Prenatal Ultrasonographic Diagnosis of Cataract: In Utero Manifestations of Cryptic Disease

2016 ◽  
Vol 39 (02) ◽  
pp. 213-218 ◽  
Author(s):  
Eran Ashwal ◽  
Asaf Achiron ◽  
Yinon Gilboa ◽  
Michal Berkenstadt ◽  
Mordecai Rosner ◽  
...  
Keyword(s):  
Cataract Extraction ◽  
In Utero ◽  
Persistent Hyperplastic Primary Vitreous ◽  
Ultrasound Evaluation ◽  
Fetal Malformations ◽  
Unilateral Case ◽  
The Mean ◽  
Mean Time ◽  
Fetal Karyotype ◽  
Bilateral Cataract Extraction

Abstract Purpose To report and review our experience with antenatal evaluation for fetuses diagnosed with congenital cataract. Materials and Methods We retrospectively identified pregnancies diagnosed with fetal cataract during antenatal ultrasound. Evaluation of fetal eyes included intraocular anatomy and biometry. Data on fetal malformations, serology and fetal karyotype were collected. Results 8 cases, identified over the course of 10 years, were reviewed. Week 15 was the mean time for diagnosis (range 11 – 34). Extraocular anomalies were demonstrated in 6 cases (central nervous system, cardiac and renal systems). Additional intraocular abnormalities were detected in two cases: one fetus had persistent hyperplastic primary vitreous and another had bilateral retinal detachment. All cases but one involved cataracts in both eyes. The unilateral case was associated with microphthalmic aphakia. All cases had negative serology for TORCHs. 7 out of the 8 fetuses were terminated. The only one who survived developed in utero cataracts secondary to maternal steroid therapy. He underwent bilateral cataract extraction during the first weeks of life and ophthalmologic evaluation at 2 years of age was unremarkable, without any visual impairment. Conclusion In most cases, fetal cataract was associated with additional abnormalities, both intra- and extra-ocular. In instances when cataracts are isolated, we suggest conducting a detailed and thorough in utero ophthalmic examination in order to improve antenatal parental counselling.

Bladder contractions and micturition in fetal sheep: their relation to behavioral states

1989 ◽  
Vol 257 (6) ◽  
pp. R1526-R1532 ◽  
Author(s):  
M. E. Wlodek ◽  
G. D. Thorburn ◽  
R. Harding
Keyword(s):  
High Voltage ◽  
Low Voltage ◽  
Control Period ◽  
In Utero ◽  
Fetal Sheep ◽  
Electrocortical Activity ◽  
The Mean ◽  
Behavioral States ◽  
Mean Time ◽  
The Brain

Fetal bladder contractions, indicative of micturition (voiding), and behavioral states were monitored in unanesthetized fetal sheep in utero during the last third of gestation. Fetal voids began during low-voltage electrocortical activity (LV ECoG) at a greater frequency (91.4 +/- 1.0%) than expected (57.2%) and began during high-voltage electrocortical activity (HV ECoG) with a lower frequency (8.7 +/- 1.0%) than expected (42.8%). Fetal voids began significantly sooner after the onset of LV ECoG (5.84 +/- 0.13 min) than after the onset of HV ECoG (10.88 +/- 0.04 min). Electroocular and nuchal muscle activities were associated with 96.2 and 66.0% of the voids, respectively, but there was no significant association between fetal voiding and swallowing episodes. Abolition of spontaneous voiding, by urine drainage (24 h), caused no significant differences, relative to a 24-h control period, in the duration or number of episodes of LV or HV ECoG or percentage of time spent in these states. Also, induction of voiding by infusing saline into the bladder did not significantly alter the time to the next change of ECoG state. However, the mean time to the next void and the mean volume of saline infused into the bladder to induce voiding tended to be less during LV ECoG than HV ECoG, although not significantly less. Our data show that most spontaneous voids in the fetus begin during LV ECoG, suggesting that voiding is regulated by descending information from the brain. Furthermore, these experiments demonstrate that fetal bladder contractions and voiding, either spontaneous or induced, do not influence the normal cycling of fetal ECoG states.

