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Sample records for acute primary angle

  1. Anterior ischemic optic neuropathy precipitated by acute primary angle closure

    Directory of Open Access Journals (Sweden)

    Choudhari Nikhil

    2010-01-01

    Full Text Available A 59-year-old man with a history of longstanding systemic hypotension developed asymmetric non-arteritic anterior ischemic optic neuropathy (NAION apparently precipitated by bilateral sequential acute primary angle closure. NAION is very rarely reported in association with raised intraocular pressure. In contrast to optical coherence tomography, the failure of scanning laser polarimetry to detect axonal swelling was another interesting finding. Possible reasoning for these observations is discussed.

  2. 急性原发性闭角型青光眼%Acute Primary Closed Angle Glaucoma(Abstract)

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    Acute primary closed angle glaucoma is fast becoming one of the most important causes of blindness in the 21 st Century. World bhnding statistics show that there are 60 million people suffering from glaucoma. Of these,approximately 6 million are blind and 1.5 million (25%) are due to acute closed angle glaucoma. With the aging population, the number of patients blind from glaucoma will continue to increase.Attacks from acute primary closed angle glaucoma can lead to irreversible blindness to the affected eye.Blindness can be effectively prevented in acute primary closed angle glaucoma because the severity of symptoms will draw the attention of the patient who will then seek for medical care. Therefore, it is essential to educate the public,doctors and healthcare workers about the danger and symptoms of acute glaucoma. With early diagnosis and treatment to the affected eye and laser iridotomy to the fellow eye-bilateral blindness from acute glaucoma can be prevented.This paper highlights important clinical advances in the management of acute primary closed angle glaucoma and also poses several questions for discussion.(1) What evidence is there to suggest that bilateral blindness from acute primary closed angle glaucom is preventable?(2) In what way is Ultrasonic Biomicroscopy (UBM) useful in clinical research in glaucoma?(3) Will UBM be important in clinical diagnosis in primary closed angle glaucoma?(4) What is the scientific basis of treatment in acute primary closed angle glaucoma?(5) What are the essential procedures to preserve vision in chronic primary closed angle glaucoma?(6) What are the reasons for blindness after laser iridotomy?(7) What is the mechanism of laser iridoplasty?(8) What are the reasons why laser iridoplasty should be combined with laser iridotomy?(9) Why there is an intraocular pressure increase in 50% of eyes within 3 months after laser iridoplasty?(10) Can UBM explain the changes in the angle after lens removal in primary closed angle

  3. Paracentesis as an initial intervention in Malay Indonesian eyes with acute primary angle closure

    Directory of Open Access Journals (Sweden)

    Widya Artini

    2012-05-01

    Full Text Available Background: Acute primary angle closure (APAC is one of the causes of blindness in Department of Ophthalmology Cipto Mangunkusumo General Hospital. Management of APAC is still controversial. Laser peripheral iridotomy is difficult to be done due to corneal edema as a result of persistent high intraocular pressure (IOP. It is believe that paracentesis will lower IOP immediately. The objective of the study was to assess outcome of paracentesis as the initial management in Malay Indonesian eyes with APAC.Methods: This intervention study was conducted at the Eye Clinic of Cipto Mangunkusumo Hospital and Jakarta Eye Center commencing in January 2005 until December 2007. Malay Indonesian eyes with APAC were included in this study in accordance with the new Asia Pacific consensus. All APAC eyes underwent paracentesis to lower IOP. The presenting and post-paracentesis IOP and peripheral anterior synechiae were noted. The outcome was termed as good when IOP was ≤ 21 mmHg and poor when IOP was > 21 mmHg.Results: A total of 45 APAC eyes were recruited. Thirty-eight of these belonged to women; mean age was 54.6 ± 1.56 years. Meanwhile, average duration of symptoms was 13.15 ± 7.4 days and mean of extent of peripheral anterior synechiae (PAS was 7.7 ± 3.1 hours. There was a strong correlation regarding duration of symptoms to the formation of PAS (r = 0.672; p < 0.001. The mean presenting IOP was 55 ± 13.37 mmHg and mean post-paracentesis IOP was 27 ± 12.78 mmHg. A decrease of 49% in IOP ( p < 0.001 was observed after paracentesis with good outcome in 19 eyes and poor outcome in 26 eyes.Conclusion: Paracentesis as an initial intervention in APAC eyes reduces the IOP immediately, but only as a temporary response. (Med J Indones. 2012;21:113-7Keywords: Acute primary angle closure (APAC, intraocular pressure (IOP, paracentesis, peripheral anterior synechiae (PAS

  4. Histoplasmosis - acute (primary) pulmonary

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/000098.htm Histoplasmosis - acute (primary) pulmonary To use the sharing features on this page, please enable JavaScript. Acute pulmonary histoplasmosis is a respiratory infection that is caused by ...

  5. Mechanism and Etiology of Primary Chronic Angle Closure Glaucoma

    Institute of Scientific and Technical Information of China (English)

    1994-01-01

    The ocular anatomic features, pupil-blocking force, status of angle synechiae closure and positivity of provocative tests were compared between the primary chronic angle closure glaucoma (PCACG) and primary a-cute angle closure glaucoma (PAACG) by using ultrasonic biometry, computerized anterior ocular segment image processing technique, gonioscopy and provocative tests. The studies showed that the anterior chamber depth of PAACG was shallower than that of PCACG; the pupil-blocking force of PAACG was st...

  6. Intermittent acute angle closure glaucoma and chronic angle closure following topiramate use with plateau iris configuration

    Directory of Open Access Journals (Sweden)

    Rajjoub LZ

    2014-07-01

    Full Text Available Lamise Z Rajjoub, Nisha Chadha, David A Belyea Department of Ophthalmology, The George Washington University, Washington, DC, USA Abstract: This is a case report describing recurrent intermittent acute angle closure episodes in the setting of topiramate use in a female suffering from migraines. Despite laser peripheral iridotomy placement for the pupillary block component, and the discontinuation of topiramate, the acute angle closure did not resolve in the left eye with chronic angle closure and the patient required urgent trabeculectomy. The right eye responded to laser peripheral iridotomy immediately and further improved after the cessation of topiramate. While secondary angle closure glaucoma due to topiramate use has been widely reported, its effects in patients with underlying primary angle closure glaucoma have not been discussed. Our report highlights the importance of recognizing the often multifactorial etiology of angle closure glaucoma to help guide clinical management. Keywords: angle closure glaucoma, plateau iris, topiramate, secondary glaucoma, drug-induced glaucoma

  7. Molecular mechanisms underlying primary open angle glaucoma

    NARCIS (Netherlands)

    Janssen, S.F.

    2014-01-01

    Primary open angle glaucoma (POAG) is a complex, multigenetic and heterogeneous optic neuropathy. It is an insidious disease that untreated leads to irreversible visual field loss and blindness. Worldwide, glaucoma causes around 12% of blindness. Although various risk factors have been established,

  8. Primary open-angle glaucoma genes

    OpenAIRE

    Fingert, J.H.

    2011-01-01

    A substantial fraction of glaucoma has a genetic basis. About 5% of primary open angle glaucoma (POAG) is currently attributed to single-gene or Mendelian forms of glaucoma (ie glaucoma caused by mutations in myocilinor optineurin). Mutations in these genes have a high likelihood of leading to glaucoma and are rarely seen in normal subjects. Other cases of POAG have a more complex genetic basis and are caused by the combined effects of many genetic and environmental risk factors, each of whic...

  9. Acute angle closure glaucoma following ileostomy surgery

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    Mariana Meirelles Lopes

    2015-02-01

    Full Text Available Angle-closure glaucoma can be induced by drugs that may cause pupillary dilatation. We report a case of a patient that developed bilateral angle closure glaucoma after an ileostomy surgery because of systemic atropine injection. This case report highlights the importance of a fast ophthalmologic evaluation in diseases with ocular involvement in order to make accurate diagnoses and appropriate treatments.

  10. Bilateral acute angle-closure glaucoma after dexfenfluramine treatment.

    Science.gov (United States)

    Denis, P; Charpentier, D; Berros, P; Touameur, S

    1995-01-01

    We report the case of a patient with narrow angles who had an attack of bilateral acute angle-closure glaucoma precipitated by dexfenfluramine, a serotoninergic drug developed for appetite suppression. Although the exact mechanism remains uncertain, the pupillary block observed in our case may be the result of the serotoninergic or indirect parasympatholytic properties of the drug on the iris sphincter muscle. Serotonergic psychoactive drugs should be prescribed cautiously in patients with known narrow angles and should be monitored by an ophthalmologist.

  11. Association of known common genetic variants with primary open angle, primary angle closure, and pseudoexfoliation glaucoma in Pakistani cohorts

    NARCIS (Netherlands)

    Micheal, S.; Ayub, H.; Khan, M.I.; Bakker, B.; Schoenmaker-Koller, F.E.; Ali, M.; Akhtar, F.; Khan, W.A.; Qamar, R.; Hollander, A.I. den

    2014-01-01

    PURPOSE: Despite the different etiology of primary open angle glaucoma (POAG), primary angle closure glaucoma (PACG), and pseudoexfoliative glaucoma (PEXG), several studies have suggested that these forms of glaucoma have overlapping genetic risk factors. Therefore, the aim of this study was to eval

  12. Primary Chronic Angle-closure Glaucoma in Chinese——A Clinical Exploration of Its Pathogenesis And Natural Course

    Institute of Scientific and Technical Information of China (English)

    1994-01-01

    Fourty-three cases (86 eyes) of primary chronic angle-closure glaucoma were randomly selected. An additional 44 cases (77 eyes) of primary acute angle-closure glaucoma and 30 normal subjects (34 eyes) were also randomly enrolled as control groups for comparison in the clinical study. Ultrasonic biometric measurements of the anterior chamber depth, lens thickness and axial length of the eyeball were performed. Using an potic microgauge attached to the slit-lamp, the entrance of anterior chamber angle was...

  13. Primary hyperparathyroidism presenting as acute gallstone pancreatitis

    Institute of Scientific and Technical Information of China (English)

    HE Jian-hong; ZHANG Quan-bao; LI Yu-min; ZHU You-quan; LI Xun; SHI Bin

    2010-01-01

    @@ Primary hyperparathyroidism (PHPT) is a generalized disorder of calcium metabolism resulting from an abnormally high level of serum calcium and an increased level of parathormone (PTH).1,2 Traditionally, symptomatic PHPT patients present with a variety of disorders including fatigue, amyotrophy, memory impairment, emotional instability, hallucination, irritation, loss of consciousness, abdominal distention, nausea, vomiting, constipation, acute pancreatitis, refractory peptic ulcer, osteopenia, hypertension, etc.3-5 Acute pancreatitis (AP) is an uncommon presentation of PHPT.6-8 We report a typical case of primary hyperparathyroidism with hypercalcemic crisis presenting as acute gallstone pancreatitis.

  14. Primary cerebello-pontine angle malignant melanoma : a case report.

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    Desai K

    2001-04-01

    Full Text Available A rare case of primary malignant melanoma in the cerebello-pontine angle, in a 17 year old girl is presented. The patient presented with one month history of headache, diplopia, facial asymmetry and ataxia. The computerised tomography (CT scan and magnetic resonance imaging (MRI revealed a large cerebello-pontine angle mass with features suggestive of a melanoma. The typical black coloured, solid and vascular melanoma was excised completely. Cerebello-pontine angle melanoma are extremely rare tumours with dismal long term outcome in majority of these cases.

  15. 急性闭角型青光眼对侧眼与可疑原发房角关闭眼的前节参数比较%Comparison of anterior segment parameters between fellow eyes of unilateral acute angle closure glaucoma and primary angle closure suspects

    Institute of Scientific and Technical Information of China (English)

    郭竞敏; 许小兰; 张虹; 王军明

    2015-01-01

    目的:探讨原发闭角型青光眼单侧急性发作( acute angle closure glaucoma,AACG)的对侧眼、可疑原发房角关闭眼(primary angle closure suspects,PACS)和正常眼的前节生物学参数差异。  方法:采用光学相干断层扫描( optical coherence tomography,OCT)和 Pentacam 三维眼前节分析诊断系统(pentacam scheimpflug system,Pentacam)完成26例26眼AACG对侧眼及与之年龄、性别匹配的28例28眼PACS和34例34眼正常眼的前节扫描。采用Pentacam获得以下参数:中央角膜厚度( CCT)、角膜容积( CV)、瞳孔直径( PD)、中央前房深度( CACD)、周边前房深度( PACD)、前房容积( CV )和房角度数( ACA )。应用图像处理软件和OCT测量虹膜厚度(IT750,IT2000),面积(IS)、体积(IV)和房角开放距离500( AOD500)进行。  结果:角膜参数(CCT,CV),PD、虹膜参数(IT750,IT2000, IS,IV)无统计学差异( P>0.05)。与 AACG 对侧眼和PACS比较,正常人CACD和PACD更深, ACV更大, ACA和AOD500更宽敞( P0.05)。以AACG对侧眼作为房角关闭好发的诊断标准,上述前房参数的受试者工作特征曲线下面积均小于0.7。  结论:AACG对侧眼和PACS的前节生物学参数无显著差异,以此作为房角关闭好发的诊断精准度较低。%AIM: To explore the differences of anterior segment parameters in the patients with fellow eyes of unilateral acute angle-closure glaucoma ( AACG ) , primary angle-closure suspects ( PACS) and normal group. METHODS: Twenty-six eyes of 26 patients with fellow eyes of AACG, 28 eyes of 28 age- and gender-matched PACS and 34 normal eyes were imaged using optical coherence tomography ( OCT) and pentacam scheimpflug system ( Pentacam ) . Anatomical parameters including central corneal thickness ( CCT ) , corneal volume ( CV ) , pupillary diameter ( PD ) , central anterior chamber depth ( CACD ) , peripheral anterior chamber depth ( PACD ) , anterior chamber volume ( ACV ) and anterior chamber angle

  16. Canaloplasty versus Viscocanalostomy in Primary Open Angle Glaucoma

    Science.gov (United States)

    Wagdy, Faried Mohammed

    2017-01-01

    Introduction The purpose of this study was to compare the efficacy and safety of canaloplasty versus viscocanalostomy in management of uncontrolled primary open angle glaucoma (POAG) with medication. Methods Canaloplasty surgery was applied for thirty eyes of thirty patients (45–55 years) with a mean age of 48 years (Group A) and viscocanalostomy surgery was applied also for thirty eyes of thirty patients (43–54 years) with a mean age of 46 years (group B). All patients were with uncontrolled primary open angle glaucoma by maximally tolerated medical therapy. Results Intraocular pressure (IOP) in both surgeries was significantly reduced through follow up period (p glaucoma (POAG) with medication.

  17. Impaired Saccadic Eye Movement in Primary Open-angle Glaucoma

    DEFF Research Database (Denmark)

    Lamirel, Cédric; Milea, Dan; Cochereau, Isabelle;

    2013-01-01

    PURPOSE:: Our study aimed at investigating the extent to which saccadic eye movements are disrupted in patients with primary open-angle glaucoma (POAG). This approach followed upon the discovery of differences in the eye-movement behavior of POAG patients during the exploration of complex visual...

  18. Bilateral Acute Angle-Closure Glaucoma Induced By Escitalopram

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    Dilbade Yıldız Ekinci

    2014-10-01

    Full Text Available Escitalopram is an antidepressant of the selective serotonin reuptake inhibitor(SSRI class. In this manuscript, we report the case of a female patient who developed bilateral acute angle-closure glaucoma induced by escitalopram. A 46-year-old female patient was admitted to our ophthalmology clinic with complaints of severe pain around the both eyes, headache, nausea, and vomiting for two days. In her past medical history, she was using escitalopram for depression for two years. Visual acuity was at hand movement level in both eyes. Anterior segment examination showed bilateral diffuse conjunctival hyperemia, corneal edema, shallow anterior chamber, and fixed dilated pupils. Intraocular pressure was 47 mmHg in the right and 68 mmHg in the left eye. The diagnosis was acute angle-closure glaucoma, and the escitalopram medication was discontinued. She was treated with topical and systemic antiglaucomatous medication. After the cornea become clear, bilateral peripheral laser iridotomy was done. In the following year, she did not begin escitalopram medication again and no other acute angle-closure attack was seen. (Turk J Ophthalmol 2014; 44:396-9

  19. Anatomy parameters in attack eye of primary acute angle-closure glaucoma patients compared to that of contralateral eye%急性闭角型青光眼发作眼与对侧眼解剖参数的比较

    Institute of Scientific and Technical Information of China (English)

    王华; 梁远波; 唐炘; 范肃洁; 孙霞; 王涛; 孙兰萍; 王宁利

    2011-01-01

    Objective To campare the central corneal thickness (CCT) between the attack eye and contralateral eye in primary acute angle-closure glaucoma(AACG) patients. Methods About 75 primary acute angle-closure glaucoma patients was observed. We measured the CCT of the both eyes in primary acute angle-closure glaucoma by A scan. Also the ACD, thickness of lens and axis were measured when the IOP was reduced. And paired t test was used to compare the difference. Results The mean CCT of the attacked eye of AACG is (576.97 ±50.93) μm while the mean CCT of the contralateral eye is (544.68 ±33.53)(μm. There is significance in CCT between the attacked eye and the contralateral eye(P 0.05). Conclusions CCT was increased in acute angle-closure glaucoma after the attack compared to the contralateral eye which should be considered during the treatment of the AACG patients.%目的 对照研究急性闭角型青光眼发作眼和对侧眼的角膜中央厚度和前房深度,晶状体厚度和眼轴长度.方法 共观察了急性闭角型青光眼75例.眼压控制后每个患者双眼接受A超检查,检查项目包括角膜中央厚度、前房深度、晶状体厚度和眼轴长度.统计分析采用配对t检验.结果 急性闭角型青光眼发作眼的平均角膜中央厚度是(576.97±50.93)μm,对侧眼的平均角膜中央厚度为(544.68±33.53)μm(P0.05).结论 与对侧眼相比,急性闭角型青光眼的角膜中央厚度较厚,可能是发作后遗留的损害.其它眼解剖参数无统计学差异,因此对侧眼也应进行预防治疗.

  20. Análise morfométrica comparativa entre olhos com glaucoma agudo primário e olhos contralaterais Comparative morphometric assessment between eyes with acute primary angle-closure glaucoma and contralateral eyes

    Directory of Open Access Journals (Sweden)

    Rafael Vidal Mérula

    2008-06-01

    üência os seios camerulares fechados quando comparados com os OCLs. Os olhos com GAP apresentaram: K médio de 45,21 ± 1,96 D, ECC média de 534,46 ± 34,15 mm, PCCA média de 2,43 ± 0,28 mm; AXL médio de 21,68 ± 0,96 mm, CR média de 4,85 ± 0,32 mm, e a relação CR/AXL de 2,24 ± 0,16. Os OCLs apresentaram: K médio de 44,92 ± 1,86 D, ECC média de 533,18 ± 31,41 mm, PCCA média de 2,51 ± 0,29 mm; AXL médio de 21,82 ± 0,92 mm, CR média de 4,85 ± 0,36 mm, e a relação CR/AXL de 2,23 ± 0,18. Houve diferença estatisticamente significativa apenas na comparação de K e PCCA, entre os olhos que tiveram GAP e os OCLs. CONCLUSÕES: A incidência de GAP foi de 20,8/1000, sendo mais freqüente em mulheres, leucodérmicas, com história familiar negativa para glaucoma e média de idade de 59,6 anos. Os olhos com GAP apresentaram, de modo estatisticamente significativo, pior acuidade visual, menor equivalente esférico hipermetrópico, maior escavação do disco óptico, maior K médio e menor PCCA que os OCLs.PURPOSE: To establish the profile of patients with acute primary angle-closure glaucoma (APACG and to assess comparatively clinical and morphometric parameters between eyes with APACG and contralateral eyes (CLEs. METHODS: Prospective study including patients attended from September 2005 to March 2007. Inclusion criteria: diagnosis of APACG. Exclusion criteria: presence of cataract (except for "glaukomflecken" that may cause low visual acuity or myopization, secondary glaucoma, previous APAGC or surgical procedure in the (CLE, no possibility to control the acute crisis of glaucoma clinically, plateau iris. The following were evaluated: incidence of APACG, age, gender, race, family history of glaucoma, corrected visual acuity (CVA and uncorrected visual acuity (UVA, spherical equivalent (SE, cup/disc ratio (C/D, gonioscopy, keratometry (K, central corneal thickness (CCT, and echobiometric data [anterior central chamber depth (ACCD, axial length (AL, lens

  1. The genetic mechanisms of primary angle closure glaucoma.

    Science.gov (United States)

    Ahram, D F; Alward, W L; Kuehn, M H

    2015-10-01

    Primary Angle Closure Glaucoma (PACG) is one of the most common types of glaucoma affecting over 15 million individuals worldwide. Family history and ethnicity are strongly associated with the development of the disease, suggesting that one or more genetic factors contribute to PACG. Although strictly heritable disease-causing mutations have not been identified, a number of recent association studies have pointed out genetic factors that appear to contribute to an individual's risk to develop PACG. In addition, genetic factors have been identified that modify PACG endophenotypes for example, axial length. Herein we review the current literature on this important topic.

  2. Circumscribed Ciliochoroidal Effusion Presenting as an Acute Angle Closure Attack

    Science.gov (United States)

    Lipa, Roslyn Kathryn Manrique; Sánchez, María Eugenia González; Ordovas, Carlos Antonio Hijar; Aragües, Abel Rojo; Borque, Carmen Garcia

    2017-01-01

    Purpose: To report a case of choroidal effusion probably caused by angiotensin receptor II blocker. Case Report: A 52-year-old man with aplastic anemia and high blood pressure who developed unilateral acute angle closure glaucoma after receiving oral cyclosporine and angiotensin II receptor blocker (losartan). Ophthalmic examination revealed visual acuity of 20/30 in the left eye, mild mydriasis, iris bombe, no anterior chamber reaction, mild conjunctival hyperemia, and the intraocular pressure of 30 mmHg. After laser YAG iridotomy, funduscopy was performed showing a choroidal circumscribed lesion at the inferotemporal quadrant. Diagnostic tests ruled out any inflammatory or malignancy process, and the choroidal lesion spontaneously disappeared. After 20 months of follow-up, patient's ocular remained stable. Conclusion: This is the third case of choroidal effusion associated with angiotensin II receptor blockers. Since idiosyncratic ciliochoroidal effusion is a diagnosis of exclusion, it is mandatory to rule out more frequent causes, such as inflammatory or malignant processes. PMID:28299016

  3. Association of Matrix Metalloproteinase-9 (MMP9 Variants with Primary Angle Closure and Primary Angle Closure Glaucoma.

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    Xueli Chen

    Full Text Available Shorter axial length observed in patients with primary angle closure glaucoma (PACG might be due to altered matrix metalloproteinase-9 (MMP9 activity resulting in ECM remodeling during eye growth and development. This study aimed to evaluate common variants in MMP9 for association with PACG. Six tag SNPs of MMP9 were genotyped in a Chinese sample of 1,030 cases, including 572 PACG and 458 primary angle closure (PAC, and 499 controls. None of 6 SNPs were significantly associated with overall PAC/PACG (P > 0.07 or with PAC/PACG subgroups (Pc > 0.18. Meta-analysis of two non-Chinese studies revealed significant association between rs17576 and PACG (ORs = 0.56, P 0.47. The largest association study to date did not find significant association between MMP9 and PAC/PACG in Chinese; meta-analysis with other Chinese datasets did not produce significant association. In most instances combination with non-Chinese datasets was not possible except for one variant showing nominally significant association. More work is needed to define the role of MMP9 variants in PACG.

  4. Molecular complexity of primary open angle glaucoma: current concepts

    Indian Academy of Sciences (India)

    Kunal Ray; Suddhasil Mookherjee

    2009-12-01

    Glaucoma is a group of heterogeneous optic neuropathies with complex genetic basis. Among the three principle subtypes of glaucoma, primary open angle glaucoma (POAG) occurs most frequently. Till date, 25 loci have been found to be linked to POAG. However, only three underlying genes (Myocilin, Optineurin and WDR36) have been identified. In addition, at least 30 other genes have been reported to be associated with POAG. Despite strong genetic influence in POAG pathogenesis, only a small part of the disease can be explained in terms of genetic aberration. Current concepts of glaucoma pathogenesis suggest it to be a neurodegenerative disorder which is triggered by different factors including mechanical stress due to intra-ocular pressure, reduced blood flow to retina, reperfusion injury, oxidative stress, glutamate excitotoxicity, and aberrant immune response. Here we present a mechanistic overview of potential pathways and crosstalk between them operating in POAG pathogenesis.

  5. Primary open-angle glaucoma: everyone’s business

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    Hannah Faal

    2012-01-01

    Full Text Available Primary open-angle glaucoma (POAG is sometimes called the ‘thief of sight’. There is no pain or discomfort, and vision loss is so gradual that people often do not notice it.POAG cannot be cured: it requires ongoing treatment for the remainder of a patient’s life. Blindness from POAG also cannot be reversed, but it can be prevented if the disease is diagnosed early and treated. Effectively addressing POAG therefore requires the careful involvement of many different people, including health workers, the patient, non-clinical staff, and health planners.As eye care practitioners, we must do more than merely diagnose and treat people with POAG; we must gain the trust of patients and show them that we are there to help.

  6. Acute stent thrombosis after primary percutaneous coronary intervention

    DEFF Research Database (Denmark)

    Clemmensen, Peter; Wiberg, Sebastian; Van't Hof, Arnoud;

    2015-01-01

    OBJECTIVES: This study sought to determine clinical, procedural, and treatment factors associated with acute stent thrombosis (AST) in the EUROMAX (European Ambulance Acute Coronary Syndrome Angiography) trial. BACKGROUND: Bivalirudin started during transport for primary percutaneous coronary int...

  7. Intraocular pressure fluctuation after water drinking test in primary angle-closure glaucoma and primary open-angle glaucoma

    Directory of Open Access Journals (Sweden)

    Yi-Chieh Poon

    2016-01-01

    Full Text Available Context: Only a few studies have assessed intraocular pressure (IOP changes during the water drinking test (WDT in patients with primary angle-closure glaucoma (PACG. Aims: The aim of this study is to investigate IOP changes during WDT in patients with PACG versus primary open-angle glaucoma (POAG. Settings and Design: This was a prospective and single tertiary center study. Materials and Methods: PACG and POAG patients (n = 15 each without prior glaucoma surgery were enrolled and subjected to WDT, wherein they consumed an amount of water proportional to their body weight within 10 min. IOP was measured at baseline and every 15 min for 1 h after water intake. Statistical Analysis Used: Intergroup comparisons were performed using Mann–Whitney U-test for continuous variables and Chi-square test for categorical variables. Wilcoxon signed-ranks test was used for comparisons of IOP before and after water intake in the two groups. Regression analysis was used to determine factors associated with IOP fluctuations during WDT. Results: IOP changes over 1 h after water intake showed no significant differences between groups. The mean maximum fluctuation from baseline was 3.61 ± 2.49 and 3.79 ± 1.91 mmHg, respectively, in the PACG and POAG groups. The mean peak IOP was 19.17 ± 4.32 and 19.87 ± 3.44 mmHg in the PACG and PAOG groups, respectively. The axial length and anterior chamber depth showed no correlations with IOP fluctuations. Conclusions: We found similar IOP fluctuation curves and peak IOP values in both PACG and POAG patients subjected to WDT. These findings suggest that WDT is a useful test to induce IOP peaks in both POAG and PACG patients.

  8. Mitochondrial damage in the trabecular meshwork occurs only in primary open-angle glaucoma and in pseudoexfoliative glaucoma.

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    Alberto Izzotti

    Full Text Available BACKGROUND: Open-angle glaucoma appears to be induced by the malfunction of the trabecular meshwork cells due to injury induced by oxidative damage and mitochondrial impairment. Here, we report that, in fact, we have detected mitochondrial damage only in primary open-angle glaucoma and pseudo-exfoliation glaucoma, among several glaucoma types compared. METHODOLOGY/PRINCIPAL FINDINGS: Mitochondrial damage was evaluated by analyzing the common mitochondrial DNA deletion by real-time PCR in trabecular meshwork specimens collected at surgery from glaucomatous patients and controls. Glaucomatous patients included 38 patients affected by various glaucoma types: primary open-angle, pigmented, juvenile, congenital, pseudoexfoliative, acute, neovascular, and chronic closed-angle glaucoma. As control samples, we used 16 specimens collected from glaucoma-free corneal donors. Only primary open-angle glaucoma (3.0-fold and pseudoexfoliative glaucoma (6.3-fold showed significant increases in the amount of mitochondrial DNA deletion. In all other cases, deletion was similar to controls. CONCLUSIONS/SIGNIFICANCE: despite the fact that the trabecular meshwork is the most important tissue in the physiopathology of aqueous humor outflow in all glaucoma types, the present study provides new information regarding basic physiopathology of this tissue: only in primary open-angle and pseudoexfoliative glaucomas oxidative damage arising from mitochondrial failure play a role in the functional decay of trabecular meshwork.

  9. PRIMARY OPEN-ANGLE GLAUCOMA AND FARMACOECONOMICS - REVIEW

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    Sarenac Vulovic Tatjana

    2016-12-01

    Full Text Available Primary open-angle glaucoma (POAG is defined as a chronic and progressive disease. Date suggested that it is the second most common cause of the blindness in the world. Blindness, as global problem, is partially consequences of poor health insurance, low medical education, etc. The only modifiable risk factor for glaucoma is intraocular pressure. Cost of the antiglaucomatous treatment increased by prescribing and using wide spectrum of antiglaucomatous drugs. If an ophthalmologist is not satisfied with glaucomatous disease control, need for the laser or surgical treatment is appeared. Disease stadium also determines the cost of the treatment. The social and economic burden of glaucoma can be changed by increased life expectancy, older population age and higher per capita GDP. Unique opinion about cost effectiveness cannot be reached, due to nonconforming findings of many studies. Treatment approach must be individualized to every patient, according to the disease's stadium, availability of therapeutic modalities and approaches, life expectancy and the level of GDP. Efficacy, compliance and potential side-effects of prescribed medication also determine the proper treatment choice.

  10. Surgery for an "Acute Erection Angle," When Counseling Fails

    NARCIS (Netherlands)

    Nugteren, Helena M.; Pascal, Astrid L.; Schultz, Willibrord C. M. Weijmar; van Driel, Mels F.

    2010-01-01

    Introduction. During erection, the penis increases in volume, rigidity, and angle. Textbooks of urology and sexology provide only very limited information about erection angle dysfunction. In some men, this angle is too tight toward their belly, causing problems with intercourse. Aim. We reported tw

  11. Bilateral simultaneous acute angle closure caused by sulphonamide derivatives: A case series

    Directory of Open Access Journals (Sweden)

    Senthil Sirisha

    2010-01-01

    Full Text Available The sulphonamide group of drugs is implicated in bilateral acute angle closure (AAC due to an idiosyncratic response. We report a series of three cases with bilateral AAC caused by different sulphonamide derivatives, their presentation and management.

  12. Bilateral simultaneous acute angle closure caused by sulphonamide derivatives: A case series

    OpenAIRE

    Senthil Sirisha; Garudadri Chandrasekhar; Rao Harsha; Maheshwari Rajat

    2010-01-01

    The sulphonamide group of drugs is implicated in bilateral acute angle closure (AAC) due to an idiosyncratic response. We report a series of three cases with bilateral AAC caused by different sulphonamide derivatives, their presentation and management.

  13. Bilateral simultaneous acute angle closure caused by sulphonamide derivatives: a case series.

    Science.gov (United States)

    Senthil, Sirisha; Garudadri, Chandrasekhar; Rao, Harsha B L; Maheshwari, Rajat

    2010-01-01

    The sulphonamide group of drugs is implicated in bilateral acute angle closure (AAC) due to an idiosyncratic response. We report a series of three cases with bilateral AAC caused by different sulphonamide derivatives, their presentation and management.

  14. Argon laser iridoplasty : A primary mode of therapy in primary angle closure glaucoma

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    Agarwal H

    1991-01-01

    Full Text Available Argon laser iridoplasty was performed in 40 eyes of 33 patients of primary angle closure glaucoma. There were 12 male and 21 female patients. The mean ages of the male and female patients were 51 years and 48.4 years respectively. Forty eyes were divided into two groups. Group I consisted of ten eyes of subacute angle closure glaucoma and group II included thirty eyes of chronic angle closure glaucoma. Argon laser iridoplasty was performed with Coherent 9000 model using laser settings of spot size 200 micron, duration 0.2 second and power 0.7 watt. A total of 80 spots were applied over 360 degree circumference. The intraocular pressure control (below 22 mm Hg was achieved after iridoplasty in all the eyes (100% in group I, where as in group II the intraocular pressure was controlled in 70% eyes. The follow up period varied from 3 months to one year with a mean of eight months. The success rate with iridoplasty was directly related to the extent of peripheral anterior synechiae, optic disc cupping and presence of visual field changes.

  15. Acute necrotizing pancreatitis as fi rst manifestation of primary hyperparathyroidism

    Institute of Scientific and Technical Information of China (English)

    Jeroen; I; Lenz; Jimmy; M; Jacobs; Bart; Op; de; Beeck; Ivan; A; Huyghe; Paul; A; Pelckmans; Tom; G; Moreels

    2010-01-01

    We report the case of a female patient with severe acute necrotizing pancreatitis associated with hypercalcemia as first manifestation of primary hyperparathyroidism caused by a benign parathyroid adenoma.Initially the acute pancreatitis was treated conservatively.The patient subsequently underwent surgical resection of the parathyroid adenoma and surgical clearance of a large infected pancreatic pseudocyst.Although the association of parathyroid adenoma-induced hypercalcemia and acute pancreatitis is a kno...

  16. A CLINICAL STUDY OF PRIMARY ANGLE CLOSURE GLAUCOMA AND ITS MANAGEMENT WITH Nd.YAG LASER IRIDOTOMY

    Directory of Open Access Journals (Sweden)

    Rajashree

    2016-02-01

    Full Text Available BACKGROUND Sixty million people are affected with glaucoma worldwide and more than 20 million have PACG. Of these, more than 5 million with PACG are blind, which is twice more than POAG. Early detection and timely treatment with Nd.YAG laser iridotomy and associated complications determine visual outcome. OBJECTIVES To study efficacy of Nd.YAG laser iridotomy in controlling intraocular pressure in primary angle closure glaucoma patients. To study role of prophylactic Nd.YAG laser iridotomy in the fellow eyes of primary angle closure glaucoma patients. To study anatomical changes in the angle of anterior chamber following peripheral iridotomy and complications of Nd.YAG laser iridotomy. METHODS A prospective study of 100 cases of primary angle closure glaucoma was conducted in Basaveshwar Teaching and General Hospital (Attached to M.R. Medical College, Kalaburagi. A detailed ophthalmic examination was performed. IOP was measured by Goldmann applanation tonometry. Gonioscopy was done by Goldmann 3 mirror lens. Nd.YAG laser was performed on all affected eyes and 82 fellow eyes of 100 patients and followed up for six months. RESULTS Among the patients included in the study 73 (73% patients were females and 27 (27% were males. In our study most of the patients were 40 to 60 years of age group. Our study included 57 (57% with PAC, 28 (28% with PACG and 15 (15% PACS. There was improvement of 2 Shaffer’s grades in 65%, 1 Shaffer’s grades in 25% of patients. In my study 53 (92.2% of 57 PAC (Acute and sub-acute patients had improved with stable visual acuities and good control of IOP at followup visits; 20 (71.4% of 28 PACG (Chronic patients had good control of IOP at followup visits with improvement of stable visual acuities. All the PACS eyes and the fellow eyes with prophylactic laser iridotomy were with good IOP control and visual acuities; 6 (3.4% eyes out of 172 eyes which underwent iridotomies were found closed at follow-up visits with shallow

  17. 原发性闭角型青光眼单侧急性发作对侧眼激光虹膜周边切除术后随访研究%Follow-up of laser peripheral iridotomy in fellow eyes with unilateral acute attack of primary angle closure glaucoma

    Institute of Scientific and Technical Information of China (English)

    张海涛; 杨华; 徐英英

    2011-01-01

    Background Laser peripheral iridotomy(LPI) is used as the primary therapy for the eyes at risk of angle closure.But there are still 28% eyes with primary angle closure suspect occur angle closure within 2 years after LPI.It is necessary to explore the associated factors of the efficacy of LPI.Objective The aim of this study was to explore the changes of intraocular pressure(IOP) and anterior chamber angle in the fellow eyes of patients with unilateral acute attack of primary angle closure glaucoma (PACG) and analyze the relevant factors influencing the successful rate of LPI.Methods Eighty-seven fellow eyes received LPI from 87 patients with unilateral acute attack of PACG were included in this study and retrospectively analyzed.The IOP and gonioscopy were performed before and 1 week,3,6,9,12 months after LPI.Successful signs of LPI were defined as an IOP 6-21mmHg without any anti-glaucoma medication,none of glaucomatous neuropathy and the coincident visual field loss,and no need of additional glaucomatous medication or surgery.This study was approved by Ethic Committee of the First Hospital of Xinxiang Medical College,and written informed consent was obtained from each patient.Results Seventy-nine eyes of 79 cases finished the medical visit throughout the follow-up duration with the age 61.4±0.4 years and 33(41.8%) males and 46(58.2%) females.The mean IOP was lowed in various time points after LPI in comparison with before operation with the general difference among different time visiting groups(F=4.056,P<0.01).Shaffer grade was increased in superior,temporal and nasal quadrants and significant differences were found between 1 week group,3 months group or 6 months group and before operation group (P<0.05).LPI lessened the range of appositional angle closure (AAC) in postoperative 1 week group and 3 months group compared with pre-operative group (P<0.05),but no statistically significant reduce was seen in range of AAC from 6 months through 12 months after

  18. Acute Ankle Sprains in Primary Care

    NARCIS (Netherlands)

    R.M. van Rijn (Rogier)

    2010-01-01

    textabstractOf all injuries of the musculoskeletal system, 25% are acute lateral ankle sprains.1 In the USA and the UK there are about 23,000 and 5000 ankle sprains, respectively, each day. In the Netherlands approximately 600,000 people sustain an ankle injury each year, of those 120,000 occur duri

  19. Primary spinal extradural hydatid cyst associated with acute bleeding

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    Guohua Zhu

    2009-07-01

    Full Text Available Aims: To report a case of unilocular primary spinal extradural hydatid cyst which manifested as acute bleeding. Methods: The clinical presentation, diagnosis, and surgical treatment of this rare case are discussed. Published cases of primary extradural hydatid cysts are reviewed. Results: Complete recovery was achieved. Repeated clinical, radiological, and serological examinations did not show any evidence of local recurrence or systemic hydatidosis during the follow-up period of 50 months. Conclusions: Primary spinal extradural hydatid cyst may present as acute bleeding.

  20. Primary spinal extradural hydatid cyst associated with acute bleeding

    Directory of Open Access Journals (Sweden)

    Yongxin Wang

    2009-01-01

    Full Text Available Aims: The purpose of this article is to report a case of unilocular primary spinal extradural hydatid cyst which manifested as acute bleeding. Methods: The clinical presentation, diagnosis, and surgical treatment of this rare case are discussed and published cases of primary extradural hydatid cysts are reviewed. Results: Complete recovery was achieved. Repeated clinical, radiological, and serological examinations did not show any evidence of local recurrence or systemic hydatidosis during the follow-up period of 50 months. Conclusions: Primary spinal extradural hydatid cyst may present as acute bleeding. (Wang Y, Geng D, Zhu G, Du G.

  1. The behavior of tillage tools with acute and obtuse lift angles

    Directory of Open Access Journals (Sweden)

    Mohammad Hossein Abbaspour-Fard

    2014-01-01

    Full Text Available An experimental investigation was conducted to study the trend of draft force against forward speed and working depth for a range of lift angles beyond acute angles for a simple plane tillage tool. The experiments were performed in an indoor soil bin facility equipped with a tool carriage and a soil preparation unit propelled by an integrated hydraulic power system. The system was also equipped with electronic instrumentation including an Extended Octagonal Ring Transducer (EORT and a data logger. The factorial experiment (4×3×3 with three replications was used based on Randomized Complete Block Design (RCBD. The independent variables were lift angle of the blade (45, 70, 90 and 120°, forward speed (2, 4 and 6 km h-1 and working depth (10, 25 and 40 cm. The variance analysis for the draft force shows that all independent variables affect the draft force at 1% level of significance. The trend of the draft force against working depth and forward speed had almost a linear increase. However, the trend of the draft force against the lift angle is reversed for lift angles >90. This finding, conflicts with the results of analytical and numerical studies which extrapolate the results achieved for acute lift angles to obtuse lift angles and have not been reported experimentally.

  2. The behavior of tillage tools with acute and obtuse lift angles

    Energy Technology Data Exchange (ETDEWEB)

    Abbaspour-Fard, M. H.; Hoseini, S. A.; Agkhani, M. H.; Sharifi, A.

    2014-06-01

    An experimental investigation was conducted to study the trend of draft force against forward speed and working depth for a range of lift angles beyond acute angles for a simple plane tillage tool. The experiments were performed in an indoor soil bin facility equipped with a tool carriage and a soil preparation unit propelled by an integrated hydraulic power system. The system was also equipped with electronic instrumentation including an Extended Octagonal Ring Transducer (EORT) and a data logger. The factorial experiment (4 × 3 × 3) with three replications was used based on Randomized Complete Block Design (RCBD). The independent variables were lift angle of the blade (45, 70, 90 and 120 degree centigrade), forward speed (2, 4 and 6 km h{sup -}1) and working depth (10, 25 and 40 cm). The variance analysis for the draft force shows that all independent variables affect the draft force at 1% level of significance. The trend of the draft force against working depth and forward speed had almost a linear increase. However, the trend of the draft force against the lift angle is reversed for lift angles > 90 degree centigrade. This finding, conflicts with the results of analytical and numerical studies which extrapolate the results achieved for acute lift angles to obtuse lift angles and have not been reported experimentally. (Author)

  3. LEARNING FROM ERRORS -TOPIRAMATE INDUCED BILATERAL ANGLE CLOSURE WITH ACUTE ONSET MYOPIA

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    Nayana

    2014-12-01

    Full Text Available : Topiramate is an oral sulfamate medication used primarily for seizure treatment and has also demonstrated efficacy in the treatment of bipolar disorders and migraine. The mechanism of causation of angle closure and acute myopia is not clearly understood and several theories have been proposed of which the uveal effusion theory is widely accepted. We report a case of topiramate induced acute myopia with bilateral acute angle closure. With the increase in the frequency of prescribing topiramate for migraine prophylaxis it is important that the prescribing physicians should be aware of these complications. It is also important to educate the patients regarding the possible symptoms so that they can report at the earliest.

  4. A Rare Cause of Acute Abdominal Pain: Primary Appendagitis Epiploica

    Directory of Open Access Journals (Sweden)

    Tarkan Ergun

    2014-03-01

    Primary appendagitis epiploica – one of the causes of acute abdominal pain – is a self-limited rare benign inflammatory condition involving the colonic epiploic appendages. Their therapy is conservative and clinically mimics other conditions requiring surgery such as acute diverticulitis or appendicitis. However, being a quite rare condition is the reason they are usually neglected by both the surgeon and the radiologist. However the computed tomography (CT findings are rather characteristic and pathognomonic. Thus, to consider CT as the diagnostic modality of choice is extremely important in order to diagnose the condition and to avoid unnecessary surgical interventions.             This is a paper reporting an acute abdominal pain case of primary appendicitis epiploica diagnosed using computed tomography. 

  5. Bilateral acute angle closure glaucoma as a presentation of isolated microspherophakia in an adult: case report

    Directory of Open Access Journals (Sweden)

    Gupta Amod

    2006-07-01

    Full Text Available Abstract Background Bilateral simultaneous angle closure glaucoma is a rare entity. To our knowledge this is the first reported case of bilateral acute angle-closure glaucoma secondary to isolated microspherophakia in an adult. Case presentation A 45-year-old woman presented with bilateral acute angle closure glaucoma, with a patent iridotomy in one eye. Prolonged miotic use prior to presentation had worsened the pupillary block. The diagnosis was not initially suspected, and the patient was subjected to pars-plana lensectomy and anterior vitrectomy for a presumed ciliary block glaucoma. The small spherical lens was detected intraoperatively, and spherophakia was diagnosed in retrospect. She had no systemic features of any of the known conditions associated with spherophakia. Pars-plana lensectomy both eyes controlled the intraocular pressure successfully. Conclusion This case demonstrates the importance of considering the diagnosis of isolated microspherophakia in any case of bilateral acute angle closure glaucoma. Lensectomy appears to be an effective first-line strategy for managing these patients.

  6. 超声乳化白内障吸出术对急性原发性闭角型青光眼眼前段的影响%Effects of anterior segment after phacoemulsification in patients with acute primary angle closure glaucoma

    Institute of Scientific and Technical Information of China (English)

    李乃洋; 赵岐; 钟兴武

    2011-01-01

    目的 使用Pentacam三维前房分析仪和眼前段光学相干断层扫描仪(AS-OCT)观察超声乳化白内障吸出术对急性原发性闭角型青光眼(APACG)患者眼前段的影响.方法 收集2010年7月至12月于中山大学附属中山医院眼科就诊的伴有白内障APACG的病例共39例(39眼).常规行超声乳化白内障吸出联合人工晶体(IOL)植入术.术前和术后3个月使用Pentacam和AS-OCT测量眼前段参数.结果 术后3个月,APACG患者眼压由术前(33.08±5.21)mm Hg降至(16.36±3.44)mm Hg(1mm Hg=0.133 kPa,t=20.644,P=0.000),中央前房深度由(1.79±0.20)mm增至(3.41±0.38) mm (t=36.191,P=0.000),周边前房深度由(0.82±0.12) mm加深至(1.81 ±0.20) mm (t=40.732,P=0.000),前房容积自(74.10±9.94) mm增加至(149.72± 17.12) mm (t=54.921,P=0.000),下方前房角自(24.03±3.50).加宽至( 43.29±3.92).(t=55.489,P=0.000),鼻侧前房角自(23.02±2.96)°加宽至(42.36±4.61).(t=43.291,P=0.000),上方前房角自(21.62±3.04).加宽至(39.66±3.53).( t=43.511,P=0.000),颞侧前房角自(22.88±2.87).加宽至(41.21±3.81).(t=44.930,P=0.000).瞳孔直径由术前(3.06±1.32)mm缩小至术后的(3.00±1.21)mm,但差异无统计学意义(t=1.177,P=0.247).结论 超声乳化白内障吸出术可改善APACG患者眼前段结构的狭窄.Pentacam和AS-OCT可简便快捷和非接触地观察眼前段,有良好的应用前景.%Objective To investigate the morphological changes of anterior segment in patients with acute primary angle closure glaucoma (APACG) after phacoemulsification using the Pentacam three-dimension anterior chamber analysis system and anterior segment optical coherence tomography (AS-OCT).Methods Thirty- nine APACG patients (39 eyes) accompanied with cataract were treated with phacoemulsification from July 2010 to December 2010 in Zhongshan Hospital.All the patients were examined by Pentacam and AS-OCT preoperation and 3 months postoperation.Outcomes included intraocular pressure (IOP

  7. Primary stenting as emergency therapy in acute basilar artery occlusion

    Energy Technology Data Exchange (ETDEWEB)

    Spreer, Joachim; Arnold, Sebastian; Klisch, Joachim; Schumacher, Martin [Section of Neuroradiology, University Hospital Freiburg, Breisacher Strasse 64, 79106 Freiburg (Germany); Els, Thomas; Hetzel, Andreas; Huppertz, Hans-Juergen; Oehm, Eckhardt [Department of Neurology, University Hospital Freiburg, Freiburg (Germany)

    2002-09-01

    In three patients with acute occlusion of the basilar artery intra-arterial fibrinolysis resulted in only partial recanalization and revealed severe stenosis as the underlying cause. Application of micro-stents without previous dilatation resulted in vessel re-opening. Two patients had an excellent clinical outcome. One patient died 10 days after the stroke due to brainstem infarction. Emergency primary stent application may improve the outcome in acute basilar artery occlusion, if intra-arterial thrombolysis fails to re-establish a sufficient flow. (orig.)

  8. Topiramate-induced bilateral acute angle closure glaucoma and myopic shift

    Directory of Open Access Journals (Sweden)

    Rajnish Raj

    2014-06-01

    Full Text Available Topiramate (TPM shows idiosyncratic adverse reaction of peripheral ciliochoroidal effusion leading to acute angle closure glaucoma (AACG, which should be diagnosed and managed at the earliest to prevent irreversible visual loss. We report, a case of TPM-induced bilateral AACG and myopic shift, which was reversed by omitting TPM and administering antiglaucoma medications. [Int J Basic Clin Pharmacol 2014; 3(3.000: 562-565

  9. Balloon-guided navigation technique to perform stenting in an acutely angled anterior cerebral artery.

    Science.gov (United States)

    Cohen, José E; Gomori, John M; Moscovici, Samuel; Itshayek, Eyal

    2012-03-01

    The complex anatomic features of wide-necked anterior communicating artery aneurysms represent an endovascular challenge. Compliant balloons and microstents are frequently required to achieve aneurysm occlusion. When the angle between the A1 and A2 segments is acute, microcatheter navigation is hazardous, and may be difficult or sometimes impossible with standard techniques. We present our technique using a support balloon to facilitate guidewire engagement and navigation of A2, and to assist with microcatheterization in this unfavorable vascular anatomy.

  10. BILATERAL ACUTE ANGLE CLOSURE GLAUCOMA AND MYOPIA INDUCED BY LOW DOSAGE TOPIRAMATE

    Directory of Open Access Journals (Sweden)

    Busra S. Arica

    2014-09-01

    Full Text Available Introduction: Topiramate, a sulfamate-substituted monosaccharide, has been shown to be effective in the treatment of epilepsy and migraine prophylaxis. However, acute secondary angle closure glaucoma and myopia has been shown to develop, especially during the first two weeks of treatment, in a small subset of patients. Case presentation: In the current case report, a 23 year old female patient developed acute myopia and angle closure glaucoma after one week topiramate treatment (25 mg/day for prophylaxis of migraine without aura. The patient was found to have significant conjunctival hyperemia, shallow anterior chamber, and bulging iris in both eyes. Grade 1 acute angle was detected in both eyes during gonioscopic examination. There was no pupillary block and intraocular pressure was 40 mmHg in both eyes. Refraction values were measured at -7.00 and -8.00 in the right and left eye, respectively. The patient and #8217;s visual acuity was at 0.1 to 0.2. Topiramate treatment was promptly discontinued, topical antiglaucomatous treatment was initiated, and laser peripheral iridotomy was performed on each eye. Intraocular pressure has declined to normal limits, refractive values were zero in both eyes and patient and #8217;s visual acuity has restored at follow-up period at 10 days after treatment. Conclusion: Side effects associated with topiramate treatments are known to disappear without long-term damage when the discontinuation of therapy and effective interventions are started early. Therefore, patients and their physicians should be alert for symptoms associated with acute secondary angle closure glaucoma and myopia; especially in the first weeks of topiramate treatment also with low dosage. [J Contemp Med 2014; 4(3.000: 168-171

  11. MISTAKES IN THE DIAGNOSIS AND TREATMENT OF PRIMARY ANGLE-CLOSURE GLAUCOMA: CASE REPORT

    Directory of Open Access Journals (Sweden)

    Marić Vesna

    2016-07-01

    Full Text Available Primary angle-closure glaucoma (PACG is a leading cause of blindness globally. It is a condition that is responsible for nearly half of patients who have a bilateral blindness caused by glaucoma. PACG is highly prevalent in Asian countries, as compared with Primary open-angle glaucoma (POAG, which is reported as the predominant disease among Whites, but prevalence of PACG in Europe has been underestimated previously. Early detection by effective screening and appropriate prophylaxis and treatment may prevent blindness from angle-closure glaucoma. The purpose of this study was to present through the cases of 3 patients with PACG the importance of each phase of glaucoma: diagnosis, treatment and follow-up.

  12. Evaluation of Optineurin as a candidate gene in Indian patients with primary open angle glaucoma.

    NARCIS (Netherlands)

    Mukhopadhyay, A.; Komatireddy, S.; Acharya, M.; Bhattacharjee, A.; Mandal, A.K.; Thakur, S.K.D.; Chandrasekhar, G.; Banerjee, A.; Thomas, R.; Chakrabarti, S.; Ray, K.

    2005-01-01

    PURPOSE: To evaluate the role of the optineurin gene (OPTN) in Indian primary open angle glaucoma (POAG) patients from different parts of the country. METHODS: Two hundred patients with POAG and 200 ethnically matched normal controls were recruited from various parts of India for the study. The enti

  13. The long-term outcomes of four alternative treatment strategies for primary open-angle glaucoma

    NARCIS (Netherlands)

    van Gestel, Aukje; Webers, Carroll A.; Severens, Johan L.; Beckers, Henny J.; Jansonius, Nomdo M.; Hendrikse, Fred; Schouten, Jan S.

    2012-01-01

    Purpose: To evaluate the long-term effects and costs of four treatment strategies for primary open-angle glaucoma compared to usual care. Methods: Cost-effectiveness analyses with a lifelong horizon were made from a societal perspective. Data were generated with a patient-level model based on discre

  14. Association between CYP1A1m1 gene polymorphism and primary open-angle glaucoma.

    Science.gov (United States)

    Costa, N B; Silva, C T X; Frare, A B; Silva, R E; Moura, K K V O

    2014-12-04

    The CYP1A1 gene is related to the generation of secondary metabolites that are capable of inducing DNA damage. The CYP1A1m1 polymorphism has been examined in many studies, and is located in a region near loci that have been linked to glaucoma, including the locus GLC1I. As a result, this polymorphism has been related to several diseases that are influenced by exposure to xenobiotic as well as primary open-angle glaucoma. We compared the prevalence of the CYP1A1m1 polymorphism in 152 Brazilian patients, 100 patients with primary open-angle glaucoma, and 52 normal controls using restriction fragment length polymorphism analysis. The frequency of the homozygous wild-type (w1/w1) CYP1A1 gene among patients with primary open-angle glaucoma (N = 100) was 16%, for genotype w1/m1, the frequency was 77%, and for m1/m1 it was 7%. Among the control group (N = 52), the frequency of the homozygous wild-type (w1/w1) CYP1A1 gene was 54%, the frequency of w1/m1 was 46%, and the frequency of m1/m1 was 0%. The presence of the CYP1A1m1 polymorphism may interfere with xenobiotic metabolism and exacerbate direct or indirect damage to the optic nerve. These CYP1A1m1 polymorphisms may be risk factors for primary open-angle glaucoma.

  15. Common Genetic Determinants of Intraocular Pressure and Primary Open-Angle Glaucoma

    NARCIS (Netherlands)

    van Koolwijk, Leonieke M. E.; Ramdas, Wishal D.; Ikram, M. Kamran; Jansonius, Nomdo M.; Pasutto, Francesca; Hysi, Pirro G.; Macgregor, Stuart; Janssen, Sarah F.; Hewitt, Alex W.; Viswanathan, Ananth C.; ten Brink, Jacoline B.; Hosseini, S. Mohsen; Amin, Najaf; Despriet, Dominiek D. G.; Willemse-Assink, Jacqueline J. M.; Kramer, Rogier; Rivadeneira, Fernando; Struchalin, Maksim; Aulchenko, Yurii S.; Weisschuh, Nicole; Zenkel, Matthias; Mardin, Christian Y.; Gramer, Eugen; Welge-Luessen, Ulrich; Montgomery, Grant W.; Carbonaro, Francis; Young, Terri L.; Bellenguez, Celine; McGuffin, Peter; Foster, Paul J.; Topouzis, Fotis; Mitchell, Paul; Wang, Jie Jin; Wong, Tien Y.; Czudowska, Monika A.; Hofman, Albert; Uitterlinden, Andre G.; Wolfs, Roger C. W.; de Jong, Paulus T. V. M.; Oostra, Ben A.; Paterson, Andrew D.; Mackey, David A.; Bergen, Arthur A. B.; Reis, Andre; Hammond, Christopher J.; Vingerling, Johannes R.; Lemij, Hans G.; Klaver, Caroline C. W.; van Duijn, Cornelia M.

    2012-01-01

    Intraocular pressure (IOP) is a highly heritable risk factor for primary open-angle glaucoma and is the only target for current glaucoma therapy. The genetic factors which determine IOP are largely unknown. We performed a genome-wide association study for IOP in 11,972 participants from 4 independen

  16. The vast complexity of primary open angle glaucoma : Disease genes, risks, molecular mechanisms and pathobiology

    NARCIS (Netherlands)

    Janssen, Sarah F.; Gorgels, Theo G. M. F.; Ramdas, Wishal D.; Klaver, Caroline C. W.; van Duijn, Cornelia M.; Jansonius, Nomdo M.; Bergen, Arthur A. B.

    2013-01-01

    Primary open angle glaucoma (POAG) is a complex progressive optic nerve neuropathy triggered by both environmental and genetic risk factors. Several ocular tissues, including the ciliary body, trabecular meshwork and optic nerve head, and perhaps even brain tissues, are involved in a chain of pathol

  17. Variants in the ASB10 Gene Are Associated with Primary Open Angle Glaucoma

    NARCIS (Netherlands)

    Micheal, S.; Ayub, H.; Islam, F.; Siddiqui, S.N.; Khan, W.A.; Akhtar, F.; Qamar, R.; Khan, M.I.; Hollander, A.I. den

    2015-01-01

    BACKGROUND: Recently nonsynonymous coding variants in the ankyrin repeats and suppressor of cytokine signaling box-containing protein 10 (ASB10) gene were found to be associated with primary open angle glaucoma (POAG) in cohorts from Oregon and Germany, but this finding was not confirmed in an indep

  18. Evaluation of Ocular Surface Disease in Asian Patients with Primary Angle Closure

    Science.gov (United States)

    Ling, Tan Ee; Othman, Khairuddin; Yan, Ong Poh; Rashid, Rasdi Abdul; Tet, Cheong Min; Yaakob, Azhany; Tajudin, Liza-Sharmini Ahmad

    2017-01-01

    Objective: To evaluate the incidence of ocular surface disease (OSD) and to determine the effects of topical pressure-lowering drugs on ocular surface disease in primary angle closure patients. Methods: This was a cross-sectional comparative study comparing primary angle closure glaucoma (PACG) patients (Group A) with primary angle closure and primary angle closure suspect (Group B). Group A was treated with topical pressure-lowering drugs; Group B was not. Data on ocular diagnosis and details of treatment were obtained from medical records. Ocular surface disease incidence was assessed using the Ocular Surface Disease Index (OSDI) questionnaire and from clinical signs using Schirmer’s test, tear break-up time and corneal fluorescein stain. Predictive Analytic Software 20 and STATA analysis software were used for statistical analyses. Results: Group A demonstrated a higher rate of OSD (OSDI 52.3%, Schirmer’s test 70.5%, tear break-up time (TBUT) 75%, corneal staining 77.3%) compared to Group B (OSDI 39.0%, Schirmer’s test 73.2%, TBUT 58.5% and cornea staining 14.6%) except for Schirmer’s test. There was a significant difference in mean score of OSDI (p=0.004), TBUT (p=0.008) and cornea staining (p<0.001) between two groups. Primary angle closure glaucoma treated with more than two medications and for more than three years had worse ocular surface disease parameters but without statistical significant difference. Conclusion: Ocular surface disease is common in PACG patients treated with topical pressure-lowering drugs. Topical pressure-lowering drugs caused significant OSD symptoms and signs except for tear production in PACG patients. Thorough evaluation of ocular surface disease is important to ensure appropriate treatment and intervention in PACG patients.

  19. Acute adrenal insufficiency due to primary antiphospholipid antibody syndrome

    Directory of Open Access Journals (Sweden)

    Kishore Kumar Behera

    2013-01-01

    Full Text Available Introduction: We report a case of acute adrenal insufficiency (AAI in a patient with antiphospholipid syndrome (APS. Case Report: A 44-year-old female patient presented to us with acute abdominal pain associated with recurrent vomiting and giddiness. On examination, her blood pressure was 80/50 mm Hg. Systemic examination was normal. Further evaluation revealed hypocortisolemia with elevated plasma adrenocorticotropin hormone indicative of primary adrenal insufficiency. Her abdominal computed tomography scan showed features of evolving bilateral adrenal infarction. Etiological work-up revealed prolonged activated thromboplastin time, which didn′t correct with normal plasma, her anti-cardiolipin antibody and lupus anticoagulant were also positive. She was diagnosed to have APS with adrenal insufficiency and she was started on intravenous steroids and heparin infusion. Conclusion: AAI due to the APS can present with acute abdominal pain followed by hypotension. A high index of suspicion is needed to make the correct diagnosis and to initiate appropriate treatment.

  20. 超声乳化联合房角分离术治疗急性闭角型青光眼合并白内障的疗效观察%Outcome and surgical techniques of phacoemulsification combined with goniosynechialysis in eyes with acute primary angle closure glaucoma and cataract

    Institute of Scientific and Technical Information of China (English)

    李乃洋; 赵岐

    2016-01-01

    目的:观察超声乳化术治疗原发性急性闭角型青光眼( acute primary angle closure glaucoma,APACG)合并白内障的疗效及并探讨相关技巧。方法:收集2012-07/2014-07于中山市人民医院眼科就诊的APACG患者67例67眼,术前充分降低眼压,减轻角膜水肿,常规行超声乳化白内障吸出术,并分离房角。记录患者术前青光眼发作时和术后3 mo的视力、眼压、降压药物数量、房角开放范围以及并发症等。并使用Pentacam和眼前段光学相干断层扫描测量仪( anterior segment ocular coherence tomography,AS-OCT)测量眼前段参数,包括中央前房深度、前房容积和瞳孔直径等。结果:术前与术后3mo相比,LogMAR视力由术前0.87±0.09增至术后0.23±0.08(t=4.086,P<0.01)。眼压由术前32.31±4.70降至17.57±4.13mmHg(t=20.266,P<0.01),中央前房深度由1.89±0.22增至3.43±0.39mm(t=24.266,P<0.01),前房容积自78.24±8.96增加至148.65± ;17.85mm3(t=51.583,P<0.01),房角开放范围由105.9°±10.81°增加至320.7°±35.77°(t=46.677,P<0.01),降压药物使用数量由术前3.05±0.40降至0.47±0.13种( t=10.166,P<0.01),差异均有统计学意义(P<0.05)。瞳孔直径由术前3.14±1.28减至术后的3.07±1.18mm ( t=1.157,P=0.247),差异无统计学意义。术中发生后囊膜破裂1例,术后人工晶状体前膜形成2例。结论:超声乳化术联合房角分离等技术治疗急性闭角型青光眼合并白内障可以取得较好的手术疗效,可以有效降低眼压和改善眼前段狭窄。%Abstract•AIM:To investigate the outcome and surgical techniques of phacoemulsification combined with goniosynechialysis in eyes with acute primary angle closure glaucoma ( APACG) and cataract.•METHODS:Sixty-seven patients (67

  1. A comparison of the circadian rhythm of intraocular pressure in primary phronic angle closure glaucoma, primary open angle glaucoma and normal eyes

    Directory of Open Access Journals (Sweden)

    Sihota Ramanjit

    2005-01-01

    Full Text Available Purpose: To evaluate the circadian rhythm of intraocular pressure (IOP in primary chronic angle closure glaucoma (PCACG, primary open angle glaucoma (POAG, and normal eyes. Methods: Cross-sectional study of newly diagnosed patients of POAG (60 eyes, PCACG following laser iridotomy (75 eyes, and age and sex matched normal controls (75 eyes. All subjects underwent applanation tonometry at 7 a.m., 10 a.m., 1 p.m., 4 p.m., 7 p.m., and 10 p.m. by a masked observer. Circadian rhythms were classified based upon the timing and presence of peak pressure. Results: Age and gender in all three groups were comparable. Diurnal IOP fluctuations were significantly higher in PCACG (7.69 + 3.03 mmHg and POAG (8.31 + 2.58 mmHg groups compared to normal controls (4.83 + 2.46 mmHg. PCACG eyes and controls had similarly timed circadian rhythms, with PCACG eyes having a consistently higher IOP. At 7 and 10 a.m., IOP peaked more often in POAG eyes compared to PCACG eyes. A plateau type of circadian rhythm was most common in normal eyes. The timing of peak IOP could be significantly correlated with the type of primary glaucoma examined. Conclusion: Afternoon peaks were more common in postiridotomy PCACG eyes, similar to the rhythm in normal eyes. Morning peaks were more frequent in POAG eyes. Diurnal fluctuation > 6 mmHg, associated with an IOP of 21 mmHg or more was never seen in a normal eye.

  2. The effect of lens parameters on the development of the primary angle-closure glaucoma

    Institute of Scientific and Technical Information of China (English)

    Zhaohui Feng; Naixue Sun; Aiyi Zhou; Donggang Han; Yun Long; Zhao Wang; Xiaohua Wang

    2007-01-01

    Objective:To investigate the role the lens dimensions played on the pathogenesis of primary angle-closure glaucoma.Methods:38 eyes of 20 patients with primary angle-closure glaucoma (PACG) and 35 eyes of 22 normal individuals without ocular abnormalities were examined. The anatomical parameters of the lens and other structures of the anterior segment were calculated using B ultrasound, computer image processing and ultrasound biomicroscopy (UBM). The parameters were compared between the patients and normal subjects. Correlation analysis was used to determine the relationship between the radii of curvature of the anterior lens surface (RCALS) and the other parameters of the anterior segment. Results:Compared with the normal eyes, the eyes of PACG had thicker lens, steeper curvature of anterior lens surface, decreased depth of the anterior chamber, narrower chamber angle, and more anterior position of the ciliary bodies and lens. All these differences were significant(P < 0.05 or P < 0.01). In the PACG group, the RCALS had significantly negative correlation with the central and peripheral lens thickness (P < 0.01 and P < 0.05 respectively), and had positive correlation with relative lens position, anterior chamber depth (ACD), angle-open distance at 500 um(AOD500), trabecular iris angle(TIA) and trabecular ciliary processes distance(TCPD, P < 0.05 or P < 0.01 ). Conclusion:The occurrence of PACG is relevant to the abnormal anatomical structures of the anterior segment. Among all factors, the lens parameters play an important role in the pathogenesis. Increased lens thickness, relative more anterior position of lens, especially steepened curvature of anterior lens surface are predisposing factors of the pathologic phenomenon in PACG including pupillary blockage, shallow anterior chamber, secondary closure of chamber angle and elevation of intraocular pressure.

  3. Variable clinical spectrum of the myocilin Gln368X mutation in a Dutch family with primary open angle glaucoma.

    NARCIS (Netherlands)

    Hogewind, B.F.T.; Mukhopadhyay, A.; Theelen, T.; Hollander, A.I. den; Hoyng, C.B.

    2010-01-01

    PURPOSE: To describe the clinical phenotype in a family with primary open angle glaucoma harboring a p.Gln368X mutation in MYOC. MATERIALS AND METHODS: We identified a proband with primary open angle glaucoma and the p.Gln368X MYOC mutation. She and her six siblings were examined clinically, includi

  4. Ultrasonic Evaluation of the Lens Thickness to Axial Length Factor in Primary Closure Angle Glaucoma

    Institute of Scientific and Technical Information of China (English)

    1993-01-01

    Ultrasonic biometry was done in 232 normal eyes and 138 eyes with primary angle closure glaucoma (ACG), using Ultrascan Digital B System IV (10 MHz). The ratio between the lens thickness and the axial length (lens thickness to axial length factor, LAF) was evaluated as a biometric index for assessing the eye with primary ACG in Chinese. LAF of 2.00 was found to be ideal point of demarcation between ACG and normal eyes (i.e., lens thickness equals to 1/5 of axial length). It appears that LAF is helpful i...

  5. Oseltamivir (Tamiflu-induced bilateral acute angle closure glaucoma and transient myopia

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    Ji Woong Lee

    2014-01-01

    Full Text Available A 27-year-old woman developed bilateral acute angle closure glaucoma (AACG and transient myopia after taking oseltamivir for four days. On the fourth day, she received systemic and topical intraocular pressure (IOP-lowering agents, and IOP decreased in both eyes. However, her visual acuity was unchanged. A myopic shift of -5.25 D OD and -5.0 D OS was estimated to have occurred in the acute phase. A-scan ultrasonography and Pentacam showed markedly shallow anterior chambers and increased lens thickness. Ultrasound biomicroscopy revealed an annular ciliochoroidal effusion with forward displacement of the lens-iris diaphragm. Ciliochoroidal effusion and transient myopia were resolved after discontinuation of oseltamivir.

  6. Unilateral Optic Neuropathy and Acute Angle-Closure Glaucoma following Snake Envenomation

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    Osman Okan Olcaysu

    2015-01-01

    Full Text Available Purpose. We aimed to describe a unique case in which a patient developed unilateral optic neuritis and angle-closure glaucoma as a result of snake envenomation. Case Report. Approximately 18 hours after envenomation, a 67-year-old female patient described visual impairment and severe pain in her left eye (LE. The patient’s best corrected visual acuity was 10/10 in the RE and hand motion in the LE. Cranial magnetic resonance imaging showed signs of neuropathy in the left optic nerve. In the LE, corneal haziness, closure of the iridocorneal angle, and mild mydriasis were observed and pupillary light reflex was absent. Intraocular pressure was 25 mmHg and 57 mmHg in the RE and LE, respectively. The patient was diagnosed with acute angle-closure glaucoma in the LE. Optic neuropathy was treated with intravenous pulse methylprednisolone. Left intraocular pressure was within normal range starting on the fourth day. One month after the incident, there was no sign of optic neuropathy; relative afferent pupillary defect and optic nerve swelling disappeared. Conclusions. Patients with severe headache and visual loss after snake envenomation must be carefully examined for possible optic neuropathy and angle-closure glaucoma. Early diagnosis and treatment of these cases are necessary to prevent permanent damage to optic nerves.

  7. Focused-ion-beam-fabricated homogeneous acute-angled Au nanorods for surface-enhanced Raman scattering

    Science.gov (United States)

    Sivashanmugan, Kundan; Liao, Jiunn-Der; Haochih Liu, Bernard

    2015-05-01

    Well-ordered acute-angled Au nanorod (NR) arrays were fabricated using a focused ion beam (FIB) (fibAu_NR). The angle between the NRs and the substrate was tilted at 30-90°. A fibAu_NR with an angle of less than 90° significantly increased the effect of surface-enhanced Raman scattering, which was evaluated using low-concentration rose bengal (milk solution with good reproducibility.

  8. The clinical effect of Ex-Press glaucoma drainage device implantation combined with phacoemulsification for primary acute angle-closure glaucoma with cataract and persistent ocular hypertension%持续高眼压下白内障青光眼联合手术中青光眼引流器的应用

    Institute of Scientific and Technical Information of China (English)

    刘杰

    2015-01-01

    目的 探讨Ex-Press青光眼引流器植入联合晶状体超声乳化吸出术治疗合并白内障的急性闭角型青光眼持续高眼压患者的临床效果和安全性.方法 回顾性分析26例(30只眼)行Ex-Press青光眼引流器植入联合超声乳化手术治疗的合并白内障的急性闭角型青光眼持续性高眼压患者术前及术后各时间段的视力、眼压及并发症发生情况.结果 所有患者均随访至1年,完全成功率为76.67%(23只眼),部分成功率23.33%(7只眼),总成功率100.00%.术前平均眼压为(32.19±9.12) mmHg(1 mmHg=0.133kPa).术后1周,1、2、3、6及12个月的平均眼压分别为(10.30±5.07) mmHg、(10.28±4.93) mmHg、(10.87±4.22) mmHg、(11.32±6.11) mmHg、(12.12 ±6.07)mmHg、(13.05±5.26)mmHg,手术后眼压均较术前低,差异有统计学意义(P<0.05).术后1周视力较术前提高,差异有统计学意义(Z=-4.19,P=0.000).30只眼中2只眼出现少量前房积血,分别于术后4~7d吸收;4只眼出现一过性低眼压,8~10 d后眼压>6 mmHg;1只眼出现渗出性脉络膜脱离,于术后14 d复位.所有患者均未出现其他并发症.结论 Ex-Press青光眼引流器植入联合晶状体超声乳化吸出术是治疗合并白内障的急性闭角型青光眼持续性高眼压的一种安全而有效的方法.%Objective To investigate the clinical effects and safety of Ex-Press glaucoma drainage device implantation combined with phacoemulsification (E-P P) for primary acute angle-closure glaucoma (PAACG) with cataract and persistent ocular hypertension.Methods The data of 30 eyes of 26 patients of PAACG with cataract and persistent ocular hypertension were retrospectively analyzed, who received E-P P surgery.The visual acuity,intraocular pressure (IOP) and complications were observed.Results All patients were followed up for 1 year.The complete success rate was 76.67% (23 eyes), the partial success rate was 23.33% (7 eyes), and the total success rate was 100

  9. Primary coronary angioplasty for acute myocardial infarction (the Primary Angioplasty Registry).

    Science.gov (United States)

    O'Neill, W W; Brodie, B R; Ivanhoe, R; Knopf, W; Taylor, G; O'Keefe, J; Grines, C L; Weintraub, R; Sickinger, B G; Berdan, L G

    1994-04-01

    During a 14-month period, 6 experienced centers prospectively enrolled 271 patients into a registry in which percutaneous transluminal coronary angioplasty was the primary treatment for acute myocardial infarction. Patients age > 18 years who presented with ST-segment elevation on the 12-lead electrocardiogram were enrolled if symptom duration was or = 2 units of blood occurred in 46 patients (18%); 14 of these transfusions were related to coronary artery bypass surgery. Primary angioplasty is associated with a high reperfusion rate, low in-hospital mortality and few recurrent myocardial ischemic events. These results point to the need for a large-scale trial comparing angioplasty with thrombolytic therapy in the setting of acute myocardial infarction.

  10. Topiramate-associated acute, bilateral, angle-closure glaucoma: case report

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    Lucas Barasnevicius Quagliato

    2013-02-01

    Full Text Available This paper describes a topiramate induced acute bilateral angle-closure glaucoma. This rare adverse effect is an idiosyncratic reaction characterized by uveal effusion and lens forward displacement, leading to increased intraocular pressure and vision loss. We describe a 55 year-old white woman with migraine, spasmodic torticollis and essential tremor, who developed bilateral acute angle-closure glaucoma, one week after starting topiramate 25 mg/day. She was seen at the Ophthalmology Emergency Department of the Fundação João Penido Burnier (Campinas, SP, Brazil with a 4 hours history of blurry vision, ocular pain and bright flashes vision. Slit lamp examination revealed moderate conjunctival injection and corneal edema, and shallow anterior chambers. Intraocular pressure was 48 mmHg in both eyes. Fundoscopic examination findings were normal. She was treated with timolol, brimonidine, dorzolamide, pilocarpine, prednisone acetate eye drops and acetazolamide. One hour after those measures, as the intraocular pressure was 30 mmHg, she received a manitol intravenous injection and the intraocular pressure normalized. After 24 hours an iridotomy with Yag laser was performed. Topiramate was discontinued and she was totally recovered after one week.

  11. Dilemmas in primary care: antibiotic treatment of acute otitis media.

    Science.gov (United States)

    True, B L; Helling, D K

    1986-09-01

    Antibiotic treatment of acute otitis media (AOM) accounts for a significant number of all antibiotic prescriptions each year. In the primary care setting, initial antibiotic selection is rarely based on direct evidence, such as cultures of middle ear fluid. Initial antibiotic therapy by the primary care practitioner involves the evaluation and application of information related to prevalence of infecting organisms; in vitro antibiotic spectrum and penetration into middle ear fluid; initial cure rate, relapse and recurrence rates; and antibiotic cost, safety, and convenience. The influence of these factors on the initial antibiotic choice for AOM is reviewed. Several therapeutic dilemmas confronting the prescriber are discussed and a rational approach to initial antibiotic therapy is presented.

  12. Acute hemodynamic response to vasodilators in primary pulmonary hypertension.

    Directory of Open Access Journals (Sweden)

    Kulkarni H

    1996-01-01

    Full Text Available Acute hemodynamic effects of high flow oxygen (O2 inhalation, sublingual isosorbide dinitrate (ISDN, intravenous aminophylline (AMN and sublingual nifedipine (NIF were studied in 32 patients with primary pulmonary hypertension (PPH. In 30 out of 32 patients the basal ratio of pulmonary to systemic vascular resistance (Rp/Rs was > 0.5 (mean = 0.77 +/- 0.20. Oxygen caused significant decrease in the mean resistance ratio to 0.68 +/- 0.20 (p = 0.005. ISDN, AMN and NIF caused increase in the resistance ratio to 0.79 +/- 0.26; 0.78 +/- 0.26; and 0.80 +/- 0.23 respectively. O2, ISDN, AMN and NIF caused a fall of Rp/Rs in 21 (65.6%, 10 (31.2%, 10(31.2% and 9(28.1% patients respectively. Thus, of the four drugs tested high flow O2 inhalation resulted in fall of Rp/Rs in two thirds of patients whereas ISDN, AMN and NIF caused a mean rise in Rp/Rs. One third of patients did respond acutely to the latter three drugs. Acute hemodynamic studies are useful before prescribing vasodilators in patients with PPH since more of the commonly used drugs like ISDN, AMN, NIF could have detrimental hemodynamic responses in some patients. However, great caution should be exercised before performing hemodynamic study as the procedure has definite mortality and morbidity.

  13. Comparison between visual field defect in pigmentary glaucoma and primary open-angle glaucoma.

    Science.gov (United States)

    Nilforushan, Naveed; Yadgari, Maryam; Jazayeri, Anisalsadat

    2016-10-01

    To compare visual field defect patterns between pigmentary glaucoma and primary open-angle glaucoma. Retrospective, comparative study. Patients with diagnosis of primary open-angle glaucoma (POAG) and pigmentary glaucoma (PG) in mild to moderate stages were enrolled in this study. Each of the 52 point locations in total and pattern deviation plot (excluding 2 points adjacent to blind spot) of 24-2 Humphrey visual field as well as six predetermined sectors were compared using SPSS software version 20. Comparisons between 2 groups were performed with the Student t test for continuous variables and the Chi-square test for categorical variables. Thirty-eight eyes of 24 patients with a mean age of 66.26 ± 11 years (range 48-81 years) in the POAG group and 36 eyes of 22 patients with a mean age of 50.52 ± 11 years (range 36-69 years) in the PG group were studied. (P = 0.00). More deviation was detected in points 1, 3, 4, and 32 in total deviation (P = 0.03, P = 0.015, P = 0.018, P = 0.023) and in points 3, 4, and 32 in pattern deviation (P = 0.015, P = 0.049, P = 0.030) in the POAG group, which are the temporal parts of the field. It seems that the temporal area of the visual field in primary open-angle glaucoma is more susceptible to damage in comparison with pigmentary glaucoma.

  14. The Clinical Outcomes of Three Surgical Managements on Primary Angle-closure Glaucoma

    Institute of Scientific and Technical Information of China (English)

    Xiulan; Zhang; Leilei; Teng; Ang; Li; Shaolin; Du; Yunyun; Zhu; Jian; Ge

    2007-01-01

    Purpose: To investigate the efficacy of trabeculectomy, phacotrabeculectomy and phacoemulsification in the management of primary angle closure glaucoma (PACG).Methods: A prospective observational study was performed in 88 chronic PACG patients (97 eyes) who were divided into three groups following defined indications to receive different surgical interventions. The indications and clinical outcomes were evaluated. The mean follow-up was (17.7±4.9) months.Results: Success rate in trabeculectomy, phacotrabeculectomy and phacoemulsification group was 81.08%, 78.57‰ and 81.25‰, respectively. The anterior chamber depth was deeper and the angle was wider postoperatively vs. preoperatively both in phacotrabeculectomy and phacoemulsification group. No obvious changes were seen in trabeculectomy group. The coefficient of outflow facility of aqueous humor (C values)significantly increased in three groups postoperatively (P<0.01 ). No severe intraoperative complications were found and the incidence of postoperative complications was low. Five eyes sustained hypotony 3± 1.87 months in trabeculectomy group and 1 eye happened malignant glaucoma in phacotrabeculectomy group. The visual acuity in patients with phacotrabeculectomy plus intraocular lens implantation and those only with phacoemulsification plus intraocular lens implantation were improved 78.57% and 93.74%, respectively. No significant improvement was found in trabeculectomy group (x2 = 47.10, P<0.001).Conclusion: Three surgical interventions were beneficial to manage PACG and with co-existing cataract. The indication choosing was suggested according to visual acuity,angle closure circumference, cataract, medication requirements and optic nerve damage.Phacotrabeculectomy was recommended for angle closed ≥180° circumference while phacoemulsification for angle closed < 180°.

  15. Characteristics of Ultrasonic Linear Motor that Incorporates Two Transducers at an Acute Angle

    Science.gov (United States)

    Suzuki, Atsuyuki; Tsunoji, Masaki; Tsujino, Jiromaru

    2013-07-01

    In this study, we have developed an ultrasonic linear motor that incorporates two transducers at an acute angle. The two transducers are used to generate the vertical and horizontal vibration components. The complex vibration is excited using two electrical sources with a phase shift. Ultrasonic motors have unique characteristics such as silent motion and absence of magnetic noise. These characteristics are suitable for use in hospitals and so on. Therefore, we focus on developing actuators for use in a medical bed, specifically a bedsore prevention bed. A study of the vibration characteristics of the motor showed that the resonant frequencies of the transducers were appropriate, although the vibration amplitude of one transducer was less than that of the other. A study of the load characteristics showed that a no-load speed of 267 mm/s and a maximum thrust of 40 N were obtained.

