scholarly journals Assessment of the Association between In Vivo Corneal Morphogeometrical Changes and Keratoconus Eyes with Severe Visual Limitation

2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
J. S. Velázquez ◽  
F. Cavas ◽  
J. Alió del Barrio ◽  
D. G. Fernández-Pacheco ◽  
J. Alió
Keyword(s):  
Case Series ◽  
Area Under The Curve ◽  
High Sensitivity ◽  
Disease Diagnosis ◽  
Minimum Thickness ◽  
Severe Visual Loss ◽  
Case Series Study ◽  
Modelling Techniques ◽  
Correlated Parameters

Assessing changes suffered by the cornea as keratoconus progresses has proven to be vital for this disease diagnosis and treatment. This study determines the corneal biometric profile in eyes considered as affected by keratoconus (KC) showing severe visual limitation, by means of in vivo 3D modelling techniques. This observational case series study evaluated new objective indices in 50 healthy and 30 KC corneas, following a validated protocol created by our research group, which has been previously used for diagnosis and characterization of KC in asymptomatic (preclinical) and mild visually impaired eyes. Results show a statistically significant reduction of corneal volume and an increase of total corneal area in the severe KC group, being anterior and posterior corneal surfaces minimum thickness points the best correlated parameters, although with no discrimination between groups. Receiving operator curves were used to determine sensitivity and specificity of selected indices, being anterior and posterior apex deviations the ones which reached the highest area under the curve, both with very high sensitivity (96.7% and 90%, respectively) and specificity (94.0% and 99.9%, respectively). The results suggest that once severe visual loss appears, anterior corneal topography should be considered for a more accurate diagnosis of clinical KC, being anterior apex deviation the key metric discriminant. This study can be a useful tool for KC classification, helping doctors in diagnosing severe cases of the disease, and can help to characterize corneal changes that appear when severe KC is developed and how they relate with vision deterioration.

Sensitivity and specificity of Sirius indices in diagnosis of keratoconus and suspect keratoconus

2021 ◽  
pp. 112067212110601
Author(s):  
Abdelrahman Salman ◽  
Taym Darwish ◽  
Ali Ali ◽  
Marwan Ghabra ◽  
Rafea Shaaban
Keyword(s):  
Sensitivity And Specificity ◽  
Predictive Accuracy ◽  
Corneal Thickness ◽  
Case Series ◽  
Area Under The Curve ◽  
Receiver Operating Characteristics ◽  
Operating Characteristics ◽  
Symmetry Index ◽  
Case Series Study ◽  
Receiver Operating

Aim To estimate the sensitivity and specificity of topographic and tomographic corneal parameters as determined by Sirius (CSO, Florence, Italy) in discriminating keratoconus (KC) and suspect keratoconus from normal cornea. Method In this retrospective case-series study, keratoconus screening indices were measured using Sirius tomographer. Receiver operating characteristics (ROC) curves were used to determine the test's overall predictive accuracy (area under the curve) and to identify optimal cut-off points to maximize sensitivity and specificity in differentiating keratoconus and suspect keratoconus from normal corneas. Results Receiver operating characteristics (ROC) curve analyses showed high predictive accuracy for Symmetry Index back (SIb), Keratoconus Vertex front (KVf), Symmetry Index front (SIf), Keratoconus Vertex back (KVb), Apex Keratometry (Curve-Apex) and Minimum corneal Thickness (ThkMin) to distinguish keratoconus from normal (area under the curve > 0.9, all). Symmetry Index back was identified as the best diagnostic parameter for detecting suspect keratoconus with AUC of 0.86. Highest specificity to detect keratoconus and suspect keratoconus was seen for SIb, 99.87% and 84.66%, respectively. These values were associated with optimal cut-off points of 0.46 D for keratoconus and 0.12 D for suspect keratoconus. Conclusion Sirius parameters evaluated in the study were effective to differentiate keratoconus from normal corneas. However, Symmetry Index back was the index with the highest ability to detect suspect keratoconus.

scholarly journals Use of remdesivir in the treatment of coronavirus disease 2019 (COVID-19) infection among Sudanese patients: a case series

