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     "He was conscious that by now Teresa’s problems had worsened, and his friend later indicated that he was resolved to arrange for her best care. She was possessed of the listlessness and flushed face typical of her disease, and she went about the house, still trying to attend to domestic matters with a glazed eye and a rasping breath that the humidity exacerbated. She was also possessed by what the tubercular Bront? sisters’ physician called a tinge of religious melancholy.... The medicals journals including the Lancet, carried news of a number of new treatments under consideration in England, including mixtures of quinine and beef tea, and the pumping of various mixtures into patients’ mouths, the most common ingredients for forcible pumping including hydrogen, coal gas, iodine, creosote, and carbolic acid. Teresa was, after all, naturally robust, and if the treatment could be hit upon, the disease would withdraw quite quickly." ( Keneally, Thomas. American Scoundrel. The Life of a Notorious Civil War General. Dan Sickles. New York: Doubleday; 2002:317)

    Effective treatment of retinopathy of prematurity (ROP) is still unavailable. A recent study suggests that prolactin levels are elevated in the circulation and in the eyes of patients with ROP in whom the regression of neovascularisation of ROP had taken place. Researchers suggest that high levels of ocular prolactin originating from internalised systemic prolactin or from hormone synthesised locally may lead to an increase in the ocular concentration of 16K-PRL. This increase would help counterbalance pathological angiogenesis by stimulating the apoptosis of blood vessels. They suggest that the observation that human milk feeding reduces ROP is most likely explained by the high concentrations of prolactin found in milk. Further investigations of the usefulness of prolactin in the treatment of ROP are suggested. ( Invest Ophthalmol Vis Sci 2004;45:2049–55)

    Two years ago investigators at Imperial College London reported the exciting results of a study which suggested that a molecule called peptide yy3–36 (PYY3–36) when injected into rodents dampens appetites for 12 hours or more. Regrettably, these results have been called into question. In a letter published in Nature more than 40 scientists announced that they cannot reproduce these results.

    Recent studies suggest that the use of parasitic worms for the treatment of autoimmune diseases may be effective. In mice, treatment with eggs, larvae, or extracts of helminth—parasitic worms such as flukes, flatworms, tapeworms, and pinworms—can dampen and perhaps prevent allergic reactions, reduce the severity of multiple sclerosis-like disease, and block the development of type 1 diabetes. Recent data indicate helminth may protect against disease by invigorating so called regulatory T cells. Preliminary trials using this therapy for the treatment of patients with ulcerative colitis and inflammatory bowel disease have been promising. ( Science 2004;305:170–1)

    The importance of REM (rapid eye movement) sleep is widely appreciated. Recent research suggests that there are significant consequences of not obtaining REM sleep. In baby rats researchers found that there was a significant reduction in brain mass after the rats were deprived of REM sleep. Histological studies confirm that programmed cell death had taken place after the rats had been deprived of REM sleep. Researchers suggest that this indicates that REM sleep has an active role in preventing apoptosis in the developing brain. ( Medical Hypotheses 2004;62:876–9)

    Recent ocular adverse drug reactions have been identified by the National Registry of Drug Induced Ocular Side Effects. Bisphonates are used to inhibit bone reabsorption in post-menopausal women. The majority of adverse side effects to this medication are inflammatory with symptoms of eye pain and photophobia frequently being reported. Scleritis was recently shown to have a cause and effect relation with this drug. Cetirizine is a selective inhibitor of peripheral H1 receptors used for the treatment of allergies. The primary ocular complication associated with this drug is oculogyric crisis. Retinoids are used to treat severe nodular acne and psoriasis. Rarely, retinoids are associated with intracranial hypertension that usually resolves within a few months of discontinuation of the medication. It is possible that the combination of retinoid and tetracycline may lead to a higher incidence of intracranial hypertension. Topiramate is used to treat epilepsy. Its use has been associated with acute onset glaucoma, suprachoroidal effusions, periorbital oedema, and scleritis. ( Ophthalmology 2004;111:1275–9)

    Orthokeratology is a non-surgical option for the correction of myopia. There are conflicting reports of the safety and efficacy of this treatment. The use of contact lenses in this therapy has been associated with corneal oedema abrasions, infection, and scarring. Now, investigators from Japan have described the complication of irregular corneal astigmatism being significantly increased with this treatment. Regular astigmatism also seems to be induced. The visual consequences of this require further study. ( J Cataract Refract Surg 2004;30:1425–9)

    Currently available ophthalmic drug delivery systems are inefficient and may lead to side effects. Only about 5% of most drugs applied as drops penetrate the cornea and reach ocular tissues. Recent studies from the University of Florida suggest that particle laden hydrogels are promising candidates for ophthalmic drug delivery. They are transparent and can release drugs for extended periods. The drug delivery rates can be controlled by varying the loading of nanoparticles in the gel. ( Invest Ophthalmol Vis Sci 2004;45:2342–7)

    The use of statins has been associated in some studies with a diminished risk of developing age related macular degeneration as well as a potential for reducing risk for severe medical conditions such as cardiovascular disease. Now, a study from Duke University suggests the possibility that long term use of oral statins may be associated with a reduced risk of open angle glaucoma, particularly among those patients with cardiovascular and lipid diseases. Non-statin cholesterol lowering agents were also associated with a reduced risk of having open angle glaucoma. The authors suggest that additional studies are necessary in order to establish whether statins are effective in preventing glaucoma. ( Arch Ophthalmol 2004;122:822–6)

    Aniridia is a rare congenital bilateral ocular disorder. In addition to iris hypoplasia it is associated with cataract glaucoma, corneal opacity, nystagmus photophobia strabismus, ectopic lens, optic nerve hypoplasia, and macular hypoplasia. Now a study from Japan suggests that, based on ultrasound biomicroscopic findings, in addition to iris hypoplasia, ciliary body hypoplasia also exists. There is anterior inclination of ciliary processes. This is thought to be at least partly responsible for shallowing of the anterior chamber. This may be important in the pathophysiology of glaucoma in these patients. ( Am J Ophthalmol 2004;137:858–62)