-
Seminars in Pediatric Neurology Jul 2024A leading cause of death and disability in infancy is abusive head trauma (AHT) and there are common clinical signs that help to establish this diagnosis. Children... (Review)
Review
A leading cause of death and disability in infancy is abusive head trauma (AHT) and there are common clinical signs that help to establish this diagnosis. Children diagnosed with AHT can have many ophthalmologic findings, including retinal hemorrhages, retinoschisis, subconjunctival hemorrhages, corneal injury, and globe rupture. If any such injuries are suspected, an ophthalmologic consultation, with indirect ophthalmoscopy, should be completed. In addition to a complete physical exam, a thorough history imaging, and lab work, should be obtained to investigate the etiology of ophthalmic pathology including accidental and systemic causes. In general, studies show that retinal hemorrhages that are multilayered, too numerous to count, and located from the posterior pole to the ora serrata are highly suspicious for abusive head trauma.
Topics: Humans; Child Abuse; Craniocerebral Trauma; Infant; Eye Injuries
PubMed: 38964817
DOI: 10.1016/j.spen.2024.101141 -
Ophthalmology Jul 2024The Laser in Glaucoma and Ocular Hypertension (LiGHT) Trial demonstrated the efficacy and safety of selective laser trabeculoplasty (SLT) compared to topical hypotensive...
PURPOSE
The Laser in Glaucoma and Ocular Hypertension (LiGHT) Trial demonstrated the efficacy and safety of selective laser trabeculoplasty (SLT) compared to topical hypotensive medication as 1-line therapy for ocular hypertension and open angle glaucoma. This sub-study explores the impact of pre-treatment (baseline) intraocular pressure (IOP) on treatment response for SLT and medication.
DESIGN
Post hoc analysis of randomised control trial data.
PARTICIPANTS
1146 eyes from 662 patients were included in this analysis: 559 eyes in the SLT group and 587 in the medication group.
METHODS
IOP reduction at 8 weeks following treatment with either SLT or prostaglandin analogue (PGA) eye drop initiation was assessed at different levels of baseline IOP, and the groups were compared. Differences in absolute and percentage IOP lowering between SLT and PGA medication were tested with a linear mixed effects model. Differences in the probability of achieving ≥20% IOP lowering between SLT and PGA medication, at different levels of baseline IOP, was estimated using a logistic mixed effects model.
MAIN OUTCOME MEASURE
IOP lowering response to SLT versus PGA eye drops.
RESULTS
Mean IOP was not significantly different between the groups, at baseline or 8 weeks following treatment initiation. Both treatments showed greater IOP lowering at higher baseline IOP and less IOP lowering at lower baseline IOP. SLT tended to achieve more IOP lowering than PGA drops at higher baseline IOP. PGA drops performed better at lower baseline IOP, and the difference compared to SLT, in terms of percentage IOP reduction, was significant at baseline IOP ≤ 17 mmHg. There was a significant difference in the relationship between baseline IOP and probability of ≥20% IOP lowering between the two treatments (p = 0.01), with SLT being more successful than PGA at baseline IOP > 22.51 mmHg.
CONCLUSIONS
These data confirm previous reports of greater IOP lowering with higher baseline IOP for both SLT and topical hypotensive medication. In treatment naïve eyes, at higher baseline IOP, SLT was more successful at achieving ≥20% IOP lowering than PGA drops. At lower baseline IOP, a statistically greater percentage, but not absolute, IOP lowering was seen with PGA drops compared to SLT, although the clinical significance of this is uncertain.
PubMed: 38964719
DOI: 10.1016/j.ophtha.2024.06.022 -
Photoresponsive heparin ionic complexes toward controllable therapeutic efficacy of anticoagulation.International Journal of Biological... Jul 2024Controllable heparin-release is of great importance and necessity for the precise anticoagulant regulation. Efforts have been made on designing heparin-releasing...
