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2021 ◽  
Vol 14 (2) ◽  
pp. 133-136
Bianca de Cecco ◽  
Mariano Carossino ◽  
Pilar Camacho-Luna ◽  
Christopher Alling ◽  

Clinical History: A 2-year-old, female Poodle dog presented to the Emergency Service at the Veterinary Teaching Hospital (VTH), Louisiana State University School of Veterinary Medicine with a history of lethargy and anorexia. At clinical examination the dog was anemic and febrile. The dog was bilaterally blind. The right eye was buphthalmic and the intraocular pressure was elevated (42 mm Hg). During an ophthalmological consult, bilateral severe panuveitis and optic neuritis with secondary glaucoma in the right eye was diagnosed and treatment was instituted. Despite treatment, the intraocular pressure kept increasing (up to 72 mm Hg overnight), and the clinicians decided to enucleate the right eye due to poor prognosis. After one month, and no response to treatment, the left eye was also enucleated. Gross Findings: Right and left eyes: The vitreous chamber was filled with a yellow, gelatinous exudate while the anterior chamber was filled with a translucent, gelatinous fluid. The retina appeared detached and embedded within the exudate present in the vitreous chamber.

2021 ◽  
Vol 3 (8) ◽  
pp. e533
The Lancet Rheumatology

Carl Guillaume Glessgen ◽  
Hanns-Christian Breit ◽  
Tobias Kai Block ◽  
Elmar Max Merkle ◽  
Tobias Heye ◽  

Abstract Objectives The goal of this study was to investigate the precise timeline of respiratory events occurring after the administration of two gadolinium-based contrast agents, gadoxetate disodium and gadoterate meglumine. Materials and methods This retrospective study examined 497 patients subject to hepatobiliary imaging using the GRASP MRI technique (TR/TE = 4/2 ms; ST = 2.5 mm; 384 × 384 mm). Imaging was performed after administration of gadoxetate (N = 338) and gadoterate (N = 159). All GRASP datasets were reconstructed using a temporal resolution of 1 s. Four regions-of-interest (ROIs) were placed in the liver dome, the right and left cardiac ventricle, and abdominal aorta detecting liver displacement and increasing vascular signal intensities over time. Changes in hepatic intensity reflected respiratory dynamics in temporal correlation to the vascular contrast bolus. Results In total, 216 (67%) and 41 (28%) patients presented with transient respiratory motion after administration of gadoxetate and gadoterate, respectively. The mean duration from start to acme of the respiratory episode was similar (p = 0.4) between gadoxetate (6.0 s) and gadoterate (5.6 s). Its mean onset in reference to contrast arrival in the right ventricle differed significantly (p < 0.001) between gadoxetate (15.3s) and gadoterate (1.8 s), analogously to peak inspiration timepoint in reference to the aortic enhancement arrival (gadoxetate: 0.9s after, gadoterate: 11.2 s before aortic enhancement, p < 0.001). Conclusions The timepoint of occurrence of transient respiratory anomalies associated with gadoxetate disodium and gadoterate meglumine differs significantly between both contrast agents while the duration of the event remains similar. Key Points • Transient respiratory anomalies following the administration of gadoterate meglumine occurred during a time period usually not acquired in MR imaging. • Transient respiratory anomalies following the administration of gadoxetate disodium occurred around the initiation of arterial phase imaging. • The estimated duration of respiratory events was similar between both contrast agents.

Diagnostics ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. 1362
Richard Thomas Meehan ◽  
Isabelle Anne Amigues ◽  
Vijaya Knight

Despite the growing number of biologic and JAK inhibitor therapeutic agents available to treat various systemic autoimmune illnesses, the lack of a validated companion diagnostic (CDx) to accurately predict drug responsiveness for an individual results in many patients being treated for years with expensive, ineffective, or toxic drugs. This review will focus primarily on rheumatoid arthritis (RA) therapeutics where the need is greatest due to poor patient outcomes if the optimum drug is delayed. We will review current FDA-approved biologic and small molecule drugs and why RA patients switch these medications. We will discuss the sampling of various tissues for potential CDx and review early results from studies investigating drug responsiveness utilizing advanced technologies including; multiplex testing of cytokines and proteins, autoantibody profiling, genomic analysis, proteomics, miRNA analysis, and metabolomics. By using these new technologies for CDx the goal is to improve RA patient outcomes and achieve similar successes like those seen in oncology using precision medicine guided therapeutics.