  16. Depth resolution, angle dependence, and the sputtering yield of Irganox 1010 by coronene primary ions.

    Science.gov (United States)

    Seah, Martin P; Spencer, Steve J; Shard, Alex G

    2013-10-01

    A study is reported of the depth resolution and angle dependence of sputtering yields using the reference organic material, Irganox 1010, for a new coronene(+) depth profiling ion source at 8 and 16 keV beam energies. This source provides excellent depth profiles as shown by 8.5 nm marker layers of Irganox 3114. Damage occurs but may be ignored for angles of incidence above 70° from the surface normal, as shown by X-ray photoelectron spectroscopy (XPS) of the C 1s peak structure. Above 70°, XPS profiles of excellent depth resolution are obtained. The depth resolution, after removal of the thickness of the delta layers, shows a basic contribution of 5.7 nm together with a contribution of 0.043 times the depth sputtered. This is lower than generally reported for cluster sources. The coronene(+) source is thus found to be a useful and practical source for depth profiling organic materials. The angle dependencies of both the undamaged and damaged materials are described by a simple equation. The sputtering yields for the undamaged material are described by a universal equation and are consistent with those obtained for C60(+) sputtering. Comparison with the sputtering yields using an argon gas cluster ion source shows great similarities, but the yields for both the coronene(+) and C60(+) primary ion sources are slightly lower.

  17. [The effect of crystalline lens extraction on intraocular pressure in patients with primary open-angle glaucoma].

    Science.gov (United States)

    Macarie, S; Macarie, Daniela

    2013-01-01

    This issue presents the results of a study on patients with cataract and primary open angle glaucoma who suffered lens extraction for cataract. We analise the effects of the lens extraction on the level of intraocular pressure at this patients.

  18. Short-term effects of relaxation music on patients suffering from primary open-angle glaucoma

    Directory of Open Access Journals (Sweden)

    Bertelmann T

    2015-10-01

    Full Text Available Thomas Bertelmann, Ilse Strempel Department of Ophthalmology, Philipps-University Marburg, Baldingerstraβe, Marburg, Germany Purpose: To evaluate whether additive relaxation music (RM has an adjuvant short-term effect on physiological and psychological parameters in patients with primary open-angle glaucoma.Methods: Prospective, randomized clinical trial. Patients in the therapy group (TG received a 30-minute RM via headphones, whereas members of the control group (CG did not. Best corrected visual acuity, intraocular pressure, visual field testing, short- and long-term mental states, and blood levels of different stress hormones were analyzed and compared.Results: A total of 25 (61%/16 (39% patients were assigned to the TG/CG. Best corrected visual acuity, daily intraocular pressure, and short-term mental state (KAB development were significantly better in the TG in comparison to controls. Visual field testing, long-term mental well-being (profile of mood states, and adrenalin, cortisol, and endothelin-I blood levels did not differ significantly between both groups.Conclusion: Additive RM applied on a daily basis can positively impact various physiological and psychological parameters in the short term. Keywords: primary open angle glaucoma, POAG, music therapy, intraocular pressure, IOP, mental health

  19. Alzheimer's disease and primary open-angle glaucoma: is there a connection

    Directory of Open Access Journals (Sweden)

    Tsolaki F

    2011-06-01

    Full Text Available Fani Tsolaki1, Eleni Gogaki1, Sotiria Tiganita1, Christina Skatharoudi1, Chrysanthi Lopatatzidi1, Fotios Topouzis2, Magdalini Tsolaki31Ophthalmology Department, Hippokrateion General Hospital, Thessaloniki, Greece; 2Ophthalmology Department, Aristotle University of Thessaloniki, Greece; 3Neurology Department, Aristotle University of Thessaloniki, GreeceAim: To present, through a thorough literature research, current and older scientific efforts to investigate the putative association between Alzheimer's disease (AD and glaucoma, especially primary open-angle glaucoma (POAG.Methods: We included in our review article epidemiological, experimental and clinical laboratory studies.Results: While many authors support the existence of a strong correlation between the AD and POAG, based on epidemiological, genetic and immunohistochemical data, others present contradictory results, leaving the issue unresolved.Conclusion: Further research, probably targeted towards genetic parameters and based on large, multicenter studies has yet to be conducted. It is the authors' opinion however, that the existing data already justify the need for at least some degree of elevated clinical alertness for the occurrence of AD in patients with glaucoma and of glaucoma in patients with AD.Keywords: Alzheimer's disease, primary open-angle glaucoma, amyloid beta, apolipoprotein E, cerebrospinal fluid pressure, review article 

  20. Lamina cribrosa defects and optic disc morphology in primary open angle glaucoma with high myopia.

    Directory of Open Access Journals (Sweden)

    Yugo Kimura

    Full Text Available PURPOSE: To investigate whether lamina cribrosa (LC defects are associated with optic disc morphology in primary open angle glaucoma (POAG eyes with high myopia. METHODS: A total of 129 POAG patients and 55 age-matched control subjects with high myopia were evaluated. Three-dimensional scan images obtained by swept source optical coherence tomography were used to detect LC defects. Radial B-scans and infrared images obtained by spectral domain optical coherence tomography were used to measure β-peripapillary atrophy (PPA lengths with and without Bruch's membrane (BM (temporal, nasal, superior, and inferior, tilt angle (vertical and horizontal, and disc diameter (transverse and longitudinal. Peripapillary intrachoroidal cavitations (PICCs, disc area, ovality index, and cyclotorsion of the optic disc were analyzed as well. RESULTS: LC defects were found in 70 of 129 (54.2% POAG eyes and 1 of 55 (1.8% control eyes (P < 0.001. Age, sex, spherical equivalent, axial length, intraocular pressure, and central corneal thickness were not significantly different among POAG eyes with LC defects, POAG eyes without LC defects, and control eyes. Temporal PPA lengths without BM in all three groups correlated significantly with vertical and horizontal tilt angles, although no PPA length with BM correlated significantly with any tilt angle. PICCs were detected more frequently in POAG eyes with LC defects than those without LC defects (P = 0.01 and control eyes (P = 0.02. POAG eyes with LC defects showed a smaller ovality index (P = 0.004, longer temporal PPA without BM (P < 0.001, and larger vertical/horizontal tilt angles (vertical, P < 0.001; horizontal, P = 0.01, and transverse diameter (P = 0.01. In multivariate analysis for the presence of LC defects, presence of POAG (P < 0.001 and vertical tilt angle (P < 0.001 were identified as significant. CONCLUSIONS: The presence of LC defects was associated with myopic optic disc morphology in POAG eyes with high

  1. Analysis of MYOC gene mutation in a Chinese glaucoma family with primary open-angle glaucoma and primary congenital glaucoma

    Institute of Scientific and Technical Information of China (English)

    ZHUO Ye-hong; WANG Mei; WEI Yan-tao; HUANG Ya-lin; GE Jian

    2006-01-01

    Background Glaucoma is one of the leading causes of blindness in the world. Primary open-angle glaucoma (POAG) and primary congenital glaucoma (PCG) are subtypes of glaucoma. Myocillin is the first gene identified to be involved in POAG. Recently, myocillin mutation has been found in PCG In this context, we reported a special glaucoma pedigree, which was composed of both PCG and POAG patients, and analyzed the mutation of myocillin in this pedigree.Methods The family was composed of the parents, a son and a daughter. All members of the family underwent the complete ophthalmologic examinations. All coding exons 1-3 and flanking introns of myocilin gene were screened for sequence alterations by polymerase chain reaction and direct DNA sequencing.Results The son was the proband, who was diagnosed as PCG in both eyes. The father was diagnosed as POAG in the right eye, the left eye was still normal. Both the sister and the mother of the proband had normal intraocular pressure without glaucomatous optic disc changes. The mutations in intron 2 of myocilin gene were detected in the family. While the proband and the father were homozygous, the mother and the sister were heterozygous for the mutation.Conclusions Homozygous mutation in intron 2 of myocilin gene is involved in both POAG and PCG. It is suggested that the pathogenesis might be overlapping in POAG and PCG.

  2. Acute aerobic exercise modulates primary motor cortex inhibition.

    Science.gov (United States)

    Mooney, Ronan A; Coxon, James P; Cirillo, John; Glenny, Helen; Gant, Nicholas; Byblow, Winston D

    2016-12-01

    Aerobic exercise can enhance neuroplasticity although presently the neural mechanisms underpinning these benefits remain unclear. One possible mechanism is through effects on primary motor cortex (M1) function via down-regulation of the inhibitory neurotransmitter gamma-aminobutyric acid (GABA). The aim of the present study was to examine how corticomotor excitability (CME) and M1 intracortical inhibition are modulated in response to a single bout of moderate intensity aerobic exercise. Ten healthy right-handed adults were participants. Single- and paired-pulse transcranial magnetic stimulation was applied over left M1 to obtain motor-evoked potentials in the right flexor pollicis brevis. We examined CME, cortical silent period (SP) duration, short- and long-interval intracortical inhibition (SICI, LICI), and late cortical disinhibition (LCD), before and after acute aerobic exercise (exercise session) or an equivalent duration without exercise (control session). Aerobic exercise was performed on a cycle ergometer for 30 min at a workload equivalent to 60 % of maximal cardiorespiratory fitness (VO2 peak; heart rate reserve = 75 ± 3 %, perceived exertion = 13.5 ± 0.7). LICI was reduced at 10 (52 ± 17 %, P = 0.03) and 20 min (27 ± 8 %, P = 0.03) post-exercise compared to baseline (13 ± 4 %). No significant changes in CME, SP duration, SICI or LCD were observed. The present study shows that GABAB-mediated intracortical inhibition may be down-regulated after acute aerobic exercise. The potential effects this may have on M1 plasticity remain to be determined.

  3. The Analysis of Pedigree GZ (Guangzhou) . 1with Primary Open Angle Glaucoma

    Institute of Scientific and Technical Information of China (English)

    Yehong Zhuo; Jian Ge; Mci Wang; Haiquan Liu; Minkai Lin

    2000-01-01

    Purpose: To analyze the hereditary modality of primary open-angle glaucoma in China.Methods: The genetic form of Pedigree GZ. 1 was analyzed using Mandalian hereditary rules.Results: Pedigree GZ. 1 had following characteristics: 1) The pedigree had four generations, and there existed POAG patients in each generation; 2) Each patient had a parent with POAG. If the parents didn't suffer from the disease, their children would not. 3) The incidence of POAG in the relatives of the patients was 1/2. In addition,The age of onset, intraocular pressure, fundus and prognosis was different from each other in the patients.Conclusions: 1 ) Pedigree GZ. 1 is inherited as an autosomal dominant trait. 2) There exists individual differences of clinical manifestations in POAG patients. Eye Science 2000; 16: 53~ 55.

  4. The Analysis of Pedigree GZ(Guangzhou).1 with Primary Open Angle Glaucoma

    Institute of Scientific and Technical Information of China (English)

    YehongZhuo; MeiWang; 等

    2002-01-01

    Purpose:To analyze the hereditary modality of primary open-angle glaucoma in China.Methods:The genetic form of Pedigree GZ.1 was analyzed using Mandalian hereditary rules.Results:Pedigree GZ.1 had following characteristics:1)The pedigree had four gene-rations,and there existed POAG patients in each generation;2) Each patient had a parent with POAG.If the parents didn't suffer from the disease,their children would not.3)The incidence of POAG in the relatives of the patients was 1/2 .In addition,The age of onset,intraocular pressure,fundus and prognosis was different from each other in the patients.Conclusions:1)Pedigree GZ.1 is inherited as an autosomal dominant trait.2) There exists individual differences of clinical manifestations in POAG patients.Eye Science 2000;16:53-55.

  5. Mapping a gene for adult-onset primary open-angle glaucoma to chromosome 3q

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    Wirtz, M.K.; Samples, J.R.; Kramer, P.L. [Oregon Health Sciences Univ., Portland, OR (United States)] [and others

    1997-02-01

    Glaucoma is the third-leading cause of blindness in the world, affecting >13.5 million people. Adult-on-set primary open-angle glaucoma (POAG) is the most common form of glaucoma in the United States. We present a family in which adult-onset POAG is inherited as an autosomal dominant trait. Twelve affected family members were identified from 44 at-risk individuals. The disease-causing gene was mapped to chromosome 3q21-24, with analysis of recombinant haplotypes suggesting a total inclusion region of 11.1 cM between markers D3S3637 and D3S1744. This is the first report of mapping of an adult-onset POAG gene to chromosome 3q, gene symbol GLC1C. 57 refs., 3 figs., 3 tabs.

  6. Soluble guanylate cyclase α1-deficient mice: a novel murine model for primary open angle glaucoma.

    Directory of Open Access Journals (Sweden)

    Emmanuel S Buys

    Full Text Available Primary open angle glaucoma (POAG is a leading cause of blindness worldwide. The molecular signaling involved in the pathogenesis of POAG remains unknown. Here, we report that mice lacking the α1 subunit of the nitric oxide receptor soluble guanylate cyclase represent a novel and translatable animal model of POAG, characterized by thinning of the retinal nerve fiber layer and loss of optic nerve axons in the context of an open iridocorneal angle. The optic neuropathy associated with soluble guanylate cyclase α1-deficiency was accompanied by modestly increased intraocular pressure and retinal vascular dysfunction. Moreover, data from a candidate gene association study suggests that a variant in the locus containing the genes encoding for the α1 and β1 subunits of soluble guanylate cyclase is associated with POAG in patients presenting with initial paracentral vision loss, a disease subtype thought to be associated with vascular dysregulation. These findings provide new insights into the pathogenesis and genetics of POAG and suggest new therapeutic strategies for POAG.

  7. Genes of the unfolded protein response pathway harbor risk alleles for primary open angle glaucoma.

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    Mary Anna Carbone

    Full Text Available The statistical power of genome-wide association (GWA studies to detect risk alleles for human diseases is limited by the unfavorable ratio of SNPs to study subjects. This multiple testing problem can be surmounted with very large population sizes when common alleles of large effects give rise to disease status. However, GWA approaches fall short when many rare alleles may give rise to a common disease, or when the number of subjects that can be recruited is limited. Here, we demonstrate that this multiple testing problem can be overcome by a comparative genomics approach in which an initial genome-wide screen in a genetically amenable model organism is used to identify human orthologues that may harbor risk alleles for adult-onset primary open angle glaucoma (POAG. Glaucoma is a major cause of blindness, which affects over 60 million people worldwide. Several genes have been associated with juvenile onset glaucoma, but genetic factors that predispose to adult onset primary open angle glaucoma (POAG remain largely unknown. Previous genome-wide analysis in a Drosophila ocular hypertension model identified transcripts with altered regulation and showed induction of the unfolded protein response (UPR upon overexpression of transgenic human glaucoma-associated myocilin (MYOC. We selected 16 orthologous genes with 62 polymorphic markers and identified in two independent human populations two genes of the UPR that harbor POAG risk alleles, BIRC6 and PDIA5. Thus, effectiveness of the UPR in response to accumulation of misfolded or aggregated proteins may contribute to the pathogenesis of POAG and provide targets for early therapeutic intervention.

  8. Oncogenic NRAS Primes Primary Acute Myeloid Leukemia Cells for Differentiation.

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    Cornelia Brendel

    Full Text Available RAS mutations are frequently found among acute myeloid leukemia patients (AML, generating a constitutively active signaling protein changing cellular proliferation, differentiation and apoptosis. We have previously shown that treatment of AML patients with high-dose cytarabine is preferentially beneficial for those harboring oncogenic RAS. On the basis of a murine AML cell culture model, we ascribed this effect to a RAS-driven, p53-dependent induction of differentiation. Hence, in this study we sought to confirm the correlation between RAS status and differentiation of primary blasts obtained from AML patients. The gene expression signature of AML blasts with oncogenic NRAS indeed corresponded to a more mature profile compared to blasts with wildtype RAS, as demonstrated by gene set enrichment analysis (GSEA and real-time PCR analysis of myeloid ecotropic viral integration site 1 homolog (MEIS1 in a unique cohort of AML patients. In addition, in vitro cell culture experiments with established cell lines and a second set of primary AML cells showed that oncogenic NRAS mutations predisposed cells to cytarabine (AraC driven differentiation. Taken together, our findings show that AML with inv(16 and NRAS mutation have a differentiation gene signature, supporting the notion that NRAS mutation may predispose leukemic cells to AraC induced differentiation. We therefore suggest that promotion of differentiation pathways by specific genetic alterations could explain the superior treatment outcome after therapy in some AML patient subgroups. Whether a differentiation gene expression status may generally predict for a superior treatment outcome in AML needs to be addressed in future studies.

  9. Risk Factors for Primary Open-Angle Glaucoma in Western Turkey

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    Güliz Fatma Yavaş

    2013-04-01

    Full Text Available Pur po se: To evaluate the prevalence of primary open-angle glaucoma (POAG in subjects aged over 40 years in Western Turkey and to quantify its association with several systemic risk factors. Ma te ri al and Met hod: The research was conducted in Afyonkarahisar, a middle Anatolian city, between November 2005 and February 2006. A total of 1533 subjects aged 40 years or more were included in the study. Diabetes mellitus, hypertension, atherosclerotic cardiac disease, obesity, smoking, alcohol consumption, and dietary habitus (meat, chicken, and fish consumption were asked. Level of blood glucose, serum total cholesterol, triglyceride, high-density lipoprotein, low-density lipoprotein, very-low-density lipoprotein, Vitamin B12, and thyroid-stimulating-hormone were determined. Ophthalmic examination was performed, and intraocular pressure was measured by tonopen. Subjects with an IOP of 21 mmHg or more and/or with a cupping/disc ratio of 0.3 or more were told to come to the clinic for visual field analysis and gonioscopy. Subjects with a typical glaucomatous visual field defect and an open angle were recorded as POAG. Risk factors for POAG were determined by chi-square test. Re sults: Prevalence of POAG was found to be 2% (30 subjects and the only associated risk factor was age (p=0.05. Dietary habitus was also not associated with glaucoma (p>0.05. Dis cus si on: This study provides a population-based data about the prevalence and risk factors of POAG in Turkey. (Turk J Ophthalmol 2013; 43: 87-90

  10. The association between primary open-angle glaucoma and fall: an observational study

    Directory of Open Access Journals (Sweden)

    Tanabe S

    2012-03-01

    Full Text Available Sachiko Tanabe1,2*, Kenya Yuki1*, Naoki Ozeki1, Daisuke Shiba1, Kazuo Tsubota11Department of Ophthalmology, Keio University School of Medicine, Shinanomachi 35, Tokyo, Japan; 2Tanabe Eye Clinic, Kai City, Yamanashi, Japan*These authors contributed equally to this workPurpose: Falls are among the most serious public health concerns for the elderly. Information conveyed via the visual sense is relevant to postural balance and movement, and proper visual function is essential to avoid falls. Here we investigated the prevalence of injurious falls among patients with primary open-angle glaucoma (POAG who were more than 45 years old, compared with comparably aged healthy subjects.Methods: This is a cross-sectional study. Consecutive patients who visited the Tanabe Eye Clinic, Yamanashi, Japan between January 1 and March 30, 2009 were screened for eligibility by ophthalmic examination. A total of 117 control subjects (77 men, 40 women; aged 60.2 ± 7.5 years who were free of ocular disease and 101 POAG patients (58 men, 43 women; aged 62.3 ± 8.7 years were consecutively enrolled. Participants answered a questionnaire on injurious fall experience during the previous 10 years. The prevalence of injurious fall in subjects with POAG versus healthy controls was examined with Fisher's exact test. Adjusted odds ratios and 95% confidence intervals were estimated with logistic regression models for the subjects with POAG (factors: age, gender, mean deviation in the better eye or worse eye.Results: The self-reported prevalence of injurious fall was 0.9% (1/117 in the control group and 6.9% (7/101 in the POAG group. The association between injurious fall and POAG was statistically significant (P = 0.026, Fisher's exact test. Within the POAG patients, the group reporting falls was significantly older and had a lower BMI, worse BCVA, and worse mean deviation in both the better and worse eye than the group reporting no falls. Worse mean deviation in the eye with

  11. Nutrition: A Primary Therapy in Pediatric Acute Respiratory Distress Syndrome

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    Bryan Wilson

    2016-10-01

    Full Text Available Appropriate nutrition is an essential component of intensive care management of children with Acute Respiratory Distress Syndrome (ARDS and is linked to patient outcomes. One out of every two children in the PICU will develop malnutrition or have worsening of baseline malnutrition, and present with specific micronutrient deficiencies. Early and adequate enteral nutrition (EN is associated with improved 60-day survival after pediatric critical illness and yet, despite early EN guidelines, critically ill children receive on average only 55% of goal calories by PICU day 10. Inadequate delivery of EN is due to perceived feeding intolerance, reluctance to enterally feed children with hemodynamic instability, and fluid restriction. Underlying each of these factors is large practice variation between providers and across institutions for initiation, advancement and maintenance of EN. Strategies to improve early initiation, advancement, and to maintain delivery of EN are needed to improve morbidity and mortality from pediatric ARDS. Both over and underfeeding prolongs duration of mechanical ventilation in children and worsens other organ function such that precise calorie goals are needed. The gut is thought to act as a ‘motor’ of organ dysfunction and emerging data regarding the role of intestinal barrier functions and the intestinal microbiome on organ dysfunction and outcomes of critical illness present exciting opportunities to improve patient outcomes. Nutrition should be considered a primary rather than supportive therapy for pediatric ARDS. Precise nutritional therapies, which are titrated and targeted to preservation of intestinal barrier function, prevention of intestinal dysbiosis, preservation of lean body mass, and blunting of the systemic inflammatory response, offer great potential for improving outcomes of pediatric ARDS. In this review we examine the current evidence regarding dose, route, and timing of nutrition, current

  12. Rehabilitation of vision disorder and improved quality of life in patients with primary open angle glaucoma

    Institute of Scientific and Technical Information of China (English)

    LUO Rong-jiang; LIU Shao-rui; TIAN Zhen; ZHU Wen-hui; ZHUO YE-hong; LIAO Rui-duan

    2011-01-01

    Background Primary open angle glaucoma (POAG) is a common cause of irreversible blindness.The variable etiology of POAG poses significant challenges for treatment and rehabilitation.We analyzed a large POAG patient cohort during treatment to reveal possible causes of vision disorder,assess vision-related quality of life (VRQL),and to evaluate the efficacy of rehabilitative treatments.Methods We analyzed the visional disturbances in 500 POAG patients (890 eyes) by regular ophthalmic examination and visual field examination using Humphrey 30° perimetry.Appropriate rehabilitative treatments for POAG were prescribed based on results of clinical examination and included correction of ametropia,health education,counseling,and the fitting of typoscopes.VRQL was assessed before and after treatment by a VRQL self-assessment questionnaire.Results Scores on the VRQL self-assessment were significantly lower compared to healthy controls.The primary cause of the vision disturbances was ametropia (97.99%),and 51.61% of the ametropia eyes had not received appropriate correction.The secondary causes of visual impairment were glaucomatous neurodegeneration (26.29%),complicated cataract,or other accompanying eye diseases.The causes of the clinical low vision (44 patients) were glaucomatous neurodegeneration (32 eyes),fundus diseases (23 eyes),keratopathy (11 eyes),and other eye diseases (10 eyes).The VRQL scores of patients improved significantly after rehabilitation and the correction of ametropia (P<0.01).Twenty-five patients with low vision were provided with typoscopes,and 21 (84%) experienced significant functional recovery,while the remaining low vision patients could see letter lines two or more levels lower (smaller) on visual charts in a near vision test.Conclusions Vision disorders in POAG patients are common and severe.Appropriate rehabilitation,especially the correction of ametropia,can significantly improve VRQL as revealed by the self-assessment of POAG patients.

  13. Differential protein expression in tears of patients with primary open angle and pseudoexfoliative glaucoma.

    Science.gov (United States)

    Pieragostino, Damiana; Bucci, Sonia; Agnifili, Luca; Fasanella, Vincenzo; D'Aguanno, Simona; Mastropasqua, Alessandra; Ciancaglini, Marco; Mastropasqua, Leonardo; Di Ilio, Carmine; Sacchetta, Paolo; Urbani, Andrea; Del Boccio, Piero

    2012-04-01

    Primary open angle (POAG) and pseudoexfoliative glaucoma (PXG) are the most common primary and secondary forms of glaucoma, respectively. Even though the patho-physiology, aqueous humor composition, risk factors, clinical features, therapy and drug induced ocular surface changes in POAG and PXG have been widely studied, to date information concerning tear protein characterization is lacking. Tears are a source of nourishment for ocular surface tissues and a vehicle to remove local waste products, metabolized drugs and inflammatory mediators produced in several ophthalmic diseases. In glaucoma, the proteomic definition of tears may provide insights concerning patho-physiology of the disease and ocular surface modifications induced by topical therapy. Our study aimed at characterizing protein patterns in tears of patients with medically controlled POAG and PXG. A comparative tears proteomic analysis by label-free LC-MS(E) highlighted differences in the expression of several proteins in the two glaucoma sub-types and control subjects, highlighting inflammation pathways expressed in both diseases. Results were independently reconfirmed by SDS-PAGE and linear MALDI-TOF MS, validating altered levels of Lysozyme C, Lipocalin-1, Protein S100, Immunoglobulins and Prolactin Inducible Protein. Moreover, we found a differential pattern of phosphorylated Cystatin-S that distinguishes the two pathologies. The most relevant results suggest that in both pathologies there may be active inflammation pathways related to the disease and/or induced by therapy. We show, for the first time, tear protein patterns expressed under controlled intraocular pressure conditions in POAG and PXG subjects. These findings could help in the understanding of molecular machinery underlying these ophthalmologic diseases, resulting in early diagnosis and more specific therapy.

  14. Extracting Primary Open-Angle Glaucoma from Electronic Medical Records for Genetic Association Studies.

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    Nicole A Restrepo

    Full Text Available Electronic medical records (EMRs are being widely implemented for use in genetic and genomic studies. As a phenotypic rich resource, EMRs provide researchers with the opportunity to identify disease cohorts and perform genotype-phenotype association studies. The Epidemiologic Architecture for Genes Linked to Environment (EAGLE study, as part of the Population Architecture using Genomics and Epidemiology (PAGE I study, has genotyped more than 15,000 individuals of diverse genetic ancestry in BioVU, the Vanderbilt University Medical Center's biorepository linked to a de-identified version of the EMR (EAGLE BioVU. Here we develop and deploy an algorithm utilizing data mining techniques to identify primary open-angle glaucoma (POAG in African Americans from EAGLE BioVU for genetic association studies. The algorithm described here was designed using a combination of diagnostic codes, current procedural terminology billing codes, and free text searches to identify POAG status in situations where gold-standard digital photography cannot be accessed. The case algorithm identified 267 potential POAG subjects but underperformed after manual review with a positive predictive value of 51.6% and an accuracy of 76.3%. The control algorithm identified controls with a negative predictive value of 98.3%. Although the case algorithm requires more downstream manual review for use in large-scale studies, it provides a basis by which to extract a specific clinical subtype of glaucoma from EMRs in the absence of digital photographs.

  15. Assessment of polygenic effects links primary open-angle glaucoma and age-related macular degeneration.

    Science.gov (United States)

    Cuellar-Partida, Gabriel; Craig, Jamie E; Burdon, Kathryn P; Wang, Jie Jin; Vote, Brendan J; Souzeau, Emmanuelle; McAllister, Ian L; Isaacs, Timothy; Lake, Stewart; Mackey, David A; Constable, Ian J; Mitchell, Paul; Hewitt, Alex W; MacGregor, Stuart

    2016-05-31

    Primary open-angle glaucoma (POAG) and age-related macular degeneration (AMD) are leading causes of irreversible blindness. Several loci have been mapped using genome-wide association studies. Until very recently, there was no recognized overlap in the genetic contribution to AMD and POAG. At genome-wide significance level, only ABCA1 harbors associations to both diseases. Here, we investigated the genetic architecture of POAG and AMD using genome-wide array data. We estimated the heritability for POAG (h(2)g = 0.42 ± 0.09) and AMD (h(2)g = 0.71 ± 0.08). Removing known loci for POAG and AMD decreased the h(2)g estimates to 0.36 and 0.24, respectively. There was evidence for a positive genetic correlation between POAG and AMD (rg = 0.47 ± 0.25) which remained after removing known loci (rg = 0.64 ± 0.31). We also found that the genetic correlation between sexes for POAG was likely to be less than 1 (rg = 0.33 ± 0.24), suggesting that differences of prevalence among genders may be partly due to heritable factors.

  16. Genetic and environmental risk factors for primary open-angle glaucoma

    Institute of Scientific and Technical Information of China (English)

    范宝剑; 梁旭辉; 汪宁; 林顺潮; 刘瑶; 谭霭仙; 彭智培

    2004-01-01

    Background Primary open-angle glaucoma (POAG) is characterized by optic nerve damage and consists of a group of genetically heterogeneous disorders. This study was to investigate the associations of genetic and environmental factors with POAG in a hospital-based Chinese population.Methods Thirty-two adult onset POAG patients and 96 age-sex matched control subjects were studied by multivariable logistic regression analysis for the relationships between POAG and its risk factors including family history, diabetes, hypertension, cardiovascular diseases, cigarette smoking, alcohol consumption and polymorphisms of the myocilin and the optineurin genes.Results Univariate analysis showed that POAG was related to family history, cardiovascular disease, alcohol consumption and a myocilin sequence alteration (T353I) (P<0.04). Multivariable logistic regression analysis confirmed that POAG was significantly associated with family history (OR=20.2), hypertension (OR=3.58), cigarette smoking (OR=10.8), alcohol consumption (OR=0.028) and T353I (OR=6.03, all P<0.05).Conclusions Family history, hypertension, cigarette smoking and T353I in the myocilin gene are risk factors for POAG. Alcohol consumption, however, has a protective effect.

  17. Common genetic determinants of intraocular pressure and primary open-angle glaucoma.

    Science.gov (United States)

    van Koolwijk, Leonieke M E; Ramdas, Wishal D; Ikram, M Kamran; Jansonius, Nomdo M; Pasutto, Francesca; Hysi, Pirro G; Macgregor, Stuart; Janssen, Sarah F; Hewitt, Alex W; Viswanathan, Ananth C; ten Brink, Jacoline B; Hosseini, S Mohsen; Amin, Najaf; Despriet, Dominiek D G; Willemse-Assink, Jacqueline J M; Kramer, Rogier; Rivadeneira, Fernando; Struchalin, Maksim; Aulchenko, Yurii S; Weisschuh, Nicole; Zenkel, Matthias; Mardin, Christian Y; Gramer, Eugen; Welge-Lüssen, Ulrich; Montgomery, Grant W; Carbonaro, Francis; Young, Terri L; Bellenguez, Céline; McGuffin, Peter; Foster, Paul J; Topouzis, Fotis; Mitchell, Paul; Wang, Jie Jin; Wong, Tien Y; Czudowska, Monika A; Hofman, Albert; Uitterlinden, Andre G; Wolfs, Roger C W; de Jong, Paulus T V M; Oostra, Ben A; Paterson, Andrew D; Mackey, David A; Bergen, Arthur A B; Reis, André; Hammond, Christopher J; Vingerling, Johannes R; Lemij, Hans G; Klaver, Caroline C W; van Duijn, Cornelia M

    2012-01-01

    Intraocular pressure (IOP) is a highly heritable risk factor for primary open-angle glaucoma and is the only target for current glaucoma therapy. The genetic factors which determine IOP are largely unknown. We performed a genome-wide association study for IOP in 11,972 participants from 4 independent population-based studies in The Netherlands. We replicated our findings in 7,482 participants from 4 additional cohorts from the UK, Australia, Canada, and the Wellcome Trust Case-Control Consortium 2/Blue Mountains Eye Study. IOP was significantly associated with rs11656696, located in GAS7 at 17p13.1 (p=1.4×10(-8)), and with rs7555523, located in TMCO1 at 1q24.1 (p=1.6×10(-8)). In a meta-analysis of 4 case-control studies (total N = 1,432 glaucoma cases), both variants also showed evidence for association with glaucoma (p=2.4×10(-2) for rs11656696 and p=9.1×10(-4) for rs7555523). GAS7 and TMCO1 are highly expressed in the ciliary body and trabecular meshwork as well as in the lamina cribrosa, optic nerve, and retina. Both genes functionally interact with known glaucoma disease genes. These data suggest that we have identified two clinically relevant genes involved in IOP regulation.

  18. Analysis of COCH and TNFA Variants in East Indian Primary Open-Angle Glaucoma Patients

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    Subhadip Chakraborty

    2013-01-01

    Full Text Available Glaucoma represents a heterogeneous group of optic neuropathies with a complex genetic basis. It is the second-largest cause of blindness in the world that reduces vision without warning and often without symptoms. Among 3 major subtypes of glaucoma, primary open-angle glaucoma (POAG is the most common form. The focus of this study is to understand the molecular basis of the disease among Indian patients with respect to two genes, Cochlin (COCH and tumor necrosis factor alpha (TNFA, selected based on reports of possible association with POAG. The genes were screened in patients and controls by PCR and direct sequencing. Although two novel changes (–450 C/T and –79 G/G were identified in the 5′upstream region of COCH, no causal variant could be identified in either gene. –450 C/T was detected in 3 patients and 2 controls and –79 G/C in a single patient. Further, we did not observe significant association with the promoter SNPs of TNFA that had been previously reported to be associated with POAG pathogenesis. Thus, our study suggests lack of association of both COCH and TNFA with POAG pathogenesis.

  19. Common genetic determinants of intraocular pressure and primary open-angle glaucoma.

    Directory of Open Access Journals (Sweden)

    Leonieke M E van Koolwijk

    Full Text Available Intraocular pressure (IOP is a highly heritable risk factor for primary open-angle glaucoma and is the only target for current glaucoma therapy. The genetic factors which determine IOP are largely unknown. We performed a genome-wide association study for IOP in 11,972 participants from 4 independent population-based studies in The Netherlands. We replicated our findings in 7,482 participants from 4 additional cohorts from the UK, Australia, Canada, and the Wellcome Trust Case-Control Consortium 2/Blue Mountains Eye Study. IOP was significantly associated with rs11656696, located in GAS7 at 17p13.1 (p=1.4×10(-8, and with rs7555523, located in TMCO1 at 1q24.1 (p=1.6×10(-8. In a meta-analysis of 4 case-control studies (total N = 1,432 glaucoma cases, both variants also showed evidence for association with glaucoma (p=2.4×10(-2 for rs11656696 and p=9.1×10(-4 for rs7555523. GAS7 and TMCO1 are highly expressed in the ciliary body and trabecular meshwork as well as in the lamina cribrosa, optic nerve, and retina. Both genes functionally interact with known glaucoma disease genes. These data suggest that we have identified two clinically relevant genes involved in IOP regulation.

  20. Consensus of primary care in acute pancreatitis in Japan

    Institute of Scientific and Technical Information of China (English)

    Makoto Otsuki; Tetsuhide Ito; Kazuo Inui; Tooru Shimosegawa; Shigeki Tanaka; Keisho Kataoka; Hiromitsu Saisho; Kazuichi Okazaki; Yosikazu Kuroda; Norio Sawabu; Yoshifumi Takeyama; Masahiko Hirota; Shinju Arata; Masaru Koizumi; Shigeyuki Kawa; Terumi Kamisawa; Kazunori Takeda; Toshihiko Mayumi; Motoji Kitagawa

    2006-01-01

    The incidence of acute pancreatitis in Japan is increasing and ranges from 187 to 347 cases per million populations. Case fatality was 0.2% for mild to moderate, and 9.0% for severe acute pancreatitis in Japan in 2003. Experts in pancreatitis in Japan made this document focusing on the practical aspects in the early management of patients with acute pancreatitis.The correct diagnosis of acute pancreatitis and severity stratification should be made in all patients using the criteria for the diagnosis of acute pancreatitis and the multifactor scoring system proposed by the Research Committee of Intractable Diseases of the Pancreas as early as possible. All patients diagnosed with acute pancreatitis should be managed in the hospital.Monitoring of blood pressure, pulse and respiratory rate,body temperature, hourly urinary volume, and blood oxygen saturation level is essential in the management of such patients. Early vigorous intravenous hydration is of foremost importance to stabilize circulatory dynamics. Adequate pain relief with opiates is also important. In severe acute pancreatitis, prophylactic intravenous administration of antibiotics at an early stage is recommended. Administration of protease inhibitors should be initiated as soon as thediagnosis of acute pancreatitis is confirmed. A combination of enteral feeding with parenteral nutrition from early stage is recommended if there are no clear signs and symptoms of ileus and gastrointestinal bleeding. Patients with severe acute pancreatitis should be transferred to ICU as early as possible to perform special measures such as continuous regional arterial infusion of protease inhibitors and antibiotics, and continuous hemodiafiltration. The Japanese Government covers medical care expense for severe acute pancreatitis as one of the projects of Research on Measures for Intractable Diseases.

  1. Acute primary haemorrhagic omental torsion mimicking perforated appendicitis: an unorthodox surgical paradox.

    Science.gov (United States)

    Rehman, Abdul

    2014-08-01

    Acute primary haemorrhagic omental torsion is an atypical and deceptive cause of acute abdomen that could closely mimic a myriad of intra-abdominal catastrophes, especially perforated appendicitis. The author reports a 30 years man who had presented with gradually worsening right-sided abdominal pain of 2 days duration. Laboratory work-up and abdominal radiographs were inconclusive. Abdominal sonography detected presence of free fluid in the pelvic cul-de-sac. Based on clinical and sonographic findings, presumptive diagnosis of perforated appendicitis was made and the patient was explored through extended Rockey-Davis incision. About 500 - 700 ml of dark-coloured blood (haemoperitoneum) was present in the peritoneal cavity and the pelvis secondary to acute haemorrhagic omental torsion. The appendix was grossly normal. Omentectomy and prophylactic appendicectomy resulted in uneventful recovery of the patient. Acute primary omental torsion is an uncommon pathology that must be kept in mind during differential diagnosis of acute abdomen, especially acute or perforated appendicitis.

  2. [Effects of nootropic agents on visual functions and lacrimal antioxidative activity in patients with primary open-angle glaucoma].

    Science.gov (United States)

    Davydova, N G; Kuznetsova, T P; Borisova, S A; Abdulkadyrova, M Zh

    2006-01-01

    The paper presents the results of an investigation of the effect of the nootropic agents pantogam and nooclerine on visual functions in patients with primary open-angle glaucoma. These agents have been found to have a beneficial effect on the functional activity of the retina and optic nerve, light sensitivity, hemo- and hydrodynamics of the eye.

  3. Association of primary open-angle glaucoma with mitochondrial variants and haplogroups common in African Americans

    Science.gov (United States)

    Gudiseva, Harini V.; Trachtman, Benjamin; Bowman, Anita S.; Sagaser, Anna; Sankar, Prithvi; Miller-Ellis, Eydie; Lehman, Amanda; Addis, Victoria; O'Brien, Joan M.

    2016-01-01

    Purpose To estimate the population frequencies of all common mitochondrial variants and ancestral haplogroups among 1,999 subjects recruited for the Primary Open-Angle African American Glaucoma Genetics (POAAGG) Study, including 1,217 primary open-angle glaucoma (POAG) cases and 782 controls, and to identify ancestral subpopulations and mitochondrial mutations as potential risk factors for POAG susceptibility. Methods Subject classification by characteristic glaucomatous optic nerve findings and corresponding visual field defects, as defined by enrolling glaucoma specialists, stereo disc photography, phlebotomy, extraction of total DNA from peripheral blood or saliva, DNA quantification and normalization, PCR amplification of whole mitochondrial genomes, Ion Torrent deep semiconductor DNA sequencing on DNA pools (“Pool-seq”), Sanger sequencing of 3,479 individual mitochondrial DNAs, and bioinformatic analysis. Results The distribution of common African haplogroups within the POAAGG study population was broadly similar to prior surveys of African Americans. However, the POAG case population was found to be enriched in L1c2 haplogroups, which are defined in part by missense mutations m.6150G>A (Val83Ile, odds ratio [OR] 1.8, p=0.01), m.6253C>T (Met117Thr, rs200165736, OR 1.6, p=0.04), and m.6480G>A (Val193Ile, rs199476128, OR 4.6, p=0.04) in the cytochrome c oxidase subunit 1 (MT-CO1) gene and by a variant, m.2220A>G (OR 2.0, p=0.01), in MT-RNR2, which encodes the mitochondrial ribosomal 16s RNA gene. L2 haplogroups were predicted to be overrepresented in the POAG case population by Pool-seq, and the difference was confirmed to be significant with Sanger sequencing, that targeted the L2-associated variants m.2416T>C (rs28358580, OR 1.2, p=0.02) and m.2332C>T (OR 1.2, p=.02) in MT-RNR2. Another variant within MT-RNR2, m.3010G>A (rs3928306), previously implicated in sensitivity to the optic neuropathy-associated antibiotic linezolid, and arising on D4 and J1

  4. Discovery and functional annotation of SIX6 variants in primary open-angle glaucoma.

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    Megan Ulmer Carnes

    Full Text Available Glaucoma is a leading cause of blindness worldwide. Primary open-angle glaucoma (POAG is the most common subtype and is a complex trait with multigenic inheritance. Genome-wide association studies have previously identified a significant association between POAG and the SIX6 locus (rs10483727, odds ratio (OR = 1.32, p = 3.87×10(-11. SIX6 plays a role in ocular development and has been associated with the morphology of the optic nerve. We sequenced the SIX6 coding and regulatory regions in 262 POAG cases and 256 controls and identified six nonsynonymous coding variants, including five rare and one common variant, Asn141His (rs33912345, which was associated significantly with POAG (OR = 1.27, p = 4.2×10(-10 in the NEIGHBOR/GLAUGEN datasets. These variants were tested in an in vivo Danio rerio (zebrafish complementation assay to evaluate ocular metrics such as eye size and optic nerve structure. Five variants, found primarily in POAG cases, were hypomorphic or null, while the sixth variant, found only in controls, was benign. One variant in the SIX6 enhancer increased expression of SIX6 and disrupted its regulation. Finally, to our knowledge for the first time, we have identified a clinical feature in POAG patients that appears to be dependent upon SIX6 genotype: patients who are homozygous for the SIX6 risk allele (His141 have a statistically thinner retinal nerve fiber layer than patients homozygous for the SIX6 non-risk allele (Asn141. Our results, in combination with previous SIX6 work, lead us to hypothesize that SIX6 risk variants disrupt the development of the neural retina, leading to a reduced number of retinal ganglion cells, thereby increasing the risk of glaucoma-associated vision loss.

  5. The efficacy of viscocanalostomy for uncontrollable primary open-angle glaucoma in a developing country

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    Khodadad Moradian

    2013-01-01

    Full Text Available Purpose: To evaluate the safety and efficacy of viscocanalostomy in the management of medically uncontrollable primary open-angle glaucoma (POAG in a developing country. Materials and Methods: This is a prospective, non-randomized case series of 14 consecutive eyes with medically uncontrollable POAG, all subjected to viscocanalostomy. The main outcome measure was success rate based on the intraocular pressure (IOP level achieved post-operatively. The procedure was considered a complete success if IOP was less than 21 mmHg without any anti-glaucoma medication. Qualified success was defined as IOP of less than 21 mmHg with anti-glaucoma medication. All patients had a regular follow-up of at least 12 months. Results: IOP was reduced from a mean baseline value of 27.9 ± 7.3 mmHg (range: 21-40 mmHg to a mean final value of 16.0 ± 2.7 mmHg (range: 13-22 mmHg, which was statistically highly significant (P < 0.005. The mean number of pre-operative anti-glaucoma medications was 3.0 ± 0.4 (range: 2-4, which was reduced significantly (P < 0.0001 to 0.3 ± 0.6 (range: 0-2 at the last follow-up visit. One year post-operatively, complete success was achieved in 71% and qualified success was observed in 21.4% of patients, summing up to an overall success rate of 92.4%. There were no major complications in any of the patients. Conclusion: Viscocanalostomy could be performed effectively and safely for control of POAG in developing countries.

  6. Mitochondrial sequence variation in African-American primary open-angle glaucoma patients.

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    David W Collins

    Full Text Available Primary open-angle glaucoma (POAG is a major cause of blindness and results from irreversible retinal ganglion cell damage and optic nerve degeneration. In the United States, POAG is most prevalent in African-Americans. Mitochondrial genetics and dysfunction have been implicated in POAG, and potentially pathogenic sequence variations, in particular novel transversional base substitutions, are reportedly common in mitochondrial genomes (mtDNA from POAG patient blood. The purpose of this study was to ascertain the spectrum of sequence variation in mtDNA from African-American POAG patients and determine whether novel nonsynonymous, transversional or other potentially pathogenic sequence variations are observed more commonly in POAG cases than controls. mtDNA from African-American POAG cases (n = 22 and age-matched controls (n = 22 was analyzed by deep sequencing of a single 16,487 base pair PCR amplicon by Ion Torrent, and candidate novel variants were validated by Sanger sequencing. Sequence variants were classified and interpreted using the MITOMAP compendium of polymorphisms. 99.8% of the observed variations had been previously reported. The ratio of novel variants to POAG cases was 7-fold lower than a prior estimate. Novel mtDNA variants were present in 3 of 22 cases, novel nonsynonymous changes in 1 of 22 cases and novel transversions in 0 of 22 cases; these proportions are significantly lower (p<.0005, p<.0004, p<.0001 than estimated previously for POAG, and did not differ significantly from controls. Although it is possible that mitochondrial genetics play a role in African-Americans' high susceptibility to POAG, it is unlikely that any mitochondrial respiratory dysfunction is due to an abnormally high incidence of novel mutations that can be detected in mtDNA from peripheral blood.

  7. Evaluation of Ex-PRESS implantation combined with phacoemulsification in primary angle-closure glaucoma

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    Liu, Bing; Guo, Da-Dong; Du, Xiu-Juan; Cong, Chen-Yang; Ma, Xiao-Hua

    2016-01-01

    Abstract To evaluate the safety and efficacy of Ex-PRESS (R50) implantation combined with phacoemulsification in primary angle-closure glaucoma (PACG) patients with cataract. Twenty-four eyes of 24 patients with unregulated PACG underwent combined cataract and glaucoma surgery. After phacoemulsification and intraocular lens implantation, the Ex-PRESS (R-50) was inserted into the anterior chamber under a scleral flap. The intraocular pressure (IOP), best corrected visual acuity (BCVA), number of medications, and complications were recorded preoperatively as well as postoperatively on day 7 and at 1, 3, 6, and 12 months. The mean follow-up was 16.4 ± 2.5 months (range 14–21 months) and the mean age of the patients was 64.7 ± 6.8 years (range 56–78 years). The mean IOP was 20.4 ± 5.4 mm Hg preoperatively and decreased to 10.2 ± 2.8, 13.1 ± 2.7, 14.9 ± 4.1, 14.3 ± 3.9, and 14.0 ± 3.6 mm Hg on day 7 and at 1, 3, 6, and 12 months after surgery (all P < 0.005). At 12 months, the mean BCVA was 0.62 ± 0.33 and the number of medications was 0.3 ± 0.6. Most of complications were resolved spontaneously and conservatively. The Ex-PRESS implantation combined with phacoemulsification cataract extraction is safe and effective for reducing IOP and antiglaucoma medications in PACG patients with cataract. PMID:27603352

  8. Stab Incision Glaucoma Surgery: A Modified Guarded Filtration Procedure for Primary Open Angle Glaucoma.

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    Jacob, Soosan; Figus, Michele; Ashok Kumar, Dhivya; Agarwal, Ashvin; Agarwal, Amar; Areeckal Incy, Saijimol

    2016-01-01

    Purpose. To describe a modified guarded filtration surgery, stab incision glaucoma surgery (SIGS), for primary open angle glaucoma (POAG). Methods. This prospective, interventional case series included patients with POAG (IOP ≥21 mmHg with glaucomatous visual field defects). After sliding superior conjunctiva down over limbus, 2.8 mm bevel-up keratome was used to create conjunctival entry and superficial corneoscleral tunnel in a single step starting 1.5 mm behind limbus. Lamellar corneoscleral tunnel was carefully dissected 0.5-1 mm into cornea and anterior chamber (AC) was entered. Kelly Descemet's punch (1 mm) was slid along the tunnel into AC to punch internal lip of the tunnel, thereby compromising it. Patency of ostium was assessed by injecting fluid in AC and visualizing leakage from tunnel. Conjunctival incision alone was sutured. Results. Mean preoperative IOP was 27.41 ± 5.54 mmHg and mean postoperative IOP was 16.47 ± 4.81 mmHg (n = 17). Mean reduction in IOP was 38.81 ± 16.55%. There was significant reduction of IOP (p < 0.000). 64.7% had IOP at final follow-up of <18 mmHg without medication and 82.35% had IOP <18 mmHg with ≤2 medications. No sight threatening complications were encountered. Conclusion. Satisfactory IOP control was noted after SIGS in interim follow-up (14.18 ± 1.88 months).

  9. Stab Incision Glaucoma Surgery: A Modified Guarded Filtration Procedure for Primary Open Angle Glaucoma

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    Soosan Jacob

    2016-01-01

    Full Text Available Purpose. To describe a modified guarded filtration surgery, stab incision glaucoma surgery (SIGS, for primary open angle glaucoma (POAG. Methods. This prospective, interventional case series included patients with POAG (IOP ≥21 mmHg with glaucomatous visual field defects. After sliding superior conjunctiva down over limbus, 2.8 mm bevel-up keratome was used to create conjunctival entry and superficial corneoscleral tunnel in a single step starting 1.5 mm behind limbus. Lamellar corneoscleral tunnel was carefully dissected 0.5–1 mm into cornea and anterior chamber (AC was entered. Kelly Descemet’s punch (1 mm was slid along the tunnel into AC to punch internal lip of the tunnel, thereby compromising it. Patency of ostium was assessed by injecting fluid in AC and visualizing leakage from tunnel. Conjunctival incision alone was sutured. Results. Mean preoperative IOP was 27.41±5.54 mmHg and mean postoperative IOP was 16.47±4.81 mmHg (n=17. Mean reduction in IOP was 38.81±16.55%. There was significant reduction of IOP (p<0.000. 64.7% had IOP at final follow-up of <18 mmHg without medication and 82.35% had IOP <18 mmHg with ≤2 medications. No sight threatening complications were encountered. Conclusion. Satisfactory IOP control was noted after SIGS in interim follow-up (14.18±1.88 months.

  10. Evaluation of Factors Influencing the Outcomes of Selective Laser Trabeculoplasty in Primary Open-Angle Glaucom

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    Necip Kara

    2011-10-01

    Full Text Available Pur po se: To determine demographic and clinical factors that affect the outcomes of selective laser trabeculoplasty (SLT in patients with primary open-angle glaucoma (POAG. Ma te ri al and Met hod: In this retrospective study, we analyzed the medical records of 54 eyes of 39 patients who underwent SLT treatment for POAG. Effects of demographic characteristics including age, sex, treated eyes, and family history of glaucoma on SLT success were investigated. Effects of clinical features including baseline intraocular pressure (IOP, baseline number of antiglaucomatous medications, baseline cup to disc ratio (c/d, trabecular meshwork (TM pigmentation, central corneal thickness, and number of laser spots on SLT success were also evaluated. Success was defined as a ≥ 20% reduction in IOP without additional medications, laser, or glaucoma surgery. Re sults: Overall, 1-year after SLT, the mean IOP reduction was 4.7±3.2 mmHg and the mean success rate was 59.3±6%. Among the all investigated factors, only baseline IOP was a significant predictor for the efficacy of SLT in POAG (p<0.001, r=570. The SLT success was 45±10% in patients with a baseline IOP values less than 21 mmHg and 72±8% in patients with a baseline IOP of 21 mmHg or higher (p=0.036. Other factors were not significantly associated with SLT treatment efficacy. Dis cus si on: SLT success is significantly predicted by baseline IOP value. However, age, sex, family history of glaucoma, treated eye, baseline number of medications, c/d, degree of TM pigmentation, CCT, and number of laser spots are not associated with SLT efficacy. (Turk J Ophthalmol 2011; 41: 304-8

  11. Comparison of combined phacotrabeculectomy with trabeculectomy only in the treatment of primary angle-closure glaucoma

    Institute of Scientific and Technical Information of China (English)

    WANG Mei; GE Jian; FANG Min; BAI Yu-jing; ZHANG Wei-zhong; LIN Ming-kai; LIU Bing-qian; HAO Yuan-tao; LING Yun-lan; ZHUO Ye-hong

    2012-01-01

    Background Trabeculectomy has become a mainstream treatment in intraocular pressure (IOP) reduction for primary angle-closure glaucoma (PACG); combined trabeculectomy and cataract surgery was reported to reduce lOP and simultaneously improve vision for patients with PACG and coexisting cataract.This study was specialized to compare the efficacy and safety of combined phacotrabeculectomy with that of trabeculectomy only in the treatment of PACG with coexisting cataract.Methods This is a comparative case series study.Thirty-one patients (31 eyes) with PACG and coexisting cataract were enrolled.Of these,17 underwent phacotrabeculectomy and 14 underwent trabeculectomy alone.lOP,filtering blebs,and complications were compared at the final follow-up.Complete success was defined as a final lOP less than 21 mmHg without lOP-lowering medication.Results After 10 months of postoperative follow-up,the phacotrabeculectomy and trabeculectomy groups showed no significant differences regarding IOP reduction ((20.59±7.94) vs.(24.85±14.39) mmHg,P=0.614),complete success rate (88% vs.71%,P=0.370),formation rate of functioning blebs (65% (11/17) vs.93% (13/14),P=0.094),and complications (41% (7/17) vs.57% (8/14),P=0.380).lOP-lowering medication was not required for most of the patients in both groups.Additional surgery interventions,including anterior chamber reformation and phacoemulsification,were needed in the trabeculectomy group,whereas no surgery was needed postoperatively in the phacotrabeculectomy group.Conclusion Phacotrabeculectomy and trabeculectomy treatments exhibit similar IOP reduction,successful rates,and complications when it comes to treating PACG patients with coexisting cataract,although additional surgery intervention may be needed for a few cases with cataract and complications after trabeculectomy.

  12. Myocilin polymorphisms and primary open-angle glaucoma: a systematic review and meta-analysis.

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    Jin-Wei Cheng

    Full Text Available BACKGROUND: Glaucoma is the leading cause of irreversible blindness in the world. Recent evidence indicates a role for genetic susceptibility to primary open-angle glaucoma (POAG. The relation between myocilin polymorphisms and POAG susceptibility has been studied in different populations. METHODS: A meta-analysis of 32 published genetic association case-control studies, which examined the relation between POAG and the R46X, R76K, Y347Y, T353I, and Q368X polymorphisms of the myocilin gene, was carried out. RESULTS: In meta-analysis, significant associations were observed between POAG risk and two myocilin polymorphisms with summarized odds ratio of 4.68 (95%CI, 2.02-10.85 for Q368X and 2.17 (95% CI, 1.32-3.57 for T353I. Both Q368X and T353I were significantly associated with high-tension glaucoma, with summarized odds ratio of 4.26 (1.69, 10.73 and 2.26 (1.37-3.72. In Westerners, significant association was observed for Q368X mutation (odds ratio, 5.17; 95% CI, 2.16-12.40. However, in Asians it was for T353I (odds ratio, 2.17; 95% CI, 1.32-3.57. CONCLUSIONS: There is strong evidence that myocilin polymorphisms are associated with POAG susceptibility, and the prevalence of myocilin mutations might be ethnicity-dependent in Caucasians for Q368X and in Asians for T353I.

  13. Association of genetic variants with primary angle closure glaucoma in two different populations.

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    Mona S Awadalla

    Full Text Available PURPOSE: A recent large genome-wide association study (GWAS identified multiple variants associated with primary angle-closure glaucoma (PACG. The present study investigated the role of these variants in two cohorts with PACG recruited from Australia and Nepal. METHOD: Patients with PACG and appropriate controls were recruited from eye clinics in Australia (n = 232 cases and n = 288 controls and Nepal (n = 106 cases and 204 controls. Single nucleotide polymorphisms (SNPs rs3753841 (COL11A1, rs1015213 (located between PCMTD1 and ST18, rs11024102 (PLEKHA7, and rs3788317 (TXNRD2 were selected and genotyped on the Sequenom. Analyses were conducted using PLINK and METAL. RESULTS: After adjustment for age and sex, SNP rs3753841 was found to be significantly associated with PACG in the Australian cohort (p = 0.017; OR = 1.34. SNPs rs1015213 (p = 0.014; OR 2.35 and rs11024102 (p = 0.039; OR 1.43 were significantly associated with the disease development in the Nepalese cohort. None of these SNPs survived Bonferroni correction (p = 0.05/4 = 0.013. However, in the combined analysis, of both cohorts, rs3753841 and rs1015213 showed significant association with p-values of 0.009 and 0.004, respectively both surviving Bonferroni correction. SNP rs11024102 showed suggestive association with PACG (p-value 0.035 and no association was found with rs3788317. CONCLUSION: The present results support the initial GWAS findings, and confirm the SNP's contribution to PACG. This is the first study to investigate these loci in both Australian Caucasian and Nepalese populations.

  14. Cytokine biomarkers in tear film for primary open-angle glaucoma

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    Gupta D

    2017-02-01

    Full Text Available Divakar Gupta,1,* Joanne C Wen,2,* Janet L Huebner,3 Sandra Stinnett,1 Virginia B Kraus,3,4 Henry C Tseng,1 Molly Walsh1 1Department of Ophthalmology, Duke University Medical Center, Durham, NC, 2Department of Ophthalmology, University of Washington, Seattle, WA, 3Duke Molecular Physiology Institute, 4Division of Rheumatology, Department of Medicine, Duke University School of Medicine, Durham, NC, USA *These authors contributed equally to this work Purpose: To determine the utility of tear film cytokines as biomarkers for early primary open-angle glaucoma (POAG. Methods: Patients without POAG and eye drop-naïve patients with newly diagnosed POAG were recruited from an academic hospital-based glaucoma practice. Tear films of recruited patients were obtained and analyzed using a multiplex, high-sensitivity electrochemiluminescent enzyme-linked immunosorbent assay for proinflammatory cytokines (IFNγ, IL-10, IL-12p70, IL-13, IL-1β, IL-2, IL-4, IL-6, IL-8, and TNFα. Results: Mean concentrations of tear film cytokines were lower in the glaucoma group for 8 of 10 cytokines tested. IL-12p70 (3.94±2.19 pg/mL in control vs 2.31±1.156 pg/mL in POAG; P=0.035 was significantly lower in the tear film of patients with newly diagnosed POAG. Conclusion: Proinflammatory cytokines were lower in eye drop-naïve newly diagnosed glaucoma patients. Tear film cytokine profiles may be used as biomarkers of early POAG. Keywords: glaucoma, biomarkers, tear film, cytokines, glaucoma diagnosis, lower limit of detection

  15. Axial Myopia Is Associated with Visual Field Prognosis of Primary Open-Angle Glaucoma.

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    Chen Qiu

    Full Text Available To identify whether myopia was associated with the visual field (VF progression of primary open-angle glaucoma (POAG.A total of 270 eyes of 270 POAG followed up for more than 3 years with ≥9 reliable VFs by Octopus perimetry were retrospectively reviewed. Myopia was divided into: mild myopia (-2.99 diopter [D], 0, moderate myopia (-5.99, 3.00 D, marked myopia (-9.00, -6.00 D and non-myopia (0 D or more. An annual change in the mean defect (MD slope >0.22 dB/y and 0.30 dB/y was defined as fast progression, respectively. Logistic regression was performed to determine prognostic factors for VF progression.For the cutoff threshold at 0.22 dB/y, logistic regression showed that vertical cup-to-disk ratio (VCDR; p = 0.004 and the extent of myopia (p = 0.002 were statistically significant. When logistic regression was repeated after excluding the extent of myopia, axial length (AL; p = 0.008, odds ratio [OR] = 0.796 reached significance, as did VCDR (p = 0.001. Compared to eyes with AL≤23 mm, the OR values were 0.334 (p = 0.059, 0.309 (p = 0.044, 0.266 (p = 0.019, 0.260 (p = 0.018, respectively, for 23 26 mm. The significance of vertical cup-to-disk ratio of (p = 0.004 and the extent of myopia (p = 0.008 did not change for the cutoff threshold at 0.30dB/y.VCDR and myopia were associated with VF prognosis of POAG. Axial myopia may be a protective factor against VF progression.

  16. Ascertainment of acute liver injury in two European primary care databases

    NARCIS (Netherlands)

    Ruigómez, A.; Brauer, R.; Rodríguez, L. A García; Huerta, C.; Requena, G.; Gil, M.; de Abajo, Francisco; Downey, G.; Bate, A.; Tepie, M. Feudjo; de Groot, M.C.H.; Schlienger, R.; Reynolds, R.; Klungel, O.

    2014-01-01

    Purpose The purpose of this study was to ascertain acute liver injury (ALI) in primary care databases using different computer algorithms. The aim of this investigation was to study and compare the incidence of ALI in different primary care databases and using different definitions of ALI. Methods T

  17. Hepatocyte growth factor genetic variations and primary angle-closure glaucoma in the Han Chinese population.

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    Zhengxuan Jiang

    Full Text Available PURPOSE: The aim of this study is to examine whether or not hepatocyte growth factor (HGF genetic variations are associated with susceptibility to primary angle-closure glaucoma (PACG in the Han Chinese population. METHODS: Three single-nucleotide polymorphisms (SNPs-rs5745718, rs17427817, and rs3735520-in the HGF gene were genotyped in 238 adult patients with PACG and 287 age-, sex-, and ethnically matched healthy controls by using a polymerase chain reaction restriction fragment length polymorphism assay. Data was analyzed by χ(2 analysis. RESULTS: The three tested analyzed polymorphisms in the HGF gene were in Hardy-Weinberg equilibrium, in all the subjects. The frequencies of the genotype and allele of rs5745718 and rs1742817 in the HGF gene were significantly different between the PACG patients and the controls. On one hand, the frequencies of the CC genotype and C allele of rs5745718 were significantly decreased in PACG patients compared with controls (Pc = 1.40×10(-3; Pc = 3.21×10(-4, respectively; however, on the other hand, significantly decreased frequencies of the GG genotype and the G allele of rs17427817 were observed in PACG patients compared with the controls (Pc = 0.006,; Pc = 6.06×10(-4, respectively. A comparison of the distributions of the genotypes and alleles of rs3735520 showed no statistically significant differences between the PACG patients and the controls (pc>0.05. The haplotype analysis results showed that the CGC haplotype frequency was significantly decreased in the patients with PACG compared with the controls (pc<0.001. No difference was detected between the patients and the controls with regard to the other haplotypes. CONCLUSIONS: Our study suggests that rs5745718 and rs17427817 are associated with a decreased risk of PACG in the Chinese Han population. The CGC haplotype was demonstrated to possibly play a protective role against PACG in this population.

  18. Variants in the ASB10 Gene Are Associated with Primary Open Angle Glaucoma.

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    Shazia Micheal

    Full Text Available Recently nonsynonymous coding variants in the ankyrin repeats and suppressor of cytokine signaling box-containing protein 10 (ASB10 gene were found to be associated with primary open angle glaucoma (POAG in cohorts from Oregon and Germany, but this finding was not confirmed in an independent cohort from Iowa. The aim of the current study was to assess the role of ASB10 gene variants in Pakistani glaucoma patients.Sanger sequencing of the coding exons and splice junctions of the ASB10 gene was performed in 30 probands of multiplex POAG families, 208 sporadic POAG patients and 151 healthy controls from Pakistan. Genotypic associations of individual variants with POAG were analyzed with the Fisher's exact or Chi-square test.In total 24 variants were identified in POAG probands and sporadic patients, including 11 novel variants and 13 known variants. 13 of the variants were nonsynonymous, 6 were synonymous, and 5 were intronic. Three nonsynonymous variants (p.Arg49Cys, p.Arg237Gly, p.Arg453Cys identified in the probands were not segregating in the respective families. This is not surprising since glaucoma is a multifactorial disease, and multiple factors are likely to be involved in the disease manifestation in these families. However a nonsynonymous variant, p.Arg453Cys (rs3800791, was found in 6 sporadic POAG patients but not in controls, suggesting that it infers increased risk for the disease. In addition, one synonymous variant was found to be associated with sporadic POAG: p.Ala290Ala and the association of the variant with POAG remained significant after correction for multiple testing (uncorrected p-value 0.002, corrected p-value 0.047. The cumulative burden of rare, nonsynonymous variants was significantly higher in sporadic POAG patients compared to control individuals (p-value 0.000006.Variants in ASB10 were found to be significantly associated with sporadic POAG in the Pakistani population. This supports previous findings that sequence

  19. Comparison of ocular response analyzer parameters in primary open angle glaucoma and exfoliative glaucoma patients

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    Emrullah Beyazyildiz

    2014-01-01

    Full Text Available Aim: We sought to identify differences in the following measures of the ocular response analyser (ORA between primary open angle glaucoma (POAG and exfoliative glaucoma (EXG patients: Corneal hysteresis (CH, corneal resistance factor (CRF, corneal-compensated intraocular pressure (IOPcc and Goldmann-correlated intraocular pressure (IOPg. We also sought to relate these ORA measures with central corneal thickness (CCT. Materials and Methods: This cross-sectional study was conducted on a total of 162 individuals (46 EXG patients, 66 POAG patients and 50 healthy subjects without any ocular and systemic disease. ORA measurements were performed, and a minimum of three readings were obtained from each test subject. Groups were compared according to their ORA parameters. Results: The mean CH levels of the EXG, POAG and healthy subjects were 7.6 ± 2.1, 9.1 ± 1.9 and 9.6 ± 1.7 mmHg, respectively. CH was significantly lower in the EXG patients compared to the other groups (P < 0.001.The mean CRF levels of the EXG, POAG and healthy subjects were 9.0 ± 2.0, 10.1 ± 1.7 and 9.8 ± 1.8mmHg, respectively. CRF levels in the eyes of the EXG patients were significantly lower compared to those of either the POAG patients (P = 0.005 or the healthy subjects (P = 0.03, but there was no significant difference in CRF levels between the POAG patients and the healthy subjects (P = 0.59. There was a significant positive correlation between CH and CCT in the EXG patients and healthy subjects (P < 0.001, but this correlation was not present in the POAG patients (P = 0.70. Conclusions: In this study, CH and CRF were found to be significantly reduced in the eyes of EXG patients compared to both the POAG patients and healthy subjects. Reduced CH in EXG patients might result in decreased support of peripapillary scleral structure and increased damage to the optic nerve during IOP increase.

  20. Comment on “Short-term effects of relaxation music on patients suffering from primary open-angle glaucoma”

    OpenAIRE

    2015-01-01

    Abdullah Kaya,1 Yakup Aksoy,2 Mehmet Koray Sevinç,3 Oktay Diner41Department of Ophthalmology, Anittepe Military Dispansery, Ankara, Turkey; 2Department of Ophthalmology, Girne Military Hospital, Girne, Cyprus; 3Department of Ophthalmology, Beytepe Military Hospital, Ankara, 4Department of Ophthalmology, Erzurum Military Hospital, Erzurum, TurkeyWe read the current study “Short-term effects of relaxation music on patients suffering from primary open-angle glaucoma” by Bertel...

  1. Predicting dihedral angle probability distributions for protein coil residues from primary sequence using neural networks

    DEFF Research Database (Denmark)

    Helles, Glennie; Fonseca, Rasmus

    2009-01-01

    Predicting the three-dimensional structure of a protein from its amino acid sequence is currently one of the most challenging problems in bioinformatics. The internal structure of helices and sheets is highly recurrent and help reduce the search space significantly. However, random coil segments...... make up nearly 40\\% of proteins, and they do not have any apparent recurrent patterns which complicates overall prediction accuracy of protein structure prediction methods. Luckily, previous work has indicated that coil segments are in fact not completely random in structure and flanking residues do...... seem to have a significant influence on the dihedral angles adopted by the individual amino acids in coil segments. In this work we attempt to predict a probability distribution of these dihedral angles based on the flanking residues. While attempts to predict dihedral angles of coil segments have been...

  2. Validity and cost-effectiveness of methods for screening of primary open angle glaucoma

    Directory of Open Access Journals (Sweden)

    Fröschl, Barbara

    2007-02-01

    Full Text Available Health political background: About 950,000 people are affected by glaucoma in Germany, about 50% of which are undiagnosed. The German Ophthalmological Society and the German Association of Ophthalmologists recommend a screening for glaucoma according to their guidelines. The Federal Joint Committee disapproved a glaucoma-screening program on expense of the compulsory health insurance in 2004. Scientific background: Primary open angle glaucoma is diagnosed by evaluation of the optic disc, the retinal fibre layer and the visual field. The main examinations are ophthalmoscopy, scanning laser polarimetry, confocal scanning laser ophthalmoscopy, retinal thickness analysis and optical coherence tomography. Scotomas are diagnosed by perimetry (standard automated perimetry, short wavelength automated perimetry and frequency doubling perimetry. The intraocular pressure is the most important treatable risk factor and is measured by (contact or non-contact tonometry. Research questions: The aim of this HTA-report is to investigate the diagnostic validity and cost effectiveness of diagnostic techniques or combinations of these methods with respect to the use in a screening setting in Germany. Methods: A systematic literature research was performed in 35 international databases and yielded 2602 articles. Overall 57 publications were included for assessment, according to predefined selection criteria. Results: The 55 medical articles deal mainly with frequency doubling perimetry, confocal scanning laser ophthalmoscopy and scanning laser polarimetry. Few articles cover short wavelength automated perimetry, tonometry and ophalmocopic evaluations by ophthalmologists. The quality of the papers is generally low, as far as the evidence in respect of screening is concerned. No single method exists with both, high sensitivity and high specificity for screening purpose. Data are also not sufficient to recommend combinations of methods. Only two economic models on cost

  3. Effect of primary iris and ciliary body cyst on anterior chamber angle in patients with shallow anterior chamber

    Institute of Scientific and Technical Information of China (English)

    Bing-hong WANG; Yu-feng YAO

    2012-01-01

    Objective:To evaluate the prevalence of primary iris and/or ciliary body cysts in eyes with shallow anterior chamber and their effect on the narrowing of the anterior chamber angle.Methods:Among the general physical check-up population,subjects with shallow anterior chambers,as judged by van Herick technique,were recruited for further investigation.Ultrasound biomicroscope (UBM) was used to detect and measure the cysts located in the iris and/or ciliary body,the anterior chamber depth (ACD),the angle opening distance at 500 μm (AOD500),and the trabecular-iris angle (TIA).A-scan ultrasonography was used to measure the ocular biometry,including lens thickness,axial length,lens/axial length factor (LAF),and relative lens position (RLP).The effect of the cyst on narrowing the corresponding anterior chamber angle and the entire angle was evaluated by the UBM images,ocular biometry,and gonioscopic grading.The eye with unilateral cyst was compared with the eye without the cyst for further analysis.Results:Among the 727 subjects with shallow anterior chamber,primary iris and ciliary body cysts were detected in 250 (34.4%) patients; among them 96 (38.4%) patients showed unilateral single cyst,21 (8.4%) patients had unilateral double cysts,and 42 (16.8%) patients manifested unilateral multiple and multi-quadrants cysts.Plateau iris configuration was found in 140 of 361 (38.8%) eyes with cysts.The mean size of total cysts was (0.6547±0.2319) mm.In evaluation of the effect of the cyst size and location on narrowing the corresponding angle to their position,the proportion of the cysts causing corresponding angle narrowing or closure among the cysts larger than 0.8 mm (113/121,93.4%) was found to be significantly higher than that of the cysts smaller than 0.8 mm (373/801,46.6%),and a significant higher proportion was also found in the cysts located at iridociliary sulcus (354/437,81.0%) than in that at the pars plicata (131/484,27.1%).In evaluating the effect

  4. Comparison between primary angioplasty and thrombolytic therapy on erectile dysfunction after acute ST elevation myocardial infarction

    Institute of Scientific and Technical Information of China (English)

    Ramazan Akdemir; Ekrem Yeter; (O)zlem Karakurt; Salih Orcan; Nihat Karakoyunlu; Mustafa Mucahit Balci; Levent Sa(g)nak; Hamit Ersoy; Mehmet Bulent Vatan; Harun Kilic

    2012-01-01

    Acute ST elevation myocarclial infarction has high mortality and morbidity rates.The majority of patients with this condition face erectile dysfunction in addition to other health problems,In this study,we aimed to investigate the effects of two different reperfusion strategies,primary angioplasty and thrombolytic therapy,on the prevalence of erectile dysfunction after acute myocardial infarction.Of the 71 patients matching the selection criteria,45 were treated with primary coronary angioplasty with stenting,and 26 were treated with thrombolytic agents.Erectile function was evaluated using the International Index of Erectile Function in the hospital to characterize each patient's sexual function before the acute myocardial infarction and 6 months after the event.The time required to restore blood flow to the artery affected by the infarct was found to be associated with the occurrence of erectile dysfunction after acute myocardial infarction.The increase in the prevalence of erectile dysfunction after acute myocardial infarction was 44.4% in the angioplasty group and 76.9% in the thrombolytic therapy group (P=0.008).In conclusion,this study has shown that reducing the time of reperfusion decreases the erectile dysfunction prevalence,and primary angioplasty is superior to thrombolytic therapy for decreasing the prevalence of erectile dysfunction after acute myocardial infarction.

  5. Primary and Secondary Prevention of Acute Coronary Syndromes: The Role of the Statins.

    Science.gov (United States)

    Diamantis, Evangelos; Troupis, Theodoros; Mazarakis, Antonios; Kyriakos, Giorgos; Troupis, Georgios; Skandalakis, Panagiotis

    2014-01-01

    Poor prognosis is strongly associated with Acute Coronary Syndrome (ACS) and, even though a number of treatment strategies are available, the incidence of subsequent serious complications after an acute event is still high. Statins are hypolipidemic factors and recent studies have demonstrated that they have a protective role during the process of atherogenesis and that they reduce mortality caused by cardiovascular diseases. This review tries to reveal the function of the statins as a component of the primary and secondary action of acute coronary syndrome and to describe the lifestyle changes that have the same effect as the use of statins.

  6. Mechanisms of angle closure in primary angle closure%原发性前房角关闭的发病机制

    Institute of Scientific and Technical Information of China (English)

    江兵; 叶雷; 田祥; 张英; 潘乐

    2013-01-01

    Objective To investigate the mechanisms of angle closure through observing changes of anterior segment morphology after laser peripheral iridotomy (LPI) in eyes with primary angle closure (PAC).Methods A prospective intervention observational case series.Forty-eight eyes with PAC,which were examined by ultrasound biomicroscopy (UBM) in darkness,were divided into three groups:The group A,simple pupillary block group; the group B,multi-mechanism group,the group C (0),simple pure non-pupillary block group.Ultrasound biomicroscopy examination was carried out before and 2 weeks after LPI treatment was preformed on PAC.UBM parameters included AOD,TIA,IT1,TCPD,ILA,ILCD,SS-IR.Results 1.Composition of the PAC was:simple pupillary block group (9 eyes,18.75%); multiple mechanism group (39 eyes,81.25%); simple pure non-pupillary block group (0 eye,0%).In multiple mechanism group (39 eyes,81.25%),there were 14.6% (7 eyes) in pupillary blocking coexisting a anterior positioned ciliary body; 12.5% (6 eyes) in pupillary blocking coexisting a thicker iris; 54.2% (26 eyes) in pupillary blocking coexisting a thicker iris and a anterior positioned ciliary body.2.The rate of angle open after LPI was 100% (9/9) in simple pupillary block group,and 41.0% (16/39) in multiple mechanism group (P =0.001).3.The preoperative peripheral iris thickness of group B (0.4029±0.0466mm) was thicker than that of group A (0.3248±0.0520mm) (P <0.05).Angle opening degree after LPI in group A were significantly increased (AOD500,TIA) compared with group B (P <0.05).There were no significant differences in iris bombe degree (ILCD,ILA) between group A and group B after LPI (P >0.05).After LPI,SS-IR in angle closure points were significantly shorter than in angle opening points (P <0.05).Conclusions The mechanism of primary angle closure is main multiple mechanism.Both a thicker iris and an anterior positioned ciliary body played a key role in the pathogenesis of angle closure after

  7. The History of Primary Angioplasty and Stenting for Acute Myocardial Infarction.

    Science.gov (United States)

    Smilowitz, Nathaniel R; Feit, Frederick

    2016-01-01

    The evolution of the management of acute myocardial infarction (MI) has been one of the crowning achievements of modern medicine. At the turn of the twentieth century, MI was an often-fatal condition. Prolonged bed rest served as the principal treatment modality. Over the past century, insights into the pathophysiology of MI revolutionized approaches to management, with the sequential use of surgical coronary artery revascularization, thrombolytic therapy, and percutaneous coronary intervention (PCI) with primary coronary angioplasty, and placement of intracoronary stents. The benefits of prompt revascularization inspired systems of care to provide rapid access to PCI. This review provides a historical context for our current approach to primary PCI for acute MI.

  8. Primary HIV infection presenting as non-traumatic rhabdomyolysis with acute renal failure.

    Science.gov (United States)

    Prabahar, Murugesan Ram; Jain, Manish; Chandrasekaran, Venkatraman; Indhumathi, Elayaperumal; Soundararajan, Periasamy

    2008-07-01

    Renal disease is a relatively common complication in patients infected with the human immunodeficiency virus (HIV). A collapsing form of focal glomerulosclerosis has been considered as the primary form of HIV nephropathy. HIV infection is also associated with an increasing number of different forms of renal disease. Acute renal failure (ARF) syndromes are frequently noted during the course of HIV infection. The most common include the following: acute and often reversible renal failure resulting from infection, hypotension, and administration of nephrotoxins used to treat opportunistic infections, and the use of highly active anti-retroviral therapy. ARF has been reported in up to 20% of hospitalized HIV infected patients compared to 3 to 5% of non-HIV infected patients. Primary HIV infection is usually symptomatic, and infected patients can present with a variety of symptoms. Although ARF syndromes are frequently noted during the course of infection, it is an uncommon presentation of primary HIV infection. We describe a 42-year-old man who presented at our hospital with acute self-limited rhabdomyolysis and who was found to have primary HIV infection. Our case and other reports suggest that a diagnosis of primary HIV infection needs to be considered in patients who present with acute rhabdomyolysis.

  9. Primary hyperparathyroidism presenting as recurrent acute pancreatitis: A case report and review of literature

    Directory of Open Access Journals (Sweden)

    Raiz A Misgar

    2011-01-01

    Full Text Available The association between pancreatitis and primary hyperparathyroidism (PHPT is controversial. We report a 32-year-old man who presented with recurrent episodes of acute pancreatitis. Primary hyperparathyroidism was diagnosed after the fourth episode of pancreatitis. He had no additional risk factors for pancreatitis. Eighteen months after successful parathyroid surgery, there has been no recurrence of abdominal pain and his serum calcium is within the normal range.

  10. A clinical trial comparing primary coronary angioplasty with tissue plasminogen activator for acute myocardial infarction

    NARCIS (Netherlands)

    M.L. Simoons (Maarten); S.G. Ellis (Stephen)

    1997-01-01

    textabstractBACKGROUND: Among physicians who treat patients with acute myocardial infarction, there is controversy about the magnitude of the clinical benefit of primary (i.e., immediate) coronary angioplasty as compared with thrombolytic therapy. METHODS: As part of the Global Use of Strategies to

  11. A diagnostic rule for acute gouty arthritis in primary care without joint fluid analysis.

    NARCIS (Netherlands)

    Janssens, H.J.E.M.; Fransen, J.; Lisdonk, E.H. van de; Riel, P.L.C.M. van; Weel, C. van; Janssen, M.

    2010-01-01

    BACKGROUND: Most cases of acute gouty arthritis are diagnosed in primary care and without joint fluid analysis in many instances. Our objectives were to estimate the validity of this diagnosis by family physicians and to develop a diagnostic rule. METHODS: Patients with monoarthritis recruited in an

  12. System of primary collimators of SR beam at the small-angle station for KSRS

    CERN Document Server

    Ariskin, N I; Korneev, V N; Sergienko, P M; Shishkov, V I; Sheromov, M A; Stankevich, V G; Vazina, A A

    2001-01-01

    The wide program of development of methods and experimental techniques for usage at the Kurchatov Synchrotron Radiation Source (KSRS) is implemented by us. The report illustrates a part of this program directed at creating the small-angle station DICSI-6 on the beam line 'Siberia-2'. It is intended for X-ray diffraction research of structures and structural changes of a wide range of objects in various areas of science and technology--molecular and cell biology, organic chemistry, solid-state physics, etc. Some technical information about the elaborated system of devices for station DICSI-6 intended for forming an X-ray synchrotron beam and method for adjustment of the system are considered.

  13. Isolated cardiophrenic angle node metastasis from ovarian primary. report of two cases

    Directory of Open Access Journals (Sweden)

    Avenia Nicola

    2011-01-01

    Full Text Available Abstract Ovarian cancer is the most lethal gynaecologic malignancy. It usually spreads out of the abdomen involving thoraco-abdominal organs and serosal surface. This disease is poorly curable and surgery, at early stage, is supposed to achieve the best survival outcome. In systemic dissemination, chemiotherapy is indicated, sometimes with neoadjuvant aim. The most common clinical expressions of advanced ovarian carcinoma are multiple adenopathy, neoplastic pleuritis, peritoneal seeding and distant metastasis, mainly hepatic and pulmonary. Isolated adenopathy of the mediastinum is rare and isolated bilateral have never been described before. We report two cases of isolated bilateral cardiophrenic angle lymphnode metastasis from ovarian carcinoma, without peritoneal and pleural involvement. Both patients were successfully resected through minimally invasive thoracic surgery. About the role of surgery, few data are available but survival seems to be longer after resection thus, more investigation is required to make the indication to surgery more appropriate in advanced cases.

  14. Acute physical activity and delayed attention in primary school students.

    Science.gov (United States)

    Gallotta, M C; Emerenziani, G P; Franciosi, E; Meucci, M; Guidetti, L; Baldari, C

    2015-06-01

    To examine the influence of different types of exertion on immediate and delayed attention in 116 primary school children divided in three groups of exertion [cognitive exertion - CE (school curricular lesson), physical exertion - PE (traditional physical education lesson), mixed cognitive and physical exertion - CPE (coordinative physical education lesson)]. CPE was the combination of physical load due to the practice of physical exercises and of cognitive load requested to perform movement-based problem solving tasks requiring accurate timing, temporal estimations, temporal production, and spatial adjustments. Children's attentional capacity was tested before (pre) and after (at 0 min and at 50 min post) a CE, a PE, or a CPE lesson, using the d2-test of attention, and analyzed using a 3 × 3 × 2 mixed analysis of covariance with exertion type and time as within factors, gender as between factor, and baseline data as covariate. Effect sizes were calculated as partial eta squared (ƞ(2)). Results showed that participants' attentional performance was significantly affected by exertion type (P < 0.0001), by time (P < 0.0001) and by exertion type × time interactions (P < 0.0001). The effect sizes ranged from medium (0.039) to large (0.437). Varying the type of exertion has different beneficial influences on the level of attention in school children.

