Bendixnikolajsen1974
To investigate morphologic features along posterior staphyloma edges in eyes with pathologic myopia using ultra-widefield optical coherence tomography (UWF-OCT) imaging.
Highly myopic patients (refractive error < 8.0 diopters or axial length ≥ 26.5 mm) were consecutively examined by prototype UWF-OCT with scan width of 23 mm and depth of 5 mm. Staphyloma edges were assessed for scleral, choroidal and retinal status, as well as measurements of angle size. Findings were correlated with pigmentary changes observed on Optos® fundus photography, and multivariate logistic regression analyses performed.
In 164 eyes diagnosed with posterior staphyloma by UWF-OCT, choroidal thinning and scleral protrusion were hallmark features of staphyloma edges, observed simultaneously in over 95% of staphylomatous eyes. Outer neural retinal thinning was observed in 80 eyes (48.8%), whilst 15 eyes (9.1%) showed retinal pigment epithelium damage. The mean angle at the staphyloma edge was 23° ± 12.4° (range 8° to 77°). Larger angles were significant predictors of retinal thinning (AOR 1.17, CI 1.09-1.25) and detection of staphyloma by Optos® pseudocolour fundus photography (AOR 1.08, CI 1.02-1.15).
These morphological findings may provide a basis for exploring the natural evolution of posterior staphyloma as part of the development of pathologic myopia.
These morphological findings may provide a basis for exploring the natural evolution of posterior staphyloma as part of the development of pathologic myopia.
The mucocutaneous line and the lip vermilion are important structures from an esthetic standpoint but also in relation to the functionality of the mouth. In the literature, several types of flaps have been described for reparation of labial defects in adults. In this study, the authors analyze results of surgical reconstruction of the lower lip in the pediatric population using unilateral or bilateral mucomuscular elastic flaps for labial reconstruction. A retrospective analysis of 10 patients operated between 2003 and 2018 at our institution was made. The following demographic and clinical data were collected age, sex, diagnosis, type of flap, follow-up, results, and complications. The Strasser scale was chosen for assessment of postoperative photographic results. Average age was 8.1 years (range 3-18). The most frequent etiology was arteriovenous malformation seen in 60% of cases. All cases corresponded to a defect of the lower lip. The average percentage of lip compromised was 44% and the largest length e collected age, sex, diagnosis, type of flap, follow-up, results, and complications. The Strasser scale was chosen for assessment of postoperative photographic results. Average age was 8.1 years (range 3-18). The most frequent etiology was arteriovenous malformation seen in 60% of cases. All cases corresponded to a defect of the lower lip. The average percentage of lip compromised was 44% and the largest length of compromise observed was 60% of the lip. Follow-up was on average 2.4 years. Esthetic results according to the Strasser method were as follows 1 patient presented an excellent esthetic result, 5 good, 4 regular, and 0 poor.Considering the esthetic outcomes and low incidence of complications of the mucomuscular elastic flap, it is an acceptable and recommended technique of choice for lip vermilion reconstruction.
Localized pain or headache from neuroma formation is a rare and challenging complication of forehead flap surgery. Here the authors present a patient who developed local pain and dysesthesia following iatrogenic injury to the left supraorbital nerve during forehead flap elevation. Following a diagnostic nerve block in clinic, surgical excision of the neuroma was performed through an upper blepharoplasty approach. The patient had immediate postoperative pain relief and remains pain free at fifteen-month follow-up. The authors describe etiology, workup, and surgical management of sensory nerve injury during forehead flap reconstruction.
Localized pain or headache from neuroma formation is a rare and challenging complication of forehead flap surgery. Here the authors present a patient who developed local pain and dysesthesia following iatrogenic injury to the left supraorbital nerve during forehead flap elevation. Following a diagnostic nerve block in clinic, surgical excision of the neuroma was performed through an upper blepharoplasty approach. The patient had immediate postoperative pain relief and remains pain free at fifteen-month follow-up. The authors describe etiology, workup, and surgical management of sensory nerve injury during forehead flap reconstruction.
Nail injuries are important causes of penetrating craniocerebral injuries. Theirs incidence is very low, but the injuries can be fatal. Since the nail gun was gradually popularized in 1959, the incidence of nail injuries has been increasing. Here we report a case of nail gun injury to superior sagittal sinus and review the literature of the past 60 years to find out what are the possible factors of nail gun injury and what are their respective ratios?
An 18-year-old male patient was accidentally injured in the head by the worker's nail gun, accompanied by scalp pain, no physical sensation disorder, and consciousness disorder. A computed tomography scan of his skull showed the penetrating site at the right frontal area, near the superior sagittal sinus. Seven days later, the patient underwent a successful surgery without neurological sequelae.
Nail injuries are rare, but can be potentially fatal. We found that nail guns were the main cause of nail injuries, and other causes include occupational injury, violence, lack of supervision of young children (potential for domestic violence, and child abuse), mental illness, and suicide attempts. While paying attention to the anatomical location of trauma, clinicians should also think more about the possibility of injury so as to provide better help to patients in time.
