Pediatric Visual Snow Syndrome (VSS): A Case Series

2019 ◽  
pp. 249-254
Author(s):  
Kenneth J. Ciuffreda ◽  
MH Esther Han ◽  
Barry Tannen
Keyword(s):  
Visual Field ◽  
Case Series ◽  
Therapeutic Interventions ◽  
Visual Condition ◽  
Visual Phenomena ◽  
Entire Visual Field ◽  
The Individual ◽  
Vision Therapy ◽  
Abnormal Visual

Visual snow syndrome (VSS) is a relatively rare, unusual, and disturbing abnormal visual condition. The individual perceives “visual snow” (VS) throughout the entire visual field, as well as other abnormal visual phenomena (e.g., photopsia). Only relatively recently has treatment been proposed (e.g., chromatic filters) in adults with VSS, but rarely in the pediatric VSS population (i.e., medications). In this paper, we present three well-documented cases of VSS in children, including their successful neuro-optometric therapeutic interventions (i.e., chromatic filters and saccadic-based vision therapy)

scholarly journals Mirtazapine for treatment of visual snow syndrome: A case series with insights into pathophysiology and therapy

2020 ◽  
Vol 4 (1) ◽  
pp. 2514183X2092569
Author(s):  
Ozan Eren ◽  
Christoph J Schankin
Keyword(s):  
Visual Field ◽  
Case Series ◽  
Therapeutic Options ◽  
Current Understanding ◽  
Visual Symptoms ◽  
Beneficial Effects ◽  
Treatment Trials ◽  
Negative Results ◽  
Entire Visual Field ◽  
Patient Series

Background: Patients with visual snow syndrome (VSS) describe tiny flickering dots in the entire visual field resembling the noise of a poorly adjusted channel of analogue television with additional symptoms. Little is known about the pathophysiology and therapeutic options for this debilitating condition. Objectives: We present a case series of three patients with VSS taking mirtazapine, one of the most often prescribed antidepressants, and discuss the utility of antidepressants by reviewing our current understanding of pathophysiology and therapy. Results: Mirtazapine has no effect on VSS, neither positive nor negative. This is in line with the reports from the literature suggested only some beneficial effects from lamotrigine. Conclusions: Since the pathophysiology of VSS is not fully understood, we still rely on the reports of individual cases or patient series. This includes not only the positive, but also the negative results to avoid unnecessary treatment trials. Looking into the literature, antidepressants do not seem to be a solution for the visual symptoms. So far, best data exists for the anticonvulsant lamotrigine.

Persistent Diplopia in Visually Mature Patients. Is it Intractable or something else? A Review and Case Series

2017 ◽  
pp. 90-108
Keyword(s):  
Botulinum Toxin ◽  
Extraocular Muscle ◽  
Botulinum Toxin Injection ◽  
Case Series ◽  
Sensory Adaptation ◽  
Single Vision ◽  
Injection Treatment ◽  
Vision Therapy ◽  
Extraocular Muscle Surgery

Diplopia is described as being intractable when there is inability to both fuse the two images and suppress the second image. Intractable diplopia persists despite achieving ocular alignment using either prisms, lenses,vision therapy,extraocular muscle surgery, or botulinum toxin injection. Treatment usually resorts to occluding or fogging the patient’s nondominant eye. Often times, however, adults having other causative mechanisms for supposedly persistent diplopia are able to achieve comfortable single vision with treatment that either establishes fusion or reactivates a preexisting sensory adaptation. This case series reviews these other causes of diplopia.

The Need for Personalized Risk-Stratified Approaches to Treatment for Gestational Diabetes: A Narrative Review

2021 ◽  
Author(s):  
Shamil D. Cooray ◽  
Jacqueline A. Boyle ◽  
Georgia Soldatos ◽  
Shakila Thangaratinam ◽  
Helena J. Teede
Keyword(s):  
Gestational Diabetes ◽  
Pregnancy Outcomes ◽  
Population Based ◽  
Adverse Pregnancy Outcomes ◽  
Therapeutic Interventions ◽  
Clinical Prediction Model ◽  
Increased Risk ◽  
Adverse Pregnancy ◽  
The Individual ◽  
Personalized Risk

AbstractGestational diabetes mellitus (GDM) is common and is associated with an increased risk of adverse pregnancy outcomes. However, the prevailing one-size-fits-all approach that treats all women with GDM as having equivalent risk needs revision, given the clinical heterogeneity of GDM, the limitations of a population-based approach to risk, and the need to move beyond a glucocentric focus to address other intersecting risk factors. To address these challenges, we propose using a clinical prediction model for adverse pregnancy outcomes to guide risk-stratified approaches to treatment tailored to the individual needs of women with GDM. This will allow preventative and therapeutic interventions to be delivered to those who will maximally benefit, sparing expense, and harm for those at a lower risk.

