Evaluation of near accommodation in type 1 diabetic patients

Aim: To evaluate accommodation in type 1 diabetic patients by PowerRef3 in our study. The PowerRef 3 can be used in studying the near triad of accommodation, vergence and pupil responses in healthy and clinical populations. Method: The accommodation of 14 patients (mean age: 33.14 ± 10.27) with type 1 diabetes and 16 control subjects (mean age: 35.81 ± 5.88) were measured by PowerRef3 at 30 cm with a standard accommodation target. The metabolic status of the diabetic patients and accommodation were compared with those of control subjects. Results: The mean accommodation, spherical equivalents and age was not significantly different between diabetic and control subjects.  The mean duration of diabetes was 13 ± 5.7 years (min: 7, max: 27). The mean accommodation was not significantly correlated with duration of diabetes and glycated hemoglobin levels, but it was significantly correlated with the spherical equivalents (p<0.05) and weakly correlated other metabolic parameters (fasting plasma glucose, cholesterol, low density lipoprotein, high density lipoprotein and triglyceride levels). Conclusion: The accommodation of type 1 diabetes patients at pre-presbyopic ages without diabetic retinopathy was similar to control subjects with PowerRef 3 measurements. This may reflect that good diabetes control, which will prevent retinopathy, may prevent the decrease in accommodation in type 1 diabetes patients

Hypotension, Syncope, and Fever in Systemic Mastocytosis without Skin Infiltration and Rapid Response to Corticosteroid and Cyclosporin: A Case Report

Mast cell disorders are defined by an abnormal accumulation of tissue mast cells in one or more organ systems. In systemic mastocytosis, at least one extracutaneous organ is involved by definition. Although, systemic mastocytosis usually represents with skin lesion called urticaria pigmentosa, in a small proportion, there is extracutaneous involvement without skin infiltration. Other manifestations are flushing, tachycardia, dyspepsia, diarrhea, hypotension, syncope, and rarely fever. Various medications have been used but there is not a definite cure for systemic mastocytosis. The principles of treatment include control of symptoms with measures aimed to decrease mast cell activation. We describe a case of systemic mastocytosis presenting with hypotension, syncope attacks, fever, and local flushing. In bone marrow biopsy, increased mast cell infiltration was demonstrated. She had no skin infiltration. A good clinicopathological response was obtained acutely with combination therapy of glucocorticoid and cyclosporine

Effective speak-up arrangements for whistleblowers: A multi-case study on the role of responsiveness, trust and culture

This research project examined the opportunities, challenges and best practices associated with different types of speak-up arrangements, both internal and external, in a variety of organisational settings across different sectors, industries and locations. While recent research on the topic has focused mainly on the experience of those who have ‘blown the whistle’, the approach used here explored arrangements for speaking up (‘speak-up arrangements’) from the viewpoint of those who develop, operate and oversee them, seeking to provide recommendations for an effective framework. Findings from the investigation show that effective speak-up arrangements: • involve a combination of different channels through which employees can voice a concern • contribute to building trust through speak-up practices that evolve over time and are supported by the independence of speak-up operators • rely on robust and consistent response systems that are supported by appropriate recording of speak-up events, coordinated follow-up activities, and willingness to respond at different management levels; there are nevertheless barriers to responsiveness caused by anonymous concerns, legal issues, and lack of a visible response, albeit inadvertent, and • may need to take into account the potentially difficult interactions between organisational and national cultures. These findings give rise to key recommendations for developing, operating and overseeing effective speak-up arrangements. These are further discussed in the ‘Recommendations’ section at the end of this report. 1. Provide a variety of voicing channels and consider the use of an external independent advice channel when introducing a speak-up arrangement. 2. Be prepared to accept that concerns received may not be strictly considered speak-up or whistle-blowing cases but some of them may nonetheless help organisations recognise previously unidentified risks. 3. Design a speak-up ‘back office’ to record concerns and use this data to strengthen risk management and response processes, investigation and intervention, acknowledging the variety of concerns that could be raised. 4. Ensure that responsiveness is well organised, clearly mandated and adequately resourced. Merely encouraging employees to speak up, without putting robust response systems in place, is likely to have negative consequences, for both employees and the organisation. 5. Make responses visible where possible. This may be achieved by exploring whether employees who raised a concern can be included in developing a solution to the problem; this in turn can contribute to developing collective sense-making and increase trust in the effectiveness of the speak-up arrangement. It is also important to emphasise continuously to managers at all levels that responding to concerns is part of their role, and to restrict their discretion about whether/how to respond. 6. Consider participating in the development of a standard for the public reporting of data from speak-up arrangements

Genomic alterations in low-grade, anaplastic astrocytomas and glioblastomas.

