Value of tissue Doppler myocardial velocities of tricuspid lateral annulus for the diagnosis of right heart failure in patients with COPD

OBJECTIVE: Aim of this study was to investigate the value of systolic indices of tricuspid valve annular motion measured by tissue Doppler imaging for the diagnosis right ventricular failure in patients with chronic obstructive pulmonary disease (COPD). METHODS: Patients with COPD with right heart failure symptoms and/or right ventricular dilatation were enrolled for the study. The control group consisted of age and sex matched patients referred to the echocardiography laboratory who had normal echocardiographic examination. Tricuspid valve annulus peak systolic velocity and myocardial acceleration during isovolumic contraction were recorded by tissue Doppler imaging. RESULTS: IVA and Sa wave velocities were found to be significantly decreased in patients with right ventricular failure. For the prediction of right heart failure IVA <3.8 m/sec2 had 91% sensitivity, 80% specificity, 90% positive predictive value (PPV), and 82% negative predictive value (NPV) and Sa wave velocity <9.2 cm/sec had 80% sensitivity, 62% specificity, 75% PPV, and 68% NPV. CONCLUSION: Tricuspid valve annular velocities measured by tissue Doppler imaging especially IVA, offer potential diagnostic value for the diagnosis of right heart failure in patients with COPD.     

Surgical management of spontaneous in-the-bag intraocular lens and capsular tension ring complex dislocation

We describe a technique to manage late spontaneous intraocular lens (IOL) and capsular tension ring (CTR) dislocation within the intact capsular bag. The subluxated IOL and CTR complex can be positioned in a closed chamber and fixed to the pars plana at both 3 and 9 o’clock quadrants with the presented ab externo direct scleral suturation technique which provides an easy, safe and effective surgical option for such cases.     

The Acute Effect of Cigarette Smoking on Pattern Visual Evoked Potentials

Reports of tobacco-induced electrocortical activation and decrements in ocular blood flow in the acute faze indicated that this effect is mediated via nicotin’s action or neuronal systems. In this study, pattern visual evoked potentials were investigated in a group of male smokers (22 right eyes of 22 subjects) in separate real smoking and sham smoking sessions. On each session, pattern visual evoked potentials were recorded before smoking, immediately after smoking, and five minutes after smoking. Latency and amplitude values for P100 peaks were assessed and analyzed in each smoking condition for both real smoking and sham smoking sessions. Real smoking significantly decreased P100 latency values (p value related to difference between pre-smoking and immediately after smoking conditions is 0.009) and increased P100 amplitude values (p value related to difference between pre-smoking and fifth minute after smoking is 0.039). Statistically no significant difference was observed in sham smoking sessions. Our results are consistent with smoking-induced stimulant effects on pattern visual evoked potentials.     

Effect of hormone replacement therapy in women on ocular refractive status and aberrations

PURPOSE: To evaluate the effects of hormone replacement therapy (HRT) on refractive status, corneal topography, and aberrations of the eye in postmenopausal women. METHODS: Thirty-six healthy postmenopausal women (72 eyes) were included in the study. All patients received HRT that consisted of 0.625 mg/day conjugated estrogen and 5 mg/day medroxyprogesterone acetate in a continuous combined regimen. Schirmer II test and tear film break-up time (BUT) were performed on all patients at the time of enrollment and 6 months after initiation of HRT. Refractive status, corneal topography, and wavefront aberrations were evaluated with the NIDEK Optical Path Difference-Scan before and 6 months after HRT was initiated. RESULTS: Mean patient age was 50.8 +/- 2.6 years (range: 47 to 57 years). The mean duration of menopause was 2.7 +/- 0.8 years (range: 1.4 to 3.5 years). The Schirmer II test and tear film BUT measurements were significantly lower after HRT (P < .05). Before HRT, the mean spherical equivalent refraction was -0.19 +/- 1.79 diopters (D) (range: -4.38 to +3.00 D). After HRT, the mean spherical equivalent refraction was -0.22 +/- 1.81 D (range: -4.63 to +/- 2.63 D). No significant differences were noted between refractive status, corneal topography, and wavefront aberrations of eyes of patients before and 6 months after HRT (P > .05). CONCLUSIONS: Hormone replacement therapy in postmenopausal women does not significantly affect refractive status, corneal topography, and wavefront aberrations of the eye at 6-month follow-up.     

Comment on roles of tissue plasminogen activator and its inhibitor in proliferative diabetic retinopathy

Letter to the editor     

Structured risk assessment for reduction of multiple risk outcomes in a secure mental health setting: Use of the START

Background

Structured risk assessment is commonly used in secure settings to aid prediction and prevention of risky behaviours; the expected benefits have rarely been investigated.

Aims

The aim of the study is to determine whether adverse outcomes (physical and verbal aggression, self‐harm, victimisation, self‐neglect, unauthorised leave and substance abuse) reduced after patients were assessed with the Short‐term Assessment of Risk and Treatability (START).

Methods

In a naturalistic study, anonymised demographic and clinical information was collected from 50 male patients. Data included START assessment and frequency of target behaviour for 3 months before and after first assessment. Chi‐square and linear mixed models analyses were used to determine whether there was any change in the behaviours of interest.

Results

There were no significant changes in physical or verbal aggression over time, although a tendency towards fewer incidents was apparent. Other adverse behaviours were very infrequent at baseline, precluding adequate analysis.

Conclusions

In this small sample, START did not achieve its primary purpose of significant reduction in adverse behaviours. Although our sample size was informed by a power calculation, we may have over‐estimated the size of anticipated change. Further, the 3‐month comparison periods before and after the assessment follow‐up period were rather short. Accordingly, we recommend more research on the value of this tool in practice rather than discontinuing its use. Copyright © 2017 John Wiley & Sons, Ltd.