  15. Assessment of the anterior chamber parameters after laser iridotomy in primary angle close suspect using Pentacam and gonioscopy

    Science.gov (United States)

    Esmaeili, Alireza; Barazandeh, Behzad; Ahmadi, Sina; Haghi, Alireza; Ahmadi Hosseini, Seyed Mahdi; Abolbashari, Fereshteh

    2013-01-01

    AIM To evaluate the changes in the anterior segment parameters of the subjects with primary angle closure suspect (PACS) before and after laser iridotomy (LI) using the Pentacam and gonioscopy. METHODS Forty-eight eyes of 48 PACS were included. Anterior chamber angle (ACA), central anterior chamber depth (ACD), anterior chamber volume (ACV) and central corneal thickness (CCT) were recorded from the Pentacam before and one month after LI. ACA was graded according to Shaffer classification using the Goldmann gonioscopy. RESULTS ACA increased significantly from 25.59±4.41 to 26.46±4.33 degrees (P=0.009) and ACV changed from 85.97±16.07mm3 to 99.25±15.83mm3 (P=0.000). The changes in ACD, CCT and intraocular pressure were non-significant (P>0.05). Gonioscopy showed significant widening of the Shaffer angle in 4 quadrants (P<0.001). CONCLUSION Pentacam can serve as the objective instrument in assessing the efficacy of LI. PMID:24195049

  16. Primary percutaneous coronary intervention ameliorates complete atrioventricular block complicating acute inferior myocardial infarction

    Directory of Open Access Journals (Sweden)

    Lee SN

    2014-11-01

    Full Text Available Su Nam Lee, You-Mi Hwang, Gee-Hee Kim, Ji-Hoon Kim, Ki-Dong Yoo, Chul-Min Kim, Keon-Woong MoonDepartment of Internal Medicine, St Vincent’s Hospital, The Catholic University of Korea, Suwon, South KoreaObjective: Complete atrioventricular block (CAVB in acute inferior ST-segment elevation myocardial infarction (STEMI is associated with poor clinical outcomes after noninvasive treatment. This study was designed to determine the effect of primary percutaneous coronary intervention (PCI in patients with CAVB complicating acute inferior STEMI, at a single center.Methods: We enrolled 138 consecutive patients diagnosed with STEMI involving the inferior wall; of these, 27 patients had CAVB. All patients received primary PCI. The clinical characteristics, procedural data, and clinical outcomes were compared in patients with versus without CAVB. Results: Baseline clinical characteristics were similar between patients with and without CAVB. Patients with CAVB were more likely to present with cardiogenic shock, and CAVB was caused primarily by right coronary artery occlusion. Door-to-balloon time was similar between those two groups. After primary PCI, CAVB was reversed in all patients. The peak creatinine phosphokinase level, left ventricular ejection fraction and in-hospital mortality rate were similar between the two groups. After a median follow up of 318 days, major adverse cardiac events did not differ between the groups (8.1% in patients without CAVB; 11.1% in patients with CAVB (P=0.702.Conclusion: We conclude that primary PCI can ameliorate CAVB-complicated acute inferior STEMI, with an acceptable rate of major adverse cardiac events, and suggest that primary PCI should be the preferred reperfusion therapy in patients with CAVB complicating acute inferior myocardial infarction. Keywords: major adverse cardiac events, PCI-capable hospital

  17. The use of amniotic membrane in trabeculectomy for the treatment of primary open-angle glaucoma: a prospective study

    Directory of Open Access Journals (Sweden)

    Stavrakas P

    2012-02-01

    Full Text Available Panagiotis Stavrakas1, Gerasimos Georgopoulos1, Maria Milia1, Dimitris Papaconstantinou1, Maria Bafa2, Efthymios Stavrakas2, Mihalis Moschos11Department of Ophthalmology, University of Athens Medical School, General Hospital of Athens (Geniko Kratiko Hospital, Athens, Greece; 2Department of Ophthalmology, Thriassio General Hospital, Athens, GreeceBackground: To investigate the effectiveness of amniotic membrane transplantation (AMT on improving the outcomes of trabeculectomy in primary open-angle glaucoma (POAG.Methods: Fifty-nine eyes affected by primary open-angle glaucoma were enrolled in this prospective randomized study. Thirty-two eyes underwent amnion-shielded trabeculectomy (study group and 27 eyes underwent trabeculectomy without any antimetabolites (control group. Success was defined as intraocular pressure (IOP <21 mmHg without any medications at 24 months follow-up. The two groups were compared in terms of IOP, bleb morphology, bleb survival and risk of failure, glaucoma medications, and complications.Results: There was no statistically significant difference in terms of postoperative IOP between the two groups and at 24 months median IOP was 15.5 mmHg for the AMT group and 16 mmHg for the control group. IOP postoperative reduction was 8 mmHg for the AMT group versus 6 mmHg for the non AMT group (P = 0.276. Two patients from the study group developed IOP >21 mmHg in contrast to seven patients from the classic trabeculectomy group. The study group had 61.0% less risk of developing IOP >21 mmHg (P = 0.203. No major complications in the AMT group were observed. AMT blebs were diffuse with mild vascularization.Conclusion: In patients with POAG, AMT showed favorable effects on bleb survival, however data failed to provide firm evidence that AMT could be used as a routine procedure in trabeculectomy.Keywords: amniotic membrane, trabeculectomy, primary open-angle glaucoma, glaucoma filtering blebIn memory of Professor Mihalis Moschos. "We

  18. Comment on “Short-term effects of relaxation music on patients suffering from primary open-angle glaucoma”

    Directory of Open Access Journals (Sweden)

    Kaya A

    2015-12-01

    Full Text Available Abdullah Kaya,1 Yakup Aksoy,2 Mehmet Koray Sevinç,3 Oktay Diner41Department of Ophthalmology, Anittepe Military Dispansery, Ankara, Turkey; 2Department of Ophthalmology, Girne Military Hospital, Girne, Cyprus; 3Department of Ophthalmology, Beytepe Military Hospital, Ankara, 4Department of Ophthalmology, Erzurum Military Hospital, Erzurum, TurkeyWe read the current study “Short-term effects of relaxation music on patients suffering from primary open-angle glaucoma” by Bertelmann and Strempel, with great interest. The authors investigated if relaxation music had a positive effect on glaucoma.We congratulate the authors for this innovative study and want to make some contributions that may widen the impression area of this study.  View original article by Bertelmann and Strempel.

  19. The Association between Primary Open-Angle Glaucoma and Blood Pressure: Two Aspects of Hypertension and Hypotension

    Directory of Open Access Journals (Sweden)

    Hye Jin Chung

    2015-01-01

    Full Text Available Glaucoma is the second leading cause of blindness worldwide. Although the mechanism of the development of primary open-angle glaucoma (POAG is not fully understood, elevated intraocular pressure (IOP is considered the most important risk factor. Several vascular factors have also been identified as risk factors and can lead to hypoperfusion of the optic nerve head and thus may play an important role in the pathogenesis and progression of POAG. The results of the present study suggest that both high and low blood pressure (BP are associated with an increased risk of POAG based on a comprehensive literature review. Elevated BP is associated with elevated IOP, leading to increased risk of glaucoma, but excessive BP lowering in glaucoma patients may cause a drop in ocular perfusion pressure (OPP and subsequent ischemic injury. The relationship between IOP, OPP, and BP suggests that the relationship between BP and glaucoma progression is U-shaped.

  20. [The effect of parenteral citicoline on visual functions and life quality of patients with primary open-angle glaucoma].

    Science.gov (United States)

    Frolov, M A; Gonchar, P A; Barashkov, V I; Kumar, V; Morozova, N S; Frolov, A M; Kazakova, K A

    2011-01-01

    The effect of nootropic drug citicoline on visual functions, perimetric indexes of static automated perimetry, morphometric characteristics of retinal tomography and life quality of patients with primary open-angle glaucoma (POAG) stage I-III and normalized intraocular pressure (IOP) was studied. 40 patients aged 46-78 years old with POAG stage I-III and normalized IOP were treated with citicoline. Among them there were 24 female and 16 male. The patients were divided into 2 equal groups--experimental and control. Patients of both groups were treated with intravenous citicoline for 10 days. The dose of citicoline in experimental group was 1000 mg/day, in control--500 mg/day. After treatment in both groups visual functions, perimetric indexes of static automated perimetry, morphometric characteristics of retinal tomography and life quality showed improvement. Citicoline has significant neuroprotective effect preventing apoptosis.

  1. ABCC5, a gene that influences the anterior chamber depth, is associated with primary angle closure glaucoma.

    Directory of Open Access Journals (Sweden)

    Monisha E Nongpiur

    2014-03-01

    Full Text Available Anterior chamber depth (ACD is a key anatomical risk factor for primary angle closure glaucoma (PACG. We conducted a genome-wide association study (GWAS on ACD to discover novel genes for PACG on a total of 5,308 population-based individuals of Asian descent. Genome-wide significant association was observed at a sequence variant within ABCC5 (rs1401999; per-allele effect size =  -0.045 mm, P = 8.17 × 10(-9. This locus was associated with an increase in risk of PACG in a separate case-control study of 4,276 PACG cases and 18,801 controls (per-allele OR = 1.13 [95% CI: 1.06-1.22], P = 0.00046. The association was strengthened when a sub-group of controls with open angles were included in the analysis (per-allele OR = 1.30, P = 7.45 × 10(-9; 3,458 cases vs. 3,831 controls. Our findings suggest that the increase in PACG risk could in part be mediated by genetic sequence variants influencing anterior chamber dimensions.

  2. A simulation study of some observable parameters of Cherenkov photons in EASs of different primaries incident at various angles

    CERN Document Server

    Das, G S; Goswami, U D

    2016-01-01

    We have studied the lateral density, arrival time and angular distributions of Cherenkov photons in Extensive Air Showers (EASs) initiated by $\\gamma$-ray, proton and iron primaries incident with different energies and at different zenith angles. This study is the extension of our earlier work \\cite{Hazarika} to cover almost the whole energy range of ground based $\\gamma$-ray astronomy and to cover a wide range of zenith angles ($\\le 40^\\circ$), as well as the extension to study the angular distribution patterns of Cherenkov photons in EASs. This type of study is important for distinguishing the $\\gamma$-ray initiated showers from the hadronic showers in the ground based $\\gamma$-ray astronomy, where Atmospheric Cherenkov Technique (ACT) is used. Importantly, such study gives an insight on the nature of $\\gamma$-ray and hadronic showers in general. In this work, we used the CORSIKA 6.990 simulation package for the generation of EASs. Similar to the case of Ref.\\cite{Hazarika}, this study also revealed that, t...

  3. Successful recanalization of acute superior mesenteric artery thrombotic occlusion with primary aspiration thrombectomy

    Institute of Scientific and Technical Information of China (English)

    Hye; Jin; Yang; Young; Kwon; Cho; Yun; Ju; Jo; Yoon; Young; Jung; Seung; A; Choi; Suk; Hoon; Lee

    2010-01-01

    Prompt revascularization of the superior mesenteric artery(SMA) thrombotic occlusion can prevent intestinal infarction and decrease necrosis of the bowel segment.Herein,we describe two cases who underwent successful endovascular recanalization for acute SMA thrombosis using a primary aspiration thrombectomy because of possible consequent laparotomy for survey of bowel viability.The two patients had dramatic pain reliefimmediately after the procedure and remained symptomfree during the follow-up period.

  4. Maximum dose angle for oblique incidence on primary beam protective barriers in the design of medical radiation therapy facilities.

    Science.gov (United States)

    Fondevila, Damián; Arbiser, Silvio; Sansogne, Rosana; Brunetto, Mónica; Dosoretz, Bernardo

    2008-05-01

    Primary barrier determinations for the shielding of medical radiation therapy facilities are generally made assuming normal beam incidence on the barrier, since this is geometrically the most unfavorable condition for that shielding barrier whenever the occupation line is allowed to run along the barrier. However, when the occupation line (for example, the wall of an adjacent building) runs perpendicular to the barrier (especially roof barrier), then two opposing factors come in to play: increasing obliquity angle with respect to the barrier increases the attenuation, while the distance to the calculation point decreases, hence, increasing the dose. As a result, there exists an angle (alpha(max)) for which the equivalent dose results in a maximum, constituting the most unfavorable geometric condition for that shielding barrier. Based on the usual NCRP Report No. 151 model, this article presents a simple formula for obtaining alpha(max), which is a function of the thickness of the barrier (t(E)) and the equilibrium tenth-value layer (TVL(e)) of the shielding material for the nominal energy of the beam. It can be seen that alpha(max) increases for increasing TVL(e) (hence, beam energy) and decreases for increasing t(E), with a range of variation that goes from 13 to 40 deg for concrete barriers thicknesses in the range of 50-300 cm and most commercially available teletherapy machines. This parameter has not been calculated in the existing literature for radiotherapy facilities design and has practical applications, as in calculating the required unoccupied roof shielding for the protection of a nearby building located in the plane of the primary beam rotation.

  5. [Angle class I malocclusion in primary dentition and findings in permanent dentition--a follow-up study].

    Science.gov (United States)

    Legovic, M; Legovic, A; Skrinjaric, T; Sasso, A; Mady, B

    2005-01-01

    The aim of the study was to examine stability and changes in Angle Class I malocclusion from deciduous to permanent dentition in 168 subjects. All the subjects had Class I malocclusion in deciduous dentition, and were examined by the same orthodontist on two occasions during deciduous and permanent dentition. None of the subjects had received orthodontic therapy in the meantime. The results showed considerable changes from primary to permanent dentition. Crowding in primary dentition was retained in permanent dentition in 45.2% cases. In 16.2% cases it changed into normocclusion and 38.6% subjects developed other types of malocclusion. Open bite was retained in permanent dentition in 17.8% cases and in 17.8% subjects transformed into normocclusion. 64.4% subjects developed other types of malocclusion. Cross bite was retained in permanent dentition in 21.4% cases and in 28.6% subjects changed to normocclusion. Other types of malocclusion in permanent dentition developed in 50% subjects. In 30.8% of cases finding of premature loss of deciduous teeth was accompanied by extraction of some permanent teeth. Normocclusion was retained in 19.2% cases while 50% of children developed some type of malocclusion. Crowding, which was retained in permanent dentition in 45.2% cases, showed the highest degree of stability. Children with this type of anomaly in primary dentition displayed the highest frequency of total malocclusions (83.3% subjects). Out of all anomalies in primary dentition, cross bite most frequently switched to normal occlusion in permanent dentition (in 28.6% cases).

  6. Acute effects of anterior thigh foam rolling on hip angle, knee angle, and rectus femoris length in the modified Thomas test

    OpenAIRE

    Vigotsky, Andrew D.; Lehman, Gregory J; Contreras, Bret; Beardsley, Chris; Chung, Bryan; Feser, Erin H.

    2015-01-01

    Background. Foam rolling has been shown to acutely increase range of motion (ROM) during knee flexion and hip flexion with the experimenter applying an external force, yet no study to date has measured hip extensibility as a result of foam rolling with controlled knee flexion and hip extension moments. The purpose of this study was to investigate the acute effects of foam rolling on hip extension, knee flexion, and rectus femoris length during the modified Thomas test. Methods. Twenty-three h...

  7. Acute effects of anterior thigh foam rolling on hip angle, knee angle, and rectus femoris length in the modified Thomas test

    OpenAIRE

    Vigotsky, Andrew D.; Lehman, Gregory J; Bret Contreras; Chris Beardsley; Bryan Chung; Feser, Erin H.

    2015-01-01

    Background. Foam rolling has been shown to acutely increase range of motion (ROM) during knee flexion and hip flexion with the experimenter applying an external force, yet no study to date has measured hip extensibility as a result of foam rolling with controlled knee flexion and hip extension moments. The purpose of this study was to investigate the acute effects of foam rolling on hip extension, knee flexion, and rectus femoris length during the modified Thomas test.Methods. Twenty-three he...

  8. A randomized trail comparing primary percutaneous coronary intervention with a strategy of short-acting thrombolysis and immediate planned primary percutaneous coronary intervention in acute myocardial infarction

    Institute of Scientific and Technical Information of China (English)

    傅向华

    2003-01-01

    A randomized trail comparing primary percutaneous coronary intervention with a strategy of short-acting thrombolysis and immediate planned primary percutaneous coronary intervention in acute myocardial infarction!050000$河北医科大学第二医院河北医科大学心脏介入中心@傅向华

  9. Pengaruh Lamanya Pemberian Citicoline dalam Memperbaiki Retinal Nerve Fiber Layer (Rnfl dan Lapang Pandangan pada Primary Open Angle Glaucoma (Poag

    Directory of Open Access Journals (Sweden)

    Kemala Sayuti

    2014-01-01

    Full Text Available AbstrakTujuan penelitian ini adalah untuk menilai pengaruh lamanya pemberian citicoline dalam memperbaiki kualitas RNFL dan lapang pandangan pada POAG. Penelitian ini dilakukan pada pasien POAG yang datang dari bulan September 2010 – Januari 2011 dengan tehnik consecutive sampling. Semua subjek penelitian yang sudah diskrining dilakukan pemeriksaan OCT dan perimetri segera sebelum pemberian citicoline, pemeriksaan ulangan dilakukan setelah 10 hari pertama, 10 hari kedua, dan 10 hari ketiga pemberian citicoline. Dari penelitian ini didapatkan perbaikan ketebalan RNFL dengan pemeriksaan OCT lebih banyak terjadi pada pemberian citicoline selama 10 hari III (45.7% dibandingkan dengan pemberian 10 hari I (25,7% dan 10 hari II (42,9%. Perbaikan mean sensitivity lapang pandangan dengan pemeriksaan perimetri lebih banyak terjadi pada pemberian citicoline selama 10 hari III (51,4% dibandingkan dengan pemberian 10 hari I (32.4% dan 10 hari II (37.2%. Lama pemberian citicoline sangat berpengaruh meningkatkan ketebalan RNFL dengan pemeriksaan OCT dan mean sensitivity lapang pandangan dengan pemeriksaan perimetri pada pasien POAG dan bermakna secara statistik dengan p=0.000 dan p=0.001Kata kunci: Primary Open Angle Glaucoma, Retinal Nerve Fiber Layer, CiticolineAbstractThe objective of this study was to assessing the influence of duration of citicoline administration in improve the quality of RNFL and visual field in POAG. The study was conducted in patients with POAG who take place in September 2010 - January 2011 with consecutive sampling technique. After screening examination, subjects underwent OCT examination and early perimetry after the administration of citicoline, re-examination were in first 10 days, second 10 days, and third 10 days. RNFL thickness by OCT examination were much more going in citicoline administered for the third 10 days (45.7% compared with the provision of first 10 days (25.7% and second 10 day (42.9%. Mean sensitivity

  10. Acute adrenal failure as the presenting feature of primary antiphospholipid syndrome in a child

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    Improda Nicola

    2012-09-01

    Full Text Available Abstract Introduction Antiphospholipid syndrome (APS is characterized by recurrent arterial and venous thrombosis and detection of antiphospholipid antibodies (aPLs. This syndrome may be associated with connective tissue disorders, or with malignancies, but it may also appear in isolated form (primary APS. We report on a pediatric patient presenting with acute adrenal failure as the first manifestation of primary APS. Case report A previously healthy 11-year-old boy developed fever, abdominal pain, and vomiting. An abdominal computed tomography scan showed nodular lesions in the adrenal glands. He was referred to our Department and a diagnosis of APS and acute adrenal failure was considered, based on positive aPLs (IgG and IgM, elevated ACTH levels and low cortisol levels. Other features were anemia, thrombocytopenia, elevated inflammatory parameters, hypergammaglobulinemia, prolonged partial thromboplastin time, positive antinuclear, anticardiolipin, anti-platelet antibodies, with negative double-stranded DNA antibodies. Lupus anticoagulant and Coomb’s tests were positive. MRI revealed a bilateral adrenal hemorrhage. A treatment with intravenous metylprednisolone, followed by oral prednisone and anticoagulant, was started, resulting in a progressive improvement. After 2 months he also showed hyponatremia and elevated renine levels, indicating a mineralcocorticoid deficiency, requiring fludrocortisones therapy. Conclusion The development of acute adrenal failure from bilateral adrenal haemorrhage in the context of APS is a rare but life-threatening event that should be promptly recognized and treated. Moreover, this case emphasizes the importance of the assessment of aPLs in patients with acute adrenal failure in the context of an autoreaction.

  11. Expression profile of the matricellular protein osteopontin in primary open-angle glaucoma and the normal human eye.

    Science.gov (United States)

    Chowdhury, Uttio Roy; Jea, Seung-Youn; Oh, Dong-Jin; Rhee, Douglas J; Fautsch, Michael P

    2011-08-16

    PURPOSE. To characterize the role of osteopontin (OPN) in primary open-angle glaucoma (POAG) and normal eyes. METHODS. OPN quantification was performed by enzyme-linked immunosorbent assay in aqueous humor (AH) obtained from human donor eyes (POAG and normal) and surgical samples (POAG and elective cataract removal). OPN expression and localization in whole eye tissue sections and primary normal human trabecular meshwork (NTM) cells were studied by Western blot and immunohistochemistry. Latanoprost-free acid (LFA)-treated NTM cells were analyzed for OPN gene and protein expression. Intraocular pressure was measured by tonometry, and central corneal thickness was measured by optical coherence tomography in young OPN(-/-) and wild-type mice. RESULTS. OPN levels were significantly reduced in donor POAG AH compared with normal AH (0.54 ± 0.18 ng/μg [n = 8] vs. 0.77 ± 0.23 ng/μg [n = 9]; P = 0.039). A similar trend was observed in surgical AH (1.05 ± 0.31 ng/μg [n = 20] vs. 1.43 ± 0.88 ng/μg [n = 20]; P = 0.083). OPN was present in the trabecular meshwork, corneal epithelium and endothelium, iris, ciliary body, retina, vitreous humor, and optic nerve. LFA increased OPN gene expression, but minimal change in OPN protein expression was observed. No difference in intraocular pressure (17.5 ± 2.0 mm Hg [n = 56] vs. 17.3 ± 1.9 mm Hg [n = 68]) but thinner central corneal thickness (91.7 ± 3.6 μm [n = 50] vs. 99.2 ± 5.5 μm [n = 70]) was noted between OPN(-/-) and wild-type mice. CONCLUSIONS. OPN is widely distributed in the human eye and was found in lower concentrations in POAG AH. Reduction of OPN in young mice does not affect IOP.

  12. Bimatoprost/timolol fixed combination (BTFC) in patients with primary open angle glaucoma or ocular hypertension in Greece

    Science.gov (United States)

    Rotsos, Tryfon G.; Kliafa, Vasso G.; Asher, Kevin J.; Papaconstantinou, Dimitrios

    2016-01-01

    AIM To evaluate the efficacy and tolerability of the fixed combination of bimatoprost 0.03% and timolol 0.5% (BTFC) in patients in Greece with primary open angle glaucoma (POAG) or ocular hypertension (OHT) whose previous therapy provided insufficient lowering of intraocular pressure (IOP). METHODS A multicenter, prospective, open-label, non-interventional, observational study of the use of BTFC in clinical practice was conducted at 41 sites in Greece. The primary endpoint was the reduction in IOP from baseline at study end, approximately 12wk after initiation of BTFC therapy. RESULTS A total of 785 eligible patients were enrolled in the study and 97.6% completed the study. The mean±SD IOP reduction from baseline at 12wk after initiation of BTFC was 6.3±2.8 mm Hg (n=764; P<0.001). In patients (n=680) who replaced their previous IOP-lowering monotherapy (a single drug, or a fixed combination of 2 drugs in a single ophthalmic drop) with once-daily BTFC, the mean±SD IOP reduction from baseline at 12wk was 6.2±2.8 mm Hg (P<0.001). IOP was reduced from baseline in 99.2% of patients, and 58.0% of patients reached or exceeded their target IOP. Substantial mean IOP reductions were observed regardless of the previous therapy. BTFC was well tolerated, with 96.0% of patients who completed the study rating the tolerability of BTFC as “good” or “very good.” Adverse events were reported in 8.3% of patients; only 0.6% of patients discontinued the study due to adverse events. CONCLUSION In clinical practice in Greece, BTFC is well tolerated and effectively lower the IOP in patients with POAG or OHT who requires additional IOP lowering on their previous therapy. PMID:26949613

  13. A genome-wide association study for primary open angle glaucoma and macular degeneration reveals novel Loci.

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    Todd E Scheetz

    Full Text Available Glaucoma and age-related macular degeneration (AMD are the two leading causes of visual loss in the United States. We utilized a novel study design to perform a genome-wide association for both primary open angle glaucoma (POAG and AMD. This study design utilized a two-stage process for hypothesis generation and validation, in which each disease cohort was utilized as a control for the other. A total of 400 POAG patients and 400 AMD patients were ascertained and genotyped at 500,000 loci. This study identified a novel association of complement component 7 (C7 to POAG. Additionally, an association of central corneal thickness, a known risk factor for POAG, was found to be associated with ribophorin II (RPN2. Linked monogenic loci for POAG and AMD were also evaluated for evidence of association, none of which were found to be significantly associated. However, several yielded putative associations requiring validation. Our data suggest that POAG is more genetically complex than AMD, with no common risk alleles of large effect.

  14. Goldmann applanation tonometry compared with corneal-compensated intraocular pressure in the evaluation of primary open-angle Glaucoma

    Directory of Open Access Journals (Sweden)

    Ehrlich Joshua R

    2012-09-01

    Full Text Available Abstract Background To better understand the role of corneal properties and intraocular pressure (IOP in the evaluation of primary open-angle glaucoma (POAG; and to determine the feasibility of identifying glaucomatous optic neuropathy (GON using IOP corrected and uncorrected for corneal biomechanics. Methods Records from 1,875 eyes of consecutively evaluated new patients were reviewed. Eyes were excluded if central corneal thickness (CCT or Ocular Response Analyzer (ORA measurements were unavailable. Presence or absence of GON was determined based on morphology of the optic disc, rim and retinal nerve fiber layer at the time of clinical examination, fundus photography and Heidelberg Retinal Tomography. Goldmann-applanation tonometry (GAT in the untreated state was recorded and Goldmann-correlated (IOPg and corneal-compensated IOP (IOPcc were obtained using the ORA. Glaucomatous eyes were classified as normal or high-tension (NTG, HTG using the conventional cutoff of 21 mm Hg. One eligible eye was randomly selected from each patient for inclusion. Results A total of 357 normal, 155 HTG and 102 NTG eyes were included. Among NTG eyes, IOPcc was greater than GAT (19.8 and 14.4 mm Hg; p  Conclusions IOPcc may account for measurement error induced by corneal biomechanics. Compared to GAT, IOPcc may be a superior test in the evaluation of glaucoma but is unlikely to represent an effective diagnostic test.

  15. Graph theoretical analysis reveals the reorganization of the brain network pattern in primary open angle glaucoma patients

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Jieqiong [Chinese Academy of Sciences, State Key Laboratory of Management and Control for Complex Systems, Institute of Automation, Beijing (China); Li, Ting; Xian, Junfang [Capital Medical University, Department of Radiology, Beijing Tongren Hospital, Beijing (China); Wang, Ningli [Capital Medical University, Department of Ophthalmology, Beijing Tongren Hospital, Beijing (China); He, Huiguang [Chinese Academy of Sciences, State Key Laboratory of Management and Control for Complex Systems, Institute of Automation, Beijing (China); Chinese Academy of Sciences, Research Center for Brain-Inspired Intelligence, Institute of Automation, Beijing (China)

    2016-11-15

    Most previous glaucoma studies with resting-state fMRI have focused on the neuronal activity in the individual structure of the brain, yet ignored the functional communication of anatomically separated structures. The purpose of this study is to investigate the efficiency of the functional communication change or not in glaucoma patients. We applied the resting-state fMRI data to construct the connectivity network of 25 normal controls and 25 age-gender-matched primary open angle glaucoma patients. Graph theoretical analysis was performed to assess brain network pattern differences between the two groups. No significant differences of the global network measures were found between the two groups. However, the local measures were radically reorganized in glaucoma patients. Comparing with the hub regions in normal controls' network, we found that six hub regions disappeared and nine hub regions appeared in the network of patients. In addition, the betweenness centralities of two altered hub regions, right fusiform gyrus and right lingual gyrus, were significantly correlated with the visual field mean deviation. Although the efficiency of functional communication is preserved in the brain network of the glaucoma at the global level, the efficiency of functional communication is altered in some specialized regions of the glaucoma. (orig.)

  16. Genome-wide linkage scan for primary open angle glaucoma: influences of ancestry and age at diagnosis.

    Directory of Open Access Journals (Sweden)

    Kristy R Crooks

    Full Text Available Primary open-angle glaucoma (POAG is the most common form of glaucoma and one of the leading causes of vision loss worldwide. The genetic etiology of POAG is complex and poorly understood. The purpose of this work is to identify genomic regions of interest linked to POAG. This study is the largest genetic linkage study of POAG performed to date: genomic DNA samples from 786 subjects (538 Caucasian ancestry, 248 African ancestry were genotyped using either the Illumina GoldenGate Linkage 4 Panel or the Illumina Infinium Human Linkage-12 Panel. A total of 5233 SNPs was analyzed in 134 multiplex POAG families (89 Caucasian ancestry, 45 African ancestry. Parametric and non-parametric linkage analyses were performed on the overall dataset and within race-specific datasets (Caucasian ancestry and African ancestry. Ordered subset analysis was used to stratify the data on the basis of age of glaucoma diagnosis. Novel linkage regions were identified on chromosomes 1 and 20, and two previously described loci-GLC1D on chromosome 8 and GLC1I on chromosome 15--were replicated. These data will prove valuable in the context of interpreting results from genome-wide association studies for POAG.

  17. Association of Common Variants in eNOS Gene with Primary Open Angle Glaucoma: A Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Yang Xiang

    2016-01-01

    Full Text Available Purpose. To clarify the association of endothelial nitric oxide synthase (eNOS polymorphisms and primary open angle glaucoma (POAG. Methods. After a systematic literature search in the MEDLINE, EMBASE, and ISI Web of Science databases, all relevant studies evaluating the association between the polymorphisms (rs2070744 and rs1799983 of eNOS gene and POAG were screened and included. The pooled odds ratios (ORs and the 95% confidence interval (CI of each single-nucleotide polymorphism (SNP in five genetic models were estimated using fixed-effect model if I2<50% in the test for heterogeneity; otherwise the random-effects model was used. Results. Thirty-one records were obtained, with five being suitable for meta-analysis. The overall results showed that both TT genotype in rs2070744 and GG genotype in rs1799983 are associated with decreased risk of POAG susceptibility. Stratified analysis based on ethnicity showed that the association of rs2070744 with POAG remained only in Caucasians. Results of subgroup analysis by sex indicated association between both polymorphisms and POAG in female group, but not in male group. Conclusions. TT genotype and/or T-allele in rs2070744, as well as GG genotype and/or G-allele in rs1799983, was associated with decreased risk for POAG overall and in female group.

  18. Evaluation of genetic association of the INK4 locus with primary open angle glaucoma in East Indian population.

    Science.gov (United States)

    Vishal, Mansi; Sharma, Anchal; Kaurani, Lalit; Chakraborty, Subhadip; Ray, Jharna; Sen, Abhijit; Mukhopadhyay, Arijit; Ray, Kunal

    2014-05-30

    INK4 locus at chromosome 9p21 has been reported to be associated with primary open angle glaucoma (POAG) and its subtypes along with the associated optic disc parameters across the populations of European, Japanese and African ancestries. The locus encodes three tumor suppressor genes namely CDKN2A, ARF, CDKN2B and a long non-coding RNA CDKN2B-AS1 (also known as ANRIL). Here, we report association study of 34 SNPs from INK4 locus with POAG in a population of Indo-European ancestry from the eastern part of India (350 patients and 354 controls). With 81% power to detect genetic association we observed only nominal association of rs1011970 (uncorrected p = 0.048) with POAG and rs10120688 (uncorrected p = 0.048) in patients without a high intra-ocular pressure (IOPgenetic association of INK4 locus with POAG in East Indian population which needs to be replicated in larger studies in diverse world populations.

  19. Current concepts on primary open-angle glaucoma genetics: a contribution to disease pathophysiology and future treatment.

    Science.gov (United States)

    Gemenetzi, M; Yang, Y; Lotery, A J

    2012-03-01

    Glaucoma is a common, complex, heterogenous disease and it constitutes the major cause of irreversible blindness worldwide. Primary open-angle glaucoma (POAG) is the most common type of glaucoma in all populations. Most of the molecular mechanisms leading to POAG development are still unknown. Gene mutations in various populations have been identified by genetic studies and a genetic basis for glaucoma pathogenesis has been established. Linkage analysis and association studies are genetic approaches in the investigation of the genetic basis of POAG. Genome-wide association studies (GWAS) are more powerful compared with linkage analysis in discovering genes of small effect that might contribute to the development of the disease. POAG links to at least 20 genetic loci, but only 2 genes identified in these loci, myocilin and optineurin, are considered as well-established glaucoma-causing genes, whereas the role of other loci, genes, and variants implicated in the development of POAG remains controversial. Gene mutations associated with POAG result in retinal ganglion cell death, which is the common outcome of pathogenetic mechanisms in glaucoma. In future, if the sensitivity and specificity of genotyping increases, it may be possible to screen individuals routinely for disease susceptibility. This review is an update on the latest progress of genetic studies associated with POAG. It emphasizes the correlation of recent achievements in genetics with glaucoma pathophysiology, glaucoma treatment perspectives, and the possibility of future prevention of irreversible visual loss caused by the disease.

  20. Novel therapeutic approaches to correct retinal metabolic abnormalities in primary open-angle glaucoma and age-related macular degeneration

    Directory of Open Access Journals (Sweden)

    K. A. Mirzabekova

    2014-01-01

    Full Text Available Common pathogenic aspects of age-related macular degeneration (AMD and primary open-angle glaucoma (POAG, i.e., the role of free radicals inducing oxidative damage of the retina and optic nerve, are discussed. Factors that activate free radical reactions as well as multilevel antioxidant protection system are reviewed. Data derived from studies on current antioxidants that are used to treat and prevent dry AMD and glaucomatous optic nerve damage are compared. Neuroprotection for glaucoma will be considered soon as a basis for its treatment. B vitamins are generally included into therapeutic algorithms for glaucomatous optic neuropathy. While being metabolic therapeutics, they stimulate adaptive compensatory mechanisms and reduce the severity of various pathological processes, e.g., hypoxia, lipid peroxidation etc. Neurotrophic, antioxidant, and regenerative effects of B vitamins as wells as their involvement in metabolism, myelinsynthesis and other processes are of special importance for ophthalmologists. Currently, several vitamin and mineral supplements that differ in composition, dosage, and schedule are approved in Russia. SuperOptic, a biologically activeadditive, contains more free lutein (10 mg and zeaxanthin (500 μg as well as potent antioxidants (vitamin E and vitamin C, microelements (zinc and copper, and balanced vitamin B complex. These components play an important role in ocular health. SuperOptic can be recommended for the prevention and treatment of AMD and glaucomatous optic nerve damage.

  1. Novel therapeutic approaches to correct retinal metabolic abnormalities in primary open-angle glaucoma and age-related macular degeneration

    Directory of Open Access Journals (Sweden)

    K. A. Mirzabekova

    2015-01-01

    Full Text Available Common pathogenic aspects of age-related macular degeneration (AMD and primary open-angle glaucoma (POAG, i.e., the role of free radicals inducing oxidative damage of the retina and optic nerve, are discussed. Factors that activate free radical reactions as well as multilevel antioxidant protection system are reviewed. Data derived from studies on current antioxidants that are used to treat and prevent dry AMD and glaucomatous optic nerve damage are compared. Neuroprotection for glaucoma will be considered soon as a basis for its treatment. B vitamins are generally included into therapeutic algorithms for glaucomatous optic neuropathy. While being metabolic therapeutics, they stimulate adaptive compensatory mechanisms and reduce the severity of various pathological processes, e.g., hypoxia, lipid peroxidation etc. Neurotrophic, antioxidant, and regenerative effects of B vitamins as wells as their involvement in metabolism, myelinsynthesis and other processes are of special importance for ophthalmologists. Currently, several vitamin and mineral supplements that differ in composition, dosage, and schedule are approved in Russia. SuperOptic, a biologically activeadditive, contains more free lutein (10 mg and zeaxanthin (500 μg as well as potent antioxidants (vitamin E and vitamin C, microelements (zinc and copper, and balanced vitamin B complex. These components play an important role in ocular health. SuperOptic can be recommended for the prevention and treatment of AMD and glaucomatous optic nerve damage.

  2. Fluctuation in systolic blood pressure is a major systemic risk factor for development of primary open-angle glaucoma

    Science.gov (United States)

    Lee, Na Young; Jung, Younhea; Han, Kyungdo; Park, Chan Kee

    2017-01-01

    We evaluated the risk of development of primary open-angle glaucoma (POAG) in terms of variability in BP using a nationwide, population-based, 11-year longitudinal study using the Korean National Health Insurance Research Database. We included patients who underwent health care examinations more than twice between January 2002 and December 2006. We divided all subjects by the quartiles of variability in systolic blood pressure (SBP), diastolic blood pressure (DBP), and the difference between SBP and DBP. Of the total of 80,021 included subjects, 910 were diagnosed with POAG between January 2007 and December 2013. Both the Kaplan-Meier survival curves and log-rank test data indicated that patients with higher-level BP variability developed POAG significantly more frequently than did patients with lower-level variability (P < 0.001). On multivariate Cox’s regression modeling including gender, age, sex, household income, smoking status, level of alcohol intake, extent of exercise, diabetes mellitus status, dyslipidemia status, SBP, and DBP; the hazard ratios among the highest and lowest quartiles of SD SBP and CV SBP were 1.256 and 1.238, respectively. Our findings suggest that subjects in the highest quartile of SBP variability were significantly more likely to develop POAG in our population-based sample of Korean adults. PMID:28262703

  3. Elevated Plasma Endothelin-1 Levels in Normal Tension Glaucoma and Primary Open-Angle Glaucoma: A Meta-Analysis

    Science.gov (United States)

    Li, Shengjie; Zhang, Aiping

    2016-01-01

    Purpose. The aim of this meta-analysis was to clarify the association between the plasma endothelin-1 level and the risks of normal tension glaucoma (NTG) and primary open-angle glaucoma (POAG). Methods. Relevant publications were collected from three databases including PubMed, EMBASE, and the Web of Science through December 31, 2015. In this study, the terms “(endothelin OR ET) AND glaucoma” were searched. Review Manager 5.2 was used to process the data. Results. Seven studies (212 cases, 164 controls) were included for the NTG analysis. The mean plasma endothelin-1 level in the NTG subjects was 0.60 pg/mL (p = 0.02, 95% CI: 0.17–1.04) higher than that of the healthy controls. Six studies (160 cases, 174 controls) were included for the POAG analysis, and the endothelin-1 level was 0.63 pg/mL (p = 0.007, 95% CI: 0.12–1.15) higher in the POAG subjects than in the healthy controls. Additionally, two studies influenced the meta-analysis results regarding the association of plasma endothelin-1 with POAG by sensitivity analysis, and the probability of publication bias was low. Conclusions. The observation that NTG and POAG subjects showed significantly elevated endothelin-1 plasma concentrations suggests that a higher plasma level of endothelin-1 might increase the risk of NTG and POAG development. PMID:27965889

  4. 预测及筛查原发性闭角型青光眼高危人群的研究进展%Research advances of predicting and screening for the primary angle closure glaucoma

    Institute of Scientific and Technical Information of China (English)

    吴若欣; 李金瑛

    2013-01-01

    If the high-risk groups of primary angle closure glaucoma can be screened before acute angle closure attacks or peripheral anterior synechia formation among anatomically narrow angle eyes,and proper prophylactic treatment can be performed in time,subsequent glaucomatous optic neuropathy can be prevented.Each of those methods,such as gonioscopy,ultrasound biomicroscopy,anterior segment optical coherence tomography and Scheimpflug photograph,has advantages and drawbacks.Latest research shows predicting and screening for PACG involved with fairly wide range of biometric measurements,including the parameters on anterior chamber,angle opening degree,iris,lens,volume change of iris,and uveal effusion as well.This article briefly reviews research advances in predicting and screening methods for high risk cases of the primary angle closure glaucoma.%危险窄房角者若能在急性房角关闭及周边虹膜前粘连形成之前筛查出高度可疑前房角关闭者,可早期阻断发病环节,对防止演变成原发性闭角型青光眼(primary angle closure glaucoma,PACG)具有重要意义.PACG的预测及筛查方法中,前房角镜检查、超声生物显微镜、眼前段相干光断层扫描、Scheimpflug照相技术有各自的优缺点.预测及筛查PACG涉及众多的眼球生物学参数测量,最新的研究进展涉及静态参数与动态参数.前者包括前房深度、宽度、体积、面积,房角开放程度参数,虹膜厚度、体积、曲率,晶状体厚度、相对位置、拱高等;后者包括虹膜容积变化测量及葡萄膜渗漏检查等.

  5. Multifocal VEP and OCT findings in patients with primary open angle glaucoma: A cross-sectional study

    Directory of Open Access Journals (Sweden)

    Moschos Marilita M

    2012-08-01

    Full Text Available Abstract Bakground To evaluate objectively the anatomical and functional changes of optic nerve in eyes with primary open angle glaucoma (POAG by the joint use of optical coherence tomography (OCT and multifocal visual evoked potentials (mfVEP. Methods 29 eyes with open angle glaucoma and visual field defects, as well as 20 eyes of 10 age-matched control normal subjects were tested. All participants underwent a complete ophthalmological examination. Moreover, Humphrey visual field test, OCT examination and recording of mfVEP were performed. Amplitude and implicit time of mfVEP, as well as RNFL thickness were measured. Differences in density components of mfVEP and in RNFL thickness among POAG eyes and control eyes were examined using Student’s t-test. Results In glaucomatous eyes the mean Retinal Response Density (RRD was lower than normal in ring 1, 2 and 3 of mfVEP (p 2, 6.9 ± 4.8 nV/deg2 and 2.6 ± 1.6 nV/deg2 in rings 1, 2 and 3 respectively. In contrast the mean implicit time was similar to control eyes. In addition, the mean RNFL thickness in POAG eyes was estimated at 76.8 ± 26.6 μm in the superior area, 52.1 ± 16.3 μm in the temporal area, 75.9 ± 32.5 μm in the inferior area and 58.6 ± 19.4 μm in the nasal area. There was a statistically significant difference in RNFL thickness in all peripapillary areas (p  Conclusions Our study shows that, although Standard Automatic Perimetry is the gold standard to evaluate glaucomatous neuropathy, the joint use of mfVEP and OCT could be useful in better monitoring glaucoma progression.

  6. Network Centrality of Resting-State fMRI in Primary Angle-Closure Glaucoma Before and After Surgery.

    Directory of Open Access Journals (Sweden)

    Fengqin Cai

    Full Text Available Using voxel-wise degree centrality (DC, as measured by resting-state fMRI, we aimed to study alterations in the brain functional networks in patients with primary angle-closure glaucoma (PACG and to reveal the plastic trajectories of surgery.A total of 23 preoperative PACG patients (49.48 ± 14.37 years old were recruited to undergo a resting-state fMRI scan, and 9 of them were rescanned 3 months after surgery. All PACG patients underwent a complete ophthalmologic examination, including intraocular pressure (IOP, retinal nerve fiber layer (RNFL thickness, vertical cup to disc ratio (V C/D, and average cup to disc ratio (A C/D. Another 23 gender- and age-matched healthy controls (48.18 ± 9.40 years old underwent scanning once for comparison. The group difference in DC was calculated in each voxel, and the correlations between the DC value and each of the clinical variables were analyzed in the PACG patients.Preoperative PACG (pre-PACG patients showed significantly decreased DC in the bilateral visual cortices but increased DC in the left anterior cingulate cortex (ACC and caudate (p < 0.05, corrected compared with the controls. Statistical analysis showed a significantly negative correlation between DC in the bilateral visual cortices and the IOP score and between DC in the anterior cingulate cortex (ACC and both the A C/D and V C/D scores in the pre-PACG patients. Three months after surgery, these postoperative PACG (post-PACG patients showed a significantly increased DC in both the bilateral visual cortices and the left precentral gyrus compared with the pre-PACG patients.Our results suggest that PACG may contribute to decreased functional centrality in the visual system and to increased degree centrality in cognition-emotional processing regions. Alterations in visual areas seem to parallel the cup to disc ratio, but not the duration of angle closure. The changes of functional centrality in PACG patients after operation may reveal the

  7. New insights into the genetics of primary open-angle glaucoma based on meta-analyses of intraocular pressure and optic disc characteristics

    NARCIS (Netherlands)

    Springelkamp, Henriët; Iglesias, Adriana I; Mishra, Aniket; Höhn, René; Wojciechowski, Robert; Khawaja, Anthony P; Nag, Abhishek; Wang, Ya Xing; Wang, Jie Jin; Cuellar-Partida, Gabriel; Gibson, Jane; Cooke Bailey, Jessica N; Vithana, Eranga N; Gharahkhani, Puya; Boutin, Thibaud; Ramdas, Wishal D; Zeller, Tanja; Luben, Robert N; Yonova-Doing, Ekaterina; Viswanathan, Ananth C; Yazar, Seyhan; Cree, Angela J; Haines, Jonathan L; Koh, Jia Yu; Souzeau, Emmanuelle; Wilson, James F; Amin, Najaf; Müller, Christian; Venturini, Cristina; Kearns, Lisa S; Hee Kang, Jae; Consortium, Neighborhood; Tham, Yih Chung; Zhou, Tiger; van Leeuwen, Elisabeth M; Nickels, Stefan; Sanfilippo, Paul; Liao, Jiemin; Linde, Herma van der; Zhao, Wanting; van Koolwijk, Leonieke M E; Zheng, Li; Rivadeneira, Fernando; Baskaran, Mani; van der Lee, Sven J; Perera, Shamira; de Jong, Paulus T V M; Oostra, Ben A; Uitterlinden, André G; Fan, Qiao; Hofman, Albert; Shyong Tai, E-; Vingerling, Johannes R; Sim, Xueling; Wolfs, Roger C W; Teo, Yik Ying; Lemij, Hans G; Khor, Chiea Chuen; Willemsen, Rob; Lackner, Karl J; Aung, Tin; Jansonius, Nomdo M; Montgomery, Grant; Wild, Philipp S; Young, Terri L; Burdon, Kathryn P; Hysi, Pirro G; Pasquale, Louis R; Wong, Tien Yin; Klaver, Caroline C W; Hewitt, Alex W; Jonas, Jost B; Mitchell, Paul; Lotery, Andrew J; Foster, Paul J; Vitart, Veronique; Pfeiffer, Norbert; Craig, Jamie E; Mackey, David A; Hammond, Christopher J; Wiggs, Janey L; Cheng, Ching-Yu; van Duijn, Cornelia M; MacGregor, Stuart

    2017-01-01

    Primary open-angle glaucoma (POAG), the most common optic neuropathy, is a heritable disease. Siblings of POAG cases have a ten-fold increase risk of developing the disease. Intraocular pressure (IOP) and optic nerve head characteristics are used clinically to predict POAG risk. We conducted a genom

  8. New insights into the genetics of primary open-angle glaucoma based on meta-analyses of intraocular pressure and optic disc characteristics.

    NARCIS (Netherlands)

    Springelkamp, H. (Henriët); Iglesias, A.I. (Adriana); Mishra, A. (Aniket); Höhn, R. (René); Wojciechowski, R. (Robert); Khawaja, A.P. (Anthony); Nag, A. (Abhishek); Wang, Y.X. (Ya Xing); Wang, J.J. (Jie Jin); Cuellar-Partida, G. (Gabriel); Gibson, J. (Jane); Cooke Bailey, J.N. (Jessica); Vithana, E.N. (Eranga); Gharahkhani, P. (Puya); Boutin, T. (Thibaud); Ramdas, W.D. (Wishal); Zeller, T. (Tanja); Luben, R.N. (Robert); Yonova-Doing, E. (Ekaterina); Viswanathan, A.C. (Ananth); Yazar, S. (Seyhan); Cree, A.J. (Angela); Haines, J.L. (Jonathan); Koh, J.Y. (Jia Yu); Souzeau, E. (Emmanuelle); Wilson, J.F. (James); Amin, N. (Najaf); Müller, C. (Christian); Venturini, C. (Cristina); Kearns, L.S. (Lisa); Hee Kang, J. (Jae); Consortium, N. (Neighborhood); Tham, Y.C. (Yih Chung); Zhou, T. (Tiger); van Leeuwen, E.M. (Elisabeth); Nickels, S. (Stefan); Sanfilippo, P. (Paul); Liao, J. (Jiemin); Linde, H.V. (Herma van der); Zhao, W. (Wanting); van Koolwijk, L.M. (Leonieke); Zheng, L. (Li); Rivadeneira, F. (Fernando); Baskaran, M. (Mani); van der Lee, S.J. (Sven); Perera, S. (Shamira); de Jong, P.T. (Paulus); Oostra, B.A. (Ben); Uitterlinden, A.G. (André); Fan, Q. (Qiao); Hofman, A. (Albert); Shyong Tai, E. (E-); Vingerling, J.R. (Johannes); Sim, X. (Xueling); Wolfs, R.C. (Roger); Teo, Y.Y. (Yik Ying); Lemij, H.G. (Hans); Khor, C.C. (Chiea Chuen); Willemsen, R. (Rob); Lackner, K.J. (Karl); Aung, T. (Tin); Jansonius, N.M. (Nomdo); Montgomery, G. (Grant); Wild, P.S. (Philipp); Young, T.L. (Terri); Burdon, K.P. (Kathryn); Hysi, P.G. (Pirro); Pasquale, L.R. (Louis); Wong, T.Y. (Tien Yin); Klaver, C.C. (Caroline); Hewitt, A.W. (Alex); Jonas, J.B. (Jost); Mitchell, P. (Paul); Lotery, A.J. (Andrew); Foster, P.J. (Paul); Vitart, V. (Veronique); Pfeiffer, N. (Norbert); Craig, J.E. (Jamie); Mackey, D.A. (David); Hammond, C.J. (Christopher); Wiggs, J.L. (Janey); Cheng, C.Y. (Ching-Yu); van Duijn, C.M. (Cornelia); MacGregor, S. (Stuart)

    2017-01-01

    textabstractPrimary open-angle glaucoma (POAG), the most common optic neuropathy, is a heritable disease. Siblings of POAG cases have a ten-fold increase risk of developing the disease. Intraocular pressure (IOP) and optic nerve head characteristics are used clinically to predict POAG risk. We condu

  9. 原发性闭角型青光眼视野损害的特点%Charactistics of visual field defects in primary angle-closure glaucoma

    Institute of Scientific and Technical Information of China (English)

    韩芳; 袁援生

    2009-01-01

    Objective To determine the difference of visual field defects between acute angle-closure glaucoma (AACG) and chronic angle-closure glaucoma (CACG) and to analyze the difference in the changes of visual field between primary angle-closure glaucoma (PACG) and primary open angle glaucoma (POAG). Methods This retrospective case series study consisted of 53 patients with CACG,42 with AACG, and 42 with POAG. Visual field tests were examined using the 30-2 threshold program of the Humphrey Visual Field Analyzer. All cases with eligible visual fields were scored from 1 to 11 with the modified criterion used by Advanced Glaneoma Intervention Study (AGIS seures, mild groups: 1-5 and moderate groups: 6-11). An upper hemifields, lower hemifields, nasal area and overall field, mean defect (MD) and pattern standard deviation (PSD) were calculated and compared among the three glaucoma groups. The differenee in central 10°(12 points) of visual field damage, the nasal area, and the most defect quadrant of static visual field in each groups were evaluated. All analyses were performed with SAS 9.1 software. The factor analysis was used to analyze significant differences in mean defect (MD), pattern standard deviation (PSD), VF scores of nasal area and overal field among the three glaucoma groups. Analysis of variance were assessed differences between VF scores of the superior hemifield and the inferior hemifield. The differences in central 10° of visual field damage,the nasal area and the most defect quadrant of static visual field in each groups were examined using a chi-square test. P<0.05 were considered to be statistically significant. Results (1) VF scores with inferior hemifieid in POAG were lower than in CACG (t=4.24, P=0.0000) and in AACC(t=3.28, P=0.0013); There were no significant differences of VF seores between the superior hemifieid and the inferior hemifield in CACG (t=1.35, P=0.1808) and AACG (t=0.55, P=0.5824). There was found a significant differences of VF scores

  10. Efficacy of recombinant tissue-type plasminogen activator thrombolysis and primary coronary stenting after acute myocardial infarction

    Institute of Scientific and Technical Information of China (English)

    陈步星; 王伟民; 赵红; 胡大一; 徐成斌; 赵明中; 卢明瑜; 刘健; 吴淳

    2003-01-01

    Objective To compare the efficacy of low dose recombinant tissue-type plasminogen activator (rt-PA) thrombolysis with primary coronary stenting after acute myocardial infarction.Methods Of 261 patients with first acute myocardial infarction, 131 were given low dose rt-PA intravenous thrombolysis, and 130 primary coronary stenting.Results The age, time from onset of chest pain to hospital presentation and infarct location between these two groups were comparable. The patency rate of the infarct-related artery (IRA) in patients in the thrombolysis group was significantly lower than that of patients in the primary stenting group (P0.05).Conclusion Comparing with low dose rt-PA thrombolytic therapy after acute myocardial infarction, primary coronary stenting has a higher patency rate of the IRA, better cardiac function and shorter hospitalization time.

  11. A Case of Primary Hypoparathyroidism Presenting with Acute Kidney Injury Secondary to Rhabdomyolysis

    Directory of Open Access Journals (Sweden)

    Abdullah Sumnu

    2016-01-01

    Full Text Available Hypoparathyroidism is the most common cause of symmetric calcification of the basal ganglia. Herein, a case of primary hypoparathyroidism with severe tetany, rhabdomyolysis, and acute kidney injury is presented. A 26-year-old male was admitted to the emergency clinic with leg pain and cramps, nausea, vomiting, and decreased amount of urine. He had been treated for epilepsy for the last 10 years. He was admitted to the emergency department for leg pain, cramping in the hands and legs, and agitation multiple times within the last six months. He was prescribed antidepressant and antipsychotic medications. He had a blood pressure of 150/90 mmHg, diffuse abdominal tenderness, and abdominal muscle rigidity on physical examination. Pathological laboratory findings were as follows: creatinine, 7.5 mg/dL, calcium, 3.7 mg/dL, alanine transaminase, 4349 U/L, aspartate transaminase, 5237 U/L, creatine phosphokinase, 262.000 U/L, and parathyroid hormone, 0 pg/mL. There were bilateral symmetrical calcifications in basal ganglia and the cerebellum on computerized tomography. He was diagnosed as primary hypoparathyroidism and acute kidney injury secondary to severe rhabdomyolysis. Brain calcifications, although rare, should be considered in dealing with patients with neurological symptoms, symmetrical cranial calcifications, and calcium metabolism abnormalities.

  12. Primary resection with and without anastomosis for perforation of acute diverticulitis.

    Science.gov (United States)

    Saccomani, G E; Santi, F; Gramegna, A

    1993-01-01

    The results of management of perforated large bowel diverticulitis were retrospectively studied over a 7-year period. 38 patients underwent operation, 20 for generalized peritonitis, 12 for local peritonitis, 5 for colovesical fistula and 1 for colovaginal fistula. The mean age of patients was 63 years (range 30-85 years). Depending on the symptoms, the spreading of the peritonitis and associated cardiovascular and pulmonary disease and diabetes mellitus, 4 types of operation were performed: primary left hemicolectomy and anastomosis with and without defunctioning colostomy, Hartmann procedure, suture and drainage with diverting colostomy. The overall mortality was 10.5%: resection and primary anastomosis entailed 3.8% mortality (1 case), while 3 deaths were observed in the 8 patients group having underwent an Hartmann procedure (37.5%). Drainage and/or diverting colostomy performed in 5 patients entailed no hospital mortality, but was followed by a 80% complication rate, requiring reoperation and several hospital admissions. The low mortality and morbidity rates obtained in the group having primary resection and anastomosis encourage wider application of this operation for perforated acute diverticulitis. Even the Hartmann procedure allows removal of the diseased colon but in a great proportion of cases reconstitution of continuity is not performed; nevertheless staged operation entailing major mortality and morbidity, expose these aged patients to remarkable hazard. Prerequisite of safe primary excision and anastomosis is vigorous intraperitoneal lavage and drainage, by the case associated to on table large bowel irrigation if concomitant obstruction is present.

  13. [Genetic variants of CYP1B1 and WDR36 in the patients with primary congenital glaucoma and primary open angle glaucoma from Saint-Petersburg].

    Science.gov (United States)

    Motushchuk, A E; Komarova, T Iu; Grudinina, N A; Rakhmanov, V V; Mandel'shtam, M Iu; Astakhov, Iu S; Vasil'ev, V B

    2009-12-01

    In 32 patients with primary congenital glaucoma (PCG), a search for mutations in the myocilin (MYOC), cytochrome P450B1 (CYP1B1), and WDR36 genes was performed. The Q368X mutation in myocilin gene, typical of the patients with adult-onset primary open-angle glaucoma (POAG), was not detected in the PCG patients. Screening of the CYP1B1 introns 2 and 3 for the presence of mutations in PCG patients revealed only six DNA polymorphisms, including IVS1-12ntT>C (g.3793 T>C), A119S (g.4160 G>T; GCC>TCC), G188G (g.4369 C>A; GGC>GGA), L432V (G.8131 C>G; CTG>GTG), D449D (g.8184 C>T; GAC>GAT), and N453S (g.8195 A>G; AAC>AGC) (nucleotide numbering is given in accordance with the GenBank sequence U56438). In the groups of PCG patients and donors without eye diseases, the frequencies of these variants were not statistically significantly different, pointing to the neutrality of these polymorphisms. Furthermore, the CYP1B1 polymorphism L432V, considered to be associated with POAG in some world populations, was not associated with this disease in the patients from St. Petersburg. DNA collections obtained from the POAG and PCG patients and from the control group were tested for the carriage of the worldwide distributed mutations of the WRD36 gene, D658G, R529Q, A449T, and N355S. D658G variant was found with equally low frequencies in the groups of POAG and PCG patients, as well as in the control group. Mutations A449T and R529Q were found only once each, while mutation N355S was not detected in any of the groups examined. Our results indicate that the WDR36 variants make no substantial contribution to the development of POAG and PCG in the patients from St. Petersburg and represent normal DNA polymorphism. It is likely that in most of the PCG patients from the population examined the disease is not associated with the CYP1B1 gene defects.

  14. GALC deletions increase the risk of primary open-angle glaucoma: the role of Mendelian variants in complex disease.

    Directory of Open Access Journals (Sweden)

    Yutao Liu

    Full Text Available DNA copy number variants (CNVs have been reported in many human diseases including autism and schizophrenia. Primary Open Angle Glaucoma (POAG is a complex adult-onset disorder characterized by progressive optic neuropathy and vision loss. Previous studies have identified rare CNVs in POAG; however, their low frequencies prevented formal association testing. We present here the association between POAG risk and a heterozygous deletion in the galactosylceramidase gene (GALC. This CNV was initially identified in a dataset containing 71 Caucasian POAG cases and 478 ethnically matched controls obtained from dbGAP (study accession phs000126.v1.p1. (p = 0.017, fisher's exact test. It was validated with array comparative genomic hybridization (arrayCGH and realtime PCR, and replicated in an independent POAG dataset containing 959 cases and 1852 controls (p = 0.021, OR (odds ratio = 3.5, 95% CI -1.1-12.0. Evidence for association was strengthened when the discovery and replication datasets were combined (p = 0.002; OR = 5.0, 95% CI 1.6-16.4. Several deletions with different endpoints were identified by array CGH of POAG patients. Homozygous deletions that eliminate GALC enzymatic activity cause Krabbe disease, a recessive Mendelian disorder of childhood displaying bilateral optic neuropathy and vision loss. Our findings suggest that heterozygous deletions that reduce GALC activity are a novel mechanism increasing risk of POAG. This is the first report of a statistically-significant association of a CNV with POAG risk, contributing to a growing body of evidence that CNVs play an important role in complex, inherited disorders. Our findings suggest an attractive biomarker and potential therapeutic target for patients with this form of POAG.

  15. Clinical relevance of the glucocorticoid receptor gene polymorphisms in glucocorticoid-induced ocular hypertension and primary open angle glaucoma

    Institute of Scientific and Technical Information of China (English)

    Xiu-Qing; Wang; Zhao-Xia; Duan; Xiang-Ge; He; Xi-Yuan; Zhou

    2015-01-01

    AIM: To avoid the side effects of ocular hypertension of glucocorticoid(GC) usage in eye, we must identify susceptible individuals, which exists in about one-third of all population. Further, the majority of all primary open angle glaucoma(POAG) patients show this phenotype.Glucocorticoid receptor(GR) regulates C responsiveness in trabecular meshwork(TM) cells. In this study, single nucleotide polymorphism(SNP) genotyping was used to determine whether there are differences in the Bcl I(rs41423247) and N363S(rs6195) polymorphisms of the GR gene in healthy and POAG patients, and glucocorticoid-induced ocular hypertension(GIOH)populations.METHODS: Three hundred and twenty-seven unrelated Chinese adults, including 111 normal controls, 117 GIOH subjects and 99 POAG patients, were recruited. DNA samples were prepared and the Bcl I and N363 S polymorphisms were screened using real-time polymerase chain reaction(RT-PCR)-restriction fragment length polymorphism(RFLP) analysis. Frequencies of the Bcl I and N363 S polymorphisms were determined and compared using Fisher’s exact test and the Chi-squared test.RESULTS: Only the Bcl I polymorphism was identified in the Chinese Han population. The frequency of the G allele was 21.6 % in normal controls, 18.3% in GIOH patients, and 13.64% in the POAG patients. There was no significant difference in polymorphism or allele frequency in the 3 groups. Furthermore, no N363 S polymorphism was found in the study subjects.CONCLUSION: The Bcl I polymorphisms in GR gene had no association with GIOH and POAG patients, and N363 S polymorphism might not exist in the Chinese Han population. Therefore, the Bcl I polymorphism might not be responsible for the development of GC-induced ocular hypertension or POAG.

  16. The role of base excision repair in the development of primary open angle glaucoma in the Polish population.

    Science.gov (United States)

    Cuchra, Magda; Markiewicz, Lukasz; Mucha, Bartosz; Pytel, Dariusz; Szymanek, Katarzyna; Szemraj, Janusz; Szaflik, Jerzy; Szaflik, Jacek P; Majsterek, Ireneusz

    2015-08-01

    Glaucoma is a leading cause of irreversible blindness in developing countries. Previous data have shown that progressive loss of human TM cells may be connected with chronic exposure to oxidative stress. This hypothesis may suggest a role of the base excision repair (BER) pathway of oxidative DNA damage in primary open angle glaucoma (POAG) patients. The aim of our study was to evaluate an association of BER gene polymorphism with a risk of POAG. Moreover, an association of clinical parameters was examined including cup disk ratio (c/d), rim area (RA) and retinal nerve fiber layer (RNFL) with glaucoma progression according to BER gene polymorphisms. Our research included 412 patients with POAG and 454 healthy controls. Gene polymorphisms were analyzed by PCR-RFLP. Heidelberg Retinal Tomography (HRT) clinical parameters were also analyzed. The 399 Arg/Gln genotype of the XRCC1 gene (OR 1.38; 95% CI 1.02-1.89 p = 0.03) was associated with an increased risk of POAG occurrence. It was indicated that the 399 Gln/Gln XRCC1 genotype might increase the risk of POAG progression according to the c/d ratio (OR 1.67; 95% CI 1.07-2.61 P = 0.02) clinical parameter. Moreover, the association of VF factor with 148 Asp/Glu of APE1 genotype distribution and POAG progression (OR 2.25; 95% CI 1.30-3.89) was also found. Additionally, the analysis of the 324 Gln/His MUTYH polymorphism gene distribution in the patient group according to RNFL factor showed that it might decrease the progression of POAG (OR 0.47; 95% CI 0.30-0.82 P = 0.005). We suggest that the 399 Arg/Gln polymorphism of the XRCC1 gene may serve as a predictive risk factor of POAG.

  17. Measurement of Systemic Mitochondrial Function in Advanced Primary Open-Angle Glaucoma and Leber Hereditary Optic Neuropathy.

    Directory of Open Access Journals (Sweden)

    Nicole J Van Bergen

    Full Text Available Primary Open Angle Glaucoma (POAG is a common neurodegenerative disease characterized by the selective and gradual loss of retinal ganglion cells (RGCs. Aging and increased intraocular pressure (IOP are glaucoma risk factors; nevertheless patients deteriorate at all levels of IOP, implying other causative factors. Recent evidence presents mitochondrial oxidative phosphorylation (OXPHOS complex-I impairments in POAG. Leber Hereditary Optic Neuropathy (LHON patients suffer specific and rapid loss of RGCs, predominantly in young adult males, due to complex-I mutations in the mitochondrial genome. This study directly compares the degree of OXPHOS impairment in POAG and LHON patients, testing the hypothesis that the milder clinical disease in POAG is due to a milder complex-I impairment. To assess overall mitochondrial capacity, cells can be forced to produce ATP primarily from mitochondrial OXPHOS by switching the media carbon source to galactose. Under these conditions POAG lymphoblasts grew 1.47 times slower than controls, whilst LHON lymphoblasts demonstrated a greater degree of growth impairment (2.35 times slower. Complex-I enzyme specific activity was reduced by 18% in POAG lymphoblasts and by 29% in LHON lymphoblasts. We also assessed complex-I ATP synthesis, which was 19% decreased in POAG patients and 17% decreased in LHON patients. This study demonstrates both POAG and LHON lymphoblasts have impaired complex-I, and in the majority of aspects the functional defects in POAG were milder than LHON, which could reflect the milder disease development of POAG. This new evidence places POAG in the spectrum of mitochondrial optic neuropathies and raises the possibility for new therapeutic targets aimed at improving mitochondrial function.

  18. Measurement of Systemic Mitochondrial Function in Advanced Primary Open-Angle Glaucoma and Leber Hereditary Optic Neuropathy.

    Science.gov (United States)

    Van Bergen, Nicole J; Crowston, Jonathan G; Craig, Jamie E; Burdon, Kathryn P; Kearns, Lisa S; Sharma, Shiwani; Hewitt, Alex W; Mackey, David A; Trounce, Ian A

    2015-01-01

    Primary Open Angle Glaucoma (POAG) is a common neurodegenerative disease characterized by the selective and gradual loss of retinal ganglion cells (RGCs). Aging and increased intraocular pressure (IOP) are glaucoma risk factors; nevertheless patients deteriorate at all levels of IOP, implying other causative factors. Recent evidence presents mitochondrial oxidative phosphorylation (OXPHOS) complex-I impairments in POAG. Leber Hereditary Optic Neuropathy (LHON) patients suffer specific and rapid loss of RGCs, predominantly in young adult males, due to complex-I mutations in the mitochondrial genome. This study directly compares the degree of OXPHOS impairment in POAG and LHON patients, testing the hypothesis that the milder clinical disease in POAG is due to a milder complex-I impairment. To assess overall mitochondrial capacity, cells can be forced to produce ATP primarily from mitochondrial OXPHOS by switching the media carbon source to galactose. Under these conditions POAG lymphoblasts grew 1.47 times slower than controls, whilst LHON lymphoblasts demonstrated a greater degree of growth impairment (2.35 times slower). Complex-I enzyme specific activity was reduced by 18% in POAG lymphoblasts and by 29% in LHON lymphoblasts. We also assessed complex-I ATP synthesis, which was 19% decreased in POAG patients and 17% decreased in LHON patients. This study demonstrates both POAG and LHON lymphoblasts have impaired complex-I, and in the majority of aspects the functional defects in POAG were milder than LHON, which could reflect the milder disease development of POAG. This new evidence places POAG in the spectrum of mitochondrial optic neuropathies and raises the possibility for new therapeutic targets aimed at improving mitochondrial function.

  19. Measurement of Systemic Mitochondrial Function in Advanced Primary Open-Angle Glaucoma and Leber Hereditary Optic Neuropathy

    Science.gov (United States)

    Van Bergen, Nicole J; Crowston, Jonathan G.; Craig, Jamie E.; Burdon, Kathryn P.; Kearns, Lisa S.; Sharma, Shiwani; Hewitt, Alex W.; Mackey, David A.; Trounce, Ian A.

    2015-01-01

    Primary Open Angle Glaucoma (POAG) is a common neurodegenerative disease characterized by the selective and gradual loss of retinal ganglion cells (RGCs). Aging and increased intraocular pressure (IOP) are glaucoma risk factors; nevertheless patients deteriorate at all levels of IOP, implying other causative factors. Recent evidence presents mitochondrial oxidative phosphorylation (OXPHOS) complex-I impairments in POAG. Leber Hereditary Optic Neuropathy (LHON) patients suffer specific and rapid loss of RGCs, predominantly in young adult males, due to complex-I mutations in the mitochondrial genome. This study directly compares the degree of OXPHOS impairment in POAG and LHON patients, testing the hypothesis that the milder clinical disease in POAG is due to a milder complex-I impairment. To assess overall mitochondrial capacity, cells can be forced to produce ATP primarily from mitochondrial OXPHOS by switching the media carbon source to galactose. Under these conditions POAG lymphoblasts grew 1.47 times slower than controls, whilst LHON lymphoblasts demonstrated a greater degree of growth impairment (2.35 times slower). Complex-I enzyme specific activity was reduced by 18% in POAG lymphoblasts and by 29% in LHON lymphoblasts. We also assessed complex-I ATP synthesis, which was 19% decreased in POAG patients and 17% decreased in LHON patients. This study demonstrates both POAG and LHON lymphoblasts have impaired complex-I, and in the majority of aspects the functional defects in POAG were milder than LHON, which could reflect the milder disease development of POAG. This new evidence places POAG in the spectrum of mitochondrial optic neuropathies and raises the possibility for new therapeutic targets aimed at improving mitochondrial function. PMID:26496696

  20. Variants in Nebulin (NEB Are Linked to the Development of Familial Primary Angle Closure Glaucoma in Basset Hounds.

    Directory of Open Access Journals (Sweden)

    Dina F Ahram

    Full Text Available Several dog breeds are susceptible to developing primary angle closure glaucoma (PACG, which suggests a genetic basis for the disease. We have identified a four-generation Basset Hound pedigree with characteristic autosomal recessive PACG that closely recapitulates PACG in humans. Our aim is to utilize gene mapping and whole exome sequencing approaches to identify PACG-causing sequence variants in the Basset. Extensive clinical phenotyping of all pedigree members was conducted. SNP-chip genotyping was carried out in 9 affected and 15 unaffected pedigree members. Two-point and multipoint linkage analyses of genome-wide SNP data were performed using Superlink-Online SNP-1.1 and a locus was mapped to chromosome 19q with a maximum LOD score of 3.24. The locus contains 12 Ensemble predicted canine genes and is syntenic to a region on chromosome 2 in the human genome. Using exome-sequencing analysis, a possibly damaging, non-synonymous variant in the gene Nebulin (NEB was found to segregate with PACG which alters a phylogenetically conserved Lysine residue. The association of this variants with PACG was confirmed in a secondary cohort of unrelated Basset Hounds (p = 3.4 × 10-4, OR = 15.3 for homozygosity. Nebulin, a protein that promotes the contractile function of sarcomeres, was found to be prominently expressed in the ciliary muscles of the anterior segment. Our findings may provide insight into the molecular mechanisms that underlie PACG. The phenotypic similarities of disease presentation in dogs and humans may enable the translation of findings made in this study to patients with PACG.

  1. Diabetes Pathology and Risk of Primary Open-Angle Glaucoma: Evaluating Causal Mechanisms by Using Genetic Information.

    Science.gov (United States)

    Shen, Ling; Walter, Stefan; Melles, Ronald B; Glymour, M Maria; Jorgenson, Eric

    2016-01-15

    Although type 2 diabetes (T2D) predicts glaucoma, the potential for unmeasured confounding has hampered causal conclusions. We performed separate sample genetic instrumental variable analyses using the Genetic Epidemiology Research Study on Adult Health and Aging cohort (n = 69,685; 1995-2013) to estimate effects of T2D on primary open-angle glaucoma (POAG; 3,554 cases). Genetic instrumental variables for overall and mechanism-specific (i.e., linked to T2D via influences on adiposity, β-cell function, insulin regulation, or other metabolic processes) T2D risk were constructed by using 39 genetic polymorphisms established to predict T2D in other samples. Instrumental variable estimates indicated that T2D increased POAG risk (odds ratio = 2.53, 95% confidence interval: 1.04, 6.11). The instrumental variable for β-cell dysregulation also significantly predicted POAG (odds ratioβ-cell = 5.26, 95% confidence interval: 1.75, 15.85), even among individuals without diagnosed T2D, suggesting that metabolic dysregulation may increase POAG risk prior to T2D diagnosis. The T2D risk variant in the melatonin receptor 1B gene (MTNR1B) predicted risk of POAG independently of T2D status, indicating possible pleiotropic physiological functions of melatonin, but instrumental variable effect estimates were significant even excluding MTNR1B variants. To our knowledge, this is the first genetic instrumental variable study of T2D and glaucoma, providing a novel approach to evaluating this hypothesized relationship. Our findings substantially bolster observational evidence that T2D increases POAG risk.

  2. Correlation between peripapillary retinal nerve fiber layer thickness and fundus autofluorescence in primary open-angle glaucoma

    Directory of Open Access Journals (Sweden)

    Reznicek L

    2013-09-01

    Full Text Available Lukas Reznicek,* Florian Seidensticker,* Thomas Mann, Irene Hübert, Alexandra Buerger, Christos Haritoglou, Aljoscha S Neubauer, Anselm Kampik, Christoph Hirneiss, Marcus Kernt Department of Ophthalmology, Ludwig-Maximilians-University, Munich, Germany *These authors contributed equally to this work Purpose: To investigate the relationship between retinal nerve fiber layer (RNFL thickness and retinal pigment epithelium alterations in patients with advanced glaucomatous visual field defects. Methods: A consecutive, prospective series of 82 study eyes with primary open-angle glaucoma and advanced glaucomatous visual field defects were included in this study. All study participants underwent a full ophthalmic examination followed by visual field testing with standard automated perimetry as well as spectral-domain optical coherence tomography (SD-OCT for peripapillary RNFL thickness and Optos wide-field fundus autofluorescence (FAF images. A pattern grid with corresponding locations between functional visual field sectors and structural peripapillary RNFL thickness was aligned to the FAF images at corresponding location. Mean FAF intensity (range: 0 = black and 255 = white of each evaluated sector (superotemporal, temporal, inferotemporal, inferonasal, nasal, superonasal was correlated with the corresponding peripapillary RNFL thickness obtained with SD-OCT. Results: Correlation analyses between sectoral RNFL thickness and standardized FAF intensity in the corresponding topographic retina segments revealed partly significant correlations with correlation coefficients ranging between 0.004 and 0.376 and were statistically significant in the temporal inferior central field (r = 0.324, P = 0.036 and the nasal field (r = 0.376, P = 0.014. Conclusion: Retinal pigment epithelium abnormalities correlate with corresponding peripapillary RNFL damage, especially in the temporal inferior sector of patients with advanced glaucomatous visual field defects. A

  3. Acute effects of anterior thigh foam rolling on hip angle, knee angle, and rectus femoris length in the modified Thomas test.

    Science.gov (United States)

    Vigotsky, Andrew D; Lehman, Gregory J; Contreras, Bret; Beardsley, Chris; Chung, Bryan; Feser, Erin H

    2015-01-01

    Background. Foam rolling has been shown to acutely increase range of motion (ROM) during knee flexion and hip flexion with the experimenter applying an external force, yet no study to date has measured hip extensibility as a result of foam rolling with controlled knee flexion and hip extension moments. The purpose of this study was to investigate the acute effects of foam rolling on hip extension, knee flexion, and rectus femoris length during the modified Thomas test. Methods. Twenty-three healthy participants (male = 7; female = 16; age = 22 ± 3.3 years; height = 170 ± 9.18 cm; mass = 67.7 ± 14.9 kg) performed two, one-minute bouts of foam rolling applied to the anterior thigh. Hip extension and knee flexion were measured via motion capture before and after the foam rolling intervention, from which rectus femoris length was calculated. Results. Although the increase in hip extension (change = +1.86° (+0.11, +3.61); z(22) = 2.08; p = 0.0372; Pearson's r = 0.43 (0.02, 0.72)) was not due to chance alone, it cannot be said that the observed changes in knee flexion (change = -1.39° (-5.53, +2.75); t(22) = -0.70; p = 0.4933; Cohen's d = - 0.15 (-0.58, 0.29)) or rectus femoris length (change = -0.005 (-0.013, +0.003); t(22) = -1.30; p = 0.2070; Cohen's d = - 0.27 (-0.70, 0.16)) were not due to chance alone. Conclusions. Although a small change in hip extension was observed, no changes in knee flexion or rectus femoris length were observed. From these data, it appears unlikely that foam rolling applied to the anterior thigh will improve passive hip extension and knee flexion ROM, especially if performed in combination with a dynamic stretching protocol.

  4. Effect of phenylhexyl isothiocyanate on aberrant histone H3 methylation in primary human acute leukemia

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    Zou Yong

    2012-07-01

    Full Text Available Abstract Background We have previously studied the histone acetylation in primary human leukemia cells. However, histone H3 methylation in these cells has not been characterized. Methods This study examined the methylation status at histone H3 lysine 4 (H3K4 and histone H3 lysine 9 (H3K9 in primary acute leukemia cells obtained from patients and compared with those in the non-leukemia and healthy cells. We further characterized the effect of phenylhexyl isothiocyanate (PHI, Trichostatin A (TSA, and 5-aza-2’-deoxycytidine (5-Aza on the cells. Results We found that methylation of histone H3K4 was virtually undetectable, while methylation at H3K9 was significantly higher in primary human leukemia cells. The histone H3K9 hypermethylation and histone H3K4 hypomethylation were observed in both myeloid and lymphoid leukemia cells. PHI was found to be able to normalize the methylation level in the primary leukemia cells. We further showed that PHI was able to enhance the methyltransferase activity of H3K4 and decrease the activity of H3K9 methyltransferase. 5-Aza had similar effect on H3K4, but minimal effect on H3K9, whereas TSA had no effect on H3K4 and H3K9 methyltransferases. Conclusions This study revealed opposite methylation level of H3K4 and H3K9 in primary human leukemia cells and demonstrated for the first time that PHI has different effects on the methyltransferases for H3K4 and H3K9.

  5. Primary percutaneous coronary intervention for acute myocardial infarction in a pediatric patient with giant coronary aneurysm due to Kawasaki disease.

    Science.gov (United States)

    Mongiovì, Maurizio; Alaimo, Annalisa; Vernuccio, Federica; Pieri, Daniele

    2014-01-01

    We report a case of acute myocardial infarction in an 8-year-old boy with a history of Kawasaki disease and giant coronary aneurysms in the right and left coronary arteries. We performed coronary angiography and percutaneous coronary intervention 4 hours after the onset of symptoms. This case suggests that primary percutaneous coronary intervention might be safe and effective in the long-term treatment of acute myocardial infarction due to coronary sequelae of Kawasaki.

  6. Nursing research of patients with acute angle-closure glaucoma at acute exacerbation%急性闭角型青光眼患者急性发作期的护理研究

    Institute of Scientific and Technical Information of China (English)

    王燕

    2016-01-01

    ABSTRACT:Objective to analyze the acute phase of the nursing intervention in patients with acute angle-closure glaucoma. Methods to choose in September 2011 - February 2014 in our hospital to receive a total of 35 patients with acute angle-closure glaucoma, the corresponding nursing measures, the nursing effect was analyzed. Results 35 patients after clinical care, an average of 30 minutes symptoms began to ease, 3 days later to intraocular pressure value to glaucoma surgery. Conclusion in patients with acute angle-closure glaucoma acute phase to take corresponding nursing intervention, can relieve patients' pain, reduce the blindness rate obviously, has clinical value.%目的:分析研究急性闭角型青光眼患者急性发作期的护理干预效果。方法选取2011年9月至2014年2月在我院接收的急性闭角型青光眼患者一共有35例,对其采取相对应的护理措施,对其护理效果给予分析。结果35例患者经过临床护理以后,平均30分钟症状开始缓解,3天以后降至到青光眼手术眼压值。结论在急性闭角型青光眼患者急性发作期采取针对性护理干预,可以使病人痛苦减轻,使其致盲率明显降低,具有临床推广价值。

  7. Acute effects of anterior thigh foam rolling on hip angle, knee angle, and rectus femoris length in the modified Thomas test

    Directory of Open Access Journals (Sweden)

    Andrew D. Vigotsky

    2015-09-01

    Full Text Available Background. Foam rolling has been shown to acutely increase range of motion (ROM during knee flexion and hip flexion with the experimenter applying an external force, yet no study to date has measured hip extensibility as a result of foam rolling with controlled knee flexion and hip extension moments. The purpose of this study was to investigate the acute effects of foam rolling on hip extension, knee flexion, and rectus femoris length during the modified Thomas test.Methods. Twenty-three healthy participants (male = 7; female = 16; age = 22 ± 3.3 years; height = 170 ± 9.18 cm; mass = 67.7 ± 14.9 kg performed two, one-minute bouts of foam rolling applied to the anterior thigh. Hip extension and knee flexion were measured via motion capture before and after the foam rolling intervention, from which rectus femoris length was calculated.Results. Although the increase in hip extension (change = +1.86° (+0.11, +3.61; z(22 = 2.08; p = 0.0372; Pearson’s r = 0.43 (0.02, 0.72 was not due to chance alone, it cannot be said that the observed changes in knee flexion (change = −1.39° (−5.53, +2.75; t(22 = −0.70; p = 0.4933; Cohen’s d = − 0.15 (−0.58, 0.29 or rectus femoris length (change = −0.005 (−0.013, +0.003; t(22 = −1.30; p = 0.2070; Cohen’s d = − 0.27 (−0.70, 0.16 were not due to chance alone.Conclusions. Although a small change in hip extension was observed, no changes in knee flexion or rectus femoris length were observed. From these data, it appears unlikely that foam rolling applied to the anterior thigh will improve passive hip extension and knee flexion ROM, especially if performed in combination with a dynamic stretching protocol.

