Estimating variability in placido-based topographic systems.

PURPOSE: To describe a new software tool for the detailed presentation of corneal topography measurements variability by means of color-coded maps. METHODS: Software was developed in Visual Basic to analyze and process a series of 10 consecutive measurements obtained by a topographic system on calibration spheres, and individuals with emmetropic, low, high, and irregular astigmatic corneas. Corneal surface was segmented into 1200 segments and the coefficient of variance of each segment's keratometric dioptric power was used as the measure of variability. The results were presented graphically in color-coded maps (Variability Maps). Two topographic systems, the TechnoMed C-Scan and the TOMEY Topographic Modeling System (TMS-2N), were examined to demonstrate our method. RESULTS: Graphic representation of coefficient of variance offered a detailed representation of examination variability both in calibration surfaces and human corneas. It was easy to recognize an increase in variability, as the irregularity of examination surfaces increased. In individuals with high and irregular astigmatism, a variability pattern correlated with the pattern of corneal topography: steeper corneal areas possessed higher variability values compared with flatter areas of the same cornea. Numerical data permitted direct comparisons and statistical analysis. CONCLUSIONS: We propose a method that permits a detailed evaluation of the variability of corneal topography measurements. The representation of the results both graphically and quantitatively improves interpretability and facilitates a spatial correlation of variability maps with original topography maps. Given the popularity of topography based custom refractive ablations of the cornea, it is possible that variability maps may assist clinicians in the evaluation of corneal topography maps of patients with very irregular corneas, before custom ablation procedures.     

Alcohol Outcome Expectancies Mediate the Relationship Between Social Anxiety and Alcohol Drinking in University Students: The Role of Gender

College alcohol drinking is a public health concern worldwide. A line of research indicates that higher social anxiety is associated with more severe college drinking. However, other studies reveal a protective role of social anxiety against alcohol drinking in college students. Attempting to reconcile contradictory findings, we examined the hypothesis that there are multiple antagonistic pathways that could explain the social anxiety-college drinking relationship. In addition, there may be individual difference variables that moderate these processes. Furthermore, it was expected that the processes could vary as a function of the alcohol drinking outcomes examined. Expectancy theory emphasizes the role of alcohol outcome expectancies in alcohol drinking. Thus, in the present study we tested whether global positive and negative alcohol outcome expectancies partially mediate the relationship between social anxiety, alcohol consumption, and alcohol-related problems in a sample of 245 university students. We also examined the moderating role of gender in these mediating processes. Results revealed parallel but oppositional processes. Higher social anxiety was associated with heavier alcohol drinking and more serious alcohol-related problems via stronger positive alcohol outcome expectancies. However, the mediating role of positive alcohol outcome expectancies varied as a function of gender. It appears that in female students the mediating effect of positive alcohol outcome expectancies was stronger than in male students. On the other hand, higher social anxiety had a protective role against alcohol consumption but not against alcohol-related problems via stronger negative alcohol outcome expectancies. Finally, there was an inverse direct relationship between social anxiety and alcohol consumption.     

Regurgitations in a Lamb with Acute Coenurosis-A case Report

Coenurosis is a disease of the central nervous system in sheep, caused by Coenurus cerebralis, the larval stage of Multiceps multiceps, which inhabits the small intestine of Canidae. A case of regurgitations in a 2.5 month old lamb with acute coenurosis is being reported. The lamb was presented with a sudden onset of ataxia and regurgitations for 10 days. The post-mortem examination revealed 4 immature C. cerebralis cysts between 0.5 and 1.5 cm in diameter located in the brainstem and cerebellum, and histopathological examination revealed multifocal pyogranulomatous meningoencephalitis, so a diagnosis of acute coenurosis was established. Thus, acute coenurosis should be included in the differential diagnosis of regurgitations in lambs.     

