bluuebunny/crossref_metadata_2025 huggingface dataset:
Progenitor Cells Purging: Negative Selection
Authors: De Rosa L. , Montuoro A. , Pandolfi A. , Paladini U. , Lanti T. , Morara R. , De Laurenzi A.
Published: April 2018

Disease relapse after autologous bone marrow transplantation (ABMT) may arise from residual tumor in the recipient and/or from cancer cells that are reinfused. The aim of purging by negative selection is to remove tumor cells from the marrow without adversely affecting the engraftment potential of the normal cell. We report the results of a study on fifty-six patients (pts) with non Hodgkin's lymphoma or acute leukemia submitted to ABMT after immunomagnetobead (1MB) purging (11 pts), Maphosphamide purging (31 pts) and no purging (14 pts). The 1MB procedure involved one incubation of 3 monoclonal antibodies (CD10, CD19 and CD22) and two incubations with magnetic beads (Dynabeads M-450). The median recovery of mononuclear cells and CFU-GM was 40% and 45% after IMB purging and 84% and 5% after Maphosphamide purging respectively. The rate of leukocyte, neutrophils and platelets recovery following ABMT was similar in the three groups of pts, although platelet recovery was slow in patients received graft purged with Maphosphamide. Our study confirms the clinical feasibility of the IMB procedure, but only randomized studies will be able to definitibely address the question of the clinical utility of purging.
Therapeutic Thrombocytapheresis: A Review of 132 Patients
Authors: Adami R.
Published: April 2018

Therapeutic thrombocytapheresis has been used is an attempt to obtain a rapid cytoreduction in thrombocythemic patients, in order to prevent or reduce thrombosis or bleeding complications. Long-term cytoreduction has to be performed with chemotherapy.

We have treated with thrombocytapheresis 132 patients with increased platelet count (76 with thrombosis and/or bleeding) due to splenectomy, essential thrombocythemia and other myeloproliferative disorders: a comparative study has been perfomed to find a platelet count that could be helpful in preventing thrombotic and hemorrhagic complications and the role of diagnosis in predicting patient's risk.
Project of Computer-aided Management of Therapeutical Apheresis
Authors: Falco C. , Scarpato N. , Nappi G. , Formisano S.
Published: April 2018

The great increase in hemapheresis units activity that occurred during the last years caused the need for a computer-aided management (1, 2).

We present a project for a data base system able to manage therapeutical apheresis (3). The program consists of five sections.

a) Patient's file card: it allows to record anamnesis, examination and blood test results easily and under computer's guidance.

b) Choice of therapeutic protocol: Therapeutic protocol is fixed in this section (device to be used, apheretic method, plasma volume to be processed, blood tests before and after apheresis).

c) Procedures: It provides procedure's data entry and guides the operator during the treatment on the ground of therapeutical protocol.

d) Data processing: It allows statistics on data placed in the data base.

e) Registers: It includes both a general register and the possibility of search by disease, device and method.
Immunotherapy in Rheumatoid Arthritis: A Review
Authors: Vitali C. , Bombardieri M. Sciuto. S.
Published: April 2018

The starting mode of the pathological process in rheumatoid arthritis (RA) is the presentation of an unknown ‘rheumatoid’ antigen by an antigen presenting cell to the receptor on the CD4+ T cell. The activation of the CD4+ T cell, and consequently of the cytokine network, is the second step in the inflammatory process.

Immunosuppression in RA, obtained using either immunosuppressive drugs (azathioprine, cyclophosphamide, methotrexate), or physical procedures (lymphoapheresis, total lymphoid irradiation) acts aspecifically on all lymphocyte populations, and can induce a number of side effects, such as myelotoxicity and opportunistic infections.

Two promising new therapeutic approaches are being developed, one aimed at specifically reducing the proliferation of activated T cell clones, and the second designed to modulate the activity of the cytokines involved in the inflammatory process. Encouraging results have been so far obtained with: a) cyclosporine A, a somewhat more specific immunosuppressive agent; b) monoclonal antibodies against surface antigens (CD4, CDS, CD7, CD25, CD54) expressed on activated T cells; c) T cell vaccination; and finally (iv) recombinant cytokines, their agonists or antagonists. Besides their utility in the treatment of the disease, these new therapeutical procedures should also lead to a better understanding of pathological processes in RA.
Biocompatibility in Hemapheresis: New Materials
Authors: Russo G.E. , Fagiolo M. , Vitaliano E. , Caramiello M.S.
Published: April 2018

The development of new technologies implying the use of semidialytic syntetic membranes in therapeutic apheresis, lays stress also on the problem of biocompatibility. The first alterations of plasma proteins and of the immune system are observable 15 minutes after the beginning of the apheretic session. This may suggest that the acute clinical reactions observed during apheresis are related to biocompatibility. However, the first chronic side effects, comparable to those observed in hemodialysis, do not occur before 10-20 sessions. It is known, in fact, that even when inactive materials, such as the last generation membrane, are used, plasma exchange affects the immune system and may determine plasma protein alterations (protein film, erythrocytic damage, ADP release, beginning of the coagulation process, complement consumption). The whole system or the type of membrane, the involucre, the potting glue and the lines affect the interactions. The contact of blood with a foreign surface initiates a number of local reaction, with subsequent reactivity of the organism. The activation of the complement system, coagulative system, fibrinolytic system and callicrein-kinin system is therefore responsible for the cell functional modifications. It is necessary to underline the role of the membrane surface used, in that the activation of the complement system, of the gathering of platelets and of the cell activity modification all increase with the increase in surface. Biocompatibility may be affected not only by the membranes, but also by the substitution fluids and by the anticoagulant used.
Rapid Diagnosis of Bacterial Contamination of Blood: Comparison of Three Automated Microbial Detection Systems
Authors: D'Antonio D. , Iacone A. , Betti S. , Violante B. , Parruti G. , Piergallini A. , Di Gianfilippo R. , Catinella V. , Striani P. , Dell'Isola M. , Colaci G. , Torlontano G.
Published: April 2018