  8. The role of base excision repair in the development of primary open angle glaucoma in the Polish population

    Energy Technology Data Exchange (ETDEWEB)

    Cuchra, Magda; Markiewicz, Lukasz; Mucha, Bartosz [Department of Clinical Chemistry and Biochemistry, Medical University of Lodz (Poland); Pytel, Dariusz [The Abramson Family Cancer Research Institute, Department of Cancer Biology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104 (United States); Department of Biochemistry and Molecular Biology, Hollings Cancer Center, Medical University of South Carolina, Charleston, SC 29425 (United States); Szymanek, Katarzyna [Department of Ophthalmology, Medical University of Warsaw, SPKSO Hospital, Warsaw (Poland); Szemraj, Janusz [Department of Medical Biochemistry, Medical University of Lodz, Lodz (Poland); Szaflik, Jerzy; Szaflik, Jacek P. [Department of Ophthalmology, Medical University of Warsaw, SPKSO Hospital, Warsaw (Poland); Majsterek, Ireneusz, E-mail: ireneusz.majsterek@umed.lodz.pl [Department of Clinical Chemistry and Biochemistry, Medical University of Lodz (Poland)

    2015-08-15

    Highlights: • We suggested the association of XRCC1 gene with the increase risk of POAG development. • We indicated the association of clinical factor and XRCC1, MUTYH, ADPRT and APE1 genes with POAG progression. • We postulated the increase level of oxidative DNA damage in group of patients with POAG in relation to healthy controls. • We suggested the slightly decrease ability to repair of oxidative DNA damage. • This is the first data that showed the role of BER mechanism in POAG pathogenesis. - Abstract: Glaucoma is a leading cause of irreversible blindness in developing countries. Previous data have shown that progressive loss of human TM cells may be connected with chronic exposure to oxidative stress. This hypothesis may suggest a role of the base excision repair (BER) pathway of oxidative DNA damage in primary open angle glaucoma (POAG) patients. The aim of our study was to evaluate an association of BER gene polymorphism with a risk of POAG. Moreover, an association of clinical parameters was examined including cup disk ratio (c/d), rim area (RA) and retinal nerve fiber layer (RNFL) with glaucoma progression according to BER gene polymorphisms. Our research included 412 patients with POAG and 454 healthy controls. Gene polymorphisms were analyzed by PCR-RFLP. Heidelberg Retinal Tomography (HRT) clinical parameters were also analyzed. The 399Arg/Gln genotype of the XRCC1 gene (OR 1.38; 95% CI 1.02–1.89 p = 0.03) was associated with an increased risk of POAG occurrence. It was indicated that the 399Gln/Gln XRCC1 genotype might increase the risk of POAG progression according to the c/d ratio (OR 1.67; 95% CI 1.07–2.61 P = 0.02) clinical parameter. Moreover, the association of VF factor with 148Asp/Glu of APE1 genotype distribution and POAG progression (OR 2.25; 95% CI 1.30–3.89) was also found. Additionally, the analysis of the 324Gln/His MUTYH polymorphism gene distribution in the patient group according to RNFL factor showed that it might

  9. Comparison of the Efficacy of Latanoprost, Bimatoprost, and Travoprost in Patients with Primary Open-Angle Glaucoma and Ocular Hypertension

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    Nur Çolak

    2014-05-01

    Full Text Available Objectives: The aim of this prospective study was to compare the efficacy of latanoprost, bimatoprost, and travoprost in lowering intraocular pressure (IOP and in preventing or delaying visual field loss in patients with primary open-angle glaucoma (POAG and ocular hypertension (OH. Materials and Methods: The study included 124 eyes of 73 patients who were diagnosed in our clinic as having POAG or OH. All of the patients had IOP values of 22-34 mmHg, an early diagnosis of POAG or OH, without any previous treatment. The patients were randomly divided into 3 Groups: Group 1; 42 eyes treated with latanoprost (0.005%, Group 2; 40 eyes treated with bimatoprost (0.03%, and Group 3; 42 eyes treated with travoprost (0.004%. The visual field has been evaluated via the Humprey visual field evaluation of statistical program Statpac mean deviation (MD and pattern standard deviation (PSD. The IOP, MD, and PSD values have been measured initially and at the end of the first year of treatment. Results: In comparison to the baseline, the mean changes of IOP values after one year of treatment were 6.99, 6.79 and 5.87 mmHg for the 3 Groups, respectively. The decrease in the IOP was statistically significant for each of the treatment groups (p0.05. Comparison of the MD and PSD values revealed no significant differences among the treatment groups both initially and at the end of the first year (p>0.05. The mean changes in MD and PSD values at the end of the first year were similar among the treatment groups (p>0.05. Conclusion: In patients with POAG and OH, treatment with latanoprost, bimatoprost, and travoprost decrease the IOP effectively. After a one-year treatment, no significant difference has been found between the efficacy of the 3 drugs in lowering IOP and in preventing or delaying visual field loss. (Turk J Ophthalmol 2014; 44: 170-4

  10. Efficacy of Monotherapy with Either Bimatoprost or Travoprost in Patients with Primary Open-Angle Glaucoma Resistant to Latanoprost Therapy

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    Yusuf Koçluk

    2011-10-01

    Full Text Available Pur po se: This prospective study aimed to evaluate the efficacy of monotherapy with either bimatoprost or travoprost in patients with primary open-angle glaucoma (POAG resistant to latanoprost therapy. Patients and Methods: Forty patients with POAG who received therapy with topical latanoprost at Gaziantep University Hospital, Department of Ophthalmology between March 2009 and March 2010 were chosen to participate in this study. The decision to stop latanoprost therapy in these patients was made either due to the fact that they were resistant to therapy or due to the necessity to further decrease the intraocular pressure (IOP; 20 subjects were chosen to receive monotherapy with bimatoprost and 20 were chosen to receive monotherapy with travoprost. The patients were observed for 6 months with follow-up visits at 1 week, 1 month, 3 months and 6 months. Results: For the group of patients receiving therapy with bimatoprost, the average decrease in IOP was measured to be 2.05 mmHg at 1 week, 2.25 mmHg at 1 month, 1.90 mmHg at 3 months and 2.40 mmHg at 6 months. For the group of patients receiving therapy with travoprost, the average decrease in IOP was measured to be 1.47 mmHg at 1 week, 1.75 mmHg at 1 month, 1.42 mmHg at 3 months and 1.27 mmHg at 6 months. At the end of 6 months, there were no significant changes observed in the mean deviation and central corneal thickness in both therapy groups. Conjunctival hyperemia and ocular irritation were the most common side effects observed in both groups, with the bimatoprost therapy group showing higher values than the travoprost group. Discussion: For patients resistant to latanoprost therapy, prior to any adjuvant therapy, monotherapy with either bimatoprost, which is a prostamide, or travoprost, a prostaglandin analogue, has been shown to be effective at lowering IOP. (Turk J Ophthalmol 2011; 41: 295-8

  11. Effect of high myopia on 24-hour intraocular pressure in patients with primary open-angle glaucoma

    Institute of Scientific and Technical Information of China (English)

    YANG Ying-xin; WANG Ning-li; WU Lie; ZHEN Yi; WANG Tao; REN Cai-xia; PENG Xiao-xia; HAO Jie; XIA Yan-ting

    2012-01-01

    Background As intraocular pressure (lOP) and lOP fluctuation are known risk factors for glaucoma,it is important to understand the effects of high myopia on these ocular parameters.The aim of this study was to investigate if primary open-angle glaucoma (POAG) patients with high myopia exhibit higher lOP and greater lOP fluctuations at resting conditions over 24 hours.@@Methods We designed a prospective control clinical study.Eighty-two eyes of 82 high-tension Chinese POAG patients only on prostaglandin analogue locally were divided into 3 groups according to various myopic grades (<-6.0 D,n=27 and between -0.76 and -5.99 D,n=33) or without myopia (-0.75 to 0.75 D,n=22).Single time lOP at 10 am,mean corrected 24-hour lOP,mean corrected night lOP,24-hour lOP fluctuation and lOPs of 10 am,2 pm,6 pm,10 pm,2 am,6 am and 8 am were measured.@@Results The lOP was higher in POAG patients with high myopia over those POAG alone in three ways:the elevated lOP value was 0.65 mmHg measured in single time lOP at 10 am,0.84 mmHg in mean corrected 24-hour lOP,0.97 mmHg in mean corrected night lOP.The 24-hour lOP fluctuation was lower in the two myopia groups than in non-myopia group.Further,using repeated measurement analysis of variance,there was no statistical significance among groups regarding the lOPs at the seven time points (P=0.77) and there was no interaction between groups and time points (P=0.71),but the difference of lOPs at the seven time points in same group was statistically significant (P=0.01).@@Conclusion High-tension POAG patients with high myopia,even on pharmacological glaucoma therapy,still have higher lOp,but 24-hour lOP fluctuation at resting conditions was lower in these patients.

  12. SETBP1 and miR_4319 dysregulation in primary myelofibrosis progression to acute myeloid leukemia

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    Albano Francesco

    2012-08-01

    Full Text Available Abstract The molecular pathogenesis underlying the primary myelofibrosis (PMF progression to acute myeloid leukemia (AML is still not well defined. The involvement of microRNA (miRNA is actually helping to shed light on an important issue in the occurrence of myeloproliferative neoplasms (MPNs. However, the role of intronic miRNA, derived from the intron regions of gene transcripts, has never been reported in MPNs. In this study, we describe a PMF case evolved to AML with a t(12;18(p13;q12 rearrangement showing the downregulation of the intronic miR_4319 and the overexpression of its host gene, SET binding protein (SETBP1. A possible molecular mechanism regulating the PMF progression to AML is discussed.

  13. Arginine deprivation using pegylated arginine deiminase has activity against primary acute myeloid leukemia cells in vivo.

    Science.gov (United States)

    Miraki-Moud, Farideh; Ghazaly, Essam; Ariza-McNaughton, Linda; Hodby, Katharine A; Clear, Andrew; Anjos-Afonso, Fernando; Liapis, Konstantinos; Grantham, Marianne; Sohrabi, Fareeda; Cavenagh, Jamie; Bomalaski, John S; Gribben, John G; Szlosarek, Peter W; Bonnet, Dominique; Taussig, David C

    2015-06-25

    The strategy of enzymatic degradation of amino acids to deprive malignant cells of important nutrients is an established component of induction therapy of acute lymphoblastic leukemia. Here we show that acute myeloid leukemia (AML) cells from most patients with AML are deficient in a critical enzyme required for arginine synthesis, argininosuccinate synthetase-1 (ASS1). Thus, these ASS1-deficient AML cells are dependent on importing extracellular arginine. We therefore investigated the effect of plasma arginine deprivation using pegylated arginine deiminase (ADI-PEG 20) against primary AMLs in a xenograft model and in vitro. ADI-PEG 20 alone induced responses in 19 of 38 AMLs in vitro and 3 of 6 AMLs in vivo, leading to caspase activation in sensitive AMLs. ADI-PEG 20-resistant AMLs showed higher relative expression of ASS1 than sensitive AMLs. This suggests that the resistant AMLs survive by producing arginine through this metabolic pathway and ASS1 expression could be used as a biomarker for response. Sensitive AMLs showed more avid uptake of arginine from the extracellular environment consistent with their auxotrophy for arginine. The combination of ADI-PEG 20 and cytarabine chemotherapy was more effective than either treatment alone resulting in responses in 6 of 6 AMLs tested in vivo. Our data show that arginine deprivation is a reasonable strategy in AML that paves the way for clinical trials.

  14. Primary percutaneous transluminal coronary angioplasty in the acute infarction of the right ventricle

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    Gligić Branko

    2003-01-01

    Full Text Available Background. Predilection site for the acute myocardial infarction of the right ventricle, (AMI-RV is the upper third of the right coronary artery and for this reason such an infarction is followed by numerous complications, primarily by conduction disorders and very often by sudden and rapid cardiogenic shock development. Methods. Primary percutaneous transluminal coronary angioplasty (PPTCA was performed on three patients in whom the acute infarction of the right ventricular was diagnosed and who had been hospitalized six hours after the beginning of chest pain. In all three patients intracoronary stent was implanted. On the admission patients had been in the threatening cardiogenic shock, with the prominent chest pain and with the elevation of ST-segment in V4R>2 mV. In the course of intervention patients were administered low-molecular intracoronary heparin with direct platelet glycoprotein IIb/IIIa inhibitors (abciximab, according to the established procedure applied in such cases. Results. The complete dilatation of the infarcted artery was established with the signs of reperfusion and the further clinical course was completely normal, there was no heart failure and patients had no subjective difficulties. Conclusion. Invasive approach in the treatment of AMI-RV is justifiable, and possibly the therapy of choice of these patients, providing well trained and equipped team is available.

  15. Gender difference in patients with acute myocardial infarction treated by primary percutaneous coronary intervention in drug-eluting stent era

    Institute of Scientific and Technical Information of China (English)

    GE Jun-bo

    2010-01-01

    @@ Primary percutaneous coronary intervention (PCI) has been the standard of care for patients with acuteST-elevation myocardial infarction (STEMI) within 12 hours of symptom onset in modern era.~(1,2) The advances and applications of robust anti-platelet and anti-coagulation medicines further improve the outcome of STEMI patients undergoing primary PCI,~3 and drug-eluting stent (DES) has also been proven to be effective and safe when applying in primary PCI.~4 Historical data indicated that women undergoing PCI exerted worse outcomes than male patients, and the gender differences in outcome after PCI are still topical and of interest, especially the outcome after primary PCI.

  16. Predicting the presence of bacterial pathogens in the airways of primary care patients with acute cough

    Science.gov (United States)

    Teepe, Jolien; Broekhuizen, Berna D.L.; Loens, Katherine; Lammens, Christine; Ieven, Margareta; Goossens, Herman; Little, Paul; Butler, Chris C.; Coenen, Samuel; Godycki-Cwirko, Maciek; Verheij, Theo J.M.

    2017-01-01

    BACKGROUND: Bacterial testing of all patients who present with acute cough is not feasible in primary care. Furthermore, the extent to which easily obtainable clinical information predicts bacterial infection is unknown. We evaluated the diagnostic value of clinical examination and testing for C-reactive protein and procalcitonin for bacterial lower respiratory tract infection. METHODS: Through a European diagnostic study, we recruited 3104 adults with acute cough (≤ 28 days) in primary care settings. All of the patients underwent clinical examination, measurement of C-reactive protein and procalcitonin in blood, and chest radiography. Bacterial infection was determined by conventional culture, polymerase chain reaction and serology, and positive results were defined by the presence of Streptococcus pneumoniae, Haemophilus influenzae, Mycoplasma pneumoniae, Bordetella pertussis or Legionella pneumophila. Using multivariable regression analysis, we examined the association of diagnostic variables with the presence of bacterial infection. RESULTS: Overall, 539 patients (17%) had bacterial lower respiratory tract infection, and 38 (1%) had bacterial pneumonia. The only item with diagnostic value for lower respiratory tract infection was discoloured sputum (area under the receiver operating characteristic [ROC] curve 0.56, 95% confidence interval [CI] 0.54–0.59). Adding C-reactive protein above 30 mg/L increased the area under the ROC curve to 0.62 (95% CI 0.59–0.65). For bacterial pneumonia, comorbidity, fever and crackles on auscultation had diagnostic value (area under ROC curve 0.68, 95% CI 0.58–0.77). Adding C-reactive protein above 30 mg/L increased the area under the ROC curve to 0.79 (95% CI 0.71–0.87). Procalcitonin did not add diagnostic information for any bacterial lower respiratory tract infection, including bacterial pneumonia. INTERPRETATION: In adults presenting with acute lower respiratory tract infection, signs, symptoms and C

  17. Low cerebrospinal fluid pressure in the pathogenesis of primary open-angle glaucoma: epiphenomenon or causal relationship? The Beijing Intracranial and Intraocular Pressure (iCOP) study.

    Science.gov (United States)

    Wang, Ningli; Yang, Diya; Jonas, Jost B

    2013-01-01

    Previous experimental and clinical investigations have suggested that some patients with primary open-angle glaucoma may have an abnormally low orbital cerebrospinal fluid pressure (CSFP). A meta-analysis of available clinical data showed a marked overlap in lumbar CSFP measurements between patients with normal-tension glaucoma and healthy subjects, so that the question arises as to which additional factors play a role in the pathogenesis of glaucomatous optic neuropathy.

  18. Cost of the medical management and prescription pattern for primary open angle glaucoma (POAG) in Ghana–a retrospective cross-sectional study from three referral facilities

    OpenAIRE

    Ocansey, Stephen; Kyei, Samuel; Diafo, Ama; Darfor, Kwabena Nkansah; Boadi-Kusi, Samuel Bert; Aglobitse, Peter B.

    2016-01-01

    Background Glaucoma is the leading cause of irreversible blindness globally, and treatment involves considerable cost to stakeholders in healthcare. However, there is infrequent availability of cost information and patterns of management, especially in developing countries. This study determined the cost of the medical management of POAG, adherence, and pattern of medication prescription in Ghana. Methods A retrospective cross-sectional study involving 891 Primary Open Angle Glaucoma (POAG) c...

  19. Comment on “Short-term effects of relaxation music on patients suffering from primary open-angle glaucoma”

    OpenAIRE

    2015-01-01

    Abdullah Kaya,1 Yakup Aksoy,2 Mehmet Koray Sevinç,3 Oktay Diner41Department of Ophthalmology, Anittepe Military Dispansery, Ankara, Turkey; 2Department of Ophthalmology, Girne Military Hospital, Girne, Cyprus; 3Department of Ophthalmology, Beytepe Military Hospital, Ankara, 4Department of Ophthalmology, Erzurum Military Hospital, Erzurum, TurkeyWe read the current study “Short-term effects of relaxation music on patients suffering from primary open-angle glaucoma&rdqu...

  20. Association between primary open angle glaucoma and genetic polymorphisms GSTM1/GSTT1 in patients from Goiânia Central-West Region of Brazil.

    Science.gov (United States)

    Silva, C T X; Costa, N B; Silva, K S F; Silva, R E; Moura, K K V O

    2014-10-31

    In this study, we evaluated the genotype profile of GSTM1 and GSTT1 polymorphisms in patient carriers of primary open-angle glaucoma in the population of Goiânia, GO, Brazil. This case-control study included 100 Brazilian patients with glaucoma and 53 patients without glaucoma. Blood samples were genotyped for polymorphisms in GST genes using polymerase chain reaction-based methods. Polymorphism frequencies were compared using the X(2) test and odds ratio (α = 0.05). The GSTM1-present genotype was 40% in the glaucoma group and 71.6% in the control group, while the GSTM1 null genotype was 60 and 28.3% in the same groups, respectively. The GSTT1-present genotype was 52% in the primary open-angle glaucoma group and 66% in the control group; the null genotype was 48% in the case group and 34% in the control group. The GSTM1 null genotype was more frequent in the glaucoma group than in the control group (P = 0.0004; odds ratio = 6.7; 95% confidence interval = 2.7- 20.3). The combined GSTM1 null and GSTT1-present genotypes were more frequent in the primary open-angle glaucoma group compared to the control group (P = 0.02; odds ratio = 3.1; 95% confidence interval = 1.2-7.9).

  1. Primary and secondary genetic responses after folic acid-induced acute renal injury in the mouse.

    Science.gov (United States)

    Calvet, J P; Chadwick, L J

    1994-12-01

    Folic acid-induced acute renal injury results in dramatic changes in gene expression. Among the genes affected by folic acid treatment are the primary response genes, c-fos and c-myc, which are thought to function to initiate cell cycle events. In this report, changes in the expression of three other genes in response to folic acid injury have been investigated: ornithine decarboxylase, epidermal growth factor (EGF), and sulfated glycoprotein-2 (SGP-2). Renal injury was found to cause a rapid decrease in EGF mRNA, which remained absent for several days after the initial injury, gradually returning to normal levels over an approximately 3-wk regeneration and recovery period. Ornithine decarboxylase mRNA showed a similar decrease. In contrast, folic acid caused a rapid increase in SGP-2 mRNA, which peaked several days after treatment, decreasing to normal levels over the 3-wk period. The mRNAs for the primary response genes were superinduced in the injured kidneys in the presence of the protein synthesis inhibitor cycloheximide. In contrast, the changes in EGF and SGP-2 mRNA levels were blocked by cycloheximide, indicating that these responses required new protein synthesis during the first few hours after folic acid injury. The opposite but parallel responses in the expression of the EGF and SGP-2 genes suggest that their regulation is coupled to the initial injury-induced dedifferentiation and subsequent return to the fully differentiated state.

  2. [Primary-care morbidity and true morbidity due to acute respiratory infections].

    Science.gov (United States)

    Pérez Rodríguez, A E; González Ochoa, E; Bravo González, J R; Carlos Silva, L; Linton, T

    1992-01-01

    The present work presents the study of morbidity due to acute respiratory infections (ARI) in areas of the town of Lisa in Ciudad Habana, and Isla Juventud (Cuba), to characterize different aspects of morbidity measured by health care attendance and to measure true morbidity. About 90% of consultations for ARI were first-time consultations, while their ratio to further consultations was 5.3. True morbidity rates (TMR), obtained trough active research, ranged from 110.4 to 163.4 cases per 1000 inhabitants, considerably higher than morbidity rates measured by primary care consultations (MRPCC) in the same time period. The true morbidity index (TMI), as measured by the ratio of the two previous rates, ranged from 5 to 15. A high proportion (47.6%) of cases reported no medical care attendance. These results provide approximate estimates of true morbidity in the study area, and allow the establishment of a new control program, also improving epidemiologic surveillance within primary care activities.

  3. Violation of the vascular platelet hemostasis as a risk factor of primary open-angle glaucoma progression

    Directory of Open Access Journals (Sweden)

    N. I. Kurysheva

    2015-01-01

    Full Text Available Purpose: to study the vascular platelet hemostasis parameters in primary open-angle glaucoma (POAG.Patients and methods: ophthalmic examination, plasma level of spontaneous and induced platelet aggregation and von Willebrand factor (vWF were performed in 67 patients with high pressure glaucoma (HPG, 41 patients had normal tension glaucoma (NTG and 38 were in control group. Period of study was 36 months. The statistical analysis included standard methods of variation statistics. The threshold P value for statistical significance was 0.05.Results: platelet aggregation was increased in glaucoma (adrenalin-induced aggregation in HPG was 63,34 %±20,42 %, р = 0,043, in NTG 62,35 %±11,53 %, р = 0,047, in comparison with control group — 49,71 %±15,96 %; ristocetin-induced aggregation in HPG was 79,45 %±28,63 %, р = 0,015, in NTG 68,98 %±12,42 %, р = 0,022, and in control group 53,56 %±8,80 % accordingly; the mean level of vWF was increased in HPG (113,25 %±24,31 %, р = 0,009 and NTG (106,85 %±21,02 %, р = 0,012 in comparisonwith control group (93,86 %±17,13 %. Patients with normal level of vWF did not have a progression of glaucoma optical neuropathy. Patients with normalized level of vWF under treatment had significant improvement of MD in 6 months (from –4,916±5,121 to –4,103±4,658, р = 0,037 and were stable in the further follow up period. Patients with increased level of vWF had deterioration of MD in 36 months (from –4,616dB±8,426 dB to –5,974dB±8,852 dB, р = 0,042, increase of cup / disk ratio (from 0,59±0,21 to 0,66±0,24, р = 0,041 and thinning of average RNFL according to HRT and OCT (from 0,21±0,09 μm to 0,17±0,08 μm, р = 0,04; from 74,37±15,34 μm to 69,44±15,12 μm, р = 0,04.Conclusion. The obtained results indicate the importance of the vascular platelet hemostasis in POAG pathogenesis and the perspectives of its correction in glaucoma treatment.

  4. [A challenge to primary open-angle glaucoma including normal-pressure. Clinical problems and their scientific solution].

    Science.gov (United States)

    Sugiyama, Kazuhisa

    2012-03-01

    Primary open-angle glaucoma (POAG), including normal-tension glaucoma (NTG), is reported by the Tajimi Study to afflict 3.9% of the total population, and this represents about 80% of all total glaucoma cases which, in total, afflict 5.0% of the population. We tried to analyze the clinical problems relating to POAG by looking at the pathogenesis, intraocular pressure (IOP), therapy, neuroprotection and surgery of the disease. To elucidate the pathogenesis of glaucoma progression, we measured retinal nerve fiber layer defect (RNFLD) angles', and divided the NTG cases into 2 groups, enlarged RNFLD and stable RNFLD. Disc hemorrhages were found to be significantly more frequent in the enlarged group than in the stable group. RNFLD was enlarged in the direction of disc hemorrhage in over 80% of the eyes. In the majority of the eyes of the enlarged group, the enlargement of RNFLD was toward the fovea. The enlargement of RNFLD in NTG was closely associated with disc hemorrhage and the deterioration of the visual field. We developed a simultaneous structure and function evaluation technique combining spectral-domain (SD) optical coherence tomography (OCT) and fundus-oriented perimeters for the detection of visual field abnormalities in the RNFLD area. We superimposed the ganglion cell complex map obtained by SD-OCT on the fundus-oriented perimeter image. We observed very early or preperimetric normal pressure glaucoma as well as disc hemorrhage adjacent to the borders of the RNFLD. The borderline of the RNFLD seemed to be the thinnest RNFL and had the lowest retinal sensitivity (Active site for RNFLD progression). To clarify the role of the circadian clock genes in the generation of a 24-hour IOP rhythm, we used the microneedle method to measure the IOP at eight time points daily, both in wild type mice and Cry-deficient (Cry 1-/-Cry 2-/-) mice. In the wild-type mice living in light-dark conditions, the pressure measured in the light phase was significantly lower than in

  5. Prognostic value of right ventricular function in patients after acute myocardial infarction treated with primary percutaneous coronary intervention

    NARCIS (Netherlands)

    M.L. Antoni (Louisa); R.W.C. Scherptong (Roderick); J.Z. Atary (Jael); H. Boersma (Eric); E.R. Holman (Eduard); E.E. van der Wall (Ernst); M.J. Schalij (Martin Jan); J.J. Bax (Jeroen)

    2010-01-01

    textabstractBackground-Data on the association between right ventricular (RV) function and adverse events after acute myocardial infarction (AMI) are scarce. The purpose of the current study was to evaluate the relation between RV function and adverse events in patients treated with primary percutan

  6. A comparative study on transradial vs transfemoral artery access for primary percutaneous coronary intervention in patients with acute myocardial infarction

    Institute of Scientific and Technical Information of China (English)

    傅向华

    2003-01-01

    A comparative study on transradial vs transfemoral artery access for primary percutaneous coronary intervention in patients with acute myocardial infarction!050000$河北医科大学第二医院河北医科大学心脏介入中心@傅向华

  7. A cost-effective strategy for primary prevention of acute rheumatic fever and rheumatic heart disease in children with pharyngitis.

    Science.gov (United States)

    Irlam, James H; Mayosi, Bongani M; Engel, Mark E; Gaziano, Thomas A

    2013-09-03

    Primary prevention of acute rheumatic fever (ARF) and rheumatic heart disease (RHD) in children depends on prompt and effective diagnosis and treatment of pharyngitis at the primary level of care. Cost-effectiveness modeling shows that the most cost-effective strategy for primary prevention in South Africa (SA) is to use a simple symptomatic clinical decision rule (CDR) to diagnose pharyngitis in children presenting at the primary level of care and then to treat them with a single dose of intramuscular penicillin. Treat All and CDR2+ strategies are affordable and simple and miss few cases of streptococcal pharyngitis at the primary level of care. The CDR2+ strategy is the most cost-effective for primary prevention of ARF and RHD in urban SA and should complement primordial and secondary prevention efforts.

  8. RNAi mediated acute depletion of Retinoblastoma protein (pRb promotes aneuploidy in human primary cells via micronuclei formation

    Directory of Open Access Journals (Sweden)

    Iovino Flora

    2009-11-01

    Full Text Available Abstract Background Changes in chromosome number or structure as well as supernumerary centrosomes and multipolar mitoses are commonly observed in human tumors. Thus, centrosome amplification and mitotic checkpoint dysfunctions are believed possible causes of chromosomal instability. The Retinoblastoma tumor suppressor (RB participates in the regulation of synchrony between DNA synthesis and centrosome duplication and it is involved in transcription regulation of some mitotic genes. Primary human fibroblasts were transfected transiently with short interfering RNA (siRNA specific for human pRb to investigate the effects of pRb acute loss on chromosomal stability. Results Acutely pRb-depleted fibroblasts showed altered expression of genes necessary for cell cycle progression, centrosome homeostasis, kinetochore and mitotic checkpoint proteins. Despite altered expression of genes involved in the Spindle Assembly Checkpoint (SAC the checkpoint seemed to function properly in pRb-depleted fibroblasts. In particular AURORA-A and PLK1 overexpression suggested that these two genes might have a role in the observed genomic instability. However, when they were post-transcriptionally silenced in pRb-depleted fibroblasts we did not observe reduction in the number of aneuploid cells. This finding suggests that overexpression of these two genes did not contribute to genomic instability triggered by RB acute loss although it affected cell proliferation. Acutely pRb-depleted human fibroblasts showed the presence of micronuclei containing whole chromosomes besides the presence of supernumerary centrosomes and aneuploidy. Conclusion Here we show for the first time that RB acute loss triggers centrosome amplification and aneuploidy in human primary fibroblasts. Altogether, our results suggest that pRb-depleted primary human fibroblasts possess an intact spindle checkpoint and that micronuclei, likely caused by mis-attached kinetochores that in turn trigger

  9. Microbiology of primary acquired nasolacrimal duct obstruction: simple epiphora, acute dacryocystitis, and chronic dacryocystitis

    Directory of Open Access Journals (Sweden)

    Pornpanich K

    2016-02-01

    Full Text Available Kanograt Pornpanich,1 Panitee Luemsamran,1 Amornrut Leelaporn,2 Jiraporn Santisuk,3 Nattaporn Tesavibul,1 Buntitar Lertsuwanroj,1 Sumalee Vangveeravong1 1Department of Ophthalmology, 2Department of Microbiology, 3Eye Surgery Unit, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand Purpose: The aim of this study was to determine the microbiology of primary acquired nasolacrimal duct obstruction (PANDO and its antimicrobial susceptibilities.Methods: Ninety-three patients (100 eyes diagnosed with PANDO, categorized as acute, chronic dacryocystitis, or simple epiphora, were prospectively enrolled. Lacrimal sac contents were cultured for aerobic and anaerobic bacteria and fungi. Cultured organisms were identified, and antimicrobial susceptibility testing was performed for aerobic bacteria. Results: Seventy-nine of the 100 samples were culture positive. One hundred twenty-seven organisms were isolated, and 29 different species were identified. Most microorganisms were Gram-positive bacteria (45 samples or 57.0% of all positive culture samples, whereas Gram-negative bacteria, anaerobic bacteria, and fungi were found in 39 (49.4%, 24 (30.4%, and four samples (5.1%, respectively. The most frequently isolated group was coagulase-negative staphylococci (27.8%, followed by nonspore-forming Gram-positive rods (anaerobe (17.7% and Pseudomonas aeruginosa (15.2%. Of the 100 samples, five, 45, and 50 samples were obtained from patients with acute dacryocystitis, chronic dacryocystitis, and simple epiphora, respectively. Subgroup analysis showed that Gram-negative organisms were isolated more frequently from the chronic dacryocystitis subgroup than from the simple epiphora subgroup (P=0.012. Antimicrobial susceptibility testing demonstrated that ciprofloxacin was the most effective drug against all Gram-positive and Gram-negative organisms. Conclusion: Patients with PANDO, with or without clinical signs of lacrimal infection, were

  10. Treatment Outcomes of Corticosteroid Injection and Extracorporeal Shock Wave Therapy as Two Primary Therapeutic Methods for Acute Plantar Fasciitis: A Prospective Randomized Clinical Trial.

    Science.gov (United States)

    Mardani-Kivi, Mohsen; Karimi Mobarakeh, Mahmoud; Hassanzadeh, Zabihallah; Mirbolook, Ahmadreza; Asadi, Kamran; Ettehad, Hossein; Hashemi-Motlagh, Keyvan; Saheb-Ekhtiari, Khashayar; Fallah-Alipour, Keyvan

    2015-01-01

    The outcome of corticosteroid injection (CSI) and extracorporeal shock wave therapy (ESWT) as primary treatment of acute plantar fasciitis has been debated. The purpose of the present study was to evaluate and compare the therapeutic effects of CSI and ESWT in patients with acute ( .05). Both ESWT and CSI can be used as the primary and/or initial treatment option for treating patients with acute plantar fasciitis; however, the CSI technique had better therapeutic outcomes.

  11. Reliable classifier to differentiate primary and secondary acute dengue infection based on IgG ELISA.

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    Marli Tenório Cordeiro

    Full Text Available BACKGROUND: Dengue virus infection causes a wide spectrum of illness, ranging from sub-clinical to severe disease. Severe dengue is associated with sequential viral infections. A strict definition of primary versus secondary dengue infections requires a combination of several tests performed at different stages of the disease, which is not practical. METHODS AND FINDINGS: We developed a simple method to classify dengue infections as primary or secondary based on the levels of dengue-specific IgG. A group of 109 dengue infection patients were classified as having primary or secondary dengue infection on the basis of a strict combination of results from assays of antigen-specific IgM and IgG, isolation of virus and detection of the viral genome by PCR tests performed on multiple samples, collected from each patient over a period of 30 days. The dengue-specific IgG levels of all samples from 59 of the patients were analyzed by linear discriminant analysis (LDA, and one- and two-dimensional classifiers were designed. The one-dimensional classifier was estimated by bolstered resubstitution error estimation to have 75.1% sensitivity and 92.5% specificity. The two-dimensional classifier was designed by taking also into consideration the number of days after the onset of symptoms, with an estimated sensitivity and specificity of 91.64% and 92.46%. The performance of the two-dimensional classifier was validated using an independent test set of standard samples from the remaining 50 patients. The classifications of the independent set of samples determined by the two-dimensional classifiers were further validated by comparing with two other dengue classification methods: hemagglutination inhibition (HI assay and an in-house anti-dengue IgG-capture ELISA method. The decisions made with the two-dimensional classifier were in 100% accordance with the HI assay and 96% with the in-house ELISA. CONCLUSIONS: Once acute dengue infection has been determined, a 2-D

  12. Evaluation of the efficacy of laser peripheral iridoplasty in reversing the darkroom provocative test result in Chinese patients with primary angle closure status post laser iridotomy

    Institute of Scientific and Technical Information of China (English)

    Ping; Huang; Ling-Ling; Wu

    2015-01-01

    AIM: To investigate the efficacy and safety of krypton laser peripheral iridoplasty(LPIP) for Chinese patients with primary angle closure(PAC) or primary angle-closure glaucoma(PACG) status post laser iridotomy in reversing the positive results of the dark room provocative test(DRPT).METHODS: This study was prospective, noncomparative,interventional case series. Thirty-three patients(thirty-eight eyes) with PAC or PACG status post patent laser iridotomy and maintained normal intraocular pressure(IOP) but with positive DRPT results were enrolled. All the subjects were treated with krypton LPIP. DRPT was repeated after krypton LPIP. Results of DRPT were recorded. The visual acuity, IOP and gonioscopy were analyzed before and after krypton LPIP. A minimum time limit for follow-up was 6mo.RESULTS: Thirty-three patients(thirty-eight eyes)were followed for 17.7 ±8.37mo(range 7-41mo) after LPIP. Positive results of DRPT decreased from 38 eyes to9 eyes(23.7%) after LPIP. Peripheral anterior synechiae of angle in 34 of 38 eyes(89.5%) remained unchanged at dynamic gonioscopy throughout the follow-up period after LPIP.CONCLUSION: LPIP decreased positive rates of the DRPT significantly. The mechanism may be that LPIP minimized contact between the peripheral iris and trabecular meshwork, which is a key factor for developing peripheral anterior synechiae.

  13. The influence of glancing angle deposited nano-rough platinum surfaces on the adsorption of fibrinogen and the proliferation of primary human fibroblasts

    Energy Technology Data Exchange (ETDEWEB)

    Dolatshahi-Pirouz, A; Foss, M; Chevallier, J; Besenbacher, F [Interdisciplinary Nanoscience Center (iNANO), Aarhus University, Aarhus (Denmark); Pennisi, C P; Yoshida, K [Center for Sensory-Motor Interaction (SMI), Aalborg University, Aalborg (Denmark); Skeldal, S; Andreasen, P [Department of Molecular Biology, Aarhus University, Aarhus (Denmark); Zachar, V [Laboratory for Stem Cell Research, Aalborg University (Denmark)], E-mail: foss@inano.au.dk

    2009-03-04

    We have used the glancing angle deposition (GLAD) method as a simple and fast method to generate nano-rough surfaces for protein adsorption experiments and cell assays. The surface roughness and the detailed geometrical surface morphology of the thin films were characterized by atomic force microscopy (AFM) and scanning electron microscopy (SEM). As the GLAD deposition angle approaches grazing incidence, sharp and whisker-like columnar protrusions are formed. Smaller and less sharp surface features appear for the thin films synthesized at higher deposition angles. By changing the GLAD deposition angle together with the total amount of mass deposited per area on the respective surfaces, the size of the surface features can be varied on the nanoscale. Using the GLAD topographies as model surfaces, we have investigated the influence of the nano-roughness on fibrinogen adsorption and on the proliferation of primary human fibroblasts. It is found that fibrinogen, an important blood protein, preferentially adheres on the whisker-like nano-rough substrates in comparison to a flat surface. Furthermore, the proliferation of the human fibroblasts is significantly reduced on the nano-rough substrates. These results demonstrate that the GLAD technique can be used to fabricate nano-rough surface morphologies that significantly influence both protein and cellular adhesion to surfaces and are therefore well suited for biological assays.

  14. Endovascular Therapy as a Primary Revascularization Modality in Acute Mesenteric Ischemia

    Energy Technology Data Exchange (ETDEWEB)

    Kärkkäinen, Jussi M., E-mail: jkarkkai@gmail.com [Kuopio University Hospital, Heart Center (Finland); Lehtimäki, Tiina T., E-mail: tiina.lehtimaki@kuh.fi; Saari, Petri, E-mail: petri.saari@kuh.fi [Kuopio University Hospital, Department of Clinical Radiology (Finland); Hartikainen, Juha, E-mail: juha.hartikainen@kuh.fi [Kuopio University Hospital, Heart Center (Finland); Rantanen, Tuomo, E-mail: tuomo.rantanen@kuh.fi; Paajanen, Hannu, E-mail: hannu.paajanen@kuh.fi [Kuopio University Hospital, Department of Gastrointestinal Surgery (Finland); Manninen, Hannu, E-mail: hannu.manninen@kuh.fi [Kuopio University Hospital, Department of Clinical Radiology (Finland)

    2015-10-15

    PurposeTo evaluate endovascular therapy (EVT) as the primary revascularization method for acute mesenteric ischemia (AMI).MethodsA retrospective review was performed on all consecutive patients treated for AMI during a 5-year period (January 2009 to December 2013). EVT was attempted in all patients referred for emergent revascularization. Surgical revascularization was performed selectively after failure of EVT. Patient characteristics, clinical presentation, and outcomes were studied. Failures and complications of EVT were recorded.ResultsFifty patients, aged 79 ± 9 years (mean ± SD), out of 66 consecutive patients with AMI secondary to embolic or thrombotic obstruction of the superior mesenteric artery were referred for revascularization. The etiology of AMI was embolism in 18 (36 %) and thrombosis in 32 (64 %) patients. EVT was technically successful in 44 (88 %) patients. Mortality after successful or failed EVT was 32 %. The rates of emergency laparotomy, bowel resection, and EVT-related complication were 40, 34, and 10 %, respectively. Three out of six patients with failure of EVT were treated with surgical bypass. EVT failure did not significantly affect survival.ConclusionsEVT is feasible in most cases of AMI, with favorable patient outcome and acceptable complication rate.

  15. Primary Sjogren's Syndrome Presenting as Acute Interstitial Pneumonitis/Hamman-Rich Syndrome

    Science.gov (United States)

    Humayun, Mohammad; Haider, Iqbal; Ayub, Maimoona; Shah, Zakir; Ajmal, Fahad

    2016-01-01

    A previously well, 45-year-old Pakistani lady was admitted to the medical unit on-call of Khyber Teaching Hospital (KTH) Peshawar with a 5-day history of fever, productive cough with copious mucoid sputum, dyspnea, and pleuritic chest pain. She also complained of dry eyes, mouth, and vagina. Her chest X-ray showed diffuse alveolar shadowing and arterial gas analysis confirmed type 1 respiratory failure. Over the next few days, she deteriorated rapidly making an urgent transfer to the medical intensive care unit (MICU) necessary, where she was mechanically ventilated. An HRCT followed by bronchoscopic biopsies made a diagnosis of acute interstitial pneumonitis (AIP), formerly known as Hamman-Rich syndrome. She also turned out to be positive for both anti-SS-A/Ro and anti-SS-B/La antibodies along with a positive Schirmer's test and lower lip biopsy. She received intravenous steroids and supportive care. The patient had a complete recovery after approximately three weeks' stay in the hospital with lung function returning back to normal. This is most probably the first ever case of primary Sjogren syndrome (pSjS) presenting as AIP, recovering completely in less than a month time. PMID:27818685

  16. Primary Sjogren’s Syndrome Presenting as Acute Interstitial Pneumonitis/Hamman-Rich Syndrome

    Directory of Open Access Journals (Sweden)

    Abidullah Khan

    2016-01-01

    Full Text Available A previously well, 45-year-old Pakistani lady was admitted to the medical unit on-call of Khyber Teaching Hospital (KTH Peshawar with a 5-day history of fever, productive cough with copious mucoid sputum, dyspnea, and pleuritic chest pain. She also complained of dry eyes, mouth, and vagina. Her chest X-ray showed diffuse alveolar shadowing and arterial gas analysis confirmed type 1 respiratory failure. Over the next few days, she deteriorated rapidly making an urgent transfer to the medical intensive care unit (MICU necessary, where she was mechanically ventilated. An HRCT followed by bronchoscopic biopsies made a diagnosis of acute interstitial pneumonitis (AIP, formerly known as Hamman-Rich syndrome. She also turned out to be positive for both anti-SS-A/Ro and anti-SS-B/La antibodies along with a positive Schirmer’s test and lower lip biopsy. She received intravenous steroids and supportive care. The patient had a complete recovery after approximately three weeks’ stay in the hospital with lung function returning back to normal. This is most probably the first ever case of primary Sjogren syndrome (pSjS presenting as AIP, recovering completely in less than a month time.

  17. Acute promyelocytic leukemia after whole brain irradiation of primary brain lymphomainan HIV-infected patient

    Directory of Open Access Journals (Sweden)

    Boban A

    2009-01-01

    Full Text Available Abstract The occurrence of acute promyelocytic leukemia (APL in HIV-infected patients has been reported in only five cases. Due to a very small number of reported HIV/APL patients who have been treated with different therapies with the variable outcome, the prognosis of APL in the setting of the HIV-infection is unclear. Here, we report a case of an HIV-patient who developed APL and upon treatment entered a complete remission. A 25-years old male patient was diagnosed with HIV-infection in 1996, but remained untreated. In 2004, the patient was diagnosed with primary central nervous system lymphoma. We treated the patient with antiretroviral therapy and whole-brain irradiation, resulting in complete remission of the lymphoma. In 2006, prompted by a sudden neutropenia, we carried out a set of diagnostic procedures, revealing APL. Induction therapy consisted of standard treatment with all-trans-retinoic-acid (ATRA and idarubicin. Subsequent cytological and molecular analysis of bone marrow demonstrated complete hematological and molecular remission. Due to the poor general condition, consolidation treatment with ATRA was given in March and April 2007. The last follow-up 14 months later, showed sustained molecular APL remission. In conclusion, we demonstrated that a complete molecular APL remission in an HIV-patient was achieved by using reduced-intensity treatment.

  18. Mutation patterns of 16 genes in primary and secondary acute myeloid leukemia (AML with normal cytogenetics.

    Directory of Open Access Journals (Sweden)

    Marta Fernandez-Mercado

    Full Text Available Acute myeloid leukemia patients with normal cytogenetics (CN-AML account for almost half of AML cases. We aimed to study the frequency and relationship of a wide range of genes previously reported as mutated in AML (ASXL1, NPM1, FLT3, TET2, IDH1/2, RUNX1, DNMT3A, NRAS, JAK2, WT1, CBL, SF3B1, TP53, KRAS and MPL in a series of 84 CN-AML cases. The most frequently mutated genes in primary cases were NPM1 (60.8% and FLT3 (50.0%, and in secondary cases ASXL1 (48.5% and TET2 (30.3%. We showed that 85% of CN-AML patients have mutations in at least one of ASXL1, NPM1, FLT3, TET2, IDH1/2 and/or RUNX1. Serial samples from 19 MDS/CMML cases that progressed to AML were analyzed for ASXL1/TET2/IDH1/2 mutations; seventeen cases presented mutations of at least one of these genes. However, there was no consistent pattern in mutation acquisition during disease progression. This report concerns the analysis of the largest number of gene mutations in CN-AML studied to date, and provides insight into the mutational profile of CN-AML.

  19. Mutation patterns of 16 genes in primary and secondary acute myeloid leukemia (AML) with normal cytogenetics.

    Science.gov (United States)

    Fernandez-Mercado, Marta; Yip, Bon Ham; Pellagatti, Andrea; Davies, Carwyn; Larrayoz, María José; Kondo, Toshinori; Pérez, Cristina; Killick, Sally; McDonald, Emma-Jane; Odero, María Dolores; Agirre, Xabier; Prósper, Felipe; Calasanz, María José; Wainscoat, James S; Boultwood, Jacqueline

    2012-01-01

    Acute myeloid leukemia patients with normal cytogenetics (CN-AML) account for almost half of AML cases. We aimed to study the frequency and relationship of a wide range of genes previously reported as mutated in AML (ASXL1, NPM1, FLT3, TET2, IDH1/2, RUNX1, DNMT3A, NRAS, JAK2, WT1, CBL, SF3B1, TP53, KRAS and MPL) in a series of 84 CN-AML cases. The most frequently mutated genes in primary cases were NPM1 (60.8%) and FLT3 (50.0%), and in secondary cases ASXL1 (48.5%) and TET2 (30.3%). We showed that 85% of CN-AML patients have mutations in at least one of ASXL1, NPM1, FLT3, TET2, IDH1/2 and/or RUNX1. Serial samples from 19 MDS/CMML cases that progressed to AML were analyzed for ASXL1/TET2/IDH1/2 mutations; seventeen cases presented mutations of at least one of these genes. However, there was no consistent pattern in mutation acquisition during disease progression. This report concerns the analysis of the largest number of gene mutations in CN-AML studied to date, and provides insight into the mutational profile of CN-AML.

  20. Primary aortoesophageal fistula: a rare cause of acute upper gastrointestinal bleeding

    Directory of Open Access Journals (Sweden)

    Samira Ineida Morais Gomes

    2011-12-01

    Full Text Available Acute upper gastrointestinal bleeding is a potentially life-threateningemergency, especially in the elderly. This condition accounts for approximately1% of all emergency room admissions. Among the causes of such bleedingis aortoesophageal fistula, a dreaded but apparently rare condition, firstrecognized in 1818. The great majority of cases are of primary aortoesophagealfistula, caused by atheromatous aortic aneurysms or, less frequently, bypenetrating aortic ulcer. The clinical presentation of aortoesophageal fistulais typically characterized by the so-called Chiari’s triad, consisting of thoracicpain followed by herald bleeding, a variable, short symptom-free interval,and fatal exsanguinating hemorrhage. The prognosis is poor, the in-hospitalmortality rate being 60%. Conservative treatment does not prolong survival,and the in-hospital mortality rate is 40% for patients submitted to conventionalsurgical treatment. Here, we report the case of a 93-year-old woman whopresented to the emergency room with a history of hematemesis. The patientwas first submitted to upper gastrointestinal endoscopy, the findings of whichwere suggestive of aortoesophageal fistula. The diagnosis was confirmedby multidetector computed tomography of the chest. Surgery was indicated.However, on the way to the operating room, the patient presented with massivebleeding and went into cardiac arrest, which resulted in her death.

  1. Changes in the retrobulbar arterial circulation after decrease of the elevated intraocular pressure in men and women with primary open angle glaucoma

    Directory of Open Access Journals (Sweden)

    Marjanović Ivan

    2013-01-01

    Full Text Available Introduction. An altered perfusion of the optic nerve head has been proposed as a pathogenic factor of glaucoma. Objective. The aim of this study was to evaluate the changes of the hemodynamic parameters in the retrobulbar arterial circulation after decrease of the elevated intraocular pressure (IOP in women and men with primary open angle glaucoma. Methods. The study included 60 patients (33 males and 27 females older than 50 years, with diagnosed and treated primary open angle glaucoma (77 eyes of 39 patients had increased IOP, >25 mm Hg. They were examined at the Clinic of Eye Diseases (complete ophthalmologic exam and Clinic of Neurology, Clinical Center of Serbia, Belgrade, from December 2009 to December 2010. Imaging of hemodynamic parameters of three retrobulbar arterial vessels: ophthalmic, central retinal and posterior ciliary arteries with color Doppler was performed. Results. Among women, hemodynamic arterial parameter of the peak-systolic velocity was increased in the central retinal artery and decreased in the ophthalmic artery and posterior ciliary arteries; end- diastolic velocity was increased in all three retrobulbar vascular levels; Pourcelot resistivity index was increased, but pulsatility index was decreased in all three vessels. Among men, peak-systolic velocity, end-diastolic velocity and pulsatility index were decreased in all three vessels; resistivity index was increased in the ophthalmic artery, but decreased in the central retinal artery and posterior ciliary arteries. There was a significant change of the ophthalmic artery pulsatility index in women, and the end-diastolic velocity of the ophthalmic artery in men. Conclusion. There was a difference of the retrobulbar arterial circulation between women and men with primary open angle glaucoma after decrease of the elevated intraocular pressure. The role of vascular factors in the supply of the optic disc neuroretinal rim is important.

  2. No association of genetic polymorphisms in CYP1B1 with primary open-angle glaucoma: a meta- and gene-based analysis

    OpenAIRE

    Dong, Shuqian; Yang, Jingyun; Yu, Weihong; Kota, Pravina; Xia, Xiaobo; Xu, Huizhuo

    2012-01-01

    Purpose To examine the effects of genetic polymorphisms in cytochrome P450, subfamily 1, polypeptide 1 (C1P1B1) on primary open-angle glaucoma (POAG). Methods A systematic literature search was performed, and random-effects meta-analyses were used to evaluate genetic polymorphisms in CYP1B1 with POAG. A gene-based analysis was conducted to investigate the cumulative effects of genetic polymorphisms in CYP1B1. Results A total of six studies from published papers were included in our analysis. ...

  3. [Interactive, multimedia learning system for the study of primary open angle glaucoma--system description from the viewpoint of the computer scientist].

    Science.gov (United States)

    Zenz, H; Maresch, H; Faulborn, J

    1994-01-01

    For use on an Apple Macintosh PC, a software packet was developed with the aid of which medical students can learn all about primary open-angle glaucoma; at the same time, it is also highly suitable for supplementing lectures. The subject is subdivided into the three sections anatomy, pathology and clinical picture. All the possibilities of computer technology, for example controllable animation, video sequences and special graphic effects are utilized. A special lexicon, a complex of questions and all the possible cross-references combine to make the learning system a very flexible and highly effective learning tool.

  4. The influence of venous blood flow on the retinal ganglion cell complex in patients with primary open angle glaucoma

    Directory of Open Access Journals (Sweden)

    N. I. Kurysheva

    2014-07-01

    Full Text Available Purpose: To study the influence of venous blood flow on the ganglion cell complex (GCC in patients with preperimetric and perimetric open angle glaucoma.Methods: 74 patients were included in the research. 59 eyes and 62 eyes were diagnosed with preperimetric and perimetric open angle glaucoma respectively. The mean age was 56.5±10.5 years. 22 (12 female and 10 male healthy individuals constituted the control group. The ganglion cell complex and retinal nerve fibre layer were evaluated with the help of optical coherence tomography (RTVue-100 OCT, Optovue, Inc., Fremont, CA. Ocular blood flow was measured by Color Doppler Imaging (multifunctional VOLUSON 730 ProSystem. The statistical analysis included correlation between GCC and RNFL thickness in both glaucoma groups.Results: The results showed a statistically significant reduction of venous blood flow velocity in both glaucoma groups compared to the control group. No difference in venous blood flow parameters between two glaucoma groups was found, except resistance index, which was higher in perimetric group in comparison to preperimetric group. A correlation was also obtained between venous blood flow parameters and GCC and RNFL thickness in both glaucoma groups.Conclusion: Early GCC damage in glaucoma might occur due to venous blood flow reduction. This fact may be of great value in understanding glaucoma pathogenesis and search for novel treatment options.

  5. A Case of Acute Budd-Chiari Syndrome Complicating Primary Antiphospholipid Syndrome Presenting as Acute Abdomen and Responding to Tight Anticoagulant Therapy

    Directory of Open Access Journals (Sweden)

    Naofumi Chinen

    2016-01-01

    Full Text Available A 34-year-old woman with primary antiphospholipid syndrome was admitted to the Gastroenterology Department of our hospital with fever, acute abdomen, watery diarrhea, and extremely high levels of inflammatory parameters. She had a history of left lower limb deep vein thrombosis and pulmonary embolism and was taking warfarin potassium. Acute gastroenteritis was suspected and an antibiotic was administered, but symptoms progressed. Abdominal ultrasonography showed occlusion of the left hepatic vein and the middle hepatic vein and her D-dimer level was high. Accordingly, Budd-Chiari syndrome was diagnosed and high-dose intravenous infusion of heparin was initiated. Her abdominal symptoms improved and the levels of inflammatory parameters and D-dimer decreased rapidly. It is known that antiphospholipid syndrome can be complicated by Budd-Chiari syndrome that usually occurs as subacute or chronic onset, but acute onset is rare. It is difficult to diagnose acute Budd-Chiari syndrome complicating antiphospholipid syndrome and this complication generally has a poor outcome. However, the present case can get early diagnosis and successful treatment with tight anticoagulant therapy.

  6. Effects of primary PCI and facilitated PCI on myocardial viability and ventricular systolic synchrony in acute myocardial infarction patients

    Institute of Scientific and Technical Information of China (English)

    谷新顺; 傅向华; 马宁

    2003-01-01

    Effects of primary PCI and facilitated PCI on myocardial viability and ventricular systolic synchrony in acute myocardial infarction patients!石家庄050000$河北医科大学第二医院@谷新顺 !石家庄050000$河北医科大学第二医院@傅向华 !石家庄050000$河北医科大学第二医院@马宁

  7. Examining Delay Intervals in the Diagnosis and Treatment of Primary Open Angle Glaucoma in an Egyptian Population and Its Impact on Lifestyle

    Science.gov (United States)

    Abu Hussein, Nahla B.; Habib, Ahmed E.; El Sayed, Yasmine M.

    2016-01-01

    Purpose. To examine causes as well as extent of delay in diagnosis and treatment of primary open angle glaucoma patients in a sample of Egyptians. Patients and Methods. 440 patients with primary open angle glaucoma were interviewed to evaluate delay in their diagnosis and treatment. The extent and cause of delay were investigated. The total delay interval, if any, was correlated with socioeconomic and other factors. Results. The median total delay was one year, with 50% of patients having a total delay of 1 year or less, of which 25% exhibited zero total delay. 25% of patients had a delay ranging from 1 to 3 years, and 25% had a total delay ranging from 3 to 27 years. Diagnostic delay accounted for 43.03% of cases. Longer delays were met in patients with certain socioeconomic factors. Patients with a positive family history of glaucoma displayed shorter delay periods. Conclusion. Significant delay in the diagnosis and treatment of glaucoma was found. Poor socioeconomic status seems to hinder timely diagnosis and treatment of POAG. Certain socioeconomic factors seem to correlate with the extent of delay. More effort is thus needed to subsidize the cost of investigations and treatment for glaucoma patients. PMID:28116140

  8. An operational definition of primary refractory acute myeloid leukemia allowing early identification of patients who may benefit from allogeneic stem cell transplantation

    DEFF Research Database (Denmark)

    Ferguson, Paul; Hills, Robert K; Grech, Angela

    2016-01-01

    Up to 30% of adults with acute myeloid leukemia fail to achieve a complete remission after induction chemotherapy - termed primary refractory acute myeloid leukemia. There is no universally agreed definition of primary refractory disease, nor have the optimal treatment modalities been defined. We.......0001) cohorts. The utilization of REF1 criteria permits the early identification of patients whose outcome after one course of induction chemotherapy is very poor, and informs a novel definition of primary refractory acute myeloid leukemia. Furthermore, these data demonstrate that allogeneic stem cell...

  9. Epidemiological characterization of primary open-angle glaucoma Caracterización epidemiológica del glaucoma primario de ángulo abierto

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    Armando Rafael Milanés Armengol

    2010-11-01

    Full Text Available Background: The primary open-angle glaucoma is a problem for public health all over the world. It is a silent and slowly progressive disease leading to blindness. In most patients this can be prevented if the risk factors leading to the disease are detected in time. Objective: To describe some epidemiological factors of patients with primary open-angle glaucoma. Methods: Clinical, epidemiological, prospective and longitudinal study in patients with primary open-angle glaucoma who attended the glaucoma consultation of the Provincial General University Hospital "Dr. Gustavo Aldereguía Lima" of Cienfuegos, from January to February 2009. The following variables were analyzed: age, sex, family and personal medical history, toxic habits and time of diagnosis of the disease. Results: There was prevalence of primary open-angle glaucoma (87, 5% mostly in females (53, 6% and patients over 61 years old as well as in white skinned patients (52 and 62% respectively. Hypertension was the leading entity referred to as pathological personal and family antecedent (62 and 42% respectively. Glaucoma and myopia predominated as previous eye history. The most frequent toxic habits were the consumption of more than 2 cups of coffee a day (53% and smoking (32%. The largest amount of patients had more than 5 years evolution of the disease. Conclusions: Primary open-angle glaucoma occurred mainly in female patients and those with a historyFundamento: el glaucoma primario de ángulo abierto constituye un problema de salud pública a nivel mundial, es una enfermedad silente y lentamente progresiva que conduce a la ceguera; en la mayoría de los enfermos esto puede prevenirse si son detectados tempranamente los factores de riesgo que pueden llevar a esta enfermedad. Objetivo: describir algunos factores epidemiológicos de pacientes portadores de glaucoma

  10. Changes in joint angle, muscle-tendon complex length, muscle contractile tissue displacement, and modulation of EMG activity during acute whole-body vibration.

    Science.gov (United States)

    Cochrane, Darryl J; Loram, Ian D; Stannard, Stephen R; Rittweger, Jörn

    2009-09-01

    It has been suggested that vibration causes small changes in muscle length, but to the best of our knowledge, these have yet to be demonstrated during whole-body vibration (WBV). This was an observational study to determine whether acute WBV would result in muscle lengthening. We hypothesized that acute WBV would increase electromyography (EMG) activity concurrently with measurable changes in muscle contractile length. Nine healthy males performed two conditions on a Galileo vibration machine for 15 s at 0 HZ (resting) and 6 HZ at a set knee angle of 18 degrees. Muscle tendon complex length, contractile tissue displacement of the medial gastrocnemius muscle, and EMG of soleus, tibialis anterior, and vastus lateralis muscles were measured. At 6 HZ the medial gastrocnemius (MG) muscle tendon complex (MTC) amplitude (375 microm) was significantly greater (P EMG modulation were found for all muscles during the 6 HZ compared to the 0 HZ condition. The major finding was that approximately 50% of the elongation occurred within the muscle itself and was associated with preceding changes in EMG. This indicates muscle lengthening may be a prerequisite for eliciting stretch reflexes. In conclusion, there is a temporal association between EMG activity and muscle contractile tissue displacement where low-frequency WBV results in small muscle length changes and increases muscle activation.

  11. Acute normovolemic hemodilution is not beneficial in patients undergoing primary elective valve surgery

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    Virmani Sanjula

    2010-01-01

    Full Text Available The objective of this study was to evaluate the effectiveness of acute normovolemic hemodilution (ANH as a sole method of reducing allogenic blood requirement in patients undergoing primary elective valve surgery. One hundred eighty eight patients undergoing primary elective valve surgery were prospectively randomized into two groups: Group I (n=100 acted as control and in Group II (n=88 autologous blood was removed (10% of estimated blood volume in patients with hemoglobin (Hb > 12g% and 7% when the Hb was < 12g% in the pre-cardiopulmonary bypass (CPB period for subsequent re-transfusion after protamine administration. The autologous blood withdrawn was replaced simultaneously with an equal volume of hydroxyl-ethyl starch solution. Banked blood was transfused in both the groups when Hb was ≤6g % on CPB and ≤8g% after CPB. Platelets were transfused when the count fell to < 100´10 9 /L and fresh frozen plasma (FFP was transfused whenever there was diffuse bleeding with laboratory evidence of coagulopathy. The two groups were comparable as regards demographic data, type of surgical procedures performed, duration of CPB and ischemia, duration of elective ventilation and re-exploration for excessive bleeding. The autologous blood withdrawn in patients with Hb≥12g% was 288.3±69.4 mL and 244.4±41.3 mL with Hb < 12g% (P=NS. The Hb concentration (g % was comparable pre-operatively (Group I= 12.1±1.6, Group II= 12.4±1.4, on postoperative day 1 (Group I =10.3±1.1, Group II= 10.6±1.2 and day 7 (Group I = 10.9±1.5, Group II=10.4±1.5. However, the lowest Hb recorded on CPB was significantly lower in Group II (Group I =7.7±1.2, Group II=6.7±0.9, P < 0.05. There was no difference in the chest tube drainage (Group I =747.2±276.5 mL, Group II=527.6±399.5 mL, blood transfusion (Group I=1.1±1.0 units vs. Group II=1.3±1.0 units intra-operatively and Group I=1.7±1.2 units vs. Group II=1.7±1.4 units post-operatively and FFP transfusion (Group I

  12. Role of apoptosis in the рathogenesis of glaucomatous optic nerve damage during primary open-angle glaucoma

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    M. A. Frolov

    2014-07-01

    Full Text Available This work is devoted to the study of the molecular mechanisms of programmed cell death or apoptosis in primary open-angleglaucoma. As one of the main factors in the pathogenesis of this disease appears the loss of retinal ganglion cells. Their death occursby apoptosis — programmed suicide mechanism. We consider two major apoptotic pathways, which are described in the literature —Fas-mediated and Bcl-2-dependent or mitochondrial. The existence of these paths and their regulators in many organs and tissues isdescribed, including the retina and optic nerve. Based on the analysis of domestic and foreign literature is presented modern view ofthe stages of this process in glaucoma. A thorough understanding of the mechanisms of apoptosis and their regulation may contribute to the development of new pharmacological methods of prevention and treatment of eye diseases

  13. Role of apoptosis in the рathogenesis of glaucomatous optic nerve damage during primary open-angle glaucoma

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    M. A. Frolov

    2013-01-01

    Full Text Available This work is devoted to the study of the molecular mechanisms of programmed cell death or apoptosis in primary open-angleglaucoma. As one of the main factors in the pathogenesis of this disease appears the loss of retinal ganglion cells. Their death occursby apoptosis — programmed suicide mechanism. We consider two major apoptotic pathways, which are described in the literature —Fas-mediated and Bcl-2-dependent or mitochondrial. The existence of these paths and their regulators in many organs and tissues isdescribed, including the retina and optic nerve. Based on the analysis of domestic and foreign literature is presented modern view ofthe stages of this process in glaucoma. A thorough understanding of the mechanisms of apoptosis and their regulation may contribute to the development of new pharmacological methods of prevention and treatment of eye diseases

  14. Acute and subacute stent thrombosis after primary percutaneous coronary intervention for ST-segment elevation myocardial infarction : incidence, predictors and clinical outcome

    NARCIS (Netherlands)

    Hesstermans, A. A. C. M.; van Werkum, J. W.; Zwart, B.; van der Heyden, J. A.; Kelder, J. C.; Breet, N. J.; van't Hof, A. W. J.; Koolen, J. J.; Brueren, B. R. G.; Zijlstra, F.; ten Berg, J. M.; Dambrink, Jan Hendrik Everwijn

    2010-01-01

    Background: Early coronary stent thrombosis occurs most frequent after primary percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction (STEMI). Objectives: To identify the specific predictors of, respectively, acute and subacute stent thrombosis in patients after prim

  15. Efficacy comparison of combined intracoronary administration of high-dose adenosine and tirofiban versus intracoronary tirofiban during primary percutaneous coronary intervention in patients with acute myocardial infarction

    Institute of Scientific and Technical Information of China (English)

    佟子川

    2013-01-01

    Objective To compare the efficacy of intracoronary administration of combined high-dose adenosine and tirofiban versus intracoronary tirofiban during primary percutaneous coronary intervention (PCI) in patients with acute myocardial infarction.Methods Consecutive 258 patients with acute ST-segment elevation myocardial infarction (STEMI) underwent primary PCI,treated with thrombus aspiration and then intracoronary tirofiban,and were randomly divided into adenosine group (n=130) and con-

  16. Acute partial Budd-Chiari syndrome and portal vein thrombosis in cytomegalovirus primary infection: a case report

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    Morard Isabelle

    2006-03-01

    Full Text Available Abstract Background Splanchnic vein thrombosis may complicate inherited thrombotic disorders. Acute cytomegalovirus infection is a rare cause of acquired venous thrombosis in the portal or mesenteric territory, but has never been described extending into a main hepatic vein. Case presentation A 36-year-old immunocompetent woman presented with acute primary cytomegalovirus infection in association with extensive thrombosis in the portal and splenic vein. In addition, a fresh thrombus was evident in the right hepatic vein. A thorough evaluation for a hypercoagulable state was negative. The clinical course, biological evolution, radiological and histological findings were consistent with cytomegalovirus hepatitis complicated by a partial acute Budd-Chiari syndrome and portal thrombosis. Therapeutic anticoagulation was associated with a slow clinical improvement and partial vascular recanalization. Conclusion We described in details a new association between cytomegalovirus infection and acute venous thrombosis both in the portal vein and in the right hepatic vein, realizing a partial Budd-Chiari syndrome. One should be aware that this rare thrombotic event may be complicated by partial venous outflow block.

  17. Experience in the Treatment of 31 Cases of Acute Angle Closure Glaucoma%31例急性闭角型青光眼患者的治疗体会

    Institute of Scientific and Technical Information of China (English)

    李宏宇

    2016-01-01

    目的:探讨急性闭角型青光眼患者的治疗方法。方法对我院2013年3月~2015年6月收治的31例急性闭角型青光眼患者的临床治疗进行观察分析。结果本组31例急性闭角型青光眼患者治疗后均康复出院,治疗有效率为100%。结论及时明确急性闭角型青光眼患者的临床分期,并行对症治疗,大部分患者均可康复出院。%Objective To investigate the treatment of patients with acute angle closure glaucoma.Methods Clinical observation and analysis of 31 cases of acute angle closure glaucoma treated in our hospital from March 2013 to June 2015 were conducted.ResultsIn this group, 31 cases of patients with acute angle closure glaucoma patients were discharged from hospital after treatment, the effective rate was 100%.Conclusion The clinical staging of patients with acute angle closure glaucoma is in a timely manner, and the patients can be discharged from hospital.

  18. Association of pattern reversal VEP parameters with the mean defect of Humphrey visual field in patients of primary open angle glaucoma.

    Science.gov (United States)

    Kothari, Ruchi; Singh, Ramji; Singh, Smita; Bokariya, Pradeep

    2013-01-01

    Glaucoma is a chronic, progressive bilateral optic neuropathy which disturbs the structural or functional integrity of the optic nerve that causes characteristic atrophic changes in it, which leads to specific visual field defects over time with loss of visual function. Primary open angle glaucoma (POAG) is the most common form of glaucoma in India and is fast emerging as a major cause of bilateral blindness. This rural hospital based study was conducted to evaluate whether glaucomatous visual field defects particularly the mean defect of Humphrey visual field could be related to VEP parameters of patients having POAG. Visual field by Humphrey perimeter and simultaneous recordings of pattern reversal visual evoked potential (PRVEP) were assessed in 100 patients with POAG. There was a significant (P VEP changes observed by us in POAG patients were consistent with the progressing mean defect quantitatively. Therefore, it can be concluded that the VEP parameters can be useful quantitative indices in the evaluation of glaucomatous visual function damage.

  19. Hypothesis-independent pathway analysis implicates GABA and acetyl-CoA metabolism in primary open-angle glaucoma and normal-pressure glaucoma.

    Science.gov (United States)

    Bailey, Jessica N Cooke; Yaspan, Brian L; Pasquale, Louis R; Hauser, Michael A; Kang, Jae H; Loomis, Stephanie J; Brilliant, Murray; Budenz, Donald L; Christen, William G; Fingert, John; Gaasterland, Douglas; Gaasterland, Terry; Kraft, Peter; Lee, Richard K; Lichter, Paul R; Liu, Yutao; McCarty, Catherine A; Moroi, Sayoko E; Richards, Julia E; Realini, Tony; Schuman, Joel S; Scott, William K; Singh, Kuldev; Sit, Arthur J; Vollrath, Douglas; Wollstein, Gadi; Zack, Donald J; Zhang, Kang; Pericak-Vance, Margaret A; Allingham, R Rand; Weinreb, Robert N; Haines, Jonathan L; Wiggs, Janey L

    2014-10-01

    Primary open-angle glaucoma (POAG) is a leading cause of blindness worldwide. Using genome-wide association single-nucleotide polymorphism data from the Glaucoma Genes and Environment study and National Eye Institute Glaucoma Human Genetics Collaboration comprising 3,108 cases and 3,430 controls, we assessed biologic pathways as annotated in the KEGG database for association with risk of POAG. After correction for genic overlap among pathways, we found 4 pathways, butanoate metabolism (hsa00650), hematopoietic cell lineage (hsa04640), lysine degradation (hsa00310) and basal transcription factors (hsa03022) related to POAG with permuted p glaucoma (NPG), the butanoate metabolism pathway was also significantly associated (p glaucoma pathogenesis, and suggest new potential therapeutic targets.

  20. Fixed combination of bimatoprost and timolol in patients with primary open-angle glaucoma or ocular hypertension with inadequate IOP adjustment

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    Gerrett Brief

    2010-09-01

    Full Text Available Gerrett Brief1, Tobias Lammich2, Edgar Nagel3, Sabine Pfennigsdorf4, Christoph W Spraul5, Selwyn Ho61Facharzt für Augenheilkunde, Dortmund, Germany; 2Neubrandenburg, Germany; 3Augenarztpraxis Rudolstadt, Germany; 4Polch, Germany; 5Geiselhart, Ulm, Germany; 6Allergan Europe, Marlow, UKObjective: To assess the efficacy and tolerability of a fixed combination of bimatoprost and timolol (BTFC in a large patient sample in a clinical setting.Methods: In this multicenter, observational, noncontrolled, open-label study, patients (n = 1862 with primary open-angle glaucoma or ocular hypertension were treated with BTFC. Assessments were made at baseline, six weeks, and three months.Results: Prior to starting BTFC, 92.3% of patients were taking other ocular hypotensive medications. In the overall group at three months, mean intraocular pressure was reduced from baseline (21.7 ± 4.5 mmHg and 21.8 ± 4.9 mmHg for the right and left eye, respectively to 16.1 ± 3.0 mmHg for each eye (P < 0.0001. The majority of patients (92% reported no adverse events. The most commonly reported adverse events (in >1% of patients were eye irritation, and ocular and conjunctival hyperemia. Adherence to treatment was generally better than (35.4% or the same as (57.5% with prior therapy. BTFC tolerability was rated as excellent or good by 92.3% of physicians and 85.8% of patients.Conclusions: In a large group of patients with primary open-angle glaucoma or ocular hypertension, treatment with BTFC was associated with consistent reductions in IOP, improved adherence to treatment, and good tolerability.Keywords: bimatoprost, timolol, intraocular pressure, fixed combination, glaucoma

  1. Apolipoprotein E gene ε4ε4 is associated with elevated risk of primary open angle glaucoma in Asians: a meta-analysis

    Science.gov (United States)

    2014-01-01

    Background Epidemiological studies have evaluated the association between Apolipoprotein E (APOE) gene ε2/ε3/ε4 polymorphism and glaucoma susceptibility. However, the published data are still inconclusive. The aim of the present study is to evaluate the impact of APOE gene ε2/ε3/ε4 polymorphism on glaucoma risk by using meta-analysis. Methods A comprehensive literature search of PubMed, EMBASE, Cochrane, Elsevier Science Direct and CNKI databases was conducted to identify relevant articles, with the last report up to January 5, 2014. Pooled odds ratio (OR) and 95% confidence interval (CI) were used to assess the strength of association by using the fixed or random effect model. Results Fifteen separate studies including 2,700 cases and 2,365 controls were included in the meta-analysis. We did not detect a significant association between APOE gene ε2/ε3/ε4 polymorphism and glaucoma in overall population (P > 0.0083). In Asians, we detected an association of the ε4ε4 genotype with elevated risk for glaucoma (OR = 5.22, 95% CI = 1.85-14.68, P = 0.002), mainly for primary open angle glaucoma (OR = 4.98, 95% CI = 1.75-14.20, P = 0.003). Conclusions The meta-analysis suggests that APOE gene ε4ε4 may be associated with elevated risk for primary open angle glaucoma in Asians. However, more epidemiologic studies based on larger sample size, case–control design and stratified by ethnicity as well as types of glaucoma are suggested to further clarify the relationship between APOE gene ε2/ε3/ε4 polymorphism and genetic predisposition to glaucoma. PMID:24885013

  2. Age- and Gender-related Disparities in Primary Percutaneous Coronary Interventions for Acute ST-segment elevation Myocardial Infarction.

    Directory of Open Access Journals (Sweden)

    Thomas Pilgrim

    Full Text Available Previous analyses reported age- and gender-related differences in the provision of cardiac care. The objective of the study was to compare circadian disparities in the delivery of primary percutaneous coronary intervention (PCI for acute myocardial infarction (AMI according to the patient's age and gender.We investigated patients included into the Acute Myocardial Infarction in Switzerland (AMIS registry presenting to one of 11 centers in Switzerland providing primary PCI around the clock, and stratified patients according to gender and age.A total of 4723 patients presented with AMI between 2005 and 2010; 1319 (28% were women and 2172 (54% were ≥65 years of age. More than 90% of patients 90 minutes was found in elderly males (adj HR 1.66 (95% CI 1.40-1.95, p<0.001 and females (adj HR 1.57 (95% CI 1.27-1.93, p<0.001, as well as in females <65 years (adj HR 1.47 (95% CI 1.13-1.91, p = 0.004 as compared to males <65 years of age, with significant differences in circadian patterns during on- and off-duty hours.In a cohort of patients with AMI in Switzerland, we observed discrimination of elderly patients and females in the circadian provision of primary PCI.

  3. Comparison of Functional Capacity using Primary Percutaneous Coronary Intervention with Pharmacological Therapy on ST Elevation Acute Coronary Syndrome Patients

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    Andini Nurkusuma Wardhani

    2015-06-01

    Full Text Available Background: Acute Coronary Syndrome (ACS is a shift manifestations pattern of ischemic myocardium. Revascularization either with Primary Percutaneous Coronary Intervention (PCI or pharmacological therapy is an optional treatment for ST Elevation Acute Coronary Syndrome (STEACS patients. The aim of the study was to compare the functional capacity using six-minute walking test on STEACS patients who underwent Primary PCI or pharmacological therapy. Methods: A cross sectional study was conducted from September to October 2012 to 35 STEACS patients who were treated after two years. The samples were obtained from the list of patients at Dr. Hasan Sadikin General Hospital. Inclusion criteria consisted of patients diagnosed as STEACS, cooperative and not experiencing cognitive disturbance. The exclusion criteria were STEACS patients with unstable angina or myocardial infarct in the last month, stable exertional angina, and pregnant women. The patients underwent 6 minutes walking test,VO2max was measured using theCalahin and Cooper formula, then Metabolic Equation Task (METs was calculated. Data were analyzed by unpaired T-test. Results: There were 19 Primary PCI and 16 pharmacological therapy patients. The average of age between the two groups was distributed evenly. Most of the STEACS patients were male, had a college/academic degree and were retired. Patients treated with pharmacological therapy had higher average of VO2 max and METs than patients with Primary PCI. There was no significantly differences of METs between those groups (p>0.05 Conclusions: There were no significantly differences of functional capacity in STEACS patients treated with Primary PCI or Pharmacological therapy.

  4. The association between clinical integration of care and transfer of veterans with acute coronary syndromes from primary care VHA hospitals

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    Every Nathan R

    2005-01-01

    Full Text Available Abstract Background Few studies report on the effect of organizational factors facilitating transfer between primary and tertiary care hospitals either within an integrated health care system or outside it. In this paper, we report on the relationship between degree of clinical integration of cardiology services and transfer rates of acute coronary syndrome (ACS patients from primary to tertiary hospitals within and outside the Veterans Health Administration (VHA system. Methods Prospective cohort study. Transfer rates were obtained for all patients with ACS diagnoses admitted to 12 primary VHA hospitals between 1998 and 1999. Binary variables measuring clinical integration were constructed for each primary VHA hospital reflecting: presence of on-site VHA cardiologist; referral coordinator at the associated tertiary VHA hospital; and/or referral coordinator at the primary VHA hospital. We assessed the association between the integration variables and overall transfer from primary to tertiary hospitals, using random effects logistic regression, controlling for clustering at two levels and adjusting for patient characteristics. Results Three of twelve hospitals had a VHA cardiologist on site, six had a referral coordinator at the tertiary VHA hospital, and four had a referral coordinator at the primary hospital. Presence of a VHA staff cardiologist on site and a referral coordinator at the tertiary VHA hospital decreased the likelihood of any transfer (OR 0.45, 95% CI 0.27–0.77, and 0.46, p = 0.002, CI 0.27–0.78. Conversely, having a referral coordinator at the primary VHA hospital increased the likelihood of transfer (OR 6.28, CI 2.92–13.48. Conclusions Elements of clinical integration are associated with transfer, an important process in the care of ACS patients. In promoting optimal patient care, clinical integration factors should be considered in addition to patient characteristics.

  5. Contribution and significance of Heidelberg retinal tomography II in diagnostics of ocular hypertension and its conversion into primary open-angle glaucoma

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    Marković Vujica

    2009-01-01

    Full Text Available Background/Aim. A term 'ocular hypertension' is used when IOP is found to be > 21 mmHg on two consecutive occasions, in the absence of detectable glaucomatous damage. The aim of this study was to determine the significance and contribution of Heidelberg Retinal Tomography II (HRT II results that show very early, subtle changes in retinal neurofibre layers (RNFL in the optic nerve head that are specific for glaucoma itself (the loss of neuroretinal rim area and an increase of Cup/Disc ratio, but are not possible to register by an ophthalmoscope. Also, when the results of the functional tests remain unchanged, that confirms the conversion of ocular hypertension into glaucoma. Methods. During a 5-year study period (2002-2007, 29 patients with ocular hypertension were examined. The frequency of control examinations, based on the presence of risk factors for glaucoma development, was 3-6 months. The examination also included IOP measurements with Goldmann Applanation Tonometry (GAT, central corneal thickness (CCT determination by pachymetry, the examination of chamber angle using indirect gonioscopy, visual field tests by computerized perimetry and also papillae nervi optici (PNO examination by using HRT II. The application of HRT II enables a great number of stereometric parameters of optic disc, the most important being the rim area and Cup/Disc (C/D ratio, which was followed during the control examination by each segment, as well as PNO in global. Results. In the examination period, three cases of conversion of ocular hypertension into a primary open-angle glaucoma were found. In the group of patients with ocular hypertension, HRT II results after six months did not show a significant increase in C/D ratio. No significant loss of rim area or rim volume was found either. In three cases of conversion, HRT II results after 3 months showed an increase of C/D ratio and also a significant loss in rim volume at first examination (0.413 comparing to the

  6. Heart rate turbulence in patients after primary percutaneous coronary intervention and fibrinolytic treatment for acute myocardial infarction

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    Isman Firdaus

    2007-03-01

    Full Text Available Heart rate turbulence (HRT as novel predictor of sudden cardiac death were superior to all other presently available indicators. HRT significantly was improves after successful reperfusion reflecting rapid restoration of baroreceptor response. We investigated turbulence onset (TO and turbulence slope (TS values among patients with acute ST-elevation myocardial infarction (STEMI underwent revascularization by means of primary PCI or fibrinolytic. We hypothesized that the values of TO and TS were different in two kinds of revascularization treatment. The subjects underwent 24 hours ECG recording after revascularization therapy. TO was quantified by the relative change of the first two sinus RR intervals following a ventricular premature beat (VPB and the last two sinus RR intervals before the VPB. TS was quantified by the maximum positive slope of a regression line assessed over any sequence of five subsequent sinus rhythm RR intervals within the first two sinus rhythm intervals after a VPB. Thirteen patients (mean of age 56 ± 9 years old who underwent revascularization treatment of acute STEMI were eligible as subject of this study.Ten patients underwent fibrinolytic therapy and three patients underwent primary PCI. TO value was significantly different between PCI group and fibrinolytic group (-3.3 ± 1.7 % vs -0.2 ± 0.9 % ; P=0.03. The Primary PCI group has better outcome on turbulence slope value (TS than fibrinolytic group but not significance (7.7 ± 4.4 msec/RR interval vs 3.4 ± 2.6 msec/RR interval; P = 0.056. In conclusion, TO was better in acute STEMI patient undergone PCI compare to that undergone fibrinolytic therapy. (Med J Indones 2007; 16:19-24 Keywords: heart rate turbulence, revascularization, myocardial infarction

  7. Pro-apoptotic activity of α-bisabolol in preclinical models of primary human acute leukemia cells

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    Fato Romana

    2011-04-01

    Full Text Available Abstract Background We previously demonstrated that the plant-derived agent α-bisabolol enters cells via lipid rafts, binds to the pro-apoptotic Bcl-2 family protein BID, and may induce apoptosis. Here we studied the activity of α-bisabolol in acute leukemia cells. Methods We tested ex vivo blasts from 42 acute leukemias (14 Philadelphia-negative and 14 Philadelphia-positive B acute lymphoid leukemias, Ph-/Ph+B-ALL; 14 acute myeloid leukemias, AML for their sensitivity to α-bisabolol in 24-hour dose-response assays. Concentrations and time were chosen based on CD34+, CD33+my and normal peripheral blood cell sensitivity to increasing α-bisabolol concentrations for up to 120 hours. Results A clustering analysis of the sensitivity over 24 hours identified three clusters. Cluster 1 (14 ± 5 μM α-bisabolol IC50 included mainly Ph-B-ALL cells. AML cells were split into cluster 2 and 3 (45 ± 7 and 65 ± 5 μM IC50. Ph+B-ALL cells were scattered, but mainly grouped into cluster 2. All leukemias, including 3 imatinib-resistant cases, were eventually responsive, but a subset of B-ALL cells was fairly sensitive to low α-bisabolol concentrations. α-bisabolol acted as a pro-apoptotic agent via a direct damage to mitochondrial integrity, which was responsible for the decrease in NADH-supported state 3 respiration and the disruption of the mitochondrial membrane potential. Conclusion Our study provides the first evidence that α-bisabolol is a pro-apoptotic agent for primary human acute leukemia cells.

