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Background The prevalence of visual impairment (VS) among children in China is increasing. The oral microbiome is crucial for maintaining homeostasis and health. This study aimed to investigate the oral health and hygiene habits of children with VS in Guangzhou and explore the differences in salivary microbiota (SM) between children with VS and healthy vision (HS). Method This study included oral health examinations and surveys of oral hygiene habits among 101 children with VS. Saliva samples from 20 children with VS and 20 with HS were analysed for oral microbiota. The 16s rRNA V3-V4 regions were sequenced using the Illumina MiSeq platform and operational taxonomic units were clustered using QIIME for statistical analysis. Results Inadequate oral hygiene was observed among 101 children with VS, aged 6–16, who displayed a high caries rate of 92.1%. There was no significant difference in the overall composition of the salivary microbiota between the two groups. HS group had a higher abundance of Bacillota , Patescibacteria , and Spirochaetota at the phylum level; Bacilli , Negativicutes , and Saccharimonadia at the class level; and Streptococcus at the genus level. In contrast, VS group showed a greater abundance of Actinomycetota , Bacteroidota , Pseudomonadota , and Fusobacteriota (at the phylum level) and Actinomycetia , Bacteroidia , Gammaproteobacteria , Fusobacteriia , and Clostridia (at the class level), along with Rothia , Neisseria , Veillonella , Prevotella_7 , Actinomyces , Leptotrichia , and Lactobacillales (at the genus level). Actinomycetota was significantly and positively correlated with gingivitis and dental caries, and Streptococcus salivarius was more abundant in children with VS. Conclusion This study underscores the importance of improving oral healthcare for schoolchildren with VS in Guangzhou, China and provides valuable insights into the characteristics of the salivary microbiota of this population, identifying potential targets for interventions aimed at enhancing oral health.

Purpose To describe clinical, ultrasonographic, radiological and histopathological features of orbital aspergillosis in immunocompetent patients. Methods Medical records of immunocompetant individuals with orbital aspergillosis between November 1995 and November 2010 were reviewed. Results Thirty-five cases (27 males, 8 females) were reviewed. Mean age at presentation was 37.63 (8–73) years and mean duration of symptoms was 12.03 (0.5–84) months. Proptosis (22.63%) and mass lesion (13.37%) were the commonest presenting complaints. Presenting visual acuity was better than 6/9 in 21 (60%) and no perception of light in 3 (8%). Ocular motility restriction was noted in 25 (71%). The commonest clinical differential diagnosis was non-specific orbital inflammatory disease (NSOID) (10.29%) followed by malignancy (7.20%). CT showed infiltrative lesions with bone destruction in 22 (63%), contiguous paranasal sinus involvement in 22 (63%) and intracranial extension in 10 (29%). Diagnosis was by histopathology and microbiological evaluation. Fungal cultures revealed Aspergillus flavus in 30 (86%) and Aspergillus fumigatus in 5 (14%). Treatment included conservative medical management in 18 (51%) and surgical debulking in 17 (49%). Average follow-up was 37.6 (3–183) months, and patient survival was 33/35 (94%). Conclusions Though orbital aspergillosis is commonly seen in immunocompromised patients, it should be suspected in young immunocompetent individuals presenting with proptosis of insidious onset and infiltrating lesions involving the paranasal sinuses. Definitive diagnosis is achieved by histopathological and microbiological evaluation. Systemic steroids should be avoided prior to definitive diagnosis. Prolonged systemic antifungal therapy with an option of additional debulking of lesions provides good disease control with improved survival.

