Abstract: OBJECTIVE: To compare the functional and anatomic outcomes of encircling scleral buckle placement for the repair of progressive symptomatic retinal detachment complicating retinoschisis (PSRDCR) with outer-layer breaks (OLBs) posterior to the equator versus primary rhegmatogenous retinal detachment (RRD). DESIGN: Retrospective comparative case series.Participants: Thirty-seven patients with PSRDCR with OLBs posterior to the equator (group A) and 703 patients with primary RRD (group B). METHODS: All eyes were treated with an encircling scleral silicone band (style 240). External drainage of subretinal and retinoschisis cavity fluid and cryopexy or laser photocoagulation around the tears and the OLBs were performed in all eyes. Best-corrected visual acuity at 6 months postoperatively and final retinal reattachment rate were analyzed. RESULTS: There was no statistically significant difference between the 2 groups in terms of patient age, gender, percentage of retinal detachments that were macula-off (p = 0.241), and preoperative best-corrected Snellen visual acuity (p = 0.927). Best-corrected Snellen visual acuity at 6 months postoperatively was < or =20/100 in 35% of eyes, 20/100-20/50 in 14% of eyes, and > or =20/40 in 51% of eyes in group A versus > or =20/100 in 37% of eyes, 20/100-20/50 in 33% of eyes, and > or =20/40 in 30% of eyes in group B (p = 0.12); the final retinal reattachment rate was 97% in group A versus 98% in group B (p = 0.77). CONCLUSIONS: Placement of an encircling scleral buckle may be an effective method to manage both PSRDCR with OLBs posterior to the equator and primary RRDs. The procedure is associated with comparable visual acuity and anatomic outcomes for both types of retinal detachment.
Abstract: PURPOSE: To evaluate the effect of refractive errors and central corneal thickness (CCT) on the measurement of intraocular pressure (IOP) by ICare rebound tonometer (RT), and its agreement with measurements by Goldmann applanation tonometer (GAT). PATIENTS AND METHODS: Two observers measured the IOP by using RT and GAT in four groups of healthy volunteers with emmetropic (n = 78), hyperopic (n = 83), myopic (n = 87) and astigmatic (n = 79) eyes. Refraction was assessed by an autorefractometer. CCT was assessed by ultrasound pachymetry. RESULTS: In all groups, no significant interobserver difference was seen in IOP values detected by both tonometers (Wilcoxon signed-rank test not significant). In all groups, IOP values were higher as measured by RT than by GAT (paired t-test p = 0.000): mean RT-GAT difference was higher in myopic eyes (+1.6 +/- 1.8 mmHg), and it was less than 1 mmHg in the other groups. RT-GAT difference was correlated to the refraction (p < 0.001), and it was greater when an higher IOP was detected by RT (significant correlation between RT-GAT difference and IOP by RT, p < 0.001). Compared with GAT values, the IOP readings by RT were greater than 2 mmHg in respectively 17.9% (emmetropic), 13.3% (hyperopic), 34.5% (myopic) and 7.6% (astigmatic) of the eyes. With both tonometers, in all groups the IOP values were correlated with CCT (p < 0.05), but the discrepancy between RT and GAT values was not related to CCT. CONCLUSIONS: In all groups of subjects, higher IOP values were detected by RT; the IOP readings exceed the GAT values usually in a range of less than 1 mmHg, except when RT detects IOP >18 mmHg and generally in myopic eyes; RT-GAT discrepancy is related to the refractive error, but not to CCT.
Abstract: OBJECTIVE: To analyse the prescribing pattern and the safety profile of different atypical antipsychotics and selective serotonin reuptake inhibitors (SSRIs) during the years 2002-2003 in paediatric setting. SETTING: Two Child Neurology and Psychiatry Divisions of Southern Italy (University of Messina and "Oasi Institute for Research on Mental Retardation and Brain Aging" of Troina). METHODS: A retrospective chart review of all children and adolescents starting an incident treatment with atypical antipsychotics or SSRIs was performed. Within the first 3 months of therapy, any potential adverse drug reaction (ADR) was identified and the clinical outcome of psychotropic drug treatment was assessed. MAIN OUTCOME MEASURE: Rate of ADR in the first 3 months of therapy with atypical antipsychotics and SSRIs in children and adolescents. RESULTS: On a total of 97 patients' charts being reviewed, 73 (75%) concerned atypical antipsychotics and 24 (25%) SSRIs. Risperidone (N=45, 62%) was the most frequently prescribed antipsychotic drug, followed by olanzapine (24, 32%). Overall, 50 (68%) antipsychotic users reported a total of 108 ADRs during the first 3 months of therapy, leading to drug discontinuation in 23 patients (31%). Among 24 users of SSRI, 12 (50%) received paroxetine, 6 (25%) sertraline, 5 (21%) citalopram and 1 (4%) fluoxetine. Only paroxetine users (21%) reported at least one ADR, however, none of SSRI users withdrew drug treatment within first 3 months. CONCLUSIONS: ADRs occurred frequently during first 3 months of treatment with atypical antipsychotics and, to a lesser extent, with SSRIs in children and adolescents. Further investigations are urgently needed to better define the benefit/risk ratio of psychotropic medications in paediatric setting.