  8. Acute Corneal Hydrops in Children with Primary Infantile Glaucoma: A Report of 31 Cases over 23 Years at the LVPEI.

    Directory of Open Access Journals (Sweden)

    Anil K Mandal

    Full Text Available Relatively little data exist regarding the outcomes of children with primary infantile glaucoma presenting with acute corneal hydrops. The aim of our study was to determine the surgical outcome of children of infantile glaucoma who presented with acute corneal hydrops.In total, 38 eyes of 31 consecutive children of infantile glaucoma presented with acute corneal hydrops who underwent primary combined trabeculotomy-trabeculectomy (CTT by a single surgeon from January 1990 to December 2012 at the LV Prasad Eye Institute (LVPEI, a tertiary eye care centre in Southern India were enrolled in this retrospective study. Primary outcome measures were intraocular pressure (IOP control (IOP ≤ 16 mmHg under anaesthesia or IOP ≤ 21 mmHg without anaesthesia and clearance of corneal edema. Secondary outcome measures were visual acuity (VA, corneal diameter, bleb appearance, intraoperative and postoperative complications.Mean age at presentation was 6.4 months (range, 2-11 months and seven eyes (23% had bilateral affliction. At presentation, all eyes (100% had moderate to severe degree of corneal edema with a mean preoperative IOP of 25.6 ±5.1 mmHg. Postoperatively, the IOP reduced to 12.0 ± 3.8 mmHg (difference = -13.6, 95% CI = -15.7 to -11.5, t = -13.18, p<0.0001, and the percentage reduction in IOP was 53.05%. Preoperatively 83% of the eyes were on antiglaucoma medication, and postoperatively 2 eyes (5.3% required 1 antiglaucoma medication for control of IOP. Preoperatively, corneal edema was present in all eyes and postoperatively it cleared in all of them. Significant myopic astigmatism was present in 28 eyes (74%, the commonest being compound myopic astigmatism (75% followed by simple myopic astigmatism (21%. Normal VA (best-corrected VA; BCVA ≥ 20/60 was achieved in 44.4% of the eyes and 22.2% eyes had low vision (BCVA, <20/60 to 20/400. Complete success (IOP control and clearance of corneal oedema was obtained in 94.7% eyes. There were no

  9. Early lens extraction with intraocular lens implantation for the treatment of primary angle closure glaucoma: an economic evaluation based on data from the EAGLE trial

    Science.gov (United States)

    Javanbakht, Mehdi; Azuara-Blanco, Augusto; Burr, Jennifer M; Ramsay, Craig; Cooper, David; Cochran, Claire; Norrie, John; Scotland, Graham

    2017-01-01

    Objective To investigate the cost-effectiveness of early lens extraction with intraocular lens implantation for the treatment of primary angle closure glaucoma (PACG) compared to standard care. Design Cost-effectiveness analysis alongside a multicentre pragmatic two-arm randomised controlled trial. Patients were followed-up for 36 months, and data on health service usage and health state utility were collected and analysed within the trial time horizon. A Markov model was developed to extrapolate the results over a 5-year and 10-year time horizon. Setting 22 hospital eye services in the UK. Population Males and females aged 50 years or over with newly diagnosed PACG or primary angle closure (PAC). Interventions Lens extraction compared to standard care (ie, laser iridotomy followed by medical therapy and glaucoma surgery). Outcome measures Costs of primary and secondary healthcare usage (UK NHS perspective), quality-adjusted life years (QALYs) and the incremental cost-effectiveness ratio (ICER) for lens extraction versus standard care. Results The mean age of participants was 67.5 (8.42), 57.5% were women, 44.6% had both eyes eligible, 1.4% were of Asian ethnicity and 35.4% had PAC. The mean health service costs were higher in patients randomised to lens extraction: £2467 vs £1486. The mean adjusted QALYs were also higher with early lens extraction: 2.602 vs 2.533. The ICER for lens extraction versus standard care was £14 284 per QALY gained at three years. Modelling suggests that the ICER may drop to £7090 per QALY gained by 5 years and that lens extraction may be cost saving by 10 years. Our results are generally robust to changes in the key input parameters and assumptions. Conclusions We find that lens extraction has a 67–89% chance of being cost-effective at 3 years and that it may be cost saving by 10 years. Trial registration number ISRCTN44464607; Results. PMID:28087548

  10. Follow-up of 100 dogs with acute diarrhoea in a primary care practice

    NARCIS (Netherlands)

    Berset-Istratescu, C M; Glardon, O J; Magouras, I; Frey, C F; Gobeli, S; Burgener, I A

    2014-01-01

    This study aimed to examine the aetiology of acute diarrhoea and the relapse rate in 100 client-owned dogs presented to a first-opinion clinic. History, physical examination, faecal testing and owner questionnaire data were collected at initial presentation (T0) and at either the time of relapse or

  11. Primary PCI and Treatment of Reperfusion Injury in Acute Myocardial Infarction

    NARCIS (Netherlands)

    M.T. Dirksen (Maurits)

    2008-01-01

    textabstractAcute myocardial infarction (AMI) is responsible for the majority of (sudden) deaths and significant morbidity, thereby causing a major burden on health care. The prognosis of patients after an AMI is mainly determined by the size of the infarct, which is dependent of the area at risk (d

  12. Homeopathic and conventional treatment for acute respiratory and ear complaints: A comparative study on outcome in the primary care setting

    Directory of Open Access Journals (Sweden)

    Fischer Michael

    2007-03-01

    Full Text Available Abstract Background The aim of this study was to assess the effectiveness of homeopathy compared to conventional treatment in acute respiratory and ear complaints in a primary care setting. Methods The study was designed as an international, multi-centre, comparative cohort study of non-randomised design. Patients, presenting themselves with at least one chief complaint: acute (≤ 7 days runny nose, sore throat, ear pain, sinus pain or cough, were recruited at 57 primary care practices in Austria (8, Germany (8, the Netherlands (7, Russia (6, Spain (6, Ukraine (4, United Kingdom (10 and the USA (8 and given either homeopathic or conventional treatment. Therapy outcome was measured by using the response rate, defined as the proportion of patients experiencing 'complete recovery' or 'major improvement' in each treatment group. The primary outcome criterion was the response rate after 14 days of therapy. Results Data of 1,577 patients were evaluated in the full analysis set of which 857 received homeopathic (H and 720 conventional (C treatment. The majority of patients in both groups reported their outcome after 14 days of treatment as complete recovery or major improvement (H: 86.9%; C: 86.0%; p = 0.0003 for non-inferiority testing. In the per-protocol set (H: 576 and C: 540 patients similar results were obtained (H: 87.7%; C: 86.9%; p = 0.0019. Further subgroup analysis of the full analysis set showed no differences of response rates after 14 days in children (H: 88.5%; C: 84.5% and adults (H: 85.6%; C: 86.6%. The unadjusted odds ratio (OR of the primary outcome criterion was 1.40 (0.89–2.22 in children and 0.92 (0.63–1.34 in adults. Adjustments for demographic differences at baseline did not significantly alter the OR. The response rates after 7 and 28 days also showed no significant differences between both treatment groups. However, onset of improvement within the first 7 days after treatment was significantly faster upon homeopathic

  13. Isolated granulocytic sarcoma of the pancreas: A tricky diagnostic for primary pancreatic extramedullary acute myeloid leukemia

    Directory of Open Access Journals (Sweden)

    Messager Mathieu

    2012-01-01

    Full Text Available Abstract We report two clinical cases of primary granulocytic sarcoma of the pancreas that were diagnosed on the surgical specimen. Atypical clinical and morphological presentations may have lead to pretherapeutic biopsies of the pancreatic mass in order to indicate primary chemotherapy. Literature review of this rare clinical presentation may help physicians to anticipate diagnostic and therapeutic strategies.

  14. Solid-state 13C NMR study of banana liquid crystals - 3: Alkyl-tail-group packing environments of an acute-angle bent-core molecule in the hexagonal columnar and cubic phases

    Science.gov (United States)

    Kurosu, Hiromichi; Endo, Yumi; Kimura, Saori; Hashimoto, Tomoko; Harada, Motoi; Lee, Eun-Woo; Sone, Masato; Watanabe, Junji; Kang, Sungmin

    2016-02-01

    Solid-state 13C nuclear magnetic resonance (NMR) measurements were performed on the hexagonal columnar and cubic phases of an acute-angle banana-shaped molecule, N(1,7)-S30. In the hexagonal columnar phase, three peaks appear at the NMR chemical shifts assigned to the internal methylene carbons of alkyl tails, indicating that the two alkyl tails have different packing structures, and one of the tails has two different conformations within a single molecule. Combined cross-polarization/magic-angle spinning and pulse saturation transfer/magic-angle spinning measurements show that one of the alkyl chains is located inside and the other is located outside the columnar structure. In the cubic phase, pulse saturation transfer/magic-angle spinning measurement shows that only one peak appears at the NMR chemical shifts assigned to the internal methylene carbons of alkyl tails, indicating that both of the alkyl chains are located outside the cubic structure.

  15. 原发性闭角型青光眼易感性与GSTM1和GSTT1基因多态性的关系%Relationship of susceptibility of primary angle-closure glaucoma with glutathione S-transferase T1 and M1 polymorphisms

    Institute of Scientific and Technical Information of China (English)

    罗丽丹

    2015-01-01

    目的:研究原发性闭角型青光眼易感性与谷胱甘肽硫转移酶T1( GSTT1)与谷胱甘肽硫转移酶M1( GSTM1)的关系。  方法:将300例原发性闭角型青光眼患者作为观察对象,同时随机选择300例健康志愿者的血液标本作为对照,并将观察组患者分为慢性、急性两亚组,采用PCR技术检测GSTM1和GSTT1基因多态性。  结果:GSTT1缺失基因型在观察组中的分布频率为54.3%,在对照组的分布频率为54.0%,两组差异无统计学意义(χ2=0.053, P>0.05);观察组中慢性组GSTT1缺失基因型分布频率为54.9%,急性组GSTT1缺失基因型分布频率为48.6%,急性组与对照组相比,差异无统计学意义(χ2=0.064,P>0.05),慢性组与对照组差异无统计学意义(χ2=0.037,P>0.05);观察组GSTM1缺失基因型分布频率为59.0%,对照组为55.7%,两组差别无统计学意义(χ2=0.013, P>0.05);GSTM1缺失基因型在观察组急性和慢性两亚组的分布频率分别为62.3%和58.1%,慢性组与对照组差异无统计学意义(χ2=0.047,P>0.05),急性组与对照组差异无统计学意义(χ2=0.005,P>0.05)。  结论:原发性闭角型青光眼易感性与GSTM1和GSTT1基因多态性间不存在明显相关性。%•AlM:To investigate the relationship of susceptibility of primary angle- closure glaucoma with glutathione S-transferase T1 ( GSTT1 ) and M1 ( GSTM1 ) polymorphisms. • METHODS: Totally, 300 cases were collected from primary angle-closure glaucoma patients and 300 health volunteers were served as control group. The observation group were divided into chronic and acute primary angle-closure glaucoma groups, then multiplex PCR technology was used to detect the genetic polymorphisms of GSTM1 and GSTT1. •RESULTS:The distribution frequencies of GSTT1-null genotype were 54. 3%, while it was 54. 0% in the control group, statistically no significance between control group and observation group (χ2 = 0. 053, P > 0. 05 ) ; The frequency GSTT

  16. Cross-reactivity and expansion of dengue-specific T cells during acute primary and secondary infections in humans.

    Science.gov (United States)

    Friberg, Heather; Bashyam, Hema; Toyosaki-Maeda, Tomoko; Potts, James A; Greenough, Thomas; Kalayanarooj, Siripen; Gibbons, Robert V; Nisalak, Ananda; Srikiatkhachorn, Anon; Green, Sharone; Stephens, Henry A F; Rothman, Alan L; Mathew, Anuja

    2011-01-01

    Serotype-cross-reactive memory T cells responding to secondary dengue virus (DENV) infection are thought to contribute to disease. However, epitope-specific T cell responses have not been thoroughly compared between subjects with primary versus secondary DENV infection. We studied CD8(+) T cells specific for the HLA-A*1101-restricted NS3(133) epitope in a cohort of A11(+) DENV-infected patients throughout acute illness and convalescence. We compared the expansion, serotype-cross-reactivity, and activation of these cells in PBMC from patients experiencing primary or secondary infection and mild or severe disease by flow cytometry. Our results show expansion and activation of DENV-specific CD8(+) T cells during acute infection, which are predominantly serotype-cross-reactive regardless of DENV infection history. These data confirm marked T cell activation and serotype-cross-reactivity during the febrile phase of dengue; however, A11-NS3(133)-specific responses did not correlate with prior antigenic exposure or current disease severity.

  17. Efficacy of amoxycillin versus amoxycillin/clavulanate in acute exacerbations of chronic pulmonary obstructive disease in primary care

    Directory of Open Access Journals (Sweden)

    Carl Llor

    2008-10-01

    Full Text Available Carl Llor1, Silvia Hernández1, Anna Ribas2, Carmen Álvarez3, Josep Maria Cots4, Carolina Bayona5, Isabel González6, Marc Miravitlles7, BRAMOX Study Group 1Primary Care Centre Jaume I, Tarragona, Spain; 2Primary Care Centre Santa Eugènia de Berga, Spain; 3Primary Care Centre Manlleu, Spain; 4Primary Care Centre La Marina, Barcelona, Spain; 5Primary Care Centre Valls, Spain; 6Primary Care Centre Maragall, Barcelona, Spain; 7Pneumology Department. Institut Clínic del Tòrax (IDIBAPS, Hospital Clínic, Barcelona, CIBER de Enfermedades Respiratorias (CIBERES, SpainBackground: Amoxycillin/clavulanate is considered first-line treatment for ambulatory exacerbations of COPD. However, narrow-spectrum antibiotics may be as useful for mild to moderate patients.Objective: To compare the clinical efficacy of amoxycillin versus amoxicyllin/clavulanate in exacerbations of COPD in primary care.Methods: A randomized, double-blind, noninferiority clinical trial was carried out in eight primary care centers in Catalonia, Spain. Spirometrically-diagnosed patients older than 40 years with COPD, without criteria of hospitalization and Anthonisen’s types I or II exacerbations were included. The main outcome was clinical cure at the end of treatment (EOT visit on day 10.Results: A total of 137 patients were enrolled in the study (68 assigned to amoxycillin and 69 to amoxycillin/clavulanate. The mean forced expiratory flow in one second was 61.6% and the mean age was 71.4 years. At EOT, 92.8% of patients in the amoxycillin/clavulanate and 90.9% in the amoxycillin group were considered clinically cured, a statistically non-significant difference. Adverse effects were observed in 11 subjects, 3 in the amoxycillin group and 8 in the amoxycillin/clavulanate group, 2 of whom required a change in treatment.Conclusions: Amoxycillin was at least as effective clinically and as safe as amoxycilin/clavulanate in the treatment of acute exacerbations of COPD in mild to

  18. Identification of Mutations in Myocilin and Beta-1,4-galactosyltransferase 3 Genes in a Chinese Family with Primary Open-angle Glaucoma

    Institute of Scientific and Technical Information of China (English)

    Rong-Feng Liao; Zi-Lin Zhong; Min-Jie Ye; Li-Yun Han; Dong-Qing Ye; Jian-Jun Chen

    2016-01-01

    Background:Glaucoma is a major cause of irreversible blindness worldwide.There is evidence showing that a subset of the disease is genetically determined.In this study,we screened for mutations in chromosome 1q-linked open-angle glaucoma (GLC1A) in a Chinese family with primary open-angle glaucoma (POAG).Methods:A total of 23 members from five generations of a family were enrolled and underwent thorough ophthalmologic examinations.In addition,200 unrelated healthy Chinese controls were also recruited as normal control.GLC1A gene was amplified by polymerase chain reaction,and DNA sequencing was performed to screen for mutations.Results:Six members were diagnosed as POAG,with severe clinical manifestations,and history of high intraocular pressures.The mean age of disease onset was 26.3 years.However,the others were asymptomatic.In six affected and three asymptomatic members,gene sequencing revealed a mutation c.C1456T in exon 3 of myocilin gene (MYOC).Furthermore,we also identified a novel mutation c.G322A in beta-1,4-galactosyltransferase 3 (B4GALT3) gene in all six affected and three asymptomatic members,which was not reported previously in POAG patients.The two newly identified variants were absent in other family members as well as controls.Conclusion:The mutations c.1456C<T (p.L486F) in MYOC and c.322G<A (p.V108I) in B4GALT3 are likely responsible for the pathogenesis of POAG in this family.

  19. Identification of Mutations in Myocilin and Beta-1,4-galactosyltransferase 3 Genes in a Chinese Family with Primary Open-angle Glaucoma

    Science.gov (United States)

    Liao, Rong-Feng; Zhong, Zi-Lin; Ye, Min-Jie; Han, Li-Yun; Ye, Dong-Qing; Chen, Jian-Jun

    2016-01-01

    Background: Glaucoma is a major cause of irreversible blindness worldwide. There is evidence showing that a subset of the disease is genetically determined. In this study, we screened for mutations in chromosome 1q-linked open-angle glaucoma (GLC1A) in a Chinese family with primary open-angle glaucoma (POAG). Methods: A total of 23 members from five generations of a family were enrolled and underwent thorough ophthalmologic examinations. In addition, 200 unrelated healthy Chinese controls were also recruited as normal control. GLC1A gene was amplified by polymerase chain reaction, and DNA sequencing was performed to screen for mutations. Results: Six members were diagnosed as POAG, with severe clinical manifestations, and history of high intraocular pressures. The mean age of disease onset was 26.3 years. However, the others were asymptomatic. In six affected and three asymptomatic members, gene sequencing revealed a mutation c.C1456T in exon 3 of myocilin gene (MYOC). Furthermore, we also identified a novel mutation c.G322A in beta-1,4-galactosyltransferase 3 (B4GALT3) gene in all six affected and three asymptomatic members, which was not reported previously in POAG patients. The two newly identified variants were absent in other family members as well as controls. Conclusion: The mutations c.1456C

  20. Efficacy and safety of prostaglandin analogues in patients with predominantly primary open-angle glaucoma or ocular hypertension: a meta-analysis

    Directory of Open Access Journals (Sweden)

    Oghenowede Eyawo

    2009-07-01

    Full Text Available Oghenowede Eyawo1, Jean Nachega2,3, Pierre Lefebvre4, David Meyer5, Beth Rachlis6, Chia-Wen Lee7, Steven Kelly7, Edward Mills81Faculty of Health Sciences, Simon Fraser University, Vancouver, Canada; 2Division of Clinical Pharmacology and Medicine, University of Cape Town, Cape Town, South Africa; 3Johns Hopkins Bloomberg School of Public Health, Baltimore, USA; 4Department of Ophthalmology, Moorfields Eye Hospital, London, United Kingdom; 5Department of Ophthalmology, Stellenbosch University, Cape Town, South Africa; 6Department of Public Health, University of Toronto, Toronto, Canada; 7Outcome Research and Evidence Based Medicine, Pfizer Ltd UK. Tadworth, UK; 8Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, CanadaBackground: First-line therapy for primary open-angle glaucoma and ocular hypertension generally involves prostaglandin analogue therapy. The relative efficacy of differing prostaglandin therapy is disputed.Methods: A meta-analysis was conducted of head-to-head randomized trials of prostaglandin therapies. We included randomized trials assessing head-to-head evaluations of prostaglandin analogues travoprost, latanoprost and bimatoprost in patients with predominantly primary open-angle glaucoma or ocular hypertension. Findings were interpreted in light of equivalence margins.Results: Our search identified 16 eligible trials, of which 15 were included in the meta-analysis. Trials were, in general, poorly reported. We pooled 9 trials assessing IOP-lowering effects of travoprost vs latanoprost (total n = 1098, weighted mean difference [WMD], –0.24 mmHg, 95% CI, –0.87 to 0.38, P = 0.45, I2 = 56%, 95% CI, 0 to 0.77, heterogeneity P = 0.01. Eight trials assessed travoprost vs bimatoprost (total n = 714, WMD, 0.88 mmHg, 95% CI, 0.13 to 1.63, P = 0.02, I2 = 56%, 95% CI, 0% to 78%, heterogeneity P = 0.02. And 8 trials assessed latanoprost vs bimatoprost (total n = 943, WMD, 0.73 mmHg, 95% CI, 0.10 to 1

  1. Hemolytic uremic syndrome as a primary manifestation of acute human immunodeficiency virus infection.

    Science.gov (United States)

    Gomes, A M; Ventura, A; Almeida, C; Correia, M; Tavares, V; Mota, M; Seabra, J

    2009-05-01

    Hemolytic uremic syndrome may be associated with human immunodeficiency virus infection but it occurs in advanced stages of human immunodeficiency virus disease. As in other forms of hemolytic uremic syndrome plasmapheresis seems to be the treatment of choice. The authors present an unusual case of hemolytic uremic syndrome associated with acute human immunodeficiency virus infection in a 38 year-old black male. The patient was admitted with fever, asthenia, nausea, diarrhea, and reduced urinary output. He was found to have anemia, thrombocytopenia and severe renal failure. Hemolytic uremic syndrome was diagnosed and he was started on plasmapheresis and hemodialysis. Serological tests were consistent with acute human immunodeficiency virus infection: the enzyme linked immunosorbent assay for human immunodeficiency virus was weakly positive, Western Blot test was negative and human immunodeficiency virus RNA quantification was positive, with > 1,000,000 copies/microl. After 4 daily treatment sessions, patient's clinical condition improved and hemoglobin, platelets, lactic dehydrogenase and renal function normalized.

  2. Primary percutaneous coronary intervention in elderly patients with ST-elevation acute myocardial infarction

    Institute of Scientific and Technical Information of China (English)

    SHEN Wei-feng

    2006-01-01

    @@ The elderly constitute a rapidly growing segment of our population and cardiovascular disease becomes more prevalent with increasing age,accounting for majority of their morbidity and mortality.1,2 ST-elevation acute myocardial infarction (STEMI) is the result of an abrupt cessation of blood supply caused by coronary occlusion, its process involving atherosclerotic plaque rupture or erosion,platelet aggregation and thrombus formation.

  3. Appraisal of the Prognosis in Patients with Acute Myocardial Infarction Treated with Primary Percutaneous Coronary Intervention

    Institute of Scientific and Technical Information of China (English)

    马晓娟; 殷惠军; 陈可冀

    2009-01-01

    Acute myocardial infarction(AMI) is still the leading factor causing crippling and death in cardiovascular disease.Percutaneous coronary intervention(PCI) can significantly reduce inpatient mortality and incidence of complication.But owing to the existence of restenosis,in-stent thrombosis,etc.,recurrent post-PCI cardiovascular events and high repeatability of hospitalization,as well as its crippling rate and mortality, remain a serious threat to the society and the patients' family.Therefore,the apprais...

  4. Preservative-free bimatoprost 0.03% in patients with primary open-angle glaucoma or ocular hypertension in clinical practice

    Science.gov (United States)

    Pillunat, Lutz E; Eschstruth, Peter; Häsemeyer, Stefan; Thelen, Ulrich; Foja, Christian; Leaback, Richard; Pfennigsdorf, Stefan

    2016-01-01

    Background Intraocular pressure (IOP)-lowering medications for primary open-angle glaucoma and ocular hypertension commonly contain preservatives that can cause ocular surface damage in many patients. The purpose of this study was to evaluate the efficacy and tolerability of, and compliance to, preservative-free (PF) bimatoprost 0.03% in patients with primary open-angle glaucoma or ocular hypertension (IOP ≥18 mmHg) in a clinical practice setting. Methods This open-label study observed patients who were switched to PF bimatoprost 0.03% for medical reasons. IOP was measured at baseline and ~12 weeks later at the final visit, and the change in IOP was calculated. Tolerability and continuation of therapy were assessed at two follow-up visits. Results A total of 1,830 patients were included in the study, and complete IOP data were available for 1,543 patients. Mean IOP was reduced by 23% from 21.64 mmHg to 16.59 mmHg (P<0.0001). In subgroup analyses, the mean IOP was significantly reduced compared with baseline, regardless of prior therapy, including those previously treated with PF monotherapy. A total of 85.7% of physicians reported the IOP-lowering efficacy of PF bimatoprost 0.03% to be as expected or better than expected. Adverse events (AEs) were experienced by 5.7% of patients, and there were no serious AEs reported. The most common AEs were eye irritation (1.7%) and hyperemia (1.4%). Physician-reported treatment compliance was reported as better than (48.7%) or equal to (43.6%) prior treatment in most patients. Most patients (82%) were expected to continue PF bimatoprost 0.03% after the end of the study. Conclusion This observational study showed that, in clinical practice, switching to PF bimatoprost 0.03% was associated with a significant IOP reduction from baseline. There was a low AE rate. PF bimatoprost 0.03% may, therefore, be an effective treatment option for patients who are intolerant of preservatives or have an inadequate response to prior IOP

  5. Preservative-free bimatoprost 0.03% in patients with primary open-angle glaucoma or ocular hypertension in clinical practice

    Directory of Open Access Journals (Sweden)

    Pillunat LE

    2016-09-01

    Full Text Available Lutz E Pillunat,1 Peter Eschstruth,2 Stefan Häsemeyer,3 Ulrich Thelen,4 Christian Foja,5 Richard Leaback,6 Stefan Pfennigsdorf7 1Department of Ophthalmology, University Hospital Carl Gustav Carus, Dresden, 2Ophthalmology Practice, Kiel, 3Eye Center Kraichgau, Wiesloch, 4Department of Ophthalmology, University of Münster, Münster, 5Ophthalmology Practice, Leipzig, Germany; 6Allergan Holdings Ltd., Marlow, UK; 7Ophthalmology Practice, Polch, Germany Background: Intraocular pressure (IOP-lowering medications for primary open-angle glaucoma and ocular hypertension commonly contain preservatives that can cause ocular surface damage in many patients. The purpose of this study was to evaluate the efficacy and tolerability of, and compliance to, preservative-free (PF bimatoprost 0.03% in patients with primary open-angle glaucoma or ocular hypertension (IOP ≥18 mmHg in a clinical practice setting. Methods: This open-label study observed patients who were switched to PF bimatoprost 0.03% for medical reasons. IOP was measured at baseline and ~12 weeks later at the final visit, and the change in IOP was calculated. Tolerability and continuation of therapy were assessed at two follow-up visits. Results: A total of 1,830 patients were included in the study, and complete IOP data were available for 1,543 patients. Mean IOP was reduced by 23% from 21.64 mmHg to 16.59 mmHg (P<0.0001. In subgroup analyses, the mean IOP was significantly reduced compared with baseline, regardless of prior therapy, including those previously treated with PF monotherapy. A total of 85.7% of physicians reported the IOP-lowering efficacy of PF bimatoprost 0.03% to be as expected or better than expected. Adverse events (AEs were experienced by 5.7% of patients, and there were no serious AEs reported. The most common AEs were eye irritation (1.7% and hyperemia (1.4%. Physician-reported treatment compliance was reported as better than (48.7% or equal to (43.6% prior treatment in

  6. A randomized control trial to evaluate the effect of adjuvant selective laser trabeculoplasty versus medication alone in primary open-angle glaucoma: preliminary results

    Directory of Open Access Journals (Sweden)

    Lee JWY

    2014-09-01

    Full Text Available Jacky WY Lee,1,2 Catherine WS Chan,2 Mandy OM Wong,3 Jonathan CH Chan,3 Qing Li,2 Jimmy SM Lai2 1The Department of Ophthalmology, Caritas Medical Centre, 2The Department of Ophthalmology, The University of Hong Kong, 3The Department of Ophthalmology, Queen Mary Hospital, Hong Kong Background: The objective of this study was to investigate the effects of adjuvant selective laser trabeculoplasty (SLT versus medication alone on intraocular pressure (IOP control, medication use, and quality of life in patients with primary open-angle glaucoma.Methods: This prospective, randomized control study recruited 41 consecutive primary open-angle glaucoma subjects with medically-controlled IOP ≤21 mmHg. The SLT group (n=22 received a single 360-degree SLT treatment. The medication-only group (n=19 continued with their usual treatment regimen. In both groups, medication was titrated to maintain a target IOP defined as a 25% reduction from baseline IOP without medication, or <18 mmHg, whichever was lower. Outcomes, which were measured at baseline and at 6 months, included the Glaucoma Quality of Life-15 (GQL-15 and Comparison of Ophthalmic Medications for Tolerability (COMTOL survey scores, IOP, and the number of antiglaucoma medicines. Results: The baseline IOP was 15.8±2.7 mmHg and 14.5±2.5 mmHg in the SLT and medication-only groups, respectively (P=0.04. Both groups had a comparable number of baseline medication (P=0.2, GQL-15 (P=0.3 and COMTOL scores (P=0.7. At 6 months, the SLT group had a lower IOP (P=0.03 and required fewer medications compared with both baseline (P<0.0001 and with the medication-only group (P=0.02. There was no statistically significant difference in the 6-month GQL-15 or COMTOL score as compared to baseline (P≥0.4 or between the two treatment groups (P≥0.2.Conclusion: A single session of adjuvant SLT provided further reductions in IOP and medication without substantial changes in quality of life or medication tolerability at 6

  7. Mechanism Research on the Primary Open-angle Glaucoma%原发性开角型青光眼发病机制的研究

    Institute of Scientific and Technical Information of China (English)

    张永梅; 于蒙; 莫日根

    2016-01-01

    青光眼是现今主要的致盲疾病之一,是一组以特征性视神经损害和视野缺损为共同特征的疾病.原发性开角型青光眼是青光眼的重要类型,发病机制尚未阐明,其临床特点是起病隐匿,多数患者眼内压升高,特征性视盘改变,进行性视神经损害,最终导致不可逆的视野缺损乃至失明.青光眼造成的视功能损伤是不可逆的,后果极为严重.在长期的医学实践中,人们发现很多青光眼有明显的遗传倾向.但是,遗传因素并不能完全解释原发性开角型青光眼的发病,同时还伴随着很多危险因素.本文对原发性开角型青光眼的危险因素和致病基因进行了概述.%Primary open-angle glaucoma (POAG) is a kind of irreversible blindness with the feature of optic nerve damage and visual field defect.POAG is an important type of glaucoma,and the mechanism is unknown.The clincial characteristic of POAG are high intraocular pressure,a characteristic change of the optic disc,and progressive optic nerve damage.The results were irreversible visual field defects and even blindness.Visual function damage of glaucoma is irreversible and had serious consequences.People find that glaucoma was significant genetic predisposition in long time medical practices.However,genetic factors do not explain the pathogenesis of primary open-angle glaucoma completely,and by a lot of risk factors were accompanied with POAG.The risk factors and disease genes of POAG are summarized.

  8. Visual functional changes during acute elevation of intraocular pressure

    Institute of Scientific and Technical Information of China (English)

    Tian-De SHOU

    2006-01-01

    Glaucoma is closely related to elevation of intraocular pressure (IOP). Many studies have done on the effect of chronic elevation of IOP on the retina and optic nerve, but less attention was paid to the effect of acute elevated IOP. Here we briefly review experimental studies on functional changes of the visual system from the retina to the visual cortex under acute elevated IOP condition, which is similar to that of acute primary angle-closure glaucoma.

  9. Fixed combination of travoprost and timolol maleate reduces intraocular pressure in Japanese patients with primary open-angle glaucoma or ocular hypertension: analysis by prostaglandin analogue

    Science.gov (United States)

    Nakano, Tadashi; Mizoue, Shiro; Fuse, Nobuo; Iwase, Aiko; Matsumoto, Shun; Yoshikawa, Keiji

    2017-01-01

    Background We have shown a decrease in mean intraocular pressure (IOP) by switching to travoprost/timolol fixed combination (TTFC) in subjects receiving prostaglandin analogue (PGA) monotherapy and requiring additional medication in a previous report. For analyzing factors affecting IOP reduction, baseline IOP and preceding PGA were selected as statistically and clinically significant factors. In this report, we examine IOP-lowering effect and adverse drug reactions by preceding PGA. Methods Patients with primary open angle glaucoma or ocular hypertension who received monotherapy with one of four PGAs (travoprost, latanoprost, tafluprost, or bimatoprost) for at least 3 months at 26 institutions and were determined to require additional medication by their primary physician were included. IOP reduction and adverse events were examined at 4, 8, and 12 weeks for each of four PGAs after switching to TTFC. Results In total, 157 patients who could be followed up for at least 4 weeks after switching to TTFC were included in the efficacy analysis. Multiple regression analysis was performed, and baseline IOP and PGA were found to be significant factors to IOP reduction. IOP reduction at week 12, adjusted with the regression model, was −3.5, −1.8, and −1.4 mmHg in the tafluprost, latanoprost, and travoprost groups, whereas it was −0.5 mmHg in the bimatoprost group. Along with differences in baseline IOP between groups, an IOP-lowering effect of >1 mmHg was noted in the tafluprost, latanoprost, and travoprost groups after the switch. IOP was maintained at 13.8–14.8 mmHg throughout the follow-up period. No serious adverse events or noteworthy issues were observed in any group after the switch. Conclusion Clinically significant IOP-reducing effects of TTFC were observed in the latanoprost, travoprost, and tafluprost groups when switching from each PGA monotherapy, while there were some differences in effects between groups, with minimal safety concerns. PMID:28053501

  10. Mapping of the disease locus and identification of ADAMTS10 as a candidate gene in a canine model of primary open angle glaucoma.

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    John Kuchtey

    2011-02-01

    Full Text Available Primary open angle glaucoma (POAG is a leading cause of blindness worldwide, with elevated intraocular pressure as an important risk factor. Increased resistance to outflow of aqueous humor through the trabecular meshwork causes elevated intraocular pressure, but the specific mechanisms are unknown. In this study, we used genome-wide SNP arrays to map the disease gene in a colony of Beagle dogs with inherited POAG to within a single 4 Mb locus on canine chromosome 20. The Beagle POAG locus is syntenic to a previously mapped human quantitative trait locus for intraocular pressure on human chromosome 19. Sequence capture and next-generation sequencing of the entire canine POAG locus revealed a total of 2,692 SNPs segregating with disease. Of the disease-segregating SNPs, 54 were within exons, 8 of which result in amino acid substitutions. The strongest candidate variant causes a glycine to arginine substitution in a highly conserved region of the metalloproteinase ADAMTS10. Western blotting revealed ADAMTS10 protein is preferentially expressed in the trabecular meshwork, supporting an effect of the variant specific to aqueous humor outflow. The Gly661Arg variant in ADAMTS10 found in the POAG Beagles suggests that altered processing of extracellular matrix and/or defects in microfibril structure or function may be involved in raising intraocular pressure, offering specific biochemical targets for future research and treatment strategies.

  11. Exome Sequencing Identifies a Missense Variant in EFEMP1 Co-Segregating in a Family with Autosomal Dominant Primary Open-Angle Glaucoma.

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    Donna S Mackay

    Full Text Available Primary open-angle glaucoma (POAG is a clinically important and genetically heterogeneous cause of progressive vision loss as a result of retinal ganglion cell death. Here we have utilized trio-based, whole-exome sequencing to identify the genetic defect underlying an autosomal dominant form of adult-onset POAG segregating in an African-American family. Exome sequencing identified a novel missense variant (c.418C>T, p.Arg140Trp in exon-5 of the gene coding for epidermal growth factor (EGF containing fibulin-like extracellular matrix protein 1 (EFEMP1 that co-segregated with disease in the family. Linkage and haplotype analyses with microsatellite markers indicated that the disease interval overlapped a known POAG locus (GLC1H on chromosome 2p. The p.Arg140Trp substitution was predicted in silico to have damaging effects on protein function and transient expression studies in cultured cells revealed that the Trp140-mutant protein exhibited increased intracellular accumulation compared with wild-type EFEMP1. In situ hybridization of the mouse eye with oligonucleotide probes detected the highest levels of EFEMP1 transcripts in the ciliary body, cornea, inner nuclear layer of the retina, and the optic nerve head. The recent finding that a common variant near EFEMP1 was associated with optic nerve-head morphology supports the possibility that the EFEMP1 variant identified in this POAG family may be pathogenic.

  12. Structural and functional brain changes in early- and mid-stage primary open-angle glaucoma using voxel-based morphometry and functional magnetic resonance imaging.

    Science.gov (United States)

    Jiang, Ming-Ming; Zhou, Qing; Liu, Xiao-Yong; Shi, Chang-Zheng; Chen, Jian; Huang, Xiang-He

    2017-03-01

    To investigate structural and functional brain changes in patients with primary open-angle glaucoma (POAG) by using voxel-based morphometry based on diffeomorphic anatomical registration through exponentiated Lie algebra (VBM-DARTEL) and blood oxygenation level dependent functional magnetic resonance imaging (BOLD-fMRI), respectively.Thirteen patients diagnosed with POAG and 13 age- and sex-matched healthy controls were enrolled in the study. For each participant, high-resolution structural brain imaging and blood flow imaging were acquired on a 3.0-Tesla magnetic resonance imaging (MRI) scanner. Structural and functional changes between the POAG and control groups were analyzed. An analysis was carried out to identify correlations between structural and functional changes acquired in the previous analysis and the retinal nerve fiber layer (RNFL).Patients in the POAG group showed a significant (P superior frontal gyrus, left inferior parietal lobule, left cuneus, and left midcingulate area; many of these regions had high correlations with the RNFL.Patients with POAG undergo widespread and complex changes in cortical brain structure and blood flow. (ClinicalTrials.gov number: NCT02570867).

  13. Association of glutathione S-transferase polymorphisms (GSTM1 and GSTT1) with primary open-angle glaucoma: an evidence-based meta-analysis.

    Science.gov (United States)

    Huang, Wenbin; Wang, Wei; Zhou, Minwen; Chen, Shida; Zhang, Xiulan

    2013-09-10

    Studies investigating the associations between glutathione S-transferase (GST) genetic polymorphisms and primary open-angle glaucoma (POAG) have reported controversial results. Therefore, a meta-analysis was performed to clarify the effects of GSTM1 and GSTT1 polymorphisms on POAG risk. Published literatures from PubMed, EMBASE, ISI Web of Science and CBM databases were retrieved. All studies evaluating the association between GSTM1/GSTT1 polymorphisms and POAG were included. Pooled odds ratio (OR) and 95% confidence interval (CI) were calculated using fixed- or random-effects model. Eleven studies on GSTM1 (1339 cases and 1412 controls) and seven studies on GSTT1 (958 cases, 1003 controls) were included. Overall analysis showed that the association between GSTM1 and GSTT1 null genotype and POAG risk is not statistically significant. Subgroup analyses showed that the null genotype of GSTM1 increased the risk of POAG in Asians. In GSTM1-GSTT1 interaction analysis, individuals with dual null genotype were associated with a significantly increased risk of POAG when compared with the dual present genotype. In conclusion, the present meta-analysis suggested that GSTM1 null genotypes are associated with increased POAG risk in Asian populations but not in Caucasian and mixed populations. Dual null genotype of GSTM1/GSTT1 is associated with increased risk of POAG. Given the limited sample size, the finding on GST polymorphisms needs further investigation.

  14. Role of the APOE ε2/ε3/ε4 polymorphism in the development of primary open-angle glaucoma: evidence from a comprehensive meta-analysis.

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    Qinglu Song

    Full Text Available Primary open-angle glaucoma (POAG is one of the leading causes of blindness worldwide. The association between the APOE ε2/ε3/ε4 polymorphism and the risk of POAG has been widely reported, but the results of previous studies remain controversial. To comprehensively evaluate the APOE ε2/ε3/ε4 polymorphism on the genetic risk for POAG, we performed a systematic review and meta-analysis of previously published studies. The PubMed and Web of Science databases were systematically searched to identify relevant studies. Data were extracted from these studies and odds ratios with corresponding 95% confidence intervals were computed to estimate the strength of the association. Stratified analyses according to ethnicity and sensitivity analyses were also conducted for further confirmation. A total of nine studies were eligible for the meta-analysis, and these studies included data on 1928 POAG cases and 1793 unrelated match controls. The combined results showed that there were no associations between the APOE ε2/ε3/ε4 polymorphism and POAG risk in any of the 10 comparison models. The analysis that was stratified by ethnicity subgroups also failed to reveal a significant association. The sensitivity analysis confirmed the stability and reliability of the findings. There was no risk of publication bias. Our meta-analysis provides strong evidence that the APOE ε2/ε3/ε4 polymorphism is not associated with POAG susceptibility in any populations.

  15. Association between the p53 codon 72 polymorphism and primary open-angle glaucoma risk: Meta-analysis based on 11 case–control studies

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    Mohsen Gohari

    2016-01-01

    Full Text Available The TP53 is important in functions of cell cycle control, apoptosis, and maintenance of DNA integrity. Studies on the association between p53 codon 72 polymorphism and primary open-angle glaucoma (POAG risk have yielded conflicting results. Published literature from PubMed and Web of Science databases was retrieved. All studies evaluating the association between p53 codon 72 polymorphisms and POAG were included. Pooled odds ratio (OR and 95% confidence interval (CI were calculated. Eleven separate studies including 2541 cases and 1844 controls were pooled in the meta-analysis. We did not detect a significant association between POAG risk and p53 codon 72 polymorphism overall population except allele genetic model (C vs. G: OR = 0.961, 95% CI = 0.961–0.820, P = 0.622. In the stratified analysis for Asians and Caucasians, there was an association between p53 codon 72 polymorphism and POAG. In the dominant model in the overall population and by ethnicity subgroups, the highest elevated POAG risk was presented. In summary, these results indicate that p53 codon 72 polymorphism is likely an important genetic factor contributing to susceptibility of POAG. However, more case–controls studies based on larger sample size and stratified by ethnicity are suggested to further clarify the relationship between p53 codon 72 polymorphism and POAG.

  16. A Study of CYP1B1 Gene Prevalent Mutations in Patients With Primary Open-Angle Glaucoma in Sistan and Baluchestan Province, Iran

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    Narooie-Nejad

    2016-03-01

    Full Text Available Background Glaucoma is the second leading cause of blindness worldwide, and it is associated with increased intraocular pressure and visual field loss. The most common type of glaucoma, primary open-angle glaucoma (POAG, involves progressive optic nerve damage and the death of ganglion cells in adults. Despite the unknown etiology, genetic predisposition plays a significant role in the development of the disease. Objectives In order to identify the genetic basis of POAG in Zahedan, Iran, three common mutations of the CYP1B1 gene (G61E, R390H, and R469W were evaluated in this study. Patients and Methods Forty patients with POAG were recruited from the ophthalmic divisions of Alzahra hospital, which is associated with Zahedan University of Medical Sciences. The CYP1B1 prevalent mutations of p.G61E, p.R390H, and p.R469W were identified in DNA extracted from the blood samples of patients using the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP technique. Results We identified no mutations in these patients in the three screened positions. Conclusions To ensure that these genes play no role in the disease, evaluation of the non-coding regions of both the CYP1B1 and MYOC genes is strongly recommended, since other genes are involved in the pathogenesis of glaucoma.

  17. Ultra-high resolution profiles of macular intra-retinal layer thicknesses and associations with visual field defects in primary open angle glaucoma

    Science.gov (United States)

    Chen, Qi; Huang, Shenghai; Ma, Qingkai; Lin, Huiling; Pan, Mengmeng; Liu, Xinting; Lu, Fan; Shen, Meixiao

    2017-01-01

    The structural characteristics of the outer retinal layers in primary open angle glaucoma (POAG) are still controversial, and these changes, along with those in the inner retinal layers, could have clinical and/or pathophysiological significance. A custom-built ultra-high resolution optical coherence tomography (UHR-OCT) combined with an automated segmentation algorithm can image and measure the eight intra-retinal layers. The purpose of this study is to determine the thickness characteristics of the macular intra-retinal layers, especially the outer layers, in POAG patients. Thirty-four POAG patients (56 eyes) and 33 normal subjects (63 eyes) were enrolled. Thickness profiles of the eight intra-retinal layers along a 6-mm length centred on the fovea at the horizontal and vertical meridians were obtained and the regional thicknesses were compared between two groups. The associations between the thicknesses of each intra-retinal layer and the macular visual field (VF) sensitivity were then analysed. POAG affected not only the inner retinal layers but also the photoreceptor layers and retinal pigment epithelium of the outer retina. However, the VF loss was correlated mainly with the damage of the inner retinal layers. UHR-OCT with automated algorithm is a useful tool in detecting microstructural changes of macula with respect to the progression of glaucoma. PMID:28169283

  18. The use of primary stenting or balloon percutaneous transluminal coronary angioplasty for the treatment of acutely occluded saphenous vein grafts. Results from the Brazilian National Registry - CENIC

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    Luiz Alberto Mattos

    2001-06-01

    Full Text Available OBJECTIVE: We conducted a comparative analysis of the in-hospital outcomes of patients who underwent primary percutaneous transluminal angioplasty (PTCA or stent implantation because of an acute myocardial infarction (AMI related to an acute vein graft occlusion. METHODS: Since 1991 the Brazilian Society of Hemodynamic and Interventional Cardiology has maintained a large database (CENIC. From these, we selected all consecutive patients, who underwent primary PTCA or stenting in the first 24 hours of AMI, with the target vessel being an occluded vein graft. Immediate results and major coronary events occurring up until hospital discharge were analyzed. RESULTS: During this period, 5,932 patients underwent primary PTCA or stenting; 158 (3% of the procedures were performed because of an acute vein graft occlusion. Stenting was performed in 74 (47% patients. Patients treated with stents had a higher success rate and lower mean residual stenosis compared with those who underwent primary balloon PTCA. The incidence of reinfarction and death were similar for stenting and balloon PTCA. CONCLUSION: Primary percutaneous treatment of AMI related to acute vein graft occlusion is still an uncommon practice. Primary stenting improved luminal diameter and offered higher rates of success; however, this strategy did not reduce the in-hospital reinfarction and death rate, compared with that occurring with PTCA treatment.

  19. Miopia aguda e glaucoma de ângulo fechado associados ao uso de topiramato em paciente jovem: relato de caso Acute myopia and angle closure glaucoma associated with topiramate use in a young patient: case report

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    Mariana Neves Brandão

    2009-02-01

    Full Text Available O glaucoma agudo de ângulo fechado pode ser secundário, dentre outras causas, ao uso de medicações sistêmicas, como o anticonvulsivante topiramato. Esse trabalho descreve o caso de uma paciente jovem com quadro agudo bilateral de miopia e glaucoma de ângulo fechado induzidos por terapia com topiramato para prevenção de crises de enxaqueca, fazendo relação com casos semelhantes descritos na literatura e revisão bibliográfica referentes à entidade.Acute angle-closure glaucoma may be induced, among other causes, by therapy with systemic drugs, such as the anticonvulsant topiramate. This paper reports the case of an young patient with acute myopia and angle-closure glaucoma associated with migraine prevention with topiramate. We make a link with similar cases described in medical journals and in a bibliographic review related to this entity.

  20. Ultrasound biomicroscopy measurement of primary angle-closure glaucoma%原发性闭角型青光眼的超声生物测量研究

    Institute of Scientific and Technical Information of China (English)

    宋金鑫; 孙乃学

    2013-01-01

    目的 应用A型眼科超声和超声生物显微镜(ultrasound biomicroscope,UBM)研究原发性闭角型青光眼(primary angle-closure glaucoma,PACG)不同瞳孔直径下眼前节和后房结构的解剖特征.方法 正常对照组24例(48眼)及PACG组24例(48眼)按照检查时瞳孔直径(d)分为以下3组:d <2.5 mm组,2.5 mm≤d≤4.0 mm组,d>4.0 mm组,进行眼轴测量和UBM检查.眼轴长度采用STORZ-A型眼科超声诊断仪测量,眼前节各项参数采用Zeiss-Humphrey-840型UBM检查.结果 PACG眼较正常眼前房浅,眼轴短,小梁网虹膜夹角变小,房角开放距离缩短,睫状突高度减小,巩膜外侧面与虹膜长轴的夹角、与睫状突夹角减小.PACG眼的角膜厚度较正常眼增厚,分别为(584.208±78.210) μm、(577.583±39.681)μm,但差异无统计学意义(P>0.05).反映瞳孔阻滞的参数虹膜晶状体接触距离差异无统计学意义(P>0.05).PACG眼与具有正常瞳孔直径的眼相比,瞳孔直径越大,小梁网虹膜夹角越小,根部虹膜越厚,虹膜晶状体接触距离越小,而正常眼的根部虹膜厚度、小梁网虹膜夹角、虹膜晶状体接触距离与瞳孔直径无相关性.结论 PACG眼与正常眼解剖结构在任何瞳孔直径下均不同.PACG眼随瞳孔直径增大,眼前节更为拥挤,睫状体旋前增加房角关闭可能.%Objective To study the characteristics in anatomy of PACG at different pupil diameters by standardized A scan and Ultrasound biomicroscope. Methods Normal group had 24 cases(48 eyes)and PACG group had 24 cases(48 eyes) ,and they were respectively divided into three groups according to the pupil diameter (d 4. 0 mm). The axial length was measured by STORZ-A, and the anterior chamber was checked by Zeiss-Humphrey-840 type UMB. Results Central anterior chamber depth, axial length, trabecular-iris angle, angle-opening distance at 500 μm,trabecular ciliary process distance,iris-ciliary process distance and ciliary process thickness were

  1. Impact of chronic obstructive pulmonary disease on patient with acute myocardial infarction undergoing primary percutaneous coronary intervention

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    Pei-Hsun Sung

    2013-12-01

    Full Text Available Background: This study reported the incidence and prognostic outcome of chronic obstructive lung disease (COPD patients with acute ST-segment elevation myocardial infarction (STEMI undergoing primary percutaneous coronary intervention (PCI. Methods: Between January 2002 and May 2011, totally 1554 consecutive patients who experienced STEMI undergoing primary PCI were enrolled into the study. Results: Of the 1554 patients, 124 (9.7% with diagnosis of COPD and 1430 (90.3% without COPD were categorized into group 1 and group 2. Although no difference in in-hospital mortality was noted between the two groups (p = 0.726. However, the hospitalization duration was notably longer (p = 0.003, the incidences of recurrent MI and re-hospitalization for congestive heart failure were significantly higher in group 1 than in group 2 (all p < 0.02. Although Kaplan-Meier analysis demonstrated that the incidence of freedom from one-year major adverse clinical outcome (MACO (defined as recurrent MI, re-admission for congestive heart failure was significantly lower in group 1 than group 2 (p = 0.012, multivariate Cox regression analysis showed COPD was not an independent predictor of MACO-free time after adjusting traditional risk factors. Conclusion: COPD was not an independent predictor of short-term and medium-term MACO in patients with STEMI undergoing primary PCI.

  2. Multicenter, prospective, open-label, observational study of bimatoprost 0.01% in patients with primary open-angle glaucoma or ocular hypertension

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    Laube T

    2012-05-01

    Full Text Available Stefan Pfennigsdorf,1 Osman Ramez,2 Gerrit von Kistowski,3 Birgit Mäder,4 Peter Eschstruth,5 Michael Froböse,6 Ulrich Thelen,7 Christoph Spraul,8 Dietmar Schnober,9 Hazel Cooper,10 Thomas Laube111Polch Ophthalmology Practice, Polch, 2Buxtehude Ophthalmology Practice, Buxtehude, 3Nürnberg Ophthalmology Practice, Nürnberg, 4Weißwasser Ophthalmology Practice, Weißwasser, 5Ophthalmology Practice, Kiel, 6Ophthalmology Practice, Bielefeld, 7Group Practice, Münster, 8Group Practice, Ulm, 9Ophthalmology Practice, Werdohl, Germany; 10Allergan, Marlow, UK, 11Group Practice, Düsseldorf, GermanyBackground: Bimatoprost 0.01% was developed for improved tolerability over bimatoprost 0.03%, while maintaining efficacy in lowering intraocular pressure (IOP. This multicenter, prospective, open-label, observational study was designed to investigate the efficacy and tolerability of bimatoprost 0.01% in routine clinical practice.Methods: Data were collected from 10,337 patients with primary open-angle glaucoma or ocular hypertension attending 1334 centers in Germany. The primary efficacy outcome was mean change in IOP in each eye from baseline to 10–14 weeks after initiation of bimatoprost 0.01%. Target IOP, prior therapies, additional treatments, and adverse events were also assessed. All treatment decisions were at the physicians’ discretion.Results: Bimatoprost 0.01% significantly lowered mean IOP from baseline by –4.1 mmHg (P < 0.0001 in all patients after a mean of 10.45 weeks. In patients without previous treatment, bimatoprost 0.01% reduced mean IOP from baseline by –6.5 mmHg (P < 0.0001. Bimatoprost 0.01% also significantly reduced IOP in patients previously treated with monotherapy of β-blockers, prostaglandin analogs, carbonic anhydrase inhibitors or bimatoprost 0.03%. No adverse events were reported by 93.9% of patients during treatment with bimatoprost 0.01%; the most commonly reported adverse events were eye irritation (2.0%, ocular

  3. Successful treatment of post-exertion acute myocardial infarction by primary angioplasty and stenting in a patient with antiphospholipid antibody syndrome.

    Science.gov (United States)

    Musuraca, Gerardo; Imperadore, Ferdinando; Terraneo, Clotilde; De Girolamo, Piergiuseppe; Cemin, Claudio; Bonmassari, Roberto; Vergara, Giuseppe

    2004-01-01

    Antiphospholipid syndrome is a disorder characterized by arterial and venous thromboses, thrombocytopaenia and stroke. Acute myocardial infarction is rarely associated with this syndrome. The treatment of these patients is a clinical challenge. This report is about a patient with antiphospholipid syndrome presenting with an acute myocardial infarction after an exercise test. The infarct-related coronary artery was successfully revascularized by primary angioplasty and stenting without any major bleeding complications. We think that the physical exertion could have favoured acute coronary thrombosis in this particular setting.

  4. 前房穿刺治疗急性闭角型青光眼的临床观察%Clinical observation of anterior chamber puncture in the treatment of acute angle closure glaucoma

    Institute of Scientific and Technical Information of China (English)

    陈秀华

    2015-01-01

    Objective:To explore the clinical effect of anterior chamber puncture in the treatment of acute angle closure glaucoma. Methods:30 patients with acute angle closure glaucoma(33 eyes) were selected.They were given anterior chamber puncture treatment.The curative effects of patients were observed.Results:The intraocular pressure and vision of patients after treatment were significantly better than those before treatment(P<0.05).Conclusion:The curative effect of anterior chamber puncture in the treatment acute angle closure glaucoma is significant.%目的:探讨前房穿刺治疗急性闭角型青光眼的临床效果。方法:收治急性闭角型青光眼患者30例(33眼),给予前房穿刺术治疗,观察患者的疗效。结果:治疗后患者眼压和视力明显优于治疗前(P<0.05)。结论:前房穿刺术治疗急性闭角型青光眼疗效显著。

  5. A Fatal Case of Acute Myeloid Leukaemia-Methotrexate Related or Primary Autoimmune Disease Related: A Rare Case Report.

    Science.gov (United States)

    Agarwal, Saurabh; Kaeley, Nidhi; Gupta, Priyanka; Gupta, Vibha; Bhatia, Rohan

    2016-03-01

    Methotrexate is being used for many years in the treatment of chronic medical disorders e.g. rheumatoid arthritis since 1951. It has been associated with various systemic toxicities and complications including bone marrow suppression and lymphomas. The development of leukaemia in a patient of chronic rheumatoid arthritis is either related with the primary disease or due to the drugs which are used in the treatment like cyclophosphamide. In our present case, a 70-year-old female who was a known case of Rheumatoid Arthritis (RA) and was on methotrexate once a week orally for the past 20 years presented with complaints of loss of appetite, loss of weight and anaemia since 2 months. After thorough examination and investigation, she was diagnosed with acute myeloid leukaemia (AML-M4) with bilateral chest consolidation.

  6. Thrombus aspiration during primary percutaneous coronary intervention for acute myocardial infarction:A review of clinical evidence and guidelines

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    Muhammad Muzaffar Mahmood; Jonathan Watt; Javed M Ahmed

    2015-01-01

    Acute ST segment elevation myocardial infarction(STEMI) is characterized by complete thrombotic occlusion of a major coronary artery. Early recanalization of the infarct-related artery is most efficiently delivered by primary percutaneous coronary intervention(PPCI),however this does not always restore normal myocardial perfusion,mainly due to distal embolization of the thrombus and microvascular obstruction. Early evidence for manual thrombus aspiration during PPCI was promising and this was once considered an important aspect of the procedure,especially in patients with a high thrombus burden. However,a large body of evidence from recent major randomized controlled trials(notably TASTE and TOTAL) does not support the routine use of manual thrombus aspiration in patients with STEMI undergoing PPCI.

  7. Biomarkers as point-of-care tests to guide prescription of antibiotics in patients with acute respiratory infections in primary care

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    Aabenhus, Rune; Jensen, Jens Ulrik Stæhr; Jørgensen, Karsten Juhl

    2014-01-01

    BACKGROUND: Acute respiratory infections (ARIs) are by far the most common reason for prescribing an antibiotic in primary care, even though the majority of ARIs are of viral or non-severe bacterial aetiology. Unnecessary antibiotic use will, in many cases, not be beneficial to the patients...... the benefits and harms of point-of-care biomarker tests of infection to guide antibiotic treatment in patients presenting with symptoms of acute respiratory infections in primary care settings regardless of age. SEARCH METHODS: We searched CENTRAL (2013, Issue 12), MEDLINE (1946 to January 2014), EMBASE (2010...

  8. Disturbed spontaneous brain activity pattern in patients with primary angle-closure glaucoma using amplitude of low-frequency fluctuation: a fMRI study

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    Huang X

    2015-07-01

    Full Text Available Xin Huang,1,* Yu-Lin Zhong,1,* Xian-Jun Zeng,2 Fuqing Zhou,2 Xin-Hua Liu,1 Pei-Hong Hu,1 Chong-Gang Pei,1 Yi Shao,1 Xi-Jian Dai21Department of Ophthalmology, 2Department of Radiology, The First Affiliated Hospital of Nanchang University, Nangchang, Jiangxi, People’s Republic of China*These authors contributed equally to this workObjective: The aim of this study is to use amplitude of low-frequency fluctuation (ALFF as a method to explore the local features of spontaneous brain activity in patients with primary angle -closure glaucoma (PACG and ALFFs relationship with the behavioral performances.Methods: A total of twenty one patients with PACG (eight males and 13 females, and twenty one healthy subjects (nine males and twelve females closely matched in age, sex, and education, each underwent a resting-state functional magnetic resonance imaging scan. The ALFF method was used to assess the local features of spontaneous brain activity. The correlation analysis was used to explore the relationships between the observed mean ALFF signal values of the different areas in PACG patients and the thickness of the retinal nerve fiber layer (RNFL. Results: Compared with the healthy subjects, patients with PACG had significant lower ALFF areas in the left precentral gyrus, bilateral middle frontal gyrus, bilateral superior frontal gyrus, right precuneus, and right angular gyrus, and higher areas in the right precentral gyrus. In the PACG group, there were significant negative correlations between the mean ALFF signal value of the right middle frontal gyrus and the left mean RNFL thickness (r=-0.487, P=0.033, and between the mean ALFF signal value of the left middle frontal gyrus and the right mean RNFL thickness (r=-0.504, P=0.020. Conclusion: PACG mainly involved in the dysfunction in the frontal lobe, which may reflect the underlying pathologic mechanism of PACG.Keywords: angle-closure glaucoma, amplitude of low-frequency fluctuation, functional

  9. Acupuncture as a primary and independent treatment in the acute phases of sudden sensorineural hearing loss

    Science.gov (United States)

    Jin, Yuanyuan; Lu, Ming

    2016-01-01

    Abstract Sudden sensorineural hearing loss (SSHL) is an otological emergency defined as a rapid hearing loss, seriously affects patient's social life. To data, no study has reported the treatment by acupuncture alone in the acute phase. In this report, Acupuncture and Moxibustion therapy of excitation-focus transfer is outlined. The patient was a 26-year-old young woman who had an SSHL coupled with ear fullness. The patient had no past medical history, but she had undergone variable emotions and had a history of excessive noise exposure. The patient refused to receive any medicine especially steroids and hyperbaric oxygen therapy. She just only received acupuncture treatment. Her symptoms and outcome measurements were improved every week and completely recovered after the last week. Even though the article presents a single case and is based on self-reports, there are very clear trends on how patients with SSHL responded to acupuncture treatments. PMID:27368045

  10. Role of Pulse Pressure and Geometry of Primary Entry Tear in Acute Type B Dissection Propagation.

    Science.gov (United States)

    Peelukhana, Srikara V; Wang, Yanmin; Berwick, Zachary; Kratzberg, Jarin; Krieger, Joshua; Roeder, Blayne; Cloughs, Rachel E; Hsiao, Albert; Chambers, Sean; Kassab, Ghassan S

    2016-08-10

    The hemodynamic and geometric factors leading to propagation of acute Type B dissections are poorly understood. The objective is to elucidate whether geometric and hemodynamic parameters increase the predilection for aortic dissection propagation. A pulse duplicator set-up was used on porcine aorta with a single entry tear. Mean pressures of 100 and 180 mmHg were used, with pulse pressures ranging from 40 to 200 mmHg. The propagation for varying geometric conditions (%circumference of the entry tear: 15-65%, axial length: 0.5-3.2 cm) were tested for two flap thicknesses (1/3rd and 2/3rd of the thickness of vessel wall, respectively). To assess the effect of pulse and mean pressure on flap dynamics, the %true lumen (TL) cross-sectional area of the entry tear were compared. The % circumference for propagation of thin flap (47 ± 1%) was not significantly different (p = 0.14) from thick flap (44 ± 2%). On the contrary, the axial length of propagation for thin flap (2.57 ± 0.15 cm) was significantly different (p propagation was calculated as 75 ± 9 J/m(2) and was fairly uniform across different specimens. Pulse pressure had a significant effect on the flap movement in contrast to mean pressure. Hence, mitigation of pulse pressure and restriction of flap movement may be beneficial in patients with type B acute dissections.

  11. Prognostic factors for short-term improvement in acute and persistent musculoskeletal pain consulters in primary care

    Directory of Open Access Journals (Sweden)

    Bolton Jennifer E

    2011-11-01

    Full Text Available Abstract Background Given the costs associated with the management of musculoskeletal pain in primary care, predicting the course of these conditions remains a research priority. Much of the research into prognostic indicators however considers musculoskeletal conditions in terms of single pain sites whereas in reality, many patients present with pain in more than one site. The aim of this study was to identify prognostic factors for early improvement in primary care consulters with acute and persistent musculoskeletal conditions across a range of pain sites. Methods Consecutive patients with a new episode of musculoskeletal pain completed self-report questionnaires at baseline, and then again at the 4/5th treatment visit, and if they were still consulting, at the 10th visit. The outcome was defined as patient self-report improvement sufficient to make a meaningful difference. Independent predictors of outcome were identified using multivariate regression analyses. Results Acute (th visit. Several variables at baseline were associated with improvement at the 4/5th visit, but the predictive models were weak and unable to discriminate between patients who were improved and those who were not. In contrast, it was possible to elicit a predictive model for improvement later on at the 10th visit, but only in patients with persistent pain. Being employed, reporting a decline in work fear-avoidance behaviour at the 4/5th visit, and being better by the 4/5th visit, were all independently associated with improvement. This model accounted for 34.3% (p Conclusions We were unable to identify baseline characteristics that predicted early outcome in musculoskeletal pain patients. However, early self-reported improvement and decline in work fear-avoidance behaviour as predictors of later improvement highlighted the importance of speedy recovery in persistent musculoskeletal pain consulters. Our findings reinforce the elusive nature of baseline predictors, and

  12. Sequential regimen of clofarabine, cytosine arabinoside and reduced-intensity conditioned transplantation for primary refractory acute myeloid leukemia

    Science.gov (United States)

    Mohty, Mohamad; Malard, Florent; Blaise, Didier; Milpied, Noel; Socié, Gérard; Huynh, Anne; Reman, Oumédaly; Yakoub-Agha, Ibrahim; Furst, Sabine; Guillaume, Thierry; Tabrizi, Resa; Vigouroux, Stéphane; Peterlin, Pierre; El-Cheikh, Jean; Moreau, Philippe; Labopin, Myriam; Chevallier, Patrice

    2017-01-01

    The prognosis of patients with acute myeloid leukemia in whom primary treatment fails remains very poor. In order to improve such patients’ outcome, we conducted a phase 2, prospective, multicenter trial to test the feasibility of a new sequential regimen, combining a short course of intensive chemotherapy and a reduced intensity-conditioning regimen, before allogeneic stem-cell transplantation. Twenty-four patients (median age, 47 years) with acute myeloid leukemia in primary treatment failure were included. Cytogenetic risk was poor in 15 patients (62%) and intermediate in nine (38%). The sequential regimen consisted of clofarabine (30 mg/m2/day) and cytosine arabinoside (1 g/m2/day) for 5 days, followed, after a 3-day rest, by reduced-intensity conditioning and allogeneic stem-cell transplantation combining cyclophosphamide (60 mg/kg), intravenous busulfan (3.2 mg/kg/day) for 2 days and anti-thymocyte globulin (2.5 mg/kg/day) for 2 days. Patients in complete remission at day +120 received prophylactic donor lymphocyte infusion. Eighteen patients (75%) achieved complete remission. With a median follow-up of 24.6 months, the Kaplan-Meier estimate of overall survival was 54% (95% CI: 33–71) at 1 year and 38% (95% CI: 18–46) at 2 years. The Kaplan-Meier estimate of leukemia-free survival was 46% (95% CI: 26–64) at 1 year and 29% (95% CI: 13–48) at 2 years. The cumulative incidence of non-relapse mortality was 8% (95% CI: 1–24) at 1 year and 12% (95% CI: 3–19) at 2 years. Results from this phase 2 prospective multicenter trial endorsed the safety and efficacy of a clofarabine-based sequential reduced-toxicity conditioning regimen, which warrants further investigation. This study was registered at www.clinicaltrials.gov, identifier number: NCT01188174. PMID:27561720

  13. Coronary collateral circulation:Effects on outcomes of acute anterior myocardial infarction after primary percutaneous coronary intervention

    Institute of Scientific and Technical Information of China (English)

    Bin Wang; Ya-Ling Han; Yi Li; Quan-Min Jing; Shou-Li Wang; Ying-Yan Ma; Geng Wang; Bo Luan; Xiao-Zeng Wang

    2011-01-01

    Background To investigate the effects of collateral coronary circulation on the outcome of the patients with anterior myocardial infarction (NII) with left anterior desending artery occlusion abruptly.Methods Data of 189 patients with acute anterior MI who had a primacy percutaneous coronary intervention (PCI) in the fast 12 h from the onset of symptoms between January 2004 and December 2008 were retrospective analyzed.Left anterior descending arteries (LAD) of all patients were occluded.LADs were reopened with primary PCL According to the collateral circulation,all patients were classified to two groups:no collateral group (n=111),patients without angiographic collateral filling of LAD or side branches (collateral index 0) and collateral group (n=78),and patients with angiographic collateral filling of LAD or side branches (collateral index 1,2 or 3).At one year's follow-up,the occurrence of death,reinfarction,stent thrombosis (ST),target vessel revascularization and readmission because of heart failure were observed.Results At one year,the mortality was lower in patients with collateral circulation compared with those without collateral circulation (1% vs.8%,P=0.049),whereas there were no differences in the occurrence of reinfarction,ST,target vessel revascularization and readmission because of heart failure.The occurrence of composite of endpoint was lower in patients with collateral circulation compared with those without collateral circulation (12% vs.26%; P=0.014).Conclusions Pre-exist collateral circulation may prefigure the satisfactory prognosis to the patients with acute anterior MI after primary PCI in the fast 12 h of MI onset.

  14. Comparison of the diagnostic ability of Moorfield′s regression analysis and glaucoma probability score using Heidelberg retinal tomograph III in eyes with primary open angle glaucoma

    Directory of Open Access Journals (Sweden)

    Jindal Shveta

    2010-01-01

    Full Text Available Purpose: To compare the diagnostic performance of the Heidelberg retinal tomograph (HRT glaucoma probability score (GPS with that of Moorfield′s regression analysis (MRA. Materials and Methods: The study included 50 eyes of normal subjects and 50 eyes of subjects with early-to-moderate primary open angle glaucoma. Images were obtained by using HRT version 3.0. Results: The agreement coefficient (weighted k for the overall MRA and GPS classification was 0.216 (95% CI: 0.119 - 0.315. The sensitivity and specificity were evaluated using the most specific (borderline results included as test negatives and least specific criteria (borderline results included as test positives. The MRA sensitivity and specificity were 30.61 and 98% (most specific and 57.14 and 98% (least specific. The GPS sensitivity and specificity were 81.63 and 73.47% (most specific and 95.92 and 34.69% (least specific. The MRA gave a higher positive likelihood ratio (28.57 vs. 3.08 and the GPS gave a higher negative likelihood ratio (0.25 vs. 0.44.The sensitivity increased with increasing disc size for both MRA and GPS. Conclusions: There was a poor agreement between the overall MRA and GPS classifications. GPS tended to have higher sensitivities, lower specificities, and lower likelihood ratios than the MRA. The disc size should be taken into consideration when interpreting the results of HRT, as both the GPS and MRA showed decreased sensitivity for smaller discs and the GPS showed decreased specificity for larger discs.

  15. Correlation Between Humphrey Visual Field, Optical Coherence Tomography and Heidelberg Retina Tomograph Parameters in Primary Open-Angle Glaucoma, Normal-Tension Glaucoma and Ocular Hypertension

    Directory of Open Access Journals (Sweden)

    Ziya Ayhan

    2011-06-01

    Full Text Available Purpose: To evaluate the correlation of Humphrey visual field (VF parameters (MD and PSD with Heidelberg Retina Tomograph (HRT 3 and Stratus optical coherence tomography (OCT parameters in patients with primary open-angle glaucoma (POAG, normal-tension glaucoma (NTG and ocular hypertension (OHT. Material and Method: Fifty-five eyes of 29 POAG patients, 32 eyes of 16 OHT patients and 26 eyes of 13 NTG patients were enrolled in the study prospectively. Humphrey visual field test as well as optic nerve head and retinal nerve fiber layer (RNFL thickness analysis with HRT 3 and Stratus OCT were performed in all patients; the measurements were repeated every 6 months. Results: The mean age of the patients was 66.4±10.0 years and the mean follow-up time was 22±2.2 months. In POAG and NTG groups, MD and PSD correlated with all analyzed parameters in HRT, except for the height variation contour (HVC. In POAG group, MD and PSD values correlated with all analyzed parameters in OCT, except for the rim area (RA. In NTG group, correlation was found between MD values and all parameters in OCT. In NTG group, PSD correlated with all parameters in OCT, except for the RNFL thickness. In OHT group, no correlation was found between MD, PSD values and HRT parameters. In OHT group, only RA values in OCT correlated with MD and PSD. In all groups, there was no statistically significant difference between the first and last examinations for MD and PSD values and for the mean RNFL thickness measured with OCT and HRT. Discussion: In our study, it was found that in POAG and NTG patients, there was a general correlation of Humphrey VF parameters with HRT 3 and Stratus OCT parameters. (Turk J Ophthalmol 2011; 41: 143-50

  16. Association of single nucleotide polymorphisms in the CYP1B1 gene with the risk of primary open-angle glaucoma: a meta-analysis.

    Science.gov (United States)

    Wang, Z; Li, M; Li, L; Sun, H; Lin, X Y

    2015-12-17

    Mutations in the CYP1B1 gene were detected in primary open-angle glaucoma (POAG) patients. However, the association between these mutations and the incidence of POAG remains to be elucidated. Here, we have conducted a meta-analysis to analyze this correlation, using relevant studies obtained from an extensive search of various electronic databases, including EMBase, Web of Science, and PubMed. The extracted studies were selected for the meta-analysis based on the inclusion and exclusion criteria. The quality of each included study was assessed by the Newcastle-Ottawa scale (NOS), and the I2 value was calculated to evaluate the heterogeneity between studies. The combined effect size was presented as the odds ratio (OR), and confidence intervals (CI) were used to assess the association between POAG and CYP1B1 mutations. Eight studies, each with a high NOS score, were included in the analysis. Compared to the mutant allele, the wild-type allele of the rs180040 polymorphism in POAG patients showed a 12% decrease in OR (OR = 0.88, 95%CI = 0.76- 1.00); also, the wild-type allele of rs1056827 showed a 23% decrease in OR of the incidence of POAG (OR = 0.77, 95%CI = 0.60-0.99). However, the latter result was controversial. Polymorphisms at rs1056836, rs10012, and rs1056837 were not correlated with the incidence of POAG (using any evaluation model). In conclusion, three of the tested SNPs in the CYP1B1 gene were correlated with POAG; however, the SNPs rs180040 and rs1056827 showed an association with risk of POAG. These results must be further validated with larger-scale evaluations.

  17. The progression of the molecular biology of optineurin and primary open angle gloucoma%OPTN基因与POAG的分子生物学研究进展

    Institute of Scientific and Technical Information of China (English)

    刘健楠; 原慧萍

    2016-01-01

    Primary open angle glaucoma (POAG) is a synthetically genetic heterogeneity in neurodegenerative disease, characterized by a gradual loss of vision.The optineurin (OPTN) gene has already been identified as one of the genes that cause POAG.OPTN mutation may result in structural and functional changes of its protein, optineurin.Optineurin has been shown to bind with a number of specific ligands.Optineurin mutation may break the interactions with proteins or make the function of binding complexes abnormal.The location, the structure of the OPTN gene, binding partners and molecular biology functions of optineurin, and the relationship between the mutation of the OPTN gene and POAG are introduced one by one in this review.%原发性开角型青光眼(POAG)是以视野渐进性缺损为特点的遗传异质性的综合性神经退行性疾病.OPTN基因是近年来已被确认的POAG的致病基因,该基因的突变可导致其所表达蛋白Optineurin结构及功能的异常.Optineurin与一些特定蛋白配体偶联后发挥相应的分子生物学功能,当其结构异常时,将导致Optineurin不能与其配体偶联或者偶联后功能异常.本综述主要介绍OPTN基因的结构、定位,其表达蛋白Optineurin的结构,Optineurin与配体偶联后的分子生物学功能,以及OPTN基因突变后与POAG发病的关系等方面的研究进展.

  18. Influence of BAK-Preserved Prostaglandin Analog Treatment on the Ocular Surface Health in Patients with Newly Diagnosed Primary Open-Angle Glaucoma

    Science.gov (United States)

    Tomić, Martina; Kaštelan, Snježana; Metež Soldo, Kata; Salopek-Rabatić, Jasminka

    2013-01-01

    Purpose. Primary open-angle glaucoma (POAG), a chronic, degenerative optic neuropathy, requires persistent decrease of intraocular pressure so as to prevent visual impairment and blindness. However, long-term use of topical ocular medications may affect ocular surface health. Purpose of this study was to evaluate the influence of BAK-preserved prostaglandin analog treatment on the ocular surface health in patients with newly diagnosed POAG. Methods. 40 newly diagnosed POAG patients were included in this prospective study. Intraocular pressure (IOP), tear break-up time (TBUT), and ocular surface disease index (OSDI) were assessed at baseline and 3-month after starting treatment with BAK-preserved travoprost 0.004%. Results. IOP decreased in all patients from baseline to 3-month final visit (23.80 ± 1.73 mmHg versus 16.78 ± 1.27 mmHg; P < 0.001). Mean TBUT decreased from 11.70 ± 1.86 seconds at baseline to 8.30 ± 1.29 seconds at 3-month final visit (<0.001). Mean OSDI score increased from 31.63 ± 18.48 to 44.41 ± 16.48 (P < 0.001). Conclusions. This study showed that BAK-preserved travoprost 0.004% is an effective medication in newly diagnosed POAG patients, but its long-term use may negatively influence ocular surface health by disrupting the tear film stability. Further studies are needed to better understand the clinical effects of different preservative types and concentrations on the ocular surface. PMID:23971041

  19. Influence of BAK-Preserved Prostaglandin Analog Treatment on the Ocular Surface Health in Patients with Newly Diagnosed Primary Open-Angle Glaucoma

    Directory of Open Access Journals (Sweden)

    Martina Tomić

    2013-01-01

    Full Text Available Purpose. Primary open-angle glaucoma (POAG, a chronic, degenerative optic neuropathy, requires persistent decrease of intraocular pressure so as to prevent visual impairment and blindness. However, long-term use of topical ocular medications may affect ocular surface health. Purpose of this study was to evaluate the influence of BAK-preserved prostaglandin analog treatment on the ocular surface health in patients with newly diagnosed POAG. Methods. 40 newly diagnosed POAG patients were included in this prospective study. Intraocular pressure (IOP, tear break-up time (TBUT, and ocular surface disease index (OSDI were assessed at baseline and 3-month after starting treatment with BAK-preserved travoprost 0.004%. Results. IOP decreased in all patients from baseline to 3-month final visit (23.80 ± 1.73 mmHg versus 16.78 ± 1.27 mmHg; P<0.001. Mean TBUT decreased from 11.70±1.86 seconds at baseline to 8.30 ± 1.29 seconds at 3-month final visit (<0.001. Mean OSDI score increased from 31.63 ± 18.48 to 44.41 ± 16.48 (P<0.001. Conclusions. This study showed that BAK-preserved travoprost 0.004% is an effective medication in newly diagnosed POAG patients, but its long-term use may negatively influence ocular surface health by disrupting the tear film stability. Further studies are needed to better understand the clinical effects of different preservative types and concentrations on the ocular surface.

  20. 高度近视与原发性开角型青光眼%Relationship between high myopia and primary open-angle glaucoma

    Institute of Scientific and Technical Information of China (English)

    王平; 姜德咏

    2004-01-01

    目的:从流行病学、临床特征及诊断、遗传学说及机制等方面对高度近视与原发性开角型青光眼的关系及研究进展进行综述.方法:仔细分析了28篇原文,总结出高度近视与原发性开角型青光眼的可能机理.结果:高度近视与原发性开角型青光眼密切相关,其可能的机制有:①升压基因学说.②胶原基因学说.结论:高度近视与原发性开角型青光眼密切相关,根据TIGR基因理论和胶原基因理论,高度近视与原发性开角型青光眼都与TIGR基因突变和胶原疾病有关.%AIM: To review the relationship between high myopia (HM) and primary open angle glaucoma (POAG) from the aspects of epidemiological features, clinic features, diagnosis, as well as genetic and molecular mechanism.METHODS: Twenty-eight original articles related to thisissue were selected. These articles were carefully reviewed to find out the possible mechanism of the relationship between HM and POAG.RESULTS: CONCLUSIONS: HM and POAG are closely related toHM is a genetically-associated disease and isclosely related with POAG. According to the TIGR gene theory and the collagen gene theory, HM and POAG are both associated with the mutations of TIGR and collagenous lesions.each other in that their mechanisms are both related to hypertension gene and collagen gene.

  1. The impact of chronic use of prostaglandin analogues on the biomechanical properties of the cornea in patients with primary open-angle glaucoma

    Science.gov (United States)

    Meda, Roman; Wang, Qianqian; Paoloni, David; Harasymowycz, Paul; Brunette, Isabelle

    2017-01-01

    Aims To determine the influence of prostaglandin analogues (PGAs) on corneal biomechanical properties in patients undergoing chronic treatment for primary open-angle glaucoma (POAG). Methods Prospective, interventional case–control study. 70 eyes from 35 patients with POAG on chronic PGA therapy were recruited. One eye per patient underwent PGA cessation for 6 weeks while the contralateral eye continued to receive the treatment. Corneal hysteresis (CH), corneal resistance factor (CRF), corneal-compensated intraocular pressure (IOP) (IOPcc), central corneal thickness (CCT) and Goldmann tonometry (Haag-Streit AG, Koeniz, Switzerland) IOP (IOPGAT) were measured at baseline (visit 1), 6 weeks after PGA cessation (visit 2) and 6 weeks after PGAs reinitiation (visit 3) and were analysed using a linear mixed-effect model. The discrepancy between IOPcc and IOPGAT was defined as IOP bias (IOPcc—IOPGAT). Results Baseline characteristics were comparable between the two groups. In the study eyes, significant increases (p<0.0001) were detected at visit 2 in CH (9.0±1.8 vs 10.3±1.7 mm Hg), CRF (10.5±2.1 vs 11.7±2.1 mm Hg), CCT (541.8±43.2 vs 551.9±41.9 μm) and IOPGAT (15.4±3.0 vs 18.4±3.8 mm Hg). IOP bias in this group was significantly lowered at visit 2 (p<0.0001). These effects were reversed at visit 3. The control eyes did not demonstrate any significant changes over the study period. Conclusion Topical PGAs induce reversible reduction in CH, CRF and CCT in patients with POAG. These changes contribute to underestimation of the IOP measured by Goldmann applanation tonometry and warrant caution when assessing response to treatment. Trial registration number NCT02388360, Results. PMID:27162226

  2. Comparison of vision-related quality of life in primary open-angle glaucoma and dry-type age-related macular degeneration.

