Risk factors for treatment failure and recurrence of anisometropic amblyopia

Purpose

The aim of this study was to identify factors associated with failed vision improvement and recurrence following occlusion therapy for anisometropic amblyopia in children aged 7–9 years.

Methods

We retrospectively reviewed the medical records of 64 children aged 7–9 years who had been diagnosed as having anisometropic amblyopia and were treated with patching. Functional treatment failure was defined as final visual acuity in the amblyopic eye of worse than 20/32. Improvement of fewer than two logMAR lines was considered relative treatment failure. Recurrence was defined as the reduction of at least two logMAR levels of visual acuity after decreased or discontinued patching.

Results

Functional and relative success rates were 51.6 and 62.5 %, respectively. The most important factor for functional treatment failure [adjusted odds ratio (OR) (95 % confidence interval, CI) 11.57 (1.4–95.74)] and the only risk factor for recurrence [adjusted OR (95 % CI) 3.04 (1.13–8.12)] were the same: high spherical equivalent (SE) of the amblyopic eye. A large interocular difference in the best-corrected visual acuity was found to be a risk factor for both functional and relative failure.

Conclusion

High SE of the amblyopic eye was the most influential risk factor for treatment failure and recurrence in compliant children aged 7–9 years.

     

Autoimmune progesterone dermatitis

Autoimmune progesterone dermatitis (APD) is an uncommon cutaneous disorder characterized by exacerbations during the luteal phase of the menstrual cycle. We describe a 27-year-old woman with a recurrent skin eruption for 3 years. She had no history of exposure to synthetic progesterones. At each menses, the patient developed scaly, erythematous maculopapular lesions over the face. Intradermal skin test reaction to progesterone was positive. Progesterone sensitivity was also demonstrated by challenge test with intramuscular progesterone acetate. These features were consistent with the diagnosis of APD. Our patient was treated successfully with conjugated estrogen for 6 months. At one year follow-up, the patient had had no recurrence of facial eruption.     

Shear bond strength of restorations applied to un-complicated crown fractures: an in vitro study

Abstract – Background: Study was designed to evaluate shear bond strengths of different restorative techniques of uncomplicated enamel‐dentin fractures in permanent incisors. Material and Methods: Forty human mandibular incisors were divided into four groups. One‐third of their anatomical crowns from the incisal edges were cut off in three groups, representing an uncomplicated enamel‐dentin fracture. Intact teeth in group 1 were used as control. In group 2, edge fragments were reattached by flowable composite (Filltek Flowable Supreme XT). In group 3, teeth were restored with universal resin composite (Filtek Z 250). In group 4, pre‐impregnated glass fiber sheet (everStickNet) was positioned onto fractured surface, and then restorations were completed with resin composite. Three‐step etch‐and‐rinse adhesive system (Adper Scotchbond Multi Purpose) was used in all test groups. Shear bond strengths of all samples were determined in universal testing machine, and data were analyzed with Kruskal–Wallis followed by Mann–Whitney U tests. Failure types were observed by light microscope. Results: Shear bond strength of sound teeth was significantly higher than those of restored teeth (P < 0.05). Mean shear bond strengths of the reattached teeth were lower than the other two restoration types; however, differences were not statistically significant (P > 0.05). Conclusions: Load‐bearing capacity of restored teeth was not as high as sound teeth in the uncomplicated crown fracture. However, shear bond strength of different types of restorations seems close to each other.     

Heat Shock Protein70: A New Marker for Subsequent Atrial Fibrillation Development?

Atrial fibrillation (AF) is a common arrhythmia, after cardiac surgery, and it is associated with a twofold increase in cardiovascular mortality and morbidity. Reperfusion injury and inflammation associated with cardiac surgery are thought to be involved in its pathogenesis. Heat shock proteins (HSPs) are a family of chaperone proteins which assist in preservation of cellular integrity by maintaining proteins in their correctly folded state. The aim of this study was to investigate pre-postoperative heat shock protein70 (HSP70) and high-sensitivity C-reactive protein in serum from patients in preoperative sinus rhythm. We prospectively screened 45 consecutive patients admitted to the hospital for elective coronary artery bypass surgery (CABG). Electrocardiogram characteristics and cardiovascular risk profile were documented. Pre- and postoperative blood samples were collected. HSP70 value was 8.9 +/- 4.8 ng/mL in Group A (study group) preoperatively and decreased to 7.7 +/- 7.0 ng/mL postoperatively. In contrast, preoperative value of HSP70 was 4.2 +/- 2.2 ng/mL and decreased to 2.7 +/- 2.6 ng/mL postoperatively in Group B (control group). Statistical analysis showed significant difference regarding preoperative HSP70 levels in Group A compared to Group B. To our knowledge, with this study, the association of pre- and postoperative circulating HSP70 with postoperative AF was demonstrated for the first time.     

