bluuebunny/crossref_metadata_2025 huggingface dataset:
The efficacy of the use of intravenous human immunoglobulin in Brazilian newborns with rhesus hemolytic disease: a randomized double‐blind trial
Authors: Santos Maria Cristina , Sá Cynthia , Gomes Jr Saint Clair , Camacho Luiz Antonio , Moreira Maria Elisabeth
Published: August 2012

BACKGROUND: The purpose of this study was to evaluate the efficacy of intravenous human immunoglobulin (IVIG) in the presence of high‐intensity phototherapy in decreasing the need for exchange transfusion in newborns with rhesus hemolytic disease.

STUDY DESIGN AND METHODS: We performed a randomized, double‐blind, placebo‐controlled trial. The trial included D+ newborns born at 32 weeks of gestational age or later with a positive direct antiglobulin test and whose mothers were Rh‐alloimmunized and did or did not receive intrauterine transfusion. The newborns were randomly assigned to receive either IVIG at a dose of 500 mg/kg or placebo (saline solution, 10 mL/kg) during the first 6 hours of life. The primary outcome was the need for exchange transfusion. The criteria for exchange transfusion were total serum bilirubin (TSB) level at or above 340 µmol/L (20 mg/dL) or increasing by 8.5 µmol/L/hr (0.5 mg/dL/hr) despite intensive phototherapy.

RESULTS: The trial included 92 newborns. There was no difference in the rate of exchange transfusion between groups: 6 of 46 (13%) in the IVIG group versus 7 of 46 (15.2%) in the placebo group (p = 0.765). There were no significant differences between groups with respect to their need for exchange transfusion, phototherapy time, peak bilirubin, or length of hospital stay. There were no adverse events related to the drug or the form of administration.

CONCLUSION: Nonspecific human immunoglobulin was not effective in preventing the need for exchange transfusion in neonates with rhesus hemolytic disease.
Reduction of allogeneic red blood cell usage during cardiac surgery by an integrated intra‐ and postoperative blood salvage strategy: results of a randomized comparison
Authors: Weltert Luca , Nardella Saverio , Rondinelli Maria Beatrice , Pierelli Luca , De Paulis Ruggero
Published: August 2012

BACKGROUND: The amount of allogeneic blood transfusion may relate to worse outcome in cardiac surgery. The reinfusion of red blood cells (RBCs) lost by patients, including those of chest drains, is a promising strategy to minimize allogeneic transfusions.

STUDY DESIGN AND METHODS: To verify this hypotheis, 1047 cardiac surgery patients were randomly assigned to either traditional intraoperative blood salvage followed by chest drain insertion or intra‐ and postoperative strategy with the Haemonetics cardioPAT system. Allogeneic RBC transfusion rate (primary endpoint) and postoperative complications (secondary endpoint) were recorded at the time of discharge from the hospital and at first month follow‐up visit, respectively.

RESULTS: The cardioPAT arm received 1.20 units of allogeneic RBCs per patient, whereas the control group required 2.11 units per patient, and this difference proved to be highly significant (p = 0.02). We observed a comparable 45‐day mortality rate but a lower rate of deep vein thrombosis (p = 0.04) and atrial fibrillation (p = 0.04) in the cardioPAT arm.

DISCUSSION: A significant reduction in patient exposure to allogeneic RBCs was observed in the cardioPAT system arm. Complications were slightly less frequent in the cardioPAT group. The use of the cardioPAT is a safe and effective strategy to reduce allogeneic RBC transfusions in cardiac surgery.
Prevalence of serologic markers for hepatitis B and C viruses in Brazilian blood donors and incidence and residual risk of transfusion transmission of hepatitis C virus
Authors: de Almeida‐Neto Cesar , Sabino Ester Cerdeira , Liu Jing , Blatyta Paula Fraiman , Mendrone‐Junior Alfredo , Salles Nanci Alves , Leão Silvana Carneiro , Wright David J. , Basques Fernando Valadares , Ferreira João Eduardo , Busch Michael P. , Murphy Edward L. ,   NHLBI Retrovirus Epidemiology Donor Study‐II (REDS‐II), International Component
Published: August 2012

BACKGROUND: We evaluate the current prevalence of serologic markers for hepatitis B virus (HBV) and hepatitis C virus (HCV) in blood donors and estimated HCV incidence and residual transfusion‐transmitted risk at three large Brazilian blood centers.

STUDY DESIGN AND METHODS: Data on whole blood and platelet donations were collected from January through December 2007, analyzed by center; donor type; age; sex; donation status; and serologic results for hepatitis B surface antigen (HBsAg), antibody to hepatitis B core antigen (anti‐HBc), and anti‐HCV. HBV and HCV prevalence rates were calculated for all first‐time donations. HCV incidence was derived including interdonation intervals that preceded first repeat donations given during the study, and HCV residual risk was estimated for transfusions derived from repeat donors.

RESULTS: There were 307,354 donations in 2007. Overall prevalence of concordant HBsAg and anti‐HBc reactivity was 289 per 100,000 donations and of anti‐HCV confirmed reactivity 191 per 100,000 donations. There were significant associations between older age and hepatitis markers, especially for HCV. HCV incidence was 3.11 (95% confidence interval, 0.77‐7.03) per 100,000 person‐years, and residual risk of HCV window‐phase infections was estimated at 5.0 per million units transfused.

