The American Academy of Ophthalmology evaluated the practice of routine screening for intraocular infection from Candida septicemia. In the United States, ophthalmologists are consulted in the hospital to screen for intraocular infection routinely for patients with Candida bloodstream infections. This practice was established in the era before the use of systemic antifungal medication and the establishment of definitions of ocular disease with candidemia. A recent systematic review found a rate of less than 1% of routinely screened patients with endophthalmitis from Candida septicemia. Other studies found higher rates of endophthalmitis but had limitations in terms of inaccuracies in ocular disease classification, lack of vitreous biopsies, selection biases, and lack of longer-term visual outcomes. Some studies attributed ocular findings to Candida infections, rather than other comorbidities. Studies also have not demonstrated differences in medical management that are modified for eye disease treatment; therefore, therapy should be dictated by the underlying Candida infection, rather than be tailored on the basis of ocular findings. In summary, the Academy does not recommend a routine ophthalmologic consultation after laboratory findings of systemic Candida septicemia, which appears to be a low-value practice. An ophthalmologic consultation is a reasonable practice for a patient with signs or symptoms suggestive of ocular infection regardless of Candida septicemia.
Ireland's emerald fields, craggy cliffs, and oceanside vistas make it one of the most varied, beautiful, and well photographed places across the globe. Add in a few white sheep peppering the vast landscape, winding tree-lined roads, and crumbling ancient castles, and you've got an idyllic island bursting with splendor.
You can't come to Ireland without stopping at Blarney Castle. A mere 20 minutes from Cork, the castle is well worth a half-day trip. Don't forget to kiss the Blarney Stone while you're here. Known as the "stone of eloquence," once you kiss it, legend says, you'll never be lost for words.
Conveniently located in the Ring of Kerry, Ross Castle lies on the shores of Lough Sheelin in County Meath. Considered by some to be haunted, this castle dates back to the early iron age. Today, you can relive its history and get a taste of royal life by spending the night in one of the beautifully renovated rooms, cottages, or the quarry house.
No trip to Ireland is complete without a visit to a castle. The not-so-secret main attraction at Birr Castle is its giant telescope, once the largest in the land (and world). The spectacular grounds lie in the Irish Heritage Town of Birr, an idyllic Georgian village that transports visitors back in time.
Castles: Ireland's castles make for some of the best pictures of Ireland. Spread across the country, these historical structures are worth taking some time to visit. See our guide to the Best Castles in Ireland to help plan your trip.
We've seen it with other critically acclaimed 2010 books, like Atlas, and Thor The Mighty Avenger. Must readers, or more importatntly retailers gamble with over-buying a new book, without knowing whether it will sell through to the fans? What is Marvel's responsibility to give books enough of a chance on the shelf to find an audience, before cutting off a new monthly title? Would books from earlier this decade, like Brian Bendis's ALIAS have survived in today's market? You'll hear a candid discussion on the subject on this episode of Word Balloon. 2b1af7f3a8