Rapid methods of determining microbial contamination are needed in suspecting contaminated banked blood or other blood products. In this study, we experimented contaminated blood units with 122 strains of bacteria and fungi. After innoculation, a comparison between ESP Blood Culture Sytem (Difco Laboratories Inc., Detroit Ml), BacT/Alert (Organon Teknica, Durham NC) and Bactec 9240 System was made for their efficiency in the detection of microbial contamination. Experimental data showed a diagnostic relevance of these automated systems with no significant differences in time detection of microbial contamination between the three methods under comparison.
Autotransfusion: 15 Years Experience at Rizzoli Orthopaedic Institute
Authors: Borghi B. , Bassi A. , De Simone N. , Laguardia A.M. , Formaro G.
Published: April 2018

The program of blood saving, result of 15 years of experience, includes predeposit (1977) hemodilution (1979) intra (1984) and postoperative (1985) salvage, careful intra and postoperative bleeding control, use of homologous transfusion only in case of intolerated anaemia even for 7-8g/dl Hb values. The use of autologous compared to homologous transfusion passed from 19% in 1984 to 62% in 1992. In 1992 in the surgical division of the 1st Anaesthesia and Intensive Care unit, 414 patients underwent prosthetic hip and knee surgery, 8% of these patients were homologously transfused.
Transfusion Therapy with Platelet Concentrates
Authors: Isacchi G.
Published: April 2018

At the end of 1960, the concept that platelet transfusion could reduce the death rate due to hemorrhage was confirmed by the reduction of life-threatening bleeding and prolonged survival in thrombocytopenic patients affected with acute leukemia and aplastic anemia. Thrombocytopenia is the result of an imbalance between platelet production and destruction: usually no bleeding problem will occur until circulating platelets fall below 20000/μl and even a platelet count of 5000/μl may be present in many patients without bleeding. Because of the high risk of alloimmunization in multiply transfused thrombocytopenic patients with random platelet concentrates, the main dilemma is the choice of strategy: “prophylactic”versus “therapeutic” treatment with platelet concentrates of cancer patients and the platelet count selected as the “transfusion trigger” for platelet support in patients without active bleeding. We describe our experience of 367 retrospective non-randomized leukemic patients transfused with platelet concentrates. A total of 225 patients (61.3%) received support therapy: the transfusions were administered prophylactically at a platelet count below 20000/μl in the group of patients with acute lymphoblastic leukemia (35% transfused) and acute myeloblastic leukemia (78% transfused). Only14 hemorrhagic episodes were observed in 148 patients receiving prophylactic platelets (9%), while 21 severe hemorrhages (27%) were documented in patients treated with therapeutic platelet concentrates. Several studies have concluded that maintaining the platelet count above 20000/μl was not justified in the majority of cancer patients. In the absence of more definitive data, a “transfusion trigger” of 10000/μl is selected for platelet transfusion support in leukemic non-bleeding patients receiving chemotherapy.
Child and Family Factors Associated With Child Maltreatment in Vietnam
Authors: Tran Nhu K. , van Berkel Sheila R. , van IJzendoorn Marinus H. , Alink Lenneke R. A.
Published: April 2018

This study aims to explore possible risk factors for child maltreatment in Vietnam by investigating the association of child and family factors with different types of child maltreatment (i.e., sexual abuse, physical abuse, emotional abuse, witnessing parental conflict, and neglect) and the occurrence of multiple types of child maltreatment. Cross-sectional data of 1,851 secondary and high school students aged 12 to 17 years (47.3% boys) in four provinces of Northern Vietnam were obtained using self-report questionnaires. Results indicated that the likelihood of emotional abuse, witnessing parental conflict, and experiencing multiple types of child maltreatment during lifetime increased with age. Boys had a higher risk than girls on lifetime sexual abuse, and past year and lifetime physical abuse. Living in a single parent family was the risk factor related to most types of child maltreatment including lifetime sexual abuse, neglect, and multiple types of child maltreatment, and both past year and lifetime witnessing parental conflict. Interestingly, low socioeconomic status (SES) and parental unemployment were associated with a decreased risk on experiencing emotional abuse in the past year and during lifetime, respectively. “Tiger parenting,” a parenting style observed frequently in East Asian parents, may be more common in families with high SES and might explain this finding. This study highlights the importance of prioritizing single parent families in parenting programs and implementing child maltreatment interventions early because of the risk on child maltreatment increased with age. More research on emotional abuse and “Tiger parenting” in Vietnam could clarify the association of emotional abuse with high SES and parental employment. Finally, the underlying mechanisms of the risk factors in Vietnam should be studied more to inform interventions.
Work and Female Breast Cancer: The State of the Evidence, 2002–2017
Authors: Engel Connie L. , Sharima Rasanayagam M. , Gray Janet M. , Rizzo Jeanne
Published: April 2018

