Ultrasound Examination of the Pupil – A New Tool for the Neuro-Ophthalmological Assessment

2020 ◽  
Author(s):  
Filippo Farina ◽  
Milan R. Vosko ◽  
Claudio Baracchini ◽  
Mario Ermani ◽  
Peter Sommer ◽  
...  
Keyword(s):  
Neurological Diseases ◽  
Good Alternative ◽  
Observer Agreement ◽  
Reliable Technique ◽  
Linear Probe ◽  
Infrared Video ◽  
History Of ◽  
Ultrasound Assessment ◽  
Current Guidelines ◽  
Ophthalmological Assessment

Abstract Background Pupil examination represents a diagnostic and prognostic test in the management of several neurological diseases. Infrared video pupillometry (IVP) is the gold standard, since it is not routinely available, a noninvasive bedside ultrasound assessment has been proposed as an alternative. The aim of this study was to assess the feasibility and reproducibility of ultrasound pupillometry (UP) in comparison with IVP. Materials and Methods 81 subjects (43 men and 38 women, mean age: 52 ± 20 years and 49 ± 19 years, respectively) with no history of neurophthalmologic disease were enrolled. UP was performed with a 12-MHz linear probe according to current guidelines for orbital insonation. Light and painful stimuli were applied to test pupillary light reflex (PLR) and ciliospinal reflex (CR). In 30 of these subjects IVP examination was performed additionally to obtain intra-observer and inter-observer agreement. Results Increasing age was associated with a decreased pupillary diameter (PD) at rest, after PLR and CR (R –0.728, p < 0.01, R –0.643, p < 0.01, R 0.674, p < 0.001 respectively), while no association was noticed with time to constriction/dilation. UP measurements were reproducible (rate of inter- and intra-observer agreement: R 0.979, p < 0.01, R 0.946, p < 0.01 respectively) and concordant with IVP (PLR R 0.831, p < 0.01; CR R 0.879, p < 0.01). Conclusion According to our study, ultrasound pupillometry is a feasible and reliable technique for bedside pupillary function assessment, and is a good alternative to infrared video pupillometry. Moreover, it represents the only way for functional pupillary assessment in patients with periorbital hematoma.

scholarly journals From the “ancestar” of turtles to the turtle-mouse: when Greek words are used for turtle taxon names

2015 ◽  
Author(s):  
Evangelos Vlachos
Keyword(s):  
Zoological Nomenclature ◽  
Alternative Systems ◽  
Proper Name ◽  
History Of ◽  
Greek Alphabet ◽  
Scientific Results ◽  
The Times ◽  
Animal Size ◽  
Current Guidelines ◽  
Phylogenetic Nomenclature

Background. Regardless using a rank-based or a phylogenetic nomenclature code, the use of Latinized binomens to describe the extant and extinct species has been essential. Ever since the times of Linnaeus, the use of Latinized Greek names has been a common practice both for neontologists and paleontologists. Methods. I critically analyzed the most common Greek words used as taxa names in the chelonian literature to establish their etymology and check whether the transliteration process has been done correctly. I also compared the current guidelines for the latinisation of Greek words recommended by the International Code of Zoological Nomenclature, with other alternative systems for the transformation of names formed in the Greek alphabet into Latin-based languages. Results. The preliminary results show that some Greek words (e.g. Chelone, Emys) dominate the chelonian nomenclature, but the history of the application of many of those names is intriguing. The use of Greek words is quite common in turtle taxa names when the name describes physical properties of the animal (size, shape, colour). However, several unfortunate examples exist, as some quite successful and famous names contain misspellings or poor choice of words that resulted in meanings opposite from the ones intended by the authors. Discussion. Naming species is an integral part of the research of both neontologists and palaeontologists, but the application of Greek words to life sciences is even far more extensive, applied to numerous terminologies as well. Forming a proper name for a taxon could aid significantly to the communication and interpretation of the scientific results. Publishing a new name requires a sense of responsibility as well, as the formation of a taxon name is a unique linguistic procedure. But in the end, to add a taxonomic side to the old shakespearean question, is not the name that is important, but the information it conveys. That which we call a turtle by any other name would be as unique.

scholarly journals Expanding the search for germline pathogenic variants for breast cancer. How far should we go and how high should we jump? The missed opportunity!