Medicare Inpatient Treatment for Elderly Non-dementia Psychiatric Illnesses 1992–2002; Length of Stay and Expenditures by Facility Type

We summarize Medicare utilization and payment for inpatient treatment of non-dementia psychiatric illnesses (NDPI) among the elderly during 1992 and 2002. From 1992 to 2002, overall mean Medicare expenditures per elderly NDPI inpatient stay declined by $2,254 (in 2002 dollars) and covered days by 2.8. However, these changes are complicated by expanded use of skilled nursing facilities and hospital psychiatric units, and decreased use of long-stay hospitals and general hospital beds. This suggests that inpatient treatment for NDPI is shifting into less expensive settings which may reflect cost-cutting strategies, preferences for less restrictive settings, and outpatient treatment advances.     

Atypical teratoid/rhabdoid tumors: imaging findings of two cases and review of the literature

Atypical teratoid/rhabdoid tumor (AT/RT) is a malignant embryonal central nervous system (CNS) tumor, manifesting in children, and composed of rhabdoid cells, with or without fields resembling a classical primitive neuroectodermal tumor (PNET), epithelial tissue and neoplastic mesenchyme. Around 200 cases of CNS AT/RT have been documented in the literature. Although the clinical and pathological findings have been defined in large series previously, and AT/RT has become increasingly recognized, awareness of typical AT/RT is important in making the correct diagnosis of this uncommon but probably underdiagnosed entity. Neuroradiologists rarely mention AT/RT in their differential diagnosis and this paper presents two additional cases in which clinical and pathological findings are combined with neuroradiological presentation.     

Activation of purinergic receptors by ATP induces ventricular tachycardia by membrane depolarization and modifications of Ca homeostasis

Cardiac myocytes are continuously exposed to extracellular nucleotides secreted by the myocytes themselves, nerve terminals, or platelets and other blood cells during coronary perfusion, and the concentrations of such extracellular nucleotides are known to increase during cardiac ischemia and hypoxia. The effects of the extracellular nucleotides ATP, ADP, UTP, and adenosine on ventricular arrhythmogenic properties were explored in 36 Langendorff-perfused mouse hearts using monophasic action potential recording. Extracellular nucleotides induced arrhythmic phenomena in form of ectopic activity and ventricular tachycardia in a potency order of ATP (n = 7) > ADP (n = 5) > UTP (n = 3) ≈ adenosine (n = 3). The purinergic receptor antagonists suramin and pyridoxal phosphate-6-azo(benzene-2,4-disulphonic acid) reduced the incidence of ATP-triggered arrhythmias. In isolated ventricular myocytes, ATP induced sustained increases in diastolic Ca²⁺ and triggered multiple Ca²⁺ waves, which were inhibited by suramin but not by the L-type Ca²⁺ channel antagonist nifedipine. In whole-cell patch clamp experiments, extracellular ATP induced two distinct types of inward currents, which were inhibited by suramin and PPADS, suggesting activation of P2X receptors. ATP also induced delayed after-depolarizations and ectopic action potentials in current clamped ventricular myocytes. In conclusion, extracellular ATP activates purinergic receptors and induces arrhythmic activity through modifications of Ca²⁺ homeostasis and an activation of depolarizing membrane currents.     

Predicting the Effect of Fed-State Intestinal Contents on Drug Dissolution

Purpose  

There are several endogenous and exogenous species in the gastrointestinal (GI) tract which can act as solubilizing agents and thereby affect drug dissolution. The purpose of this study is to understand food effects on drug dissolution and provide insight into their anticipated overall effect on absorption and bioavailability.