The authors undertook a scoping review to assess the literature from 2002 to 2017 on the relationship between occupation and female breast cancer. Case–control, cohort, and meta-analytic studies suggest that women working as flight attendants, in medical professions, some production positions, sales and retail, and scientific technical staff are likely to have elevated risk of breast cancer. In addition, occupational exposures to night-shift work, ionizing radiation, some chemicals, job stress, and sedentary work may increase risk of breast cancer. Occupational physical activity appears to decrease risk. Workplace exposures to passive smoke and occupational exposure to nonionizing radiation do not appear to affect breast cancer risk. Some studies of occupational categories and workplace exposures indicate that risk may be modified by duration of exposure, timing of exposure, dose, hormone-receptor subtypes, and menopausal status at diagnosis. The compelling data from this review reveal a substantial need for further research on occupation and breast cancer.
Good Catch! Using Interdisciplinary Teams and Team Reflexivity to Improve Patient Safety
Authors: Reiter-Palmon Roni , Kennel Victoria , Allen Joseph , Jones Katherine J.
Published: April 2018

Interdisciplinary teams play an important role implementing innovations that facilitate the quality and safety of patient care. This article examined the role of reflexivity in team innovation implementation and its association with an objective patient safety outcome, inpatient fall rates (a fall is an unintended downward displacement of a patient’s body to the ground or other object). In this study, we implemented, supported, and evaluated interdisciplinary teams intended to decrease fall risk in 16 small rural hospitals. These hospitals were part of a collaborative that sought to increase knowledge and facilitate reflexivity about fall event reporting and fall risk reduction structures and processes. We assessed team reflexivity at the start and at the end of the 2-year intervention and innovation implementation at the end of the intervention. The 16 hospitals reported objective fall event data and patient days throughout the project, which we used to calculate comparative rates for assisted, unassisted, and injurious falls. The results suggest that teams benefited from the intervention, increasing reflexivity from the start of the project to the end, which was related to innovation implementation and decreases in fall rates. Theoretical and practical applications of the results are discussed.
An Assessment of the Impact of Just Culture on Quality and Safety in US Hospitals
Authors: Edwards Marc T.
Published: April 2018

In pursuit of high reliability, numerous organizations have promoted Just Culture, but its impact has never been assessed. This report combines data from a longitudinal survey–based study of clinical peer review practices in a cohort of 457 acute care hospitals with 43 measures from the Hospital Compare database and interprets them in relation to the long-term trends of Agency for Healthcare Research and Quality (AHRQ) data on the Hospital Survey of Patient Safety Culture. In all, 211 of 270 respondents (79%) indicated that their hospital has adopted Just Culture. More than half believe that it has had a positive impact. Just Culture implementation and its degree of impact are associated with somewhat better peer review process, but not with objective measures of hospital performance. Non-Punitive Response to Error has consistently been the lowest scoring category (45% positive) in the AHRQ database. Widespread adoption of Just Culture has not reduced reluctance to report or the culture of blame it targets.
Profile of Persons With Epilepsy Receiving Home Care Services
Authors: Kehyayan Vahe , Hirdes John P.
Published: April 2018

The objective of this study was to describe the profile of persons with epilepsy (PWE) receiving home care to understand their needs and impact on health care. In this cross-sectional study, sociodemographic, psychosocial, and health characteristics of PWE 60 years of age and above were compared with PWE in the below 60 years age (the comparison) group. Relative to the comparison group, the aged 60 years and above group was more likely to have health and mental health issues, cognitive impairment, functional dependence, psychosocial needs, and health care resource utilization. This study showed that PWE receiving home care services are greatly affected by social, functional, and health issues. Future studies are needed to further explore the burden of PWE on caregivers and health care systems compared with nonepilepsy groups.
Comparing Strategies for Recruiting Small, Low-Wage Worksites for Community-Based Health Promotion Research
Authors: Hammerback Kristen , Hannon Peggy A. , Parrish Amanda T. , Allen Claire , Kohn Marlana J. , Harris Jeffrey R.
Published: April 2018

Background. HealthLinks is a workplace health promotion program developed in partnership with the American Cancer Society. It delivers a package of evidence-based interventions and implementation support to small worksites in low-wage industries. As part of a randomized, controlled trial of HealthLinks, we studied approaches to recruiting these worksites. Aims. This study aims to guide future recruitment for community-based worksite health promotion interventions by comparing three approaches, including leveraging relationships with community partners. Method. We recruited 78 small, low-wage worksites in King County, Washington, to participate in the trial via three approaches: phone calls to companies on a purchased list (“cold”), phone calls to a list of eligible companies provided by a health insurer (“lukewarm”), and personal referrals from local health insurers and brokers (“warm”). Eligible and interested worksites received an in-person visit from researchers and completed additional steps to enroll. Results. Of the worksites screened and deemed eligible, 32% of the “cold” worksites enrolled in HealthLinks, as did 48% and 60%, respectively, of the “lukewarm” and “warm” worksites. Compared with “warm” worksites, “cold” worksites were twice as likely to be ineligible. Discussion. Two distinct factors help explain why “warmer” worksites were more likely to enroll in HealthLinks. First, eligibility was significantly higher among warmer referrals. Second, most of the warm-referred worksites eligible for the study agreed to meet in person with the project team to hear more about the project. Conclusions. “Warmer” recruitment approaches yielded higher recruitment. Leveraging relationships with community partners can help researchers identify and successfully recruit small, low-wage worksites.
Pituitary Apoplexy in an Ectopic Pituitary Tumour
Authors: O'Connor G. , Dinn J. , Farrell M. , Phillips J. , Stack J. , Eustace P.
Published: April 2018

