What is new in recommendations on ophthalmological screening in patients treated with chloroquine and hydroxychloroquine? Update and literature review.

Based on the present literature, in March 2016, new recommendations of the American Academy of Ophthalmology for ophthalmic screening tests in patients treated with chloroquine and hydroxychloroquine were published. These recommendations emphasized the fact that toxicity is related to the dose calculated by real weight. The recommended hydroxychloroquine and chloroquine doses have been limited. It is no longer recommended to calculate the cumulative dose of chloroquine to establish the risk of toxicity. Kidney failure and the use of tamoxifen are proven risk factors of ocular complications in these patients. The screening agenda was established and available diagnostic methods were evaluated. Screening in patients treated with chloroquine derivatives may prevent an irreversible complication-toxic retinopathy. The present recommendations warn against making premature decision on medicine withdrawal, especially in the light of the most recent studies on their beneficial systemic influence. This paper systematizes the information on ophthalmological screening in chloroquine derivatives users.

Maternal tetrahydrobiopterin deficiency: the course of two pregnancies and follow-up of two children in a mother with 6-pyruvoyl-tetrahydropterin synthase deficiency.

No reports are available about the course of pregnancies in women with tetrahydrobiopterin (BH(4)) deficiencies or the effects of treatment with BH(4), L-dopa/carbidopa and 5-hydroxytryptophan (5-OHTrp) on fetal development. We present for the first time the case of a mother with late-diagnosed mild form of 6-pyruvoyl-tetrahydropterin synthase (PTPS) deficiency, the course of her two subsequent pregnancies and clinical evaluation with follow-up of two offspring. In both pregnancies neurotransmitter precursors, as well as BH(4) dosages were increased proportionally to the mother's weight gain. To prevent maternal phenylketonuria (MPKU) syndrome, special attention was paid to increasing BH(4) dosages. Both pregnancies were complicated by threatened premature labour, by the mother's nicotinism and additionally, in the first pregnancy, by gestational diabetes mellitus and vaginitis. The first child was born in the 31st week of pregnancy with the symptoms of moderate intrauterine growth retardation (IUGR) and brain malformation in the form of right sided closed-lip schizencephaly with absence of septum pellucidum. Although the girl demonstrates mild left-sided hemiparesis, her psychological development at the age of 8 years is above average. The second child was born in the 37th week of pregnancy without brain anomalies and at the age of 5 years his psychomotor development is appropriate for the age. As the cause of brain malformations resulting in physical impairment in the first child is unknown, more data are essential to verify conclusions about the influence of the mother's BH(4) deficiency and the safety of her treatment for fetal development.

[The cases of teratology in Mallophaga of South Africa]. / Przypadki teratologii wsród wszolów (Mallophaga) z Afryki poludniowej.

The following types ofteratology were found in the collection of 1278 individuals of Mallophaga coming from the birds of South Africa origin: deformity clypeus in Quadraceps kilimandjarensis (KELL.) from Stephanibyx coronatus (BURCH.), partial atrophy of one of the antennae of two males Q. kilimandjarensis and abdomen plates deformity of two females Q. kilimandjarensis, in male and female Quadraceps chorleyi TIMM. from Hoplopterus armatus (BURCH.), in female Saemundssonia africana TIMM. from Stephanibyx coronatus (BODD.) and male Plegadiphilus threskiornis (BEDF.) from Threskiornis aethiopicus (LATH.) the only representative of Amblycera (the other teratology belonged to Ischnocera suborder). Generally teratology was found in 0.70% of the collection.

[Ultrastructural surface properties in Columbicola columbae s. str. (Esthiopteridae, Mallophaga-Ischnocera) from domestic pigeons]. / Osobliwosci ultrastruktur powierzchniowych u Columbicola columbae s. str. (Esthiopteridae, Mallophaga-Ischnocera) z golebia domowego.

All post-embryonal stages of Columbicola columbae columbae (L.), the common parasite of pigeon, were investigated with regard to morphology, particularly surface ultrastructures. Many qualitative characters differing C. columbae s. str. from the investigated up to now species of Mallophaga were found in SEM. They are among others double lateral protuberances of head (clavus and clavulus) as well as parallel sculpture of pore organs on the last two segments of antennae. The structures showed at the photograms were interpreted with regard to their functions.

