Article Text

PDF

From the Library

Statistics from Altmetric.com

“Spender noted that Isherwood’s round shining eyes had a steadiness which seemed to come from the strain of effort, as though their feat of balancing themselves in Christopher’s face at the same time balanced the whole world which they saw. They were the eyes of someone who, when he is a passenger in an aeroplane, thinks that the machine is kept in the air by an act of his will, and that unless he continues to look steadily in front of him it will fall instantly to the ground. These were under sharp-angled eyebrows which added to the impression of his being a strained school leader.” (

)

Cardiorespiratory fitness, measured as exercise capacity, is a strong predictor of risk of death among both women and men. In a study of 5721 asymptomatic women volunteers who took an exercise test, a follow up study of up to 8 years revealed that the risk of death among asymptomatic women whose exercise capacity was less than 85% of the value predicted by a nomogram was twice that of women whose exercise capacity was more than this value. The marked prognostic value of cardiovascular fitness and the fact that it can be improved by small amounts of regular exercise should be re-emphasised by public health campaigns. (

)

Migraine is a common and disabling disorder. A small but significant proportion of those who have migraine with aura present with a form of visual disturbances such as scintillating scotoma. It has been difficult to image patients with migraine aura with functional brain imaging since spontaneous attacks are unpredictable. Investigators report a volunteer with episodic migraine in whom intravenous glyceryl trinitrate triggered a migraine with visual aura. PET scanning during the migrainous attack revealed right side occipital activation during the visual aura. The activation was in the primary visual region of the occipital cortex. Further study of migraine patients with glyceryl trinitrate triggering may be useful in providing insight into the neuroanatomical correlate of this syndrome. (

)

Recent controlled studies of the use of herbal remedies for the common cold have been distinctly discouraging. Now a study of two herbal remedies used to treat irritable bowel syndrome also produced negative results. Cuma xanthorrhiza, a herb that comes from the same family as ginger, and Fumaria officinalis, a herb with antispasmodic properties, performed no better than placebo in patients with irritable bowel syndrome. (

)

Despite the pleas of public health officials, drivers in most countries continue to talk on mobile phones while driving. A study from Perth, Western Australia, of 465 drivers revealed that the use of a mobile phone up to 10 minutes before a crash was associated with a fourfold increased likelihood of crashing. This was equally true in men and women. Using a hands free phone did not provide any significant degree of safety. Laws limiting all phone use while driving are difficult to enforce although some countries have tried to do so. Public health measures that emphasise the danger of their use while driving need to be intensified. (

)

It is well known that commercial airline pilots are exposed to increased levels of ionising radiation. These exposures are from solar particle events and galactic cosmic radiation. In a population based case-control study of 445 men, commercial pilots were found to have an increased risk of developing nuclear cataract. This was independent of age, smoking status, and sunbathing habits. (

)

Several classifications of different forms of nystagmus exist. Clinicians from the Institute of Neurology in London have recently described a new form of nystagmus that presented as a paroxysmal upbeat nystagmus. This nystagmus occurred primarily while driving a vehicle. Eye closure at an early stage would sometimes prevent the nystagmus. Treatment with high dose gavapentin was dramatically effective, probably by increasing GABA levels. The authors describe this nystagmus as optic flow induced nystagmus. (

)

Over the past decade many retinal surgeons have increased the number of primary vitrectomies for the management of pseudophakic and aphakic retinal detachment. Other experts have advocated that conventional scleral buckling should be the preferred initial treatment. In a prospective randomised multicentred clinical trial in Iran, 225 eyes with pseudophakic or aphakic retinal detachment were assigned randomly either to conventional scleral buckling or primary vitrectomy without any buckle. In this study comparable results were obtained with both procedures. Moreover, there were no significant differences in rates of complications. The authors conclude that the choice of surgical procedure should depend on various factors including patient compliance, cost of surgery, experience and capability of the surgeons, and availability of appropriate instrumentation. (

)

Increasingly it appears that hypertension is unavoidable if one lives long enough. Data from the Framingham cohort showed that less than 7% of people living beyond 80 years of age had normal blood pressure. Since people over 80 are the fastest growing age group in many western countries, the authors suggest that research into the best and safest ways to treat hypertension in this age group should be a high priority. Current treatments of elderly, especially women, are particularly ineffective; adequate control of blood pressure was achieved in less than a quarter of hypertensive women over the age of 80. (

)

Ultrasound biomicroscopy (UBM) has been used successfully to identify the anatomical characteristic of eyes with narrow angle pathology. However, UBM requires immersion of the eye in fluid and is therefore time consuming and inconvenient to perform as a routine clinical exam. Investigators from the Cleveland Clinic studied a high speed anterior segment optical coherence tomography (OCT) prototype and found that it was equal to the UBM studies in quantitative anterior chamber angle measurement and detection of narrow angles. The OCT prototype was easier to use and did not require contact with the eye. OCT of the anterior segment of the eye appears to be a promising new clinical technique. (

)

View Abstract

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.