Intravitreal Bevacizumab for Photodynamic Therapy-Induced Massive Macular Detachment in Acute Central Serous Chorioretinopathy

We present a long followed up case of acute central serous chorioretinopathy (CSC) complicated by a severe visual loss due to massive pigment epithelium detachment of the macula after a full-dose photodynamic therapy (PDT). Rapid anatomical and functional improvement was observed after a single intravitreal injection of bevacizumab. To our knowledge, we report the first case of PDT-treated CSC complicated by severe visual loss. We can only speculate that the serous detachment of the posterior pole might have been caused by PDT-induced VEGF overexpression, explaining such an impressive response to Avastin treatment.Key Words: Bevacizumab, Central serous chorioretinopathy, Photodynamic therapy     

Investigating machine learning techniques for MRI-based classification of brain neoplasms

Purpose  

Diagnosis and characterization of brain neoplasms appears of utmost importance for therapeutic management. The emerging of imaging techniques, such as Magnetic Resonance (MR) imaging, gives insight into pathology, while the combination of several sequences from conventional and advanced protocols (such as perfusion imaging) increases the diagnostic information. To optimally combine the multiple sources and summarize the information into a distinctive set of variables however remains difficult. The purpose of this study is to investigate machine learning algorithms that automatically identify the relevant attributes and are optimal for brain tumor differentiation.     

Comparison of the aneugenic properties of nocodazole,paclitaxel and griseofulvin in vitro. Centrosome defects and alterations in protein expression profiles

We have comparatively investigated the aneugenic activity of two anticancer drugs, nocodazole (NOC) and paclitaxel (PTX), and the antifungal griseofulvin with promising role in cancer treatment (GF), which affect microtubule dynamics in different ways. The comparison was achieved in HFFF2 human fibroblasts, MCF‐7 human breast cancer cells and C2C12 mouse myoblasts, and focused on three issues: (i) induction of chromosome delay by estimation of MN frequency using CREST analysis; (ii) disturbance of spindle organization with Aurora‐A/β‐tubulin immunofluorescence; and (iii) alterations in the expression of Aurora‐A, β‐ and γ‐tubulin by western blotting. They induced chromosome delay, provoked metaphase arrest and promoted microtubule disorganization, reflecting their common characteristic of generating aneuploidy. In particular, NOC induced mainly monopolar metaphases, although PTX induced only multipolar metaphases. GF generated different types of abnormal metaphases, exhibiting cell specificity. Additionally, NOC decreased the expression of Aurora‐A and β‐tubulin, while the opposite held true for PTX and GF. γ‐Tubulin expression was not modulated owing to NOC treatment, whereas PTX and GF increased γ‐tubulin expression. Our findings throw a light on the manifestation of the aneugenicity of the studied compounds through centrosome proliferation/separation and protein expression, reflecting their different effects on microtubule dynamics. Copyright © 2012 John Wiley & Sons, Ltd.     

Flecainide versus ibutilide for immediate cardioversion of atrial fibrillation of recent onset.

AIMS: This study compared the efficacy and safety of intravenous flecainide and ibutilide for immediate cardioversion of atrial fibrillation (AF). METHODS AND RESULTS: We conducted a prospective, randomised trial, including 207 patients with AF of recent onset (< or = 48 h). Flecainide was given over 20 min at a dose of 2 mg/kg body weight (maximum 200 mg), ibutilide was infused at a dose of 1 mg (or 0.01 mg/kg if less than 60 kg) over 10 min, followed by a 10 min observation period and an identical second dose if AF did not convert to sinus rhythm (SR). Treatment was considered successful if SR occurred within 90 min of starting medication. The conversion rates were 56.4% in patients given flecainide and 50.0% in patients given ibutilide (P=0.34). Multivariate analysis revealed that a lower age for women independently increased the probability of conversion. None of the other variables, including left atrial size, left ventricular systolic function, presence of left ventricular hypertrophy, plasma levels of potassium or magnesium at baseline, or concomitant use of digoxin, beta-blocker, diltiazem or verapamil were predictors of conversion. The frequency of adverse events was comparable in the two treatment groups. CONCLUSIONS: There was no significant difference in the cardioversion efficacy or in the risk of adverse events between flecainide and ibutilide in patients with AF of recent onset. In patients without contraindications to both medications, the physician's choice has to be governed by other factors.     

Interleukin-1B and interleukin-1 receptor antagonist gene polymorphisms in Greek multiple sclerosis (MS) patients with bout-onset MS

We investigated the association of specific polymorphisms of the interleukin IL-1b (AvaI ?511 and TaqI +3,953) and IL-1 receptor antagonist (IL-1RN) (a variable number of tandem repeats; VNTR) genes with both the susceptibility to and the clinical characteristics in Greek multiple sclerosis (MS) patients cohort with bout-onset. Genotypes were determined from 351 patients with clinically definite MS and 375 age- and sex-matched healthy controls. Our results showed no significant differences in the distribution of these polymorphisms between MS patients and controls. Furthermore, stratification for clinical characteristics, such as age at disease onset, clinical course, sex, and severity did not provide significant differences between patients and controls. Together, our findings suggest that IL-1B and IL-1RN gene polymorphisms may not be relevant to the susceptibility to MS or the clinical characteristics of Greek MS patients.     