A case report of a patient with unilateral visual loss, due to infarction in an ectopic pituitary tumour, is presented. Good return of vision followed surgical removal of the tumour
Efficacy of Norfloxacin in Bacterial Conjunctivitis
Authors: Huber-Spitzy V. , Arocker -Mettinger E. , Baumgartner I.
Published: April 2018

We investigated the efficacy and safety of norfloxacin 0.3% ophthalmic solution in 120 patients with bacterial conjunctivitis or blepharitis. Patients were selected for the study if they showed conjunctival hyperemia and at least three of the following criteria: a) symptoms of a surface ocular infection; b) a purulent discharge; c) crusting of the eyelids, and d) thickened, red lid margins. After taking a specimen for culture from the conjunctiva or skin-lash margin, the test drug was administered to the infected eye every two hours for one day, then 4 times daily for one week. Of the 120 patients who entered the study, 84.1% were cured. No serious adverse reactions occurred.
Bilateral Pigmented Retinopathy following Measles: Long-Term Follow-Up and Possible Association with Keratoconus
Authors: Peduzzi M. , Torlai F. , Delvecchio G.
Published: April 2018

A case of pigmentary retinopathy following measles is presented with follow-up of 24 years. A 29-year-old man complained of almost complete blindness during measles infection at the age of 5 (1966). Ophthalmoscopy revealed retinal edema with pallor of the optic disc and in a few months pigment alterations gave the fundus a salt-and-pepper appearance. In 1974 and 1985 a pigmentary retinopathy was present with optic atrophy and typical bone corpuscle deposits, and marked impairment of visual function.

In 1990 (i.e. 24 years after the onset of symptoms) the fundus shows pigmentary degeneration with optic atrophy and narrowed vessels, ERG is extinguished and visual fields and dark adaptation cannot be recorded owing to amaurosis. The patient also present bilateral keratoconus. The possible association between these two entities, which to our knowledge has not been previously reported, is discussed.
Choroidal Granuloma Caused by Atypical Mycobacterium in a Patient with AIDS: A Case report
Authors: Cagini C. , Fiore C. , Pasticci M.B. , Menichetti F. , Pauluzzi S.
Published: April 2018

The case presented is a chorioretinal granuloma in a patient with AIDS. The neoformation appeared to be caused by atypical mycobacterium, although it was not possible to isolate the germ. The chorioretinal infection caused by atypical mycobacterium in patients with AIDS occurs very rarely and has so far been described only as a post-mortem finding.
Improvement of Siderotic ERG
Authors: Kuhn F. , Witherspoon C.D. , Skalka H. , Morris R.
Published: April 2018

For fear of endophthalmitis and siderosis, ferrous intraocular foreign bodies are usually removed as soon as they are discovered; markedly reduced, siderotic ERG changes are considered permanent. We report a patient who presented with a chronically retained intravitreal foreign body and significant clinical as well as electrophysiologic signs of siderosis. Only 3 months after surgery, the ERG showed almost complete recovery. If siderosis is not present, adequate and regular follow-up examinations may in certain cases substitute for immediate removal of chronically retained intraocular foreign bodies.
The Safety and Efficacy of Topical Norfloxacin Compared with Placebo in the Treatment of Acute, Bacterial Conjunctivitis
Authors: Miller I.M. , Wittreich J. , Vogel R. , Cook T.J. ,   The Norfloxacin-Placebo Ocular Study Group, Archer K.F. , Bellakhdar N. , Castan R. , Fisher S.J. , Gordon J.M. , Horwitz B.L. , Kamenetzky S.A. , Karp D.W. , Koby M.N. , Laibovitz R.A. , Long D.A. , Rafi M. , Shulman D.G. , Yolles E.A.
Published: April 2018

Two hundred and eighty-four patients with acute conjunctivitis were enrolled in a double-masked study comparing norfloxacin ophthalmic solution with placebo. The proportion of patients who were clinically improved after 5 days treatment was 88.1 % in the norfloxacin group and 71.6% in the placebo group (p<0.01). The proportion of patients who had all organisms eradicated, including the coagulase-negative staphylococci, after two to three days treatment was 52.7% for norfloxacin and 23.9% for placebo (p<0.01) and 64.7% and 26.3% (p<0.01) respectively when the coagulase-negative staphylococci were not included. Adverse experiences occurred in 4.2% of the patients receiving norfloxacin compared to 7.1% of the placebo patients. None of the adverse experiences was serious.
The Ciliary Body - The Third Organ Found to Synthesize Indoleamines in Humans
Authors: Martin X. D. , Malina H. Z. , Brennan M. C. , Hendrickson Ph. H. , Lichter P. R.
Published: April 2018