Seasonal variations of systemic lupus erythematosus flares in southern France

ObjectiveExposure to sunlight is one of the environmental factors involved in the pathogenesis of systemic lupus erythematosus. We investigated whether there is seasonal variation in the incidence of cutaneous and noncutaneous severe lupus flares in southern France.MethodsWe retrospectively reviewed clinical and biological data from all SLE patients hospitalized for a flare of the disease during a two year period in our centre and collected corresponding meteorological data from the official website of MeteoFrance.ResultsForty one patients, mean age 36.7 ± 13.8 years, were included. Twenty-six patients (63.4%) had kidney biopsy performed, showing in all cases proliferative nephritis, associated with membranous nephritis in 9 (22%). We found a clear seasonal pattern for overall lupus flares with 39% of flares occurred in Spring. Among patients without any cutaneous involvement, this seasonal pattern was still observed (p = 0.024). Patients under antimalarials presented flares significantly later in the sunny season than those without (respectively median in July versus May, p = 0.044). There were strong positive correlations between occurrence of lupus flares and maximum temperature increase (ρ = 0.87, p < 0.001), minimum temperature increase (ρ = 0.87, p < 0.001), and duration of sunshine increase (ρ = 0.78, p = 0.003). These correlations were also observed in patients with renal flares.ConclusionWe confirmed a seasonal pattern for lupus flares among patients living in Southern France, with most flares in spring, in correlation with an increase in temperature and duration of sunshine. A similar seasonal pattern was observed in patients with no cutaneous involvement and with visceral involvement.     

Transseptal use of high-density grid catheter for VT mapping and retrograde hemodynamic support with Impella pump in presence of Mitraclips

Journal of Interventional Cardiac Electrophysiology - We sought to establish the technical feasibility of VT-mapping with high-density catheters in patients with Mitraclips, requiring a hemodynamic...     

Diode-laser-induced cataract and iris atrophy as a complication of eyelid hair removal

PURPOSE: To caution about ocular risks of dermatologic diode laser, including cataract formation and iris atrophy. DESIGN: Observational case report. METHODS: A 63-year-old woman underwent diode epilation in the upper eyelid area without protective eye shields and experienced a sharp ocular pain during treatment of her left eye. She later presented with decreased vision in that eye and sensitivity to light. RESULTS: Iris atrophy and a nuclear cataract were seen on examination. In the absence of any such observations at previous eye examinations and of any contributory ocular history, these findings were attributed to the diode laser treatment. CONCLUSION: Diode laser epilation in the upper eyelid region could entail risks for intraocular structures, including cataractogenesis and iris atrophy.     

Recurrence of Fuchs marginal keratitis within a lamellar graft

We report a case of Fuchs marginal keratitis with a recurrence and spontaneous perforation on the lamellar graft. A constellation of marginal corneal infiltrates and stromal thinning under a pseudopterygium characterize this condition. Two years after an initial lamellar keratoplasty, the pathology recurred within the graft. A repeat lamellar keratoplasty was performed, this time combined with a conjunctival autograft.     

Prevalence,clinical correlates and treatment of permanent atrial fibrillation among the elderly: insights from the first prospective population-based study in rural Greece

To investigate the prevalence of permanent atrial fibrillation (AF), its clinical associated conditions and treatment status in the elderly population in rural Greece. 720 people (46.1% males) older than 65 years (mean age: 72.5 ± 5.7 years) living in four villages in rural Greece were screened with an electrocardiogram (response rate: 90.5%) for the presence of permanent AF. They underwent a physical examination, including blood pressure (BP) measurement, and body mass index (BMI) calculation, in addition to an interview about their medical history, physical activity, smoking habits, alcohol consumption and medication use. Subjects with AF for whom anticoagulants were contraindicated were identified and stroke risk stratification was performed using the CHADS2 algorithm. The prevalence of permanent AF was 5% (6.6% among men and 3.6% among women) and it increased with age. In the entire population, ECG evidence of myocardial ischaemia and ventricular premature beats were independently associated with the presence of permanent AF (OR 5.266; 95% CI 2.22–12.49, P = 0.0001 and OR 2.61; 95% CI 1.059–6.432, P = 0.037, respectively), while female sex was independently associated with the absence of the AF (OR 0.327; CI 0.147–0.729, P = 0.006). From those patients who were eligible for anticoagulation, 40.6% were treated with anticoagulants, 34.3% were given antiplatelets therapy and the rest received no antithrombotic treatment. This is the first prospective study demonstrating the prevalence, clinical correlates and treatment status of permanent AF in Greece. These results confirm the high prevalence of permanent AF among the elderly and underscore the issue regarding anticoagulants underutilization.