Cataract extraction and intraocular pressure-lowering agents delivery: A nationwide French study between 2005 and 2017

2021 ◽  
pp. 112067212110443
Author(s):  
Chloé Chamard ◽  
Héléna Huguet ◽  
Alain M Bron ◽  
Catherine Creuzot-Garcher ◽  
Erika Nogue ◽  
...  
Keyword(s):  
Real Life ◽  
Cataract Extraction ◽  
Healthcare Database ◽  
Bilateral Cataract ◽  
Life Study ◽  
National Healthcare ◽  
French Study ◽  
Pressure Lowering ◽  
The Mean ◽  
Bilateral Cataract Extraction

Purpose: Cataract and glaucoma are among the leading causes of blindness worldwide in older people, and they are often concomitant. To assess topical intraocular (IOP)-lowering agents delivery changes after cataract extraction. Material and methods: Longitudinal matched exposed–unexposed study from the French national healthcare database from January 1, 2005 to January 1, 2017. We compared individuals using topical IOP-lowering agents who underwent bilateral cataract extraction with individuals matched on IOP-lowering agents load, age, and sex who did not undergo cataract extraction. IOP-lowering agents number of drops was assessed 12 months before the first cataract extraction and compared with number of drops 12 months after the second cataract extraction. Results: About 1194 individuals treated with IOP-lowering agents were included, 597 exposed to bilateral cataract extraction and 597 unexposed to any surgery (total mean age 74.8 ± 8.3 years; 69.0% women). Mean IOP-lowering agents delivery at baseline was 1.4 daily drops in both groups. The mean number of drops decreased greater in the exposed than unexposed group (−25.5% vs −3.5%; p < 0.0001). Overall, 159 (26.6%) and 48 (8.0%) individuals in the exposed and unexposed groups interrupted medication ( p < 0.0001). Conclusions: A decrease of around one quarter of IOP-lowering agents delivery was observed after cataract extraction in the present real-life study with a longstanding interruption observed in one quarter of patients. Phacoemulsification as a standalone procedure reduces IOP-lowering agents delivery in ocular hypertension and glaucoma.

Predicting Daily Maintenance Dose of Fluindione, an Oral Anticoagulant Drug

1996 ◽  
Vol 75 (05) ◽  
pp. 731-733 ◽  
Author(s):  
V Cazaux ◽  
B Gauthier ◽  
A Elias ◽  
D Lefebvre ◽  
J Tredez ◽  
...  
Keyword(s):  
Effective Dose ◽  
Maintenance Dose ◽  
Successive Approximations ◽  
Hemorrhagic Complication ◽  
Simple Method ◽  
Individual Variations ◽  
Anticoagulant Drug ◽  
The Mean ◽  
Mean Time ◽  
Daily Maintenance Dose

SummaryDue to large inter-individual variations, the dose of vitamin K antagonist required to target the desired hypocoagulability is hardly predictible for a given patient, and the time needed to reach therapeutic equilibrium may be excessively long. This work reports on a simple method for predicting the daily maintenance dose of fluindione after the third intake. In a first step, 37 patients were delivered 20 mg of fluindione once a day, at 6 p.m. for 3 consecutive days. On the morning of the 4th day an INR was performed. During the following days the dose was adjusted to target an INR between 2 and 3. There was a good correlation (r = 0.83, p<0.001) between the INR performed on the morning of day 4 and the daily maintenance dose determined later by successive approximations. This allowed us to write a decisional algorithm to predict the effective maintenance dose of fluindione from the INR performed on day 4. The usefulness and the safety of this approach was tested in a second prospective study on 46 patients receiving fluindione according to the same initial scheme. The predicted dose was compared to the effective dose soon after having reached the equilibrium, then 30 and 90 days after. To within 5 mg (one quarter of a tablet), the predicted dose was the effective dose in 98%, 86% and 81% of the patients at the 3 times respectively. The mean time needed to reach the therapeutic equilibrium was reduced from 13 days in the first study to 6 days in the second study. No hemorrhagic complication occurred. Thus the strategy formerly developed to predict the daily maintenance dose of warfarin from the prothrombin time ratio or the thrombotest performed 3 days after starting the treatment may also be applied to fluindione and the INR measurement.