Controllable heparin-release is of great importance and necessity for the precise anticoagulant regulation. Efforts have been made on designing heparin-releasing systems, while, it remains a great challenge for gaining the external-stimuli responsive heparin-release in either intravenous or catheter delivery. In this study, an azobenzene-containing ammonium surfactant is designed and synthesized for the fabrication of photoresponsive heparin ionic complexes through the electrostatic complexation with heparin. Under the assistance of photoinduced trans-cis isomerization of azobenzene, the obtained heparin materials perform reversible athermal phase transition between ordered crystalline and isotropic liquid state at room temperature. Compared to the ordered state, the formation of isotropic state can effectively improve the dissolving of heparin from ionic materials in aqueous condition, which realizes the photo-modulation on the concentration of free heparin molecules. With good biocompatibility, such a heparin-releasing system addresses photoresponsive anticoagulation in both in vitro and in vivo biological studies, confirming its great potential clinical values. This work provides a new designing strategy for gaining anticoagulant regulation by light, also opening new opportunities for the development of photoresponsive drugs and biomedical materials based on biomolecules.
PubMed: 38964688
DOI: 10.1016/j.ijbiomac.2024.133631 -
Behavioural Processes Jul 2024Recently, ghost crabs (Ocypode quadrata) were shown to exhibit behavior consistent with passing the mark test, which implies the capacity for self-recognition....
Recently, ghost crabs (Ocypode quadrata) were shown to exhibit behavior consistent with passing the mark test, which implies the capacity for self-recognition. Considering this, it seems reasonable to suggest these animals can also distinguish their mirror image from different social stimuli, such as live conspecifics. In the current research, ghost crabs were placed in an experimental tank bisected by a mirror, clear partition separating a conspecific, and non-reflective partition on separate trials. Aggressive threat displays, time spent near partitions, eye cleaning, and partition contact were recorded during each condition. Results showed more aggression in trials with a conspecific present (i.e. clear partition), though this effect was only marginally significant. In addition, eye cleaning was significantly lower in the clear, compared to mirror and non-reflective treatments. Significantly more contact occurred with non-reflective partitions and time near each barrier was similar. These findings might suggest the capacity to distinguish mirror reflections from conspecifics, and mirror self-recognition could promote such ability. This, and other alternatives, are discussed as potential explanations for the observed effects.
PubMed: 38964669
DOI: 10.1016/j.beproc.2024.105076 -
The American Journal of Clinical... Jul 2024The relationships between 25-hydroxyvitamin D (25(OH)D) and calcium and age-related macular degeneration (AMD) are unclear.
BACKGROUND
The relationships between 25-hydroxyvitamin D (25(OH)D) and calcium and age-related macular degeneration (AMD) are unclear.
OBJECTIVE
This study aimed to investigate the causal role of 25(OH)D concentrations, calcium concentrations, and dietary supplements use of vitamin D and calcium on the risk of AMD and its subtypes.
METHODS
Independent genetic variants associated with 25(OH)D and calcium concentrations were used as instrumental variables in published genome-wide association studies (GWASs) of European ancestry. The bidirectional two-sample Mendelian randomization (MR) analyses were performed using summary-level data from the UK Biobank and FinnGen datasets. Sensitivity analyses were conducted to ensure the robustness of the MR results. The meta-analyses were conducted using both fixed-effect and random-effect models to provide comprehensive and reliable estimates.
RESULTS
A standard deviation increase in calcium concentrations was linked to a 14%, 17%, and 13% reduction in the likelihood of developing AMD (95% confidence interval [CI] = 0.77, 0.97), wet AMD (95% CI = 0.73, 0.95), and dry AMD (95% CI = 0.75, 1.00), respectively. No significant causal relationships were detected between genetically predicted 25(OH)D concentrations and AMD and its subtypes (all P > 0.05). The combined analyses showed that higher calcium concentrations were associated with a reduced risk of overall AMD, with an OR of 0.89 (95% CI = 0.81, 0.98).
CONCLUSIONS
This study provides evidence supporting the causal relationship between calcium concentrations and the risk of AMD and its subtypes, which may have important implications for the prevention, monitoring, and treatment of AMD.
