OBJECTIVE: To review the efficacy and safety of oral doxycycline antibiotics versus macrolides in the treatment of meibomian gland dysfunction (MGD).
METHODS: Systematic review and meta-analysis.
METHODS: We performed a systematic search of electronic databases for all peer-reviewed published studies which included clinical outcomes of oral antibiotic MGD treatment. Individual study data were extracted and evaluated in a weighted pooled analysis, including total sign and symptom scores, meibomian gland secretion score, tear break-up time (TBUT), fluorescein staining score and rate of complications.
RESULTS: Two thousand nine hundred and thirty-three studies were found, of which 54 were eligible for the systematic review, and six prospective studies were ultimately included for analysis, reporting on 563 cases from three countries. Age of affected patients ranged between 12 and 90 years. Overall, both treatment methods induced improvement in MGD signs and symptoms. In pooled analysis, macrolides were significantly superior in the total signs score (pooled standardized mean difference (SMD) -0.51, 95% confidence interval (CI): -0.99 to -0.03), meibomian gland secretion score (pooled SMD -0.25, 95%CI: [-0.48, -0.03]), TBUT (SMD -0.31, 95%CI: [-0.50, -0.13]) and fluorescein staining score (SMD -1.01, 95%CI: [-1.72, -0.29]). Moreover, while no severe complications were reported for both treatments, the macrolide group exhibited significantly less adverse events (pooled odds ratio 0.24 with a 95% CI of 0.16 to 0.34).
CONCLUSIONS: Both macrolides and tetracyclines are effective treatments for MGD. In this study, macrolides exhibited better efficacy and safety profile compared to tetracyclines.

Acute mesenteric ischemia (AMI) is a deadly and common surgical emergency. While several imaging modalities aid in the diagnosis of AMI preoperatively, there are limited intraoperative tools for surgeon decision making regarding bowel viability. Here we offer a review of the utility and limitations of the many extensively studied techniques. We classify each of these modalities into three hallmarks of healthy bowel: oxygenation, myoelectric activity and perfusion. Finally, we offer a brief discussion of emerging and promising techniques to assist surgeons in intraoperative decision making for patients with mesenteric ischemia.

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Pancreatic function tests are most commonly used to diagnose chronic pancreatitis. These tests include tests which document exocrine or endocrine gland insufficiency and tests which instead measure gradations of decreased secretory capacity. The tests in the former category generally become abnormal when advanced, longstanding chronic pancreatitis is present. Tests in the latter category, however, have the potential to detect chronic pancreatitis at an earlier stage than other available diagnostic tests, including commonly used imaging tests such as computed tomography and endoscopic retrograde cholangiopancreatography. This potential advantage of diagnostic sensitivity is, however, counterweighed by the fact that these tests which measure stimulated secretory capacity are only available at a very few referral centres. This article will review the variety of pancreatic function tests and describe their rationale, accuracy, cost, and clinical usefulness.

A variety of biochemical, pharmacological, and toxicological properties have been attributed to labile forms of iron that are associated with cells or with biological fluids. Unlike the major fraction of bioiron which is protein bound, the labile bioiron is chelatable and therefore amenable for detection by metal-sensing devices that are coupled to chelation moieties. The present review deals with the detection of various labile forms of iron present in living cells and in fluids of biological interest, in health and disease. The main focus of the review is on the design and application of fluorescent probes as analytical tools for assessing labile iron and iron transport mechanisms and the efficiency of iron chelators in solution and in cellular systems.

Pre- and postcolumn derivatization with a suitable chromophore or fluorophore have often been utilized to enhance the sensitivity and selectivity of detection for analytes possessing a carboxyl group. The major classes of UV and fluorescent derivatization reagents include the coumarin analogues, alkyl halides, diazoalkanes, and amines. The derivatization reaction conditions, HPLC systems for separation of the conjugates and detection limits of various analytes are presented in this review. High mass sensitivity for various carboxylic acids have been achieved with the hydrazides, anthracenes, and diazoalkanes.

The technique of assessing tear stability using the fluorescein instillation technique has been widely used in the clinical diagnosis of \"dry eye\" and in the screening of potential contact lens wearers. Various inconsistencies in the application of the tear break-up time (TBUT) techniques and the results obtained were noted in the literature and this review summarizes the differences and the conclusions of various investigators. The reliability of this technique using two different methods of observation was examined and the mean TBUT of Hong Kong Chinese subjects (HK-Chinese) was determined. We conclude that the TBUT can be measured reliably using either the scanning or full beam method in most patients. The mean TBUT of HK-Chinese is approximately 8 s and about 70% of HK-Chinese have TBUT\'s less than 10 s.

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From the long-term review of past results no type of replacement cover will entirely match the qualities of the original. Management must therefore be directed towards conservation of all viable skin flaps. Whole body fluorescence has proved a useful technique for obtaining a line of demarcation at an early stage. Demarcation of non-vascularised skin flaps allows excision and preparation of full thickness skin grafts to obtain the most satisfactory type of replacement cover. Where full thickness skin grafts can be prepared they should be applied tothe functionally most important areas.

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