Retrospective analysis of mortality within 30 days of systemic anticancer therapy and comparison with a previous audit at an Australian Regional Cancer Centre

2021 ◽  
pp. 107815522110160
Author(s):  
Bernadatte Zimbwa ◽  
Peter J Gilbar ◽  
Mark R Davis ◽  
Srinivas Kondalsamy-Chennakesavan
Keyword(s):  
Checkpoint Inhibitors ◽  
Anticancer Therapy ◽  
Mortality Rates ◽  
Feedback Process ◽  
Time To Death ◽  
Cancer Centre ◽  
Haematology Patients ◽  
The Mean ◽  
Regional Cancer Centre ◽  
Mean Time

Purpose To retrospectively determine the rate of death occurring within 14 and 30 days of systemic anticancer therapy (SACT), compare this against a previous audit and benchmark results against other cancer centres. Secondly, to determine if the introduction of immune checkpoint inhibitors (ICI), not available at the time of the initial audit, impacted mortality rates. Method All adult solid tumour and haematology patients receiving SACT at an Australian Regional Cancer Centre (RCC) between January 2016 and July 2020 were included. Results Over a 55-month period, 1709 patients received SACT. Patients dying within 14 and 30 days of SACT were 3.3% and 7.0% respectively and is slightly higher than our previous study which was 1.89% and 5.6%. Mean time to death was 15.5 days. Males accounted for 63.9% of patients and the mean age was 66.8 years. 46.2% of the 119 patients dying in the 30 days post SACT started a new line of treatment during that time. Of 98 patients receiving ICI, 22.5% died within 30 days of commencement. Disease progression was the most common cause of death (79%). The most common place of death was the RCC (38.7%). Conclusion The rate of death observed in our re-audit compares favourably with our previous audit and is still at the lower end of that seen in published studies in Australia and internationally. Cases of patients dying within 30 days of SACT should be regularly reviewed to maintain awareness of this benchmark of quality assurance and provide a feedback process for clinicians.

Vitamin D Level Stability in Dystrophinopathy Patients on Vitamin D Supplementation

2021 ◽  
pp. 1-7
Author(s):  
Naomi Vather-Wu ◽  
Matthew D. Krasowski ◽  
Katherine D. Mathews ◽  
Amal Shibli-Rahhal
Keyword(s):  
Vitamin D ◽  
Retrospective Cohort ◽  
Vitamin D Supplementation ◽  
Hydroxyvitamin D ◽  
Frequent Monitoring ◽  
25 Hydroxyvitamin D ◽  
The Mean ◽  
Stable Maintenance ◽  
Mean Time

Background: Expert guidelines recommend annual monitoring of 25-hydroxyvitamin D (25-OHD) and maintaining 25-OHD ≥30 ng/ml in patients with dystrophinopathies. Objective: We hypothesized that 25-OHD remains stable and requires less frequent monitoring in patients taking stable maintenance doses of vitamin D. Methods: We performed a retrospective cohort study, using the electronic health record to identify 26 patients with dystrophinopathies with a baseline 25-OHD ≥30 ng/mL and at least one additional 25-OHD measurement. These patients had received a stable dose of vitamin D for ≥3 months prior to their baseline 25-OHD measurement and throughout follow-up. The main outcome measured was the mean duration time the subjects spent with a 25-OHD ≥30 ng/mL. Results: Only 19% of patients dropped their 25-OHD to <  30 ng/ml, with a mean time to drop of 33 months and a median nadir 25-OHD of 28 ng/mL. Conclusions: These results suggest that measurement of 25-OHD every 2–2.5 years may be sufficient in patients with a baseline 25-OHD ≥30 ng/mL and who are on a stable maintenance dose of vitamin D. Other patients may require more frequent assessments.