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Hikmat Abdel-Razeq
Keyword(s):  
Breast Cancer ◽  
Brca1 And Brca2 ◽  
Healthy Women ◽  
Panel Testing ◽  
Pathogenic Variants ◽  
Gene Panel Testing ◽  
History Of ◽  
Risk Reducing ◽  
Current Guidelines ◽  
Missed Opportunity

Since the identification of BRCA1 and BRCA2 genes 3 decades ago, genetic testing and genetic counseling have become an integral part of routine clinical practice. The risk of breast cancer among carriers of germline pathogenic variants, like BRCA1 and BRCA2, is well established. Risk-reducing interventions, including bilateral mastectomies and salpingo-oophorectomies are both effective and have become more acceptable. Many researchers and professional societies view current guidelines as restrictive and may miss many at-risk women, and are calling to expand testing to include all patients with breast cancer, regardless of their personal or family history of cancer, while others are calling for wider adoption to even include all healthy women at age 30 or older. This review will address expanding testing in two directions; horizontally to include more patients, and even healthy women, and vertically to include more genes using next-generation sequencing-based multi-gene panel testing.

Misoprostol-augmented induction of labour for third trimester fetal demise in a patient with prior hysterotomies

2021 ◽  
Vol 14 (1) ◽  
pp. e239872
Author(s):  
Isabel Beshar ◽  
Karolina Thomson ◽  
James Byrne
Keyword(s):  
Induction Of Labour ◽  
Gravid Uterus ◽  
Published Data ◽  
Third Trimester ◽  
Fetal Demise ◽  
Multiple Organs ◽  
Complex Patient ◽  
History Of ◽  
Current Guidelines ◽  
Vaginal Birth After Caesarean

A 31-year-old G3P2002 with history of two prior caesarean sections presented with influenza-like illness, requiring intubation secondary to acute respiratory distress syndrome. Investigations revealed intrauterine fetal demise at 30-week gestation.She soon deteriorated with sepsis and multiple organs impacted. Risks of the gravid uterus impairing cardiopulmonary function appeared greater than risks of delivery, including that of uterine rupture. Vaginal birth after caesarean was achieved with misoprostol and critical care status rapidly improved.Current guidelines for management of fetal demise in patients with prior hysterotomies are mixed: although the American College of Obstetricians and Gynecologists recommends standard obstetric protocols rather than misoprostol administration for labour augmentation, there is limited published data citing severe maternal morbidity associated with misoprostol use. This case report argues misoprostol-augmented induction of labour can be a reasonable option in a medically complex patient with fetal demise and prior hysterotomies.

Supercomputing in the Study and Stimulation of the Brain

2021 ◽  
pp. 290-300
Author(s):  
Laura Dipietro ◽  
Seth Elkin-Frankston ◽  
Ciro Ramos-Estebanez ◽  
Timothy Wagner
Keyword(s):  
High Performance ◽  
Neurological Diseases ◽  
Data Sets ◽  
Imaging Data ◽  
Building Simulations ◽  
History Of ◽  
Brain Imaging Data ◽  
Evolution Of Science ◽  
Computational Systems ◽  
The Brain

The history of neuroscience has tracked with the evolution of science and technology. Today, neuroscience's trajectory is heavily dependent on computational systems and the availability of high-performance computing (HPC), which are becoming indispensable for building simulations of the brain, coping with high computational demands of analysis of brain imaging data sets, and developing treatments for neurological diseases. This chapter will briefly review the current and potential future use of supercomputers in neuroscience.

scholarly journals Screening for Maternal Thyroid Dysfunction in Pregnancy: A Review of the Clinical Evidence and Current Guidelines

2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
Donny L. F. Chang ◽  
Elizabeth N. Pearce
Keyword(s):  
Thyroid Dysfunction ◽  
Clinical Evidence ◽  
Thyroid Autoimmunity ◽  
Overt Hypothyroidism ◽  
Ongoing Debate ◽  
History Of ◽  
Maternal Thyroid ◽  
Current Guidelines ◽  
Levothyroxine Treatment ◽  
In Pregnancy

