Anterior clear spaces in keratoconus

Anterior clear spaces were observed prospectively at slit-lamp examination in 26 of 69 consecutive eyes (38%) with keratoconus. Two corneal buttons with this finding were examined by light and electron microscopy and revealed breaks in Bowman's layer. Anterior clear spaces should be considered in the spectrum of clinical findings in keratoconus.     

Chemotherapy with cisplatin and vinorelbine for elderly patients with locally advanced or metastatic non-small-cell lung cancer (NSCLC)

Background  

Although modest improvements in the survival of patients with non-small cell lung cancer (NSCLC) can be achieved with cisplatin-based chemotherapy (CT), its value is disputed in the geriatric setting. In this study, we evaluate the feasibility of vinorelbine/cisplatin CT for elderly NSCLC patients.     

Management of hydatid disease (echinococcosis) in pregnancy

Hydatid disease, manifesting as single or multiple hydatid cysts and caused by Echinococcus granulosus, is common in many parts of the world, especially the tropical countries. Although rare, this disease can also present during pregnancy, especially in endemic areas. Although much has been written about hepatic hydatidosis, there are only a few articles (mainly case reports) on hydatid disease in association with pregnancy. A literature search was done through Medline/PubMed and Medscape independently by the authors from 1950 to 2007 for key words "echinococcosis" and "pregnancy" and "management." All retrieved articles were reviewed. Manual cross-referencing was also done with inclusion of all relevant articles. In this review, we have attempted to summarize the presentation and available management approaches to hydatid disease, and have suggested evidence-based guidelines for its management during pregnancy.     

Pharmacological closure of patent ductus arteriosus: effects on pulse pressure and on endothelin-1 and vasopressin excretion

Widened pulse pressure is a classic sign of significant left-to-right shunting patent ductus arteriosus (PDA), but little evidence supports this statement in the early life of premature infants with respiratory distress syndrome (RDS) needing nonsteroidal anti-inflammatory drugs (NSAIDs), the pharmacological treatment for PDA. Pulse pressure and urinary endothelin-1 (ET-1) and arginine vasopressin (AVP) vasoactive factors involved in the transitional circulation were measured before and after the NSAIDs treatment of 46 RDS premature infants receiving either ibuprofen (n = 22) or indomethacin (n = 24), with 28 responders and 18 nonresponders to the first NSAIDs course. We found that following pharmacological PDA closure, systolic and diastolic blood pressure significantly increased, maintaining a stable pulse pressure. However, when pharmacological closure failed, the trend (nonsignificant) was for a more consistent increase in systolic than in diastolic blood pressure, which determined a statistically significant widening pulse pressure. In addition, urinary ET-1 excretion rates decreased significantly after PDA closure, whereas persistent more aggressive pharmacological therapy failed. Urinary AVP excretion rates decreased insignificantly after therapy, uninfluenced by the efficacy of the drugs. We concluded that widened pulse pressure is a clinical sign of failed PDA pharmacological closure in RDS premature infants. ET-1 levels remain elevated when NSAIDs fail to interrupt left-to-right PDA shunting that complicates recovery from RDS.     

Magnetic resonance imaging in the preoperative staging of endometrial carcinoma

PURPOSE OF INVESTIGATION: Magnetic resonance imaging (MRI) has emerged as an important imaging modality in the evaluation of the extension of endometrial carcinoma which is essential in planning treatment and predicting prognosis. This study aimed to assess the value of MRI in the preoperative staging of endometrial carcinoma. METHODS: We included in this study 162 patients with a histological diagnosis of endometrial carcinoma who underwent MRI pelvic imaging and surgical staging. MRI images were compared with pathological findings to measure MRI's sensitivity, specificity, positive and negative predictive values and diagnostic accuracy in what concerns myometrial, cervical and lymph node invasion. RESULTS: MRI differentiation of deep myometrial invasion from superficial disease agreed with pathological findings in 77% of cases, with a sensitivity of 83%, a specificity of 72% and a diagnostic accuracy of 77%. Concerning cervical invasion, MRI had a sensitivity, specificity and diagnostic accuracy of 42%, 92%, 81% respectively. In assessing lymph node invasion, MRI presented a sensitivity of just 17%, a specificity of 99% and a diagnostic accuracy of 89%. CONCLUSION: Our study confirmed the high accuracy of MRI imaging in assessing myometrial and cervical invasion in endometrial carcinoma. When evaluating lymph node invasion, micrometastases are responsible for the low sensitivy of MRI.     

Agar Biopolymer Films for Biodegradable Packaging: A Reference Dataset for Exploring the Limits of Mechanical Performance

This article focuses on agar biopolymer films that offer promise for developing biodegradable packaging, an important solution for reducing plastics pollution. At present there is a lack of data on the mechanical performance of agar biopolymer films using a simple plasticizer. This study takes a Design of Experiments approach to analyze how agar-glycerin biopolymer films perform across a range of ingredients concentrations in terms of their strength, elasticity, and ductility. Our results demonstrate that by systematically varying the quantity of agar and glycerin, tensile properties can be achieved that are comparable to agar-based materials with more complex formulations. Not only does our study significantly broaden the amount of data available on the range of mechanical performance that can be achieved with simple agar biopolymer films, but the data can also be used to guide further optimization efforts that start with a basic formulation that performs well on certain property dimensions. We also find that select formulations have similar tensile properties to thermoplastic starch (TPS), acrylonitrile butadiene styrene (ABS), and polypropylene (PP), indicating potential suitability for select packaging applications. We use our experimental dataset to train a neural network regression model that predicts the Young’s modulus, ultimate tensile strength, and elongation at break of agar biopolymer films given their composition. Our findings support the development of further data-driven design and fabrication workflows.     

Biopolymer-Based Films from Sodium Alginate and Citrus Pectin Reinforced with SiO2

Blend films based on sodium alginate (SA) and citrus pectin (P) reinforced with different concentrations of SiO₂ (0–10% w/w) were developed in this study. From the morphological (SEM) and structural (FT-IR) evaluation, it was verified that the incorporation of the reinforcing agent did not drastically modify the microstructure of the films, nor did new chemical bonds form. However, the XRD results suggested a slight reduction in the crystallinities of the blends by the incorporation of SiO₂. Among the formulations prepared, the addition of a 5% reinforcing agent was responsible for the simultaneous improvement of mechanical and barrier properties. Comparing the control sample (SA/P) with the SA/P/5.0%SiO₂ film, the tensile strength increased from 27.7 ± 3.7 to 40.6 ± 4.5 MPa, and the water-vapor transmission rate decreased from 319.8 ± 38.7 to 288.9 ± 23.5 g m⁻² day⁻¹. Therefore, SiO_2, as a reinforcing agent in SA/P blends, represents a simple and effective strategy for improving the properties of biopolymer-based films in applications, such as packaging.