Blindness and glaucoma: A multicenter data review from 7 academic eye clinics

Purpose To evaluate frequency, conversion rate, and risk factors for blindness in glaucoma patients treated in European Universities. Methods This multicenter retrospective study included 2402 consecutive patients with glaucoma in at least one eye. Medical charts were inspected and patients were divided into those blind and the remainder (''controls''). Blindness was defined as visual acuity-0.05 and/or visual field loss to less than 10°. Results Unilateral and bilateral blindness were respectively 11.0% and 1.6%at the beginning, and 15.5%and 3.6% at the end of the observation period (7.5±5.5 years, range:1-25 years)//conversion to blindness (at least unilateral) was 1.1%/year. 134 eyes (97 patients) developed blindness by POAG during the study. At the first access to study centre, they had mean deviation (MD) of -17.1±8.3 dB and treated intraocular pressure (IOP) of 17.1±6.6 mmHg. During follow-up the IOP decreased by 14%in these eyes but MD deteriorated by 1.1±3.5 dB/year, which was 5-fold higher than controls (0.2±1.6 dB/year). In a multivariate model, the best predictors for blindness by glaucoma were initial MD (p<0.001), initial IOP (p<0.001), older age at the beginning of follow-up (p<0.001), whereas final IOP was found to be protective (p<0.05). Conclusions In this series of patients, blindness occurred in about 20%. Blindness by glaucoma had 2 characteristics: late diagnosis and/or late referral, and progression of the disease despite in most cases IOP was within the range of normality and target IOP was achieved//it could be predicted by high initial MD, high initial IOP, and old age

[Latent pathology of the thyroid: an epidemiological and statistical study of thyroids sampled during 507 consecutive autopsies]

In order to highlight the occult pathology of the thyroid in the aged, the authors examined all the glands withdrawn from 507 consecutive autopsies on subjects of 67.10 years of median age. In 10 tables there are weight and measurements of the thyroids, macro and microscopic details and pathologic appearances. Adenomas were found in 17.1% of cases and histologically besides the known cases referred also to the Hürtle cells type, 4 clear cells adenomas and 5 adenolipomas were found. In 27.42% the subjects were affected or were dead for a malignant extrathyroidal neoplasm, and in 26% of these there was a metastasis in the thyroid. Never a primitive thyroid carcinoma, macroscopically and clinically evident, but in 53 thyroid glands, 54 occult carcinomas (OC) were found, particularly 37 papillary and 17 medullary. IN 57% of 165 histologically treated thyroids, to evidence C-cells, hyperplasia of these cells was found associated with various pathologic conditions, more in aged subjects. In 147 glands were found 170 nodules of various number of cells, at times positive for calcitonin. These solid cellular nodes (SCN) were evaluated as nodular C-cells hyperplasia. Besides isolated cases of acute thyroiditis (also the mycotic type), of tubercular thyroiditis and Hashimoto's, in 12% of the glands a lymphocytic chronic thyroiditis was found, frequently with Hürtle cells. Others observations were: basophilic thickening of colloid also with calcium oxalate crystals, lipoid degeneration of follicular cells and fat interfollicular and interlobular infiltration, thyroid amyloidosis, inner and media elastic calcification of thyroid arteries, presence of cysts with squamous cells coating, parathyroid glands and cartilage intrathyroidal plaques

The reaction of cinnamaldehyde and cinnam(o)yl derivatives with thiols

Spurred by the alleged relevance of the thia-Michael reaction in the bioactivity of various classes of cinnam(o)yl natural products and by the development of a quick NMR assay to study this reaction, we have carried out a systematic study of the “native” reactivity of these compounds with dodecanethiol and cysteamine as models, respectively, of simple thiols and of reactive protein thiols that can benefit from iminium ion catalysis in Michael reactions. In contrast with what commonly assumed in the literature, cinnamoyl esters and amides as well as cinnamyl ketones and oximes, did not show any reactivity with the two probe thiols, while cinnamaldehyde (1a) reacted with cysteamine to afford a mixture of a thiazoline derivative and compounds of multiple addition, and with aliphatic thiols to give a single bis-dithioacetal (6). Chalchones and their vinylogous C5-curcuminoid derivatives were the only cinnamoyl derivatives that gave a thia-Michael reaction. From a mechanistic standpoint, loss of conjugation in the adduct might underlie the lack of native Michael reactivity with thiol, that is restored by the presence of another conjugating group on the carbonyl, as in chalcones and C5-curcuminoids. A critical revision of the chemical and biomedical literature on cinnamaldehyde and related compounds seems therefore required

A 1-year randomized study of the clinical and confocal effects of tafluprost and latanoprost in newly diagnosed glaucoma patients