Abstract Objective: To describe important sequelae occurring among a cohort of children aged 5 years who had had meningitis during the first year of life and who had been identified by a prospective national study of meningitis in infancy in England and Wales between 1985 and 1987. Design: Follow up questionnaires asking about the children's health and development were sent to general practitioners and parents of the children and to parents of matched controls. The organism that caused the infection and age at infection were also recorded. Setting: England and Wales. Participants: General practitioners and parents of children who had had meningitis before the age of 1 year and of matched controls. Main outcome measures: The prevalence of health and developmental problems and overall disability among children who had had meningitis compared with controls. Results: Altogether, 1584 of 1717 (92.2%) children who had had meningitis and 1391 of 1485 (93.6%) controls were successfully followed up. Among children who survived to age 5 years 247 of 1584 (15.6%) had a disability; there was a 10-fold increase in the risk of severe or moderate disability at 5 years of age among children who had had meningitis (relative risk 10.3, 95% confidence interval 6.7 to 16.0, P<0.001). There was considerable variation in the rates of severe or moderate disability in children infected with different organisms. Conclusion: The long term consequences of having meningitis during the first year of life are significant: 32 of 1717 (1.8%) children died within five years. Not only did almost a fifth of children with meningitis have a permanent, severe or moderately severe disability, but subtle deficits were also more prevalent. What is already known on this topic Meningitis in infancy is associated with important long term consequences There is considerable variation in outcome depending on which organism caused the infection What this study adds This follow up study of 1717 children who had meningitis in infancy found that they had a 10-fold increase in risk of severe or moderate disabilities at age 5 years compared with children in the control group The outcome of having meningitis was associated with the age at infection, and children who had meningitis in the neonatal period were more likely to have health and development problems than those older than 1 month Subtle deficits, such as middle ear disease and visual and behavioural problems, were more prevalent among children who had had meningitis in infancy

Tests for antinuclear antibodies, antineutrophil cytoplasmic autoantibody, hepatitis B surface antigen, anti-hepatitis C virus antibody, anti-human immunodeficiency virus antibody and syphilis antibody were negative. The fibrinoid necrosis was surrounded by moderately dense lymphohistiocytic infiltrate [Figure 3]a, [Figure 3]b, [Figure 3]c, [Figure 3]d. Based on the clinical features, histopathology and laboratory examinations, a diagnosis of papulonecrotic tuberculid was rendered. [...]with the diagnosis of papulonecrotic tuberculid and optic neuritis she was started on antituberculosis medications. [5] The association between papulonecrotic tuberculid and optic neuritis as reported in our case gives us a new understanding of the complication of papulonecrotic tuberculid. [...]we should pay more attention to ocular manifestations of the patients with papulonecrotic tuberculid.

The chytrid fungus, Batrachochytrium dendrobatidis (Bd), is implicated in worldwide amphibian declines. Bd has been shown to qualitatively transition from the mouthparts of tadpoles to the hindlimbs during metamorphosis, but we lack evidence of consistency in the timing of this transition across amphibian species. We also do not have predictive functions for the abundance of Bd in mouthparts and limbs as tadpoles develop or for the relationship between keratin and Bd abundance. Hence, researchers presently have little guidance on where to sample developing amphibians to maximize Bd detection, which could affect the accuracy of prevalence and abundance estimates for this deadly pathogen. Here, we show consistency in the timing of the transition of Bd from mouthparts to hind limbs across two frog species ( Osteopilus septentrionalis and Mixophyes fasciolatus ). Keratin and Bd simultaneously declined from the mouthparts starting at approximately Gosner stage 40. However, keratin on the hindlimbs began to appear at approximately stage 38 but, on average, Bd was not detectable on the hindlimbs until approximately stage 40, suggesting a lag between keratin and Bd arrival. Predictive functions for the relationships between developmental stage and keratin and developmental stage and Bd for mouthparts and hind limbs are provided so that researchers can optimize sampling designs and minimize erroneous conclusions associated with missing Bd infections or misestimating Bd abundance.

Eosinophilic granulomatosis with polyangiitis (EGPA) is a rare antineutrophil cytoplasmic antibody-associated vasculitis that can affect any organ system. It is most often characterised by chronic airway inflammation along with prominent peripheral blood eosinophilia, although the disease can affect the cardiovascular, gastrointestinal, renal or central nervous systems. Ocular manifestations are uncommon and when they do occur, are varied in their clinical presentations. To the best of our knowledge, this is the first case of corneal melt secondary to EGPA to have been reported.