CONCLUSION: Improvement in donor selection, socioeconomic conditions, and preventive measures, implemented over time, may have helped to decrease prevalence of HBV and HCV, relative to previous reports. Incidence and residual risk of HCV are also diminishing. Ongoing monitoring of HBV and HCV markers among Brazilian blood donors should help guide improved recruitment procedures, donor selection, laboratory screening, and counseling strategies.
The first example of a patient with etoricoxib‐induced immune hemolytic anemia
Authors: Mayer Beate , Genth Ramona , Dehner Rainer , Salama Abdulgabar
Published: August 2012

BACKGROUND: Etoricoxib, a selective inhibitor of cyclooxygenase 2, is increasingly used in pain relief. Here, we report the first case of etoricoxib‐induced immune hemolytic anemia.

STUDY DESIGN AND METHODS: An 84‐year‐old male patient developed anemia 1 week after treatment with etoricoxib. There was no evidence of hemoglobinemia or hemoglobinuria. Administration of the drug was halted, and the patient recovered without further complications.

RESULTS: The patient's red blood cells (RBCs) were found to be strongly coated with immunoglobulin G and C3d. Eluted antibodies and dialyzed serum from the patient were not reactive with untreated RBCs, but with etoricoxib‐treated RBCs, RBCs in the presence of etoricoxib, urine containing drug metabolites (ex vivo antigen), and two of four additional COX inhibitor drugs analyzed.

DISCUSSION: Although the causative antibodies were drug dependent usually leading to abrupt and intravascular hemolysis, the patient only gradually developed anemia. These findings together with a positive direct and indirect antiglobulin test may lead to confusion with autoimmune hemolytic anemia of warm type. A nonreactive eluate was the key serologic finding in identifying drug‐induced immune hemolytic anemia in this case.

CONCLUSION: Etoricoxib should be considered as a risk in the development of immune hemolytic anemia, with the causative antibodies potentially reacting with other COX inhibitors.
Single Transseptal Big Cryoballoon Pulmonary Vein Isolation using an Inner Lumen Mapping Catheter
Authors: CHUN KR JULIAN , BORDIGNON STEFANO , GUNAWARDENE MELANIE , URBAN VERENA , KULIKOGLU MEHMET , SCHULTE‐HAHN BRITTA , NOWAK BERND , SCHMIDT BORIS
Published: August 2012

Background:
 The single big cryoballon technique for pulmonary vein isolation (PVI) has been limited by the need for two transseptal punctures (TP). We therefore investigated feasibility and safety of a simplified approach using a single TP and a novel circumferential mapping catheter (CMC).

Methods:
 Patients underwent 28‐mm cryoballoon PVI using a single TP. The CMC (Achieve© Medtronic Inc., Minneapolis, MN, USA) served as (1) guidewire and (2) as a PV mapping tool. Primary endpoint was PVI without switching to a regular guidewire. Secondary endpoints included: (1) PV signal quality during freezing, (2) time to PVI, (3) classification of successful ablation technique, (4) complications, and (5) procedural data.

Results:
 A total of 32 patients (126 PVs) were studied (mean age: 62 ± 11 years, 24 males, left atrium: 40 ± 4 mm). The primary endpoint was achieved in 29/32 patients (91%) and 123/126 PVs (98%) with a procedure and fluoroscopy time of 126 ± 26 minutes and 18.9 ± 7.5 minutes, respectively. Real‐time visualization of PVI could be observed in 61/126 (48%) PVs. Time to sustained PVI versus nonsustained PVI was 66 ± 56 seconds versus 129 ± 76 seconds (P < 0.001). One phrenic nerve palsy was observed. After a follow‐up of 250 ± 84 days 23/32 patients (72%) remained in sinus rhythm.

Conclusion:
 The “simplified single big cryoballoon” PVI strategy appears to be safe and feasible. However, real‐time PV recording was achieved in <50% of PVs. Therefore, further catheter refinements are warranted. (PACE 2012; 35:1304–1311)
Pregnancy and birth outcomes of women with intellectual disability in Sweden: a national register study
Authors: HÖGLUND BERIT , LINDGREN PETER , LARSSON MARGARETA
Published: August 2012

Objective. To investigate the antenatal health and demographic factors as well as pregnancy and delivery outcomes in women with intellectual disability (ID) in Sweden. Design. A population‐based register study. Setting. The National Patient Register (NPR) linked to the Medical Birth Register (MBR). Sample. Women with ID classified as International Classification of Diseases (ICD) 8–10 who gave birth in 1999–2007 (n = 326), identified from the NPR linked to the MBR, were compared with all first‐time, singleton mothers without ID or any other psychiatric diagnoses during this period in Sweden (n = 340 624). Methods. Population‐based data were extracted from the NPR and the MBR. Main outcome measures. Health and socio‐demography at first antenatal visit, mode of delivery, pain relief during labor, preterm birth and discharge from hospital. Results. A higher proportion of women with ID were teenagers (18.4 vs. 3.3%), obese (20.1 vs. 8.6%) and single (36.6 vs. 6.2%) compared with women without ID, and women with ID smoked more often (27.9 vs. 7.9%). Women with ID had more often a preterm birth (12.2 vs. 6.1%), a cesarean section (CS) (24.5 vs. 17.7%) and used less nitrous oxide as pain relief during labor (59.5 vs. 75.8%). Women with ID had a higher risk for preterm birth [odds ratio (OR) 1.68], CS (OR1.55), non‐use of nitrous oxide (OR 1.89) and discharge from hospital to a place other than home (OR 2.24). Conclusion. Pregnant women with ID should be considered a risk group suggesting that better tailored pre‐ and intrapartum care and support are needed for these women.
Change in self‐reported oral health in relation to use of dental services over 2 yr
Authors: Brennan David S. , Spencer A. J. , Roberts‐Thomson Kaye F.
Published: August 2012