scholarly journals Surveillance System in Smart Cities: A Dependability Evaluation Based on Stochastic Models

Electronics ◽  
2021 ◽  
Vol 10 (8) ◽  
pp. 876
Author(s):  
Igor Gonçalves ◽  
Laécio Rodrigues ◽  
Francisco Airton Silva ◽  
Tuan Anh Nguyen ◽  
Dugki Min ◽  
...  
Keyword(s):  
Surveillance System ◽  
Smart Cities ◽  
Heterogeneous Data ◽  
Time To Failure ◽  
Video Streams ◽  
Dependability Evaluation ◽  
The Mean ◽  
Mean Time ◽  
The Internet Of Things

Surveillance monitoring systems are highly necessary, aiming to prevent many social problems in smart cities. The internet of things (IoT) nowadays offers a variety of technologies to capture and process massive and heterogeneous data. Due to the fact that (i) advanced analyses of video streams are performed on powerful recording devices; while (ii) surveillance monitoring services require high availability levels in the way that the service must remain connected, for example, to a connection network that offers higher speed than conventional connections; and that (iii) the trust-worthy dependability of a surveillance system depends on various factors, it is not easy to identify which components/devices in a system architecture have the most impact on the dependability for a specific surveillance system in smart cities. In this paper, we developed stochastic Petri net models for a surveillance monitoring system with regard to varying several parameters to obtain the highest dependability. Two main metrics of interest in the dependability of a surveillance system including reliability and availability were analyzed in a comprehensive manner. The analysis results show that the variation in the number of long-term evolution (LTE)-based stations contributes to a number of nines (#9s) increase in availability. The obtained results show that the variation of the mean time to failure (MTTF) of surveillance cameras exposes a high impact on the reliability of the system. The findings of this work have the potential of assisting system architects in planning more optimized systems in this field based on the proposed models.

scholarly journals The impact of COVID-19 infection on hip fracture 30-day mortality

Trauma ◽  
2021 ◽  
pp. 146040862094972
Author(s):  
Ahmed Fadulelmola ◽  
Rob Gregory ◽  
Gavin Gordon ◽  
Fiona Smith ◽  
Andrew Jennings
Keyword(s):  
Hip Fracture ◽  
Hip Fractures ◽  
Hospital Admissions ◽  
The Elderly ◽  
Primary Outcome Measure ◽  
Time To Death ◽  
Significant Difference ◽  
The Mean ◽  
The Impact ◽  
Mean Time

Introduction: A novel virus, SARS-CoV-2, has caused a fatal global pandemic which particularly affects the elderly and those with comorbidities. Hip fractures affect elderly populations, necessitate hospital admissions and place this group at particular risk from COVID-19 infection. This study investigates the effect of COVID-19 infection on 30-day hip fracture mortality. Method: Data related to 75 adult hip fractures admitted to two units during March and April 2020 were reviewed. The mean age was 83.5 years (range 65–98 years), and most (53, 70.7%) were women. The primary outcome measure was 30-day mortality associated with COVID-19 infection. Results: The COVID-19 infection rate was 26.7% (20 patients), with a significant difference in the 30-day mortality rate in the COVID-19-positive group (10/20, 50%) compared to the COVID-19-negative group (4/55, 7.3%), with mean time to death of 19.8 days (95% confidence interval: 17.0–22.5). The mean time from admission to surgery was 43.1 h and 38.3 h, in COVID-19-positive and COVID-19-negative groups, respectively. All COVID-19-positive patients had shown symptoms of fever and cough, and all 10 cases who died were hypoxic. Seven (35%) cases had radiological lung findings consistent of viral pneumonitis which resulted in mortality (70% of mortality). 30% ( n = 6) contracted the COVID-19 infection in the community, and 70% ( n = 14) developed symptoms after hospital admission. Conclusion: Hip fractures associated with COVID-19 infection have a high 30-day mortality. COVID-19 testing and chest X-ray for patients presenting with hip fractures help in early planning of high-risk surgeries and allow counselling of the patients and family using realistic prognosis.