Background/aims:This is a retrospective cohort uveitis survey to determine the clinical features of uveitis in children and assess the rate of complications at two referral centres in Saudi Arabia.Methods:All children under the age of 16 years presenting with uveitis for the first time between 1997 and 2007 to The Eye Center and King Khaled Eye Specialist Hospital in Riyadh, Saudi Arabia were included. Clinical features of uveitis entities were described. Last follow-up visual acuity and ocular complications were analysed.Results:A total of 163 cases of uveitis in children were included. The age range was 1–16 years with a mean age of 10 years. The most frequent clinical type of uveitis in children included acute anterior non-granulomatous uveitis 26%, intermediate uveitis 20%, Vogt–Koyanagi–Harada (VKH) disease 16% and juvenile idiopathic arthritis (JIA) 15%. Anterior uveitis accounted for 42%, intermediate for 20%, posterior for 7%, and panuveitis for 31%. Immune-mediated uveitis was present in 144 (88%) patients, while infectious causes manifested in 19 (12%) patients.Conclusions:The most common cause of uveitis in children was anterior non-granulomatous uveitis of undetermined aetiology. There was a high prevalence of intermediate uveitis, VKH and JIA. Infectious causes of uveitis were uncommon.

BackgroundThe aim of this study is to determine whether statistical associations can be demonstrated in ocular syphilis between baseline clinical and laboratory parameters with visual acuity at presentation and with any change in visual acuity after treatment.MethodsCharts of 26 patients (42 eyes) with ocular syphilis presenting to the Uveitis clinic of the Jules-Gonin Eye Hospital were reviewed. A baseline cross-sectional analysis was performed in order to identify any association between visual acuity at presentation and demographic, clinical or laboratory parameters. After treatment, any analogy between these parameters and a change in visual acuity was subsequently assessed in a series of univariate comparisons.ResultsThe following factors were associated with worse initial visual acuity: severity of visual field impairment at presentation (p=0.012), macular oedema (p=0.004) and optic neuropathy (p=0.031). There was a borderline association with the presence of vasculitis on fluroangiography (p=0.072). Improvement in best corrected visual acuity after treatment was significantly associated with the presence of vasculitis on fluroangiography (p=0.005), neurosyphilis, according to lumbar puncture findings (p=0.037) and marginally with anterior uveitis (p=0.070). Inflammation relapse was associated with the coexistence of pain as presenting sign (p<0.001) and with a longer duration of symptoms prior to the initial visit (p=0.023).ConclusionsSevere ocular inflammation associated with vasculitis, vitritis or anterior uveitis in ocular syphilis would appear to be a reversible phenomenon that responds well to appropriate antibiotic treatment, resulting in improvement in visual acuity. Prompt treatment enables a good visual prognosis, while any delay in therapy increases the risk of subsequent relapse.

Background We report a rare presentation of extrapulmonary tuberculosis. Case presentation A 29-year-old Burmese woman with human immunodeficiency virus infection and known pulmonary tuberculosis who had been treated for 5 months presented to our hospital with unilateral progressive painful visual loss of 1 month’s duration. She was diagnosed with tuberculous panophthalmitis with subretinal and intraorbital abscesses, conjunctival abscess, and extraocular muscle tuberculoma. The diagnosis was confirmed by a conjunctival pus swab with a positive result for acid-fast bacilli and a positive result for a mycobacterial culture. There was high suspicion of multidrug-resistant tuberculosis. Despite receiving ongoing aggressive treatment with conventional antituberculous medications, this patient required subtotal orbital exenteration to control her infection and prevent further progression. Second-line antituberculous medications were added to the first-line therapy, with satisfactory results achieved. Conclusions Tuberculous panophthalmitis with intraocular and intraorbital abscesses is a rare presentation of extrapulmonary tuberculosis. Patients who do not respond to first-line antituberculous therapy might be infected with either single-drug or multidrug-resistant Mycobacterium tuberculosis . Patient compliance is one of the key factors that can alter the course of treatment. Careful patient monitoring can improve disease progression, outcome, and prognosis.