To investigate change in oral health in relation to use of dental services, a random sample of 45‐ to 54‐yr‐old subjects from Adelaide, South Australia, was surveyed in 2004–2005 (n = 986, response rate = 44.4%). Service use and a global oral‐health transition (GOHT) statement were collected over 2 yr. Worsening in oral health was reported from the GOHT statement by 25% of persons, while improvement was reported by 30%. Prevalence ratios (PRs, 95% CI), adjusted for sex, education, health card status, and toothbrushing, showed that worsening oral health was inversely associated with dental visiting (PR = 0.5, 0.4–0.7) and with scaling and cleaning services (PR = 0.6, 0.4–0.9), whereas extractions (PR = 2.3, 1.6–3.4) and dentures (PR = 2.2, 1.3–3.7) were associated with a higher prevalence of worsening. Scaling and cleaning services were associated with improvement in oral health (PR = 1.5, 1.01–2.3), while endodontic services were inversely associated with improvement (PR = 0.3, 0.1–0.9). Worsening in oral health was associated with extractions and dentures and was inversely associated with visiting and preventive care. Improvement in oral health was associated with preventive care and was inversely associated with endodontic treatment.
Factors Controlling Compositional Changes in a Northern Andean Páramo (La Rusia, Colombia)
Authors: Valencia Jorge , Lassaletta Luis , Velázquez Eduardo , Nicolau José M. , Gómez‐Sal Antonio
Published: August 2012

In this study, we aimed to assess the processes controlling compositional change in a Northern Andean páramo highly affected by human‐induced disturbances over the last few decades (La Rusia, Colombia). Along the 3000–3800 m asl altitudinal range, we randomly sampled fifty 10 × 10 m plots. Therein, we measured altitude and variables related to soil conditions (i.e., moisture, nutrient contents, bulk density, and texture), occurrence of human‐induced disturbances (i.e., fire, vegetation clearing, potato cultivation, and cattle grazing), and land‐use history. We also recorded richness and abundance of plant species, identifying them as exotic or native. We differentiated four groups of plots according to their species composition. The groups had significant differences in altitude, soil conditions, land‐use history, and particularly, in richness of exotic species and exotic/native cover ratio. They could be ascribed to shrub‐ and grass‐páramo vegetation types based on their relative dominance of woody and herbaceous species; however, these groups were not arranged according to the hypothetical composition of altitudinal belts, but rather formed a mosaic of patches. This mosaic was determined not only by altitude but also by soil conditions and disturbance history of sites. Our results corroborate recent findings which highlight shrub‐ and grass‐páramo vegetation types as patches of contrasting species composition and structure that depend on local environmental variables, as well as human‐induced disturbances as a major determinant of compositional discontinuities in these ‘high mountain’ tropical ecosystems.
The stretching of Hercules
Authors: Deason A. J. , Belokurov V. , Evans N. W. , Watkins L. L. , Fellhauer M.
Published: August 2012

We present VLT/FORS2 spectroscopy of candidate blue horizontal branch (BHB) stars in the vicinity of the Hercules ultrafaint dwarf galaxy. We identify eight convincing Hercules BHB members, and a further five stars with similar systemic velocities to that of Hercules, but ∼0.5 kpc from the centre of the galaxy along its major axis. It is likely that these stars once belonged to Hercules, but have been tidally stripped and are now unbound. We emphasize the usefulness of looking for any gradient in the systemic velocity of this stretched system, which would further support our interpretation of the origin of its elongated and distended morphology.
INTIMATE PARTNER VIOLENCE IN U.S. METROPOLITAN AREAS: THE CONTEXTUAL INFLUENCES OF POLICE AND SOCIAL SERVICES*
Authors: XIE MIN , LAURITSEN JANET L. , HEIMER KAREN
Published: August 2012

Although community responses to the problem of intimate partner violence typically focus on increasing and improving policing and social services, few studies have examined the relationship among police force size, social service providers, and women's safety at home. To address this issue, we use data from the National Crime Victimization Survey to examine patterns of intimate partner violence for 40 metropolitan statistical areas (MSAs) over a 16‐year period (1989–2004). We analyze the data using three‐level multilevel models, with individual respondents (N = 487,166) nested within years, nested within MSAs. Net of other important individual and contextual factors, the results show that women's likelihood of victimization is significantly lower in MSAs that employ more sworn officers per capita, whereas the states’ mandatory arrest laws are not found to have significant independent effects. Above and beyond the effects of police force size, we also find a significant negative relationship between the size of the social service workforce and intimate partner violence. Future research should develop collaborative data collection efforts to examine the specific activities of police and social service workers in dealing with intimate partner violence so that the mechanisms underlying these significant relationships can be understood more clearly.
Diagnosis, treatment and outcomes for koala chlamydiosis at a rehabilitation facility (1995–2005)
Authors: Griffith JE , Higgins DP
Published: August 2012

Objective

To document the application of diagnostics and treatments at one rehabilitation facility over 10 years and their effects on recovery and post‐release survival of 88 koalas treated for chlamydiosis, and to highlight associated wildlife care issues with potential significance to animal welfare and disease ecology.

Design

Using a retrospective analysis of medical records, we identified risk factors for successful release using a logistic regression model and descriptive statistics.

