Comparison of netarsudil and latanoprostene bunod as adjuncts to maximum medical therapy in primary open-angle glaucoma.

OBJECTIVE: Compare the efficacy of new agents netarsudil 0.02% (NET) and latanoprostene bunod 0.024% (LB) ophthalmic solutions as adjuncts to traditional 4-class maximum medical therapy (MMT) in primary open angle glaucoma (POAG). DESIGN: Single-centre retrospective cohort study using records from a university glaucoma clinic from 2017 to 2021 with follow-up at 30-90 days. PARTICIPANTS: Patients with POAG already taking 4-class MMT who either added NET (n = 24) or exchanged a currently prescribed prostaglandin analogue (PGA) for LB (n = 11) with no prior surgery except for selective laser trabeculoplasty or cataract extraction >1 year prior. METHODS: Either addition of NET or exchange of PGA for LB and otherwise continuing MMT. Outcome measures were absolute intraocular pressure reduction (IOPR) in mm Hg, percent IOPR, and proportion of patients achieving >10% IOPR. RESULTS: Data from 35 eyes in 35 patients were analyzed. Intraocular pressure reduction after adding NET was significantly greater than after exchanging a PGA for LB. Percent IOPR by NET also was significantly greater than after exchanging PGA for LB. The proportion of patients reaching therapeutic threshold after the addition of NET was significantly greater than after exchange of PGA for LB. CONCLUSIONS: In patients with POAG on MMT, addition of NET was associated with significantly greater magnitude of IOPR and a significantly greater proportion of patients reaching the >10% IOPR threshold compared with exchange of PGA for LB.

Acute inflammatory presentation of orbital metastasis from urothelial carcinoma: a case report.

Orbital metastasis of urothelial carcinoma is very rare; only 22 cases have been documented. In this case report, we describe a patient 1 month status post transurethral resection of urothelial carcinoma who presented with a clinical picture suggestive of orbital cellulitis. However, neither broad-spectrum antibiotics nor a subsequent trial of methylprednisolone was effective at relieving the patient's symptoms. CT imaging of the head, chest, abdomen, pelvis, and lower extremity showed no signs of metastatic disease. Six days after presentation, punch biopsy of the mass was performed and confirmed urothelial carcinoma metastatic to the orbit. The patient died 3 months later due to multiple sites of distant metastasis. This case report suggests that a high index of suspicion for orbital metastasis is important for patients with a history of urothelial carcinoma with new and acute onset of ocular symptoms and emphasizes the need for urgent systemic evaluation and treatment.

Abdominal Wall Dyskinesia: Case Report.

The clinical presentation of repetitive choreiform involuntary movements of the anterior abdominal wall was first introduced as "belly dancer's dyskinesia." Etiologies of this rare condition include idiopathic causes, medication inducement, or post-abdominal surgery. We report a case of orobuccal stereotypic movements and abdominal wall dyskinesia secondary to prochlorperazine intake. The movements began 2 weeks after cessation of prochlorperazine. The patient took this dopamine receptor-blocking medication for 6 months to treat nausea due to chemotherapy. To our knowledge, abdominal wall dyskinesia as a tardive syndrome of prochlorperazine has not been previously reported.

Modification of a pilot-scale continuous flow reactor for hydrothermal liquefaction of wet biomass.

A pilot-scale continuous flow reactor (CFR) was modified for hydrothermal liquefaction (HTL) of algae slurry under subcritical conditions to investigate the feasibility of scaling up from batch to continuous processing. Modifications included a novel dual filter system that can remove solids at system pressure and temperature, and undergo in-situ cleaning. Commissioning was carried out to address potential particle settling and clogging problems, and to estimate reactor transport characteristics. CFR performance was evaluated by running 31.4 L algae slurry with solids loadings of 3-5 wt.% under 325-350 °C and 18 MPa for 7 h. C and N elemental yields in HTL aqueous phase reached 39.0 wt.% and 61.8 wt.%, respectively. Future improvements to the CFR system will focus on higher solids loading and addition of in-line HTL liquid upgrading capabilities following the filtration system. •A high-temperature, high-pressure filtration system was designed to remove solids from HTL liquid/gaseous products at near reaction conditions to keep heavy oils in the liquid phase.•Uninterrupted reactor operation was achieved by cycling between the dual filter systems and performing in-situ filter cleaning.•Measured reactor residence time distributions were narrow and close to the calculated theoretical mean time.