Indoleamines are associated with circadian rhythms in pineal gland and retina. Because the ciliary epithelium has an embryonic origin similar to that of pineal gland and retina, and intraocular pressure shows circadian variations, indoleamines were searched for in aqueous humor and ciliary body in humans. In aqueous humor, serotonin, 6-hydroxymelatonin, and melatonin were simultaneously detected and measured using high-performance liquid chromatography with electrochemical detection. The concentration was 48.7±10.9 ng/ml for serotonin, 0.47±0.8 ng/ml for melatonin, and 13.9±7.7 ng/ml for 6 hydroxy melatonin. In ciliary bodies from freshly enucleated human eyes, tryptophan, 5-hydroxytryptophan, serotonin, and 5-hydroxyindoleacetic acid were detected using high-performance liquid chromatography with simultaneous fluorescence- and electrochemical detection. Finally, the enzymatic activities of arylalkylamine N-acetyltransferase (NAT) and hydroxyindole-O-methyltrans-ferase (HIOMT), enzymes indispensable in the synthesis of melatonin, were measured. The NAT activity was 273±25 pmol/mg protein/hour and that of HIOMT, 13520±50 pmol/mg protein/hour in ciliary body. Comparison of these activities (NAT versus HIOMT) permits the suggestion that NAT is a limiting enzyme in serotonin metabolism in this tissue. These findings indicate that a circadian rhythm of indoleamines exists in human aqueous humor and that the human ciliary body is the third organ, after the pineal gland and the retina, found to synthesize indoleamines in humans.
Dacryo-Fornix-rhinostomy with Two Flaps
Authors: Del Castillo J. Murube , Baradas A. Martinez , King J. Hernandez , Vilella M. E. Cruz , Caycedo M. Bahamon
Published: April 2018

The two most frequent sites of obstruction of the lacrimal pathways are under the lacrimal sac, in the ductus lacrimonasalis, and over the lacrimal sac, in the canaliculi. The obstruction of the first type already has a satisfactory solution with the different forms of dacryo-cysto-rhinostomies. Obstruction of the second type has a satisfactory resolution only in a limited number of cases. For patients in whom current treatment methods are unsuccessful, a technique of dacryo-fornix-rhinostomy is presented, consisting in opening a new pathway between the infero-medial conjunctival cul-de-sac and the atrial part of the nasal cavity. A piece of bone is removed from the antero-lateral wall of the atrium nasi, and the bottom of the infero-medial conjuctival fornix is opened to the precedent wound. The exposed nasal mucosa is cut into two flaps, one being sutured to the posterior lip, and the other to the anterior lip of the conjuctival wound. A conformer is maintained in the new path for several weeks. The new path has an almost vertical trajectory, making the flow of tears very easy. Blinking and the movements of the eyes have a pumping effect.
Intrachoroidal Dye Leakage in Indocyanine Green Fundus Angiography after Experimental Commotio Retinae
Authors: Miki T. , Kitashoji K. , Kohno T.
Published: April 2018

Dye leakage in sodium fluorescein (FLUO) fundus angiography indicates damage to the blood-retinal barrier. However, dye leakage in indocyanine green (ICG) fundus angiography does not mean the same, because of the larger molecular size of the dye and impermeability of the choroidal vessels to it. The possibility of dye leakage in ICG angiography has not yet been revealed in an experimental study in which the blood-retinal barrier is undamaged. We report here that intrachoroidal dye leakage may occur in ICG angiography in an experimental model of the traumatic retinal opacity of the rabbit eye, even when the blood-retinal barrier is undamaged. This mechanism of dye leakage in ICG angiography is quite different from the leakage of FLUO angiography. Pathological choroidal vessels with increased permeability, such as choroidal neovascularization under the retinal pigment epithelium, can be observed using ICG angiography.
Choroidal Angiography with Indocyanine Green Dye: Absorption and Fluorescence Techniques
Authors: Panzardi G. , Donati M.C. , Longobardi G. , Poggi P.
Published: April 2018

The results of choroidal indocyanine green (I.C.G.) angiography by the absorption and fluorescence techniques are compared. Both techniques were done using the same apparatus, a modified fundus camera, an image intensifier coupled to a solid-state video camera and a U Matic video recorder. Both were performed with the same dye dilution in the same patients, at a 24-hour interval. The light source was the unmodified 50 Watt halogen light bulb of the fundus camera. The angiograms obtained by the absorption and the fluorescence techniques refer to the same chorioretinal area and the same angiographic phase. Comparison of all the angiograms shows that I.C.G. fluorescence angiography provides a better resolution of choroidal vascular details than the absorption technique.
Binocular Vision Regained after Monocular Traumatic Aphakia by Wearing Contact Lenses
Authors: Bilgin L. Közer , Pakter S. , Sezen F. , Tutkun I. Tugal
Published: April 2018

In this study 35 patients with monocular traumatic aphakia were enrolled to document the degree of binocular vision gained by optical correction with contact lenses. The most important factors in achieving binocular vision were the interval between formation of the traumatic cataract and surgery and between the operation and starting wearing contact lenses. There was a statistically significant correlation between these two intervals and the achievement of near stereopsis and normal visual acuity.
Recurrent Herpetic Keratitis during Topical Acyclovir Application
Authors: Soriano J.M. , Funk J. , Janknecht P. , Matz B.
Published: April 2018

