-4 medium designed specifically for S. mirum. No lag period was apparent in growth in AG-4676. S. mirum did not grow in Dulbecco minimal essential medium-10% fetal bovine serum, the medium for AG-4676, indicating the need for cells or a cellular product. S. mirum-infected AG-4676 cells exhibited vacuolization and granulation and an increase in polynucleation compared with uninfected controls (36/100 versus 14/100, P less than 0.001). Infection significantly decreased the growth rate of AG-4676, especially late in the growth cycle. In a representative experiment, growth of AG-4676 at 11 days was reduced from 9 X 10(5) to 2 X 10(4) cells by S. mirum infection. S. mirum grew to high titers in conditioned medium of AG-4676, obtained from cell-free supernatants of 1- to 5-day-old AG-4676 cultures. This growth promotion was not due to osmotic conditioning of the medium. Preliminary characterization of this growth promotion substance showed it to be active after 0.22-micron filtration, heating at 56 degrees C for 30 min, freezing and thawing, and dilution at 10(-1) but not 10(-2). AG-4676-propagated S. mirum produced death or cataracts in suckling Wistar rats at the same frequency (55/60, 91.7%) as SP-4-propagated organisms (60/65, 92.3%).
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PMID:Characterization of Spiroplasma mirum (suckling mouse cataract agent) in a rabbit lens cell culture. 664 63

Onchocerciasis is commonly known as River Blindness and affects about 18 million people around the world. It is transmitted by black flies that breed in river and stream rapids and transmit the parasitic microfilariae, Onchocerca volvulus, to people who live and work near such rivers. Infection with the microfilariae results in blindness or visual impairment for 1 or 2 million people. The microfilariae migrate to superficial tissues and may invade any part of the eye and ocular structure. Living worms cause little damage, however, their death triggers a localized inflammation which can lead to blindness. Sclerosing keratitis, a severe corneal involvement, is the major cause of blindness from the disease. The World Health Organization (WHO) Expert Committee on Onchocerciasis has estimated that 9% of the disease is found in Africa, the rest occur in Yemen and Latin America. Treatment with ivermectin is contraindicated for pregnant and lactating women, children under 5 years of age, asthmatics, and people with other diseases. The WHO Onchocerciasis Control Program in 11 countries of West Africa has eliminated the risk of onchocerciasis by aerial spraying of black fly breeding sites only from 1 country. A single annual oral dose (150 mg/kg) of ivermectin can reverse early lesions in the cornea. Ivermectin must be taken annually to sustain protection against blindness, thus its incorporation into primary health care along with malaria, AIDS, trachoma, xerophthalmia, and cataract is most cost effective. Nigeria and Tanzania have optometry schools, and optometrists can play a significant role in onchocerciasis control and blindness prevention programs by training local health care workers to distribute invermectin in vision screening programs.
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PMID:Onchocerciasis and other eye problems in developing countries: a challenge for optometrists. 824 90

A case of postsurgical endophthalmitis caused by Agrobacterium radiobacter in a 70-year-old male is reported. A. radiobacter organisms are normally environmental bacteria but may occasionally be opportunistic pathogens. Infection in this case occurred after the patient was discharged following routine cataract surgery. The infection cleared after empiric therapy intraocular administration of vancomycin and gentamicin.
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PMID:Case of bacterial endophthalmitis caused by an Agrobacterium radiobacter-like organism. 894 Apr 75

A 35-year-old man was diagnosed with Mycobacterium abscessus keratitis in the left eye 3 weeks after bilateral laser in situ keratomileusis (LASIK). Infection in the right eye developed 6 weeks after surgery. Despite aggressive treatment with topical amikacin and clarithromycin and oral clarithromycin, the infection progressed in both eyes. To improve antibiotic penetration, the LASIK flap was removed in both eyes. Culture positivity was prolonged; however, after 8 weeks of intensive topical antibiotics, the infection was eradicated. The final best corrected visual acuity was 20/30 in both eyes.
J Cataract Refract Surg 2002 May
PMID:Bilateral Mycobacterium abscessus keratitis after laser in situ keratomileusis. 1197 73

A case of Nocardia asteroides keratitis occurring 3 weeks after laser in situ keratomileusis (LASIK) in a nontraumatized eye is reported. The patient presented with decreased vision, inflammation, and stromal melting of the LASIK flap, discrete infiltrates, and an anterior chamber cellular reaction. Cultures for acid-fast bacteria grew Nocardia asteroides after 5 days. Infection progressed despite treatment with topical antibiotics and eventually required penetrating keratoplasty (PKP). Postoperatively, the patient was placed on moxifloxacin, a fourth-generation flouroquinolone. The patient experienced a recurrence of Nocardia keratitis at the graft-host interface 2 months after the PKP. This eventually resolved with a combination of topical moxifloxacin and imipenem therapy.
J Cataract Refract Surg 2005 Oct
PMID:Nocardia keratitis after laser in situ keratomileusis: clinicopathologic correlation. 1633 76


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