Recurrent subacute visual loss presenting in a 52-year-old Caucasian woman with chronic relapsing inflammatory optic neuropathy: a case report

<p>Abstract</p> <p>Introduction</p> <p>Chronic relapsing inflammatory optic neuropathy is a recently described form of recurrent isolated subacute optic neuropathy. The condition is highly responsive to systemic steroid treatment and prone to relapse on steroid withdrawal. A complete work up for demyelination, autoimmune disease and sarcoidosis must be made before considering chronic relapsing inflammatory optic neuropathy.</p> <p>Case presentation</p> <p>We describe the case of a 52-year-old Caucasian woman who presented with isolated subacute optic neuropathy. There was no evidence of demyelination, autoimmunity or sarcoidosis. There was an abrupt and prompt response to systemic corticosteroids and a relapse of the condition on steroid withdrawal.</p> <p>Conclusions</p> <p>Chronic relapsing inflammatory optic neuropathy requires careful consideration and differentiation from demyelinating optic neuritis and ischemic optic neuropathy since the treatment is different and the outcome without treatment is likely to be poor. The importance of identifying these patients has considerable clinical implications as the condition is highly responsive to steroids.</p

Food Insecurity at the University of Denver: A Qualitative Exploratory Study to Identify Challenges and Opportunities for Improvements Around Food Insecurity on DU’s Campus

The purpose of this course-based research project was to understand students’ perceptions and opinions about student food insecurity on the University of Denver campus, identifying challenges and opportunities for improvement, with the hope that the results will support the DU community’s efforts to prevent and address food insecurity on DU’s campus

Mortality and Institutionalization After Percutaneous Endoscopic Gastrostomy in Parkinson's Disease and Related Conditions

BACKGROUND: Percutaneous endoscopic gastrostomy (PEG) can facilitate feeding and medication administration in dysphagic patients with Parkinson's disease and related disorders. Information on survival, institutionalization, and complications post PEG might inform feeding decisions. METHOD: A total of 93 patients with Parkinson's disease and related disorders were identified by review of PEG registers and by searching the administrative databases in 2 large UK university hospitals (2005–2017); 83 case notes were available for retrospective review. Care processes and outcomes were assessed. RESULTS: The following were the diagnoses: 58 (70%) had Parkinson's disease, 10 (12%) had progressive supranuclear palsy, 5 (6%) had multiple system atrophy, 3 (4%) had dementia with Lewy bodies, and 7 (8%) had vascular parkinsonism. The median age was 78 years (interquartile range 72–82); 29 (35%) were women. Care processes included a future care plan in place prior to admission for 18 patients (22%), and PEG was placed during emergency admission in 68 patients (82%). The outcomes included median survival at 422 days; 30‐day mortality rate was 6% (5 patients); and of 56 patients admitted from home, 18 (32%) were discharged to institutions (nursing or care homes). The most common complication was aspiration pneumonia for 18 (22%) of patients. Age, sex, diagnosis, admission type, comorbidities, and place of residence did not predict survival. Discharge to own home and follow‐up by the home enteral feeding team were associated with longer survival. CONCLUSION: We recommend markers of advanced disease should prompt advanced care planning. Discussions about PEG feeding should include information about post‐PEG survival, complications, and risk of institutionalization. Further research is needed on quality‐of‐life post PEG and ways to reduce aspiration pneumonia. All PEG patients should have nutrition team follow‐up