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Gould later reported “Pressure at left temple” and “decided on unsteadiness-rising from a seated position, bad enough at time to make even brief city trips hazardous.” Piano playing impossible; he cancelled at least one CBC recording session because of the inner ear troubles. He was seen to stumble in his later years and noted in his diary in 1980 that he “fell en route to the bathroom in mid-sleep this am and hurt his left knee.” His eyes worried him. In the spring of 1976 he noted concern about a possible infection (left eye being glued shut upon waking), and that fall noted “left eye is constantly bloodshot.” In later years he reported a “sty-like sensation” and “puffiness in eyes” and this from around 1980. “Eye dry sore (after rubbing, etc”) and/or teary, filmy vision less sharp, “speck of sand syndrome  =  bloodshot, general darkening in eye tone especially left side.” (

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A central tenet of modern biology is that genetic information is inherited in the form of DNA and copied into RNA and expressed as protein. However, a recent discovery that a species of plant can summon up genes its parents have lost, emphasised the increasing recognition that RNA is more versatile and important a molecule in its own right. Investigators at the University of Connecticut even suggest that life probably began as an “RNA world” in which concatenations of RNA molecules do “double duty as genetic template and reproductive machinery.” (

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Endophthalmitis is a devastating intraocular infection with a high potential for ocular morbidity including permanent severe visual loss. Postoperative endophthalmitis is one of the most dreaded complications of intraocular surgery. A systematic review of the incidence of acute endophthalmitis following penetrating keratoplasty reveals that the incidence endophthalmitis associated with penetrating keratoplasty has declined during the past decade. The current rate of endophthalmitis after penetrating keratoplasty appears to be approximately 0.20%. (

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In the past four decades cataract surgery has undergone a remarkable, technical refinement with a simplified postoperative care and faster visual recovery. A systematic review of English language articles was conducted by performing a broad search of PubMed from 1963 to March 2003. In this review the incidence of endophthalmitis associated with cataract extraction appears to have increased over the past decade. This upward trend in endophthalmitis frequency coincides with a development of sutureless clear corneal incisions. (

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It is well documented that consumption of alcoholic beverages can increase blood pressure. The benefits of the polyphenolic compounds of red wine are also well known. Nevertheless, it would appear that compared with abstinence consumption of red wine and beer both elevate systolic blood pressure in otherwise normotensive men. (

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The so called Mediterranean diet has been used in many studies because several of its components appear to be associated with benefits to health. The diet is characterised by a high intake of vegetables, legumes, fruits, and cereals; a moderate to high intake of fish; a low intake of saturated lipids but a high intake of unsaturated lipids, particularly olive oil. There is a low to moderate intake of dairy products; a low intake of meat, and a modest intake of ethanol mostly as wine. In a multicentred prospective cohort study from nine European countries nearly 75 000 men and women aged 60 or more were studied. In this study an increase in the modified Mediterranean diet score was associated with a lower overall mortality. This health protecting effect was independent of the country of residence of the study group. (

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Infection and inflammation is implicated in endothelial dysfunction and atherogenesis. This effect appears to even involve childhood infections. Ultrasound data from the Avon Longitudinal Study of parents and children showed that even mild acute infections in childhood are associated with impaired endothelium dependent vasodilatation. This finding points to a potential role for extrinsic inflammatory stimuli in the pathogenesis of atherosclerosis from an early age. (

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The accepted doctrine is that exercise early in life may help to prevent osteoporosis in later life. This dictum gains support from a study of Norwegian premenopausal athletes. In this study low bone mineral density was two to three times as common in a matched non-athletic group of women as in athletes. Weight bearing exercises in medium and high impact sports may therefore protect young women risk of bone loss. (

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Recent evidence suggests that the “Black Death” was not an epidemic of bubonic plague. It was a viral haemorrhagic fever with a long incubation period. It originated in Africa and spread to Europe and Asia. Its legacy is a genetic deletion CCR5-Δ42 that provides almost complete resistance to HIV-1 in homozygous people. The frequency of this deletion is estimated to be 10% in European populations but the deletion is absent among sub-Saharan Africans, Asians, and American Indians. (

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Symptomatic rhegmatogenous retinal detachment (RRD) is cause for early surgical intervention. Management of asymptomatic, clinical RRD, however, is a controversial subject. In a single observer prospective consecutive case series of 18 asymptomatic clinical RRDs none of them became symptomatic over a period of observation averaging 46 months. The posterior margin of one retinal detachment progressed slightly over a period of 4 months and then stabilised for 4 years. The author suggests that asymptomatic clinical RRDs can probably be safely observed for many years. (

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There is enormous public interest in vitamin supplementation and a generally held belief that vitamin supplementations provide protection from infections. In a meta-analysis of randomised controlled trials investigating the effect of multivitamins and mineral supplements on infections the evidence was weak and conflicting that there was any protective effect. The authors note there is considerable heterogeneity between studies. They further conclude at present not evidence exists to recommend the routine use of micronutrient supplements for an elderly population. (

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