F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 512
Author(s):  
Maysoun Yousif ◽  
Ghada Abd El-Raheem ◽  
Doaa Mohamed
Keyword(s):  
Side Effects ◽  
Liver Enzymes ◽  
Case Series ◽  
Supportive Therapy ◽  
First Case ◽  
Case Series Study ◽  
New Treatment ◽  
Series Study

Introduction: The coronavirus disease 2019 (COVID-19) pandemic is affecting populations worldwide. Remdesivir is an anti-retroviral agent, with a broad spectrum of usage. Remdesivir usage against COVID-19 had been studied both in vitro and in vivo but is still considered a new treatment for COVID-19 and is not available in all countries. The aim of our study was to report several cases of the use of remdesivir in Sudanese patients and report the adverse events related to the course of treatment. Methods: A case series study was conducted in Imperial Hospital, Khartoum, Sudan reporting two cases who received remdesivir for treating COVID-19 besides other treatments such as steroids and supportive therapy in December 2020. Cases were males aged over 65 years. Cases presentation: Both patients were severe cases of COVID-19 admitted to the intensive care unit (ICU), who received remdesivir for treating COVID-19 infection. Several side effects were reported: the first case had increased liver enzymes and then unexpectedly died from severe resistant hypotension; and hypoalbuminemia was noticed in the second case. Conclusions: Remdesivir use among patients in Sudan must be studied extensively in order to determine the unexpected fatal event and assess the association of this event to remdesivir use, as well as to report the frequency of the side effects.

scholarly journals Lightning Injury: Changi Hospital Experience

2003 ◽  
Vol 10 (4) ◽  
pp. 223-232 ◽  
Author(s):  
HH Tan ◽  
SH Goh
Keyword(s):  
Life Support ◽  
Significant Proportion ◽  
Case Series ◽  
Weather Conditions ◽  
Disease Diagnosis ◽  
Prolonged Treatment ◽  
Work Related ◽  
Lightning Injuries ◽  
Case Series Study ◽  
Lightning Injury

Introduction Lightning injury is a major concern in Singapore, which has one of the highest incidences of lightning activity in the world. This study examined the frequency and type of lightning injuries that presented to an Accident and Emergency (A&E) department situated in the east of Singapore to identify the groups at risk and the spectrum of injuries sustained. Materials and methods This is a case series study with a sample size of 24. Cases that were seen in the A&E department of Changi General Hospital from July 1997 to June 2002 with the International Classification of Disease diagnosis code of E907 for lightning injury were collected and analyzed. Results In our study, 83% lightning injuries were work-related and 79% occurred in those below 40 years old. In the work-related category, a significant proportion occurred at the airport (45%) with most of the incidents occurring while working near or in contact with the aircraft (7 out of 9). The other major proportion occurred at construction sites (40%) with a significant number of cases occurring while in contact with cranes (6 out of 8). There was one telephone-related injury. In the non-work related incidents, two out of four occurred while playing golf. Most of the injuries (87.5%) were minor with no long-term morbidity. There was one death and one critical case requiring cardiopulmonary resuscitation. The latter survived and recovered quite remarkably. One patient had serious depression requiring prolonged treatment. Conclusion Precaution should be taken during lightning-prone weather conditions in workplaces that involve large metal structures like cranes and aircrafts and in open space. This also applies to recreational sports like golf. Lightning injury, though rare, is not uncommon and emergency room doctors should be conversant with the treatment of this condition and its complications. Immediate basic and advanced cardiac life support administered to a lightning casualty who collapsed can be life saving.

INTEGRATING INFORMATION FROM FDG - AND AMYLOID PET FOR DETECTING DIFFERENT TYPES OF DEMENTIA IN OLDER PERSONS. A CASE-SERIES STUDY

2016 ◽  
pp. 1-6
Author(s):  
L. Ruffini ◽  
F. Lauretani ◽  
M. Scarlattei ◽  
A. Ticinesi ◽  
T. Meschi ◽  
...  
Keyword(s):  
Molecular Imaging ◽  
Fdg Pet ◽  
Older Persons ◽  
Case Series ◽  
Amyloid Plaque ◽  
Histopathological Diagnosis ◽  
Amyloid Pet ◽  
Older Individuals ◽  
Case Series Study