Dentritic herpetic keratitis developed in a 49-year-old patient during topical acyclovir treatment. A positive herpes simplex culture was obtained. After acyclovir was replaced by trifluorthymidine and interferon, the dentritic lesion disappeared and herpes simplex culture became negative. Six months later a carcinoma of the larynx was diagnosed. The acyclovir-resistant herpetic keratitis may be associated with the carcinoma because resistant herpes simplex virus strains are predominantly described in patients suffering from immune deficiency.
Influence of Carteolol and Timolol on IOP and Visual Fields in Glaucoma: A Multi-Center, Double-Masked, Prospective Study
Authors: Flammer J. , Kitazawa Y. , Bonomi L. , Mills B. , Fsadni M. , Dorigo M.T. , Shirato S. , Journel B. , Chavy B. , Chevallier B. , Guillou F. , Valtot F. , Prünte CH.
Published: April 2018

The influences of Carteolol and Timolol eye drops on intraocular pressure (IOP) and visual fields were compared in a multi-center, double-masked, prospective study. Two-hundred and forty eyes of 120 patients were initially included in the study, and 142 eyes of 72 patients fulfilled all the criteria for final statistical analysis. Both drugs significantly reduced IOP. The visual fields in both treatment groups did not change during one year of treatment. In both groups some patients improved slightly, and others deteriorated slightly. This indicates that locally applied beta-blockers may efficiently stop further progression of visual field defects in cases with increased IOP and early visual field damage. There was no difference between Carteolol and Timolol in this regard. The side effects were minimal, and there were no differences in their frequency or intensity in the two treatment groups.
Relationship Cataract Density and Visual Field Damage
Authors: Yao K. , Flammer J.
Published: April 2018

In interpreting visual field results, two questions arise: a) what type of visual field damage is produced by cataract, and b) can the influence on the visual field somehow be predicted? To answer these questions, cataract density was quantified with the Opacity Lens Meter (OLM) 701, and visual field tests were done before and after IOL-implantation surgery with Octopus Program G1 in 58 eyes of 58 patients (mean age 71±8 years) with cataract but with no other detectable ocular diseases. The average improvement of mean damage (MD) after surgery was 5.4 dB, and that of D (20) (defect 20 on the Bebie Curve) was 5.7 dB. The improvement of the visual fields was, as expected, statistically highly significant (p<0.0001). The corrected loss variance (CLV), however, increased on the average only by 2.5 dB2, which was not significant. The predictive value of the OLM reading for opacity-induced MD depends on the type of cataract. It is good for cortical and nuclear cataracts but poor for posterior subcapsular opacifications. The overall predictive value (R = 0.66) is, nevertheless, better than for preoperative visual acuity (R = -0.54). If OLM and visual acuity (VA) are considered together, the predictive value is slightly higher (R = 0.72). Thus, optical density influences on visual field performance can be substracted from general visual field results.
Clinical Correlations in Hiv-1 and Hiv-2 Infected Patients
Authors: Monteiro-Grillo M. , Sousa A.P. , Galvao J. , Yueh M. , Neves C. , Ribeiro-Da-Silva J.
Published: April 2018

In Portugal, the prevalence of human immunodeficiency virus type 2 (HIV-2) seropositivity is higher than in other European countries or North America. Recent literature data points out a possible difference on the pathogenic potential and on the natural history of HIV-1 and HIV-2, suggesting a lower virulence of HIV-2. Facing these hypothesis and the increasing number of HIV-2 cases, we analysed two infected groups HIV-1 and HIV-2, trying to correlate the ophthalmologic lesions present in both populations and searching for a difference in the clinical presentation of the ocular disorder. We studied prospectively 214 patients with HIV infection at several stages, 83% HIV-1 and 17% HIV-2. Ocular manifestations were present in both populations with a significant prevalence in HIV-1 (48%), compared to HIV-2 (19%) (p<0.005). The ophthalmologic pathology found, particularly noninfectious retinopathy, infectious retinitis and neuro-ophthalmic disorders, were considered important for the disease's diagnosis and prognosis. All these ophthalmic findings were present in the HIV-1 population. In the HIV-2 group the most frequent lesion was noninfectious retinopathy. Within each group, HIV-1 and HIV-2, the comparison of the survival between AIDS patients with and without ocular lesions, revealed a significant shorter survival time in those with ocular pathology (p<0.001 and p<0.05). There seems to exist a certain analogy in clinical expression in both groups, although it is possible to admit a lower severity in ocular involvement in patients infected by HIV-2.
Intraocular Levels of Cefuroxime in Inflamed Rabbit Eyes
Authors: Koul S. , Philipson A. , Philipson B.T. , Arvidson S.
Published: April 2018

The pharmacokinetics of cefuroxime was studied in the inflamed rabbit eye employing subconjunctival, intravitreal and combined intravitreal-intravenous routes of administration to study the intraocular levels and the duration of minimum inhibitory concentrations (MIC) of the antibiotic in the vitreous and in the aqueous. A standard inoculum of viable S. aureus was injected into the vitreous of 36 pigmented rabbits to establish experimental endophthalmitis. A biological method was used for the antibiotic assay. Penetration of systemically and subconjunctivally administered-cefuroxime into the inflamed vitreous was poor. Intraocular inflammation increased the clearance of the intravitreally injected cefuroxime. A dose of 75 mg subconjunctivally produced levels in the aqueous far exceeding MIC for over six hours. Penetration of intravitreally injected cefuroxime into the aqueous was poor, inconsistent and short lasting. Following a single intravitreal injection of 1000 μg cefuroxime, levels exceeding the MIC for common ocular pathogens persisted in the vitreous for at least 24 hours but supplementation with intravenous cefuroxime neither increased the intraocular levels nor delayed the clearance of the intravitreally injected antibiotic.
Evaluation of Efficacy and Safety of Ciprofloxacin Ophthalmic Solution versus Chloramphenicol
Authors: Power W.J. , Collum L.M.T. , Easty D.L. , Bloom P.A. , Laidlaw D.A.H. , Libert J. , Sangers D. , Wuokko M. , Saksela T.
Published: April 2018