    Science.gov (United States)

    Karadeniz Ugurlu, S; Kocakaya Altundal, A E; Altin Ekin, M

    2017-03-01

    PurposeTo compare quality of life (QoL) in patients with primary open-angle glaucoma (POAG) and dry-type age-related macular degeneration (AMD) with similar best-corrected visual acuity.MethodsAge-, sex-, and visual acuity-matched POAG and dry AMD patients were included in the study. Each patient performed 24-2 and 10-2 SITA standard visual field tests. Contrast sensitivity was evaluated with CSV-1000 HGT instrument. The 25 item National Eye Institute Visual Function Questionnaire (NEI-VFQ-25) was used to analyze QoL. Overall and subscale scores were converted to scores between 0 and 100, the higher scores indicating better vision-related QoL.ResultsOverall NEI-VFQ-25 scores were 86.44 and 84.66 in glaucoma and AMD groups, respectively (P=0.244). The highest scores were obtained in 'vision-related dependency' subgroup in glaucoma and 'color and peripheral vision' in AMD group, whereas the lowest scores were noted 'in peripheral vision' in both glaucoma and AMD patients. Glaucoma patients had significantly lower scores in ocular pain, color vision, and peripheral vision subgroups compared with the AMD group, whereas AMD patients had lower scores in near and distance vision activities, vision-related social activity, and dependency subgroups. Contrast sensitivity results and mean defect values showed correlation with NEI-VFQ-25 scores in both groups.ConclusionsGlaucoma and AMD patients with similar visual acuity experienced similar overall impairment in QoL. However, glaucoma patients described more difficulty with peripheral vision and ocular pain, whereas AMD patients complained more about near and distance vision and dependency items.

  3. Outcomes after primary coronary intervention with drug eluting stent implantation in diabetic patients with acute ST elevation myocardial infarction

    Institute of Scientific and Technical Information of China (English)

    ZHANG Qi; HU Jian; YANG Zhen-kun; ZHENG Ai-fang; ZHANG Xian; SHEN Wei-feng; SHEN Jie; ZHANG Rui-yan; QIU Jian-ping; LU Ji-de; ZHANG Yu; CHEN Yue-hua; ZHANG Jun-feng; ZHANG Jian-sheng

    2007-01-01

    Background Drug-eluting stent (DES) has been used widely for the treatment of patients with acute coronary syndrome with or without diabetes mellitus during percutaneous coronary intervention (PCI), but its long-term safety and efficacy in diabetic patients with acute ST elevation myocardial infarction (STEMI) remain uncertain. This study aimed to investigate the clinical outcomes after primary coronary intervention with DES implantation for diabetic patients with acute STEMI, compared with non-diabetic counterparts.Methods From December 2004 to March 2006, 56 consecutive diabetic patients (diabetic group) and 170 non-diabetic patients (non-diabetic group) with acute STEMI who underwent primary PCI with DES implantation in 3 hospitals were enrolled. Baseline clinical, angiographic, and procedural characteristics, as well as occurrence of major adverse cardiac event (MACE) including cardiac death, non-fatal recurrent myocardial infarction (re-MI) and target vessel revascularization (TVR) during hospitalization and one-year clinical follow-up were compared between the two groups.Results Patients in diabetic group were more hyperlipidemic (69.6% and 51.8%, P=0.03) and had longer time delay from symptom onset to admission ((364±219) minutes and (309±223) minutes,P=0.02) than those in non-diabetic group.The culprit vessel distribution, reference vessel diameter, and baseline TIMI flow grade were similar between the two groups, but multi-vessel disease was more common in diabetic than in non-diabetic group (82.1% and 51.2%, P<0.001).Despite similar TIMI flow grades between the two groups after stenting, the occurrence of TIMI myocardial perfusion grade (TMPG)≥2 was lower in diabetic group (75.0% vs 88.8% in non-diabetic groups, P=0.02). The MACE rate was similar during hospitalization between the two groups (5.4% vs 3.5%, P=0.72), but it was significantly higher in diabetic group (16.1%) during one-year follow-up, as compared with non-diabetic group (6.5%, P=0

  4. VGLUT2-dependent glutamatergic transmission in primary afferents is required for intact nociception in both acute and persistent pain modalities.

    Science.gov (United States)

    Rogoz, Katarzyna; Lagerström, Malin C; Dufour, Sylvie; Kullander, Klas

    2012-07-01

    Glutamate is an essential transmitter in pain pathways. However, its broad usage in the central and peripheral nervous system prevents us from designing efficient glutamate-based pain therapies without causing harmful side effects. The discovery of vesicular glutamate transporters (VGLUT1-3) has been a crucial step in describing specific glutamatergic neuronal subpopulations and glutamate-dependent pain pathways. To assess the role of VGLUT2-mediated glutamatergic contribution to pain transmission from the entire primary sensory population, we crossed our Vglut2(f/f) line with the Ht-Pa-Cre line. Such Vglut2-deficient mice showed significantly decreased, but not completely absent, acute nociceptive responses. The animals were less prone to develop an inflammatory-related state of pain and were, in the partial sciatic nerve ligation chronic pain model, much less hypersensitive to mechanical stimuli and did not develop cold allodynia or heat hyperalgesia. To take advantage of this neuropathic pain-resistant model, we analyzed Vglut2-dependent transcriptional changes in the dorsal spinal cord after nerve injury, which revealed several novel candidate target genes potentially relevant for the development of neuropathic pain therapeutics. Taken together, we conclude that VGLUT2 is a major mediator of nociception in primary afferents, implying that glutamate is the key somatosensory neurotransmitter.

  5. Determinants of initiation, implementation, and discontinuation of amoxicillin by adults with acute cough in primary care

    Science.gov (United States)

    Gillespie, David; Farewell, Daniel; Brookes-Howell, Lucy; Butler, Christopher C; Coenen, Samuel; Francis, Nick A; Little, Paul; Stuart, Beth; Verheij, Theo; Hood, Kerenza

    2017-01-01

    Aim To investigate the determinants of adherence to amoxicillin in patients with acute lower respiratory tract infection. Materials and methods Three European data sets were used. Adherence data were collected using self-reported diaries. Candidate determinants included factors relating to patient, condition, therapy, health care system/provider, and the study in which the patient participated. Logistic and Cox regression models were used to investigate the determinants of initiation, implementation, and discontinuation of amoxicillin. Results Although initiation differed across samples, implementation and discontinuation were similar. Determinants of initiation were days waited before consulting, duration of prescription, and being in a country where a doctor-issued sick certificate is required for being off work for <7 days. Implementation was higher for older participants or those with abnormal auscultation. Implementation was lower for those prescribed longer courses of amoxicillin (≥8 days). Time from initiation to discontinuation was longer for longer prescriptions and shorter for those from countries where single-handed practices were widespread. Conclusion Nonadherence to amoxicillin was largely driven by noninitiation. Differing sets of determinants were found for initiation, implementation, and discontinuation. There is a need to further understand the reasons for these determinants, the impact of poor adherence to antibiotics on outcomes, and to develop interventions to improve antibiotic use when prescribed. PMID:28352162

  6. Right Ventricular Function After Acute Myocardial Infarction Treated With Primary Percutaneous Coronary Intervention (from the Glycometabolic Intervention as Adjunct toPrimary Percutaneous Coronary Intervention in ST-Segment Elevation Myocardial Infarction III Trial)

    NARCIS (Netherlands)

    Gorter, Thomas M; Lexis, Chris P H; Hummel, Yoran M; Lipsic, Erik; Nijveldt, Robin; Willems, Tineke P; van der Horst, Iwan C C; van der Harst, Pim; van Melle, Joost P; van Veldhuisen, Dirk J

    2016-01-01

    Right ventricular (RV) dysfunction is a powerful risk marker after acute myocardial infarction (MI). Primary percutaneous coronary intervention (PCI) has markedly reduced myocardial damage of the left ventricle, but reliable data on RV damage using cardiac magnetic resonance imaging (MRI) are scarce

  7. Short-term effect of latanoprost and timolol eye drops on tear fluid and the ocular surface in patients with primary open-angle glaucoma and ocular hypertension

    DEFF Research Database (Denmark)

    Thygesen, John; Aaen, Kim; Theodorsen, F.;

    2000-01-01

    ophthalmology, open-angle glaucoma, ocular hypertension, glaucoma therapy, latanoprost, timolol, Rose-Bengal test, break-up time, Schirmer-1-test, conjunctival impression cytology......ophthalmology, open-angle glaucoma, ocular hypertension, glaucoma therapy, latanoprost, timolol, Rose-Bengal test, break-up time, Schirmer-1-test, conjunctival impression cytology...

  8. The Semiotic and Conceptual Genesis of Angle

    Science.gov (United States)

    Tanguay, Denis; Venant, Fabienne

    2016-01-01

    In the present study, we try to understand how students at the end of primary school conceive of angle: Is an angle a magnitude for them or a geometric figure, and how do they manage to coordinate the two aspects in their understanding of the concepts of angle and of angle measurement? With the aim of better grasping the way "angle" is…

  9. Implications of myocardial reperfusion on survival in women versus men with acute myocardial infarction undergoing primary coronary intervention.

    Science.gov (United States)

    Meller, Stephanie M; Lansky, Alexandra J; Costa, Ricardo A; Soffler, Morgan; Costantini, Costantino O; Brodie, Bruce R; Cox, David A; Stuckey, Thomas D; Fahy, Martin; Grines, Cindy L; Stone, Gregg W

    2013-10-15

    We evaluated the effects of myocardial perfusion after primary percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI) on gender-based mortality rates. Research has demonstrated a gender-specific response of cardiomyocytes to ischemia and a potential increase in myocardial salvage in women compared with men. Myocardial blush grade (MBG), an angiographic surrogate of myocardial perfusion, is an independent predictor of early and late survival after AMI. Whether the incidence and prognosis of myocardial perfusion differs according to gender among patients with AMI undergoing PCI is unknown. MBG and short- and long-term mortality were evaluated in 1,301 patients (male = 935; female = 366) with AMI randomized to primary angioplasty ± abciximab versus stent ± abciximab. Following PCI, >96% of patients achieved final Thrombolysis In Myocardial Infarction 3 flow, of which MBG 2/3 was present in 58.3% of women versus 51.1% of men (p = 0.02). Worse MBG was an independent predictor of mortality in women at 30 days (7.4% for MBG 0/1 vs 2.4% for MBG 2/3, p = 0.04) and at 1-year (11.0% for MBG 0/1 vs 3.4% for MBG 2/3, p = 0.01); however, MBG was not associated with differences in mortality for men. In conclusion, impaired myocardial perfusion following PCI for AMI, indicated by worse MBG, is an independent predictor of early and late mortality in women but not in men. These findings imply an enhanced survival benefit from restoring myocardial perfusion for women compared with men during primary angioplasty and may have clinical implications for interventional strategies in women.

  10. Mesenchymal Stem Cells Support Survival and Proliferation of Primary Human Acute Myeloid Leukemia Cells through Heterogeneous Molecular Mechanisms

    Science.gov (United States)

    Brenner, Annette K.; Nepstad, Ina; Bruserud, Øystein

    2017-01-01

    Acute myeloid leukemia (AML) is a bone marrow malignancy, and various bone marrow stromal cells seem to support leukemogenesis, including osteoblasts and endothelial cells. We have investigated how normal bone marrow mesenchymal stem cells (MSCs) support the in vitro proliferation of primary human AML cells. Both MSCs and primary AML cells show constitutive release of several soluble mediators, and the mediator repertoires of the two cell types are partly overlapping. The two cell populations were cocultured on transwell plates, and MSC effects on AML cells mediated through the local cytokine/soluble mediator network could thus be evaluated. The presence of normal MSCs had an antiapoptotic and growth-enhancing effect on primary human AML cells when investigating a group of 51 unselected AML patients; this was associated with increased phosphorylation of mTOR and its downstream targets, and the effect was independent of cytogenetic or molecular-genetic abnormalities. The MSCs also supported the long-term proliferation of the AML cells. A subset of the patients also showed an altered cytokine network with supra-additive levels for several cytokines. The presence of cytokine-neutralizing antibodies or receptor inhibitors demonstrated that AML cells derived from different patients were heterogeneous with regard to effects of various cytokines on AML cell proliferation or regulation of apoptosis. We conclude that even though the effects of single cytokines derived from bone marrow MSCs on human AML cells differ among patients, the final cytokine-mediated effects of the MSCs during coculture is growth enhancement and inhibition of apoptosis.

  11. Acute Gastroenteritis and Campylobacteriosis in Swiss Primary Care: The Viewpoint of General Practitioners

    Science.gov (United States)

    Bless, Philipp J.; Muela Ribera, Joan; Schmutz, Claudia; Zeller, Andreas; Mäusezahl, Daniel

    2016-01-01

    Acute gastroenteritis (AG) is frequently caused by infectious intestinal diseases (IID) including food- and waterborne pathogens of public health importance. Among these pathogens, Campylobacter spp. plays a major role. Many European countries monitor selected IIDs within disease surveillance systems. In Switzerland, the information on IIDs is restricted to limited surveillance data, while no data is available for AG. We conducted a qualitative study among Swiss general practitioners (GPs) to investigate the case management of AG and campylobacteriosis patients, the associated disease burden and the determinants leading to registration in the National Notification System for Infectious Diseases (NNSID). Interviews were conducted with a semi-structured questionnaire and underwent inductive content analysis based on Grounded Theory. The questionnaire was repeatedly adapted to capture emerging themes until the point of theoretical saturation. GPs perceived AG and campylobacteriosis of little relevance to their daily work and public health in general. According to GP self-estimates each consults about two cases of AG per week and diagnoses a median of five campylobacteriosis cases per year. A large proportion of AG cases receives telephone consultations only and gets medical advice from the practice nurse. Antibiotic therapy is considered useful and stool diagnostics are performed for about a fifth of consulting AG patients. Stool diagnostics (“test”) and antibiotic therapy (“treat”) are interrelated and follow four strategies: “Wait & See”, “Treat & See”, “Treat & Test”, and “Test & See”. AG case management is diverse and includes different triage steps. A small proportion of AG patients have stool diagnostics performed and only positive tested patients are reported to the NNSID. As a result severe cases and cases with a history of travel abroad are overrepresented in the NNSID. The use of multiplex PCR panels in routine diagnostics likely

  12. Targeting FLT3 in primary MLL-gene-rearranged infant acute lymphoblastic leukemia.

    Science.gov (United States)

    Stam, Ronald W; den Boer, Monique L; Schneider, Pauline; Nollau, Peter; Horstmann, Martin; Beverloo, H Berna; van der Voort, Ella; Valsecchi, Maria G; de Lorenzo, Paola; Sallan, Stephen E; Armstrong, Scott A; Pieters, Rob

    2005-10-01

    Acute lymphoblastic leukemia (ALL) in infants is characterized by rearrangements of the mixed lineage leukemia (MLL) gene, drug resistance, and a poor treatment outcome. Therefore, novel therapeutic strategies are needed to improve prognosis. Recently, we showed that FLT3 is highly expressed in MLL rearranged ALL (MLL). Here we demonstrate FLT3 expression in infants with MLL (n = 41) to be significantly higher compared to both infant (n = 8; P < .001) and noninfant patients with ALL (n = 23; P = .001) carrying germline MLL genes. Furthermore, leukemic cells from infants with MLL were significantly more sensitive to the Fms-like tyrosine kinase 3 (FLT3) inhibitor PKC412 (N-benzoyl staurosporine) than noninfant ALL cells, and at least as sensitive as internal tandem duplication-positive (ITD+) AML cells. Surprisingly, activation loop mutations only occurred in about 3% (1 of 36) of the cases and no FLT3/ITDs were observed. However, measuring FLT3 phosphorylation in infants with MLL expressing varying levels of wild-type FLT3 revealed that high-level FLT3 expression is associated with ligand-independent FLT3 activation. This suggests that infant MLL cells displaying activated FLT3 as a result of overexpression can be targeted by FLT3 inhibitors such as PKC412. However, at concentrations of PKC412 minimally required to fully inhibit FLT3 phosphorylation, the cytotoxic effects were only fractional. Thus, PKC412-induced apoptosis in infant MLL cells is unlikely to be a consequence of FLT3 inhibition alone but may involve inhibition of multiple other kinases by this drug.

  13. [Bone marrow autotransplantation in patients with acute myeloblastic leukemia in primary remission].

    Science.gov (United States)

    Richard, C; Iriondo, A; Baro, J; Conde, E; Hermosa, V; Alsar, M J; Gómez Casares, M T; Muruzabal, M J; Pérez Encinas, M; Zubizarreta, A

    1990-09-22

    Fifteen bone marrow autotransplants (BMAT) in patients with acute myeloblastic leukemia (AML) were performed after the first remission. The mean age was 37 years (range 12 to 60 years). According to the morphological classification FAB, 8 patients had monocytic leukemia (M4, M5) and 7 myeloid leukemia (M1, M2, M3). The mean interval elapsed between the date of complete remission and the BMAT was 3.9 months (range 1 to 5-9 months). In 8 patients this interval was longer than 6 months and in 7 cases it was shorter than 6 months. After achievement of the complete remission all patients underwent certain cycles of intensification before the BMAT. Eight patients received only a cycle whereas 7 patients received more than one cycle (between 2 and 4). The conditioning protocol consisted of cyclophosphamide (CP) (60 mg/kg x 2) and total body radiotherapy (TBR) (10 Gy) in 9 patients; CP and busulfan in five; and CP, cytarabine at high doses and melphalan in one case. Marrow extraction was performed after completion of chemotherapy of intensification. In 5 cases the bone marrow was depleted of leukemic cells by previous in vitro treatment with ASTA-Z. There are at present 8 alive patients. The survival free of illness was 51.8%. Seven patients died: 3 cases because relapse of the leukemia, 3 due to attachment failure of the transplantation, and one patient suffered a viral myocarditis. The survival free of illness was significantly longer in those patients transplanted after 6 months of the complete remission.

  14. The effects of acute aerobic exercise on the primary motor cortex.

    Science.gov (United States)

    Singh, Amaya M; Staines, W Richard

    2015-01-01

    The effect of aerobic exercise on primary motor cortical excitability is a relevant area of interest for both motor learning and motor rehabilitation. Transient excitability changes that may follow an exercise session are a necessary precursor to more lasting neuroplastic changes. While the number of studies is limited, research suggests that a session of aerobic exercise can create an ideal environment for the early induction of plasticity. Potential mechanisms include the upregulation of neurotransmitter activity, altered cerebral metabolism and cortisol levels, and increases in brain-derived neurotrophic factor. While there is considerable evidence that chronic physical activity positively impacts brain health and function, studies examining cortical excitability changes and motor performance after a single session of exercise are lacking. Further research is required to determine the clinical utility and feasibility of aerobic exercise.

  15. Acute syphilitic chorioretinitis after a missed primary diagnosis: a case report

    Directory of Open Access Journals (Sweden)

    Handtrack Claudia

    2008-02-01

    Full Text Available Abstract Introduction Syphilis is well known as an infectious disease which can present with a large variety of symptoms. Clinical diagnosis can be difficult and may be complicated in modern medicine by immunosuppressive treatment and possible side effects of medication. Case presentation We describe a rare case of placoid chorioretinitis due to Treponema pallidum which developed after the primary symptom of proteinuria was not recognized as a rare manifestation of syphilis. Diagnosis of syphilitic chorioretinitis and/or endophthalmitis was made by broad range amplification of the bacterial 16S ribosomal RNA gene obtained from vitreous after diagnostic vitrectomy. Conclusion This case shows that clinicians should be alert in patients with proteinuria and chorioretinitis as they can represent rare manifestations of syphilis. Syphilis should be in the differential diagnosis of any unknown symptom and in the presumed side effects of medication.

  16. A quantitative analysis of the benefits of pre-hospital infarct angioplasty triage on outcome in patients undergoing primary angioplasty for acute myocardial infarction

    NARCIS (Netherlands)

    van 't Hof, AWJ; van de Wetering, H; Ernst, N; Hollak, F; de Pooter, F; Suryapranata, H; Hoorntje, JCA; Gosselink, M; Zijlstra, F; de Boer, MJ; Dambrink, Jan Hendrik Everwijn

    2005-01-01

    Primary coronary angioplasty has been shown to be a very effective reperfusion modality in patients with acute myocardial infarction (MI). However, the time from diagnosis to therapy is often very long, often due to interhospital transfer of the patient. This study evaluates the effect of improving

  17. Clinical, epidemiological and virological features of dengue virus infections in vietnamese patients presenting to primary care facilities with acute undifferentiated fever

    NARCIS (Netherlands)

    K.T.D. Thai; H.L. Phuong; T.T.T. Nga; P.T. Giao; L.Q. Hung; N.V. Nam; T.Q. Binh; C. Simmons; J. Farrar; T.T. Hien; H.R. van Doorn; M.D. de Jong; P.J. de Vries

    2010-01-01

    Objectives: To explore clinical and virological characteristics and describe the epidemiology of dengue in patients who presented with acute undifferentiated fever (AUF) at primary health centers (PHC) in Binh Thuan Province, Vietnam. Methods: A prospective observational study was conducted from 200

  18. Depression and Anxiety after Acute Myocardial Infarction Treated by Primary PCI

    Science.gov (United States)

    Kala, Petr; Hudakova, Nela; Jurajda, Michal; Kasparek, Tomas; Ustohal, Libor; Parenica, Jiri; Sebo, Marek; Holicka, Maria

    2016-01-01

    Aims The main objective of the study was to find out prevalence of depression and anxiety symptoms in the population of patients with AMI with ST-segment elevation (STEMI), treated with primary PCI (pPCI). Secondary target indicators included the incidence of sleep disorders and loss of interest in sex. Methods and results The project enrolled 79 consecutive patients with the first AMI, aged <80 years (median 61 years, 21.5% of women) with a follow-up period of 12 months. Symptoms of depression or anxiety were measured using the Beck Depression Inventory II tests (BDI-II, cut-off value ≥14) and Self-Rating Anxiety Scale (SAS, cut-off ≥ 45) within 24 hours of pPCI, before the discharge, and in 3, 6 and 12 months). Results with the value p<0.05 were considered as statistically significant. The BDI-II positivity was highest within 24 hours after pPCI (21.5%) with a significant decline prior to the discharge (9.2%), but with a gradual increase in 3, 6 and 12 months (10.4%; 15.4%; 13.8% respectively). The incidence of anxiety showed a relatively similar trend: 8.9% after pPCI, and 4.5%, 10.8% and 6.2% in further follow-up. Conclusions Patients with STEMI treated by primary PCI have relatively low overall prevalence of symptoms of depression and anxiety. A significant decrease in mental stress was observed before discharge from the hospital, but in a period of one year after pPCI, prevalence of both symptoms was gradually increasing, which should be given medical attention. PMID:27074002

  19. The Role of Endoscopic Ultrasound in Primary Pancreatic Lymphoma Presented with Acute Pancreatitis: A Case Report

    Directory of Open Access Journals (Sweden)

    Seyed Hassan Abedi

    2014-09-01

    Full Text Available Context Primary pancreatic lymphoma (PPL is rare but manageable malignant tumor of the pancreas which may be confused with pancreatic adenocarcinoma. Case report We report a 38 year-old smoker man with IVDA and history of B (inactive carrier, C (Ia genotype hepatitis and negative for HIV admitted to our hospital because of nausea, vomiting, epigastric and RUQ pain as a result of long period of alcohol consumption. Due to high amount of amylase (480 U/L and lipase (326 U/L Pancreatitis was diagnosed. Four days after admission CT was done that showed enhancement a large tumor of the head of the pancreas. Endoscopic ultrasound (EU revealed diffusely enlarged of pancreas. There was a mixed echoic mass lesion 37-50 mm at the head of pancreas (R/O walled off necrosis with adhesion to portal vein and SMV. On the other hand the CBD was 9 mm. Abdominal MRI and MRCP for patient was done. The intra-hepatic bile ducts, main hepatic ducts, CHD and CBD were mildly dilated and displaced to the right side by a large lobulated mass (160×112×130 mm of pancreatic head with low signal intensity on T1W images and high intensity on T2W images. We did EUS-FNA and there was a mixed echoic lesion (38-40mm adhered to head of pancreas with invasion to portal vein, SMA and SMV. The diagnosis of pancreatic lymphoma was established by immunohistochemical study and the assessment of the neoplastic cells revealed B cell lymphoma phenotypes. Conclusion Herein we present an interesting 38 year- old man with pancreas head tumor. Primary pancreatic lymphoma is almost never suspected clinically. It is usually diagnosed by imaging and histological methods.

  20. Comparison of the efficacy and safety of fixed combination travoprost/timolol and dorzolamide/timolol in patients with primary open-angle glaucoma and ocular hypertension

    Directory of Open Access Journals (Sweden)

    Babić Nikola

    2013-01-01

    Full Text Available Introduction. Combining two medications in one bottle may improve compliance by reducing the time required to administer drops and the frequency of the total number of medication bottles. Objective. To compare the efficacy of reduced intraocular pressure (IOP and safety of fixed combination travoprost 0.004%/timolol 0.5% vs. fixed combination dorzolamide 2%/timolol 0.5% in patients with primary open-angle glaucoma or ocular hypertension. Methods. Prospective randomized clinical study included 60 patients divided into 2 groups. Follow-up was done at day 14 and 45 and month 3. IOP measurements were taken at each follow-up examination at 8 am, 10 am and 4 pm. Results. Both fixed combinations reduced IOP significantly compared to initial values at all follow-ups (p<0.001. Mean pooled IOP at all visits and time points was slightly lower in the travoprost/timolol group compared with the dorzolamide/timolol group (16.13 mmHg vs. 16.15 mmHg. Mean IOP reduction from baseline ranged from -7.46 mmHg to -9.92 mmHg in the travoprost/timolol group and from -6.93 mmHg to -8.93 mmHg for the dorzolamide/timolol group. Mean (±standard error of the mean reduction in diurnal IOP from baseline to 3rd month was 8.96±2.79 in the travoprost/timolol group versus 8.07±2.91 in patients receiving dorzolamide/timolol fixed combination (p=0.196. The most frequent treatment-related adverse events were conjunctival hyperemia in the travoprost/timolol group, and dry eye and foreign body sensation in the dorzolamide/timolol group. Conclusion. Travoprost/timolol fixed combination was slightly more effective than dorzolamide/timolol fixed combination in reducing mean diurnal IOP. Travoprost/timolol group resulted in an IOP reduction for up to 1.07 mmHg higher than dorzolamide/timolol group. Both fixed combinations were well tolerated and safe.

  1. Age at natural menopause genetic risk score in relation to age at natural menopause and primary open-angle glaucoma in a US-based sample

    Science.gov (United States)

    Pasquale, Louis R.; Aschard, Hugues; Kang, Jae H.; Bailey, Jessica N. Cooke; Lindström, Sara; Chasman, Daniel I.; Christen, William G.; Allingham, R. Rand; Ashley-Koch, Allison; Lee, Richard K.; Moroi, Sayoko E.; Brilliant, Murray H.; Wollstein, Gadi; Schuman, Joel S.; Fingert, John; Budenz, Donald L.; Realini, Tony; Gaasterland, Terry; Gaasterland, Douglas; Scott, William K.; Singh, Kuldev; Sit, Arthur J.; Igo, Robert P.; Song, Yeunjoo E.; Hark, Lisa; Ritch, Robert; Rhee, Douglas J.; Gulati, Vikas; Havens, Shane; Vollrath, Douglas; Zack, Donald J.; Medeiros, Felipe; Weinreb, Robert N.; Pericak-Vance, Margaret A.; Liu, Yutao; Kraft, Peter; Richards, Julia E.; Rosner, Bernard A.; Hauser, Michael A.; Haines, Jonathan L.; Wiggs, Janey L.

    2017-01-01

    Abstract Objective: Several attributes of female reproductive history, including age at natural menopause (ANM), have been related to primary open-angle glaucoma (POAG). We assembled 18 previously reported common genetic variants that predict ANM to determine their association with ANM or POAG. Methods: Using data from the Nurses’ Health Study (7,143 women), we validated the ANM weighted genetic risk score in relation to self-reported ANM. Subsequently, to assess the relation with POAG, we used data from 2,160 female POAG cases and 29,110 controls in the National Eye Institute Glaucoma Human Genetics Collaboration Heritable Overall Operational Database (NEIGHBORHOOD), which consists of 8 datasets with imputed genotypes to 5.6+ million markers. Associations with POAG were assessed in each dataset, and site-specific results were meta-analyzed using the inverse weighted variance method. Results: The genetic risk score was associated with self-reported ANM (P = 2.2 × 10–77) and predicted 4.8% of the variance in ANM. The ANM genetic risk score was not associated with POAG (Odds Ratio (OR) = 1.002; 95% Confidence Interval (CI): 0.998, 1.007; P = 0.28). No single genetic variant in the panel achieved nominal association with POAG (P ≥0.20). Compared to the middle 80 percent, there was also no association with the lowest 10th percentile or highest 90th percentile of genetic risk score with POAG (OR = 0.75; 95% CI: 0.47, 1.21; P = 0.23 and OR = 1.10; 95% CI: 0.72, 1.69; P = 0.65, respectively). Conclusions: A genetic risk score predicting 4.8% of ANM variation was not related to POAG; thus, genetic determinants of ANM are unlikely to explain the previously reported association between the two phenotypes. PMID:27760082

  2. Retinal nerve fiber layer in primary open-angle glaucoma with high myopia determined by optical coherence tomography and scanning laser polarimetry

    Institute of Scientific and Technical Information of China (English)

    WANG Xiao-en; WANG Xiao-yu; GU Yang-shun; HUANG Zhu

    2013-01-01

    Background Fundus changes associated with high myopia (HM) may mask those associated with primary open-angle glaucoma (POAG).This study aim to determine the characteristics of RNFL thickness changes in patients with both POAG and HM and compare these to changes in patients with only HM.The diagnostic capabilities of both OCT and GDxVCC in this subset of patients are also evaluated.Methods Twenty-two eyes with POAG and HM (spherical equivalent (SE) between-6.0 and-12.0 D) were evaluated,and 22 eyes with HM were used for comparison.Characteristic retinal nerve fiber layer (RNFL) thickness profiles in patients with POAG and HM were examined using optical coherence tomography (OCT) and scanning laser polarimetry with variable corneal compensation (GDxVCC),and the diagnostic capabilities of these imaging modalities were compared.RNFL parameters evaluated included superior average (Savg-GDx),inferior average (lavg-GDx),temporal-superior-nasal-inferior-temporal (TSNIT) average,and nerve fiber indicator (NFI) on GDxVCC and superior average (Savg-OCT),inferior average (lavg-OCT),nasal average (Navg-OCT),temporal average (Tavg-OCT),and average thickness (AvgThick-OCT) on OCT (fast RNFL scan).Visual field testing was performed and defects were evaluated using mean defect (MD) and pattern standard deviation (PSD).Results The RNFL parameters (P <0.05) significantly different between groups included Savg-GDx,lavg-GDx,TSNIT average,NFI,Savg-OCT,lavg-OCT,Tavg-OCT,and AvgThick-OCT.Significant correlations existed between TSNIT average and AvgThick-OCT (r=0.778),TSNIT average and MD (r=0.749),AvgThick-OCT and MD (r=0.647),TSNIT average and PSD (r=-0.756),and AvgThick-OCT and PSD (r=-0.784).The area under the receiver operating characteristic curve (AUROC) values of TSNIT average,Savg-GDx,lavg-GDx,NFI,Savg-OCT,lavg-OCT,Navg-OCT,Tavg-OCT,and AvgThick-OCT were 0.947,0.962,0.973,0.994,0.909,0.917,0.511,0.906,and 0.913,respectively.The NFI AUROC was the highest value.Conclusions RNFL

  3. Factors Influencing the Placebo Effect in Patients with Primary Open-Angle Glaucoma or Ocular Hypertension: An Analysis of Two Randomized Clinical Trials.

    Directory of Open Access Journals (Sweden)

    Taichi Kawamura

    Full Text Available To explore factors related to the placebo effect in patients with primary open-angle glaucoma (POAG or ocular hypertension (OH.This was a retrospective cohort study of patients with POAG and patients with OH who were treated with placebo. The patients' data were extracted from two randomized, double-masked, parallel, multicenter clinical trials (trial 1 and trial 2 in Japan. We explored the baseline factors that were associated with the intraocular pressure (IOP-lowering effect of placebo ophthalmic solution after 4 weeks of instillation treatment at two time points by using multivariable models. The time points were Hour 0 (between 08:30 and 10:30 before instillation and Hour 2 (within 1.5 to 2.5 h after instillation and by 12:30 at the baseline date and after 4 weeks. The changes in IOP from baseline to 4 weeks at the two time points were evaluated for the IOP-lowering effect induced by placebo instillation.Of the 330 patients included in the two trials, 89 patients were eligible for the analysis. The results of the multivariable analysis for Hour 0 indicated a high IOP at the baseline date (coefficient: 0.24, 95% confidence interval (CI: 0.02 to 0.46, P = 0.03, and the magnitude of the IOP fluctuation at the baseline date (coefficient: 0.57, 95% CI: 0.24 to 0.90, P = 0.001 was associated with the IOP-lowering effect after 4 weeks. With respect to Hour 2, the trial type was associated with the IOP-lowering effect (coefficient: -1.15, 95% CI: -2.14 to -0.16, P = 0.02.A large fluctuation in IOP during the day is associated with the IOP-lowering effect induced by placebo in patients with POAG or OH. This finding would be helpful to researchers when designing studies related to glaucoma in the early stages of clinical development of drugs.

  4. Fixed combination of latanoprost and timolol vs the individual components for primary open angle glaucoma and ocular hypertension: a systematic review and meta-analysis

    Institute of Scientific and Technical Information of China (English)

    Yi; Xing; Fa-Gang; Jiang; Teng; Li

    2014-01-01

    AIM:To assess the effects of the fixed combination of0.005% latanoprost and 0.5% timolol(FCLT) vs their individual components for primary open angle glaucoma(POAG) and ocular hypertension(OHT).· METHODS:After searched PubMed, EMBASE, the Cochrane Library and SCI, all randomized controlled clinical trials(RCTs) and cross-over studies were included. The control groups were the monotherapy or the concomitant therapy of latanoprost and timolol. The outcomes were visual field defect, optic atrophy, mean intraocular pressure(IOP) and IOP fluctuation. The analysis was carried out in RevMan version 5.1 software.RESULTS:Thepost-interventionmeanIOPofFCLTwas significantly lower compared to timolol [mean difference(MD)-2.92, 95%CI-3.28 to-2.55, P <0.00001] and latanoprost(MD-1.11, 95%CI-1.51 to-0.72, P <0.00001). The postintervention IOP fluctuation was also significantly lower compared to timolol(MD-0.88, 95%CI-1.23 to-0.53, P <0. 00001) and latanoprost( MD- 0. 63, 95 % CI- 1. 04to-0.22, P =0.002). The mean IOP was higher in FCLT morning dose group than the one in unfixed combination of 0.005% latanoprost and 0.5% timolol(UFCLT)(MD1.10, 95% CI 0.81 to 1.39, P <0.00001). Otherwise, there was no difference between FCLT evening dose group and UFCLT(MD 0.34, 95% CI-0.01 to 0.69, P =0.06).There was no statistical difference for the incidence ofvisual field defect and optic atrophy between FCLT and the monotherapy of components.CONCLUSION:A better IOP lowering effect has been demonstrated for FCLT compared to the monotherapy of components. The IOP lowering effect was worse for FCLT morning dose and almost same for FCLT evening dose compared to the UFCLT. We need more long-term high quality RCTs to demonstrate the outcomes of visual field defect and optic atrophy.visual field defect and optic atrophy between FCLT and the monotherapy of components.CONCLUSION:A better IOP lowering effect has been demonstrated for FCLT compared to the monotherapy of components. The IOP lowering effect

  5. An observational study of bimatoprost 0.01% in treatment-naïve patients with primary open angle glaucoma or ocular hypertension: the CLEAR trial

    Directory of Open Access Journals (Sweden)

    Nixon DR

    2012-12-01

    Full Text Available Donald R Nixon,1 Susan Simonyi,2 Meetu Bhogal,2 Christopher S Sigouin,3 Andrew C Crichton,4 Marino Discepola,5 Cindy ML Hutnik,6 David B Yan71Private Practice, Barrie, ON, 2Allergan Inc, Markham, ON, 3CLINWest Research, Burlington, ON, 4University of Calgary, Calgary, AB, 5McGill University, Montreal, QC, 6London Health Sciences Centre, London, ON, 7University of Toronto, Toronto, ON, CanadaBackground: This study was designed to evaluate the occurrence and severity of ocular hyperemia in subjects with elevated intraocular pressure (IOP due to primary open angle glaucoma (POAG or ocular hypertension (OHT following treatment with bimatoprost 0.01% in a real-world clinical setting.Methods: This was an open-label, observational study conducted at 67 centers in Canada. Subjects with elevated IOP due to POAG or OHT instilled bimatoprost 0.01% topically as monotherapy once daily. Ocular hyperemia was graded by the investigator at baseline and weeks 6 and 12 using a photographic five-point grading scale. Change in IOP from baseline was also evaluated at these time points. This analysis includes only the subgroup of 522 subjects who were naïve to IOP-lowering medication prior to the study.Results: After 12 weeks of treatment with bimatoprost 0.01%, hyperemia was graded as none-to-mild (grades 0, +0.5, or +1 for 93.3% of subjects and as moderate-to-severe (grades +2 or +3 for 6.7%. At weeks 6 and 12, most subjects (93.2% and 93.5% had no change in hyperemia grade from baseline. IOP was reduced by 7.4 mmHg (29.8% at week 6 and 7.7 mmHg (30.9% at week 12 from baseline.Conclusion: This real-world, observational study found that bimatoprost 0.01% instilled once daily reduced IOP by a mean of 30% from baseline without moderate or severe ocular hyperemia in 93% of treatment-naïve subjects with POAG or OHT.Keywords: glaucoma, intraocular pressure, hyperemia, bimatoprost

  6. Clinical effectiveness of brinzolamide 1%–brimonidine 0.2% fixed combination for primary open-angle glaucoma and ocular hypertension

    Directory of Open Access Journals (Sweden)

    Sharma S

    2015-11-01

    Full Text Available Sourabh Sharma,1 Sameer Trikha,1 Shamira A Perera,1 Tin Aung1,2 1Glaucoma Department, Singapore Eye Research Institute, Singapore National Eye Centre, 2Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore Abstract: The main first-line treatment strategy for glaucoma is to reduce intraocular pressure (IOP by topical ocular hypotensive medications, but many patients require multiple medications for adequate IOP control. Fixed-combination therapies provide several benefits, including simplified treatment regimens, theoretical improved treatment adherence, elimination of the potential for washout of the first drug by the second, and the reduction in ocular exposure to preservatives. β-Adrenoceptor antagonists (particularly 0.5% timolol are the most commonly used agents in combination with other classes of drugs as fixed-combination eyedrops, but they are contraindicated in many patients, owing to local allergy or systemic side effects. A fixed-combination preparation without a β-blocker is therefore warranted. This paper reviews the clinical effectiveness of brinzolamide 1% and brimonidine 0.2% fixed combination (BBFC for use in patients with primary open-angle glaucoma and ocular hypertension. We searched PubMed and the ClinicalTrials.gov registry, and identified three randomized controlled trials comparing BBFC vs its constituents (brimonidine vs brinzolamide, and one comparing BBFC with unfixed brimonidine and brinzolamide. All of the studies demonstrated mean diurnal IOP to be statistically significantly lower in the BBFC group compared with constituent groups and noninferior to that with the concomitant group using two separate bottles. The safety profile of BBFC was consistent with that of its individual components, the most common ocular adverse events being ocular hyperemia, visual disturbances, and ocular allergic reactions. Common systemic adverse effects included altered taste

  7. Safety and feasibility of transradial approach for primary percutaneous coronary intervention in elderly patients with acute myocardial infarction

    Institute of Scientific and Technical Information of China (English)

    YAN Zhen-xian; ZHOU Yu-jie; ZHAO Ying-xin; LIU Yu-yang; SHI Dong-mei; GUO Yong-he; CHENG Wan-jun

    2008-01-01

    Background Transradial coronary intervention has been widely used because of its effects in lowering the incidence of complications in vascular access site and improving patient satisfaction compared to the femoral approach. This study aimed to investigate the safety and feasibility of transradial approach for primary percutaneous coronary intervention (PCI) in elderly patients with acute myocardial infarction (AMI).Methods A total of 103 consecutive elderly patients (age≥65 years) who were diagnosed as having AMI were indicated for PCI. Among them, 57 patients received primary PCI via the transradial approach (transradial intervention, TRI group),and 46 underwent primary PCI via the transfemoral approach (transfemoral intervention, TFI group). The success rate of puncture, puncture time, cannulation time, reperfusion time, the total time for PCI, the success rate of PCI, the use rates of temporary pacemaker and intra-aortic balloon pump (IABP), and the total length of hospital stay of the patients in the two groups were compared. After the procedure, vascular access site complications and major adverse cardiovascular events (MACE) in the two groups in one month were observed.Results The success rates of puncture (98.2% vs 100.0%) and PCI (96.5% vs 95.7%) for the patients in the TRI and TFI groups were not statistically significant (P>0.05). The puncture time ((2.4±1.1) vs (2.0±0.9) minutes), cannulation time ((2.7±0.5) vs (2.6±0.5) minutes), reperfusion time ((16.2±4.5) vs (15.4±3.6) minutes), total time of the procedure ((44.1±6.8) vs (41.2±5.7) minutes), use rates of temporary pacemaker (1.8% vs 2.2%) and IABP (0 vs 2.2%) in the two groups were not statistically significant (P>0.05), but the hospital stay of the TFI group was longer than that of the TRI group ((10.1±4.6) VS (7.2±2.6) days, P0.05).Conclusion The transradial approach for primary PCI is safe and feasible for elderly patients with AMI.

  8. A clinical training unit for diarrhoea and acute respiratory infections: an intervention for primary health care physicians in Mexico.

    Science.gov (United States)

    Bojalil, R; Guiscafré, H; Espinosa, P; Viniegra, L; Martínez, H; Palafox, M; Gutiérrez, G

    1999-01-01

    In Tlaxcala State, Mexico, we determined that 80% of children who died from diarrhoea or acute respiratory infections (ARI) received medical care before death; in more than 70% of the cases this care was provided by a private physician. Several strategies have been developed to improve physicians' primary health care practices but private practitioners have only rarely been included. The objective of the present study was to evaluate the impact of in-service training on the case management of diarrhoea and ARI among under-5-year-olds provided by private and public primary physicians. The training consisted of a five-day course of in-service practice during which physicians diagnosed and treated sick children attending a centre and conducted clinical discussions of cases under guidance. Each training course was limited to six physicians. Clinical performance was evaluated by observation before and after the courses. The evaluation of diarrhoea case management covered assessment of dehydration, hydration therapy, prescription of antimicrobial and other drugs, advice on diet, and counselling for mothers; that of ARI case management covered diagnosis, decisions on antimicrobial therapy, use of symptomatic drugs, and counselling for mothers. In general the performance of public physicians both before and after the intervention was better than that of private doctors. Most aspects of the case management of children with diarrhoea improved among both groups of physicians after the course; the proportion of private physicians who had five or six correct elements out of six increased from 14% to 37%: for public physicians the corresponding increase was from 53% to 73%. In ARI case management, decisions taken on antimicrobial therapy and symptomatic drug use improved in both groups; the proportion of private physicians with at least three correct elements out of four increased from 13% to 42%, while among public doctors the corresponding increase was from 43% to 78%. Hands

  9. Real-life data on antibiotic prescription and sputum culture diagnostics in acute exacerbations of COPD in primary care

    Science.gov (United States)

    Bathoorn, Erik; Groenhof, Feikje; Hendrix, Ron; van der Molen, Thys; Sinha, Bhanu; Kerstjens, Huib AM; Friedrich, Alex W; Kocks, Janwillem WH

    2017-01-01

    Background Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) are generally treated with optimization of bronchodilation therapy and a course of oral corticosteroids, mostly without antibiotics. The Dutch guidelines recommend prudent use of antibiotics, with amoxicillin or doxycycline as first choice. Here we evaluate adherence to these guidelines with regard to antibiotic prescription in AECOPD in primary care and the use of sputum cultures. Methods We retrospectively analyzed a longitudinal cohort of patients in three primary care practices in the north-eastern region of the Netherlands from 2009 to 2013 (n=36,172 subjects) participating in the Registration Network Groningen. Antibiotics prescribed for AECOPD −10/+28 days from the start date of corticosteroid courses were evaluated. In addition, we assessed regional data on the susceptibility of respiratory pathogens from COPD patients. Results We identified 1,297 patients with COPD. Of these, 616 experienced one or more exacerbations, resulting in a total of 1,558 exacerbations, for which 1,594 antibiotic courses were prescribed. The recommended antibiotics doxycycline and amoxicillin accounted for 56% of the prescribed antibiotics overall and for 35% in subsequent antibiotic courses. The alternative choices were not based on culture results because only in 67 AECOPD events (2.9%) sputum samples were taken. Regional data including 3,638 sputum samples showed that pathogens relevant in AECOPD were detected in 19% of cultures. Conclusion Our study shows that guidelines regarding the prescription of antibiotics are poorly followed, particularly in recurrent exacerbations. Sputum cultures were performed in a small minority of cases. Performing sputum diagnostics in patients with early treatment failure or a repeated exacerbation when antibiotic treatment is started may further rationalize antibiotic treatment. PMID:28144133

  10. D-dimer testing for safe exclusion and risk stratification in patients with acute pulmonary embolism in primary care

    Directory of Open Access Journals (Sweden)

    Zhou Yin

    2015-01-01

    Full Text Available Background: Safe exclusion and risk stratification are currently recommended for the initial management of patients with acute pulmonary embolism (APE. The aim of this study was to assess the safe exclusion and risk stratification value of D-dimer (DD for APE when tested at the beginning of admission. Materials and Methods: All consecutive Chinese APE patients and controls were recruited from January 2010 to December 2012. All measurements of serum indexes were made in duplicate and blinded to the patients′ status. All the 40 patients with the first episode of APE were confirmed by multi-detector computed tomographic pulmonary angiography. The plasma prothrombin time (PT, activated partial thromboplastin time, thrombin time, fibrinogen, and DD levels were measured within 24 h of admission. We used the Mann-Whitney U-test to determine the differences between groups and drew receiver operator characteristic curve to evaluate the indexes′ value in the APE screening. Results: The PT and DD in the APE group were significantly higher than those in the disease control group (P 1820 μg/L as cut-off value, the sensitivity, specificity, positive and negative predictive value was 82.5%, 75.2%, 56.9%, and 91.6%, respectively. Conclusion: The patients with APE showed significant higher DD levels compared with disease controls, suggesting a negative qualitative DD test result can safely and efficiently exclude APE in primary care.

  11. Long-Term Follow-Up of Nonoperatively and Operatively Treated Acute Primary Patellar Dislocation in Skeletally Immature Patients

    Directory of Open Access Journals (Sweden)

    Eva Bengtsson Moström

    2014-01-01

    Full Text Available Purpose. The present study reports a long-term follow-up of acute primary patellar dislocation in patients with open physes. The purpose of the study was to evaluate knee function and recurrence rates after surgical and nonsurgical treatment of patellar dislocation. Methods. A total of 51 patients, including 29 girls and 22 boys, who were 9–14 years of age at the time of injury, were retrospectively evaluated. The minimum follow-up time was 5 years. Thigh muscle torque, range of motion, the squat test, the knee injury and osteoarthritis outcome score (KOOS, the Kujala score, and the recurrence rate were registered. Radiological predisposing factors at the time of injury were determined. Results. Quality of life and sports/recreation were the most affected subscales, according to KOOS, and a reduced Kujala score was also observed in all treatment groups. The surgically treated patients had a significantly lower recurrence rate. Those patients also exhibited reduced muscle performance, with a hamstring to quadriceps ratio (H/Q of 1.03. The recurrence rate was not correlated with knee function. Conclusions. Patellar dislocation in children influences subjective knee function in the long term. Surgery appears to reduce the recurrence rate, but subjective knee function was not restored.

  12. Transient widespread cortical and splenial lesions in acute encephalitis/encephalopathy associated with primary Epstein–Barr virus infection

    Directory of Open Access Journals (Sweden)

    Shuo Zhang

    2016-01-01

    Full Text Available Infection with Epstein–Barr virus (EBV is very common and usually occurs in childhood or early adulthood. Encephalitis/encephalopathy is an uncommon but serious neurological complication of EBV. A case of EBV-associated encephalitis/encephalopathy with involvement of reversible widespread cortical and splenial lesions is presented herein. An 8-year-old Chinese girl who presented with fever and headache, followed by seizures and drowsiness, was admitted to the hospital. Magnetic resonance imaging revealed high signal intensities on diffusion-weighted imaging in widespread cortical and splenial lesions. The clinical and laboratory examination results together with the unusual radiology findings suggested acute encephalitis/encephalopathy due to primary EBV infection. After methylprednisolone pulse therapy together with ganciclovir, the patient made a full recovery without any brain lesions. The hallmark clinical–radiological features of this patient included severe encephalitis/encephalopathy at onset, the prompt and complete recovery, and rapidly reversible widespread involvement of the cortex and splenium. Patients with EBV encephalitis/encephalopathy who have multiple lesions, even with the widespread involvement of cortex and splenium of the corpus callosum, may have a favorable outcome with complete disappearance of all brain lesions.

  13. Effectiveness and Feasibility of Transradial Approach for Primary Percutaneous Coronary Intervention in Patients With Acute Myocardial Infarction

    Institute of Scientific and Technical Information of China (English)

    Li-jun GAN; Qing-xian LI; Rong LIU; Yu-xin ZHAO; Jian-jun QIU; Yu-hua LIAO

    2009-01-01

    Objectives To evaluate the effectiveness and feasibility of transradial approach for primary, emergency percutane-ous coronary intervention (PCI) in patients with acute myocardial infarction (AMI). Methods One hundred and ninety five patients with AMI undergone primary PCI were randomized into two groups using different catheter insertion pathways: 105 cases by transfemoral approach and 90 cases by transradial approach. We compared data of different op-erating approaches in terms of success rate of access, cannulation time, the time from local anesthesia to the first bal-loon inflation, the total procedure time, success rate of PCI, access site complications, total duration of hospitalization, and the clinical outcomes at six-month follow-up. Results The success rate of artery puncture, cannulation time, and the time from local anesthesia to the first balloon inflation in the transradial and transfemoral groups were 98. 9 % vs 100 % (P 0. 05), 3. 15 ± 1.56 minutes vs 2. 86 ± 0. 97 minutes (P 0. 05), and 18. 56 ± 4. 37 minutes vs 17.75 ± 3. 21 minutes (P 0. 05), respectively. Although the total procedure time was significantly shorter in the transfemoral group (27.89 ± 3.95 minutes) than in the transradial group (29. 75 + 4. 38 minutes) (P < 0. 05), the overall PCI suc-cess rate was similar between the two groups (96. 2 % vs 96. 7 %). Use of the transradial approach was associated with fewer access site complications (2. 2 % vs 11.4 %, P <0. 05) and a shorter length of hospital stay (10. 6 days vs 13.8 days, P < 0. 05). At six-month follow-up, the cumulative cardiac event-free survival rate was 86. 1% and 86. 4% (P 0. 05), respectively, in the transradial and transfemoral groups. Conclusions Transradial approach achieved similar effectiveness as transfemoral approach in emergency PCI. However, the use of the transradial approach decreased access complications and hospital stay. Primary PCI via transradial approach is safe, effective, and feasible in patients

  14. Nonurgent Use of the Emergency Department by Pediatric Patients: A Theory-Guided Approach for Primary and Acute Care Pediatric Nurse Practitioners.

    Science.gov (United States)

    Ohns, Mary Jean; Oliver-McNeil, Sandra; Nantais-Smith, Leanne M; George, Nancy M

    2016-01-01

    Providing quality, cost-effective care to children and their families in the appropriate setting is the goal of nurse practitioners in primary and acute care. However, increased utilization of the emergency department (ED) for nonurgent care threatens cost-effective quality care, interrupts continuity of care, and contributes to ED overcrowding. To date, descriptive research has identified demographics of those using the ED for nonurgent care, the chief complaints of children seeking nonurgent care, the cost to the health care system of pediatric nonurgent care, and characteristics of associated primary care settings. Using Donabedian's Model of Quality of Healthcare and a Theory of Dependent Care by Taylor and colleagues, acute and primary care pediatric nurse practitioners can incorporate interventions that will channel care to the appropriate setting and educate caregivers regarding common childhood illnesses and the value of continuity of care. By using a theoretical framework as a guide, this article will help both acute and primary care pediatric nurse practitioners understand why parents seek nonurgent care for their children in the ED and actions they can take to ensure that care is provided in an optimal setting.

  15. 原发性开角型青光眼的基因学研究进展%Advances in molecular genetic study of primary open angle glaucoma

    Institute of Scientific and Technical Information of China (English)

    王德贵

    2013-01-01

    原发性开角型青光眼(POAG)是一组威胁和损害视神经视觉功能,与病理性眼压升高有关的临床眼病,其全球范围内的致盲率仅次于白内障.近几年来,遗传学的研究方法在眼科基础研究中应用较多,主要有家系连锁分析、全基因组关联分析、病例对照相关研究等,通过这些方法已发现多个相关基因.目前已发现报道超过20个染色体位点与POAG相关,较为公认的有MYOC、OPTN、WDR36.然而这3个基因的突变能解释的POAG仅占不到10%.只有一小部分POAG病例遵循孟德尔遗传规律,更多的是由多个基因共同作用所导致.就目前较为明确的POAG相关基因位点,尤其是已确认的MYOC、OPTN、WDR36,以及最新发现的CAVI/CAV24个相关致病基因的定位、结构、功能和突变等方面进行综述,希望能揭示研究相关的一些规律,为POAG进一步的遗传研究提供理论参考.%Primary open angle glaucoma (POAG) is a group of disorders characterized by loss of retinal ganglion cells (RGCs) associated with optic nerve degeneration and visual field damage.With the application of molecular biology in ophthalmology,at least 20 chromosome loci have been identified to be linked to POAG.Only 3 causative genes were identified from these loci,i.e.myocilin (MYOC),optineurin (OPTN) and WD repeat domain 36 (WDR36),which altogether account for less than 10% of POAG.Only a portion of POAG Complies with Mendelian inheritance,and a considerable fraction results from a large number of variants in multiple genes,each contributing less effects.The main technological approaches include family linkage analysis,genome-wide scan,casecontrol association study,etc.Association studies found at least 16 genes to be related to POAG,but reports on glaucoma-causing effects of these genes are conflicting.In this article,we reviewed the POAG related genes,especially the four well known causative genes of MYOC,OPTN,WDR36,and CA V1/CA V2,in terms of

  16. Prognostic value of C-reactive protein levels within 6 hours after the onset of acute anterior myocardial infarction with primary PCI

    Institute of Scientific and Technical Information of China (English)

    刘君; 傅向华; 马宁

    2003-01-01

    Prognostic value of C-reactive protein levels within 6 hours after the onset of acute anterior myocardial infarction with primary PCI!050000$河北医科大学第二医院@刘君 !050000$河北医科大学第二医院@傅向华 !050000$河北医科大学第二医院@马宁

  17. Prognostic and biologic significance of DNMT3B expression in older patients with cytogenetically normal primary acute myeloid leukemia.

    Science.gov (United States)

    Niederwieser, C; Kohlschmidt, J; Volinia, S; Whitman, S P; Metzeler, K H; Eisfeld, A-K; Maharry, K; Yan, P; Frankhouser, D; Becker, H; Schwind, S; Carroll, A J; Nicolet, D; Mendler, J H; Curfman, J P; Wu, Y-Z; Baer, M R; Powell, B L; Kolitz, J E; Moore, J O; Carter, T H; Bundschuh, R; Larson, R A; Stone, R M; Mrózek, K; Marcucci, G; Bloomfield, C D

    2015-03-01

    DNMT3B encodes a DNA methyltransferase implicated in aberrant epigenetic changes contributing to leukemogenesis. We tested whether DNMT3B expression, measured by NanoString nCounter assay, associates with outcome, gene and microRNA expression and DNA methylation profiles in 210 older (⩾60 years) adults with primary, cytogenetically normal acute myeloid leukemia (CN-AML). Patients were dichotomized into high versus low expressers using median cut. Outcomes were assessed in the context of known CN-AML prognosticators. Gene and microRNA expression, and DNA methylation profiles were analyzed using microarrays and MethylCap-sequencing, respectively. High DNMT3B expressers had fewer complete remissions (CR; P=0.002) and shorter disease-free (DFS; P=0.02) and overall (OS; PDNMT3B expression remained an independent predictor of lower CR rates (P=0.04) and shorter DFS (P=0.04) and OS (P=0.001). High DNMT3B expression associated with a gene expression profile comprising 363 genes involved in differentiation, proliferation and survival pathways, but with only four differentially expressed microRNAs (miR-133b, miR-148a, miR-122, miR-409-3p) and no differential DNA methylation regions. We conclude that high DNMT3B expression independently associates with adverse outcome in older CN-AML patients. Gene expression analyses suggest that DNMT3B is involved in the modulation of several genes, although the regulatory mechanisms remain to be investigated to devise therapeutic approaches specific for these patients.

  18. Subsequent primary malignancies and acute myelogenous leukemia transformation among myelodysplastic syndrome patients treated with or without lenalidomide.

    Science.gov (United States)

    Rollison, Dana E; Shain, Kenneth H; Lee, Ji-Hyun; Hampras, Shalaka S; Fulp, William; Fisher, Kate; Al Ali, Najla H; Padron, Eric; Lancet, Jeffrey; Xu, Qiang; Olesnyckyj, Martha; Kenvin, Laurie; Knight, Robert; Dalton, William; List, Alan; Komrokji, Rami S

    2016-07-01

    The few studies that have examined rates of acute myeloid leukemia (AML) transformation in lenalidomide-treated myelodysplastic syndrome (MDS) patients have been limited to deletion 5q MDS. The association between lenalidomide and subsequent primary malignancies (SPMs) in MDS patients has not been evaluated previously. We conducted a retrospective cohort study to evaluate the risk of both SPM and AML in association with lenalidomide. A cohort of MDS patients (n = 1248) treated between 2004 and 2012 at Moffitt Cancer Center were identified, and incident cases of SPM and AML transformation were ascertained. Using a nested case-control design, MDS controls were 1:1 matched to SPM (n = 41) and AML (n = 150) cases, on age and date of MDS diagnosis, gender, follow-up time, IPSS, and del (5q). Associations between lenalidomide and (1) SPM incidence and (2) AML transformation were estimated with hazards ratios (HR) and 95% confidence intervals (CIs) in the cohort and odds ratios (OR) in the case-control analysis. SPM incidence did not differ significantly between cohort MDS patients treated with (0.7 per 100 person-years) or without lenalidomide (1.4 per 100 person-years) (HR = 1.04, 95% CI = 0.40-2.74), whereas a significantly reduced SPM risk was observed in the case-control sample (OR = 0.03, 95% CI = Lenalidomide was not associated with AML transformation in the cohort analysis (HR = 0.75, 95% CI = 0.44-1.27) or in the case-control analyses (OR = 1.16, 95% CI = 0.52-2.56), after adjustment for potential confounders. Lenalidomide was not associated with increased risk of SPM or AML transformation in a large cohort of MDS patients mostly including nondeletion 5q MDS.

  19. 电容触摸式LCD视角补偿及三基色色散特性研究%Research on Viewing Angle Compensation of LCD with Capacitive Touch Panel and Dispersion Characteristics of Three Primary Colors

    Institute of Scientific and Technical Information of China (English)

    黄翀; 欧阳艳东; 郭阳明; 吴永俊

    2013-01-01

      通过延迟膜实现对偏振光的调制,改善液晶显示器件视角和补偿RGB三基色色散特性。用WGD-6型光学多道分析器分别测试电容触摸式LCD以及带延迟膜的电容触摸式LCD在不同电压驱动下垂直方向上不同视角的三基色电光特性。结果表明,随着视角的不断增大,电容触摸式LCD垂直方向上绿基色的相对光强偏离红、蓝基色的相对光强十分严重,导致显示图像偏色现象严重;在电容触摸式LCD表面贴加延迟膜之后,能够有效地降低三基色相对光强的差值,从而达到颜色校正、扩大可视角度的目的。%Viewing angles of liquid crystal display (LCD) can be improved and three primary colors disper⁃sion characteristics of red-green-blue (RGB) can be compensated by modulating polarized light with retardation film. Electro-optical characteristics of three primary colors of capacitive touch panel (CTP) LCD with and with⁃out retardation film under different driving voltages at vertical direction with different viewing angles are tested by WGD-6 optical multi-channel analyzer respectively. Experimental results show that as viewing angles in⁃crease, relative light intensity of green primary color of CTP LCD at vertical direction deviates seriously from that of red and blue primary colors. It results in obvious color deviation. Relative light intensity difference of three primary colors is reduced effectively after a retardation film is coated on the surface of CTP-LCD. So color correction and viewing angle increment can be achieved.

  20. Clinical management of primary non-acute promyelocytic leukemia acute myeloid leukemia: Practice Guidelines by the Italian Society of Hematology, the Italian Society of Experimental Hematology, and the Italian Group for Bone Marrow Transplantation.

    Science.gov (United States)

    Morra, Enrica; Barosi, Giovanni; Bosi, Alberto; Ferrara, Felicetto; Locatelli, Franco; Marchetti, Monia; Martinelli, Giovanni; Mecucci, Cristina; Vignetti, Marco; Tura, Sante

    2009-01-01

    As many options are now available to treat patients with de novo acute myeloid leukemia, the Italian Society of Hematology and two affiliated societies (SIES and GITMO) commissioned project to an Expert Panel aimed at developing clinical practice guidelines for acute myeloid leukemia treatment. After systematic comprehensive literature review, the Expert Panel formulated recommendations for the management of primary acute myeloid leukemia (with the exception of acute promyelocytic leukemia) and graded them according to the supporting evidence. When evidence was lacking, consensus-based statements have been added. First-line therapy for all newly diagnosed patients eligible for intensive treatment should include one cycle of induction with standard dose cytarabine and an anthracycline. After achieving complete remission, patients aged less than 60 years should receive consolidation therapy including high-dose cytarabine. Myeloablative allogeneic stem cell transplantation from an HLA-compatible sibling should be performed in first complete remission: 1) in children with intermediate-high risk cytogenetics or who achieved first complete remission after the second course of therapy; 2) in adults less than 40 years with an intermediate-risk; in those aged less than 55 years with either high-risk cytogenetics or who achieved first complete remission after the second course of therapy. Stem cell transplantation from an unrelated donor is recommended to be performed in first complete remission in adults 30 years old or younger, and in children with very high-risk disease lacking a sibling donor. Alternative donor stem cell transplantation is an option in high-risk patients without a matched donor who urgently need transplantation. Patients aged less than 60 years, who either are not candidate for allogeneic stem cell transplantation or lack a donor, are candidates for autologous stem cell transplantation. We describe the results of a systematic literature review and an

  1. Factores de riesgo vascular en el glaucoma primario de ángulo abierto Vascular risk factors in primary open angle glaucoma

    Directory of Open Access Journals (Sweden)

    A. Belzunce

    2004-12-01

    enfermedad pulmonar obstructiva crónica (EPOC es el GRD más frecuente (6%. El factor de riesgo vascular más frecuente en ambos grupos es la hipertensión arterial (54 frente a un 40% seguido del accidente cerebrovascular (26 frente al 12% del grupo control. El tratamiento médico más utilizado en estos pacientes son los betabloqueantes solos (24,3% o en asociación (18,9% Conclusiones. El GPAA está asociado con la enfermedad cerebrovascular y las variaciones de la presión arterial (hiper/hipotensión. Las enfermedades del sistema respiratorio (neumonía y EPOC, circulatorio (insuficiencia cardiaca congestiva-ICC- y cardiopatía isquémica son la causa de morbilidad más prevalente en este grupo. El tratamiento médico del glaucoma más utilizado son los betabloqueantes que están contraindicados en pacientes con EPOC e ICC.Purpose. To determine whether cardiovascular risk factors distribution differ between primary open-angle glaucoma (POAG and control subjects. To assess the strength of this association in POAG. To analyze the most frequent patology in this group of patients for a better selection of medical treatment. Methods. Observational cross-sectional study in patients with a diagnosis of POAG. Fifty glaucoma patients were selected with consecutive sampling between those who had been admitted to an terciary hospital by any reason and compared with fifty admitted to the same hospital patients without POAG diagnosis in the same period of time. The variables age, sex, the reason for admission to hospital clasificated by diagnosis related group (DRG and diagnostic mayor criteria (DMC, treatment for glaucoma, stroke, diabetes mellitus, high blood pressure, ischaemic cardiopathy, Raynaud phenomenon, low blood pressure, hypercholesterolemia and tobacco were investigated. Results. An association was found between POAG and stroke (prevalence ratio=2.16;CI al 95%=1.01-2.20; p=0.074*, low blood pressure (prevalence ratio=5; CI=1.14-2.63; p=0.092* and high blood pressure

  2. Guidelines on acute gastroenteritis in children : a critical appraisal of their quality and applicability in primary care Epidemiology and research methodology in primary care

    NARCIS (Netherlands)

    van den Berg, Jose; Berger, Marjolein Y.

    2011-01-01

    Background: Reasons for poor guideline adherence in acute gastroenteritis (AGE) in children in high-income countries are unclear, but may be due to inconsistency between guideline recommendations, lack of evidence, and lack of generalizability of the recommendations to general practice. The aim of t

  3. Improved outcomes from transradial over transfemoral access in primary percutaneous coronary intervention for patients with acute ST-segment elevation myocardial infarction and upstream use of tirofiban

    Institute of Scientific and Technical Information of China (English)

    ZHANG Qi; QIU Jian-ping; ZHANG Rui-yan; HU Jian; YANG Zhen-kun; DING Feng-hua; DU Run

    2013-01-01

    Background Transradial access has been increasingly used during primary percutaneous coronary intervention (PCI)for patients with acute ST-segment elevation myocardial infarction (STEMI) in last decade.Clinical benefits of upstream use of tirfiban therapy in STEMI patients treated by primary PCI have been reported.We investigated the merits of transradial vs.transfemoral access in primary PCI for STEMI patients with upstream use of tirofiban.Methods Patients with STEMI treated with tirofiban between December 2006 and October 2012 then by primary PCI were compared between transradial (n=298) and transfemoral (n=314) access.Baseline demographics,angiographic and PCI features and primary endpoint of major adverse cardiac events (MACE) at 30-day clinical follow-up were recorded.Results Baseline and procedural characteristics were comparable between the two groups,apart from more patients in transradial group had hypertension and were treated by thrombus aspiration during primary PCI.Significantly fewer MACE occurred in the transradial group (5.4%) compared with the transfemoral group (9.9%) at 30-day clinical follow-up.Major bleeding events at 30-day clinical follow-up were 0 in transradial group and in 2.9% of transfemoral group.Multivariate analysis confirmed transradial approach as an independent negative predictor of 30-day MACE (HR 0.68;95% CI 0.35-0.91; P=0.03).Conclusions Using transradial approach in primary PCI for acute STEMI infarction patients treated with tirofiban was clearly beneficial in reducing bleeding complications and improving 30-day clinical outcomes.

  4. Tuning cofactor redox potentials: the 2-methoxy dihedral angle generates a redox potential difference greater than 160 mV between the primary (QA) and secondary (QB) quinones of the photosynthetic reaction center

    Science.gov (United States)

    Taguchi, Alexander T.; Mattis, Aidas J.; O'Malley, Patrick J.; Dikanov, Sergei A.; Wraight, Colin A.

    2013-01-01

    Only quinones with a 2-methoxy group can act simultaneously as the primary (QA) and secondary (QB) electron acceptors in photosynthetic reaction centers from Rb. sphaeroides. 13C HYSCORE measurements of the 2-methoxy in the semiquinone states, SQA and SQB, were compared with QM calculations of the 13C couplings as a function of dihedral angle. X-ray structures support dihedral angle assignments corresponding to a redox potential gap (ΔEm) between QA and QB of ~180 mV. This is consistent with the failure of a ubiquinone analog lacking the 2-methoxy to function as QB in mutant reaction centers with a ΔEm ≈ 160–195 mV. PMID:24079813

  5. High-grade acute organ toxicity as positive prognostic factor in primary radio(chemo)therapy for locally advanced, inoperable head and neck cancer

    Energy Technology Data Exchange (ETDEWEB)

    Wolff, Hendrik Andreas; Bosch, Jan; Hennies, Steffen; Hess, Clemens F.; Christiansen, Hans [Dept. of Radiotherapy and Radiooncology, Univ. Medicine Goettingen (Germany); Jung, Klaus [Dept. of Medical Statistics, Univ. Medicine Goettingen (Germany); Overbeck, Tobias [Dept. of Haematology and Oncology, Univ. Medicine Goettingen (Germany); Matthias, Christoph; Roedel, Ralph M. [Dept. of Otorhinolaryngology, Univ. Medicine Goettingen (Germany)

    2010-05-15

    Purpose: to test for a possible correlation between high-grade acute organ toxicity during primary radio(chemo)therapy and treatment outcome in patients with locally advanced head and neck squamous cell carcinoma (HNSCC). Patients and methods: from 05/1994 to 01/2009, 216 HNSCC patients were treated with radio(chemo)therapy in primary approach. They received normofractionated (2 Gy/fraction) irradiation including associated nodal drainage sites to a cumulative dose of 70 Gy. 151 patients received additional concomitant chemotherapy (111 patients 5-fluorouracil/mitomycin C, 40 patients cisplatin-based). Toxicity during treatment was monitored weekly according to the Common Toxicity Criteria (CTC), and any toxicity grade CTC {>=} 3 of mucositis, dysphagia or skin reaction was assessed as high-grade acute organ toxicity for later analysis. Results: a statistically significant coherency between high-grade acute organ toxicity and overall survival as well as locoregional control was found: patients with CTC {>=} 3 acute organ toxicity had a 5-year overall survival rate of 4% compared to 8% in patients without (p < 0.01). Thereby, multivariate analyses revealed that the correlation was independent of other possible prognostic factors or factors that may influence treatment toxicity, especially concomitant chemotherapy and radiotherapy technique or treatment-planning procedure. Conclusion: these data indicate that normal tissue and tumor tissue may behave similarly with respect to treatment response, as high-grade acute organ toxicity during radio(chemo)therapy showed to be an independent prognostic marker in the own patient population. However, the authors are aware of the fact that a multivariate analysis in a retrospective study generally has statistical limitations. Therefore, their hypothesis should be further analyzed on biomolecular and clinical levels and other tumor entities in prospective trials. (orig.)

  6. Combined surgery for acute angle-closure glaucoma surgery%联合手术治疗急性闭角型青光眼合并白内障

    Institute of Scientific and Technical Information of China (English)

    郝黎

    2013-01-01

    Objective To observe the efficacy of the phacoemulsification and intraocular lens implantation with trabeculectomy for acute angle-closure glaucoma with cataract.Methods 38 patients (50eyes) of acute angle-closure glaucoma with cataract had received phacoemulsification and intraocular lens implantation combined with trabeculectomy.The follow-up ranged from 6 to 12 months.Results Visual acuity was increased after operation.The postoperative best corrected visual acuity was ≤ 0.2 in 9 eyes (18.00%),> 0.2 in 41 eyes (82.00%).Postoperative intraocular pressure was controlled in normal range in 48 eyes (96.00%).Postoperative functional filtering bleb was obtained in 48 eyes (96.00%).No severe complication occurred.Conclusion The phacoemulsification and intraocular lens implantation combined with trabeculectomy is valuable for acute angle-closure glaucoma with cataract.%目的 观察联合手术治疗急性闭角型青光眼合并白内障的临床效果.方法 38例(50眼)急性闭角型青光眼合并白内障行超声乳化人工晶状体植人联合小梁切除术,随访6 ~12个月.结果 手术后视力均较术前有不同程度提高.术后最佳矫正视力≤0.2者9眼(18.00%),>0.2者41眼(82.00%).术后眼压控制在正常范围内者48眼(96.00%).术后功能性滤过泡为48眼(96.00%).无严重并发症发生.结论 联合手术治疗急性闭角型青光眼合并白内障是有效的.

  7. Burden of acute otitis media in primary care pediatrics in Italy: a secondary data analysis from the Pedianet database

    Directory of Open Access Journals (Sweden)

    Marchisio Paola

    2012-11-01

    Full Text Available Abstract Background The incidence of acute otitis media (AOM vary from country to country. Geographical variations together with differences in study designs, reporting and settings play a role. We assessed the incidence of AOM in Italian children seen by primary care paediatricians (PCPs, and described the methods used to diagnose the disease. Methods This secondary data analysis from the Pedianet database considered children aged 0 – 6 years between 01/2003 and 12/2007. The AOM episodes were identified and validated by means of patient diaries. Incidence rates/100 person-years (PY were calculated for total AOM and for single or recurrent AOM. Results The 92,373 children (52.1% males were followed up for a total of 227,361 PY: 23,039 (24.9% presented 38,241 episodes of AOM (94.6% single episodes and 5.4% recurrent episodes. The total incidence rate of AOM in the 5-year period was 16.8 episodes per 100 PY (95% CI: 16.7-16.9, including single AOM (15.9 episodes per 100 PY; 95% CI: 15.7-16.1 and recurrent AOM (0.9 episodes per 100 PY; 95% CI: 0.9-0.9. There was a slight and continuously negative trend decrease over time (annual percent change −4.6%; 95%CI: -5.3, -3.9%. The AOM incidence rate varied with age, peaking in children aged 3 to 4 years (22.2 episodes per 100 PY; 95% CI 21.8-22.7. The vast majority of the AOM episodes (36,842/38,241, 96.3% were diagnosed using a static otoscope; a pneumatic otoscope was used in only 3.7%. Conclusions Our data fill a gap in our knowledge of the incidence of AOM in Italy, and indicate that AOM represents a considerable burden for the Italian PCP system. Educational programmes concerning the diagnosis of AOM are needed, as are further studies to monitor the incidence in relation to the introduction of wider pneumococcal conjugate vaccines.

  8. Acute Acalculous Cholecystitis: A Rare Presentation of Primary Epstein-Barr Virus Infection in Adults—Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Zuhal Yesilbag

    2017-01-01

    Full Text Available Primary Epstein-Barr virus (EBV infection is almost always a self-limited disease characterized by sore throat, fever, and lymphadenopathy. Hepatic involvement is usually characterized by mild elevations of aminotransferases and resolves spontaneously. Although isolated gallbladder wall thickness has been reported in these patients, acute acalculous cholecystitis is an atypical presentation of primary EBV infection. We presented a young women admitted with a 10-day history of fever, nausea, malaise who had jaundice and right upper quadrant tenderness on the physical examination. Based on diagnostic laboratory tests and abdominal ultrasonographic findings, cholestasis and acute acalculous cholecystitis were diagnosed. Serology performed for EBV revealed the acute EBV infection. Symptoms and clinical course gradually improved with the conservative therapy, and at the 1-month follow-up laboratory findings were normal. We reviewed 16 adult cases with EBV-associated AAC in the literature. Classic symptoms of EBV infection were not predominant and all cases experienced gastrointestinal symptoms. Only one patient underwent surgery and all other patients recovered with conservative therapy. The development of AAC should be kept in mind in patients with cholestatic hepatitis due to EBV infection to avoid unnecessary surgical therapy and overuse of antibiotics.

  9. Acute Acalculous Cholecystitis: A Rare Presentation of Primary Epstein-Barr Virus Infection in Adults—Case Report and Review of the Literature

    Science.gov (United States)

    Karadeniz, Asli; Kaya, Fatih Oner

    2017-01-01

    Primary Epstein-Barr virus (EBV) infection is almost always a self-limited disease characterized by sore throat, fever, and lymphadenopathy. Hepatic involvement is usually characterized by mild elevations of aminotransferases and resolves spontaneously. Although isolated gallbladder wall thickness has been reported in these patients, acute acalculous cholecystitis is an atypical presentation of primary EBV infection. We presented a young women admitted with a 10-day history of fever, nausea, malaise who had jaundice and right upper quadrant tenderness on the physical examination. Based on diagnostic laboratory tests and abdominal ultrasonographic findings, cholestasis and acute acalculous cholecystitis were diagnosed. Serology performed for EBV revealed the acute EBV infection. Symptoms and clinical course gradually improved with the conservative therapy, and at the 1-month follow-up laboratory findings were normal. We reviewed 16 adult cases with EBV-associated AAC in the literature. Classic symptoms of EBV infection were not predominant and all cases experienced gastrointestinal symptoms. Only one patient underwent surgery and all other patients recovered with conservative therapy. The development of AAC should be kept in mind in patients with cholestatic hepatitis due to EBV infection to avoid unnecessary surgical therapy and overuse of antibiotics. PMID:28194287

  10. The impact of childhood acute rotavirus gastroenteritis on the parents’ quality of life: prospective observational study in European primary care medical practices

    Directory of Open Access Journals (Sweden)

    Domingo Javier

    2012-05-01

    Full Text Available Abstract Background Rotavirus (RV is the commonest cause of acute gastroenteritis in infants and young children worldwide. A Quality of Life study was conducted in primary care in three European countries as part of a larger epidemiological study (SPRIK to investigate the impact of paediatric rotavirus gastroenteritis (RVGE on affected children and their parents. Methods A self-administered questionnaire was linguistically validated in Spanish, Italian and Polish. The questionnaire was included in an observational multicentre prospective study of 302 children aged Results Questionnaire responses showed that acute RVGE in a child adversely affects the parents’ daily life as well as the child. Parents of children with RVGE experience worry, distress and impact on their daily activities. RVGE of greater clinical severity (assessed by the Vesikari scale was associated with higher parental worries due to symptoms and greater changes in the child’s behaviour, and a trend to higher impact on parents’ daily activities and higher parental distress, together with a higher score on the symptom severity scale of the questionnaire. Conclusions Parents of a child with acute RVGE presenting to primary care experience worry, distress and disruptions to daily life as a result of the child’s illness. Prevention of this disease through prophylactic vaccination will improve the daily lives of parents and children.

  11. Acupuncture as analgesia for non-emergent acute non-specific neck pain, ankle sprain and primary headache in an emergency department setting: a protocol for a parallel group, randomised, controlled pilot trial

    OpenAIRE

    2014-01-01

    Introduction This study aims to assess the feasibility of acupuncture as an add-on intervention for patients with non-emergent acute musculoskeletal pain and primary headache in an emergency department (ED) setting. Methods and analysis A total of 40 patients who present to the ED and are diagnosed to have acute non-specific neck pain, ankle sprain or primary headache will be recruited by ED physicians. An intravenous or intramuscular injection of analgesics will be provided as the initial st...

  12. The development and validation of a multidimensional sum-scaling questionnaire to measure patient-reported outcomes in acute respiratory tract infections in primary care: the Acute Respiratory Tract Infection Questionnaire: ARTIQ

    DEFF Research Database (Denmark)

    Aabenhus, R.; Thorsen, H.; Siersma, V.

    2013-01-01

    OBJECTIVE: Patient-reported outcomes are seldom validated measures in clinical trials of acute respiratory tract infections (ARTIs) in primary care. We developed and validated a patient-reported outcome sum-scaling measure to assess the severity and functional impacts of ARTIs. METHODS: Qualitative...... interviews and field testing among adults with an ARTI were conducted to ascertain a high degree of face and content validity of the questionnaire. Subsequently, a draft version of the Acute Respiratory Tract Infection Questionnaire (ARTIQ) was statistically validated by using the partial credit Rasch model...... to test dimensionality, objectivity, and reliability of items. Test of known groups' validity was conducted by comparing participants with and without an ARTI. RESULTS: The final version of the ARTIQ consisted of 38 items covering five dimensions (Physical-upper, Physical-lower, Psychological, Sleep...

