Successful Adjuvant Intraoperative Electron Beam Radiotherapy for Keloid: First Case Report and Review of Literature

Treatment of keloids is usually challenging, requiring a multimodal approach with no universally accepted treatment modality among the wide range of alternative keloid treatments. Excision of keloid lesion usually eliminates symptoms and it is the main treatment with considerable recurrence rate. Recurrence rate ranges from 45-100% when surgical excision is performed as monotherapy. Furthermore, Recurrent Keloids have a higher recurrence rate after surgery. In this case we discuss a challenging case of young female presented with third recurrence in lobule of the ear with defect necessitated flap reconstruction with concern for possible damage by the flap if radiation was given as external beam postoperatively. Intraoperative electron beam therapy was utilized with high safety and efficacy. To our knowledge this is the first case in the Middle East to use this technique in treating Keloid. Conclusion Treatment of keloids is usually challenging, requiring a multimodal approach. Excision of keloid lesion usually eliminates symptoms and it is the main treatment with considerable recurrence rate .Recurrence rate ranges from 45-100% when surgical excision is performed as monotherapy. Furthermore, Recurrent Keloids have a higher recurrence rate after surgery. Radiation is a valid option for decreasing risk of recurrence in recurrent keloid with high safety and efficacy profile. In this case we discuss a challenging case of young female presented with third recurrence in lobule of the ear with defect necessitated flap reconstruction with concern for possible damage by the flap if radiation was given as external beam postoperatively. Intraoperative electron beam therapy was utilized with high safety and efficacy. To our knowledge this is the first case in the Middle East to use this technique in treating Keloid. Keywords: Keloid; Radiation; Intraoperative Radiation; IOeRT

Autologous conditioned serum applications in the treatment of musculoskeletal diseases: a narrative review

Aim: Autologous conditioned serum has been studied as a treatment option in musculoskeletal disorders and resulted in varying outcomes. This study aims to pool the current data on this matter. Materials & methods: Major databases were searched for the topics, and after screening the results, the final 21 papers (level of evidence I or II) were included. Results & conclusion: This study showed a major focus of the literature on the effectiveness of autologous conditioned serum in osteoarthritis, in which there is much high-quality evidence suggesting its safety and efficacy. Also, some of the available experiments are assessing its application in tendinopathies and radiculopathies which, despite positive results, recommend further evaluations on this topic.

Rotational stability and clinical outcomes of a new one piece toric intraocular lens with anchor-wing haptics

Background To evaluate the safety and efficacy of a new toric intraocular lens (IOL) with anchor-wing haptics. Methods The new toric IOL with anchor-wing haptics (NS60YT, NIDEK Co., Ltd.) was implanted in eligible patients with age-related cataracts with preoperative corneal astigmatism of 1.0 D or greater at a university hospital and two private hospitals in Japan. The following IOL cylinder powers were evaluated: 1.50 D (NS60YT3), 2.25 D (NS60YT4), 3.00 D (NS60YT5) and 4.50 D (NS60YT7). All patients were assessed out to 12 months postoperatively. The primary endpoint was visual acuity (VA) with spherical addition at 6 months postoperatively, and the primary analysis calculated the proportion of eyes with VA with spherical addition of 0.1 logMAR or better. The magnitude of rotation was compared to the intended axis of IOL implantation at each postoperative examination. Adverse events were evaluated for the safety analysis. Results This study enrolled 64 eyes of 53 patients. At 6 months postoperatively, for all IOL powers, VA with spherical addition of 0.1 logMAR or better was achieved in 90% [95% confidence interval (CI): 80–96] of eyes. The mean IOL rotation was 5.3 ± 4.3° at 12 months postoperatively. The mean magnitude of rotation ranged from 1.9° to 2.5° between each postoperative examination from 1 day to 12 months. There were no vision-threatening intraoperative or postoperative complications for the duration of the study. Conclusions The NS60YT IOL remained stable after implantation and was efficacious for treating 1.00 D or greater astigmatism in patients with senile cataracts. Trial registration This study was registered at ClinicalTrials.gov (NCT03242486) on August 8, 2017 - Retrospectively registered.

Supporting Tourism by Assessing the Predictors of COVID-19 Vaccination for Travel Reasons

The persistence of the SARS-CoV-2 virus imposed vaccination passports for traveling in most countries. We investigated psychological factors that predict the intention to vaccinate for travel. In a cross-sectional study, we examined how demographic variables, vaccination status, perceived risk of infection and severity of disease contracted at travel destination, safety and effectiveness of vaccines against contracting COVID-19 during travel, and conspiracy beliefs are related to intention to vaccinate for travel. Further analyses involved differences between vaccinated and unvaccinated individuals in a Romanian sample regarding conspiracy beliefs, attitudes about vaccines, and self-efficacy of controlling COVID-19 infection. Results showed that the intention to vaccinate for travel reasons is best predicted by vaccination status and perceptions of safety and efficacy of vaccines against COVID-19. Thus, vaccinated individuals believing that vaccines are safe and effective most probably will take another vaccine booster if it will allow them to travel. Positive relationships of the intention to vaccinate for travel reasons were found with age, vaccination status, conspiracy beliefs, perceptions of safety and effectiveness of vaccines, intention to travel, and a more cautious approach to travel. No significant relationships were found between perceptions of risk for self or for transmitting the disease to others, severity of disease, and the intention to vaccinate for travel. We also found significant differences between vaccinated and unvaccinated participants, as unvaccinated participants showed higher levels of conspiracy beliefs and less trust in the safety and efficacy of vaccines. We conclude that campaigns focused on promoting information on the safety and efficacy of vaccines is the most important direction for promoting vaccination in young travelers.