The results of this clinical study demonstrate that ciprofloxacin ophthalmic solution 0.3% is as safe and as effective as 0.5% chloramphenicol ophthalmic solution in the treatment of conjunctivitis and blepharitis of bacterial aetiology. Both agents achieved microbiological improvement rates in excess of 90% after 1 week's treatment. On ciprofloxacin 93.5% of patients were judged clinically cured or improved versus 84.6% on chloramphenicol after 1 week. There were no serious adverse affects. One patient in each group suffered drug-related side-effects (chemosis, erythema) which resolved on discontinuation or changing of therapy. Cirpofloxacin is not associated with the rare, but serious, side effect of aplastic anaemia which is associated with chloramphenicol use. On the evidence of this study ciprofloxacin would appear to be an appropriate agent for general use as a topical ophthalmic formulation.
Hyperbaric Oxygenation Combined with Nifedipine Treatment for Recent-Onset Retinal Artery Occlusion
Authors: Beiran I. , Reissman P. , Scharf J. , Nahum Z. , Miller B.
Published: April 2018

We describe the results of early hyperbaric oxygenation combined with nifedipine treatment for central retinal artery occlusion, and explain the results pathophysiologically. We report four cases in which hyperbaric oxygenation therapy was applied in combination with nifedipine, eyeball massage, and glycerol for the treatment of central retinal artery occlusion. In two of the cases in which therapy was started less than 100 minutes after the acute onset of visual loss and one case in which therapy was started during the course of central arterial occlusion, considerable improvement in visual acuity was observed, while in the fourth case in which therapy was started six hours after the acute onset of visual loss, no improvement appeared. We conclude from these results that hyperbaric oxygenation therapy has a beneficial effect on the final visual outcome of central retinal artery occlusion, provided it is applied early enough. Further investigation is needed to fully define the nature and terms of this beneficial effect.
Noonan's Syndrome with Keratoconus and Optic Disc Coloboma
Authors: Ascaso F.J. , Del Buey M.A. , Huerva V. , Latre B. , Palomar A.
Published: April 2018

We report the case of a 14-year-old girl with multiple findings characteristic of Noonan's syndrome, including short stature, mild mental retardation, facial, skeletal and renal abnormalities. In addition, ophthalmic examination revealed a keratoconus in the left eye and a right optic disc coloboma. To date, only two cases of Noonan's syndrome with keratoconus have been reported, and this is the second case of this syndrome with optic disc coloboma. To our knowledge, this is the first report of Noonan's syndrome associated with unilateral keratoconus and contralateral optic disc coloboma. In view of the large number of patients with Noonan's syndrome reported to date and the rarity of these ocular abnormalities, it is most likely that this association is fortuitous. Ocular findings reported in patients with Noonan's syndrome are reviewed.
Prognostic Value of Visual Evoked Responses in Childhood Amblyopia
Authors: Henč-Petrinović L. , Deban N. , Gabrić N. , Petrinović J.
Published: April 2018

We assessed the possible clinical utility of pattern reversal visual evoked potentials in predicting the success of pleoptic treatment. Thirty amblyopic children –- 16 strabismic, 11 anisometropic and three of refractive type (in all cases the amblyopia was monocular) –- and ten children without amblyopia (control group) were examined by conventional psychometric methods. Visual evoked potentials (VEP) to pattern reversal stimulation were also recorded. The amblyopic group was treated with occlusion of the preferred eye for three to six months. Psychometric and VEP tests were repeated in 15 amblyopic children after the treatment. The pre-treatment VEP amplitude side-differences (between amblyopic and better fellow eye) were significant, with first positive wave, P1, being invariably lower on the amblyopic side. We correlated the side-differences in visual acuity with the corresponding side-differences in amplitude and latency of the P1 wave. In the former the correlation coefficient was r = 0.47 (p<0.01), and in the latter r = 0.65 (p<0.01). Latency was prolonged in the eyes with significantly reduced visual acuity in which the wave form was also typical for amblyopia. We then correlated the difference between pre- and post- treatment visual acuity of the amblyopic eye with the pre- and post-treatment difference in amplitude (correlation coeff. r-0.51 (p=0.05)) and latency of the P1 wave (correlation coeff. r=0.40 (p>0.05)). Finally, by correlating the pre- and post-treatment difference in visual acuity with the pretreatment P1 amplitude and latency (for the former, there was no regular interdependence, and for the latter r=-0.64 (p=0.01)), we tried to test our assumption that an alteration of VEP indicates poor visual rehabilitation of the amblyopic eye. Although the correlation was not unanimous, this study showed that VEP recording may still serve as an extra aid in predicting the therapeutic outcome in amblyopic children.
Proteins in the Subretinal Fluid
Authors: Berrod J.P. , Kayl P. , Rozot P. , Raspiller A.
Published: April 2018