A significant progress has been made in the understanding of the neurobiology of Alzheimer’s disease. The post-mortem studies are the gold standard for a correct histopathological diagnosis, contributing to clarify the correlation with cognitive, behavioral and extra-cognitive domains. However, the relationship between pathological staging and clinical involvement remains challenging. Neuroimaging, including positron emission tomography (PET) and magnetic resonance, could help to bridge the gap by providing in vivo information about disease staging. In the last decade, advances in the sensitivity of neuroimaging techniques have been described, in order to accurately distinguish AD from other causes of dementia. Fluorodeoxyglucose-traced PET (FDG-PET) is able to measure cerebral metabolic rates of glucose, a proxy for neuronal activity, theoretically allowing detection of AD. Many studies have shown that this technique could be used in early AD, where reduced metabolic activity correlates with disease progression and predicts histopathological diagnosis. More recently, molecular imaging has made possible to detect brain deposition of histopathology-confirmed neuritic β-amyloid plaques (Aβ) using PET. Although Aβ plaques are one of the defining pathological features of AD, elevated levels of Aβ can be detected with this technique also in older individuals without dementia. This raises doubts on the utility of Aβ PET to identify persons at high risk of developing AD. In the present case-series, we sought to combine metabolic information (from FDG-PET) and amyloid plaque load (from Aβ PET) in order to correctly distinguish AD from other forms of dementia. By selecting patients with Aβ PET + / FDG-PET + and Aβ PET – / FDG-PET +, we propose an integrated algorithm of clinical and molecular imaging information to better define type of dementia in older persons.

scholarly journals Equine grass sickness in italy: a case series study

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Laus Fulvio ◽  
Corsalini Jacopo ◽  
Mandara Maria Teresa ◽  
Bazzano Marilena ◽  
Bertoletti Alice ◽  
...  
Keyword(s):  
Nervous System ◽  
Abdominal Pain ◽  
Histological Examination ◽  
Central Italy ◽  
Clinical Signs ◽  
Case Series ◽  
Scientific Paper ◽  
Grass Sickness ◽  
Case Series Study

Abstract Background Equine grass sickness (EGS) has been reported in several European and extra-European countries. Despite this, no scientific paper about clinical cases of EGS in Italy has been published. EGS is a disease affecting almost exclusively horses kept on pasture, characterized by clinical signs related to lesions in autonomic nervous system (ANS), particularly in the enteric nervous system (ENS). According to clinical presentation, acute, subacute and chornic syndromes can be observed, with various sympthoms including dullness, anorexia, dysphagia, drooling of saliva, tachycardia, ptosis, patchy sweating and muscle fasciculations. In horses affected by acute forms, mild to moderate abdominal pain and large volumes of nasogastric reflux can be observed. The etiology is still speculative and many hypothesis have been proposed to explain the pathogenesis. Case presentation The present study describes four cases of EGS (one subacute and three chronic forms) occurred in Central Italy during early spring. In all the cases included in the study, the prognosis was poor and the horses were euthanized. The diagnosis was confirmed by histological examination of ANS or ENS. In two cases, in vivo diagnosis was obtained by histological examination of enteric bioptic samples collected during laparoscopy. Conclusions EGS in Italy could be underdiagnosed and incidence understimated. Greater awareness should be applied in Italy for the inclusion of EGS in differential diagnosis for horses presenting clinical signs of abdominal pain associated or not with gastric reflux and muscular fasciculation. All the cases in this study concerned horses kept in the same pasture, confirming a possible premise-linked and management-linked factors on the ethiopathogenesis of EGS. The age of horses ranged from 2 to 6 years, that is consistent with the risk factor age for EGS (from 2 to 7 years of age). Previous suspected EGS diagnosis in the same livestock and recent cool dry weather were considered additional potential risk factors.

scholarly journals Use of Remdesivir in The Treatment of COVID-19 Infection Among Sudanese Patients - Case Series

2021 ◽  
Author(s):  
Maysoun Ahmed Awad Yousif ◽  
Ghada Omer Hamad Abd El-Raheem ◽  
Doaa Salih Ibrahim Mohamed
Keyword(s):  
Side Effects ◽  
Liver Enzymes ◽  
Case Series ◽  
The Other ◽  
Elevated Liver Enzymes ◽  
Case Series Study ◽  
Profound Hypotension ◽  
Series Study