Procedure

We examined the clinical presentation, signalment, diagnostics, treatments, outcomes and whether released koalas were re‐presented by the end of 2008 indicating post‐release survival.

Results

Records of 88 koalas were included. Treatments and diagnostics were directed at the anatomical site displaying clinical signs. Younger age and use of ancillary treatments were associated with successful release. The type, route and duration of the treatments used were not those theorised to result in microbial cure. Despite this, approximately 50% of koalas were released and many survived in the wild for extended periods.

Conclusions

Wildlife rehabilitators' records can guide research priorities and the development of care facilities and policies. This study identified the need for more accessible chlamydial diagnostic tests and veterinary support of carers, and the need for a more rigorous assessment of novel therapies. Current treatment regimens appear to be moderately successful in terms of clinical improvement, but it is unclear which aspects are responsible for the success or whether microbial cure is achieved. The long‐term effect of released koalas on wild populations requires further study to assess its contribution to the conservation of koala populations.
Photodynamic Mechanisms induced by a Combination of Hypericin and a Chlorin Based‐Photosensitizer in Head and Neck Squamous Cell Carcinoma Cells
Authors: Gyenge Emina Besic , Lüscher Daniel , Forny Patrick , Antoniol Martina , Geisberger Georg , Walt Heinrich , Patzke Greta , Maake Caroline
Published: August 2012

The aim of this study was to elucidate photodynamic therapy (PDT) effects mediated by hypericin and a liposomal meso‐tetrahydroxyphenyl chlorin (mTHPC) derivative, with focus on their 1:1 mixture, on head and neck squamous cell carcinoma cell lines. Absorption, excitation and photobleaching were monitored using fluorescence spectrometry, showing the same spectral patterns for the mixture as measured for single photosensitizers. In the mixture mTHPC showed a prolonged photo‐stability. Singlet oxygen yield for light‐activated mTHPC was ΦΔ = 0.66, for hypericin ΦΔ = 0.25 and for the mixture ΦΔ = ~0.4. A linear increase of singlet oxygen yield for mTHPC and the mixture was found, whereas hypericin achieved saturation after 35 min. Reactive oxygen species fluorescence was only visible after hypericin and mixture‐induced PDT. Cell viability was also more affected with these two treatment options under the selected conditions. Examination of death pathways showed that hypericin‐mediated cell death was apoptotic, with mTHPC necrotic and the 1:1 mixture showed features of both. Changes in gene expression after PDT indicated strong up‐regulation of selected heat‐shock proteins. The application of photosensitizer mixtures with the features of reduced dark toxicity and combined apoptotic and necrotic cell death may be beneficial in clinical PDT. This will be the focus of our future investigations.
Variceal recurrence, rebleeding rates and alterations in clinical and laboratory parameters following post‐variceal obliteration using endoscopic sclerotherapy
Authors: Krishnan Arunkumar , Srinivasan Vijaya , Venkataraman Jayanthi
Published: August 2012

Objective

To study the rates of variceal recurrence and rebleeding following sclerotherapy and its effect on clinical and laboratory parameters in patients with portal hypertension.

Methods

A total of 237 patients with portal hypertension together with esophageal variceal bleeding were included in the study. There were 138 patients with cirrhosis (group I), 42 with non‐cirrhotic portal fibrosis (group II), and 57 with extrahepatic portal vein obstruction (group III). Baseline data and post‐obliteration follow‐up for rebleeding rates and changes in clinical and laboratory parameters were recorded.

Results

In all, 106 patients in group I, 31 in group II and 43 in group III experienced obliteration of varices. The recurrence of grade II varices occurred in 17 patients (9.4%) during a mean period of 9 months. Rebleeding from varices was observed in 4 patients (3.8%) in group I and 1 (3.2%) in group II, while none in group III experienced rebleeding. There was a significant improvement in ascites, jaundice, liver status, international normalized ratio and platelet count in group I patients after variceal eradication (P < 0.05). The main cause of death in the cirrhotic patients was active liver disease but not rebleeding.

Conclusions

Following obliterative endoscopic sclerotherapy, rates of recurrence and rebleeding were significantly low when patients are kept under close observation. Disappearance of varices or reduction of variceal size improves the liver status in surviving cirrhotic patients.
Assessing the Relationship Between Landscape Patterns and Nonpoint‐Source Pollution in the Danjiangkou Reservoir Basin in China1
Authors: Hao Fanghua , Zhang Xuan , Wang Xiao , Ouyang Wei
Published: August 2012

Abstract:  The constrained ordination method from quantitative ecology was utilized to assess the relationship between landscape patterns and nonpoint‐source (NPS) pollution for the purpose of identifying effective water‐quality improvement practices in Danjiangkou Reservoir (DJKR) basin, China. The soil and water assessment tool (SWAT) was applied to simulate NPS pollution and the Fragstats model was applied to calculate the landscape metrics. The study concluded that organic nutrients formed the main NPS pollutant in the DJKR basin and that most of the NPS pollution occurred along with soil loss. Based on partial redundancy analysis, the conclusion that landscape metrics were significantly correlated to NPS pollution indices was obtained. Specifically, the composition of LULC (land use/land cover) was the most effective factor to estimate NPS pollution. Dry cultivated land was identified as the main source of NPS pollution, and paddy fields were characterized with the most intensive soluble nutrients loss. In addition, the reason that fragmented and complex landscape patterns exacerbate NPS pollution was that natural landscape composed most of this area. Moreover, the fragmented natural landscape indicated intensive agricultural activities that were the crucial trigger for NPS pollution. Combined with the economic condition in China, Conversion of Cropland to Forests Program (CCFP) should be conducted selectively and gradually in the DJKR basin.
Pathophysiology of uveitis
Authors: DICK A
Published: August 2012

Purpose This talk will overview the pathophysiology of non‐infectious uveitis in relation to recent SUN (standardised uveitis nomenclature) disease classification.