On the absorption probabilities and mean time for absorption for discrete Markov chains

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Nikolaos Halidias
Keyword(s):  
Markov Chain ◽  
Random Walk ◽  
Markov Chains ◽  
Generating Function ◽  
Discrete Time ◽  
Probability Generating Function ◽  
The Mean ◽  
Mean Time ◽  
Absorption Probabilities

Abstract In this note we study the probability and the mean time for absorption for discrete time Markov chains. In particular, we are interested in estimating the mean time for absorption when absorption is not certain and connect it with some other known results. Computing a suitable probability generating function, we are able to estimate the mean time for absorption when absorption is not certain giving some applications concerning the random walk. Furthermore, we investigate the probability for a Markov chain to reach a set A before reach B generalizing this result for a sequence of sets A 1 , A 2 , … , A k {A_{1},A_{2},\dots,A_{k}} .

scholarly journals Voxelwise Principal Component Analysis of Dynamic [S-Methyl-11C]Methionine PET Data in Glioma Patients

Cancers ◽  
2021 ◽  
Vol 13 (10) ◽  
pp. 2342
Author(s):  
Corentin Martens ◽  
Olivier Debeir ◽  
Christine Decaestecker ◽  
Thierry Metens ◽  
Laetitia Lebrun ◽  
...  
Keyword(s):  
Principal Component Analysis ◽  
Principal Component ◽  
Component Analysis ◽  
Added Value ◽  
Time Activity ◽  
Positron Emission ◽  
Activity Curve ◽  
The Mean ◽  
Mean Time ◽  
Met Pet

Recent works have demonstrated the added value of dynamic amino acid positron emission tomography (PET) for glioma grading and genotyping, biopsy targeting, and recurrence diagnosis. However, most of these studies are based on hand-crafted qualitative or semi-quantitative features extracted from the mean time activity curve within predefined volumes. Voxelwise dynamic PET data analysis could instead provide a better insight into intra-tumor heterogeneity of gliomas. In this work, we investigate the ability of principal component analysis (PCA) to extract relevant quantitative features from a large number of motion-corrected [S-methyl-11C]methionine ([11C]MET) PET frames. We first demonstrate the robustness of our methodology to noise by means of numerical simulations. We then build a PCA model from dynamic [11C]MET acquisitions of 20 glioma patients. In a distinct cohort of 13 glioma patients, we compare the parametric maps derived from our PCA model to these provided by the classical one-compartment pharmacokinetic model (1TCM). We show that our PCA model outperforms the 1TCM to distinguish characteristic dynamic uptake behaviors within the tumor while being less computationally expensive and not requiring arterial sampling. Such methodology could be valuable to assess the tumor aggressiveness locally with applications for treatment planning and response evaluation. This work further supports the added value of dynamic over static [11C]MET PET in gliomas.

On classes of life distributions based on the mean time to failure function

2021 ◽  
Vol 58 (2) ◽  
pp. 289-313
Author(s):  
Ruhul Ali Khan ◽  
Dhrubasish Bhattacharyya ◽  
Murari Mitra
Keyword(s):  
Damage Model ◽  
Replacement Policy ◽  
Time To Failure ◽  
Mean Time To Failure ◽  
Moment Convergence ◽  
Life Distributions ◽  
Cumulative Damage Model ◽  
The Mean ◽  
Age Replacement ◽  
Mean Time

AbstractThe performance and effectiveness of an age replacement policy can be assessed by its mean time to failure (MTTF) function. We develop shock model theory in different scenarios for classes of life distributions based on the MTTF function where the probabilities $\bar{P}_k$ of surviving the first k shocks are assumed to have discrete DMTTF, IMTTF and IDMTTF properties. The cumulative damage model of A-Hameed and Proschan [1] is studied in this context and analogous results are established. Weak convergence and moment convergence issues within the IDMTTF class of life distributions are explored. The preservation of the IDMTTF property under some basic reliability operations is also investigated. Finally we show that the intersection of IDMRL and IDMTTF classes contains the BFR family and establish results outlining the positions of various non-monotonic ageing classes in the hierarchy.

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