Telematics enabled virtual simulation system for radiation treatment planning

In this paper, GALENOS, a Telematics Enabled Virtual Simulation System for Radiation Treatment Planning (RTP) is described. The design architecture of GALENOS is in accordance with the dual aim of virtual simulation of RTP, i.e. to allow (a) delineation of target volume and critical organs, and (b) placement of irradiation fields. An important feature of GALENOS is the possibility for on-line tele-collaboration between health care professionals under a secure framework. The advantages of GALENOS include elimination of patient transfers between departments and health care institutions as well as availability of patient data at sites different than those of his/her physical presence.     

Posttraumatic stress reactions among children following the Athens earthquake of September 1999

Abstract. The objective of the present study was to assess symptoms of posttraumatic stress disorder (PTSD), depression and anxiety among children 6 months after they had been exposed to an earthquake (EQ) affecting the northwestern suburbs of Athens in September 1999. A total of 115 children attending two elementary schools located at the epicentre of the EQ were assessed. A group of 48 children not affected by the EQ attending a school not affected by the EQ were used as controls. The children and their parents completed a number of questionnaires. Overall, there was a high rate (78%) of severe to mild PTSD symptoms in the EQ exposed group. Additionally, a substantial proportion of these children scored above criteria (32%) for depression compared to the control group (12.5%). Severe or moderate symptoms of PTSD were associated with high scores of depression (p = 0.002). The relationship between PTSD symptoms and anxiety was limited to the avoidance factor of the anxiety questionnaire (p = 0.029). Those who were most likely to be affected were children alone at the time of the EQ, and children who sustained injuries. In summary, countries where EQs are frequent should be prepared to offer psychological support to a substantial proportion of children presenting with PTSD and depressive symptoms and should educate and prepare children to cope with these events.     

The Sociocultural Context of the European Early Promotion Project

This chapter describes the socio-cultural settings and the relevant health care services within which the European Early Promotion Project was conducted, in order to render the interpretation of study results more meaningful and to justify cross-cultural differences. Greece, Cyprus and Serbia are characterised by lower social expenditure, welfare provision and higher poverty rates than the UK and, especially, Finland, the latter having achieved an advanced welfare provision system. Large differences also exist among participating countries in child mental health and primary care services. Finland and the UK have made the biggest advances in promotional work with families, while Greece, Cyprus and Serbia present, to a smaller or larger degree, deficiencies in their health service infrastructure and in their ability to follow social, economic and scientific advances in the area of maternal and child well-being.     

European ST80 community-associated methicillin-resistant Staphylococcus aureus orbital cellulitis in a neonate

Background

To report atypical features on Spectral domain optical coherence tomography (SD-OCT) in a case of non-familial pure adult nanophthalmos.

Case presentation

A 39?year old male hyperope was found to have biometric and fundus findings typical of nanophthalmos. The additional atypical features included serous pigment epithelial detachment (PED) in right eye and a cuff of subretinal fluid with underlying yellow deposits along superotemporal arcade in the left eye. Fundus flourescein angiogram showed hyperfluorescence due to window defect, dye pooling due to serous PED in right eye and leak superior to disc in right eye and superotemporally in left eye. Cirrus-SD OCT horizontal line scan passing through the fovea showed extensive inner limiting membrane corrugations causing distorted foveal contour in both eyes. A large juxtafoveal serous PED and a small extrafoval PED were seen with folds in the retinal pigment epithelium (RPE)-choriocapillary layer in the right eye.

Conclusion

Structural disruptions in the RPE-choriocapillary complex in the form of folds or juxtafoveal serous PED and RPE folds can be atypical features of nanophthalmic macula better discerned on high resolution OCT.     

Classification of brain tumor type and grade using MRI texture and shape in a machine learning scheme

The objective of this study is to investigate the use of pattern classification methods for distinguishing different types of brain tumors, such as primary gliomas from metastases, and also for grading of gliomas. The availability of an automated computer analysis tool that is more objective than human readers can potentially lead to more reliable and reproducible brain tumor diagnostic procedures. A computer‐assisted classification method combining conventional MRI and perfusion MRI is developed and used for differential diagnosis. The proposed scheme consists of several steps including region‐of‐interest definition, feature extraction, feature selection, and classification. The extracted features include tumor shape and intensity characteristics, as well as rotation invariant texture features. Feature subset selection is performed using support vector machines with recursive feature elimination. The method was applied on a population of 102 brain tumors histologically diagnosed as metastasis ( 24 ), meningiomas ( 4 ), gliomas World Health Organization grade II ( 22 ), gliomas World Health Organization grade III ( 18 ), and glioblastomas ( 34 ). The binary support vector machine classification accuracy, sensitivity, and specificity, assessed by leave‐one‐out cross‐validation, were, respectively, 85%, 87%, and 79% for discrimination of metastases from gliomas and 88%, 85%, and 96% for discrimination of high‐grade (grades III and IV) from low‐grade (grade II) neoplasms. Multiclass classification was also performed via a one‐vs‐all voting scheme. Magn Reson Med, 2009. © 2009 Wiley‐Liss, Inc.