scholarly journals Symptom Cluster-Matching Antidepressant Treatment: A Case Series Pilot Study

2021 ◽  
Vol 14 (6) ◽  
pp. 526
Author(s):  
Sławomir Murawiec ◽  
Marek Krzystanek
Keyword(s):  
Depressive Symptoms ◽  
Pilot Study ◽  
Antidepressant Treatment ◽  
Case Series ◽  
Symptom Cluster ◽  
Study Results ◽  
Cluster Matching ◽  
The Individual ◽  
Meta Analyses ◽  
Effectiveness Studies

Despite treating depression with antidepressants, their effectiveness is often insufficient. Comparative effectiveness studies and meta-analyses show the effectiveness of antidepressants; however, they do not provide clear indications as to the choice of a specific antidepressant. The rational choice of antidepressants may be based on matching their mechanisms of action to the symptomatic profiles of depression, reflecting the heterogeneity of symptoms in different patients. The authors presented a series of cases of patients diagnosed with depression in whom at least one previous antidepressant treatment was shown to be ineffective before drug targeted symptom cluster-matching treatment (SCMT). The presented pilot study shows for the first time the effectiveness of SCMT in the different clusters of depressive symptoms. All the described patients obtained recovery from depressive symptoms after introducing drug-targeted SCMT. Once validated in clinical trials, SCMT might become an effective and rational method of selecting an antidepressant according to the individual profile of depressive symptoms, the mechanism of their formation, and the mechanism of drug action. Although the study results are preliminary, SCMT can be a way to personalize treatment, increasing the likelihood of improvement even in patients who meet criteria for treatment-resistant depression.

scholarly journals Inflammation, epigenetics, and metabolism converge to cell senescence and ageing: the regulation and intervention

2021 ◽  
Vol 6 (1) ◽  
Author(s):  
Xudong Zhu ◽  
Zhiyang Chen ◽  
Weiyan Shen ◽  
Gang Huang ◽  
John M. Sedivy ◽  
...  
Keyword(s):  
Cell Fate ◽  
Cellular Response ◽  
State Of The Art ◽  
Cell Senescence ◽  
Therapeutic Interventions ◽  
Cell Fate Decision ◽  
The Past ◽  
Fate Decision ◽  
The Individual ◽  
Remarkable Progress

AbstractRemarkable progress in ageing research has been achieved over the past decades. General perceptions and experimental evidence pinpoint that the decline of physical function often initiates by cell senescence and organ ageing. Epigenetic dynamics and immunometabolic reprogramming link to the alterations of cellular response to intrinsic and extrinsic stimuli, representing current hotspots as they not only (re-)shape the individual cell identity, but also involve in cell fate decision. This review focuses on the present findings and emerging concepts in epigenetic, inflammatory, and metabolic regulations and the consequences of the ageing process. Potential therapeutic interventions targeting cell senescence and regulatory mechanisms, using state-of-the-art techniques are also discussed.

scholarly journals Could metabolomics drive the fate of COVID-19 pandemic? A narrative review on lights and shadows

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Michele Mussap ◽  
Vassilios Fanos
Keyword(s):  
Molecular Mechanisms ◽  
Vascular Dysfunction ◽  
Asymptomatic Infection ◽  
Multiple Organ ◽  
Therapeutic Interventions ◽  
Patient Specific ◽  
Wide Range ◽  
Life Threatening ◽  
The Individual ◽  
Host Metabolism

Abstract Human Severe Acute Respiratory Syndrome CoronaVirus 2 (SARS-CoV-2) infection activates a complex interaction host/virus, leading to the reprogramming of the host metabolism aimed at the energy supply for viral replication. Alterations of the host metabolic homeostasis strongly influence the immune response to SARS-CoV-2, forming the basis of a wide range of outcomes, from the asymptomatic infection to the onset of COVID-19 and up to life-threatening acute respiratory distress syndrome, vascular dysfunction, multiple organ failure, and death. Deciphering the molecular mechanisms associated with the individual susceptibility to SARS-CoV-2 infection calls for a system biology approach; this strategy can address multiple goals, including which patients will respond effectively to the therapeutic treatment. The power of metabolomics lies in the ability to recognize endogenous and exogenous metabolites within a biological sample, measuring their concentration, and identifying perturbations of biochemical pathways associated with qualitative and quantitative metabolic changes. Over the last year, a limited number of metabolomics- and lipidomics-based clinical studies in COVID-19 patients have been published and are discussed in this review. Remarkable alterations in the lipid and amino acid metabolism depict the molecular phenotype of subjects infected by SARS-CoV-2; notably, structural and functional data on the lipids-virus interaction may open new perspectives on targeted therapeutic interventions. Several limitations affect most metabolomics-based studies, slowing the routine application of metabolomics. However, moving metabolomics from bench to bedside cannot imply the mere determination of a given metabolite panel; rather, slotting metabolomics into clinical practice requires the conversion of metabolic patient-specific data into actionable clinical applications.