Abstract: PURPOSE: Since, during the menstrual cycle, changes in neuronal activity and in auditory, olfactory, and taste thresholds were found, visual evoked potentials were investigated. MATERIALS & METHODS: In 50 healthy women the latency and the amplitude of P100 wave of pattern reversal visual evoked potentials were measured during the different menstrual phases (follicular, periovular, and luteal), as determined by sonography and serum progesterone level. RESULTS: Compared with the follicular phase, during the luteal phase significant reduction in latency (101.29+/-4.42 vs. 104.76+/-5.02 ms, P<0.01) and increase in amplitude (10.44+/-3.15 vs. 8.62+/-3.09 microV, P<0.05) were recorded. CONCLUSIONS: Fluctuations in ovarian steroid hormones affect the excitability of the visual system.
Abstract: BACKGROUND: In patients with end-stage renal disease pulse wave velocity (PWV) has been widely assessed, but its behavior in mild to moderate chronic kidney disease (CKD) has been less investigated. We evaluated PWV in mild to moderate CKD. METHODS: We studied 31 patients with grade II-IV CKD. Aortic PWV (aPWV), aortic and upper limb augmentation index, creatinine clearance, C-reactive protein, serum fibrinogen, interleukin-1, interleukin-6, tumor necrosis factor, albumin, total and high-density lipoprotein cholesterol and blood pressure were evaluated. RESULTS: aPWV (7.95 +/- 0.64 m/s), but not augmentation index was significantly higher (p = 0.03) in CKD patients than age-matched healthy subjects (aPWV: 6.24 +/- 0.43 m/s; upper limb: 32.8 +/- 1.9; aortic: 27.7 +/- 1.9). At univariate regression analysis, aPWV was significantly correlated with age (r = 0.44; p = 0.013), interleukin-6 (r = 0.43; p = 0.027), pulse (r = 0.39; p = 0.029), systolic blood pressure (r = 0.37; p = 0.038) and tumor necrosis factor (r = 0.39; p = 0.029). At multivariate analysis, pulse pressure was the only significant independent determinant (beta = 0.37; p = 0.05) of aPWV. CONCLUSION: The results of this study confirm an aPWV increase in mild to moderate CKD and emphasize association between pulse pressure and PWV, independently of renal failure.
Abstract: PURPOSE: The purpose of the present study was to examine the effectiveness of an instructional procedure called aided language modeling (ALM) on symbol comprehension and expression in 2 preschool children with autism who used few words functionally. ALM consists of engaging the child in interactive play activities and providing models of use of augmentative and alternative communication symbols during play. METHOD: A multiple-baseline design across sets of symbol vocabulary was used with 2 children who had autism. Four vocabulary items were taught in each of 3 legs of the design, for each child. RESULTS: Both participants demonstrated increased symbol comprehension and elicited symbol production. In addition, both participants demonstrated that symbol comprehension and symbol production could be maintained. For both children, performance on symbol production lagged behind rate of responses on symbol comprehension. CONCLUSIONS: The current research presents preliminary evidence that a modeling intervention may be effective in increasing symbol comprehension and production, and may be an appropriate intervention strategy for some preschoolers with autism. Future research should continue to investigate this strategy and its effects on functional communication.
Abstract: We report a case of leiomyoma of the finger in the right hand of a 12-year-old boy: a rare site for localization and unusual for age. This is a benign tumor originating from non-striated muscle that is very uncommon in the hand. The uterus is considered the most common location for leiomyoma and when it occurs in the extremities, it is more common in the leg, ankle and foot. It usually occurs in the third and fourth decades of life and it is rarely diagnosed before surgery as the diagnosis can only be confirmed histologically.
Abstract: This study employed simulations of encounters with suicidal peers to assess the impact of classroom suicide response lessons. Students were asked to anonymously write how they would respond, and how concerned they would be in regard to two vignettes of troubled peers. On the posttest, students who had participated in the classes provided significantly more "tell an adult" responses than those in the control group, whereas no differences existed between the groups on the pretest. On both the pretest and posttest, all students expressed greater concern on the unambiguous vignette (student said that he has been thinking about killing himself) than on the ambiguous vignette (student wrote an essay about final decisions); and, overall, females expressed greater concern than males. These results provide evidence for the efficacy of the classes and the utility of the simulations for assessing their impact.
Abstract: The THC-YAG laser (holmium laser) war used to perform ab externo sclerostomies in patients affected by various types of glaucoma. This approach was employed in 48 eyes with diagnoses of medically uncontrolled chronic open angle glaucoma, plateau iris or neovascular glaucoma. Post-operatively, 5-FU was injected. At the tend of the follow-up (mean 10.22 +/- 3.4 months), in 25 eyes (52.1%) the IOP was under control without medical therapy. In 12 eyes (25.0%) it was necessary to use antiglaucomatous topical therapy, and in 11 eyes (22.9%) the IOP was uncontrolled despite therapy. The authors stress the importance of a correct pharmacological protocol before and after operation and describe the surgical technique. They confirm the validity of this approach, owing to its minical invasiveness, the possibility of repeating the procedure, and the low complication rate.
Abstract: Different neurotransmitter systems in the retina and optic nerve can be modified during aging. An increase in GABA and dopamine receptor density in the retina of senescent rats has been demonstrated. Lack of data exists on the aging-related changes in optic nerve neurotransmitters. However, it is possible that neurotransmitter changes in the optic nerve at the lateral geniculate nucleus are similar to those in other areas of central nervous system.