Nail injuries are rare, but can be potentially fatal. We found that nail guns were the main cause of nail injuries, and other causes include occupational injury, violence, lack of supervision of young children (potential for domestic violence, and child abuse), mental illness, and suicide attempts. While paying attention to the anatomical location of trauma, clinicians should also think more about the possibility of injury so as to provide better help to patients in time.
A 24-year-old man with right unilateral hip disarticulation, intolerant of a traditional socket-mounted prosthesis (TSP), underwent pelvic transcutaneous osseointegration and was fit with a prosthetic lower extremity 7 months later. Twenty-four months after osseointegration, he remains pain-free and complication-free, wears his prosthesis all waking hours, walks without assistive devices and can carry 2-handed objects, and works as a livestock farmer.
Through 24 months, the world's first patient with pelvic osseointegration has no complications and better mobility than most patients with unilateral hip disarticulation using TSPs. Pelvic osseointegration seems reasonable to further consider in carefully selected patients.
Through 24 months, the world's first patient with pelvic osseointegration has no complications and better mobility than most patients with unilateral hip disarticulation using TSPs. Pelvic osseointegration seems reasonable to further consider in carefully selected patients.
Our main objective was to assess the association between the markers p16 and Ki-67 and recurrence of disease in patients previously treated for cervical high-grade squamous intraepithelial lesion (HSIL).
This is a case-control study at the National Cancer Institute conducted between 2005 and 2015. Of the patients with a pathologically confirmed diagnosis of HSIL, 107 cases were selected. They were divided into 2 groups 28 cases with recurrence after treatment and a control group of 79 patients without recurrence. We identified clinical, pathological, and treatment variables.
Two experienced pathologists performed immunohistochemical analysis of biomarkers; they agreed on their interpretation, and we calculated the odds ratios (ORs) associated with recurrence. For group comparisons, we used the Wilcoxon signed-rank, χ2, or Fisher's exact test, depending on the type of variable. We conducted logistic regression models to estimate ORs and determine the factors associated with recurrence. The recurrence-free period was defined as the time frame between conization and either recurrence of disease or the last date the patient was seen. We used Kaplan-Meier plots to visualize survival curves and log-rank tests to compare the curves. We established a p value <0.05 as statistically significant.
After pathologists performed immunohistochemical analysis, they achieved an agreement level of 83.7% for p16 and 60% for Ki-67. We did not find an association between recurrence and either p16 expression (p = 0.69) or the percentage of Ki-67 expression (p = 0.71). The recurrence-free period analysis did not reveal a difference in p16 expression (p = 0.57) nor in the percentage of Ki-67 expression in the 3-tiered scale (p = 0.56).
Our main limitation was a reduced sample size.
We found no association between p16 and Ki-67 positivity and the risk of recurrence in previously treated HSIL.
We found no association between p16 and Ki-67 positivity and the risk of recurrence in previously treated HSIL.
The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP) delivered in a group format could facilitate the implementation of evidence-based psychological treatments.
This study compared the efficacy of group UP and diagnosis-specific cognitive behavioral therapy (dCBT) for anxiety and depression in outpatient mental health services.
In this pragmatic, multi-center, single-blinded, non-inferiority, randomized controlled trial (RCT), we assigned 291 patients with major depressive disorder, social anxiety disorder, panic disorder, or agoraphobia to 14 weekly sessions in mixed-diagnosis UP or single-diagnosis dCBT groups. The primary test was non-inferiority, using a priori criteria, on the World Health Organisation 5 Well-Being Index (WHO-5) at the end of the treatment. Secondary outcomes were functioning and symptoms. We assessed outcomes at baseline, end-of-treatment, and at a 6-month follow-up. Selleckchem WM-8014 A modified per-protocol analysis was performed.
At end-of-treatment, WHO-5 mean scores , panic disorder, and agoraphobia in outpatient mental health services. The long-term effects of UP on well-being need further investigation. If study findings are replicated, UP should be considered a viable alternative to dCBT for common anxiety disorders and depression in outpatient mental health services.
The inherent morbidity associated with fetal ovine models of myelomeningocele (MMC) has created challenges for long-term survival of lambs. We aimed to develop a fetal ovine surgical spinal exposure model which could be used to evaluate long-term safety after direct spinal cord application of novel therapeutics for augmentation of in utero MMC repair.
At gestational age (GA) 100-106, fetal lambs underwent surgical intervention. Laminectomy of L5-L6 was performed, dura was removed, and an experimental product was directly applied to the spinal cord. Paraspinal muscles and skin were closed and the fetus was returned to the uterus. Lambs were delivered via cesarean section at GA 140-142. Lambs were survived for 3 months with regular evaluation of motor function by the sheep locomotor rating scale. Spinal angulation was evaluated by magnetic resonance imaging at 2 weeks and 3 months.
Five fetal surgical intervention lambs and 6 control lambs who did not undergo surgical intervention were included. All lambs survived to the study endpoint of 3 months.