This study was designed to improve the understanding of the mechanisms that govern the origin of retinal detachment (RD) by examining the quantitative composition of proteins in the subretinal fluid (SRF). Inflammation proteins and immunoglobulins (Ig) were titrated from SRF and sera in 25 patients with RD The following concentrations were found in SRF: total proteins 16 g/l; albumin 12.6 g/l; pre-albumin 0.37 g/l; transferin 1.8 g/l in 68% of cases; haptoglobin and alpha 2 macroglobin were present in only one SRF: alpha 1 antitrypsin 0.86 g/l in 48%; orosomucoid 0.57 g/l in 32%; IgG 2 g/l in 52%; Ig A 0.17 g/l in 88% and IgM 15.9 mg/l in 56%. Correlations were found between the duration of detachment and the concentration of total proteins (p < 0.01). The extent of RD was correlated with the concentration of IgG or IgA in the SRF (p < 0.01). These findings suggest that the correlation between the Ig concentration and the extent of RD is an argument for the participation of choriocapillaris in the genesis of SRF
Accuracy of the Potential Acuity Meter in Predicting the Visual Outcome in Cases of Cataract Associated with Macular Degeneration
Authors: Alio J.L. , Artola A. , Ruiz-Moreno J.M. , Ismail M.M. , Ayala M.J.
Published: April 2018

In order to ascertain the accuracy and specificity of the Potential Acuity Meter (PAM) in the preoperative evaluation of likely postoperative visual acuity in cases of cataract associated with age-related macular degeneration (ARMD), we studied the results in 130 cases, 54 of whom had preoperatively proved or suspected ARMD associated with a cataract. All of them were operated with extracapsular extraction and implantation of an intraocular lens (IOL), and final visual acuity was established when all the patients were visited three months postoperatively. A positive linear correlation was found between normal ocular fundus and PAM prediction (r = 0.77), and in the group of patients with preoperatively confirmed ARMD (r = 0.77). No difference was found between the preoperative PAM estimation and the final visual acuity in both groups. The PAM prediction was less accurate in cases with doubtful preoperative ARMD (r = 0.58) for whom showed PAM the highest score of false negatives in favor of the final visual acuity. Our results show that PAM is a reliable clinical technique for the prediction of visual results after cataract surgery in cases with preoperatively proved or doubtful macular pathology. To the best of our knowledge, this is the first report regarding the sensitivity and specificity of the PAM in diseased or suspicious maculas associated with cataract.
Bilateral Optic Neuropathy Associated with the Crest Variant of Scleroderma
Authors: Boschi A. , Snyers B. , Lambert M.
Published: April 2018

We report a case of bilateral optic neuropathy associated with the CREST syndrome, a variant of scleroderma. Immunosuppressive therapy achieved significant improvement of the visual symptoms for two years. The pathophysiological mechanisms underlying this unique association remain unclear.
Idiopathic Canthaxanthine Retinopathy
Authors: Sharkey J.A.
Published: April 2018

An unusual case of canthaxanthine retinopathy is described. The usual aetiological factors were absent, ingested dietary canthaxanthine is implicated as a possible cause.
The Efficacy of 0.75% Bupivacaine with ph Adjustment and Hyaluronidase for Peribulbar Blockade: The Incidence of Prolonged Ptosis
Authors: Mather C. , Smith J. Hayden , Bloom P.A.
Published: April 2018

A prospective, double masked, randomised study was performed to compare the speed of onset of peribulbar anaesthesia using pH adjusted 0.75% bupivacaine, with and without the addition of hyaluronidase. No significant difference in speed of onset occurred due to the addition of hyaluronidase. There were 7 cases of post operative ptosis in the study group, including 1 case of orbital apex syndrome and 2 cases of transient 3rd nerve palsy. This incidence of post operative ptosis using pH adjusted 0.75% bupivacaine was statistically significantly greater than in a matched control group who received a 50:50 mixture of 1% lignocaine and 0.5% bupivacaine with hyaluronidase (p < 0.05). The possible causes of this increased incidence of post operative ptosis are discussed.
Efficacy of Collagen Shields after Extracapsular Cataract Extraction
Authors: Menchini U. , Lanzetta P. , Ferrari E. , Soldano F. , Vita S.
Published: April 2018

The efficacy of presoaked porcine collagen shields was compared with subconjunctivally injected corticosteroids and antibiotics in reducing ocular inflammation after ECCE with IOL implantation, and signs of reduced oxygen delivery to the cornea were assessed. Fifty eyes of fifty patients were recruited. At the end of surgery 25 eyes (group 1) received a 24-h shield presoaked with 0.1% betamethasone disodium phosphate and 0.5% netilmycin. The other 25 eyes (group 2) received 1 mg betamethasone disodium phosphate and 250 mg piperacillin as a subconjunctival injection. The eyes were then taped closed. Inflammatory parameters (anterior chamber flare, fibrin, folds of Descemet's membrane, corneal edema) and tolerability of the delivery system (pain, itching) were evaluated 24 h after surgery. None of the patients lost the shield and the collagen devices were well tolerated. Groups 1 and 2 showed no significant differences in the parameters considered. There was, however, transient, slight diffuse superficial corneal edema in 24% of group 1 and 4% of group 2, raising the question of inadequate oxygen transmission through collagen shields under closed lids. The results suggest that collagen shields used with the right drug solution have no significant adverse effect and may be a less invasive alternative to subconjunctival injection.