2021 ◽  
Youling Bai ◽  
Li Zhang ◽  
Chengwei Liu ◽  
Xiaobing Cui ◽  
Li Dan ◽  

Abstract Most previous studies have explored the relationship between gray matter volume and sleep quality, but little is known about the relationship between white matter volume and sleep quality. Data were collected using the Pittsburgh Sleep Quality Index and voxel-based morphometry among 352 healthy college students. Results showed that the global PSQI score was negatively associated with the white matter volume, including in the right middle occipital gyrus, the left superior temporal gyrus, the right the precentral gyrus, the left supramarginal gyrus, the left middle frontal gyrus, the left precunes, and the right superior frontal gyrus. Results also indicated that the white matter volume in specific regions negatively predicted the factor of PSQI. These specific brain regions may be replicated in brain areas related to sleep quality. In summary, we suggested that an investigation of white matter structural alterations in the specific regions might be beneficial to tackle underlying neurological mechanisms of sleep quality.

2021 ◽  
Vol 11 (8) ◽  
pp. 1006
Kaisa M. Hartikainen

Hemispheric asymmetries in affective and cognitive functions have been extensively studied. While both cerebral hemispheres contribute to most affective and cognitive processes, neuroscientific literature and neuropsychological evidence support an overall right hemispheric dominance for emotion, attention and arousal. Emotional stimuli, especially those with survival value such as threat, tend to be prioritized in attentional resource competition. Arousing unpleasant emotional stimuli have prioritized access, especially to right-lateralized attention networks. Interference of task performance may be observed when limited resources are exhausted by task- and emotion-related processing. Tasks that rely on right hemisphere-dependent processing, like attending to the left visual hemifield or global-level visual features, are especially vulnerable to interference due to attention capture by unpleasant emotional stimuli. The aim of this review is to present literature regarding the special role of the right hemisphere in affective and attentional brain processes and their interaction. Furthermore, clinical and technological implications of this interaction will be presented. Initially, the effects of focal right hemisphere lesion or atrophy on emotional functions will be introduced. Neurological right hemisphere syndromes including aprosodia, anosognosia and neglect, which further point to the predominance of the intact right hemisphere in emotion, attention and arousal will be presented. Then there will be a brief review of electrophysiological evidence, as well as evidence from patients with neglect that support attention capture by emotional stimuli in the right hemisphere. Subsequently, experimental work on the interaction of emotion, attention and cognition in the right hemispheres of healthy subjects will be presented. Finally, clinical implications for better understanding and assessment of alterations in emotion–attention interaction due to brain disorder or treatment, such as neuromodulation, that impact affective brain functions will be discussed. It will be suggested that measuring right hemispheric emotion–attention interactions may provide basis for novel biomarkers of brain health. Such biomarkers allow for improved diagnostics in brain damage and disorders and optimized treatments. To conclude, future technological applications will be outlined regarding brain physiology-based measures that reflect engagement of the right hemisphere in affective and attentional processes.

Wiebe G Knol ◽  
Frans B Oei ◽  
Ricardo P J Budde ◽  
Maarten ter Horst

Abstract Background Femoral cannulation is commonly used in minimally invasive cardiac surgery to establish extracorporeal circulation. We present a case with a finding that should be evaluated when screening candidates for minimally invasive cardiac surgery. Case presentation A 57-year-old male patient was scheduled for minimally invasive repair of the mitral and tricuspid valve and a MAZE-procedure. During surgery there was difficulty advancing the venous cannula inserted in the right femoral vein. On transesophageal echocardiography a guidewire advanced from the femoral vein was observed entering the right atrium from the superior vena cava. Despite inserting a second venous cannula in the jugular vein, venous drainage was insufficient for minimal invasive surgery. The approach was converted to a median sternotomy with bicaval cannulation. Re-examination of the preoperative computed tomography scan showed an interrupted inferior vena cava with azygos continuation. Discussion In patients with major venous malformations such as the interrupted inferior vena cava with azygos continuation a full sternotomy is the preferred approach. The venous system should be evaluated when screening candidates for minimally invasive mitral valve surgery with preoperative computed tomography. Additional cues to suspect interruption of the inferior vena cava are polysplenia and a broad superior mediastinal projection on the chest radiograph, mimicking a right paratracheal mass.

2021 ◽  
Vol 5 (3) ◽  
pp. 306-312
Nao Obara ◽  
Shigeki Yamaguchi ◽  
Yoshitaka Okada

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