Observational studies have demonstrated that maternal thyroid dysfunction and thyroid autoimmunity in pregnancy may be associated with adverse obstetric and fetal outcomes. Treatment of overt maternal hyperthyroidism and overt hypothyroidism clearly improves outcomes. To date there is limited evidence that levothyroxine treatment of pregnant women with subclinical hypothyroidism, isolated hypothyroxinemia, or thyroid autoimmunity is beneficial. Therefore, there is ongoing debate regarding the need for universal screening for thyroid dysfunction during pregnancy. Current guidelines differ; some recommend an aggressive case-finding approach, whereas others advocate testing only symptomatic women or those with a personal history of thyroid disease or other associated medical conditions.

scholarly journals Typing of hereditary renal amyloidosis presenting with isolated glomerular amyloid deposition

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Danyang Li ◽  
Dan Liu ◽  
Hui Xu ◽  
Xiao-juan Yu ◽  
Fu-de Zhou ◽  
...  
Keyword(s):  
Gene Mutations ◽  
Amyloid Deposition ◽  
Renal Diseases ◽  
Heterozygous Mutation ◽  
Renal Amyloidosis ◽  
Aged Patients ◽  
Reliable Technique ◽  
Dna Mutations ◽  
Amyloid Deposits ◽  
History Of

Abstract Background The commonly used methods for amyloid typing include immunofluorescence or immunohistochemistry (IHC), which sometimes may come with diagnostic pitfalls. Mass spectrometry (MS)-based proteomics has been recognized as a reliable technique in amyloid typing. Case presentation We reported two middle-aged patients who presented with proteinuria, hypertension and normal renal function, and both had a family history of renal diseases. The renal biopsies of both patients revealed renal amyloidosis with the similar pattern by massive exclusively glomerular amyloid deposition. The IHC was performed by using a panel of antibodies against the common types of systemic amyloidosis, and demonstrated co-deposition of fibrinogen Aα chain and apolipoprotein A-I in the glomerular amyloid deposits of each patient. Then the MS on amyloid deposits captured by laser microdissection (LMD/MS) and genetic study of gene mutations were investigated. The large spectra corresponding to ApoA-I in case 1, and fibrinogen Aα chain in case 2 were identified by LMD/MS respectively. Further analysis of genomic DNA mutations demonstrated a heterozygous mutation of p. Trp74Arg in ApoA-I in case 1, and a heterozygous mutation of p. Arg547GlyfsTer21 in fibrinogen Aα chain in case 2. Conclusions The current study revealed that IHC was not reliable for accurate amyloid typing, and that MS-based proteomics and genetic analysis were essential for typing of hereditary amyloidosis.

scholarly journals Advanced Colon Cancer Before the Age of 20 Years: A Case for Extension of the Current Colonscopy Surveillance Guidelines in Hereditary Nonpolyposis Colorectal Cancer Syndrome

2004 ◽  
Vol 18 (5) ◽  
pp. 319-320 ◽  
Author(s):  
Victor K Wong ◽  
Eric M Yoshida ◽  
Anthony G Ryan ◽  
Stephen GF Ho ◽  
Baljinder Salh
Keyword(s):  
Colorectal Cancer ◽  
Colon Cancer ◽  
Hereditary Nonpolyposis Colorectal Cancer ◽  
Pelvic Mass ◽  
Cancer Syndrome ◽  
Advanced Colon Cancer ◽  
Hereditary Nonpolyposis ◽  
History Of ◽  
Current Guidelines ◽  
Colorectal Adenocarcinomas

BACKGROUND:Hereditary nonpolyposis colorectal cancer (HNPCC) currently accounts for between 2% to 6% of all colorectal adenocarcinomas. Controversies exist regarding the current guidelines for colonoscopic screening for colon cancer.CASE REPORT:A case of colon cancer in a young Japanese man with a family history of colon cancer that did not meet the criteria for HNPCC is reported. A malignant pelvic mass discovered shortly before his 20th birthday prompted a colonoscopy. The findings at colonscopy determined that the patient and his family fulfilled the criteria of HNPCC.CONCLUSION:Before finding a pelvic mass metastatic from adenocarcinoma of the ascending colon, this patient was clearly outside of the current guidelines for HNPCC screening. It is suggested that in similar patients, even if they do not fulfill all the criteria for HNPCC, it would be appropriate to consider screening well before the recommended lower age.