Methods The experimental and translational human evidence of autoimmunity and activation of immunity will be discussed. In addition the talk will highlight the pathways and mechanisms of tissue damage that results in sight‐threatening disease.

Results Traditionally, despite active immune regulatory mechanisms operative within the ocular environment, inflammation still occurs. Activated antigen and non‐antigen specific T cells are generated in uveitis. The interplay with innate immunity and in particular cells of myeloid lineage both systemically and within the local environment dictate the severity and extent of pathology we observe

Conclusion The understanding of immune responses during the uveitis open many avenues to potential novel immunotherapies that not only suppress inflammation but attempt to redress immune balance, tolerance and local homeostasis within ocular tissues
Symptoms and signs of anterior uveitis
Authors: NERI P , ARAPI I , CAPUANO V , PIRANI V
Published: August 2012

Purpose To review the symptoms and signs of anterior ueveitis (AU), based on the anatomic classification of uveitis, iritis and iridocyclitis.

Methods Review of symptoms and signs of AU.

Results Perikeratic injection, cells and flare in the anterior chamber, small keratic precipitates (KPs) are peculiar findings of alternating unilateral acute non‐granulomatous anterior uveitis, which is commonly described in association with HLA‐B27 antigen and spondyloarthropaties. In such cases, fibrinous exudate or hypopyon can also occur. Patients presenting acute anterior uveitis typically show red eyes, photophobia, ocular pain, and often blurred vision. In chronic anterior uveitis, the onset is usually subtle and patients may be asymptomatic until the development of complications. Viral anterior uveitis is typically unilateral, characterized by recurrent episodes of anterior uveitis. Endotheliitis, high intraocular pressure, and patchy/sectoral iris atrophy are also present. Chronic flare, Koeppe and Busacca nodules of the iris, medium‐size KPs or large mutton‐fat KPs, peripheral anterior synechiae and broad‐based posterior synechiae represent hallmarks of granulomatous anterior uveitis which tends to chronicity. Juvenile Idipoathic Arthritis (JIA)‐associated anterior uveitis is peculiarly a bilateral non‐granulomatous chronic anterior uveitis, frequently worsened by several complications.

Conclusion The typology of AU influences its clinical presentation: the clinical findings can vary on the basis of its acute or chronic, granulomatous or non‐granulomatous nature. Specific AU subtypes are characterized by a large number of distinct ocular signs.
Imaging in uveitis: techniques and indications
Authors: HERBORT CP
Published: August 2012

Purpose To present the array of the main imaging methods used or that should be used in the investigation of uveitis and specify their respective indications.

Methods Review of the different imaging modalities as well as laser flare photometry (LFP).

Results Imaging work‐up of (posterior) uveitis automatically and routinely always comprised FA and more recently OCT. FA usually does not bring new unknown elements as it gives information on the superficial structures accessible to fundus examination but it allows more precise appraisal of the pathology of these superficial structures such as retinal vasculitis, macular oedema, retinal ischemia, subretinal fluid, retinal neovessels as well as optic disc inflammation. OCT gives morphologic quasi‐histologic details of the retina, especially useful because it is non‐invasive and allows close follow‐up. FAF gives information on inflammation induced changes on the retinal pigment epithelium and photoreceptor outer segments but FAF still needs to be better standardized if possible at all. Mostly, these methods fail to give information on the choroid, at least as often involved as the retina, which can only be explored by ICGA. Unlike FA and OCT, ICGA very often shows occult unknown elements. It is therefore obvious that ICGA should be included in routine imaging work‐up of those cases of posterior uveitis where angiography is deemed necessary and choroiditis cannot be excluded.

Conclusion Classical imaging methods and newer modalities together with LFP transformed uveitis monitoring into a precise clinical science, as long as these methods are used which unfortunately is far from being the case.
Preparation, fixation, embedding, sectioning and staining – basic requirements of morphological tissue investigation
Authors: KNOP N , KNOP E
Published: August 2012

Purpose A thorough understanding of the body construction of different cell types and tissues (referred to as “morphology”, i.e. structural study), is a prerequisite for understanding of physiology, pathology and clinics. Morphology is usually performed by use of imaging techniques, referred to as microscopy, and respective techniques for pre‐treatment (preparation) of the object of interest (tissue specimen).

Methods We will explain and discuss different imaging and preparation techniques for the morphological analysis of tissues, with a focus on ocular tissues.

Results There is a wide variety of morphological techniques that can be differentiated by their resolution or by imaging medium into e.g. conventional light microscopy (LM) and electron microscopy (EM). More recent developments include confocal laser scanning‐, optical coherence‐ (OCT), multi‐photon‐ and acoustic microscopy, that may allow inspection of living tissues at a microscopical/ cellular level. Conventional morphology (histology) requires a respective preparation that consists of tissue fixation to stop natural post mortal degradation and typically requires embedding of the fixed tissue into a medium that can be sectioned, followed by the actual sectioning, as well as measures to increase contrast, e.g. by staining. This also applies to transmission electron microscopy (TEM) whereas scanning electron microscopy (SEM), that displays surfaces, requires the stabilisation of tissue against the energy of the electron beam.