PubMed: 38964658
DOI: 10.1016/j.ajcnut.2024.06.018 -
Ophthalmology. Glaucoma Jul 2024To determine the cumulative incidence and features of glaucoma in Vogt-Koyanagi-Harada (VKH) syndrome patients compared to non-glaucoma patients. (Review)
Review
TOPIC
To determine the cumulative incidence and features of glaucoma in Vogt-Koyanagi-Harada (VKH) syndrome patients compared to non-glaucoma patients.
CLINICAL RELEVANCE
Knowing the exact burden of secondary glaucoma in VKH could guide its screening and management in clinical practice as a part of the regular follow-up for VKH patients.
METHODS
The review protocol was pre-registered on PROSPERO [CRD42023462794]. PubMed, Scopus, Web of Science, EBSCOhost, and Google Scholar were searched for studies reporting the cumulative incidence and features of glaucoma presentation in VKH. A manual search was also conducted to supplement the primary search. Subgroup analyses based on glaucoma type, VKH stage, and patients' age were conducted. All analyses were conducted using STATA. Fixed- and random-effects models were selected according to the observed heterogeneity. Studies' methodological quality was determined using the NIH tool.
RESULTS
The analysis of 7084 eyes revealed a progressive increase in the cumulative incidence of secondary glaucoma over time. The cumulative incidence was lowest at VKH onset (7%) and highest at 15 years (26%). Open-angle (12%; 95%CI: 9-14%) is more common than angle-closure glaucoma (7%; 95%CI: 3-13%). Glaucoma cumulative incidence is highest in the chronic recurrent stage of VKH (33%; 95%CI: 12-59%) and among children <18 years of age (26%; 95%CI: 16-37%). Features associated with glaucoma occurrence in VKH showed comparable rates to non-glaucoma cases. However, a meta-analysis to determine risk factors of glaucoma development in VKH was not feasible secondary to the lack of adjusted risk measures in included studies. Studies' quality was questionable in 5 studies. The certainty of evidence was moderate-to-high.
CONCLUSION
The cumulative incidence of glaucoma increases throughout VKH's course, with a higher tendency in children, chronic recurrent stages, and long-term follow-up. Future research should focus on examining risk factors of glaucoma development in VKH through adjusted multivariable regression models.
PubMed: 38964611
DOI: 10.1016/j.ogla.2024.06.005 -
Actas Dermo-sifiliograficas Jul 2024acute radiation dermatitis (ARD) is the most widely reported radiotherapy-induced adverse event. Currently, there is no objective or reliable method to measure ARD.
BACKGROUND
acute radiation dermatitis (ARD) is the most widely reported radiotherapy-induced adverse event. Currently, there is no objective or reliable method to measure ARD.
OBJECTIVE
our main objective was to identify and quantify the effects of radiotherapy with a computational model using optical coherence tomography (OCT) skin scanning. Secondary objectives included determining the ARD impact of different radiotherapeutic schemes and adjuvant topical therapies.
METHODS
we conducted a prospective, single-center case series study in a tertiary referral center of patients with breast cancer who were eligible for whole breast radiotherapy (WBRT).
RESULTS
a total of 39 women were included and distributed according to the radiotherapeutic schemes (15, 20, and 25 fractions). A computational model was designed to quantitatively analyze OCT findings. After radiotherapy, OCT scanning was more sensitive revealing vascularization changes in 84.6% of the patients (vs 69.2% of the patients with ARD by clinical examination). OCT quantified an increased vascularization at the end of WBRT (P < .05) and a decrease after 3 months (P = .032). Erythematous skin changes by OCT were more pronounced in the 25-fraction regime.
CONCLUSION
an OCT computational model allowed for the identification and quantification of vascularization changes on irradiated skin, even in the absence of clinical ARD. This may allow the design of standardized protocols for ARD beyond the skin color of the patients involved.
PubMed: 38964604
DOI: 10.1016/j.ad.2024.07.002 -
NeuroImage Jul 2024N, N-dimethyltryptamine (DMT) is a psychedelic tryptamine acting on 5-HT2A serotonin receptors, which is associated with intense visual hallucinatory phenomena and...