Findings on Colonoscopy after Diverticulitis: A Multicenter Review

2019 ◽  
Vol 85 (12) ◽  
pp. 1381-1385 ◽  
Author(s):  
Adam Studniarek ◽  
Kunal Kochar ◽  
Christina Warner ◽  
Saleh Eftaiha ◽  
Sandra Naffouj ◽  
...  
Keyword(s):  
Diverticular Disease ◽  
Acute Diverticulitis ◽  
Teaching Hospitals ◽  
Average Risk ◽  
Major Teaching ◽  
History Of ◽  
Advanced Adenomas ◽  
Current Guidelines ◽  
Villous Adenomas ◽  
Serrated Adenomas

Diverticular disease is a common problem where patients with diverticulosis have a 1–4 per cent risk of acute diverticulitis. Current guidelines recommend a colonoscopy after.the resolution of acute diverticulitis. The aim of this study was to evaluate the yield of significant findings on colonoscopy after an episode of diverticulitis. This is a retrospective analysis of patients who underwent colonoscopy after an episode of diverticulitis between November 2005 and August 2017 at three major teaching hospitals. Advanced adenomas were defined as adenomas ≥1 cm, serrated adenomas, and tubulovillous or villous adenomas. A total of 584 patients (298 males; 51%) underwent colonoscopy for a history of diverticulitis after resolution of acute symptoms. Colonoscopy was complete in 488 patients (84%). Among these 488 patients, 446 had diverticular disease, 31 had advanced adenomas, and four had adenocarcinomas. Colonoscopies were incomplete in 96 patients (16%). Forty-six of those patients underwent surgery. The overall incidence of advanced adenomas and adenocarcinomas was 32 (5.4%) and nine (1.5%), respectively. In our study, the prevalence of advanced adenomas and adenocarcinomas was relatively high compared with the average risk individuals. Our findings support that patients after an episode of diverticulitis should continue to get a colonoscopy.

Lynch-like syndrome in endometrial cancer: Features of a growing population.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 5585-5585
Author(s):  
Sushmita Gordhandas ◽  
Ryan Kahn ◽  
Brandon Paul Maddy ◽  
Becky Baltich Nelson ◽  
Gulce Askin ◽  
...  
Keyword(s):  
Family History ◽  
Inclusion Criteria ◽  
Background Current ◽  
Dna Mismatch ◽  
Younger Age ◽  
History Of ◽  
Comprehensive Search ◽  
Current Guidelines ◽  
Similar Stage ◽  
Growing Population

5585 Background: Current guidelines recommend screening all endometrial cancers (EC) and colorectal cancers (CRC) for defects in DNA mismatch repair (MMR). Tumor screening combined with germline genetic testing can categorize patients into three groups: intact-MMR, Lynch syndrome (LS), and Lynch-like syndrome (LLS). Our objective was to describe features of the growing population of patients with LLS in EC and compare to existing CRC literature. Methods: A systematic search of databases between 1990-2018 identified studies of EC patients with tumor testing (MMR immunohistochemistry or microsatellite instability) and germline assessment for LS. Data on clinicopathologic features was abstracted when available. Associations between LS, LLS, and intact-MMR were analyzed using descriptive statistics. Results: The comprehensive search produced 3,427 publications; 29 met inclusion criteria. Abstracted data and features of each group are presented in the table. Conclusions: In EC, LLS closely resembles LS with younger age at diagnosis, more advanced stage and higher grade as compared to patients with intact-MMR. LLS in EC is similar to intact-MMR in regard to histology, and family history of LS-associated cancer. The CRC literature is limited, but reports LS and LLS have similar stage, grade and histology. In CRC, LS and LLS are diagnosed at a younger age, and are more likely to have family history of LS-associated cancers than intact-MMR. Features of EC with intact-MMR, LLS, and LS. [Table: see text]

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