INTRODUCTION: The aim of the present study was to compare the confocal and clinical features of newly diagnosed glaucoma patients receiving unpreserved prostaglandins (tafluprost) versus preserved prostaglandins (latanoprost). MATERIALS AND METHODS: 40 patients were randomized to tafluprost 0.0015% (20 patients; 32 eyes) or latanoprost 0.005% + benzalkonium chloride 0.02% (20 patients; 35 eyes) once daily for 1 year. Inclusion criteria were new glaucoma diagnosis, and no ocular treatments for 6 months before the study. Patients were evaluated at baseline and every 3 months with a complete ophthalmologic evaluation, Schirmer's test, break-up time test, confocal microscopy of the central cornea, and measurement of intraocular pressure (IOP). Investigators were masked to treatment. Both eyes were analyzed if they fulfilled inclusion criteria. Treatments and changes between follow-up and baseline were compared by analysis of variance (ANOVA), t test and Chi-square test. RESULTS: At baseline, the two groups had similar age, ocular surface and confocal findings; keratocyte activation was present in 40%, branching pattern in 85%, and beading in 75%, with no inter-group differences. At follow-up, no significant clinical changes were detected, apart from a drop of IOP by 3.6-4.2 mmHg in the two groups (p < 0.001, with no difference between treatments). Despite inter-treatment ANOVA for confocal microscopy being negative, subtle changes were present. During follow-up, all eyes without nerve branching pattern at baseline progressively developed it when treated with latanoprost, whereas no change occurred using tafluprost treatment (p = 0.05). None of the eyes without beading at baseline developed it at the end of the study in the tafluprost group, whereas beading did occur in 75% of patients treated with latanoprost (p = 0.05). Both treatments were associated with increased keratocyte activation at follow-up; the change from baseline was statistically significant after month 3 with latanoprost (p = 0.02) and after month 6 with tafluprost (p = 0.04). CONCLUSIONS: The two study treatments had similar clinical effects, but tafluprost had a more favorable profile for some confocal parameters of the cornea

Radiofrequency ablation of hepatocellular carcinoma: CT texture analysis of the ablated area to predict local recurrence

Purpose: To investigate the role of CT-texture analysis of liver ablation area to predict local recurrence after HCC ablation. Methods: Patients treated with liver ablation were retrospectively enrolled. CT-texture analysis was performed on the core and borders of ablation area 1-2&nbsp;months after procedure. Tumors were grouped according to the onset of local recurrence at follow-up (persistence, recurrence-free, short- or long-term recurrence). Differences in texture parameters and which parameters were predictive of recurrence risk were assessed using a Cox regression model. Results: 151 HCCs were treated in 98 patients (72&nbsp;±&nbsp;9&nbsp;years, 83 men). 68 HCCs reported no disease recurrence, 32 persistent disease, 19 short-term and 32 long-term recurrence. Median follow-up was 280 [IQR: 156-569] days. Venous phase (Ven)Skewness (HR 6.07, 1.29-28.6, p&nbsp;=.02) and VenKurtosis (HR 2.27, 1.23-4.21, p&nbsp;=.01) of the ablation core were predictive of short-term recurrence. VenHUmean (HR 0.30, 0.11-0.81, p&nbsp;=.02) and VenGLRLM_HGRE (HR 1.06, 1.01-1.11, p&nbsp;=.02) of the core were independent predictors of tumor recurrence (C-index 0.64, CI 0.52-0.76, p&nbsp;=.03). Arterial phase (Art)Entropy of ablation border predicted the recurrence risk (HR 3.15, 1.05-9.42, p&nbsp;=.04) and values higher than 3.71 reported an increased recurrence incidence (p&nbsp;=.05). ArtHUstd (HR 1.14, 1.04-1.24, p&nbsp;=.01), LateHUmean (HR 8.69, 1.11-68.23, p&nbsp;=.04), LateGLRLM_HGRE (HR 0.9, 0.82-0.99, p&nbsp;=.03), LateGLZLM_HGZE (HR 1.01, 1.00-1.02, p&nbsp;&lt;.01) and LateGLZLM_SZHGE (HR 0.99, 0.99-1.00, p&nbsp;=.02) of ablation border were independent predictors of local recurrence risk (C-index 0.73, CI 0.61-0.86, p&nbsp;&lt;.01). Conclusions: CT texture analysis of ablation area performed at 1-2&nbsp;months follow-up could estimate the risk of local recurrence of hepatocellular carcinoma treated by radiofrequency ablation

Mean retinal sensitivity at each location for Compass (A), HFA (B), and their difference (C).

<p>Mean retinal sensitivity at each location for Compass (A), HFA (B), and their difference (C).</p

Bland-Altman plots for mean sensitivity of the central 10° (2°– 1° measurement), normal group.

<p>x, average of mean sensitivity of the two tests (dB). y, difference of mean sensitivity of the two tests (dB).</p

Eye tracking compensation.

<p>(A) The green dot shows the expected presentation position on the retina of one of the 24–2 measurement locations. (B) The red dot shows the actual presentation position in presence of a 3-degree eye movement at the time of presentation (see arrow) and in absence of a compensation mechanism: the red dot is where the HFA would actually measure sensitivity, without a chance to time-correlate presentation of this stimulus with the information provided by the gaze tracker. The use of a 25 Hz retinal tracker instead, enables Compass to maintain the expected presentation position even in presence of wide and fast eye movements.</p