Abstract Introduction: COVID-19 infection is a viral pandemic started in 2019, all societies have the susceptibility of getting infected. Remdesivir is an anti-retroviral agent, with a broad spectrum of activity. Remdesivir activity against COVID-19 had been studied in both in vitro and in vivo, but still considered new for COVID-19 treatment and not available in all countries. The aim of our study was to report the use of remdesivir among Sudanese population and report the adverse events related to the course of treatment. Methods: case series study was conducted in Imperial Hospital reporting the three cases who received Remdesivir for treating COVID-19 infection.Cases presentation: Three cases had received remdesivir for treating COVID-19 infection, side effects reported were elevated liver enzymes, profound hypotension and hypoalbuminemia. Discussion: All three patients were severe cases of COVID-19 admitted to the ICU. Unexpectedly, severe resistant hypotension was the cause of death in 2 cases who received remdesivir. Increased liver enzymes was noticed in one case. In the other hand, hypoalbuminemia was noticed in one case as well.

scholarly journals Application of a scheimpflug-based biomechanical analyser and tomography in the early detection of subclinical keratoconus in chinese patients

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yan Liu ◽  
Yu Zhang ◽  
Yueguo Chen
Keyword(s):  
Sensitivity And Specificity ◽  
Area Under The Curve ◽  
High Sensitivity ◽  
Biomechanical Properties ◽  
Chinese Patients ◽  
Youden Index ◽  
Roc Curve Analysis ◽  
Surgical Safety ◽  
Morphological Index

Abstract Background In vivo corneal biomechanics evaluation has been used to help screen early keratoconus in recent years. This study is to evaluate the value of a Scheimpflug-based biomechanical analyser combined with tomography in detecting subclinical keratoconus by distinguishing normal eyes from frank keratoconus (KC) and forme frusta keratoconus (FFKC) eyes in Chinese patients. Methods Study design: diagnostic test. This study included 31 bilateral frank keratoconus patients, 27 unilateral clinically manifesting keratoconus patients with very asymmetric eyes, and 79 control subjects with normal corneas. Corneal morphological and biomechanical parameters were measured using a Pentacam HR and a Corvis ST (OCULUS, Wetzlar, Germany). The diagnostic ability of computed parameters reflecting corneal biomechanical and morphological traits [including the Belin-Ambrósio deviation index (BAD_D), the Corvis biomechanical index (CBI) and the tomographic and biomechanical index (TBI)] was determined using receiver operating characteristic (ROC) curve analysis and compared by the DeLong test. Additionally, the area under the curve (AUC), the best cut-off values, and the Youden index for each parameter were reported. A novel corneal stiffness parameter, the stress-strain index (SSI), was also compared between KC, FFKC and normal eyes. Results Every morphological and biomechanical index analysed in this study was significantly different among KC, FFKC and normal eyes (P = 0.000). The TBI was most valuable in detecting subclinical keratoconus (FFKC eyes), with an AUC of 0.928 (P = 0.000), and both forms of corneal ectasia (FFKC and frank KC eyes), with an AUC of 0.966 (P = 0.000). The sensitivity and specificity of the TBI was 97.5 and 77.8 % in detecting FFKC and 97.5 and 89.7 % in detecting any KC, respectively, with a cut-off value of 0.375. The morphological index BAD_D and the biomechanical index CBI were also very useful in distinguishing eyes with any KC from normal eyes, with AUCs of 0.965 and 0.934, respectively. The SSI was significantly different between KC, FFKC and normal eyes (P = 0.000), indicating an independent decrease in corneal stiffness in KC eyes. Conclusions The combination of a Scheimpflug-based biomechanical analyser and tomography could increase the accuracy in detecting subclinical keratoconus in Chinese patients. The TBI was the most valuable index for detecting subclinical keratoconus, with a high sensitivity and specificity. Evaluation of corneal biomechanical properties in refractive surgery candidates could be helpful for recognizing potential keratoconic eyes and increasing surgical safety.

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