Conclusion Knowledge of morphological techniques allows to chose the right technique for your question in order to perform morphological investigation with an optimal result.
Immunohistochemical identification of tissue antigens – principal methological requirements, considerations and results
Authors: KNOP E , KNOP N
Published: August 2012

Purpose To identify specific components (antigens, i.e. protein or polysaccharide macromolecules) of tissues and cells, these are labelled by specific antibodies (AB). Their localization is visualized by marker molecules. Such techniques are known as immunohistochemistry (IHC).

Methods We will explain and discuss different techniques for the IHC labelling in histological specimens on a light microscopical level in order to discuss their advantages and disadvantages.

Results AB are generated after injection into an animal and are used directly (polyclonal AB) or after plasma‐cell fusion with tumor cells to produce monoclonal AB. AB are incubated on tissue sections, on cells in culture, or on complete tissues. Pre‐treatment of the tissue can block unwanted reactivities, or permeabilize the cells for improved AB entry, or re‐activates antigens (antigen‐retrieval) that were masked by tissue fixation. Direct IHC uses an AB that directly carries a marker and results in simple, quick procedures. Indirect techniques, in contrast, amplify the primary AB by secondary AB and/or tertiary reagents and result in more laborious techniques with improved sensitivity and staining intensity. Markers are often enzymes for production of a visible color signal or fluorescent molecules. It is also possible to perform simultaneous staining of different antigens on the same section in order to show co‐localization of different antigens and to suggest/verify interaction of factors in a biological process.

Conclusion IHC is a widely used technique to identify specific macromolecules together with their localization in the tissue and thus provides important information on cell biology.
Immuno electron microscopy – tracking the sub‐cellular localization of antigens in high resolution
Authors: AKHTAR S
Published: August 2012

Purpose Any antigen to which an antibody can be generated can be localized, at sub‐cellular level and viewed under very high magnification by immuno‐electron microscopy (immune‐EM). The applications of EM immunocytochemistry are very wide ranging.

Methods A particular antigen is localized by primary antibody (monoclonal or polyclonal) within a tissue. The primary antibody is visualized using a secondary antibody, the gold conjugates of 5 or 10nm size. The gold particles are opaque and can be seen under an electron microscope. The antibody can be used on pre‐embedded or post embedded tissue. In the pre‐embedding method, a fresh thin piece of tissue is treated with primary and secondary antibodies. In the post‐embedding method, primary and secondary antibodies are used on ultrathin sections. The immunocytochemistry is also carried out on cryosection. Double immune labeling is also carried out by some authors.

Results A number of extracellular matrix proteins and non‐collagenous glycoproteins, such as collagen, elastin, fibronectin, laminin, keratan sulphate proteoglycan, BKS1, chondroitin sulphate, keratoepithilin have been demonstrated by the immuno‐EM procedure. A number of cellular proteins such as keratoepithelin and actin were also shown by immuno‐EM.

Conclusion Immuno‐EM is a very powerful technique since it combines the specificity and flexibility of immunocytochemistry with the resolution at high magnification of electron microscopy. Acknowledgement: Supported by National Plan for Science and Technology, KSU, Riyadh.
Herpetic eye disease
Authors: VASSILEVA P
Published: August 2012

Purpose Human herpes viral infection is a major cause of morbidity worldwide and a frequent cause of ocular pathology – conjunctivitis, keratitis, scleritis, uveitis, optic neuritis. It is a recurrent disease and the complications may lead to blindness.

Methods Diverse clinical picture with various manifestations, risk factors and diagnostic problems are discussed in a retrospective review of 120 consecutive patients with herpetic eye infection referred to our hospital for a year. Pathogenesis and classification of ocular herpetic disease are analyzed. 50 patients (42%) had stromal keratitis. Symptoms and signs of recurrence were documented in 34 patients (28%). Herpes simplex infection was observed in 85 patients (71%) and varicella zoster virus in 35 patients (29%). Therapeutic approach depended on clinical form and stage.

Results Controversies in optimal management and current treatment strategy are demonstrated. Treatment of complications, including severe cases with corneal perforation are presented.

Conclusion Systemic antiviral treatment demonstrate beneficial effect in our series of patients. Importance of differentiating HSV and VZV is emphasized. But still to date scientifically proven answers on herpetic eye disease are very limited.
Treatment: medical therapy
Authors: HERGELDZHIEVA T
Published: August 2012

Purpose To present the current medical treatment of herpetic eye disease (HED).

Methods Electronic search of PubMed using the terms randomized clinical trials, treatment, herpes, and eye was performed.

Results For herpes simplex virus (HSV) epithelial keratitis, trifluridine and acyclovir are more effective than idoxuridine or vidarabine. Brivudine and ganciclovir are at least as effective as acyclovir. The effectiveness of corneal epithelial débridement is improved by an antiviral agent. For HSV stromal keratitis, topical corticosteroids in addition to a topical antiviral agent are effective in managing HSV stromal keratitis. Topical cyclosporine A in conjunction with prophylactic antivirals is an alternative treatment for HSV stromal keratitis, especially in cases of non‐necrotizing disease not controlled by corticosteroids or in cases with side effects from steroid treatment. In patients with necrotizing HSV stromal keratitis, amniotic membrane transplantation with postoperative antivirals and corticosteroids are recommended when antivirals alone do not control the disease. For HSV iridocyclitis, a study’s results show a trend for a benefit from oral acyclovir in addition to topical corticosteroids. For ophthalmic herpes zoster, oral antiviral drugs at the first signs of infection are recommended for all patients. The monotherapy with antiviral ointment is insufficient. For metaherpetic eye disease, antiviral agents are generally contraindicated and resurfacing therapy and/or surgical reconstruction should be considered.