RIGHTS : This article is licensed under the BioMed Central licence at http://www.biomedcentral.com/about/license which is similar to the 'Creative Commons Attribution Licence'. In brief you may : copy, distribute, and display the work; make derivative works; or make commercial use of the work - under the following conditions: the original author must be given credit; for any reuse or distribution, it must be made clear to others what the license terms of this work are.To extend our understanding of potential stepwise genetic alterations that may underlie tumor progression from low-grade astrocytomas to glioblastomas, histopathologic and comparative genomic hybridization analyses were performed on tumor specimens from 68 primary lesions, including 40 glioblastomas, 10 anaplastic and 18 low-grade astrocytomas. The number of aberrations per case increased towards the higher grade tumors (grade II: 1.66+/-1.49; grade III: 2.80+/-1.68; grade IV: 3.02+/-1.07; F=6.955, p=0.002). A gain of 7/7q was common and the most frequently seen aberration in low-grade astrocytomas, whereas loss of 10q was the most frequently seen anomaly in anaplastic astrocytomas and glioblastomas. Chromosome 7p amplification was only detected in glioblastomas. Chromosome 10/10q deletion and combination of 1p, 19q and 17p deletions were specific to high-grade astrocytic tumors. Sequences of chromosome 7 and 10 seem to have pivotal roles in the biology of human gliomas. The genomic copy deletions of chromosomes 1p and 19q might provide an alternative mechanism in the genesis of astrocytomas

Nephrocalcinosis (enamel renal syndrome) caused by autosomal recessive FAM20A mutations

Calcium homeostasis requires regulated cellular and interstitial systems interacting to modulate the activity and movement of this ion. Disruption of these systems in the kidney results in nephrocalcinosis and nephrolithiasis, important medical problems whose pathogenesis is incompletely understood

Distribution of rotifers of high mountain lakes in the Eastern Black Sea Range of Turkey

WOS: 000405865700010Six expeditions were conducted in 2005-2007 on the rotifer fauna 459 high mountain lakes of the Eastern Black Sea Range. All of the lakes are located a altitudes between 2530 and 3370 m except Uzungol (1100 m). A total of 63 rotifer taxa were identified. All of the taxa that were identified are new records for their localities except Notholca squamula and Cephalodella gibba. Dissotrocha rnacrostyla, Hexarthra jenkinae, Lecane clara, Lecane kluchor, and Lecane latissima arc new records for the Turkish inland water fauna. The trophic classification based on the orthophosphate includes 22 lakes as ultraoligotrophic and 37 lakes as oligotrophic; by Secchi depth, 20 lakes are ultraoligotrophic, 12 lakes oligotrophic, and 27 lakes mesotrophic. Rotifer species richness showed a decrease with altitude (20 species in Lake Uzungol with an altitude of 1100 in and 4 species in Lake Deniz with an altitude of 3370 in). We propose that 80% of the rotifer taxa were indicators of oligotrophic conditions and the remaining 20% were indicators of mesotrophic conditions.Scientific and Technological Research Council of Turkey (TUBITAK)Turkiye Bilimsel ve Teknolojik Arastirma Kurumu (TUBITAK) [104/Y/183]This project was supported by the Scientific and Technological Research Council of Turkey (TUBITAK, Project 104/Y/183). We are deeply grateful for that support, WC would also like to thank Dr Suleyman Balik, Dr Cent Aygen, Dr Haim Somek, Dr Hasan M Sari, Dr Murat Ozbek, Dr Ali Ilhan, Dr Esat T Topkara, Dr Ozdemir Egemen, Dr. Ash Basaran, and Mesut Kaptan for their invaluable support and help with technical issues

Craniodentofacial Manifestations in a Rare Syndrome: Orofaciodigital Type IV (Mohr-Majewski Syndrome)

Background. The orofaciodigital syndromes (OFDS) are a heterogeneous group of syndromes that affect the face, oral cavity, and the digits. OFDS type IV (OMIM %258860) is rare and characterized by broad nasal root and tip, orbital hypertelorism or telecanthus, micrognathia, hypoplastic mandible, and low-set ears. Oral symptoms may include cleft lip, cleft or highly arched palate, bifid uvula, cleft or hypoplastic maxillary and mandibular alveolar ridge, oral frenula, lingual hamartoma, and absent or hypoplastic epiglottis. Dental anomalies are common and generally include disturbances in the number of teeth. Case Report. This report presents a six-year-old girl, referred with the chief complaint of missing teeth. She was diagnosed as having OFDS type IV based on clinical findings. Her parents reported three deceased children and two fetuses that had the same phenotype. She was the seventh child of consanguineous parents who were first cousins. Conclusion. This is a very rare syndrome. Many reported OFDS type IV cases have consanguineous parents, consistent with an autosomal recessive trait. Manifestation of cleft palate in the healthy sibling may be mild expression of the disorder or an unrelated isolated cleft