The most appropriate treatment for the infantile Hypertrophic Pyloric Stenosis (HPS) is still debated. The non-surgical conservative treatment with oral or intravenous administration of atropine does not enjoy a widespread appreciation for several factors (...).

To develop a consensus statement for use of dilute atropine in control of myopia progression in children based on review of existing literature, opinions and suggestions of the members of the Group of Paediatric Ophthalmologist and Strabismologists, Mumbai (GPOS).
Literature review, group discussions, questionnaire study and consensus building by supermajority voting.
About 65% of paediatric ophthalmologists in Mumbai have started prescribing atropine sulphate 0.01% as routine in their patients showing myopia progression. Majority of the respondents who have used it for >1 year in their patient population are extremely happy with the results. About 47% respondents expressed concerns regarding some yet unknown side effects of long-term use in our patient population. Majority of the respondents agree that it is safe and have rarely encountered side effects with its use.
Atropine sulphate 0.01% is a safe and effective treatment for myopia control. Most trained paediatric ophthalmologists recommend its use in children with progressive simple myopia.

To determine whether the removal of atropine from the 2010 ACLS guidelines for non-shockable cardiac arrests was associated with a change in survival.
Using the Get With The Guidelines®-Resuscitation registry, we included adults with an index in-hospital cardiac arrest between 2006 and 2015. The primary outcome was survival to hospital discharge. Secondary outcomes included return of spontaneous circulation and favorable functional outcome. An interrupted time-series analysis was used to compare survival before (pre-guidelines) and after (post-guidelines) introduction of the 2010 guidelines. A difference-in-difference approach was used to compare the interrupted time-series results between the non-shockable and shockable cohorts to account for guideline changes unrelated to atropine.
We included 20,499 non-shockable and 3968 shockable cardiac arrests. Patient characteristics were similar between the pre-guidelines and post-guidelines period. Atropine was used for 8653 (87%) non-shockable and 680 (35%) shockable cardiac arrests in the pre-guidelines period and 3643 (35%) non-shockable and 320 (16%) shockable cardiac arrests in the post-guidelines period. The change over time in survival from the pre-guidelines to the post-guidelines period was not significantly different for the non-shockable compared to the shockable cohort (risk difference: 2.0% [95%CI: -0.8, 4.8] per year, p = 0.17). The immediate change in survival after introducing the guidelines was also not different between the cohorts (risk difference: 3.5% [95%CI: -2.6, 9.7], p = 0.26). Results were similar for the secondary outcomes and in multiple sensitivity analyses.
The removal of atropine from the 2010 guidelines was not associated with a significant change in survival.

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The prevalence of myopia has increased worldwide in recent decades. In East Asia\'s metropolises ≥ 80% of young adults are affected. This dramatic increase is mainly caused by changes in lifestyle and behaviour. Atropine has been used for more than 100 years to arrest myopia progression. It has become an evidence-based treatment regimen in the last decade, although the exact mechanism of the effect of treatment is still unknown. Atropine eye drops can slow myopia progression by an average of - 0.54 dioptres (D)/year in Asian children and - 0.35 D/year in Caucasian children. However, a non-response rate of about 10% has been found. Treatment should be established in schoolchildren only (age ≥ 6 years) with myopia ≤ - 2 D (spherical equivalent, cycoplegic refraction) and with documented myopic progression of - 0.5 D in the preceding year. 0.01% eyedrops should be instilled into the lower fornix at bedtime. Atropine 0.01% therapy is well tolerated. Atropine is usually administered for 2 years since efficacy is somewhat better in the second year. During treatment, a 6-month follow-up with cycoplegic refraction and axial length measurement is recommended. After the 2-year period, atropine withdrawal is justified if progression is less than - 0.25 D/year in the second year. Even after atropine has been stopped, follow-up examinations are needed to detect any rebound. Atropine-therapy is resumed if progression is again higher than - 0.5 D/year. Topical atropine is used off-label.
Die Prävalenz der Myopie hat in den letzten Jahrzehnten weltweit zugenommen. In den südostasiatischen Metropolen werden Raten von ≥ 80% bei jungen Erwachsenen erreicht. Diese teilweise dramatische Zunahme ist vor allem den veränderten Lebensgewohnheiten geschuldet. Seit mehr als 100 Jahren weiß man um die hemmende Wirkung des Atropins auf die Myopieprogression. Obgleich der genaue Wirkungsmechanismus noch unbekannt ist, wurde in der letzten Dekade doch eine evidenzbasierte Behandlungsstrategie entwickelt. Atropintropfen können die Myopieprogression bei asiatischen Kindern im Mittel um − 0,54 Dioptrien (dpt)/Jahr und bei kaukasischen Kindern um − 0,35 dpt/Jahr mildern. Zu beachten ist jedoch eine Nichtansprechrate von ca. 10%. Die Behandlung sollte nur bei Schulkindern (Alter ≥ 6 Jahre) mit einer nachgewiesenen Progressionsrate von − 0,5 dpt im Vorjahr begonnen werden. Die zykloplegisch ermittelte Ausgangsrefraktion sollte zumindest − 2 dpt (sphärisches Äquivalent) betragen. Empfohlen wird die Applikation 0,01%iger Tropfen 1× am Abend vor dem Schlafengehen in den Bindehautsack. Die Therapie mit 0,01% gilt als gut verträglich und nebenwirkungsarm. Die Behandlung wird zunächst über 2 Jahre durchgeführt, da zum Teil im 2. Jahr eine bessere Effektivität erzielt wurde. Ein halbjährliches Kontrollintervall während der Behandlung mit jeweiliger Bestimmung der Refraktion in Zykloplegie und Messung der Achsenlänge wird empfohlen. Anschließend kann ein Auslassversuch erfolgen, wenn die Progression unter − 0,25 dpt/Jahr im 2. Jahr gefallen ist. Auch nach Therapieende sind weitere Kontrollen angezeigt, wobei eine erneute Behandlung bei einem neuerlichen Ansteigen der Progression über − 0,5 dpt/Jahr anzuraten ist. Ferner ist zu beachten, dass die Behandlung mit Atropinaugentropfen eine Off-Label-Anwendung darstellt.