Contact lens complications in an urgent-care population: the University of California, Los Angeles, contact lens study.

OBJECTIVES: This is a prospective study in an urgent-care ophthalmic setting to investigate contact lens (CL) complications and their association with extended wear (EW). METHODS: Data on CL designs, care system(s), and ocular complications were collected over a 6-month period. RESULTS: One thousand three hundred and sixty-nine patients presented to the Jules Stein Eye Institute urgent care with symptoms of eye problems. Of these, 56 were identified with diagnoses etiologically associated with CL wear, and 49 were studied. The five most common ocular diagnoses found in our study were in the following order: epithelial staining or abrasion/epithelial defect, conjunctival injection, papillae, corneal neovascularization, and presumed microbial keratitis (PMK). Fifteen of 49 patients were diagnosed with PMK. The mean number of complications was 3.43 per eye. Most of the patients (65%) reported some form of EW. Analysis of the patients with PMK showed an association with EW. There seemed to be no statistical difference in the number of complications per symptomatic eye with hydrogel and silicone hydrogel lenses although 13 of the 15 patients with PMK were silicone hydrogel wearers. CONCLUSIONS: We studied various aspects of care and compliance in an urgent-care population and found that most of our urgent-care patients slept with CLs on their eyes. Symptomatic CL wear-related complications, and specifically MK, strongly correlate with EW with less relation to lens design, material, and wear modality. We therefore conclude that CL EW is a risk factor leading to urgent-care visits.

Novel regulatory function for the CCAAT-binding factor in Candida albicans.

Candida albicans is an opportunistic human pathogen that can sense environmental changes and respond by altering its cell morphology and physiology. A number of environmental factors have been shown to influence this dimorphic transition, including pH, starvation, serum, and amino acids. In this report, we investigate the function of the C. albicans CCAAT-binding factor. In Saccharomyces cerevisiae, this heterooligomeric transcriptional activator stimulates the expression of genes that encode proteins involved in respiration. To examine the function of this transcription factor in C. albicans, we cloned CaHAP5 and generated a hap5delta/hap5delta mutant of C. albicans. Using mobility shift studies, we identified four separate complexes from C. albicans cell extracts whose DNA-binding activities were abolished in the hap5delta/hap5delta mutant, suggesting that they represented sequence-specific CCAAT-binding complexes. We found that the C. albicans hap5delta homozygote was defective in hyphal development under a variety of conditions, and the mutant displayed a carbon source-dependent "hyperfilamentation" phenotype under certain growth conditions. In addition, the mRNA levels for two enzymes involved in respiration, encoded by COX5 and CYC1, were overexpressed in the hap5delta/hap5delta mutant when grown in medium containing amino acids as the sole carbon and nitrogen source. Thus, the C. albicans CCAAT-binding factor appeared to function as a repressor of genes encoding mitochondrial electron transport components, in contrast to its activator function in S. cerevisiae. These data provide the first evidence that the CCAAT-binding factor can act as a transcriptional repressor and raise new and interesting questions about how carbon metabolism is regulated in this opportunistic human pathogen.