  13. Clinical Analysis of Primary Angle Closure Glaucoma After Glaucoma Filtering Surgery%原发性闭角型青光眼滤过术后恶性青光眼的临床分析

    Institute of Scientific and Technical Information of China (English)

    张智伟

    2016-01-01

    Objective To investigate the risk factors and therapeutic effect of primary angle closure glaucoma after glaucoma filtering surgery.Methods 90 cases(90 eyes)with primary angle closure glaucoma in our hospital were selected,experimental group of 28 cases of malignant glaucoma after operation,there were no malignant glaucoma in 62 cases,the control group,the clinical data were retrospectively analyzed.Results Age,sex,preoperative intraocular pressure,lens thickness,axial length,type of glaucoma,and the structure of the angle of the room were the risk factors of postoperative malignant glaucoma. All patients were satisfied with the treatment effect.Conclusion Young patients with primary angle closure glaucoma with shorter axial length are prone to complications of malignant glaucoma after filtering surgery and need to be strengthened to prevent.%目的:探讨原发性闭角型青光眼滤过术后恶性青光眼的发病因素与治疗效果。方法选取我院收治的90例(90眼)原发性闭角型青光眼患者,术后恶性青光眼28例为实验组,术后未出现恶性青光眼62例为对照组,回顾性分析其临床资料。结果年龄、性别、术前眼压、晶体厚度、眼轴长度、青光眼类型、房角结构是引发术后恶性青光眼的危险因素;所有患者治疗效果比较满意。结论年轻的眼轴长度较短的原发性闭角型青光眼患者在滤过手术后容易出现恶性青光眼并发症,需要加强预防。

  14. A combined analysis of four observational studies evaluating the intraocular pressure-lowering ability and tolerability of bimatoprost 0.01% in patients with primary open-angle glaucoma or ocular hypertension

    Science.gov (United States)

    Stevens, Annemie; Iliev, Milko E; de Jong, Leo; Grobeiu, Ioana; Hommer, Anton

    2016-01-01

    Objective Combine and evaluate data from four clinical practice studies investigating the intraocular pressure (IOP)-lowering ability, tolerability of and patient adherence to bimatoprost 0.01% therapy in patients with primary open-angle glaucoma or ocular hypertension. Methods Data were combined from four multicenter, prospective, observational studies. Patients (n=2,593) were recruited from 328 sites in Austria, Belgium, Switzerland, and the Netherlands. Assessments were at study entry (baseline) and after 10–14 weeks. Results Bimatoprost 0.01% lowered mean IOP by 5.0 mmHg from baseline to final visit (Pbimatoprost 0.01% monotherapy from previous monotherapy reduced mean IOP by a further 3.2±3.6 mmHg (17.2%, Pbimatoprost 0.01% from previous prostaglandin monotherapy reduced mean IOP by 2.9±3.5 mmHg (15.5%), including by 3.1±3.4 mmHg (15.8%) and 3.3±4.1 mmHg (16.9%) for previous latanoprost and travoprost treatment, respectively (all Pbimatoprost 0.01% lowered IOP effectively in treatment-naïve and previously treated ocular hypertension and primary open-angle glaucoma patients, and was associated with good tolerability and patient adherence over 12 weeks. PMID:27103783

  15. 激光周边虹膜成形及切除术治疗药物难控制的急性闭角型青光眼%Laser peripheral iridoplasty combined with iridectomy for the unmanageable acute angle-closure glaucoma by medication

    Institute of Scientific and Technical Information of China (English)

    刘国颖; 刘斐

    2014-01-01

    AIM: To investigate the effect and safety of laser peripheral iridoplasty combined with iridectomy in the unmanageable acute angle - closure glaucoma by medication. METHODS:Totally 19 cases (21 eyes) with acute angle-closure glaucoma, including 15 cases ( 17 eyes ) with primary glaucoma and 4 cases (4 eyes) with intumescent cataract - induced glaucoma, were recruited into the study. The intraocular pressure ( IOP ) of all cases were still >21mmHg after 24h drug treatment, and then were treated by laser peripheral iridoplasty combined with iridectomy. The visual accurity, IOP, cornea, peripheral anterior chamber depth, anterior chamber angle and complications were observed at 24h after the surgery. RESULTS:The mean IOP of all cases was reduced from 53. 09±11. 01mmHg before the surgery to 14. 98±4. 21mmHg at 24h after the treatment, with significant statistical difference ( P CONCLUSION: Laser peripheral iridoplasty combined with iridectomy is an effective and safe method for the treatment of the unmanageable acute angle - closure glaucoma by medication.%目的:探讨激光周边虹膜成形联合周边虹膜切除术,治疗药物难控制的急性闭角型青光眼的效果和安全性。  方法:选取药物治疗24 h后眼压仍高于21 mmHg的原发性急性闭角型青光眼15例17眼和白内障膨胀期继发的急性闭角型青光眼4例4眼,共19例21眼,采用激光周边虹膜成形联合周边虹膜切除术,术后24 h观察视力、眼压、角膜、周边前房深度、房角及并发症。  结果:所有患者激光术后24 h眼压均有大幅度的下降,术前眼压53.09±11.01mmHg,术后24h眼压下降至14.98±4.21mmHg,治疗前后差异有统计学意义( P  结论:激光周边虹膜切除联合周边虹膜成形术,是降低药物难控制的急性闭角型青光眼眼压的一种安全有效的方法。

  16. Incremental predictive value of myocardial scintigraphy with {sup 123}I-BMIPP in patients with acute myocardial infarction treated with primary percutaneous coronary intervention

    Energy Technology Data Exchange (ETDEWEB)

    Nanasato, Mamoru; Hirayama, Haruo [Nagoya Daini Red Cross Hospital, Cardiovascular Center, Nagoya (Japan); Ando, Akitada; Isobe, Satoshi; Nonokawa, Makoto; Murohara, Toyoaki [Nagoya University Graduate School of Medicine, Department of Cardiology, Nagoya (Japan); Kinoshita, Yoshimi; Nanbu, Ichiro [Nagoya Daini Red Cross Hospital, Department of Radiology, Nagoya (Japan); Yokota, Mitsuhiro [Nagoya University Graduate School of Medicine, Cardiovascular Division, Department of Clinical Pathophysiology, Nagoya (Japan)

    2004-11-01

    It is unclear whether {sup 123}I-labelled {beta}-methyl iodophenyl pentadecanoic acid ({sup 123}I-BMIPP) myocardial scintigraphy adds further predictive value for future cardiac events compared with the variables obtained during cardiac catheterisation in patients with acute myocardial infarction (AMI) treated with primary percutaneous coronary intervention (PCI). We therefore investigated whether {sup 123}I-BMIPP imaging in patients with AMI treated by primary PCI was useful in predicting future cardiac events. One hundred and fifty-nine patients with AMI who were treated with primary PCI and underwent left ventriculography (LVG) on admission underwent {sup 201}Tl and {sup 123}I-BMIPP myocardial scintigraphy. Scintigrams were visually classified, and the total defect score (TDS) was calculated. Major adverse cardiac events (MACE) were defined as cardiac death including sudden death, congestive heart failure and recurrence of acute coronary syndrome. Patients were followed up for a mean of 34.5 months (12-63 months). Twenty-six patients had MACE. Kaplan-Meier analysis indicated that patients with the top 50% of {sup 123}I-BMIPP TDSs had a significantly higher rate of MACE (P=0.007). Patients with mismatch between {sup 201}Tl and {sup 123}I-BMIPP images also had significantly more MACE (P=0.02). In the prediction of MACE, the global chi-square value was 5.2 (P=0.001) based on LVEF (<45%) and the number of diseased vessels (two or three). Adding {sup 123}I-BMIPP TDS and the mismatch improved the global chi-square value ({chi}{sup 2}=7.2) Myocardial scintigraphy using {sup 201}Tl and {sup 123}I-BMIPP predicts future cardiac events in patients with AMI treated with primary PCI, and provides additional predictive value compared with the variables obtained with cardiac catheterisation alone. (orig.)

  17. Glaucoma agudo bilateral em paciente jovem secundário ao uso de topiramato: relato de caso Bilateral acute angle closure glaucoma in a young patient receiving oral topiramate: case report

    Directory of Open Access Journals (Sweden)

    Fausto Stangler

    2007-02-01

    Full Text Available Topiramato é droga derivada das sulfas e utilizada sistemicamente como anticonvulsivante. Pode produzir efusão uveal e causar glaucoma agudo por fechamento angular pelo deslocamento da íris e do cristalino anteriormente, com miopização transitória. O processo cede com a suspensão da droga, se identificado precocemente. Os autores relatam, pela primeira vez na literatura científica nacional, um caso no qual a efusão uveal ocorreu após a administração de topiramato para tratamento de enxaqueca. Paciente branca de 40 anos foi examinada no setor de emergência do Hospital Banco de Olhos de Porto Alegre apresentando cefaléia intensa, dor ocular e diminuição da visão em ambos os olhos. Referia uso de topiramato desde dez dias antes do início dos sintomas. O exame biomicroscópico mostrava injeção conjuntival, quemose e câmara anterior rasa nos dois olhos. A pressão intra-ocular era de 40 mmHg no olho direito e 38 mmHg no olho esquerdo. Os achados fundoscópicos estavam normais nos dois olhos. A ultra-sonografia ocular mostrou efusão uveal e descolamento de coróide bilateral nos dois olhos. Foi realizado o diagnóstico de efusão uveal relacionada com o uso de topiramato. A medicação foi suspensa com melhora do quadro clínico e da acuidade visual três dias após a apresentação inicial. A efusão uveal induzida por drogas ocorre raramente. O topiramato pode causar edema do corpo ciliar e relaxamento da zônula, com conseqüente deslocamento anterior do diafragma irido-cristaliniano, causando miopização aguda e fechamento angular. Como o mecanismo de fechamento angular não envolve bloqueio pupilar, iridectomias periféricas e o uso de mióticos tópicos não são efetivos nesses casos. Houve regressão completa do quadro após a suspensão da medicação.This paper reports a clinical case of uveal effusion in both eyes causing bilateral acute angle closure glaucoma in a young patient after oral administration of topiramate

  18. Diagnosis and Management of Acute Abdomen in Primary Hospital%基层医院急腹症临床诊治体会

    Institute of Scientific and Technical Information of China (English)

    宋进军

    2015-01-01

    Objective:To improve the acute abdomen's treatment level of grass -roots medical professionals by comprehensive analysis to diagnose and treatment of common acute abdomen from primary hospital.Method:Retrospectively analyzed diagnose and treatment of patients with acute abdomen collected in the hospital in recent years.Results:By detailed analysis of clinical history from patients,and by taking both physical and laboratory examination to patients,as well as cooperation consultation with other departments,to make a definite diagnose in time,reduce the misdiagnosed,and win the best treatment time,alleviate the suffering of patients.Conclusion:Primary hospital should increase the acute abdomen cure rate,pay attention to detailed clinical history of patients and take reasonable check carefully,follow the treatment principles of acute abdomen in order to reduce the missed diagnosis and misdiagnosis.%目的:对基层医院常见急腹症的诊断与治疗进行综合分析,以提高基层医务人员对急腹症的救治水平。方法:对本院近几年内收治的急腹症患者的诊断、治疗进行回顾性分析研究。结果:通过对患者详尽病史分析、全面的体格检查及辅助检查,以及他科合作会诊,及时确诊,减少误诊,为患者赢得最佳治疗时间,减轻患者痛苦。结论:基层医院要提高急腹症救治率,必须重视对患者进行病史综合分析及认真仔细合理的检查,掌握急腹症的救治处理原则,才能减少的误诊、漏诊。

  19. Barriers and facilitators to the dissemination of DECISION+, a continuing medical education program for optimizing decisions about antibiotics for acute respiratory infections in primary care: A study protocol

    Directory of Open Access Journals (Sweden)

    Gagnon Marie-Pierre

    2011-01-01

    Full Text Available Abstract Background In North America, acute respiratory infections are the main reason for doctors' visits in primary care. Family physicians and their patients overuse antibiotics for treating acute respiratory infections. In a pilot clustered randomized trial, we showed that DECISION+, a continuing medical education program in shared decision making, has the potential to reduce the overuse of antibiotics for treating acute respiratory infections. DECISION+ learning activities consisted of three interactive sessions of three hours each, reminders at the point of care, and feedback to doctors on their agreement with patients about comfort with the decision whether to use antibiotics. The objective of this study is to identify the barriers and facilitators to physicians' participation in DECISION+ with the goal of disseminating DECISION+ on a larger scale. Methods/design This descriptive study will use mixed methods and retrospective and prospective components. All analyses will be based on an adapted version of the Ottawa Model of Research Use. First, we will use qualitative methods to analyze the following retrospective data from the pilot study: the logbooks of eight research assistants, the transcriptions of 15 training sessions, and 27 participant evaluations of the DECISION+ training sessions. Second, we will collect prospective data in semi-structured focus groups composed of family physicians to identify barriers and facilitators to the dissemination of a future training program similar to DECISION+. All 39 family physicians exposed to DECISION+ during the pilot project will be eligible to participate. We will use a self-administered questionnaire based on Azjen's Theory of Planned Behaviour to assess participants' intention to take part in future training programs similar to DECISION+. Discussion Barriers and facilitators identified in this project will guide modifications to DECISION+, a continuing medical education program in shared

  20. Prospective multicenter randomized trial comparing physician versus patient transfer for primary percutaneous coronary intervention in acute ST-segment elevation myocardial infarction

    Institute of Scientific and Technical Information of China (English)

    ZHANG Qi; YANG Zheng-kun; SHEN Wei-feng; ZHANG Rui-yan; QIU Jian-ping; ZHANG Jun-feng; WANG Xiao-long; JIANG Li; LIAO Min-lei; ZHANG Jian-sheng; HU Jian

    2008-01-01

    Background Primary percutaneous coronary intervention (PCI) has been identified as the first therapeutic option for patients with acute ST-segment elevation myocardial infarction (STEMI).The strategy of transferring patient to a PCI center was recently recommended for those with acute STEMI who were present to PCI incapable hospitals,which include lack of facilities or experienced operators.In China,some local hospitals have been equipped with PCI facilities,but they have no interventional physicians qualified for performing primary PCI.This study was conducted to assess the feasibility,safety and efficacy of the strategy of transferring physician to a PCI-equipped hospital to perform primary PCI for patients with acute STEMI.Methods Three hundred and thirty-four consecutive STEMI patients with symptom presentation ≤12 hours in five local hospitals from November 2005 to November 2007 were randomized to receive primary PCI by either physician transfer (physician transfer group,n=165)or patient transfer(patient transfer group,n=169)strategy.Door-to-balloon time,in-hospital and 30-day major adverse cardiac events(MACE,including death,non-fatal re-infarction,and target vessel revascularization)were compared between the two groups.Results Baseline characteristics between the two groups were comparable.Thrombolysis In myocardial infarction (TIMI) 3 flow was revealed in more patients in the physician transfer group at initial angiography(17.6% vs 10.1%,P<0.05).The success rate of primary PCI(96.3% vs 95.4%,P>0.05)and length of hospital stay were similar between the two groups ((15±4)days vs(14±3)days,P>0.05).In the physician transfer group,door-to-balloon time was significantly shortened ((95±20) minutes vs(147±29)minutes,P<0.0001)and more patients received primary PCI with door-to-balloon time less than 90 minutes(21.2% vs 7.7%,P<0.001).During hospitalization,MACE occurred in 6.7% and 11.2% of patients in the physician and patient transfer groups

  1. Prospective unmasked randomized evaluation of the iStent inject® versus two ocular hypotensive agents in patients with primary open-angle glaucoma

    Science.gov (United States)

    Fea, Antonio M; Belda, Jose I; Rękas, Marek; Jünemann, Anselm; Chang, Lydia; Pablo, Luis; Voskanyan, Lilit; Katz, L Jay

    2014-01-01

    Purpose The purpose of this study was to compare outcomes of subjects with open-angle glaucoma (OAG) not controlled on one medication who underwent either implantation of two iStent inject® trabecular micro-bypass devices or received medical therapy consisting of a fixed combination of latanoprost/timolol. Patients and methods Of 192 subjects who qualified for the study and were enrolled, 94 were randomized to surgery with implantation of two iStent inject® devices in the treated eye and 98 to receive medical therapy. Results At the month 12 visit, 94.7% of eyes (89/94) in the stent group reported an unmedicated intraocular pressure (IOP) reduction of ≥20% versus baseline unmedicated IOP, and 91.8% of eyes (88/98) in the medical therapy group reported an IOP reduction ≥20% versus baseline unmedicated IOP. A 17.5% between-group treatment difference in favor of the iStent inject group was statistically significant (P=0.02) at the ≥50% level of IOP reduction. An IOP ≤18 mmHg was reported in 92.6% of eyes (87/94) in the iStent inject group and 89.8% of eyes (88/98) in the medical therapy group. Mean (standard deviation) IOP decreases from screening of 8.1 (2.6) mmHg and 7.3 (2.2) mmHg were reported in the iStent inject and medical therapy groups, respectively. A high safety profile was also noted in this study in both the iStent inject and medical therapy groups, as measured by stable best corrected visual acuity, cup-to-disc ratio, and adverse events. Conclusion These data show that the use of iStent inject is at least as effective as two medications, with the clinical benefit of reducing medication burden and assuring continuous treatment with full compliance to implant therapy as well as having a highly favorable safety profile. PMID:24855336

  2. Collaboration improves outcomes: cross county, joint acute and primary care, working party to select a super absorbent dressing.

    Science.gov (United States)

    Fenwick, Kim; Florence, Lorraine; Godar, Sue; Guy, Heidi; Tilbe, Helen

    2012-11-01

    This abstract highlights the work undertaken by the Bedfordshire and Hertfordshire Tissue Viability Nurses Forum (BHTVNF) to select a super absorbent dressing for local formularies. A range of super absorbent dressings was selected to be included in the evaluation based on their accessibility via FP10 or NHS Supply chain. Dressings were evaluated in the hospital setting, community setting and leg ulcer clinics. Table top evaluations were also undertaken. Performance of dressings both clinically and via table top were considered along with costs. It was interesting to find out that hospital patients had different needs to community patients and as such three recommendations were made. The acute sector has added one super absorbent which is different from the community selected one. The community has also selected a lower performing super absorbent which the acute sector has not chosen.

  3. Acute acalculous cholecystitis in a patient with primary Epstein-Barr virus infection: a case report and literature review

    Directory of Open Access Journals (Sweden)

    J. Agergaard

    2015-06-01

    In conclusion primary EBV infection should be considered in cases of AAC, especially in young women. In cases associated with EBV infection neither administration of antibiotics nor surgical drainage may be indicated.

  4. Prospective unmasked randomized evaluation of the iStent inject® versus two ocular hypotensive agents in patients with primary open-angle glaucoma

    Directory of Open Access Journals (Sweden)

    Fea AM

    2014-05-01

    Full Text Available Antonio M Fea,1 Jose I Belda,2 Marek Rękas,3 Anselm Jünemann,4 Lydia Chang,5 Luis Pablo,6 Lilit Voskanyan,7 L Jay Katz81Università degli Studi di Torino, Clinica Oculistica, Torino, Italy; 2Hospital Torrevieja Salud, UTE, Servicio de Oftalmologia, Alicante, Spain; 3Military Institute of Medicine, Department of Ophthalmology, Warsaw, Poland; 4Universitätsaugenklinik, Erlangen, Germany; 5Hinchingbrooke Hospital NHS Trust and Moorfields Bedford Hospital NHS Trust, United Kingdom; 6Hospital Universitario Miguel Servet, Servicio Oftalmologico, Zaragoza, Spain; 7SV Malayan Ophthalmological Center, Yerevan, Armenia; 8Wills Eye Institute, Jefferson Medical College, Philadelphia, PA, USAPurpose: The purpose of this study was to compare outcomes of subjects with open-angle glaucoma (OAG not controlled on one medication who underwent either implantation of two iStent inject® trabecular micro-bypass devices or received medical therapy consisting of a fixed combination of latanoprost/timolol.Patients and methods: Of 192 subjects who qualified for the study and were enrolled, 94 were randomized to surgery with implantation of two iStent inject® devices in the treated eye and 98 to receive medical therapy.Results: At the month 12 visit, 94.7% of eyes (89/94 in the stent group reported an unmedicated intraocular pressure (IOP reduction of ≥20% versus baseline unmedicated IOP, and 91.8% of eyes (88/98 in the medical therapy group reported an IOP reduction ≥20% versus baseline unmedicated IOP. A 17.5% between-group treatment difference in favor of the iStent inject group was statistically significant (P=0.02 at the ≥50% level of IOP reduction. An IOP ≤18 mmHg was reported in 92.6% of eyes (87/94 in the iStent inject group and 89.8% of eyes (88/98 in the medical therapy group. Mean (standard deviation IOP decreases from screening of 8.1 (2.6 mmHg and 7.3 (2.2 mmHg were reported in the iStent inject and medical therapy groups, respectively. A high

  5. 重视原发性闭角型青光眼诊断与治疗方法的新转变%Progress in the diagnosis and treatment of primary angle closur e glaucoma

    Institute of Scientific and Technical Information of China (English)

    吕爱国; 郭黎霞; 范肃洁

    2016-01-01

    Glaucoma is the largest cause of irreversible blindness around the world .With the acceleration of population aging process , the incidence of glaucoma also gradually increases .Once the patient′s visual function is damaged , it will not be recoverable .What′s more, it will give obstacle to patient′s life and bring great economic burden .China is one of the high incidence areas on primary angle closure glaucoma.Therefore, to decrease the patient′s visual function damage down to minimum , early detection and early intervention become the primary goal of prevention and treatment of blindness of glaucoma in China.In this paper, the author reviews the new changes and development trend of the diagnosis and treatment of angle closure glaucoma in recent years .%青光眼是世界上第一大不可逆性致盲眼病。随着人口老龄化进程的加快,青光眼的发病率也在逐步提高,而这部分病人的视功能一旦受到损伤就不可恢复,这必然会给病人的生活造成障碍并带来一定的经济负担。我国是原发性闭角型青光眼( PACG)的高发区,故早期发现、早期干预,将患者的视功能损害程度降到最低成为我国青光眼防盲工作的首要目标。本文中笔者对近年来有关闭角型青光眼诊断和治疗方法的新转变与发展趋势进行评述。

  6. Research progress on related genes for primary open angle glaucoma%原发性开角型青光眼的相关基因研究进展

    Institute of Scientific and Technical Information of China (English)

    艾力江·艾尔肯; 具尔提·哈第尔

    2014-01-01

    原发性开角型青光眼( POAG )是以视野缺损和视神经损害为特征的致盲性眼病。最近几年越来越多学者的研究结果表明基因的变异及遗传在原发性开角型青光眼的发生发展中起非常重要的作用。现在已知的原发性开角型青光眼致病基因有20余种,现在就目前较为确定的原发性开角型青光眼的相关基因,尤其是已确认的MYOC、OPTN、WDR36及CAV1/CAV2基因的定位、结构及相关研究等方面进行综述,为在原发性开角型青光眼的遗传基因研究方面提供一点参考。%Primary open angle glaucoma ( POAG ) is the main cause of blindness with visual field damage and optic nerve degeneration.In recent years, a lot of researches have been done, showing that genetic factors and gene mutation play an important role in POAG.There are more than 20 related POAG genes. Now we will review the related genes of POAG, especially the well known causative genes of MYOC, OPTN, WDR36, and CAV1/CAV2, in terms of their locations, structures, research progress, et al, and provide a reference for genetic research in primary open-angle glaucoma.

  7. How to reduce avoidable admissions due to acute diabetes complications?: Interrelation between primary and specialized attention in a diabetes unit

    Directory of Open Access Journals (Sweden)

    N. V. García-Talavera Espín

    2012-12-01

    Full Text Available Introduction: Type 2 Diabetes Mellitus is a serious health problem. In the year 2030 it will affect 366 million people around the world. Objective: Evaluate the effectiveness of a mixed intervention and reducing the amount and seriousness of acute complications in diabetics from our Health Area. Materials and method: Protocols of action as well as information documents were produced. Diabetes Unit coordinated educational activities in the different support levels of the Area VII of Murcia. Information talks were provided for the people in charge of the Diabetes Unit in every Care Center and Service of the Health Area. Personalized training was provided for patients treated in the differet Care levels. The study comprised three stages. Information leaflets were spread and talks offered to the patient regarding in house handling of hypo and hyper glycemia. Results: A reduction of 39% of the emergencies due to acute non complicated diabetes was achieved, as well as a reduction of 47.6% of hospital admissions. There was a reduction of 67.8% of the amount of total hospital stays for the group of patients under 35 years who were admitted into the hospital due to type 1 or 2 diabetes mellitus that didn't show any complications (GRD295. Conclusions: There was a reduction of more than thirty percent in the emergencies due to acute decompensations in the disease and a significant reduction in the avoidable hospital stays in the young adult, thus improving the patients' life quality and reducing the social cost of the diabetic patient.

  8. Comparison of risk of acute kidney injury after primary percutaneous coronary interventions with the transradial approach versus the transfemoral approach (from the PRIPITENA urban registry).

    Science.gov (United States)

    Cortese, Bernardo; Sciahbasi, Alessandro; Sebik, Rodrigo; Rigattieri, Stefano; Alonzo, Alessandro; Silva-Orrego, Pedro; Belloni, Flavia; Seregni, Romano G; Giovannelli, Francesca; Tespili, Maurizio; Ricci, Roberto; Berni, Andrea

    2014-09-15

    The risk of acute kidney injury (AKI) is a major issue after percutaneous coronary interventions (PCIs), especially in the setting of ST-elevation myocardial infarction. Preliminary data from large retrospective registries seem to show a reduction of AKI when a transradial (TR) approach for PCI is adopted. Little is known about the relation between vascular access and AKI after emergent PCI. We here report the results of the Primary PCI from Tevere to Navigli (PRIPITENA), a retrospective database of primary PCI performed at high-volume centers in the urban areas of Rome and Milan. Primary end point of this study was the occurrence of AKI in the TR and transfemoral (TF) access site groups. Secondary end points were major adverse cardiovascular events, stent thrombosis, and Thrombolysis in Myocardial Infarction major and minor bleedings. The database included 1,330 patients, 836 treated with a TR and 494 with a TF approach. After a propensity-matched analysis performed to exclude possible confounders, we identified 450 matched patients (225 TR and 225 TF). The incidence of AKI in the 2 matched groups was lower in patients treated with TR primary PCI (8.4% vs 16.9%, p = 0.007). Major adverse cardiovascular events and stent thrombosis were not different among study groups, whereas major bleedings were more often seen in the TF group. At multivariate analysis, femoral access was an independent predictor of AKI (odds ratio 1.654, 95% confidence interval 1.084 to 2.524, p = 0.042). In conclusion, in this database of primary PCI, the risk of AKI was lower with a TR approach, and the TF approach was an independent predictor for the occurrence of this complication.

  9. Impact of admission creatinine level on clinical outcomes of patients with acute ST-elevation myocardial infarction undergoing primary percutaneous coronary intervention with drug-eluting stent implantation

    Institute of Scientific and Technical Information of China (English)

    ZHANG Qi; ZHANG Rui-yan; SHEN Jie; ZHANG Jian-sheng; HU Jian; YANG Zheng-kun; ZHANG Xian; ZHENG Ai-fang; SHEN Wei-feng

    2008-01-01

    Background Prognosis of patients with acute ST-elevation myocardial infarction (STEMI) and renal dysfunction (RD) who received primary percutaneous coronary intervention (PCI) has not been fully investigated in the drug-eluting stent (DES) era.This study aimed to evaluate the impact of admission serum creatinine level on short-term outcomes in patients with acute STEMI undergoing DES-based primary PCI.Methods Primary PCI with DES implantation was attempted in 619 consecutive STEMI patients within 12 hours of symptom onset.Among them,86 patients had a serum creatinine level >115 μmol/L on admission (RD group),and the remaining 533 patients had normal renal function (non-RD group).The primary endpoint was 30-day major adverse cardiac events (MACE,including death,non-fatal reinfarction,and target vessel revascularization),and the secondary endpoint was subacute stent thrombosis.Results Patients in the RD group were older than those in the non-RD group.There are more female patients in the RD group and they had a history of hypertension,myocardial infarction and revascularization.The occurrence rates of Killip class ≥2 (29.1% vs 18.6%,P=0.02) and multi-vessel (62.8% vs 44.5%,P=0.001) and triple vessel disease (32.6% vs 18.2%,P=0.002),in-hospital mortality (9.3% vs 3.8%,P=0.03),and MACE rate during hospitalization (17.4% vs 7.7%,P=0.006) were higher in the RD group than those in the non-RD group.At a 30-day clinical follow-up,the MACE-free survival rate was significantly reduced in the RD group (76.7% vs 89.9%,P=0.0003).Angiographic stent thrombosis occurred in 3 (3.5%) and 7 (1.3%) of patients in the RD group and non-RD group,respectively (P=0.15).Multivariate analysis revealed that the serum creatinine level≥115 μmol/L on admission was an independent predictor for MACE rate at a 30-day follow-up (Hazard ratio (HR) 3.31,95% CI 1.19-9.18,P<0.001).Conclusion Despite similar prevalence of stent thrombosis at a 30-day clinical follow-up,the short-term prognosis of

  10. Primary dengue haemorrhagic fever in patients from northeast of Brazil is associated with high levels of interferon-β during acute phase

    Science.gov (United States)

    Oliveira, Renato Antônio dos Santos; da Silva, Mayara Marques Carneiro; Calzavara-Silva, Carlos Eduardo; Silva, Ana Maria; Cordeiro, Marli Tenório; de Moura, Patrícia Muniz Mendes Freire; Baptista, Paulo Neves; Marques, Ernesto Torres de Azevedo; Gil, Laura Helena Vega Gonzales

    2016-01-01

    Dengue is an acute febrile disease caused by the mosquito-borne dengue virus (DENV) that according to clinical manifestations can be classified as asymptomatic, mild or severe dengue. Severe dengue cases have been associated with an unbalanced immune response characterised by an over secretion of inflammatory cytokines. In the present study we measured type I interferon (IFN-I) transcript and circulating levels in primary and secondary DENV infected patients. We observed that dengue fever (DF) and dengue haemorrhagic fever (DHF) patients express IFN-I differently. While DF and DHF patients express interferon-α similarly (52,71 ± 7,40 and 49,05 ± 7,70, respectively), IFN- β were associated with primary DHF patients. On the other hand, secondary DHF patients were not able to secrete large amounts of IFN- β which in turn may have influenced the high-level of viraemia. Our results suggest that, in patients from our cohort, infection by DENV serotype 3 elicits an innate response characterised by higher levels of IFN- β in the DHF patients with primary infection, which could contribute to control infection evidenced by the low-level of viraemia in these patients. The present findings may contribute to shed light in the role of innate immune response in dengue pathogenesis. PMID:27223651

  11. Long-term outcome of primary angioplasty compared with fibrinolysis across age groups: a Danish Multicenter Randomized Study on Fibrinolytic Therapy Versus Acute Coronary Angioplasty in Acute Myocardial Infarction (DANAMI-2) substudy

    DEFF Research Database (Denmark)

    Fosbøl, Emil Loldrup; Thune, Jens Jakob; Kelbaek, Henning;

    2008-01-01

    BACKGROUND: Primary angioplasty in patients with acute ST-elevation myocardial infarction has been shown to be superior to fibrinolysis. Whether elderly patients have the same long-term benefit from angioplasty, compared with fibrinolysis, as younger patients is unknown. METHODS: The effect...... of angioplasty versus fibrinolysis was investigated in 1,572 patients from the DANAMI-2 study across age groups. End points were total mortality and a composite end point of death, reinfarction, or disabling stroke. Follow-up was 3 years. RESULTS: Increasing age was associated with mortality (adjusted hazard...... ratio [HR] 2.45 per 10 year increment, 95% confidence interval [CI] 1.78-3.37, P angioplasty over fibrinolysis on the combined outcome was independent of age: patients aged

  12. 小儿急性原发性EB病毒感染临床分析%Children with acute primary EB infection, clinical analysis

    Institute of Scientific and Technical Information of China (English)

    刘文梅

    2016-01-01

    Objective To analyze the clinical symptoms of children with acute primary EB infection. Methods In our hospital from January 2013 to January 2016 were admitted to the pediatric acute primary EB virus infection were analyzed using the ELISA method examination, 110 cases were EBV-VCA-IgM positive. Results In 110 cases of infectious mononucleosis in 6 cases accounted for 5.5%, accounted for 40%of 44 cases of acute upper respiratory tract infection, lymphadenitis in 9 cases accounted for 8.2%, 25.5%in 28 cases of acute bronchitis or pneumonia, 4 cases of viral encephalitis were accounted for 3.6%, accounted for 5.5%of 6 cases of viral myocarditis, idiopathic platelet reduction purpura in 7 cases accounted for 6.4%, 5 cases of allergic purpura disease in 1 cases accounted for 4.5%, Kawasaki accounted for 0.9%. Conclusion Children with acute primary EB infection may lead to respiratory system, nervous system, circulatory system and other serious damage, timely treatment, can effectively control the disease.%目的:分析探讨小儿急性原发性E B病毒感染的临床症状。方法:我院于2013年1月至2016年1月共收治的小儿急性原发性EB病毒感染患儿进行分析,使用ELISA法检查,检测EBV-VCA-IgM,阳性110例。结果:110例患儿中,传染性单核细胞增多症6例占5.5%,急性上呼吸道感染44例占40.0%,淋巴结炎9例占8.2%,急性支气管炎或肺炎28例25.5%,病毒性脑炎4例占3.6%,病毒性心肌炎6例占5.5%,特发性血小板减少性紫癜7例占6.4%,过敏性紫癜5例占4.5%,川崎病1例占0.9%。结论:小儿急性原发性EB病毒感染会导致呼吸系统、神经系统、循环系统等的严重损伤,及时治疗,能有效控制病情。

  13. Patterns of infection in patients with myelodysplastic syndromes and acute myeloid leukemia receiving azacitidine as salvage therapy. Implications for primary antifungal prophylaxis.

    Science.gov (United States)

    Falantes, Jose F; Calderón, Cristina; Márquez-Malaver, Francisco J; Aguilar-Guisado, Manuela; Martín-Peña, Almudena; Martino, María L; Montero, Isabel; González, Jose; Parody, Rocío; Pérez-Simón, Jose A; Espigado, Ildefonso

    2014-02-01

    Incidence, etiology, and outcome of infectious episodes in patients with myeloid neoplasms receiving azacitidine are uncertain, with no prospective data available in this group of patients. The aim of the current study was to analyze the incidence and factors related to the probability of infection in a cohort of patients with myelodysplastic syndrome (MDS) and acute myeloid leukemia (AML) treated with azacitidine who did not receive any type of antimicrobial prophylaxis. Significantly, the group of patients who received prior intensive chemotherapy had more infectious episodes (P = 10(-4)), and particularly, invasive aspergillosis (P = .015), than patients who received frontline azacitidine. Primary antifungal prophylaxis might be recommended in MDS and AML patients receiving azacitidine as salvage therapy after intensive regimens.

  14. Monitoring the changes in plasm C-reactive protein,fibrinogen and blood white cell in patients with primary hypertension combined with acute cerebral infarction

    Institute of Scientific and Technical Information of China (English)

    Yuanfei Deng; Juan Hang; Yane Chen

    2006-01-01

    BACKGROUND: Inflammatow reaction and the increased level of its accompanying active protein play an important role in the occurrence and development of cerebral infarction. C-reactive protein, fibrinogen and white blood cell, as the monitoring index of inflammatory reaction, are very important in the occurrence and development of acute cerebral infarction.OBJECTIVE: To make a comparison between patients with primary hypertension accompanied with acute cerebral infarction and with simple primary hypertension by observing the changes in plasma C-reactive protein and fibrinogen levels as well as white blood cell and differential counts and analyzing their significances.DESIGN : Controlled observation.SETTTNG: Ward Building for VIP, Shenzhen Hospital, Peking University.PARTICIPANTS: Totally 133 patients with primary hypertension were selected from Ward Building for VIP,Shenzhen Hospital, Peking University during September 2003 to September 2005. The diagnostic criteda were based on the hypertension diagnosis criteria formulated by the 7th World Health Organization-lnternational Society of Hypertension Guidelines (WHO-ISH) in 1998. The informed consents were obtained from all the participants. The involved patients were assigned into two groups: primary hypertension group, in which, there were 65 patients with primary hypertension ( degree 2), including 42 males and 23 females,with mean age of (61 ±14)years and mean blood pressure of (162.7±6.8)/(94.2±8.4) mm Hg(1 mm Hg =0.133 kPa), and primary hypertension combined with cerebral infarction group, in which, there were 68 patients with primary hypertension combined with cerebral infarction ( meeting the diagnostic criteria formulated in the 4th National Cerebrovascular Diseases Meeting in 1995 and diagnosed by skull CT or MRI to exclude the patients with lacunar infarction), including 42 males and 26 females, with mean age of (56±15)years and mean blood pressure of (176.4±9.2)/(96.3±9.7) mm Hg.METHODS: Plasm C

  15. Safety and efficacy of thrombectomy in patients undergoing primary percutaneous coronary intervention for Acute ST elevation MI: A Meta-Analysis of Randomized Controlled Trials

    Directory of Open Access Journals (Sweden)

    Grossman P Michael

    2010-02-01

    Full Text Available Abstract Background Clinical trials comparing thrombectomy devices with conventional percutaneous coronary interventions (PCI in patients with acute ST elevation myocardial infarction (STEMI have produced conflicting results. The objective of our study was to systematically evaluate currently available data comparing thrombectomy followed by PCI with conventional PCI alone in patients with acute STEMI. Methods Seventeen randomized trials (n = 3,909 patients of thrombectomy versus PCI were included in this meta-analysis. We calculated the summary odds ratios for mortality, stroke, post procedural myocardial blush grade (MBG, thrombolysis in myocardial infarction (TIMI grade flow, and post procedural ST segment resolution (STR using random-effects and fixed-effects models. Results There was no difference in risk of 30-day mortality (44/1914 vs. 50/1907, OR 0.84, 95% CI 0.54-1.29, P = 0.42 among patients randomized to thrombectomy, compared with conventional PCI. Thrombectomy was associated with a significantly greater likelihood of TIMI 3 flow (1616/1826 vs. 1533/1806, OR 1.41, P = 0.007, MBG 3 (730/1526 vs. 486/1513, OR 2.42, P Conclusions Thrombectomy devices appear to improve markers of myocardial perfusion in patients undergoing primary PCI, with no difference in overall 30-day mortality but an increased likelihood of stroke. The clinical benefits of thrombectomy appear to be influenced by the device type with a trend towards survival benefit with MAT and worsening outcome with mechanical devices.

  16. The role of appropriate diagnostic testing in acute respiratory tract infections: An antibiotic stewardship strategy to minimise diagnostic uncertainty in primary care.

    Science.gov (United States)

    Brink, Adrian John; Van Wyk, Johan; Moodley, V M; Corcoran, Craig; Ekermans, Pieter; Nutt, Louise; Boyles, Tom; Perovic, Olga; Feldman, Charles; Richards, Guy; Mendelson, Marc

    2016-05-10

    Antibiotic resistance has increased worldwide to the extent that it is now regarded as a global public health crisis. Interventions to reduce excessive antibiotic prescribing to patients can reduce resistance and improve microbiological and clinical outcomes. Therefore, although improving outpatient antibiotic use is crucial, few data are provided on the key interventional components and the effectiveness of antibiotic stewardship in the primary care setting, in South Africa. The reasons driving the excessive prescription of antibiotics in the community are multifactorial but, perhaps most importantly, the overlapping clinical features of viral and bacterial infections dramatically reduce the ability of GPs to distinguish which patients would benefit from an antibiotic or not. As a consequence, the need for tools to reduce diagnostic uncertainty is critical. In this regard, besides clinical algorithms, a consensus of collaborators in European and UK consortia recently provided guidance for the use of C-reactive protein point-of-care testing in outpatients presenting with acute respiratory tract infections (ARTIs) and/or acute cough, if it is not clear after proper clinical assessment whether antibiotics should be prescribed or not. A targeted application of stewardship principles, including diagnostic stewardship as described in this review, to the ambulatory setting has the potential to affect the most common indications for systemic antibiotic use, in that the majority (80%) of antibiotic use occurs in the community, with ARTIs the most common indication.

  17. [Renal infarction and acute arterial obstruction of the lower extremity encountered after surgery for primary lung cancer].

    Science.gov (United States)

    Tamaki, Masafumi; Miura, Kazumasa; Norimura, Shoko; Kenzaki, Koichirou; Yosizawa, Kiyoshi

    2013-02-01

    The patient was 68-year-old who underwent left upper lobectomy and lymph node dissection. On the 4th postoperative day, he developed vomiting and lumbar pain. On 5th postoperative day, he complained of pain, sensory paralysis and cold sensation of the right lower extremity. Computed tomography(CT)examination revealed left renal infarction and acute arterial obstruction of the right common iliac artery. Emergency thrombectomy of the right lower extremity was performed. Postoperatively, he received anticoagulant therapy and was able to leave the hospital on the 20th postoperative day. Attention should be paid to the infarction of abdominal organs when developing abdominal symptoms after lung cancer surgery in elderly patients.

  18. Comparison of Acute Toxicities in Two Primary Chemoradiation Regimens in the Treatment of Advanced Head and Neck Squamous Cell Carcinoma

    Science.gov (United States)

    Fan, Katherine Y.; Gogineni, Hrishikesh; Zaboli, David; Lake, Spencer; Zahurak, Marianna L.; Best, Simon R.; Levine, Marshall A.; Tang, Mei; Zinreich, Eva S.; Saunders, John R.; Califano, Joseph A.; Blanco, Ray G.; Pai, Sara I.; Messing, Barbara; Ha, Patrick K.

    2013-01-01

    Purpose The optimal dosage and frequency of platinum-based chemoradiotherapy (CRT) regimen for treating advanced head and neck squamous cell carcinoma remains unresolved. This study aims to compare the toxicity and efficacy of weekly versus more dose-intensive cisplatin-based CRTs. Methods We reviewed 155 stage III/IV head and neck squamous cell carcinoma patients with no evidence of distant metastasis treated with one of two CRT regimens from 2000 to 2010 at Greater Baltimore Medical Center. Twice-daily radiation was provided as a split course over a 45-day period. Regimen A consisted of concomitant cisplatin (30 mg/m2/1 h) weekly for 6 cycles; regimen B consisted of concomitant cisplatin (12 mg/m2/1 h) and 5-fluorouracil (600 mg/m2/20 h) on days 1 through 5 and days 29 through 33. Main outcome measures included acute toxicities (myelosuppression, neurotoxicity, nephrotoxicity, gastrointestinal dysfunction), unplanned hospitalizations, and disease control at 12 months. Results Patients on regimen A were much less likely to experience ototoxicity due to their treatment (0% vs. 9.8%, P = 0.04). They were more likely to experience thrombocytopenia acutely (46% vs. 26%, P = 0.02), but the toxicity was not limiting (grade 1–2). No significant differences exist in the incidence of other toxicities or unplanned hospitalizations. At 1 year, 97% of patients on A vs. 86% of patients on regimen B were free of disease (P = 0.11). Conclusions With concurrent radiotherapy, low-dose, single-agent, weekly cisplatin is less likely than higher-dose daily cisplatin plus 5-fluorouracil provided at the beginning and end of treatment to be associated with ototoxicity. The preliminary data suggest at least equivalent efficacy, but longer follow-up is required. PMID:22290566

  19. Use and outcome of thrombus aspiration in patients with primary PCI for acute ST-elevation myocardial infarction: results from the multinational Euro Heart Survey PCI Registry.

    Science.gov (United States)

    Weipert, Kay F; Bauer, Timm; Nef, Holger M; Möllmann, Helge; Hochadel, Matthias; Marco, Jean; Weidinger, Franz; Zeymer, Uwe; Gitt, Anselm K; Hamm, Christian W

    2016-09-01

    The clinical benefit of thrombus aspiration (TA) in patients presenting with acute ST-elevation myocardial infarction (STEMI) and treated with primary percutaneous coronary intervention (PCI) is not well defined. Furthermore, there is a large variation in the use of TA in real-world registries. Between 2005 and 2008, a total of 7146 consecutive patients with acute STEMI undergoing primary PCI were prospectively enrolled into the PCI Registry of the Euro Heart Survey Programme. For the present analysis, patients treated additionally with TA (n = 897, 12.6 %) were compared with those without TA (n = 6249, 87.4 %). Patients with hemodynamic instability at initial presentation (15.1 vs. 11.0 %; p < 0.001) and resuscitation prior to PCI (10.4 vs. 7.4 %; p = 0.002) were more frequently treated with TA. TIMI flow grade 0/1 before PCI was more often found among those with TA (73.5 vs. 58.6 %; p < 0.001). After adjustment for confounding factors in the propensity score analysis, TA was not associated with improved in-hospital survival (risk difference -1.1 %, 95 % confidence interval -2.7 to 0.6 %). In this European real-world registry, the rate of TA use was low. Hemodynamically unstable patients were more likely to be treated with TA. Consistent with the results of the TASTE study and the TOTAL trial, TA was not associated with a significant reduction in short-term mortality.

  20. The degree of acute descending control of spinal nociception in an area of primary hyperalgesia is dependent on the peripheral domain of afferent input.

    Science.gov (United States)

    Drake, Robert A R; Hulse, Richard P; Lumb, Bridget M; Donaldson, Lucy F

    2014-08-15

    Descending controls of spinal nociceptive processing play a critical role in the development of inflammatory hyperalgesia. Acute peripheral nociceptor sensitization drives spinal sensitization and activates spino-supraspinal-spinal loops leading to descending inhibitory and facilitatory controls of spinal neuronal activity that further modify the extent and degree of the pain state. The afferent inputs from hairy and glabrous skin are distinct with respect to both the profile of primary afferent classes and the degree of their peripheral sensitization. It is not known whether these differences in afferent input differentially engage descending control systems to different extents or in different ways. Injection of complete Freund's adjuvant resulted in inflammation and swelling of hairy hind foot skin in rats, a transient thermal hyperalgesia lasting hyperalgesia (≥7 days). Much longer lasting thermal hyperalgesia was apparent in glabrous skin (1 h to >72 h). In hairy skin, transient hyperalgesia was associated with sensitization of withdrawal reflexes to thermal activation of either A- or C-nociceptors. The transience of the hyperalgesia was attributable to a rapidly engaged descending inhibitory noradrenergic mechanism, which affected withdrawal responses to both A- and C-nociceptor activation and this could be reversed by intrathecal administration of yohimbine (α-2-adrenoceptor antagonist). In glabrous skin, yohimbine had no effect on an equivalent thermal inflammatory hyperalgesia. We conclude that acute inflammation and peripheral nociceptor sensitization in hind foot hairy skin, but not glabrous skin, rapidly activates a descending inhibitory noradrenergic system. This may result from differences in the engagement of descending control systems following sensitization of different primary afferent classes that innervate glabrous and hairy skin.

  1. Smac mimetic induces cell death in a large proportion of primary acute myeloid leukemia samples, which correlates with defined molecular markers

    Science.gov (United States)

    Lueck, Sonja C.; Russ, Annika C.; Botzenhardt, Ursula; Schlenk, Richard F.; Zobel, Kerry; Deshayes, Kurt; Vucic, Domagoj; Döhner, Hartmut; Döhner, Konstanze

    2016-01-01

    Apoptosis is deregulated in most, if not all, cancers, including hematological malignancies. Smac mimetics that antagonize Inhibitor of Apoptosis (IAP) proteins have so far largely been investigated in acute myeloid leukemia (AML) cell lines; however, little is yet known on the therapeutic potential of Smac mimetics in primary AML samples. In this study, we therefore investigated the antileukemic activity of the Smac mimetic BV6 in diagnostic samples of 67 adult AML patients and correlated the response to clinical, cytogenetic and molecular markers and gene expression profiles. Treatment with cytarabine (ara-C) was used as a standard chemotherapeutic agent. Interestingly, about half (51%) of primary AML samples are sensitive to BV6 and 21% intermediate responsive, while 28% are resistant. Notably, 69% of ara-C-resistant samples show a good to fair response to BV6. Furthermore, combination treatment with ara-C and BV6 exerts additive effects in most samples. Whole-genome gene expression profiling identifies cell death, TNFR1 and NF-κB signaling among the top pathways that are activated by BV6 in BV6-sensitive, but not in BV6-resistant cases. Furthermore, sensitivity of primary AML blasts to BV6 correlates with significantly elevated expression levels of TNF and lower levels of XIAP in diagnostic samples, as well as with NPM1 mutation. In a large set of primary AML samples, these data provide novel insights into factors regulating Smac mimetic response in AML and have important implications for the development of Smac mimetic-based therapies and related diagnostics in AML. PMID:27385100

  2. Diagnostic accuracy of point-of-care testing for acute coronary syndromes, heart failure and thromboembolic events in primary care: a cluster-randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Diemand Albert

    2011-03-01

    Full Text Available Abstract Background Evidence of the clinical benefit of 3-in-1 point-of-care testing (POCT for cardiac troponin T (cTnT, N-terminal pro-brain natriuretic peptide (NT-proBNP and D-dimer in cardiovascular risk stratification at primary care level for diagnosing acute coronary syndromes (ACS, heart failure (HF and thromboembolic events (TE is very limited. The aim of this study is to analyse the diagnostic accuracy of POCT in primary care. Methods Prospective multicentre controlled trial cluster-randomised to POCT-assisted diagnosis and conventional diagnosis (controls. Men and women presenting in 68 primary care practices in Zurich County (Switzerland with chest pain or symptoms of dyspnoea or TE were consecutively included after baseline consultation and working diagnosis. A follow-up visit including confirmed diagnosis was performed to determine the accuracy of the working diagnosis, and comparison of working diagnosis accuracy between the two groups. Results The 218 POCT patients and 151 conventional diagnosis controls were mostly similar in characteristics, symptoms and pre-existing diagnoses, but differed in working diagnosis frequencies. However, the follow-up visit showed no statistical intergroup difference in confirmed diagnosis frequencies. Working diagnoses overall were significantly more correct in the POCT group (75.7% vs 59.6%, p = 0.002, as were the working diagnoses of ACS/HF/TE (69.8% vs 45.2%, p = 0.002. All three biomarker tests showed good sensitivity and specificity. Conclusion POCT confers substantial benefit in primary care by correctly diagnosing significantly more patients. Trial registration DRKS: DRKS00000709

  3. Relation of Stature to Outcomes in Korean Patients Undergoing Primary Percutaneous Coronary Intervention for Acute ST-Elevation Myocardial Infarction (from the INTERSTELLAR Registry).

    Science.gov (United States)

    Moon, Jeonggeun; Suh, Jon; Oh, Pyung Chun; Lee, Kyounghoon; Park, Hyun Woo; Jang, Ho-Jun; Kim, Tae-Hoon; Park, Sang-Don; Kwon, Sung Woo; Kang, Woong Chol

    2016-07-15

    Although epidemiologic studies have shown the impact of height on occurrence and/or prognosis of cardiovascular diseases, the underlying mechanism is unclear. In addition, the relation in patients with ST-segment elevation myocardial infarction (STEMI) who underwent primary percutaneous coronary intervention (PCI) remains unknown. We sought to assess the influence of height on outcomes of patients with acute STEMI undergoing primary PCI and to provide a pathophysiological explanation. All 1,490 patients with STEMI undergoing primary PCI were analyzed. Major adverse cardiac and cerebrovascular events (MACCE) were defined as all-cause mortality, nonfatal myocardial infarction, nonfatal stroke, and unplanned hospitalization for heart failure (HF). Patients were divided into (1) MACCE (+) versus MACCE (-) and (2) first- to third-tertile groups according to height. MACCE (+) group was shorter than MACCE (-) group (164 ± 8 vs 166 ± 8 cm, p = 0.012). Prognostic impact of short stature was significant in older (≥70 years) male patients even after adjusting for co-morbidities (hazard ratio 0.951, 95% confidence interval 0.912 to 0.991, p = 0.017). The first-tertile group showed the worst MACCE-free survival (p = 0.035), and most cases of MACCE were HF (n, 17 [3%] vs 6 [1%] vs 2 [0%], p = 0.004). On post-PCI echocardiography, left atrial volume and early diastolic mitral velocity to early diastolic mitral annulus velocity ratio showed an inverse relation with height (p <0.001 for all) despite similar left ventricular ejection fraction. In conclusion, short stature is associated with occurrence of HF after primary PCI for STEMI, and its influence is prominent in aged male patients presumably for its correlation with diastolic dysfunction.

  4. Outcome of children with acute myeloid leukaemia (AML) experiencing primary induction failure in the AIEOP AML 2002/01 clinical trial.

    Science.gov (United States)

    Quarello, Paola; Fagioli, Franca; Basso, Giuseppe; Putti, Maria C; Berger, Massimo; Luciani, Matteo; Rizzari, Carmelo; Menna, Giuseppe; Masetti, Riccardo; Locatelli, Franco

    2015-11-01

    Paediatric patients with acute myeloid leukaemia (AML) who fail induction due to primary resistance to chemotherapy account for a significant proportion of cases and have a particularly dismal prognosis. We report the clinical and biological data, and final outcome of 48 paediatric patients with primary-resistant AML enrolled in the Associazione Italiana di Ematologia e Oncologia Pediatrica AML 2002/01 clinical trial. These patients had a significantly higher white blood cell count at diagnosis compared to other AML patients. Cytogenetic and molecular features did not differ between patients with primary induction failure and patients allocated to the high-risk group. For the whole patient population, the probability of overall survival, event-free survival (EFS) and disease-free survival (DFS) was 21·8% ± 6·2, 20·4% ± 5·9, and 49·5% ± 11·3, respectively. Twenty-eight (58%) patients received haematopoietic stem cell transplantation (HSCT); 3 were autologous and 25 were allogeneic. Patients who underwent HSCT had improved EFS (31·2% vs. 5%, P < 0·0001). Only one of the 20 patients who did not receive HSCT is alive and disease free. The 19 patients in complete remission at time of HSCT showed significantly better DFS than the 9 with active disease (46% vs. 0%, P = 0·02). This study represents one of the largest series with long-term follow up of paediatric AML patients with primary refractory disease. Children who underwent transplantation had an encouraging long-term outcome. Disease recurrence remains the major cause of treatment failure; a better understanding of the disease biology is desirable to develop more effective treatment strategies.

  5. Relation of hyperglycemia to ST-segment resolution after primary percutaneous coronary intervention for acute myocardial infarction

    Institute of Scientific and Technical Information of China (English)

    CHI Hong-jie; ZHANG Da-peng; XU Yuan; YANG Zhong-su; WANG Le-feng; CUI Liang; YANG Xin-chun

    2007-01-01

    Background Hyperglycemia has been shown to be a powerful predictor of poor outcome after ST-segment elevation myocardial infarotion (STEMI). This study aimed to evaluate the effect of admission glucose on microvascular flow after successful primary percutaneous coronary intervention (PCI) in patients with STEMI.Methods Successful primary PCI was performed in 267 patients with STEMI. The maximum ST elevation of single electrocardiogram (ECG) lead before and 60 minutes after PCI was measured, and patients were then divided into 3 groups according to the degree of ST-segment resolution (STR): absent (<30%), partial (30% to 70%) or complete(≥7o%).Results Of the 267 patients, 48 (18.0%) had absent STR, 137 (51.3%) experienced partial STR, and 82 (30.7%) had complete STR. The degree of STR decreased with increasing admission glucose levels (P=0.032), and patients with hyperglycemia (serum glucose level ≥11 mmol/L) were more likely to have absent STR (P=0.001). Moreover,hyperglycemia was an independent predictor of incomplete STR (odds ratio, 1.870; 95% confidence interval, 1.038 to 3.371, P=0.037).Conclusions Hyperglycemia on admission is associated with abnormal coronary microvascular reperfusion in patients with STEMI after successful primary PCI, which may contribute, at least in part, to the poor outcomes in these patients.

  6. New Management of Angle-closure Glaucoma by Phacoemulsification with Foldable Posterior Chamber Intraocular Lens Implantation

    Institute of Scientific and Technical Information of China (English)

    Jian Ge; Yan Guo; Yizhi Liu; Mingkai Lin; Yehong Zhuo; Bing Chen; Xiuqi Chen

    2000-01-01

    Objective: To investigate the management of angle-closure glaucoma by phacoemulsification with foldable posterior chamber intraocular lens (PC-IOL) implantation. Design: Retrospective, noncontrolled interventional case series.Participants: In 36 eyes with angle-closure glaucoma (ACG), there were 18 eyes with primary acute angle-closure glaucoma (PACG), 14 eyes with primary chronic angle-closure glaucoma (PCCG), 3 eyes with secondary acute angle-closure glaucoma (SACG) and 1 eye with secondary chronic angle-closure glaucoma (SCCG).Intervention: Phacoemulsification with posterior chamber intraocular lens implantation.Main Outcome Measures: Postoperative visual acuity, IOP, axial anterior chamber depth.Results: After a mean postoperative follow-up time of 8.81 ± 7.45 months, intraocular pressure was reduced from a preoperative mean of 23.81 ± 17.84 mmHg to a postoperative mean of 12.54 ± 4. 73 mmHg ( P = 0. 001 ). Mean anterior chamber depth was 1.75 ± 0.48 mm preoperatively and 2.29 ± 0.38 mm postoperatively ( P = 0. 000).Best spectacle-corrected visual acuity in 36 eyes ranged from 0. 01 to 0. 7 (20/200 to 20/30) postoperatively, which was better than preoperative VA ranging from hand movement to 0.4 (20/50) ( P= 0. 000).Conclusion: Phacoemulsification with posterior chamber foldable intraocular lens implantation can be a good alternative in treating angle-closure glaucoma. Eye Science 2000; 16:22 ~ 28.

  7. 原发性闭角型青光眼易感基因位点统计模型预测分析研究%Statistical model analysis of primary angle closure glaucoma associated genes and SNP

    Institute of Scientific and Technical Information of China (English)

    桑景荭; 张业武; 王宁利

    2015-01-01

    目的 评价相关易感基因位点检测对PACG患者的诊断效力.方法 实验研究.通过统计反演算和统计模拟的演算,对已知4个相关易感单核苷酸多态性(SNP)位点rs11024102(PLEKHA7)、rs3753841 (COL11A1)、rs1015213(PCMTD1-ST18)及rs1401999(ABCC5)检测的敏感性、特异性和阳性预测值进行评价.结果 在对单一SNP位点的统计模拟中,rs11024102(PLEKHA7)对PACG患者诊断的敏感性为55.88%,特异性为51.31%;rs3753841(COL11A1)诊断的敏感性为54.47%,特异性为51.00%;rs1015213(PCNTD1-ST18)诊断的敏感性为59.93%,特异性为45.32%;rs1401999(ABCC5)诊断的敏感性为52.97%,特异性为50.00%.4个SNP位点的阳性预测值曲线均贴近无效参考值.4个位点的联合作用在提高敏感度场景的统计模拟中,获得的ROC曲线下面积为0.51.在提高特异度的场景中,ROC曲线下面积为0.52.4个位点自由组合的统计模拟结果发现单一SNP位点和多个SNP位点组合的诊断效力均较差.结论 4个已知相关易感基因位点检测对PACG诊断效力差,尚不能作为单独的诊断试验用于临床筛查.%Objective To evaluate GWAS significant associated SNP for primary angle closure glaucoma.Methods Experimental study.Taking advantage of different statistical models,the usefulness was evaluated by sensitivity,specificity and the area under the receiver-operating characteristic curve (ROC),which indicates the accuracy of genetic profiling in discriminating between primary angle closure glaucoma patients and normal controls.Results rs11024102 (PLEKHA7)had a sensitivity of 55.88% with a specificity of 51.31% ; the sensitivity and specificity of rs3753841 (COL1 1 A1) was 54.47% and 51.00% respectively.The sensitivity of rs1015213 (PCNTD1-ST18) and rs1401999 (ABCC5) were 59.93% and 52.97%.The specificity of these two SNP were 45.32% and 50.00%.The positive predictive value curves of these four SNP were nearly reference line.The area

  8. Reducing Door to- Balloon- Time for Acute ST Elevation Myocardial Infarction In Primary Percutaneous Intervention: Transformation using Robust Performance Improvement.

    Science.gov (United States)

    Ellahham Md, Samer; Aljabbari, Samir; Harold Mananghaya, Tristan; J Raji, Salama; Al Zubaidi, Abdulmajeed

    2015-01-01

    Cardiovascular diseases (CVDs) are the leading causes of death in the UAE. Prompt reperfusion access is essential for patients who have Myocardial Infarction (MI) with ST-segment elevation as they are at a relatively high risk of death.This risk may be reduced by primary percutaneous coronary intervention (PCI), but only if it is performed in a timely manner. Guidelines recommend that the interval between arrival at the hospital and intracoronary balloon inflation (door-to-balloon (D2B) time) during primary PCI should be 90 minutes or less. The earlier therapy is initiated, the better the outcome. Our aim was to decrease the door-to-balloon time for patients with ST segment elevation myocardial infarction (STEMI) who come through the emergency department (ED) in Sheikh Khalifa Medical City,a tertiary hospital in UAE, to meet the standard of less than 90 minutes. A multidisciplinary team was formed including interventional cardiologists, catheterization laboratory personnel, emergency department caregivers and quality staff. The project utilized the Lean Six Sigma Methodology which provided a powerful approach to quality improvement. The process minimized waste and variation, and a decreased median door-to-balloon time from 75.9 minutes to 60.1 minutes was noted. The percentage of patients who underwent PCI within 90 minutes increased from 73% to 96%. In conclusion, implementing the Lean Six Sigma methodology resulted in having processes that are leaner, more efficient and minimally variable. While recent publication failed to provide evidence of better outcome, the lessons learned were extrapolated to other primary percutaneous coronary intervention centers in our system.This would have marked impact on patient safety, quality of care and patient experience.

  9. Reducing Door to- Balloon- Time for Acute ST Elevation Myocardial Infarction In Primary Percutaneous Intervention: Transformation using Robust Performance Improvement

    Science.gov (United States)

    Ellahham, MD, Samer; Aljabbari, Samir; Harold Mananghaya, Tristan; J. Raji, Salama; Al Zubaidi, Abdulmajeed

    2015-01-01

    Cardiovascular diseases (CVDs) are the leading causes of death in the UAE. Prompt reperfusion access is essential for patients who have Myocardial Infarction (MI) with ST-segment elevation as they are at a relatively high risk of death.This risk may be reduced by primary percutaneous coronary intervention (PCI), but only if it is performed in a timely manner. Guidelines recommend that the interval between arrival at the hospital and intracoronary balloon inflation (door-to-balloon (D2B) time) during primary PCI should be 90 minutes or less. The earlier therapy is initiated, the better the outcome. Our aim was to decrease the door-to-balloon time for patients with ST segment elevation myocardial infarction (STEMI) who come through the emergency department (ED) in Sheikh Khalifa Medical City,a tertiary hospital in UAE, to meet the standard of less than 90 minutes. A multidisciplinary team was formed including interventional cardiologists, catheterization laboratory personnel, emergency department caregivers and quality staff. The project utilized the Lean Six Sigma Methodology which provided a powerful approach to quality improvement. The process minimized waste and variation, and a decreased median door-to-balloon time from 75.9 minutes to 60.1 minutes was noted. The percentage of patients who underwent PCI within 90 minutes increased from 73% to 96%. In conclusion, implementing the Lean Six Sigma methodology resulted in having processes that are leaner, more efficient and minimally variable. While recent publication failed to provide evidence of better outcome, the lessons learned were extrapolated to other primary percutaneous coronary intervention centers in our system.This would have marked impact on patient safety, quality of care and patient experience. PMID:26734321

  10. A combined analysis of five observational studies evaluating the efficacy and tolerability of bimatoprost/timolol fixed combination in patients with primary open-angle glaucoma or ocular hypertension

    Directory of Open Access Journals (Sweden)

    Pfennigsdorf S

    2013-06-01

    Full Text Available Stefan Pfennigsdorf,1 Leo de Jong,2 Stefan Makk,3 Yvette Fournichot,4 Alain Bron,5 Robert J Morgan-Warren,6 John Maltman6 1Ophthalmology Practice, Polch, Germany; 2Academic Medical Center, University of Amsterdam, Amsterdam, Netherlands; 3Ophthalmology Practice, Graz, Austria; 4Ophthalmology Practice, Schlieren, Switzerland; 5Department of Ophthalmology, University Hospital, Dijon, France; 6Allergan Ltd, Marlow, UK Objective: The aim of this study was to evaluate the safety and efficacy of a fixed combination of bimatoprost 0.03% and timolol (BTFC in a clinical setting, in a large sample of patients with primary open-angle glaucoma or ocular hypertension and insufficient intraocular pressure (IOP lowering on prior therapy. Methods: Patient data were combined (n = 5556 from five multicenter, observational, non-controlled, open-label studies throughout Europe. Patients were identified from 830 sites in Austria, France, Germany, The Netherlands, and Switzerland. Assessments were made at baseline, 6 weeks (in Austrian, German and Swiss centers, and 12 weeks in all centers. Results: BTFC lowered mean IOP from baseline by 5.4 mmHg over the 12-week duration of the studies (P < 0.0001. At study entry, 92.9% of patients were receiving another ocular hypotensive medication. In patients with no previous treatment (n = 311, BTFC reduced IOP by -9.1 mmHg, corresponding to a reduction from baseline of 36.4% (P < 0.0001. In patients receiving prior therapy of a prostaglandin analog, a ß-blocker, or a fixed combination, BTFC reduced IOP by a further 24.5%, 25.9%, and 21.4%, respectively. The majority of patients (90.3% reported no adverse events. The most common adverse events were conjunctival hyperemia (3.2% and eye irritation (2.8%. BTFC was rated as "good" or "very good" by 92.5% of physicians and 88.0% of patients. Most patients (96.3% were equally or more compliant with BTFC than with their previous treatment. Conclusion: In routine clinical practice

  11. Primary coronary angioplasty in 9,434 patients during acute myocardial infarction: predictors of major in- hospital adverse events from 1996 to 2000 in Brazil

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    Mattos Luiz Alberto

    2002-01-01

    Full Text Available OBJECTIVE: To verify the results after the performance of primary coronary angioplasty in Brazil in the last 4 years. METHODS: During the first 24 hours of acute myocardial infarction onset, 9,434 (12.2% patients underwent primary PTCA. We analyzed the success and occurrence of major in-hospital events, comparing them over the 4-year period. RESULTS: Primary PTCA use increased compared with that of all percutaneous interventions (1996=10.6% vs. 2000=13.1%; p<0.001. Coronary stent implantation increased (1996=20% vs. 2000=71.9%; p<0.001. Success was greater (1998=89.5% vs. 1999=92.5%; p<0.001. Reinfarction decreased (1998=3.9% vs. 99=2.4% vs. 2000=1.5%; p<0.001 as did emergency bypass surgery (1996=0.5% vs. 2000=0.2%; p=0.01. In-hospital deaths remained unchanged (1996=5.7% vs. 2000=5.1%, p=0.53. Balloon PTCA was one of the independent predictors of a higher rate of unsuccessful procedures (odds ratio 12.01 [CI=95%] 1.58-22.94, and stent implantation of lower mortality rates (odds ratio 4.62 [CI=95%] 3.19-6.08. CONCLUSION: The success rate has become progressively higher with a significant reduction in reinfarction and urgent bypass surgery, but in-hospital death remains nearly unchanged. Coronary stenting was a predictor of a lower death rate, and balloon PTCA was associated with greater procedural failure.

  12. Aquaporin 9, a promising predictor for the cytocidal effects of arsenic trioxide in acute promyelocytic leukemia cell lines and primary blasts.

    Science.gov (United States)

    Iriyama, Noriyoshi; Yuan, Bo; Yoshino, Yuta; Hatta, Yoshihiro; Horikoshi, Akira; Aizawa, Shin; Takeuchi, Jin; Toyoda, Hiroo

    2013-06-01

    A close correlation between the cytocidal effects of arsenic trioxide (ATO) and aquaporin-9 (AQP9) expression levels has been proposed, yet detailed studies are still needed to confirm this association. Thus, in the present study, the correlation between the expression levels of AQP9 and sensitivity to ATO was investigated using two acute promyelocytic leukemia (APL) cell lines, NB4 and HT93A, as well as primary APL cells from newly diagnosed and relapsed APL patients. A substantially higher sensitivity to ATO-mediated induction of apoptosis was observed in the NB4 cells when compared to that in the HT93A cells. In addition, markedly higher expression levels of AQP9, as assessed using flow cytometry, along with more intracellular arsenic accumulation, were observed in the NB4 cells. More importantly, similar to APL cell lines, the trend of expression levels of AQP9 correlated closely with the differential sensitivity to ATO-mediated induction of apoptosis in primary APL cells. In contrast, no correlation was observed between ATO sensitivity associated with AQP9 expression levels and the expression profiles of cell surface markers as well as chromosomal alterations. These results provide direct evidence that the expression levels of AQP9, rather than other biomarkers such as cell surface markers and chromosomal alterations, correlate closely with the sensitivity to ATO in both APL cell lines and primary blasts. These findings suggest that the AQP9 expression status of APL patients is a predictive marker for the successful outcome of ATO treatment, since AQP9 plays a pivotal role in various arsenite-mediated biological effects on normal and cancer cells. Moreover, flow cytometry may be a new convenient and valuable tool for analyzing the AQP9 status of APL patients compared to current methods such as western blotting.

  13. Influence of lifestyle on primary open angle glaucoma patients%生活方式对原发性开角型青光眼患者的影响

    Institute of Scientific and Technical Information of China (English)

    潘英姿; 方圆

    2016-01-01

    原发性开角型青光眼(POAG)患者应遵守医生制定的治疗方案进行治疗,定期复查,并坚持目前普遍认同的健康生活方式如拒绝吸烟、适量运动、多吃水果蔬菜等.根据现有的研究结果,POAG患者应尽量避免可能升高眼压的活动如某些瑜伽动作、长时间吹奏管乐器、过量饮用咖啡等,以最大限度降低青光眼进展的风险,保护视神经.%Primary open angle glaucoma (POAG) patients should comply with medical therapy and follow-up recommendations by doctors provided.Doctors also suggest POAG patients advocating for activities consistent with overall good health such as avoidance of smoking,moderate exercise and a diet high in fruits and vegetables.According to the existing research results,POAG patients should avoid some activities that could elevate intraocular pressure such as certain yoga positions,playing high wind instruments for long periods of time,and drinking large amounts of caffeinated coffee,to reduce the risk of glaucoma progression and protect optic nerve.

  14. 原发性开角型青光眼致病基因研究进展及研究策略%Research progress and strategies on identification of disease-caused genes in primary open angle glaucoma

    Institute of Scientific and Technical Information of China (English)

    顾明亮

    2012-01-01

    Glaucoma is an optic nerve disease characterized by optic nerve damage and visual impairment.Its characteristics are progressive,irreversible and with genetic heterogeneity.It is the second most common causes,after cataract,of the blindness.Primary open angle glaucoma (POAG) is the most common type.In this review,we will provide a brief overview of glaucoma,including classical genetics research strategies,research progre.ss,and current research strategies,challenges and countermeasures in identification of causative genes by whole-exome sequencing.%青光眼是一种以视神经损伤和相应视功能损害为特征的视神经疾病,具有渐进性、不可逆性和遗传异质性的特点,是位居第二的致盲性疾病,其中原发性开角型青光眼则最为常见.此文对青光眼经典的遗传学研究策略及主要的研究进展进行简要的概述;对采取全外显子组测序(whole-exome sequencing)鉴定致病基因的策略、面临的挑战及采取的对策进行系统的阐述.

  15. Comparison of diagnostic capability of macular ganglion cell complex and retinal nerve fiber layer among primary open angle glaucoma, ocular hypertension, and normal population using Fourier-domain optical coherence tomography and determining their functional correlation in Indian population

    Directory of Open Access Journals (Sweden)

    Nabanita Barua

    2016-01-01

    Full Text Available Context: Analysis of diagnostic ability of macular ganglionic cell complex and retinal nerve fiber layer (RNFL in glaucoma. Aim: To correlate functional and structural parameters and comparing predictive value of each of the structural parameters using Fourier-domain (FD optical coherence tomography (OCT among primary open angle glaucoma (POAG and ocular hypertension (OHT versus normal population. Setting and Design: Single centric, cross-sectional study done in 234 eyes. Materials and Methods: Patients were enrolled in three groups: POAG, ocular hypertensive and normal (40 patients in each group. After comprehensive ophthalmological examination, patients underwent standard automated perimetry and FD-OCT scan in optic nerve head and ganglion cell mode. The relationship was assessed by correlating ganglion cell complex (GCC parameters with mean deviation. Results were compared with RNFL parameters. Statistical Analysis: Data were analyzed with SPSS, analysis of variance, t-test, Pearson′s coefficient, and receiver operating curve. Results: All parameters showed strong correlation with visual field (P 0.5 when compared with other parameters. None of the parameters showed significant diagnostic capability to detect OHT from normal population. In diagnosing early glaucoma from OHT and normal population, only inferior GCC had statistically significant AUC value (0.715. Conclusion: In this study, GCC and RNFL parameters showed equal predictive capability in perimetric versus normal group. In early stage, inferior GCC was the best parameter. In OHT population, single day cross-sectional imaging was not valuable.

  16. Size of the Optic Nerve Head and Its Relationship with the Thickness of the Macular Ganglion Cell Complex and Peripapillary Retinal Nerve Fiber Layer in Patients with Primary Open Angle Glaucoma

    Directory of Open Access Journals (Sweden)

    Nobuko Enomoto

    2015-01-01

    Full Text Available Purpose. To evaluate the relationships among the optic nerve head (ONH area, macular ganglion cell complex (mGCC thickness, circumpapillary retinal nerve fiber layer (cpRNFL thickness, and visual field defects in patients with primary open angle glaucoma (POAG. Methods. This retrospective study included 90 eyes of 90 patients with POAG. The ONH area, rim area, mGCC thickness, and cpRNFL thickness were measured using optical coherence tomography. Mean deviation (MD was measured using standard automated perimetry. The relationships among clinical factors including age, refraction, the ONH area, the rim area, the mGCC thickness, the cpRNFL thickness, and MD were evaluated using correlation coefficients and multiple regression analyses. Results. The significant correlation of the ONH area with refraction (r=0.362, P<0.001, the mGCC thickness (r=0.225, P=0.033, and the cpRNFL thickness (r=0.253, P=0.016 was found. Multiple regression analysis showed that the ONH area, rim area, and MD were selected as significant contributing factors to explain the mGCC thickness and cpRNFL thickness. No factor was selected to explain MD. Conclusions. The ONH area, in other words, the disc size itself may affect the mGCC thickness and cpRNFL thickness in POAG patients.

  17. Epidemiology of primary angle-closure glaucoma in a rural population in Shaanxi Province of China%中国陕西省农村原发性闭角型青光眼流行病学调查

    Institute of Scientific and Technical Information of China (English)

    白芝兰; 任百超; 杨建刚; 何媛; 陈莉; 孙乃学

    2005-01-01

    目的:调查陕西省农村≥40岁人群原发性闭角型青光眼的患病率及影响因素.方法:2003-07/12,采用按比例随机整群抽样的方法在陕南、陕北及关中3个地区农村调查8 500人,其中≥40岁人群3 500人,所有受检人员均进行标准问卷调查,包括询问青光眼确诊史、家族史、发作史及手术史,并进行了相关的眼科检查,包括视力、外眼、Van Herick周边前房深度评估、眼底检查.≥50岁人群及怀疑有高眼压者对其应用压平式眼压计测量眼压.对可疑青光眼者进行进一步检查,包括复查眼压、前房角镜检查、暗室试验、视野检查.结果:8 500人中有6 815人完成了青光眼的相关检查,总受检率为80.18%,其中≥40岁人群3 500人中有2 835人完成了青光眼的相关检查,受检率为81.00%.Van Herick周边前房深度分级:2级、1级和0级分别占10.4%、3.0%和0.2%.≥40岁人群原发性闭角型青光眼患者有31例,其患病率为1.09%,通过多因素logistic回归分析显示随着年龄的增长患病率显著增加(P=0.008).虽然女性较男性多见(0R:1.77,95%CI为O.77~4.10),文盲较非文盲多见(OR:1.71,95%CI为0.76~3.87),但其差异无统计学意义(P不同性别=0.180,P不同文化程度=0.199).事前未被诊断为青光眼的患者占67.74%(21例),在另外1 0例有确诊史的青光眼患者中只有6例(60%)曾作过虹膜根切术.48.39%(15例)原发性闭角型青光眼患者存在不同程度的视力损伤,其中盲目占29.03%.70.97%(22例)为慢性闭角型青光眼.结论:陕西省农村≥40岁人群的窄房角比例高于亚洲其他国家人群.原发性闭角型青光眼的患病率与国内其他报道相近,且随着年龄的增长而增加.大部分患者无青光眼确诊史.%· AIM: To assess the prevalence and related risk factors for primary angle-closure glaucoma in a rural population for 40 years of age or older in Shaanxi Province.· METHODS: By using a stratified, cluster

  18. Prasugrel vs clopidogrel in cardiogenic shock patients undergoing primary PCI for acute myocardial infarction. Results of the ISAR-SHOCK registry.

    Science.gov (United States)

    Orban, M; Mayer, K; Morath, T; Bernlochner, I; Hadamitzky, M; Braun, S; Schulz, S; Hoppmann, P; Hausleiter, J; Tiroch, K; Mehilli, J; Schunkert, H; Massberg, S; Laugwitz, K-L; Sibbing, D; Kastrati, A

    2014-12-01

    There is limited clinical data comparing different P2Y12-receptor inhibitors in patients with acute myocardial infarction (AMI) complicated by cardiogenic shock. The aim of the ISAR-SHOCK registry was to compare the clinical outcome of patients treated with clopidogrel vs prasugrel in this setting. Patients (n=145) with AMI complicated by cardiogenic shock and undergoing primary PCI in two centres (Deutsches Herzzentrum München and Klinikum rechts der Isar, Technical University Munich) between January 2009 and May 2012 were included in this registry. The use of prasugrel for patients within this registry reflected co-morbidities and platelet function testing results during the acute AMI phase. Early outcome at 30-days was reported with regard to all-cause mortality, myocardial infarction (MI), stent thrombosis (ST) and bleeding events. With regard to antiplatelet treatment in the 145 cardiogenic shock patients, 50 patients were initially treated or immediately switched to prasugrel while 95 patients were treated with clopidogrel. All-cause mortality was lower in prasugrel- vs clopidogrel-treated patients (30 % vs 50.5%, HR: 0.51, 95% CI [0.29-0.92], p=0.025). No significant differences in prasugrel- vs clopidogrel-treated patients were observed for the occurrence of MI (p=0.233), ST (p=0.306) or TIMI major bleedings (p=0.571). Results of the ISAR-SHOCK registry suggest that the use of prasugrel in AMI patients complicated by cardiogenic shock might be associated with a lower mortality risk as compared to clopidogrel therapy without increasing the risk of bleeding. These findings, however, need confirmation from specifically designed randomised studies in this high-risk cohort of patients.

  19. The observation of anterior segment morphological changes in eyes with primary angle closure after LPI by using UBM%原发性前房角关闭行LPI后眼前节形态学的UBM观察

    Institute of Scientific and Technical Information of China (English)

    吴杨杨; 宋胜仿; 刘世纯; 李春华; 张永烨; 吕莎

    2014-01-01

    观察原发性前房角关闭(primary angle closure, PAC)行YAG激光周边虹膜切除术(laser peripheral iridotomy, LPI)后眼前节形态学的变化。方法:选择2012年3月至2013年3月在我院诊断为PAC并行LPI的患者28例(48眼)为研究对象,应用超声生物显微镜(ultrasound biomicroscopy, UBM),观察LPI术前及术后1天、1周、1个月及3个月各时间点颞上、正上、正下、颞侧、鼻侧共5个位点的房角开放距离(angle opening distance, AOD500)、小梁虹膜夹角(trabecu-lar-iris angle, TIA)、小梁睫状体距离(trabecular ciliary process distance, TCPD)、虹膜睫状体距离(iris ciliary process distance , ICPD)、虹膜晶体夹角(iris lens angle, ILA)、虹膜晶体接触距离(iris lens process distance, ILCD)、虹膜厚度1(iris thickness, ITl)、IT2、IT3以及中央前房深度(cental depth distance, ACD)的变化。结果:AOD500、TIA:术后较术前均增大(P<0.05);术后1周大于术后其余时间点(P>0.05)。TCPD:除个别位点较术前增加(P>0.05),其余时间点相应位点较术前增加(P<0.05);术后1周大于术后其余时间点(P>0.05)。ILA:术后较术前均减小(P<0.05);术后1天至术后3个月逐渐增大(P>0.05)。ILCD:术后较术前均增大(P<0.05),术后1天至术后3个月逐渐减小(P>0.05);IT1、IT2、IT3:术后较术前均减小(P<0.05);术后各时间点间比较(P>0.05)。ACD:术后较术前增加(P>0.05)。 LPI术前及术后各时间点平均ILA与平均ILCD的相关性显示二者呈高度负相关。结论:PAC患者行LPI术后周边前房明显加深,虹膜膨隆和瞳孔阻力减轻,但术后3个月内眼前节形态并不稳定,个别参考值有不同程度的回退,LPI术后有必要进行长期随访观察。%Objective To evaluate the changes in the anterior segment morphology by using ultrasound biomicroscopy (UBM) after YAG laser

  20. 眼前节相干光断层扫描在原发性闭角型青光眼诊治中的应用%Anterior segment optical coherence tomography for the evaluation of primary angle closure glaucoma

    Institute of Scientific and Technical Information of China (English)

    刘杏; 李媚

    2013-01-01

    眼前节相干光断层扫描(AS-OCT)是继超声生物显微镜(UBM)后又一种眼前段成像检测手段,其为无创性、非接触性,分辨率较UBM高.可测量包括角膜、前房、前房角、虹膜、晶状体等多个眼前段结构参数.本文评价了AS-OCT在原发性闭角型青光眼(PACG)诊治中利用AS-OCT了解PACG和正常人眼前段生物学参数的差异,了解周边虹膜切开(或切除)术后、小梁切除术后、白内障手术后PACG的眼前段结构性参数的变化,以及对小梁切除术后滤过泡功能进行评估等,强调AS-OCT在PACG的诊断、发病机制、治疗观察中具有重要的临床应用价值.%Anterior segment optical coherence tomography (AS-OCT) is an imaging instrument developped after ultrasound biomi-croscopy (UBM). Moreover, AS-OCT is a non-invasive and non-contact instrument with a higher resolution than UBM. AS-OCT offers anterior segment images of the cornea, anterior chamber, anterior chamber angle, iris and lens. In this article, the value of AS-OCT is e-valuated in the diagnosis and treatment of primary angle closure glaucoma (PACG), including the application of AS-OCT in observing the differences between PACG and normal controls, the changes in anterior segment configuration after peripheral iridectomy/trabeculec-tomy/ cataract surgery in PACG, and the morphology of filtering blebs after trabeculectomy. The present study showed that AS-OCT would play an important role in the diagnosis, treatment choice and pathogenesis study of PACG.

  1. Generation of reactive oxygen species in the anterior eye segment. Synergistic codrugs of N-acetylcarnosine lubricant eye drops and mitochondria-targeted antioxidant act as a powerful therapeutic platform for the treatment of cataracts and primary open-angle glaucoma

    Directory of Open Access Journals (Sweden)

    Mark A. Babizhayev

    2016-12-01

    Mitochondrial targeting of compounds with universal types of antioxidant activity represents a promising approach for treating a number of ROS-related ocular diseases of the aging eye and can be implicated in the management of cataracts and primary open-angle glaucoma.

