Background: To characterise and compare ocular pathologies presenting to an emergency eye department (EED) during the COVID-19 pandemic in 2020 against an equivalent period in 2019. Methods: Electronic patient records of 852 patients in 2020 and 1818 patients in 2019, attending the EED at a tertiary eye centre (University Hospitals of Leicester, UK) were analysed. Data was extracted over a 31-day period during: (study period 1 (SP1)) COVID-19 pandemic lockdown in UK (24th March 2020–23rd April 2020) and (study period 2 (SP2)) the equivalent 2019 period (24th March 2019–23rd April 2019). Results: A 53% reduction in EED attendance was noted during lockdown. The top three pathologies accounting for >30% of the caseload were trauma-related, keratitis and uveitis in SP1 in comparison to conjunctivitis, trauma-related and blepharitis in SP2. The overall number of retinal tears and retinal detachments (RD) were lower in SP1, the proportion of macula-off RD’s (84.6%) was significantly ( p = 0.0099) higher in SP1 (vs 42.9% in SP2). Conclusion: COVID-19 pandemic related lockdown has had a significant impact on the range of presenting conditions to the EED. Measures to stop spread of COVID-19 such as awareness of hand hygiene practices, social distancing measures and school closures could have an indirect role in reducing spread of infective conjunctivitis. The higher proportion of macula-off RD and lower number of retinal tears raises possibility of delayed presentation in these cases. Going forward, we anticipate additional pressures on EED and other subspecialty services due to complications and associated morbidity from delayed presentations.
We report on four individuals in one kindred with relative or absolute short stature; increased upper/lower segment ratio with decreased arm span; mandibular prognathism and dental abnormalities; fractures following minimal trauma; mild to moderate anemia with extramedullary hematopoiesis; and radiographic changes of osteopetrosis, including sclerosis of the cranial base, generally increased bone density, sclerosis of the vertebral end plates, and transverse bands and poor diaphyseal modelling of the long bones. There is intrafamilial variability of clinical and radiographic findings in individuals with this mild, autosomal recessive form of osteopetrosis. We summarize ten families from the literature, which include 18 cases of mild recessive osteopetrosis. The manifestations of many are similar to those of the individuals reported here. Two other types of recessive osteopetrosis have been reported previously: osteopetrosis associated with renal tubular acidosis, and severe osteopetrosis with hepatosplenomegaly, pancytopenia, and early death. Autosomal dominant osteopetrosis is variable but usually mild. Pedigree analysis is currently the only reliable method of determining the pattern of inheritance in mild osteopetrosis.
An alternative exponential equation with a parameter as an exponent was compared to a recently published exponential procedure for estimating mean and median particle size. Both equations were fit to literature values for particle size distributions of esophageal extrusa, rumen digesta, and feces. In addition, 112 observations of particle-size distributions of esophageal extrusa were fit to both equations for comparison. Both equations gave adequate fits of rumen digesta and feces, but the earlier model was biased by regular deviations from observed data for esophageal extrusa. Use of the previously published model overestimated mean particle size in esophageal extrusa from 4.5 to 10.3%. Median particle size was underestimated from 4.9 to 5.6%. Analytic solutions exist for mean and median particle sizes for the earlier model, but it is necessary to estimate numerically the mean and median particle sizes when using the proposed equation. Even though the solution for the proposed equation must be determined numerically, it will prevent bias between experimental treatments, give more accurate estimates of mean and median particle size, and result in a lower residual sums of squares. In addition, a single equation can be used to model particle size reduction throughout the digestive tract.
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