231 research outputs found
Ovarian steroid cell tumor in pregnancy-a rare occurrence: Report of a case and review of the literature
No full textBackground: Steroid-cell tumors of the ovary are very rare, especially during pregnancy, and they must be distinguished from luteoma of pregnancy.
Case: An 18-year-old female, gravida 3, para 1-0-1-1, at 38 weeks' of gestation, had an adnexal mass that was discovered incidentally during a Caesarean section. The tumor was excised and her male infant was normal.
Results: Histologic workup revealed the tumor to be a steroid-cell tumor, which is exceedingly rare in pregnancy.
Conclusions: Ovarian steroid-cell tumors, which are malignant one-third of the time, are difficult to distinguish from luteoma of pregnancy.Peer reviewe
Gender and climate change framework for analysis, policy & action
No full text"This paper by Jyoti Parikh provides a framework to anlayse gender and climate change concerns keeping in view the strengths and vulnerability of poor ‐ women in particular. The author also provides policy recommendations for policies and actions.
Alternative therapy in glaucoma management: Is there any role?
No full textGlaucoma is one of the leading causes of blindness worldwide. Various randomized controlled clinical trials have shown that lowering intraocular pressure (IOP) does reduce progression of primary open-angle glaucoma. However, there is lots of interest in nonpharmacological options that includes lifestyle adjustment and alternative and complementary therapy (ACT). At least 5% glaucoma population uses ACT. Various lifestyle activities like exercise and alcohol can reduce IOP by 1 to 2 mm Hg but would have small effect on glaucoma. The psychological stress can increase IOP. Hypothetically and few studies do show neuroprotective effect (or effect on ocular blood flow) of alcohol, Gingko biloba, bilberry, but the current evidence is weak for its routine use. We must also remember the side effects of ′medications′ (e.g., marijuana, alcohol) before promoting as remedy for glaucoma. In current armamentarium of glaucoma management, ACT cannot substitute the conventional treatment available to lower IOP
Enter the reverend: introduction to and application of Bayes' theorem in clinical ophthalmology
No full textBackground: Ophthalmic practice utilizes numerous diagnostic tests, some of which are used to screen for disease. Interpretation of test results and many clinical management issues are actually problems in inverse probability that can be solved using Bayes' theorem. Design: Use two-by-two tables to understand Bayes' theorem and apply it to clinical examples. Samples: Specific examples of the utility of Bayes' theorem in diagnosis and management. Methods: Two-by-two tables are used to introduce concepts and understand the theorem. The application in interpretation of diagnostic tests is explained. Clinical examples demonstrate its potential use in making management decisions. Main Outcome Measure: Positive predictive value and conditional probability. Results: The theorem demonstrates the futility of testing when prior probability of disease is low. Application to untreated ocular hypertension demonstrates that the estimate of glaucomatous optic neuropathy is similar to that obtained from the Ocular Hypertension Treatment Study. Similar calculations are used to predict the risk of acute angle closure in a primary angle closure suspect, the risk of pupillary block in a diabetic undergoing cataract surgery, and the probability that an observed decrease in intraocular pressure is due to the medication that has been started. The examples demonstrate how data required for management can at times be easily obtained from available information. Conclusions: Knowledge of Bayes' theorem helps in interpreting test results and supports the clinical teaching that testing for conditions with a low prevalence has a poor predictive value. In some clinical situations Bayes' theorem can be used to calculate vital data required for patient management. © 2011 The Authors. Clinical and Experimental Ophthalmolog
Likelihood ratios: Clinical application in day-to-day practice
No full textIn this article we provide an introduction to the use of likelihood ratios in clinical ophthalmology. Likelihood ratios permit the best use of clinical test results to establish diagnoses for the individual patient. Examples and step-by-step calculations demonstrate the estimation of pretest probability, pretest odds, and calculation of posttest odds and posttest probability using likelihood ratios. The benefits and limitations of this approach are discussed
The Neuropeptide VGF is Reduced in Human Bipolar Postmortem Brain and Contributes to Some of the Behavioral and Molecular Effects of Lithium
No full textRecent studies demonstrate that the neuropeptide VGF (non-acronymic) is regulated in the hippocampus by antidepressant therapies and animal models of depression and that acute VGF treatment has antidepressant-like activity in animal paradigms. However, the role of VGF in human psychiatric disorders is unknown. We now demonstrate using in situ hybridization that VGF is downregulated in bipolar disorder in the CA region of the hippocampus and Brodmann’s Area 9 (BA9) of the prefrontal cortex. The mechanism of VGF in relation to LiCl was explored. Both LiCl intraperitoneally (IP) and VGF intracerebroventricularly (ICV) reduced latency to drink in novelty-induced hypophagia and LiCl was not effective in VGF+/- mice suggesting that VGF may contribute to the effects of LiCl in this behavioral procedure that responds to chronic antidepressant treatment. VGF by intrahippocampal injection also had novel activity in an amphetamineinduced hyperlocomotion assay thus mimicking the actions of LiCl injected IP in a system that phenocopies manic-like behavior. Moreover, VGF+/- mice exhibited increased locomotion following amphetamine and did not respond to LiCl, suggesting that VGF is required for the effects of LiCl in curbing the response to amphetamine. Finally, VGF by ICV in vivo activated the same signaling pathways as LiCl and is necessary for the induction of MAPK and AKT by LiCl thus lending insight into the molecular mechanisms underlying the actions of VGF. The dysregulation of VGF in bipolar disorder as well as the behavioral effects of the neuropeptide similar to LiCl suggests that VGF may underlie the pathophysiology of bipolar disorder.Peer reviewe
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