  2. Thorombolytic therapy with rescue percutaneous coronary intervention versus primary percutaneous coronary intervention in patients with acute myocardial infarction: a multicenter randomized clinical trial

    Institute of Scientific and Technical Information of China (English)

    GAO Run-lin; L(U) Shu-zheng; WEI Meng; ZENG Ding-yin; CHEN Ji-lin; QIN Xue-wen; XU Bo; DU Chang-hui; HAN Ya-ling; YANG Xin-chun; MAO Jie-ming; FANG Wei-yi; WANG Lei; SHEN Wei-feng; LI Zhan-quan; JIA Guo-liang

    2010-01-01

    Background Although thrombolytic therapy with rescue percutaneous coronary intervention (PCI) is a common treatment strategy for ST-segment elevation acute myocardial infarction (STEMI), scant data are available on its efficacy relative to primary PCI, and comparison was therefore the aim of this study.Methods This multicenter, open-label, randomized, parallel trial was conducted in 12 hospitals on patients (age ≤70 years) with STEMI who presented within 12 hours of symptom onset (mean interval >3 hours). Patients were randomized to three groups: primary PCI group (n=101); recombinant staphylokinase (r-Sak) group (n=104); and recombinant tissue-type plasminogen activator (rt-PA) group (n=106). For all patients allocated to the thrombolytic therapy arm, coronary angiography was performed at 90 minutes after drug therapy to confirm infarct-related artery (IRA) patency; rescue PCI was performed in cases with TIMI flow grade ≤2. Bare-metal stent implantation was planned for all patients. Results After randomization it required an average of 113.4 minutes to start thrombolytic therapy (door-to-needle time)and 141.2 minutes to perform first balloon inflation in the IRA (door to balloon time).Rates of IRA patency (TIMI flow grade 2 or 3) and TIMI flow grade 3 were significantly lower in the thrombolysis group at 90 minutes after drug therapy than in the primary PCI group at the end of the procedure (70.5% vs. 98.0%, P <0.0001, and 53.0% vs. 85.9%, P <0.0001, respectively). Rescue PCI with stenting was performed in 117 patients (55.7%) in the thrombolytic therapy arm. Rates of patency and TIMI flow grade 3 were still significantly lower in the rescue PCI than in the primary PCI group (88.9% vs. 97.9%, P=0.0222, and 68.4% vs. 85.0%, P=0.0190, respectively). At 30 days post-therapy, mortality rate was significantly higher in the thrombolysis combined with rescue PCI group than in primary PCI group (7.1% vs. 0, P=0.0034). Rates of death/Ml and bleeding complications were

  3. A new angle on the Euler angles

    Science.gov (United States)

    Markley, F. Landis; Shuster, Malcolm D.

    1995-01-01

    We present a generalization of the Euler angles to axes beyond the twelve conventional sets. The generalized Euler axes must satisfy the constraint that the first and the third are orthogonal to the second; but the angle between the first and third is arbitrary, rather than being restricted to the values 0 and pi/2, as in the conventional sets. This is the broadest generalization of the Euler angles that provides a representation of an arbitrary rotation matrix. The kinematics of the generalized Euler angles and their relation to the attitude matrix are presented. As a side benefit, the equations for the generalized Euler angles are universal in that they incorporate the equations for the twelve conventional sets of Euler angles in a natural way.

  4. Absence of gender disparity in short-term clinical outcomes in patients with acute ST-segment elevation myocardial infarction undergoing irolimus-eluting stent based primary coronary intervention: a report from Shanghai Acute Coronary Event (SACE) Registr

    Institute of Scientific and Technical Information of China (English)

    ZHANG Qi; LIAO Min-lei; HU Jian; SHEN Wei-feng; QIU Jian-ping; ZHANG Rui-yan; LI Yi-gang; HE Ben; JIN Hui-gen; ZHANG Jun-feng; WANG Xiao-long; JIANG Li

    2010-01-01

    Background Randomized, controlled trials have demonstrated the superiority of sirolimus-eluting stent (SES) implantation during primary percutaneous coronary intervention (PCI), as opposed to bare-metal stents, in patients with ST-elevation myocardial infarction (STEMI). This study aimed to test the hypothesis that clinical benefits of SES treatment were independent of gender in this setting.Methods A total of 2042 patients with STEMI undergoing SES-based primary PCI were prospectively enrolled into Shanghai Acute Coronary Event (SACE) registry (1574 men and 468 women). Baseline demographics, angiographic and PCI features, and in-hospital and 30-day major adverse cardiac events (MACE) were analyzed as a function of gender. Results Compared with men, women were older and more frequently had hypertension, diabetes, and hypercholesterolemia. Use of platelet glycoprotein IIb/IIIa receptor inhibitor (GPI, 65.5% vs. 62.2%, P=0.10) and procedural success rate (95.0% vs. 94.2%, P=0.52) were similar in both genders. In-hospital death and MACE occurred in 3.8% and 7.6%, and 4.5% and 8.1% in the male and female patients, respectively (all P >0.05). At 30-day follow-up, survival (94.3% vs. 93.8%, P=0.66) and MACE-free survival (90.2% vs. 89.3%, P=0.52) did not significantly differ between men and women. After adjustment for differences in patient demographics, angiographic and proceduralfeatures, there were no significant difference in either in-hospital (OR=0.77, 95%C/ of 0.48 to 1.22, P=0.30) or 30-day mortality (OR=1.28, 95%C/ of 0.73 to 2.23, P=0.38) between women and men.Conclusion Despite more advanced age and clustering of risk factors in women, female patients with STEMI treated by SES-based primary PCI had similar in-hospital and short-term clinical outcomes as their male counterparts.

  5. Non-compliance with Drug Therapy in Patients with Primary Open-angle Glaucoma No cumplimiento del tratamiento farmacológico en pacientes con glaucoma primario de ángulo abierto

    Directory of Open Access Journals (Sweden)

    Ariana Fernández García

    2012-06-01

    Full Text Available

    Background: Early treatment and patient’s compliance with this treatment are the most effective ways of preventing glaucoma related blindness. Objectives: To identify the behavior of patients` compliance or non compliance with the treatment in cases of primary open-angle glaucoma. Methods: A descriptive and cross sectional study was conducted including 106 patients with confirmed primary open-angle glaucoma who were treated at the Glaucoma Service of the Dr. Salvador Allende Hospital in Havana during the first quarter of 2011. We analyzed the following variables: age, sex, educational level, personal pathological antecedents and family history of glaucoma, treatment and treatment compliance and self-reported general health condition and vision. Results: Average age among patients was 60.7 years old, 72.7% were women and 51.9% did not comply with drug treatment. 91, 6% of patients used monotherapy and 73.6% used timolol alone or in combination with another drug. 68, 9% had a family history of glaucoma. Hypertension (51, 1% was the most commonly reported chronic disease. The most referred self-assessment of general health and vision was that of regular (42, 5% and 49, 1% respectively. Conclusions: More than half of patients did not comply with drug therapy as indicated for the control of the disease. This behavior was associated with age in the cases included in this study.


    Fundamento: el tratamiento precoz y su cumplimiento, por parte del paciente, son las formas más efectivas de prevenir la ceguera por glaucoma. Objetivos: identificar el cumplimiento o no cumplimiento del tratamiento en pacientes con glaucoma primario de ángulo abierto. Métodos: estudio descriptivo,  transversal en 106 pacientes con glaucoma primario de ángulo abierto confirmado, atendidos en el

  6. A combined analysis of four observational studies evaluating the intraocular pressure-lowering ability and tolerability of bimatoprost 0.01% in patients with primary open-angle glaucoma or ocular hypertension

    Directory of Open Access Journals (Sweden)

    Stevens A

    2016-04-01

    Full Text Available Annemie Stevens,1 Milko E Iliev,2 Leo de Jong,3 Ioana Grobeiu,4 Anton Hommer5 1Department of Ophthalmology, Ghent University Hospital, Ghent, Belgium; 2Department of Ophthalmology, University of Bern, Bern, Switzerland; 3Department of Ophthalmology, Academic Medical Centre, Amsterdam, the Netherlands; 4Allergan Holdings Ltd, Marlow, UK; 5Private Office, Vienna, Austria Objective: Combine and evaluate data from four clinical practice studies investigating the intraocular pressure (IOP-lowering ability, tolerability of and patient adherence to bimatoprost 0.01% therapy in patients with primary open-angle glaucoma or ocular hypertension. Methods: Data were combined from four multicenter, prospective, observational studies. Patients (n=2,593 were recruited from 328 sites in Austria, Belgium, Switzerland, and the Netherlands. Assessments were at study entry (baseline and after 10–14 weeks. Results: Bimatoprost 0.01% lowered mean IOP by 5.0 mmHg from baseline to final visit (P<0.0001. Individual IOP goals were achieved in 75.5% of patients. Results were similar in right and left eyes; right-eye data are presented here for brevity. The greatest mean IOP reduction was 6.7±4.7 mmHg (28.8% reduction from baseline to final visit, P<0.0001 in treatment-naïve patients. Switching to bimatoprost 0.01% monotherapy from previous monotherapy reduced mean IOP by a further 3.2±3.6 mmHg (17.2%, P<0.0001. Switching to bimatoprost 0.01% from previous prostaglandin monotherapy reduced mean IOP by 2.9±3.5 mmHg (15.5%, including by 3.1±3.4 mmHg (15.8% and 3.3±4.1 mmHg (16.9% for previous latanoprost and travoprost treatment, respectively (all P<0.0001. IOP reduction in patients previously treated with a fixed combination was 2.7±4.0 mmHg (14.2%, P<0.0001. The most commonly reported adverse events were conjunctival hyperemia (5.2% and eye irritation (4.7%. Tolerability was rated as “very good” or “good” by 90.1% of patients. Adherence was rated by

  7. Renal insufficiency is an independent predictor of in-hospital mortality for patients with acute myocardial infarction receiving primary percutaneous coronary intervention

    Institute of Scientific and Technical Information of China (English)

    Jian-ping LI; Mohetaboer MOMIN; Yong HUO; Chun-yan WANG; Yan ZHANG; Yan-jun GONG; Zhao-ping LIU; Xin-gang WANG; Bo ZHENG

    2012-01-01

    Objective:To investigate the relationship between renal function and clinical outcomes among patients with acute ST-segment elevation myocardial infarction (ASTEMI),who were treated with emergency percutaneous coronary intervention (PCI).Methods:420 patients hospitalized in Peking University First Hospital,diagnosed with ASTEMI treated with emergency (PCI) from January 2001 to June 2011 were enrolled in this study.Estimated glomerular filtration rate (eGFR) was used as a measure of renal function.We compared the clinical parameters and outcomes between ASTEMI patients combined renal insufficiency and the patients with normal renal function.Results:There was a significant increase in the concentrations of fibrinogen and D-Dimer (P<0.05) and a much higher morbidity of diabetes mellitus in the group of patients with chronic kidney disease (CKD; eGFR<60 ml/(min·1.73 m2)) (P<0.01).CKD (eGFR<60 ml/(min·1.73 m2)) was an independent predictor of in-hospital mortality for patients hospitalized with ASTEMI receiving PCI therapy rapidly (P=0.032,odds ratio (OR) 4.159,95% confidence interval (CI) 1.127-15.346).Conclusions:Renal insufficiency is an independent predictor of in-hospital mortality for patients hospitalized with ASTEMI treated with primary PCI.

  8. Loss of regulatory T cell function on anti-inflammation is correlated with increased risk of acute kidney injury development in patients with primary glomerulonephritis.

    Science.gov (United States)

    Dong, Qin; Cai, Chen; Gao, Feng; Xu, Ziqian; Fang, Yuan; Wang, Lijie; Cui, Jie

    2015-01-01

    Inflammation is believed to play a major role in the pathophysiology of acute kidney injury (AKI). The injury induces the generation of inflammatory mediators like cytokines and chemokines by tubular and endothelial cells which contribute to the recruiting of leukocytes into the kidneys. Early AKI risk evaluation is limited to demographic characteristics and past clinical histories, and no specific treatment is available. To better identify patients at risk of developing AKI, and devise more targeted treatment and prevention regimen, we tracked 158 primary glomerulonephritis patients for their occurrence of AKI, and analyzed the characteristics of their adaptive immune system. We found that in patients that later developed AKI, peripheral blood T cell composition is shifted toward IFN-g-producing Th1-like cells. While the composition of CD4(+)CD25(+) T cells were similar between patients that later developed AKI and patients without AKI development, in patients that later developed AKI, their CD4(+)CD25(+) T cells secreted less regulatory cytokine IL-10, and was unable to suppress proinflammatory cytokine production by CD4(+) T cells, while in patients without AKI development, CD4(+)CD25(+) T cells were able to suppress CD4(+) T cell-mediated IFN-g and IL-17 expression under stimulation, partially through IL-10 secretion. Collectively, we identified a defect in CD4(+)CD25(+) T cell regulatory function in patients at risk of developing AKI.

  9. The influence of joint application of arsenic trioxide and daunorubicin on primary acute promyelocytic leukaemia cells and apoptosis and blood coagulation of cell strain.

    Science.gov (United States)

    Zhang, Xiaojuan; Qin, Na; Chen, Xinghua; Guo, Shuxia

    2015-05-01

    This test cultivated three groups of acute promyelocytic leukemia (APL) and NB4 cells in liquid in vitro, processed them with arsenic trioxide (ATO), daunorubicin (DNR), ATO+DNR respectively, and then set up blank control group. Apoptosis of cells in each group was observed using flow cytometry, procoagulant activity of APL and NB4 cells in each group was detected with recalcification time, and expressions of tissue factor (TF), thrombomodulin and annexin II of NB4 cells in each group were measured using ELISA method. The results showed that the apoptosis rate increased 4-8 times compared with blank control group after processing APL and NB4 cells with ATO and DNR; procoagulant activity decreased obviously; and expression of TF and annexin II of NB4 cells reduced significantly (P<0.05). We concluded that combination of ATO and DNR could promote APL and NB4 cell apoptosis effectively without aggravating blood coagulation disorders, which might improve coagulation function of APL by inhibiting coagulation and hyperfibrinolysis through reducing expression of TF and annexin II. This drug combination may be a safe and effective method in the treatment of APL of primary high white blood cells type.

  10. Non-typeable Haemophilus influenzae and Streptococcus pneumoniae as primary causes of acute otitis media in colombian children: a prospective study

    Directory of Open Access Journals (Sweden)

    Castrejon Maria M

    2011-01-01

    Full Text Available Abstract Background Acute otitis media (AOM is one of the most frequently encountered bacterial infections in children aged Streptococcus pneumoniae (S. pneumoniae and non-typeable Haemophilus influenzae (NTHi are historically identified as primary AOM causes. Nevertheless, recent data on bacterial pathogens causing AOM in Latin America are limited. This prospective study aimed to identify and characterize bacterial etiology and serotypes of AOM cases including antimicrobial susceptibility in Methods From February 2008 to January 2009, children ≥3 months and Results Of the 106 enrolled children, 99 were included in the analysis. Bacteria were cultured from 62/99 (63% of samples with S. pneumoniae, H. influenzae, or S. pyogenes. The most commonly isolated bacteria were H. influenzae in 31/99 (31% and S. pneumoniae in 30/99 (30% of samples. The majority of H. influenzae episodes were NTHi (27/31; 87%. 19F was the most frequently isolated pneumococcal serotype (10/30; 33%. Of the 30 S. pneumoniae positive samples, 8/30 (27% were resistant to tetracycline, 5/30 (17% to erythromycin and 8/30 (27% had intermediate resistance to penicillin. All H. influenzae isolates tested were negative to beta-lactamase. Conclusions NTHi and S. pneumoniae are the leading causes of AOM in Colombian children. A pneumococcal conjugate vaccine that prevents both pathogens could be useful in maximizing protection against AOM.

  11. Glaucoma, Open-Angle

    Science.gov (United States)

    ... Programs Home > Statistics and Data > Glaucoma, Open-angle Glaucoma, Open-angle Open-angle Glaucoma Defined In open-angle glaucoma, the fluid passes ... 2010 2010 U.S. Age-Specific Prevalence Rates for Glaucoma by Age and Race/Ethnicity The prevalence of ...

  12. Efficacy and Tolerability of Travoprost 0.004%/Timolol 0.5% Fixed-Dose Combination for the Treatment of Primary Open-Angle Glaucoma or Ocular Hypertension Inadequately Controlled with Beta-Blocker Monotherapy

    Science.gov (United States)

    Park, Ki Ho; Hubatsch, Douglas A.; Erichev, Valeriy; Paczka, Jose A.; Roberts, Timothy V.

    2017-01-01

    Objective. To evaluate the efficacy and tolerability of travoprost 0.004%/timolol 0.5% fixed-dose combination (TTFC) in patients with open-angle glaucoma (OAG) or ocular hypertension (OHT) inadequately controlled on beta-blocker monotherapy. Methods. In this phase IV, open-label study, 156 patients on beta-blocker monotherapy with mean intraocular pressure (IOP) between 18 and 32 mmHg were randomized (no washout period) to receive TTFC for 8 weeks (TTFC group) or to continue beta-blocker monotherapy for 4 weeks followed by TTFC for the remaining 4 weeks (beta-blocker group). Results. The mean IOP (±standard deviation) at baseline in the TTFC and beta-blocker groups was 22.5 ± 2.5 mmHg and 22.2 ± 2.3 mmHg, respectively, and at weeks 4 and 8, was 16.7 ± 3.1 mmHg and 16.1 ± 3.1 mmHg, respectively, in TTFC group and 21.1 ± 3.1 mmHg and 16.1 ± 2.8 mmHg, respectively, in the beta-blocker group. There was a significant least squares mean difference between TTFC and beta-blocker in 8 a.m. IOP at week 4 (−4.6 mmHg; one-sided 95% confidence interval [−inf, −3.9]; p < 0.0001 [primary endpoint]); the upper bound of the 95% confidence interval was within the prespecified limit (<0). Both treatments were well tolerated. Conclusion. Superior IOP control was achieved with TTFC in patients with OAG or OHT previously uncontrolled with beta-blockers. No new safety findings were identified. This trial is registered with ClinicalTrials.gov NCT02003391. PMID:28239491

  13. A comparison of the sensitivity of EQ-5D, SF-6D and TTO utility values to changes in vision and perceived visual function in patients with primary open-angle glaucoma

    Directory of Open Access Journals (Sweden)

    Bozzani Fiammetta Maria

    2012-08-01

    Full Text Available Abstract Background Economic viability of treatments for primary open-angle glaucoma (POAG should be assessed objectively to prioritise health care interventions. This study aims to identify the methods for eliciting utility values (UVs most sensitive to differences in visual field and visual functioning in patients with POAG. As a secondary objective, the dimensions of generic health-related and vision-related quality of life most affected by progressive vision loss will be identified. Methods A total of 132 POAG patients were recruited. Three sets of utility values (EuroQoL EQ-5D, Short Form SF-6D, Time Trade Off and a measure of perceived visual functioning from the National Eye Institute Visual Function Questionnaire (VFQ-25 were elicited during face-to-face interviews. The sensitivity of UVs to differences in the binocular visual field, visual acuity and visual functioning measures was analysed using non-parametric statistical methods. Results Median utilities were similar across Integrated Visual Field score quartiles for EQ-5D (P = 0.08 whereas SF-6D and Time-Trade-Off UVs significantly decreased (p = 0.01 and p = 0.001, respectively. The VFQ-25 score varied across Integrated Visual Field and binocular visual acuity groups and was associated with all three UVs (P ≤ 0.001; most of its vision-specific sub-scales were associated with the vision markers. The most affected dimension was driving. A relationship with vision markers was found for the physical component of SF-36 and not for any dimension of EQ-5D. Conclusions The Time-Trade-Off was more sensitive than EQ-5D and SF-6D to changes in vision and visual functioning associated with glaucoma progression but could not measure quality of life changes in the mildest disease stages.

  14. Genetic association of SNPs near ATOH7, CARD10, CDKN2B, CDC7 and SIX1/SIX6 with the endophenotypes of primary open angle glaucoma in Indian population.

    Directory of Open Access Journals (Sweden)

    Ferdinamarie Sharmila Philomenadin

    Full Text Available Primary open angle glaucoma (POAG belonging to a group of optic neuropathies, result from interaction between genetic and environmental factors. Study of associations with quantitative traits (QTs is one of the successful strategies to understand the complex genetics of POAG. The current study attempts to explore the association of variations near/in genes like ATOH7, SIX1/SIX6 complex, CDKN2B, CARD10, and CDC7 with POAG and its QTs including vertical cup to disc ratio (VCDR, central corneal thickness (CCT, intra ocular pressure (IOP, and axial length (AL. Case-control study design was carried out in a sample size of 97 POAG cases and 371 controls from South India. Model-based (additive, recessive, dominant association of the genotypes and their interaction was carried out between cases and controls using chi-square, linear and logistic regression methods. Nominal significance (P<0.05 was observed for QTs like i VCDR with SNPs rs1900004 (ATOH7; rs1192415 (CDC7; rs10483727 (SIX1/SIX6, rs9607469 (CARD10; ii CCT with rs1192415; iii IOP with rs1900004 and iv AL with rs1900004 and rs1063192 (CDKN2B. We were able to replicate previously known interactions between ATOH7-SIX6 and SIX6-CDKN2B along with few novel interactions between ATOH7-CDC7 and SIX6 with genes including CARD10 and CDC7. In summary, our results suggest that a probable interaction among the candidate genes for QTs, play a major role in determining the individual's susceptibility to POAG.

  15. A novel mutation in the myocilin gene identified in a Chinese primary open angle glaucoma family%原发性开角型青光眼家系一新的myocilin基因突变

    Institute of Scientific and Technical Information of China (English)

    田强; 李海云; 李富华; 赵堪兴; 王立; 单晓艳; 庞玉英; 李祎馨; 吴梅筠; 邱枫

    2007-01-01

    目的 探讨一个中国人原发性开角型青光眼(primary open angle glaucoma,POAG)家系的myocilin基因缺陷.方法 对一个5代POAG大家系进行全面的临床检查后,用聚合酶链反应扩增家系成员myocilin基因的所有外显子以及相邻部分内含子,对其产物直接测序.结果 家系的遗传方式符合常染色体显性遗传.确诊年龄在26~59岁之间.在所有青光眼患者,可疑者以及4例尚未出现明显青光眼体征的家系成员发现携带myocilin基因T455K突变.无该突变的家系成员中无POAG患者及可疑者.突变位于myocilin蛋白C-末端非常保守的氨基酸残基.结论 T455K突变是中国人所特有的新的致病性myocilin基因突变.突变的临床表型为混合发病年龄型POAG且具有很高的外显率.这个新基因突变的发现证实中国人的致病性myocilin基因突变类型与其他种族不同.

  16. 原发性开角型青光眼患者Myocilin基因的单核苷酸多态性%Single nucleotide polymorphisms of the myocilin gene in primary open-angle glaucoma patients

    Institute of Scientific and Technical Information of China (English)

    范宝剑; 梁旭辉; 彭智培; Larry Baum; 谭霭仙; 汪宁; 林顺潮

    2004-01-01

    目的探讨Myocilin(MYOC)基因的单核苷酸多态性(single nucleotide polymorphisms, SNPs) 及其与原发性开角型青光眼(primary open-angle glaucoma, POAG)发病的关系.方法应用高通量构象敏感性凝胶电泳和荧光标记自动测序法筛选和鉴定香港157例POAG散发患者和155名对照MYOC基因的SNPs.结果在MYOC基因所有3个外显子及邻近的非编码区共检出17种SNPs:1-83G→A、G12R、P16L、A17S、R46X、R76K、R91X、T123T、D208E、L215P、730+35A→G、A260A、I288I、E300K、T353I、Y471C和1515+73G→C.其中,R91X、E300K和Y471C仅在POAG患者中检测到.此外,1515+73G→C各基因型在POAG患者与对照人群中的分布差异具有显著意义,POAG患者中CG型频率为0.6%,低于对照组的4.5%(P=0.036).其余16种SNPs各基因型在两组人群中的分布差异均无显著意义.结论 MYOC基因多态性可能与中国人POAG发病有关,提示MYOC基因是POAG的相关基因.

  17. Dual-phase contrast-enhancement multislice computed tomography imaging for the assessment of elderly patients with acute myocardial infarction after primary percutaneous coronary intervention

    Institute of Scientific and Technical Information of China (English)

    Shaofeng Guan; Weiyi Fang; Xinkai Qu; Jianding Ye; Yan Shen; Jing Jiao

    2009-01-01

    Background Evaluation of acute myocardial infarction after reperfusion by dual phase contrast-enhancement multislice computed tomography (MSCT) was implicated in porcine model. There have been few attempts to use this diagnostic modality for the early assessment of coronary reperfusion in patients with ST-elevation myocardial infarction (STEMI), especially after primary percutaneous coronary intervention (PCI). In elderly patients with STEMI, the safety issues remain unknown. Methods Dual phase contrast-enhancement MSCT examinations were performed in 11 elderly patients (≥60 years old) with STEMI within one week after primary PCI. The presence, location and enhancement pattern on MSCT were evaluated. MSCT findings were compared with the catheter angiographic results and area under the curve of creatine kinase (CK) release. Serum creatinine level was recorded before and after MSCT scan. Results MSCT scans were successfully performed in all the patients. Early myocardial perfusion defect (early defect, ED) was detected in all of the 11 patients (100%) in the early phase of the contrast bolus (subendocardial ED in 10 patients and transmural in 1 patient). Mean CT attenuation value of ED was significantly different from CT attenuation value of remote myocardium (46±17 HU vs 104 ± 17 HU; P < 0.01). Location of ED area correlated well with infarction related artery territory on catheter angiography in all of the 11 patients (100%). On delayed phase of MSCT scan, different enhancement patterns were observed: isolated subendocardial late enhancement (LE) in 6 patients, subendocardial residual perfusion defect (RD) and subepicardial LE in 1 patient, subendocardial RD in 4 patients. Infarct volume assessed by MSCT correlated well with area under the curve CK release (R=0.72, P < 0.01). Serum creatinine level after MSCT scan showed no difference with that before MSCT scan. Conclusion Dual phase MSCT could be safely implicated in elderly patients with STEMI. Variable

  18. Risk of ischaemic heart disease and acute myocardial infarction in a Spanish population: observational prospective study in a primary-care setting

    Directory of Open Access Journals (Sweden)

    Cucalón José M

    2006-02-01

    Full Text Available Abstract Background Ischaemic heart disease is a global priority of health-care policy, because of its social repercussions and its impact on the health-care system. Yet there is little information on coronary morbidity in Spain and on the effect of the principal risk factors on risk of coronary heart disease. The objective of this study is to describe the epidemiology of coronary disease (incidence, mortality and its association with cardiovascular risk factors using the information gathered by primary care practitioners on cardiovascular health of their population. Methods A prospective study was designed. Eight primary-care centres participated, each contributing to the constitution of the cohort with the entire population covered by the centre. A total of 6124 men and women aged over 25 years and free of cardiovascular disease agreed to participate and were thus enrolled and followed-up, with all fatal and non-fatal coronary disease episodes being registered during a 5-year period. Repeated measurements were collected on smoking, blood pressure, weight and height, serum total cholesterol, high-density and low-density lipoproteins and fasting glucose. Rates were calculated for acute myocardial infarction and ischaemic heart disease. Associations between cardiovascular risk factors and coronary disease-free survival were evaluated using Kaplan-Meier and Cox regression analyses. Results Mean age at recruitment was 51.6 ± 15, with 24% of patients being over 65. At baseline, 74% of patients were overweight, serum cholesterol over 240 was present in 35% of patients, arterial hypertension in 37%, and basal glucose over 126 in 11%. Thirty-four percent of men and 13% of women were current smokers. During follow-up, 155 first episodes of coronary disease were detected, which yielded age-adjusted rates of 362 and 191 per 100,000 person-years in men and women respectively. Disease-free survival was associated with all risk factors in univariate

  19. Relationship of glutathione S-transferase M1 and T1 polymorphisms with the susceptibility of primary angle-closure glaucoma of Chinese Han population in Chongqing%GSTT1和GSTM1基因多态性与重庆地区汉族人群中原发性闭角型青光眼易感性的关系

    Institute of Scientific and Technical Information of China (English)

    陈瑾; 侯胜平; 高小劲; 胡泊; 李平华

    2013-01-01

    Objective To investigate the relationship of genetic polymorphisms of glutathione S-trans-ferase M1 (GSTM1),and glutathione S-transferase T1 (GSTT1) with the susceptibility of primary angleclosure glaucoma in Chinese Han population.Methods Blood samples were collected from 211 Han patients with primary angle-closure glaucoma (PACG) and 422 health volunteers (control),and the 211 PACG patients were separated into an acute PACG (APACG) group and a chronic PACG (CPACG) group according to diagnostic criteria.Furthermore,multiple allele-specific polymerase chain reaction (multiplex PCR) was employed to detect the genetic polymorphisms of GSTT1 and GSTM1.Results The distribution frequencies of GSTT1null genotype were 53.1% and 53.8% in the PACG group and control group,respectively,but no significant difference was found (Chi square =0.028 6,P =0.866).Furthermore,the distribution frequencies of GSTT1-null genotype in the APACG group and CPACG group were 46.3% and 55.4%,respectively,which were not significantly different from that of the control group (Chi square =0.126 7,P =0.722; Chi square =0.036 2,P =0.849).The distribution frequencies of GSTM1-null genotype were 58.3% and 56.3% in the PACG group and control group,respectively,but no significant difference was found (Chi square =0.206 3,P =0.650).The distribution frequencies of GSTM1 were 61.1% and 56.3% in the APACG group and CPACG group,respectively,but no significant difference was found as compared with the control group (Chi square =0.027 9,P =0.867 ; Chi square =0.006 4,P =0.936).Moreover,the combined analysis of GSTT1 and GSTM1 genotypes showed that no significant difference was found in comparison of the four genotypes of GSTT1 and GSTM1 between the PACG (APACG and CPACG) group and control group.Conclusion In Han population with PACG in Chongqing area of China,no relationship is found between the null genotypes of GSTT1 and GSTM1 and PACG susceptibility,and the correlation of genetic

  20. Impact of different clinical pathways on outcomes of patients with acute ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention: the RAPID-AMI study

    Institute of Scientific and Technical Information of China (English)

    ZHANG Qi; ZHANG Rui-yan; QIU Jian-ping; JIN Hui-gen; ZHANG Jun-feng; WANG Xiao-long; JIANG Li; LIAO Min-lei; HU Jian; DING Feng-hua; ZHANG Jian-sheng; SHEN Wei-feng

    2009-01-01

    Background Current guidelines support primary percutaneous coronary intervention (primary PCI) as the first treatment of choice (as opposed to thrombolytic therapy) for patients with acute ST-segment elevation myocardial infarction (STEMI) especially when delivered within 12 hours of symptom onset. We aimed to evaluate the impact of different clinical pathways on reduction of reperfusion delay and subsequent improvement in outcomes in patients with STEMI.Methods From November 2005 to November 2007, 546 consecutive patients with definite STEMI, who upon arrival at the emergency room were triaged to undergo primary PCI, were included. Of them, 271 patients were brought directly to catheterization laboratory (rapid group), and 275 patients were admitted to the coronary care unit (CCU) or cardiac ward first, and then transferred to the catheterization laboratory (non-rapid group). Primary endpoint was door-to-balloon (D28) time, and secondary endpoints included infarct size assessed by peak CK-MB level and rates of major cardiac adverse events (MACE) including death, reinfarction, or target-vessel revascularization during hospitalization and at 30-day clinical follow-up.Results Baseline clinical characteristics, angiographic features and procedural success rates were comparable between the two groups, except that more patients received glycoprotein Ⅱb/Ⅲa receptor inhibitors before angiography (84.0% and 77.1, P=0.042) and had TIMI 3 flow in the culprit vessel at initial angiogram (17.1% and 9.2%, P=0.007) in the non-rapid group. The D2B time was shortened ((108±44) minutes and (138±31) minutes, P <0.0001), and number of patients with D2B time <90 minutes was greater (22.6% and 10.9%, P <0.0001) in the rapid group. The advantages associated with rapid intra-hospital transfer were enhanced if the patients presented to the hospital at regular hours. Peak CK-MB level was significantly reduced in the rapid group. In-hospital mortality (4.1% and 5.8%) and cumulative

  1. Effect of intracoronary administration of anisodamine on slow reflow phenomenon following primary percutaneous coronary intervention in patients with acute myocardial infarction

    Institute of Scientific and Technical Information of China (English)

    FU Xiang-hua; XUE Ling; FAN Wei-ze; GU Xin-shun; WEI Yong-yun; JIANG Yun-fa; WU Wei-li; LI Shi-qiang; HAO Guo-zhen; WEI Qing-min

    2007-01-01

    Background Many basic and clinical studies have proved that anisodamine can produce significant effect on relieving microvascular spasm, improving and dredging the coronary microcirculation. It may be beneficial to the improvement of slow-reflow phenomenon (SRP) following percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI).So we investigated the effect of intracoronary administration of anisodamine on SRP of infarct related artery (IRA)following primary PCI in patients with ST segment elevated acute myocardial infarction (STEAMI).Methods Twenty-one patients with SRP from a total of 148 STEAMI patients accepted primary PCI were enrolled into this study from September 2004 to December 2005. When SRP happened, nitroglycerin (200 μg) was "bolus" injected firstly into IRA to exclude the spasm of epicardial artery and identify SRP as well as a baseline and self-control agent following PCI. Ten minutes later, 1000 μg of anisodamine was injected into IRA with SRP at 200 μg/s, while the coronary angiography (CAG) was taken before and at 1st, 3rd and 10th minute after administration of nitroglycerin or anisodamine,respectively. The corrected TIMI frame count (cTFC), TIMI myocardial perfusion grade (TMPG) and the diameter of IRA were calculated and analyzed by Gibson's TIMI frame count method using quantitative computer angiography (QCA)system to evaluate the influence of anisodamine on coronary flow and vessel lumen. In the meantime the invasive hemodynamic parameters of intracoronary and systemic artery (systolic, diastolic and mean pressure) and electrocardiogram (ECG) were measured and monitored. The changes of ventricular performance parameters and the adverse reaction were evaluated and followed-up at 1 month post-PCI.Results No significant changes in cTFCs and TMPGs were found at 1st, 3rd and 10th minute after intracoronary administration of nitroglycerin as compared with the baseline control (P>0.05). cTFCs were decreased by 58.3%, 56

  2. Prevalence and prognostic implications of ST-segment deviations from ambulatory Holter monitoring after ST-segment elevation myocardial infarction treated with either fibrinolysis or primary percutaneous coronary intervention (a Danish Trial in Acute Myocardial Infarction-2 Substudy)

    DEFF Research Database (Denmark)

    Idorn, Lars; Høfsten, Dan Eik; Wachtell, Kristian;

    2007-01-01

    Ambulatory Holter monitoring has been shown to be useful in stratifying cardiovascular risk after acute myocardial infarction. However, it remains unclear whether ST-segment deviations might predict clinical outcomes in a population treated with primary percutaneous coronary intervention (PCI......) compared with thrombolysis. Holter monitoring was initiated at discharge from ST-segment elevation myocardial infarction in 958 patients followed for 2,773 patient-years, randomized to immediate revascularization with either fibrinolysis (n=474) or PCI (n=484). The primary end point was all-cause mortality...

  3. New Comprehensive Cytogenetic Scoring System for Primary Myelodysplastic Syndromes (MDS) and Oligoblastic Acute Myeloid Leukemia After MDS Derived From an International Database Merge

    Science.gov (United States)

    Schanz, Julie; Tüchler, Heinz; Solé, Francesc; Mallo, Mar; Luño, Elisa; Cervera, José; Granada, Isabel; Hildebrandt, Barbara; Slovak, Marilyn L.; Ohyashiki, Kazuma; Steidl, Christian; Fonatsch, Christa; Pfeilstöcker, Michael; Nösslinger, Thomas; Valent, Peter; Giagounidis, Aristoteles; Aul, Carlo; Lübbert, Michael; Stauder, Reinhard; Krieger, Otto; Garcia-Manero, Guillermo; Faderl, Stefan; Pierce, Sherry; Le Beau, Michelle M.; Bennett, John M.; Greenberg, Peter; Germing, Ulrich; Haase, Detlef

    2012-01-01

    Purpose The karyotype is a strong independent prognostic factor in myelodysplastic syndromes (MDS). Since the implementation of the International Prognostic Scoring System (IPSS) in 1997, knowledge concerning the prognostic impact of abnormalities has increased substantially. The present study proposes a new and comprehensive cytogenetic scoring system based on an international data collection of 2,902 patients. Patients and Methods Patients were included from the German-Austrian MDS Study Group (n = 1,193), the International MDS Risk Analysis Workshop (n = 816), the Spanish Hematological Cytogenetics Working Group (n = 849), and the International Working Group on MDS Cytogenetics (n = 44) databases. Patients with primary MDS and oligoblastic acute myeloid leukemia (AML) after MDS treated with supportive care only were evaluated for overall survival (OS) and AML evolution. Internal validation by bootstrap analysis and external validation in an independent patient cohort were performed to confirm the results. Results In total, 19 cytogenetic categories were defined, providing clear prognostic classification in 91% of all patients. The abnormalities were classified into five prognostic subgroups (P < .001): very good (median OS, 61 months; hazard ratio [HR], 0.5; n = 81); good (49 months; HR, 1.0 [reference category]; n = 1,809); intermediate (26 months; HR, 1.6; n = 529); poor (16 months; HR, 2.6; n = 148); and very poor (6 months; HR, 4.2; n = 187). The internal and external validations confirmed the results of the score. Conclusion In conclusion, these data should contribute to the ongoing efforts to update the IPSS by refining the cytogenetic risk categories. PMID:22331955

  4. Heart-type Fatty acid-binding protein in Acute Myocardial infarction Evaluation (FAME: Background and design of a diagnostic study in primary care

    Directory of Open Access Journals (Sweden)

    Doevendans Pieter A

    2008-04-01

    Full Text Available Abstract Background Currently used biomarkers for cardiac ischemia are elevated in blood plasma after a delay of several hours and therefore unable to detect acute coronary syndrome (ACS in a very early stage. General practitioners (GPs, however, are often confronted with patients suspected of ACS within hours after onset of complaints. This ongoing study aims to evaluate the added diagnostic value beyond clinical assessment for a rapid bedside test for heart-type fatty-acid binding protein (H-FABP, a biomarker that is detectable as soon as one hour after onset of ischemia. Methods Participating GPs perform a blinded H-FABP rapid bedside test (Cardiodetect® in patients with symptoms suggestive of ACS such as chest pain or discomfort at rest. All patients, whether referred to hospital or not, undergo electrocardiography (ECG and venapunction for a plasma troponin test within 12–36 hours after onset of complaints. A final diagnosis will be established by an expert panel consisting of two cardiologists and one general practitioner (blinded to the H-FABP test result, using all available patient information, also including signs and symptoms. The added diagnostic value of the H-FABP test beyond history taking and physical examination will be determined with receiver operating characteristic curves derived from multivariate regression analysis. Conclusion Reasons for presenting the design of our study include the prevention of publication bias and unacknowledged alterations in the study aim, design or data-analysis. To our knowledge this study is the first to assess the diagnostic value of H-FABP outside a hospital-setting. Several previous hospital-based studies showed the potential value of H-FABP in diagnosing ACS. Up to now however it is unclear whether these results are equally promising when the test is used in primary care. The first results are expected in the end of 2008.

  5. A pharmacoeconomic analysis to determine the relative cost-effectiveness of bimatoprost 0.03% eye drops and brimonidine 0.2% eye drops in patients of primary open-angle glaucoma/ocular hypertension

    Directory of Open Access Journals (Sweden)

    Navreet Kaur Natt

    2014-01-01

    Full Text Available Aims: The aim was to compare efficacy and cost-effectiveness of bimatoprost 0.03% and brimonidine 0.2% in primary open-angle glaucoma (POAG/ocular hypertension (OHT. Settings and Design: Open, randomized, cross-over, comparative study. Materials and Methods: Forty patients of POAG or OHT with intraocular pressure (IOP <30 mm Hg were included in the study after a written informed consent. The patients were divided randomly into two groups of 20 patients each. Patients of group A were administered bimatoprost 0.03% eye drops once daily, and those of group B brimonidine 0.2% eye drops twice daily for a period of 4 weeks. After a washout period of 4 weeks, the patients were crossed over that is, group A was administered brimonidine 0.2% and group B bimatoprost 0.03%. Fall in IOP at 4 weeks was recorded. The daily cost of each drug was calculated by maximum retail price and the average number of drops per bottle. The cost-effectiveness was then calculated as the cost of drug/mm Hg fall in IOP. Statistics: Independent samples t-test was used to compare the efficacy of both drugs. Results: IOP lowering with bimatoprost (8.9 ± 1.598 mm Hg was significantly (P < 0.0001 higher than brimonidine (6.55 ± 1.26 mm Hg. The number of drops/ml were 33.43 ± 0.52 and 25.49 ± 0.26, respectively, for bimatoprost and brimonidine. Treatment with bimatoprost was costlier than brimonidine with daily costs/eye Rs. 4.02 ± 0.06 and 3.14 ± 0.03, yearly costs/eye Rs. 1467.46 ± 20.74 and 1147.75 ± 11.15, respectively. Bimatoprost was more cost-effective than brimonidine with the cost-effectiveness ratio (CER respectively Rs. 13.10 ± 2.61/mm Hg and Rs. 13.96 ± 2.86/mm Hg. Incremental CER Rs. 10.43/mm Hg implies lower costs/mm Hg extra IOP lowering by bimatoprost than Rs. 13.96 for brimonidine. Conclusion: In spite of being costlier, bimatoprost is more efficacious and cost-effective than brimonidine.

  6. Surgical outcomes of mitomycin C combined with adjustable suture trabeculectomy for primary angle-closure glaucoma%丝裂霉素C联合可拆除缝线在小梁切除术中的临床应用

    Institute of Scientific and Technical Information of China (English)

    杨红艳

    2016-01-01

    目的:观察丝裂霉素 C 联合可拆除缝线在青光眼小梁切除术中的效果。方法对30例(35眼)青光眼患者进行丝裂霉素联合可拆除缝线的小梁切除术,术后随诊观察视力、眼压和滤过泡状况。结果手术后第1周眼压为(12.49±1.68) mmHg,第1个月眼压为(14.28±2.22)mmHg,第1年眼压为(17.29±2.87)mmHg 与手术前眼压相比较差异有统计学意义(P <0.05);术后1年功能型滤过泡35眼(82.86%)。结论丝裂霉素 C 联合可拆除缝线在小梁切除术中能有效降低眼压,减少术后并发症,提高手术成功率。%Objective To investigate the safety and efficacy of mitomycin C combined with adjustable suture trabeculectomyin treating primary angle-closure glaucoma.Methods This study included 30 patients(35 eyes)who underwent adjustable suture trabeculectomy combined with mitomycin C.Visual acuity,intraocular pressure and filtering blebs were measured.Results Mean postoperative intraoc-ular pressures were (12.49 ±1.68)mmHg at 1 week,(14.28 ±2.22)mmHg at 1 month and (17.29 ±2.87)mmHg at 1 year,re-spectively.There was significant difference between preoperation and postoperation(P <0.05).The rate of effective filtering bleb was 82.86% at 1 year.Conclusions Mitomycin C combined with adjustable suture trabeculectomy is a safe and effective surgical proce-dure to decrease intraocular pressure,reduce postoperative complications and raise success rate of the surgery.

  7. GWAS for susceptibility genes of primary open-angle glaucoma%原发性开角型青光眼易感基因研究中 GWAS 的应用

    Institute of Scientific and Technical Information of China (English)

    唐冰花; 曹文俊

    2016-01-01

    Primary open-angle glaucoma(PoaG)is a kind of complex diseases caused by interaction between multiple genes and environmental factors,and genetic factors play important roles in PoaG development. Genome-wide association study(GWas)is widely applied into genetic research for PoaG,and it has obtained a series of research results. this method can analyze candidate susceptibility genes in PoaG patients,and quantitatively analyze related genes of endophenotypes. Vertical cup-disc ratio(VCDr),intraocular pressure(IoP),central corneal thickness(CCt)and optic disc area(oDa)can also be analyzed. these abnormal phenotype-related genes are crucial in the development of PoaG. this article reviews the findings of GWas for PoaG.%原发性开角型青光眼(PoaG)是由多个基因及环境因素相互作用所致的复杂疾病,遗传因素在其发生发展中起重要作用。全基因组关联研究(GWas)方法被广泛应用到该病的遗传学研究中,并取得了一系列研究成果。该方法除可分析 PoaG 患者的候选易感基因外,还可定量分析 PoaG 内在表型有关基因,包括垂直杯盘比(VCDr)、眼内压(IoP)、中央角膜厚度(CCt)和视神经盘区(oDa),这些异常表型的相关基因在PoaG 的发展中是至关重要的。文章归纳了 GWas 在 PoaG 易感基因研究中的应用。

  8. Contact Angle Goniometer

    Data.gov (United States)

    Federal Laboratory Consortium — Description:The FTA32 goniometer provides video-based contact angle and surface tension measurement. Contact angles are measured by fitting a mathematical expression...

  9. 小梁切除术联合丝裂霉素应用治疗16例急性闭角型青光眼疗效分析%The Effcacy Analysis of 16 Cases of Acute Angle-closure Glaucoma in Trabeculectomy With Mitomycin Application Therapy

    Institute of Scientific and Technical Information of China (English)

    王海菊

    2016-01-01

    Objective To analyse the treatment of acute angle-closure glaucoma trabeculectomy combined mitomycin the curative effect. Methods According to the principle of random, in our hospital from February 2015 to February 2016, 31 cases of acute angle closure glaucoma patients were divided into two groups, 15 patients in control group only with trabeculectomy, 16 cases of the observation group were treated by trabeculectomy combined with mitomycin treatment.Results Observation group effect of surgery and postoperative intraocular pressure to improve the effect was better than the control group, comparing the two groups was statistically significant difference (P<0.05).ConclusionTrabeculectomy combined mitomycin method applied in treatment of acute angle-closure glaucoma, had a higher success rate of surgery.%目的:分析小梁切除术联合丝裂霉素治疗急性闭角型青光眼的疗效。方法按照随机原则,将我院2015年2月~2016年2月收治的31例急性闭角型青光眼患者分为两组,15例对照组患者单独采用小梁切除术,16例观察组患者采用小梁切除术联合丝裂霉素进行治疗。结果观察组的手术效果及术后眼压改善效果均优于对照组,两组比较差异有统计学意义(P<0.05)。结论使用小梁切除术联合丝裂霉素的方法应用治疗急性闭角型青光眼,手术成功率较高。

  10. Safety and efficacy of early administration of tirofiban in patients with acute ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention: a meta-analysis

    Institute of Scientific and Technical Information of China (English)

    Liu Yangchun; Su Qiang; Li Lang

    2014-01-01

    Background Tirofiban has been widely used as an adjunctive pharmacologic agent for revascularization in patients undergoing percutaneous coronary intervention,and the outcomes appear attractive.However,the potential benefits from early administration of tirofiban in patients with acute ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI) remain unclear.Methods We conducted a search in MEDLINE,EMBASE,and the Cochrane Central Register of Controlled Trials up to September 2012 without language restriction.A total of eight randomized trials (n=1 577 patients) comparing early (emergency department or ambulance) versus late (catheterization laboratory) administration of tiroflban in STEMI patients undergoing PPCI were included in this meta-analysis.Risk ratio (RR) was computed from individual studies and pooled with random-or fixed-effect models.Results There were no differences in post-procedural Thrombolysis In Myocardial Infarction (TIMI) flow grade 3 and Corrected TIMI Frame Count (RR=1.02,95% confidence interval (C/):0.99-1.05,P=0.18; weighted mean difference (WMD)=-0.93,95% CI:-5.37-3.52,P=0.68,respectively) between the two groups.Similarly,there were no significant differences in the incidence of 30-day mortality (RR=1.69,95% CI:0.69-4.13,P=0.25) and re-myocardial infarction (RR=0.71,95% CI:0.21-2.35,P=0.57) between early and late administration of tirofiban.As to the safety end points,no significant difference was observed in hospital minor bleeding (RR=1.08,95% CI:0.54-2.14,P=0.83) and hospital and 30-day major bleeding between the two groups (RR=0.98,95% CI:0.46-2.10,P=0.96; RR=1.32,95% CI:0.59-2.97,P=0.49,respectively).Conclusions Early administration of tiroflban in patients undergoing PPCI for STEMI was safe,but no beneficial effects on post-procedural angiographic or clinical outcomes could be identified as compared with late administration.Besides the negative finding,more high

  11. 中国人近视与原发性开角型青光眼相关性的 Meta 分析%Meta-analysis of association between myopia and primary open angle glaucoma

    Institute of Scientific and Technical Information of China (English)

    项勇刚; 夏凌云; 张勇; 曾宪涛; 许玲

    2014-01-01

    Objective To explore the association between myopia and primary open angle glaucoma ( POAG) by Meta-analysis.Methods Relevant studies, published up to July 20, 2013, were searched from CNKI and VIP databases . After data extraction, a meta-analysis was performed using CMA (comprehensive meta analysis) v2.2 software.Results Five studies were finally recruited , including 3 studies that reported the association between myopia and POAG independ-ently.The results of meta-analysis showed that myopia evidently increases the risk of POAG by 3.07 times ( OR=3.07, 95%CI=1.90~4.96), and high myopia obviously increases the risk of POAG by 7.15 times (OR=7.15, 95% CI=4.01~12.75).Sensitivity analysis showed that the results were robust .The publication bias analysis was not conducted . Conclusion Based on the current evidence , myopia is probably an independent and significant risk factor for POAG , and the high myopia persons were with higher risk for POAG .%采用Meta分析的方法探讨中国人近视与原发性开角型青光眼( POAG)的相关性。方法检索CNKI和VIP数据库中自建库至2013年7月20日之间公开发表的文献,对符合纳入标准的研究进行数据提取之后,采用Comprehensive Meta Analysis ( CMA) v2.2软件进行 Meta分析。结果最终纳入5个研究,其中3个研究将高度近视作为暴露因素单独列出来。 Meta分析结果显示,暴露于近视的人群罹患POAG的风险增加3.07倍(OR =3.07,95%CI =1.90~4.96;P <0.01);暴露于高度近视者(屈光度数>-6.0 D),罹患POAG的风险增加7.15倍(OR =7.15,95%CI =4.01~12.75;P <0.01)。敏感性分析显示结果稳健性好,未行发表偏倚分析。结论当前证据表明近视很可能是开角型青光眼的一个独立的、有意义的危险因素,并且高度近视者罹患POAG的风险高。

  12. Comparison of macular choroidal thickness between primary open angle glaucoma and normal subjects%原发性开角型青光眼患者与正常人黄斑区脉络膜厚度的比较

    Institute of Scientific and Technical Information of China (English)

    张苗苗; 王建荣; 刘伟

    2015-01-01

    目的:研究原发性开角型青光眼(POAG)患者黄斑区脉络膜厚度与正常人之间的差异。方法应用增强深部成像的相干光断层扫描(EDI-OCT)仪测量60例(60只眼)POAG 患者(POAG 组)和60例(60只眼)正常人(对照组)黄斑区脉络膜厚度。组内相关系数(ICC)表示检测者内和检测者间信度分析。结果检测者内的 ICC 值为0.994~0.999(P <0.001),检测者间的 ICC 值为0.995~0.998(P <0.001)。黄斑区脉络膜厚度特征为黄斑中心凹下方最厚,鼻侧最薄。POAG 组黄斑区各象限脉络膜厚度均明显厚于对照组(t =3.114~4.456,P <0.05)。POAG 组和对照组黄斑区象限脉络膜厚度均随年龄增加及眼轴增长而变薄(r =-0.456~-0.520,-0.445~-0.491;P <0.05)。结论POAG 患者的黄斑区脉络膜厚度比正常人厚;POAG 患者黄斑区脉络膜增厚与青光眼的发病机制相关。%Objective To compare the macular choroidal thickness between primary open angle glaucoma (POAG)and normal subjects using enhanced depth imaging optical coherence tomography (EDI-OCT).Methods Scans were per-formed by EDI-OCT in eyes of 60 POAG patients and 60 age-and sex-matched normal subjects.The reliability analysis of intra-and inter-observer was tested using intraclass correlation coefficient (ICC).Results The intra-and inter-ob-server ICC values ranged from 0.994 to 0.999 and 0.995 to 0.998 respectively (both P <0.001).In the COPD pa-tients and controls,the choroidal thickness beneath the fovea was thickest and the nasal choroidal thickness was thin-nest.Each quadrant of choroidal thickness in POAG patients were thicker than that of the controls (t =3.114 to 4.456, P <0.05).For both subjects investigated,the choroidal thickness showed a negative correlation with age and axial length (r =-0.456 to -0.520,-0.445 to -0.491;P <0.05).Conclusion The choroidal thickness of POAG pa

  13. Effect of fundus image devices for early diagnosis of primary open angle glaucoma%眼底图像分析系统在原发性开角型青光眼早期诊断中的作用

    Institute of Scientific and Technical Information of China (English)

    潘英姿

    2009-01-01

    眼底图像分析技术的迅速发展使视神经损害的直接定量检测成为可能,同时因其检测手段客观、结果可靠而日益受到重视.但由于临床医师对眼底图像分析技术如海德堡视网膜断层扫描、相干光断层扫描等在青光眼早期诊断中的意义仍存在认识上的分歧,因此有必要就此问题进行论述.有多数研究结果表明,现有的检测设备不仅在分辨率和重复性方面已经达到临床要求,而且能够较好地区分正常人和青光眼的眼底改变,但现阶段利用视神经结构定量指标来实现对青光眼的早期诊断,其敏感性和特异性尚不尽如人意.其原因是多方面的,如结构指标个体差异较大,缺乏完善的正常人数据库,缺乏达成共识的敏感而特异的诊断指标等.尽管如此,现有的研究趋势表明,利用图像分析技术测量青光眼性视神经损害已显示出令人鼓舞的临床应用前景,临床医师若能充分了解各种图像分析手段的优缺点,这些新的检测技术将成为早期诊断原发性开角型青光眼的有益补充手段.%Evaluation of the optic disc and retinal nerve fiber layer measurements (RNFL) with sterephotography is the current "gold standard" for the diagnosis of early primary open angle glaucoma (POAG), but it is still subjective and is dependent too much upon an experienced observer.Substantial variability exists in the interpretation of optic disc change over time.There are consistent evidences that image analysis devices such as optical coherence tomography (OCT) and Heidelberg retina tomograph (HRT-Ⅱ) can detect early to moderate glaucoma as well as expert assessment of stereoscopic optic disc and RNFL photographs.Optic disc and RNFL defect can be quantitatively measured by these devices.But the sensitivity and specificity of the measurements obtained with these devices are not good enough for the early diagnosis of POAG at this time due to several reasons, such as

  14. 深层巩膜切除术联合透明质酸片植入治疗原发性开角型青光眼%Deep sclerectomy with hyaluronate implant for primary open-angle glaucoma

    Institute of Scientific and Technical Information of China (English)

    姜发纲; Klaus W.Ruprecht

    2004-01-01

    目的:探讨深层巩膜切除联合透明质酸片植入(DSHI)治疗原发性开角型青光眼(POAG)的临床疗效.方法:回顾性总结在Saarland大学眼科医院行DSHI治疗的POAG.结果:符合条件并入选的有216患者的377只POAG.平均随诊31(5~51)mo.术前平均眼压(28.3±8.4)mmHg(1mmHg=O.133kPa),术后1wk,6mo,1、2、3、4a眼压分别为(9.7±3.6)、(12.4+5.3)、(15.5±8.7)、(15.4±6.8)、(16.1±6.7)、(17.4±7.5)mmHg.术前平均视力为0.65,术后1wk,6mo,1、2、3、4a视力分别为0.63、O.68、0.72、0.71、0.76、0.70.术后la显效(不加抗青光眼药物且眼压≤21mmHg)率为89%,有效(加抗青光眼药物时眼压≤21mmHg)率为9%.术后4a时,显效率为45%,有效率48%.并发症包括切口渗漏、前房出血、脉络膜脱离等.结论:DSHI对POAG治疗效果良好,并发症少且轻微.%AIM: To explore the clinical effects of deep sclerectomy with hyaluronate implant (DSHI) for primary open-angle glaucoma (POAG).METHODS: A retrospective investigation was made in patients with POAG treated with DSHI in Saarland University.RESULTS: A tolal of 377 eyes in 216 patients with POAG were selected. The average follow-up was 31months (5-51 months). The mean intraocular pressure (IOP) was 28.3+8.4 mmHg (1mmHg=0.133kPa) before surgery, and9.7+3.6, 12.4+5.3, 15.5+8.7, 15.4+6.8,16.1+6.7 and 17.4+7.5 mmHg respectively at 1 week, 6months, 1 year, 2 years, 3 years and 4 years after surgery. The mean visual acuity was 0.65 before surgery,and 0.63, 0.68, 0.72, 0.71, 0.76, 0.70 respectively at 1week, 6 months, 1 year, 2 years, 3 years and 4 years after surgery. Complete success rate (IOP≤21 mmHg without antiglaucoma medication) was 89% and qualified success rate (IOP≤21mmHg with antiglaucoma medication) was 9% at 1 year after surgery. They were 45%and 48% at 4 years after surgery respectively. Complications included wound leak, hyphema and choroidal detachment, etc.CONCLUSION: DSHI is efficacious for POAG. Complications following

  15. Advances in molecular genetic study on primary angle-closure glaucoma%原发性闭角型青光眼的基因学研究进展

    Institute of Scientific and Technical Information of China (English)

    段觉昵

    2015-01-01

    原发性闭角型青光眼(PACG)是具有很强遗传倾向的复杂眼病,在全球范围内PACG患者中以亚洲人居多,且女性占大多数.目前PACG发病的分子生物学机制研究已引起关注,研究方法多采用关联分析或全基因组关联研究(GWAS),但迄今为止其发病机制仍未清晰阐明,PACG的遗传学研究还面临许多挑战.目前已有个别可疑候选基因和最新报道的3个易感基因位点被证实与PACG发病有关,已发表的相关基因研究报道也很少.但是,研究发现一些与POAG有关的基因与PACG发病具有相关性;另一方面,因为PACG患者眼部具有特殊的解剖生物学特征,因此一些参与眼球发育或与眼轴改变调控的基因也陆续被报道,并在部分特定人群中发现了基质金属蛋白酶(MMPs)、肝细胞生长因子(HGF)等与PACG之间的关联.此外,应用GWAS技术对PACG患者进行的分子遗传学研究也有望取得新的突破.%Primary angle-closure glaucoma (PACG) is a group of complex ophthalmic disorders with genetic heterogeneity.PACG appears to be more frequently occurred in Asian population and females worldwide.Recently,some studies tried to find the possible pathogenesis of PACG from biomolecular level,some association analysis and genome-wide association study (GWAS) technique have been used to illustrate the mechanism of PACG.But so far its pathogenesis still is not yet elucidated,there are much more puzzles in molecular genetic study on PACG.Up to now,only a few uncertain genes and three new susceptibility loci were reported to be associated with PACG and only 40 literature were published.However,some genes referred to POAG display a close association with PACG.As eyes with PACG tend to share certain anatomic biometric characteristics,the associations between PACG and several genes,such as matrix metalloproteinases (MMPs) and hepatocyte growth factor (HGF),which involve in the modulation of eye growth.Besides,GWAS shows us another

  16. Reading Angles in Maps

    Science.gov (United States)

    Izard, Véronique; O'Donnell, Evan; Spelke, Elizabeth S.

    2014-01-01

    Preschool children can navigate by simple geometric maps of the environment, but the nature of the geometric relations they use in map reading remains unclear. Here, children were tested specifically on their sensitivity to angle. Forty-eight children (age 47:15-53:30 months) were presented with fragments of geometric maps, in which angle sections…

  17. Application of a new-type sutureless anastomosis stent to the primary reconstruction of the bilioenteric continuity after acute bile duct injury in dogs

    Institute of Scientific and Technical Information of China (English)

    Jianhui Li; Yi Lü; Bo Qu; Zhiyong Zhang; Chang Liu; Yuan Shi; Bo Wang; Xuewen Ji; Liang Yu

    2007-01-01

    Objective: To evaluate the effect of a new-type sutureless magnetic bilioenteric anastomosis stent that was used to reconstruct the bilioenteric continuity (primarily under the circumstances of severe inflammation after acute bile duct injury in dogs).Methods: Establishing an animal model of acute bile duct injury with severe inflammation and bile peritonitis in dogs. The newtype sutureless magnetic bilioenteric anastomosis stent was used to reconstruct the bilioenteric continuity primarily. Results: The experiment group anastomosis healed well with a mild local inflammation reaction, and the collagen lined up in order without the occurrence of observable bile leakage and infection. Conclusion: It was safe and feasible to use the new-type anastomosis stent to reconstruct the bilioenteric continuity primarily under the circumstances of severe inflammation after acute bile duct injury in dogs.

  18. 视网膜静脉阻塞患者中原发性开角型青光眼发病比例的研究%Percentage of primary open angle glaucoma in retinal vein occlusion patients

    Institute of Scientific and Technical Information of China (English)

    许珂; 吴玲玲; 马志中; 刘瑜玲; 钱芳

    2016-01-01

    背景 有研究表明,高加索人视网膜静脉阻塞(RVO)与原发性开角型青光眼(POAG)的产生存在关联,但目前鲜见关于亚洲人群RVO患者中POAG发病比例的报道. 目的 观察以医院人群为基础的RVO患者中POAG的发病比例.方法 采用横断面观察性研究设计,连续纳入2011年10月至2013年5月在北京大学第三医院眼科确诊且病程在1年以内的RVO患者375例,患者均接受房角镜检查,POAG的诊断参照国际地域性和流行病学眼科学学会的青光眼诊断标准.根据眼底彩色照片和FFA将RVO分为视网膜中央静脉阻塞(CRVO)型、半侧视网膜静脉阻塞(HRVO)型和视网膜分支静脉阻塞(BRVO)型;按照静脉阻塞的部位分为动静脉交叉RVO(AV-RVO)型、视盘RVO(OC-RVO)型、无视盘水肿的视神经RVO(NONHS-RVO)型及有视盘水肿的视神经RVO(ONHS-RVO)型.分别统计不同RVO类型患者中POAG的发病比例.结果 共317例患者纳入青光眼筛查并完成各检查项目,应答率为84.5%.POAG在RVO患者中的发病比例为8.2%,其中在CRVO型中的比例为7.1%,在HRVO型中为23.5%,在BRVO型中为6.2%.OC-RVO型患者和NONHS-RVO型患者中POAG的发病比例分别为27.9%和13.2%,明显高于AV-RVO和ONHS-RVO中的4.7%和1.3%,差异均有统计学意义(均P<0.05). 结论 中国RVO患者中POAG的发病比例是正常人群的3~4倍;OC-RVO型和NONHS-RVO型患者中POAG的发病比例较高,提示RVO的发病可能与POAG的视盘结构改变密切相关.%Background Researches determined that the pathogenesis of retinal vein occlusion (RVO) is associated with primary open angle glaucoma (POAG) in Caucasian population.However,the relationship between RVO and POAG in Asian population is unclear.Objective This study was to survey the percentage of POAG in RVO patients in China.Methods A prospective cross-sectional observational study based on hospital was performed.Three hundred and seventy five patients with newly

  19. 原发性开角型青光眼家系的MYOC基因突变研究%Analysis on the gene mutations of MYOC in primary open angle glaucoma pedigree

    Institute of Scientific and Technical Information of China (English)

    谢小兵; 周新; 田艳丽; 曲喜英; 匡多秀; 朱惠斌; 喻京生; 宁兴旺

    2009-01-01

    目的 对来自重庆地区的1个原发性开角型青光眼(POAG)家系进行MYOC基因突变筛查,研究POAG与MYOC基因突变的相关性,探讨MYOC基因突变在中国人POAG发病中的作用.方法 1个4代共39例的青光眼家系,8例为已确诊患者,健康对照者100名.用单链构象多态性分析(SSCP)、PCR.限制性片段长度多态性(RFLP)和基因测序的方法筛选MYOC基因的突变(包括G34C、C136T、G144T、G227A、C624G、G736A、C1009G、A1036G、C1081T、G1099A、G1138A、A1139C、T1430A、C1441A和C1442T等),同时对检测到的突变结果进行生物信息学分析.结果 在该家系中,发现1个G227A(Arg76Lys)突变,该突变存在2例已确诊的POAG患者和1例家系表型正常者中,健康对照者中未榆出.发现1个缺失突变(C1009del),该突变存在于家系中所有发病患者和1例4岁的子代亲属,健康对照者中未检出.未发现其他突变.由于C1009del突变是首次发现,据此我们申请了GenBank号,已发表的GenBank序列号为FJ237047,对应的蛋白序列号为ACI62293.结论 G227A(Arg76Lys)突变为已报道的多态性位点,与该家系青光眼的发病无相关性.移码突变C1009del突变与青光眼的发病密切相关,也可由此推测青光眼患者亲属的发病率较正常人高.%Objective To screen the mutations of MYOC gene in a Chinese primary open angle glaucoma (POAG) family from Cbengqing and investigate the relationship between the mutations in MYOC/TIGR gene and POAG.Methods In a large 4-generation glaucoma family, myocilin gene (MYOC) was screened in 39 family members, 8 of which were confirmed patients. Normal controls included 100 normal Chinese subjects.The known mutations of MYOC gene ( including G34C, C136T, G144T, G227A, C624G,G736A, C1009G, A1036G, C1081T, G1099A, G1138A, A1139C, T1430A, C1441A and C1442T) were detected by single strand conformation polymorphism(SSCP) , po]ymerase chain reaction restriction fragment length polymorphism (PCR

  20. Layer-by-layer analysis of retinal thickness in primary open-angle glaucoma using optical coherence tomography%POAG患者视网膜各层厚度的OCT分析

    Institute of Scientific and Technical Information of China (English)

    张萌; 章畅; 王玉宏; 吕帆

    2014-01-01

    Objective To analysis each layer of retinal thickness,especially the ganglion cell layer (GCL) in the macular area,in patients with primary open-angle glaucoma (POAG) using an RTVue OCT; to assess its value in the diagnosis of glaucoma.Methods In this prospective case-control study,76 patients (91 eyes) with POAG (30 patients [30 eyes] in the early stage,25 patients [29 eyes] in the middle stage and 21 patients [32 eyes] in late stage) and 32 healthy age-and gender-matched controls (32 eyes) were recruited.The macular area was scanned with an RTVue OCT,and the retina was divided into nine layers with self-programming retinal image processing software.The thickness of each layer and the total retinal thickness were calculated and an LSD-t test was used to compare the average thickness of the macular area in each retinal layer for early,middle and late POAG patients and the control group.Results In the early stage of POAG,the mean thicknesses of the retinal nerve fiber layer (RNFL) and ganglion cell layer (GCL) were 31.6±9.2 μm and 33.9±5.0 μm,respectively,becoming thinner (P<0.05) than healthy controls.In the middle stage,the mean thicknesses of the RNFL and GCL were 31.2±3.4 μm and 34.1±3.9 μm,respectively,which was thinner than the control group (P<0.05).In the late stage,the mean thicknesses of the RNFL,GCL,inner plexiform layer (IPL),inner segment of the photoreceptor (IS),and total retina (TR) were 18.8±7.6 μm,24.2±7.9 μm,38.0±6.4 μm,22.8±4.4 μm and 299.5±15.1 μm,respectively,and all measurements were thinner than the controls (P<0.05).The mean thickness of the inner nuclear layer (INL) was 39.1±6.6 μm,which was thicker than the controls (P<0.05).Conclusion The mean thickness of the retinal macular area of POAG patients became obviously thinner.The GCL was especially affected by early POAG.GCL combined with clinical observations can be used as an early diagnostic indicator of POAG.%目的 利用RTVue OCT对POAG患者黄斑区视网

  1. 选择性激光小梁成形术治疗原发性开角型青光眼%Selective laser trabeculoplasty in the treatment for primary open-angle glaucoma

    Institute of Scientific and Technical Information of China (English)

    于爱萍; 王瑞夫

    2011-01-01

    目的 评价选择性小梁激光成形术(SLT)治疗各类原发性开角性青光眼(POAG)的疗效观察.方法 79例(93眼)根据种族的不同(小梁Seheie色素分级)、年龄及眼压情况分为3组,采用国通公司倍频Q-开关.532 nm ND:YAG激光器,单脉冲,时间为3 ns,波长532 nm,光斑直径400μm,脉冲能量设置0.4~1.6 mJ.术前在盐酸奥布卡因表麻下放置前房角镜,瞄准功能小梁网,选择相应的脉冲能量、象限范围和激光点数进行治疗或重复治疗.术后随访眼压(1 h、1 d、1周、1个月、3个月、6个月、1年)、眼底及视野.结果 3个组79例(93眼)术前1年平均眼压依次为(23.1±6.3)mmHg、(26.52±6.1)mmHg和(29.52±6.1)mmHg;术后1年眼压依次为(12.52±4.3)mmHg、(15.58±4.7)mmHg和(16.65±4.5)mmHg.术前与术后眼压相比有显著下降(P<0.01).3个组眼底C/D比,术前为0.50~0.70±0.15~0.13;术后为0.57~0.68±0.16~0.42.视力:术前0.85~0.57±0.32~0.29;术后0.91~0.58±0.30~0.27,两者比较其差异均无统计学意义.结论 SLT对各类POAG均有显著降压作用.%Objective To evaluate selective laser trabeculoplasty(SLT) in treating primary open angle glaucoma(POAG) and observation on the therapeutic effect. Methods 79 patients, 93 eyes were divided into 3 groups acording to the different races, medical history, age, IOP. The ELLEX Laser distributed by GT-Medical Company,with double frequency, 532 nm, Nd:YAG, single pulse, pulse width 3ns, spot size 400 μm, pulse energy 0.4-1. 6mJ was used. Pre-op: Oxybuprocaine HCI for topical anesthesia, a gonioscope, aiming at functional trabecular meshwork, selected different pulse energy, quadrant, different spots, and/or retreatment. Post-op: IOP follow-up at 1 hour, 1 day, 1 week, 1 month, 3 months,6 months.1 year, retina, visual field, visual acuity. Results comparison on pre-op and post-op IOP, the three groups of 79 patients and 93 eyes, pre-op average IOP was (23. 134±6.34)mmHg, (26.524±6.11)mmHg and

  2. Measurement of acute nonspecific low back pain perception in primary care physical therapy: reliability and validity of the brief illness perception questionnaire

    NARCIS (Netherlands)

    Hallegraeff, J.M.; Schans, Cees van der; Krijnen, W.P.; Greef, M.H. de

    2013-01-01

    The Dutch version of the Brief Illness Perception Questionnaire is an appropriate instrument for measuring patients' perceptions in acute low back pain patients, showing acceptable internal consistency and reliability. Concurrent validity is adequate, however, the instrument may be unsuitable for de

  3. Measurement of acute nonspecific low back pain perception in primary care physical therapy : reliability and validity of the brief illness perception questionnaire

    NARCIS (Netherlands)

    Hallegraeff, Joannes M.; van der Schans, Cees P.; Krijnen, Wim P.; de Greef, Mathieu H. G.

    2013-01-01

    Background: The eight-item Brief Illness Perception Questionnaire is used as a screening instrument in physical therapy to assess mental defeat in patients with acute low back pain, besides patient perception might determine the course and risk for chronic low back pain. However, the psychometric pr

  4. Primary care based randomised, double blind trial of amoxicillin versus placebo for acute otitis media in children aged under 2 years

    NARCIS (Netherlands)

    Damoiseaux, RAMJ; van Balen, FAM; Hoes, AW; Verheij, TJM; de Melker, RA

    2000-01-01

    Objective To determine the effect of antibiotic treatment for acute otitis media in children between 6 months and 2 years of age. Design Practice based, double blind, randomised, placebo controlled trial. Setting 53 general practices in the Netherlands. Subjects 240 children aged 6 months to 2 years

  5. Photoelectric angle converter

    Science.gov (United States)

    Podzharenko, Volodymyr A.; Kulakov, Pavlo I.

    2001-06-01

    The photo-electric angle transmitter of rotation is offered, at which the output voltage is linear function of entering magnitude. In a transmitter the linear phototransducer is used on the basis of pair photo diode -- operating amplifier, which output voltage is linear function of the area of an illuminated photosensitive stratum, and modulator of a light stream of the special shape, which ensures a linear dependence of this area from an angle of rotation. The transmitter has good frequent properties and can be used for dynamic measurements of an angular velocity and angle of rotation, in systems of exact drives and systems of autocontrol.

  6. Direct ambulance transport to catheterization laboratory reduces door-to-balloon time in patients with acute ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention: the DIRECT-STEMI study

    Institute of Scientific and Technical Information of China (English)

    QIU Jian-ping; ZHANG Qi; LU Ji-de; WANG Hai-rong; LIN Jie; GE Zhi-ru; ZHANG Rui-yan; SHEN Wei-feng

    2011-01-01

    Background Primary percutaneous coronary intervention (PCI) has been clearly identified as the first therapeutic option for patients with acute ST-segment elevation myocardial infarction (STEMI). The importance of reducing door-to-balloon (D2B) time has gained increased recognition. This study aimed to assess the feasibility, safety and efficacy of the strategy of direct ambulance transportation of patients with acute STEMI to catheterization lab to receive primary PCI.Methods The study population included 141 consecutive patients with chest pain and ST-segment elevation who were admitted to the catheterization laboratory directly by the ambulance and underwent primary PCI (DIRECT group).Another 145 patients with STEMI randomly selected from the PCI database, were served as control group (conventional group); they were transported to catheterization laboratory from emergency room (ER). The primary endpoint of D2B time,and secondary endpoint of in-hospital and 30-day major adverse cardiac events (MACE, including death, non-fatal reinfarction, and target vessel revascularization) were compared.Results Baseline and procedural characteristics between the two groups were comparable, except more patients in the DIRECT group presented TIMI 0-1 flow in culprit vessel at initial angiogram (80.1% and 73.8%, P=0.04). Comparing to conventional group, the primary endpoint of D2B time was reduced ((54±18) minutes and (112±55) minutes, P <0.0001)and the percentage of patients with D2B <90 minutes was increased in the DIRECT group (96.9% and 27.0%, P<0.0001).The success rate of primary PCI with stent implantation with final Thrombolysis in Myocardial Infarction (TIMI) 3 flow was significantly higher in the DIRECT group (93.8% and 85.2%, P=0.03). Although no significant difference was found at 30-day MACE free survival rate between the two groups (95.0% and 89.0%, P=0.06), a trend in improving survival status in the DIRECT group was demonstrated by Kaplan-Meier analysis

  7. 青少年开角型青光眼临床表型及遗传学特征%Clinical and genetic characteristics of primary juvenile-onset open-angle glaucoma

    Institute of Scientific and Technical Information of China (English)

    刘铁城

    2014-01-01

    青少年开角型青光眼(juvenile-onset open-angle glaucoma,JOAG)是常染色体显性遗传性疾病,具有发病年龄早、眼压高和进展快等特点.本文回顾了JOAG的临床表型、相关基因及功能,为建立基因型和表型之间的联系,为探讨青光眼的发病机制提供帮助.

  8. 中国原发性开角型青光眼一家系MYOC基因的突变分析%Analysis of MYOC gene mutation in a primary open angle glaucoma family from China

    Institute of Scientific and Technical Information of China (English)

    王凤云; 李杨; 兰兰; 李博; 陆晓和

    2014-01-01

    Background Primary open angle glaucoma (POAG) is one of the frequent glaucomatous types,and genetic factor participates in pathogenesis and development of the disease.Recently,MYOC mutation was found to be associated with POAG.Objective This study was to describe the clinical and genetic findings in a POAG family from Luoyang,China.Methods This study protocol was approved by Ethic Committee of Affiliated First Hospital of Henan University of Science and Technology.The study adhered to Declaration of Helsinki.A POAG family with 29 members of 5 generations was surveyed and followed-up for 5-year duration.The mode of inheritance was determined by the pedigree analysis.The periphery blood sample was collected form 12 families and 100 health controls for the extraction of genomic DNA under the informed consent.The third exon and its flanking introns of MYOC were amplified,and quantitative real time PCR products were sequenced,and the structure and function of mutated gene were examined by restriction fragment length polymorphism analysis.The predicted effects of the detected variants on the secondary structure of MYOC protein were evaluated using Garnier-Osguthorpe-Robson (GOR) method,and homology analysis of protein was carried out by Blast software provided by National Center for Biotechnology Information (NCBI).Results This POAG family included 29 members of 5 generations,and the clinical data were not clear in 11 family members.Three individuals from 3 generations were determined POAG,another one was ocular hypertension,and 2 were carriers.Pedigree analysis appeared an autosomal dominant inheritance.In 12 subjects included 6 members genetically affected and 6 members with normal phenotype,the heterozygous mutation was found in the third exon of MYOC gene in 6 genetically affected members,which revealed a T→C transition at position 1021 (p.S341P),resulting in a switch of serine (Ser) to proline (Pro).It was a missense mutation abolished a CviKI-1 restriction site

  9. Angle-Ply Weaving

    Science.gov (United States)

    Farley, Gary L.

    1990-01-01

    Bias-direction or angle-ply weaving is proposed new process for weaving fibers along bias in conventional planar fabric or in complicated three-dimensional multilayer fabric preform of fiber-reinforced composite structure. Based upon movement of racks of needles and corresponding angle yarns across fabric as fabric being formed. Fibers woven along bias increases shear stiffness and shear strength of preform, increasing value of preform as structural member.

  10. The diagnosis of urinary tract infections in young children (DUTY: protocol for a diagnostic and prospective observational study to derive and validate a clinical algorithm for the diagnosis of UTI in children presenting to primary care with an acute illness

    Directory of Open Access Journals (Sweden)

    Downing Harriet

    2012-07-01

    Full Text Available Abstract Background Urinary tract infection (UTI is common in children, and may cause serious illness and recurrent symptoms. However, obtaining a urine sample from young children in primary care is challenging and not feasible for large numbers. Evidence regarding the predictive value of symptoms, signs and urinalysis for UTI in young children is urgently needed to help primary care clinicians better identify children who should be investigated for UTI. This paper describes the protocol for the Diagnosis of Urinary Tract infection in Young children (DUTY study. The overall study aim is to derive and validate a cost-effective clinical algorithm for the diagnosis of UTI in children presenting to primary care acutely unwell. Methods/design DUTY is a multicentre, diagnostic and prospective observational study aiming to recruit at least 7,000 children aged before their fifth birthday, being assessed in primary care for any acute, non-traumatic, illness of ≤ 28 days duration. Urine samples will be obtained from eligible consented children, and data collected on medical history and presenting symptoms and signs. Urine samples will be dipstick tested in general practice and sent for microbiological analysis. All children with culture positive urines and a random sample of children with urine culture results in other, non-positive categories will be followed up to record symptom duration and healthcare resource use. A diagnostic algorithm will be constructed and validated and an economic evaluation conducted. The primary outcome will be a validated diagnostic algorithm using a reference standard of a pure/predominant growth of at least >103, but usually >105 CFU/mL of one, but no more than two uropathogens. We will use logistic regression to identify the clinical predictors (i.e. demographic, medical history, presenting signs and symptoms and urine dipstick analysis results most strongly associated with a positive urine culture result. We will

  11. Acute morphine induces matrix metalloproteinase-9 up-regulation in primary sensory neurons to mask opioid-induced analgesia in mice

    Directory of Open Access Journals (Sweden)

    Liu Yen-Chin

    2012-03-01

    Full Text Available Abstract Background Despite decades of intense research efforts, actions of acute opioids are not fully understood. Increasing evidence suggests that in addition to well-documented antinociceptive effects opioids also produce paradoxical hyperalgesic and excitatory effects on neurons. However, most studies focus on the pronociceptive actions of chronic opioid exposure. Matrix metalloproteinase 9 (MMP-9 plays an important role in neuroinflammation and neuropathic pain development. We examined MMP-9 expression and localization in dorsal root ganglia (DRGs after acute morphine treatment and, furthermore, the role of MMP-9 in modulating acute morphine-induced analgesia and hyperalgesia in mice. Results Subcutaneous morphine induced a marked up-regulation of MMP-9 protein in DRGs but not spinal cords. Morphine also increased MMP-9 activity and mRNA expression in DRGs. MMP-9 up-regulation peaked at 2 h but returned to the baseline after 24 h. In DRG tissue sections, MMP-9 is expressed in small and medium-sized neurons that co-express mu opioid receptors (MOR. In DRG cultures, MOR agonists morphine, DAMGO, and remifentanil each increased MMP-9 expression in neurons, whereas the opioid receptor antagonist naloxone and the MOR-selective antagonist D-Phe-Cys-Tyr-D-Trp-Arg-Thr-Pen-Thr-NH2 (CTAP suppressed morphine-induced MMP-9 expression. Notably, subcutaneous morphine-induced analgesia was enhanced and prolonged in Mmp9 knockout mice and also potentiated in wild-type mice receiving intrathecal injection of MMP-9 inhibitors. Consistently, intrathecal injection of specific siRNA targeting MMP-9 reduced MMP-9 expression in DRGs and enhanced and prolonged morphine analgesia. Subcutaneous morphine also produced heat hyperalgesia at 24 h, but this opioid-induced hyperalgesia was not enhanced after MMP-9 deletion or inhibition. Conclusions Transient MMP-9 up-regulation in DRG neurons can mask opioid analgesia, without modulating opioid-induced hyperalgesia

  12. Assessment and management of patients with acute red eye.

    Science.gov (United States)

    Watkinson, Sue

    2013-06-01

    This article provides an overview of the role of the nurse in the assessment and management of five ocular conditions that give rise to an acute red eye in older people. The conditions discussed are acute closed angle glaucoma, acute iritis, acute conjunctivitis, herpes zoster ophthalmicus and bacterial corneal ulcer.

  13. 激光周边虹膜切开术在急性闭角型青光眼的临床应用%Clinical application of laser peripheral iridotomy in acute angle closure glaucoma

    Institute of Scientific and Technical Information of China (English)

    林延; 王玮

    2011-01-01

    目的 观察激光周边虹膜切开术在治疗急性闭角型青光眼临床前期及间歇期的效果,探讨其作用机制.方法 49例78只眼闭角型青光眼行激光周边虹膜切开术,采用倍频532 nm激光烧灼、ND:YAG激光击穿周边虹膜,术后观察前房反应、眼压,随访3~12个月.结果 所有眼术后均出现了虹膜炎性反应,1 d后消退;一过性眼压升高3眼(22~30 mmHg),经处理后降至正常;前房出血2眼,1 d后吸收;角膜内皮损伤混浊2眼,3 d后消退.结论 激光周边虹膜切开术并发症少,不影响降压效果,适合于急性闭角型青光眼临床前期及间歇期的治疗.%Objective To observe the therapeutic effects of laser peripheral iridotomy on angle closure glaucoma at early and interim period. Methods Forty-nine patients (78 eyes) with diagnosed angle closure glaucoma were received laser peripheral iridotomy . The laser with frequency of 53