[A case of necrotic scleromalacia during the course of rheumatoid arthritis]. / Przypadek scleromalatio necroticans w przebiegu reumatoidalnego zapalenia stawów.

Necrotic scleromalacia occurred in both eyes of patient, 80, with rheumatoid arthritis lasting for 00 years. The authors report the clinical course of the disease during a 2.5 year follow-up, methods of treatment and compared their own observations with those of others.

[Changes in the visual system of patients with carotid artery occlusion]. / Zmiany w narzadzie wzroku u chorych z niedroznoscia tetnic szyjnych.

The authors presented results of visual system examination in 28 persons in whom disturbances of blood flow in carotid arteries were diagnosed with colour doppler ultrasonography. The patients underwent routine ophthalmological examination, including kinetic and static perimetry. Ocular signs only, with no neurological changes, were found in 46% of patients. In 21% of cases there were episodes of transient blindness; homonymous hemianopsia occurred in 10%, acute ischaemic optic neuropathy in 11%, and secondary neovascular glaucoma in 14% of patients.

Heterodoxus spiniger (Boopiidae, Mallophaga) from Canis familiaris from India in the light and scanning electron microscopes.

Knowledge of morphometric characteristics of Heterodoxus spiniger was widened on the basis of material collected from dog (Canis familiaris) from India. Study, mostly by scanning electron microscope, concerned the males, females and nymphs of H. spiniger. The functional role of some elements, particularly observed surface ultrastructures, has been pointed out. The differences between postembrional stages were determined as well as literature data on H. spiniger were critically analysed.

[Morphologic features, with particular regard to surface ultrastructure, of Docophoroides brevis (Docophoroididae, Mallophaga)]. / Cechy morfologiczne ze szczególnym uwzglednieniem ultrastruktur powierzchniowych u Docophoroides brevis (Docophoroididae, Mallophaga).

Bodies of nymphs and adults of Docophoroides brevis (Docophoroididae), parasite of Diomedea exulans, were studied under light and scanning microscopes. Developmental features of nymphs corresponded with similar features of other Philopteroidea. In adults type and distribution of sensillae were similar to other Ischnocera. Structures pointing to parasite's adaptation to holding itself on host's feathers, were distinguished. They were, besides characteristic claws, the mouth apparatus, groups of hooked processes on tibiae of the II and III pairs of legs, and sculpture of roundish fields on the sides of abdomen sternites. In the shape of male's genital apparatus, protruding to the outside of terminal sclerite, structures helping both partners to contact during copulation were discerned.

Intraspecific morphometric variability of Goniocotes chrysocephalus (Phthiraptera, Ischnocera).

Morphometric variability of G. chrysocephalus was analysed and compared between and within the groups of individuals collected from single pheasant host (idiohostal populations) and from great number of hosts belonging to the same species (synhostal). The congruence of ranges of variation of 4 characters from 3 idio- and 1 synhostal population was examined. The arithmetic means of head width and abdomen as well as total body length of males from 2 idiohostal populations were statistically different from synhostal one. On the other hand, in the females such differences were only in the head width of idiohostal populations.

[Variability of the metric characteristics of lice (Mallophaga) from pheasants (Phasianus colchicus L.)]. / Zmiennosc cech metrycznych u wszolów (Mallophaga) z bazanta (Phasianus colchicus L.).

The variability of metric characters of 7 examined species to the biting lice, typical for the pheasants, totalled 2-6% for imagines. In some species the coefficients of variability for the measurements of thorax and abdomen reached value of 10%. As a rule, the head dimensions as well as the total length of three species had the lowest (to 3%) variability. The nymphs were characterized by the higher coefficients of variability of all examined characters, though also the lowest (3-8%) values were noted for the head dimensions whereas the highest (to 19%) ones for abdomen width. Such high values are probably associated with extending of the abdomen which is slightly sclerotized in the nymphs.