Conclusion Appropriate and timely treatment of different forms of HED benefits better visual prognosis and improved quality of life.
Treatment: surgical methods
Authors: DEKARIS I , RATKOVIC M , PAUK M , DRACA N
Published: August 2012

Purpose Herpetic keratitis may lead to a significant corneal scaring and loss of vision which often leads to surgical treatment, which can be both penetrating (PKP) and deep anterior lamellar keratoplasty (DALK). However, the survival of corneal grafts is hampered by the presence of neovascularization (NV) and possible recurrence of herpetic disease. In our prospective study we have used bevacizumab treatment at the end of surgery, aiming to decrease corneal NV,and consequently to increase graft survival rate.

Methods Twelve high‐risk eyes undergoing PKP due to post‐herpetic corneal scar were progressively followed up for 17.54 months (range 6‐24). There were 7 females and 5 males of average age 51 and 44.28 years, respectively. All surgeries were ended by subconjunctival bevacizumab injection (25 mg/ml) under the NV. Grafts were prospectively examined for their clearance, presence of NV and endothelial cells density (ECD) loss.

Results At the end of follow‐up 11 out of 12 (91.7%) of corneal grafts remained clear; corneal NV reduction was found in all eyes and ECD loss at 24 months was 26.63%. Two out of 12 (16.6%) of patients had herpetic recurrence in their graft, which was successfully treated with systemic acyclovir.

Conclusion Subconjunctival bevacizumab may offer an adjunctive measure during surgical treatment of post‐herpetic corneal scars. This might be explained by suppression of the angiogenic potential mediated by VEGF in such patients.
Limbal stem cell transplantation techniques
Authors: DUA H
Published: August 2012

Abstract not provided
Modern pterygium surgery
Authors: GICQUEL JJ
Published: August 2012

Pterigyum is the most common surgically managed ocular surface disorder . The primary Goals are to prevent recurrences in advanced cases and get a proper esthetic result in younger patients with less symptomatic cases There has been 1 article every month for the last 4 decades on the subject… Bare sclera technique should be avoided at all costs, because it involves too many recurrences. Hence will discuss other techniques, such as conjonctivo‐limbalautograft (sutured or glued), conjunctival graft, amniotic membrane and the use of anti‐mitotic drugs.
Anterior and posterior lamellar keratoplasty
Authors: NUBILE M
Published: August 2012

Abstract not provided
Corneal collagen cross linking: traditional vs transepithelial
Authors: MENCUCCI R
Published: August 2012

Abstract not provided
How to localise retinal tears ?
Authors: KOROBELNIK JF
Published: August 2012

Abstract not provided
Eyelid tumours : The relative value of clinical signs
Authors: LASUDRY J
Published: August 2012

Purpose Despite the fact that the majority of eyelid tumours are benign, proper management in daily practice requires to detect the malignant ones.

Methods A few clinical behaviour criteria are usually examined to support the hypothesis of a malignancy, however most are of limited reliability.

Results In any case of doubt, biopsy is recommended, which is readily done in the outpatient setting, to reach a pathologic diagnosis, and to draw the appropriate management plan.

Conclusion In all malignant cases, complete carcinologic control is required.
Bases of pathological diagnosis of eyelid tumours
Authors: LOEFFLER K
Published: August 2012

Purpose This presentation will discuss a variety of tumours of the eyelid and adjacent conjunctiva both clinically and histopathologically.

Methods Clinical features of some "usual" and "unusual" tumours will be correlated with histopathologic findings.

Results In many cases, the clinical diagnosis based on certain morphologic criteria and patient's history will be correct. However, it is not infrequent that only histopathologic examination will reveal the exact diagnosis and help to further manage the patient appropriately.

Conclusion The correct diagnosis of eyelid lesions can usually be established using appropriate clinical features but histopathology is mandatory to confirm this since "surprises" are more frequent than we might assume.
Bases of surgery for eyelid reconstruction
Authors: BRISCOE D
Published: August 2012

Purpose Eyelid defects can be complex and often demand individual approaches in order to achieve a successful functional and cosmetic reconstruction. The course gives the basis of understanding and experience of the issues involved in rebuilding an eyelid. Course participants will be equipped with simple principles of understanding that will make this task much more simple.

Methods Key principles of reconstruction including area and location of the defect, layers, support, anchorage, vascular supply, and the use of flaps and grafts, are discussed in detail. Numerous cases with graphic photographs and diagrams are presented and their reconstruction possibilities worked out interactively with the course participants.
B27‐associated uveitis
Authors: WILLERMAIN F
Published: August 2012

B27 associated uveitis is a very frequent form of non infectious intraocular inflammation which account for approximately 50 % of acute anterior uveitis. Its main clinical features, natural history and association with seronegative arthritis are well known. B27 associated uveitis are thus often considered as an easy diagnosis. However, several aspects of the disease remain challenging and debated. This lecture will insist on the most controversial aspects of the work up, treatment, and management of ocular complications of B27 associated uveitis.
Behçet disease, sarcoidosis, VKH
Authors: ABU EL ASRAR A
Published: August 2012

Abstract not provided
Experimental glaucoma models
Authors: KALESNYKAS G
Published: August 2012

Purpose To introduce in vivo methods for experimental glaucoma research.

