48 research outputs found
Corneal Cross-Linking as a Treatment for Keratoconus: Four-Year Morphologic and Clinical Outcomes with Respect to Patient Age.
No full textPURPOSE:
To report the 4-year outcomes of corneal cross-linking (CXL) for progressive keratoconus in a population of different age groups.
DESIGN:
Retrospective, single-center, nonrandomized clinical study.
PARTICIPANTS:
Four hundred consecutive eyes treated with corneal CXL for progressive keratoconus from April 2006 through April 2010.
INTERVENTION:
After removal of the epithelium, the cornea was irrigated for 30 minutes with a solution of 0.1% riboflavin and 20% dextran, followed by irradiation with an ultraviolet A light of 3 mW/cm(2) for 30 minutes.
MAIN OUTCOME MEASURES:
Best-corrected visual acuity (BCVA), sphere and cylinder refraction, corneal topography, Scheimpflug tomography, and aberrometry were assessed at baseline and at 1, 6, 12, 24, 36, and 48 months after corneal CXL treatment. The compiled data were stratified according to age (group A, younger than 18 years; group B, 18-29 years; group C, 30-39 years; and group D, older than 40 years).
RESULTS:
Comparative analysis included 400 eyes of 301 patients. Functional results showed a significant increase in BCVA in group A by a mean reduction of -0.11 logarithm of the minimum angle of resolution (logMAR) after 12 months, in group B by a mean reduction of -0.31 logMAR after 36 months, in group C by a mean reduction of -0.33 logMAR after 36 months, and in group D by a mean reduction of -0.26 logMAR after 36 months. Morphologic results showed an analogous regularization of corneal shape with a significant reduction of opposite sector index by a mean value of -0.53 at 12 months in group A, -1.14 at 36 months in group B, -1.10 at 36 months in group C, and -0.55 at 12 months for group D. Optical quality improvement was demonstrated by a mean significant reduction of coma -1.52 μm after 12 months in group A, -1.58 μm after 24 months in group B, -2.57 μm after 36 months for group C, and -0.25 μm after 36 months in group D.
CONCLUSIONS:
Outcomes stratified by age indicate the efficacy of corneal CXL in stabilizing the progression of ectatic disease in all age groups and improving the functional and morphologic parameters in select groups. Results indicated better functional and morphologic results in the population between 18 and 39 years of age
Nonsyndromic total anomalous venous return associated with a de novo translocation inolving chromosomes 10 and 21 t(10;21)(q23.1;q11.2)
No full textEpicardial damage induced by topical cooling during paediatric cardiac surgery
No full textObjective - To study electrocardiographic changes in infants and children in whom topical cooling was used during surgical repair of congenital heart defects. Design - A retrospective study of all patients who had surgical repair of congenital heart disease during cold blood cardioplegia and topical cooling from January to August 1990. Eleven patients (group 1) had topical cooling with ice and 15 (group 2) with cold saline. Patients - All 36 paediatric patients operated on during this period. All the available electrocardiographic records were analysed. Ten patients in whom reliable records were not available were excluded. Twenty six patients entered in this retrospective study. Interventions - Topical cooling with ice or with a slush of cold saline. Main outcome measure - Recordings from all the precordial leads were examined and scored as the sum of the maximum ST elevation (mV) in each precordial lead. The score obtained for each electrocardiogram was recorded together with the timing of the electrocardiogram (preoperative, arrival in intensive care unit immediately after surgery, postoperatively in the intensive care unit, and at discharge). Results - There were no differences between the two groups in terms of demographic data, diagnosis, duration of ischaemia, and postoperative myocardial performance. There was temporary ST elevation during the first 48 postoperative hours in all the children in group 1 but in only seven of the 15 children in group 2 (Fisher's test, p < 0.005). The mean (SD) score for maximum ST elevation was 1.34 (0.83) mV in group 1 and 0.52 (0.64) mV in group 2 (Student's t test, p < 0.01). Conclusions - These temporary electrocardiographic changes in the presence of adequate myocardial performance induced by hypothermic-osmotic injury. The use of ice for topical cooling may damage the epicardium in children
Caratterizzazione Molecolare della traslocazione t(10;21) in un paziente affetto da Ritorno Venoso Polmonare Anomalo Totale (TAPVR)
No full textVitreo-papillary adhesion as a prognostic factor in pseudo- and lamellar macular holes
No full textPurpose To determine the incidence of vitreopapillary adhesion (VPA) and to investigate its value as a prognostic factor in the surgical outcome of pseudo- (PMH) and lamellar macular holes (LMH). Methods A total of 76 consecutive patients, diagnosed with PMH (41 eyes) or LMH (35 eyes) were included. Eyes with VPA were alternatively assigned to the surgical or control group. Surgery consisted of a 25G vitrectomy and internal limiting membrane peeling with blue dye staining. There were six visits: baseline, the day of surgery, and 1, 3, 6, and 9 post-operative months. Main outcome measures were the incidence of VPA and changes in the outer retinal layers and visual acuity. Results VPA was found in 27% (11/41) of patients with PMH and 37% (13/35) with LMH (P = 0.03). In presence of VPA, the best-corrected visual acuity (BCVA) improved in the surgery group from 32 +/- 8 to 47 +/- 8 letters, whereas the control group went from 34 +/- 7 to 31 +/- 8 letters. The difference in letters between the surgery and control groups was statistically significant for both distance (P - 0.032) and near (P - 0.04) vision. Intra-retinal cysts were significantly correlated with a poor functional prognosis (P = 0.01). We found the presence of focal damage to the outer retinal layers in LMH and PMH. Conclusion VPA is more frequent in the presence of LMH vs PMH. It significantly influences the tangential forces at the vitreoretinal interface, exacerbating anatomical changes, and worsening the functional prognosis. Functional difference between the surgical and control groups was statistically significant for distant and near vision in presence of VPA. Eye (2012) 26, 810-815, doi:10.1038/eye.2012.43; published online 16 March 201
Nonsyndromic total anomalous venous return associated with a de novo translocation involving chromosomes 10 and 21 t(10;21)(q23.3;q11:2)
No full textTranscriptional deregulation and a missense mutation define ANKRD1 as a candidate gene for total anomalous pulmonary venous return
No full textCOVID-19 cardiac involvement in a 38-day old infant
No full textThe spectrum of clinical manifestations of coronavirus disease 2019 in children is yet to be fully elucidated. We report the case of an infant who tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and developed mild cardiovascular inflammation, a novelty for patients of very young age, that contributes to defining the puzzling nature of this disease in pediatric patients. The potential cardiovascular involvement of SARS-CoV-2 in children should always be taken into account
