Bossenbeard4328

To compare widefield optical coherence tomography-angiography (OCTA) to ultra-widefield fluorescein angiography (UWFA) in the assessment of nonperfusion in retinal vein occlusion (RVO).

Cross-sectional study of 43 eyes of 43 RVO patients examined using both widefield OCTA (Plexelite, Carl Zeiss Meditec) with a panoramic montage of five 12x12mm images and UWFA (Optos®, 200°). Qualitative analysis was performed according to nonperfusion areas (cutoff 3 disc areas) on widefield OCTA. The quantitative analysis assessed the vascular density (VD) on the widefield OCTA and ischemic index (ISI) on UWFA.

ISI on UWFA and VD in the superficial and deep plexus correlated significantly (p=0.019, r = 0.357 and p<0.013, r = 0.375, respectively). The qualitative classification on widefield OCTA and ISI on UWFA correlated significantly (p<0.001, r = 0.618). For the detection of marked nonperfusion (ISI≥25%), widefield OCTA had a sensitivity of 100% and a specificity of 64.9%.

The presence of nonperfusion on UWFA correlated with widefield OCTA. OCTA could help to identify high-risk RVO patients who might benefit from a further evaluation using fluorescein angiography.

The presence of nonperfusion on UWFA correlated with widefield OCTA. OCTA could help to identify high-risk RVO patients who might benefit from a further evaluation using fluorescein angiography.The aim of this evidence-based project was to improve the medical screening process, enhance medical decision-making, and standardize the utilization of an adult traumatic brain injury (TBI) neuroimaging guideline among advanced practice providers (APPs) in an urban emergency department (ED). Neuroimaging, specifically computed tomography (CT), helps identify life-threatening intracranial injuries when clinically appropriate. The literature supports the utilization of neuroimaging guidelines, clinical examinations, and provider expertise when identifying the need for a head CT scan. Although head CT scans are clinically useful, they increase health care costs and pose potential cancer risks from radiation exposure. Eight APPs (i.e., nurse practitioners, physician assistants) were trained in the American College of Emergency Physicians' (ACEP's) TBI clinical guideline with one-on-one education. Preintervention, retrospective, baseline data were collected for a period of 4 months (n = 152). Three months of postintervention data were collected to assess adherence to the guideline (n = 132), including physicians' charts that were reviewed as a comparison. The findings demonstrated a statistically significant reduction in head CT scans that did not meet ACEP criteria among APPs after training (p = 0.010). The results of this project suggest improved medical decision-making among APPs, avoidance of unnecessary costs, and a reduction in radiation exposure for patients. This project could be easily replicated in other ED settings using the ACEP TBI guideline as part of their standardized procedures, clinical policies, or protocols.Purpose Dysphagia is a serious extra pulmonary manifestation of chronic obstructive pulmonary disease (COPD). However, the nature of abnormalities in swallowing physiology in COPD has yet to be clearly established. We explored the frequency of swallowing measures outside the healthy reference range in adults with COPD. Method Participants were 28 adults aged 41-79 years (18 men, 20 women) with stable COPD. Disease severity was classified as GOLD (Global Initiative For Chronic Obstructive Lung Disease) Stages 1 (4%), 2 (25%), 3 (53%), and 4 (18%). Participants underwent a videofluoroscopy and swallowed 20% w/v thin barium in, followed by 20% w/v mildly, moderately, and extremely thick barium prepared with a xanthan gum thickener. Blinded duplicate ratings of swallowing safety, efficiency, kinematics, and timing were performed according to the ASPEKT method (Analysis of Swallowing Physiology Events, Kinematics and Timing). Comparison data for healthy adults aged the third quartile for skewed parameters). Results Participants with COPD did not display greater frequencies of penetration-aspiration, but they were significantly more likely (p less then .05) to display incomplete laryngeal vestibule closure (LVC), longer time-to-LVC, and shorter LVC duration. They also displayed significantly higher frequencies of short upper esophageal sphincter opening, reduced pharyngeal constriction, and pharyngeal residue. Conclusion This analysis reveals differences in swallowing physiology in patients with stable COPD characterized by impaired safety related to the mechanism, timing, and duration of LVC and by impaired swallowing efficiency with increased pharyngeal residue related to poor pharyngeal constriction.10-Hydroxycamptothecin (HCPT) is a widely used anticancer drug that induces cytotoxicity by triggering the cell apoptotic pathway. Studies have shown that HCPT has harmful effects on normal cells, but whether HCPT affects the development of mouse oocytes in vitro has not been reported. First, this study investigated the development of oocytes exposed to 60 μM HCPT in vitro. In the HCPT-treated group, the first polar body extrusion (PBE) rate of oocytes decreased, spindle morphology was abnormal, DNA double-strand break, oxidative stress level increased, and mitochondrial distribution was abnormal. The apoptosis and autophagy levels of oocytes in the HCPT-treated group were detected by qRT-PCR and western blot. Compared with the control group, the expressions of key regulators of oocyte apoptosis (bax, caspase-3) and autophagy (lc3, beclin, ATG12) pathway were increased in the HCPT-treated group. HCPT treatment induced apoptosis and autophagy in oocytes. Melatonin (MT) can protect cell structure, prevent DNA damage, and reduce the content of peroxides. So we wondered whether MT could ameliorate the harmful effects of mouse oocytes induced by HCPT. Interestingly, the addition of 1 mM MT can protect oocytes from HCPT toxicity to some extent. Compared with the HCPT group, the addition of 1 mM MT increased the PBE ratio of oocytes, decreased ROS levels, and decreased spindle abnormalities and DNA breakage ratio. selleck products In summary, these results revealed that HCPT exhibited adverse effects on mouse oocyte maturation and quality, and MT administration alleviated the negative influence of HCPT.