Occipitoparietal alpha-band responses to the graded allocation of top-down spatial attention

2014 ◽  
Vol 112 (6) ◽  
pp. 1307-1316 ◽  
Author(s):  
Isabel Dombrowe ◽  
Claus C. Hilgetag
Keyword(s):  
Visual Field ◽  
Spatial Attention ◽  
Brain Regions ◽  
Alpha Band ◽  
Top Down ◽  
Attentional Resources ◽  
Parietal Lobes ◽  
Visual Spatial ◽  
Entire Visual Field ◽  
Band Activity

The voluntary, top-down allocation of visual spatial attention has been linked to changes in the alpha-band of the electroencephalogram (EEG) signal measured over occipital and parietal lobes. In the present study, we investigated how occipitoparietal alpha-band activity changes when people allocate their attentional resources in a graded fashion across the visual field. We asked participants to either completely shift their attention into one hemifield, to balance their attention equally across the entire visual field, or to attribute more attention to one-half of the visual field than to the other. As expected, we found that alpha-band amplitudes decreased stronger contralaterally than ipsilaterally to the attended side when attention was shifted completely. Alpha-band amplitudes decreased bilaterally when attention was balanced equally across the visual field. However, when participants allocated more attentional resources to one-half of the visual field, this was not reflected in the alpha-band amplitudes, which just decreased bilaterally. We found that the performance of the participants was more strongly reflected in the coherence between frontal and occipitoparietal brain regions. We conclude that low alpha-band amplitudes seem to be necessary for stimulus detection. Furthermore, complete shifts of attention are directly reflected in the lateralization of alpha-band amplitudes. In the present study, a gradual allocation of visual attention across the visual field was only indirectly reflected in the alpha-band activity over occipital and parietal cortexes.

Enabling Occupation: The Importance of an Affirming Environment

2001 ◽  
Vol 68 (2) ◽  
pp. 80-89 ◽  
Author(s):  
Karen L. Rebeiro
Keyword(s):  
Mental Illness ◽  
Qualitative Study ◽  
Social Environment ◽  
Occupational Therapists ◽  
Therapeutic Interventions ◽  
Occupational Engagement ◽  
Occupational Performance ◽  
The Social ◽  
The Individual ◽  
Over Time

Occupational therapists have become increasingly concerned with factors beyond the individual which impact occupational performance. Several recent models propose that the environment is a significant influence on occupational performance and upon its meaningfulness. An in-depth, qualitative study was conducted which explored the meaning of occupational engagement for eight women with mental illness (Rebeiro & Cook, 1999). This study yielded several important insights about the environment, which have recently been replicated by Legault and Rebeiro (2001) and Rebeiro, Day, Semeniuk, O'Brien, and Wilson (In Press). Participants suggested that environments that provide opportunity, and not prescription are more conducive to fostering occupational performance. Participants further suggested that an environment that provides Affirmation of the individual as a person of worth, a place to belong, and a place to be supported, enables occupational performance over time. A series of research studies indicated that the social environment is an important consideration in planning therapeutic interventions which aim to enable occupation. Implications for occupational therapy practice, education and research are offered

scholarly journals Do facial first impressions reflect a shared social reality?

2018 ◽  
Author(s):  
Clare Sutherland ◽  
Gillian Rhodes ◽  
Nichola Burton ◽  
Andrew Young
Keyword(s):  
Case Series ◽  
Social Reality ◽  
Observer Agreement ◽  
Three Dimensions ◽  
First Impressions ◽  
Dimensional Approach ◽  
Individual Level ◽  
Common Structure ◽  
The Stability ◽  
The Individual

Influential facial impression models have repeatedly shown that trustworthiness, youthful-attractiveness and dominance dimensions subserve a wide variety of first impressions formed from strangers’ faces, suggestive of a shared social reality. However, these models are built from impressions aggregated across observers. Critically, recent work has now shown that inter-observer agreement in facial impressions is less than perfect, raising the important question of whether these dimensional models are meaningful at the individual-observer level. We addressed this question using a novel case series approach, building individual models of facial impressions for different observers. Strikingly, three dimensions of trustworthiness, youthful/attractiveness and competence/dominance appeared across the majority of individual observer models, demonstrating that the dimensional approach is indeed meaningful at the individual level. Nonetheless, we also found striking differences in the stability of the competence/dominance dimension across observers. Taken together, results suggest that individual differences in impressions arise in the context of a largely common structure that supports a shared social reality.

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