Methods Animal models with natural elevation of intraocular pressure (IOP) and genetic manipulation to raise IOP will be discussed. Experimental elevation of IOP in rats and mice will be presented in more detail.

Results Up to 30% of retinal ganglion cell (RGC) loss during a 3‐week period can be achieved with rat laser photocoagulation model. Similarly, experimental elevation of IOP in mice can result in up to 30% RGC axon loss in the optic nerve with a 6‐week follow‐up.

Conclusion The age and strain of animals should be considered in experimental glaucoma research.
Methods to study neuroprotection
Authors: ZACK DJ
Published: August 2012

Abstract not provided
Oxygen induced retinopathy (OIR) mouse model
Authors: UUSITALO‐JÄRVINEN H
Published: August 2012

Purpose To introduce mouse model for oxygen induced retinopathy (OIR).

Methods Newborn mice are exposed to 75 % oxygen at P7 for 5 days. High oxygen level leads to regression of retinal vasculature and large avascular areas of retina. At P12, upon return to normoxia avascular retinal areas become ischemic. Ischemia drives revascularization of the retina and formation of pre‐retinal neovascularization.

Results The rate of revascularization and the amount of pre‐retinal neovascularization can be analyzed and quantified from retinal flat‐mount preparations and cross sections.

Conclusion OIR model is a highly reproducible in vivo model for the studies on hypoxia driven angiogenesis.
Femtosecond laser and microkeratome preparation of ultrathin (UT) DSAEK Grafts, the six months clinical results
Authors: MURTA J , ROSA A , QUADRADO M , BRITO S , CARDOSO A
Published: August 2012

Purpose To evaluate the use of a femtosecond laser and a mechanical microkeratome to prepare ultrathin posterior corneal disks for Descemet stripping automated endothelial keratoplasty (DSAEK) and to assess associated visual results, disk thickness and endothelial cell loss.

Methods This clinical study involved ultrathin DSAEK tissue preparation used in 28 patients with endothelial dysfunction. The first cut was performed with an Intralase FS60 laser and the second cut with a Moria CBm 300‐ microkeratome. The thickness of the first cut was modified for each cornea to obtain a final graft thickness of 120 µm. Post‐op central graft thickness was performed with corneal laser tomography (Spectralis). Central endothelial cell density (ECD) was calculated before, 3 and 6 months after surgery.

Results Final graft thickness was 92.9+28.5 µm, 83.1+23.6 µm, 77.2+16.9 µm and 74.3+27.5 µm at one week, one three and six months post‐op, respectively. No loss of corneas due to irregular cuts or perforation during preparation. The mean BSCVA was 0.4, 0.5, 0.7 and 0.7(0.39, 0.35, 0.16 and 0.17 LogMAR) after one week, one, three and six months post‐op, respectively. A 26.3% and 31.2% endothelial cell loss was observed after 3 and 6 months of the surgery, respectively. Significant positive correlation between BCVA (logMAR) and central graft thickness at 1 and 3 months was observed (r=0.76,p=0.01; r=0.73,p=0.01) as well as between BCVA (logMAR) at 3 months and preoperative central graft thickness (r=0.82,p=0.007; Spearman correlation). Patients without bullous keratopathy achieved better visual outcome at 3 months (p=0.04, Mann‐Whitney test).

Conclusion Femtosecond laser and microkeratome can be used sequentially to prepare custom ultrathin DSAEK grafts with no loss of corneas. This procedure minimizes the variability inherent to microkeratomes and allows very quick recovery of visual acuity after posterior lamellar keratoplasty.
Endothelial cell viability of endothelial lenticules
Authors: THURET G , HE Z , CAMPOLMI N , HA THI BM , PISELLI S , DUMOLLARD JM , PEOC'H M , MURAINE M , TOUBEAU D , GAIN P
Published: August 2012

Purpose Despite concerns about the attrition of the post‐operative endothelial cell density (ECD), endothelial keratoplasty, whatever the method of lenticule preparation has gain popularity over penetrating keratoplasty because of a short/medium‐term favourable benefit/risk balance. Because the long and very long‐term issues may mostly depend on the endothelial cell (EC) pool brought by the graft, and because the supplementary handling necessary to cut the lenticules may stress EC, we focused our attention on the EC viability of endothelial lenticules

Methods Systematic review of the literature and experimental data from our laboratory

Results We indentified in PubMed, articles where EC viability was assessed after lenticule preparation, and those with post‐operative clinical data. Methods of EC assessment and interpretation were analysed. Experimental assessment using a specifically designed triple Hoechst/Ethidium/Calcein staining coupled with image analysis of the whole graft surface provide a precise objective determination of the viable ECD (vECD), the only which is important for the recipient.

Conclusion Almost all published series show that the preparation of endothelial lenticules trigger a significant EC loss. Reduction of initial ECD is liable to have long or very long‐term functional consequences, that remain to be investigate (maximal published follow‐up is only of 4‐5 years). Experimental data, especially the vECD, allow a precise quantification of the phenomenon and therefore comparison between different cutting techniques. There are strong bodies of evidence proving that we don’t graft as many EC as we think
Infectious keratitis in children
Authors: BREMOND‐GIGNAC D
Published: August 2012

Purpose To precise infectious keratitis in children that could be a severe pathology leading to visual impairment

Methods qrqrehehtjert

Results qerhjt

Conclusion qorgqrehg

Commercial interest
Infectious crystalline keratopathy and its management
Authors: DUA H
Published: August 2012

Abstract not provided