N, N-dimethyltryptamine (DMT) is a psychedelic tryptamine acting on 5-HT2A serotonin receptors, which is associated with intense visual hallucinatory phenomena and perceptual changes such as distortions in visual space. The neural underpinnings of these effects remain unknown. We hypothesised that changes in population receptive field (pRF) properties in the primary visual cortex (V1) might underlie visual perceptual experience. We tested this hypothesis using magnetic resonance imaging (MRI) in a within-subject design. We used a technique called pRF mapping, which measures neural population visual response properties and retinotopic maps in early visual areas. We show that in the presence of visual effects, as documented by the Hallucinogen Rating Scale (HRS), the mean pRF sizes in V1 significantly increase in the peripheral visual field for active condition (inhaled DMT) compared to the control. Eye and head movement differences were absent across conditions. This evidence for short-term effects of DMT in pRF may explain perceptual distortions induced by psychedelics such as field blurring, tunnel vision (peripheral vision becoming blurred while central vision remains sharp) and the enlargement of nearby visual space, particularly at the visual locations surrounding the fovea. Our findings are also consistent with a mechanistic framework whereby gain control of ongoing and evoked activity in the visual cortex is controlled by activation of 5-HT2A receptors.
PubMed: 38964563
DOI: 10.1016/j.neuroimage.2024.120718 -
Survey of Ophthalmology Jul 2024The science of diabetes care has progressed to provide a better understanding of the oxidative and inflammatory lesions and pathophysiology of the neuro-vascular unit... (Review)
Review
The science of diabetes care has progressed to provide a better understanding of the oxidative and inflammatory lesions and pathophysiology of the neuro-vascular unit within the retina (and brain) that occur early in diabetes, even pre-diabetes. Screening for retinal structural abnormalities, has traditionally been performed by fundus examination or color fundus photography; however, these current imaging techniques detect the disease only when there are sufficient lesions, predominantly hemorrhagic, that are recognized to occur late in the disease process after significant neuronal apoptosis and atrophy as well as microvascular occlusion with alterations in vision. Thus, interventions have been primarily oriented toward the later-detected stages, and clinical trials, while demonstrating a slowing of the disease progression, demonstrate minimal visual improvement and modest reduction in the continued loss over prolonged periods. Similarly, vision measurement utilizing charts detects only problems of visual function late, as the process begins most often parafoveal with increasing number and progressive expansion, including into the fovea. While visual acuity has long been used to define endpoints of visual function for such trials, current methods reviewed herein are found to be imprecise. We review improved methods of testing visual function and newer imaging techniques with the recommendation that these must be utilized to discover and evaluate the injury earlier in the disease process, even in the pre-diabetic state. This would allow earlier therapy with ocular as well as systemic pharmacologic treatments that lower the and neuro-inflammatory processes within eye and brain. This also may include newer, micropulsed laser therapy that, if applied during the earlier cascade should result in improved and often normalized retinal function without the adverse treatment effects of standard photocoagulation therapy.
PubMed: 38964559
DOI: 10.1016/j.survophthal.2024.07.001 -
Advanced Drug Delivery Reviews Jul 2024Cytosolic delivery of proteins and peptides provides opportunities for effective disease treatment, as they can specifically modulate intracellular processes. However,... (Review)
Review
Cytosolic delivery of proteins and peptides provides opportunities for effective disease treatment, as they can specifically modulate intracellular processes. However, most of protein-based therapeutics only have extracellular targets and are cell-membrane impermeable due to relatively large size and hydrophilicity. The use of organelle-targeting strategy offers great potential to overcome extracellular and cell membrane barriers, and enables localization of protein and peptide therapeutics in the organelles. Although progresses have been made in the recent years, organelle-targeted protein and peptide delivery is still challenging and under exploration. We reviewed recent advances in subcellular targeted delivery of proteins/peptides with a focus on targeting mechanisms and strategies, and highlight recent examples of active and passive organelle-specific protein and peptide delivery systems. This emerging platform could open a new avenue to develop more effective protein and peptide therapeutics.
PubMed: 38964543
DOI: 10.1016/j.addr.2024.115387