The effect of systemic erythropoietin and oral prednisolone on recent-onset non-arteritic anterior ischemic optic neuropathy: a randomized clinical trial

Graefe's Archive for Clinical and Experimental Ophthalmology - To evaluate the effect of systemic erythropoietin, as well as oral steroids, in the management of recent-onset non-arteritic...     

Incidence of pressure ulcers in intensive care units and direct costs of treatment: Evidence from Iran

Background and objective

Pressure ulcer (PU) is one of the important and frequent complications of hospitalization, associated with high treatment costs. The present study was conducted to determine the incidence of PU and its direct treatment costs for patients in intensive care unit (ICU) in Iran.

Intraindividual comparison of histopathological diagnosis obtained by stereotactic serial biopsy to open surgical resection specimen in patients with intracranial tumours

Background

There are concerns in the literature about the accuracy of histopathological diagnosis obtained by stereotactic biopsy in patients with brain tumours. The aim of this study was to analyse intraindividually the histopathological accuracy of stereotactic biopsies of intracerebral lesions in comparison to open surgical resection.

Materials and methods

Between 2007 and 2011 a total of 635 patients underwent stereotactic serial biopsy in our department. Among these patients we identified 51 patients, who underwent magnetic resonance (MR) based stereotactic biopsy and subsequent open resection within 30 days. Mortality and morbidity data as well as final histopathological diagnoses of both procedures were compared with regard to tumour grade and tumour cell type. Patients with discrepancies between the histological diagnosis obtained by biopsy and open resection were classified into three subgroups (same cell type but different grading; same grading but different cell type and different grading as well as different cell type).

Results

The mean number of tissue samples taken by stereotactic serial biopsy from each patient was 12 (range 7–21). Minor morbidity was 6% and major morbidity was 14% after open surgery compared to no morbidity after stereotactic biopsy. Mortality was 2% after stereotactic biopsy (one patient died after stereotactic biopsy as a result of a fatal bleeding) compared to 0% in the resection group. Silent bleeding rate without any clinical symptoms was 8% in the biopsy group. A complete correlation of histopathological findings between the biopsy group and the resection group was achieved in 76% and was increased to 90% by analyzing clinical and neuroradiological information. In patients with recurrence the correlation was higher (94%) than for patients with primary brain lesions (67%). The discrepancies between the open resection group and biopsy group were analysed.

Conclusion

Stereotactic MR guided serial biopsy is a minimal invasive procedure with low morbidity and high diagnostic accuracy for diagnosis and grading of brain tumours. Diagnostic accuracy of stereotactic biopsy can be enhanced further by careful interpretation of neuroradiological and clinical information.     

玻璃体腔组织纤溶酶原激活剂治疗玻璃体黄斑粘连

目的：评估仅玻璃体腔注射组织纤溶酶原激活剂(TPA)对玻璃体黄斑牵引以及玻璃体腔注射TPA和贝伐单抗对视网膜血管疾病的改善作用。

方法：前瞻性研究。对24例24眼患者进行干预性系统研究。其中5眼玻璃体黄斑牵引综合征(VMT),19眼视网膜血管疾病包括：糖尿病黄斑水肿(DME)眼,糖尿病性玻璃体出血(VH)眼,视网膜中央静脉阻塞(CRVO)和新生血管年龄相关性黄斑变性眼(AMD)。在注射前及注射1mo后分别进行视力,B超和OCT检查。3眼VMT接受玻璃体腔单次注射TPA50 μg,2眼接受100 μg 注射。19例视网膜血管疾病患者接受玻璃体腔组织纤溶酶原激活剂(50 μg)和贝伐单抗(1.25 mg)联合治疗。

结果：纳入病例中男性10眼视网膜血管疾病和VMT患者平均年龄分别为56.8y 和60.4y。纳入病例中男性10眼(41.7%),女性14眼(58.3%)。22眼(91.7%)晶状体眼,2眼(8.3%)人工晶状体眼。VMT和视网膜血管疾病的玻璃体后部脱离(PVD)分别为0(0/5)和57.8%(11/19)(P=0.04)。在改善最佳矫正视力(BCVA)和降低黄斑中心凹厚度(CMT)方面,与无PVD眼相比,有PVD眼改善更多。

结论：在VMT患者中,单独玻璃体腔内注射TPA不能成功诱导玻璃体后部完全脱离。玻璃体腔联合注射TPA和贝伐单抗可引起视网膜血管疾病患者玻璃体后部脱离,提高最佳矫正视力以及降低黄斑中心凹厚度。     

Outcomes of combined phacoemulsification/intraocular lens implantation and silicon oil removal

International Ophthalmology - To evaluate the outcomes and complications of simultaneous silicon oil removal (SOR) and phacoemulsification and intra ocular lens implantation. In this retrospective...