Choroidal Vascularity Index and Choroidal Thickness Changes Following Renal Transplantation

Objectives:This study aimed to evaluate changes in subfoveal choroidal thickness (SFCT), choroidal vascularity index (CVI), estimated glomerular filtration rate (GFR), mean arterial pressure (MAP), and intraocular pressure (IOP) after renal transplantation.Materials and Methods:A total of 49 renal transplantation patients were included in this prospective study. CVI and SFCT on enhanced-depth imaging optic coherence tomography (EDI-OCT), MAP at the cubital fossa, GFR, and IOP were measured preoperatively and at postoperative 1 week and 1 month. In the analysis of EDI-OCT images, luminal area (LA) and stromal area of the choroid were determined using the image binarization method. CVI was defined as the ratio of LA to total choroid area. The effects of GFR, IOP, and MAP on CVI and SFCT were investigated.Results:The study included 23 women (47%) and 26 men (53%) with a mean age of 26.28±8.25 years (range: 18-52). Changes between preoperative, postoperative 1-week, and postoperative 1-month GFR values, CVI, and SFCT measurements were evaluated. There were significant differences between preoperative and postoperative GFR and SFCT measurements (p<0.001), but no significant differences between preoperative and postoperative CVI (p=0.09), MAP (p=0.14), or IOP (p=0.84) measurements.Conclusion:The present study demonstrated that SFCT increased significantly with GFR, while there was no change in CVI values

Macular Imaging Characteristics in Children with Myelinated Retinal Nerve Fiber and High Myopia Syndrome

Objectives:To investigate the macular imaging features in patients with unilateral myelinated retinal nerve fiber (MRNF) and high myopia syndrome.Materials and Methods:Six patients with unilateral MRNF and high myopia syndrome and 13 myopic controls were enrolled in this study. Spectral domain (SD) optical coherence tomography (OCT), SD enhanced depth imaging OCT, and OCT angiography (OCTA) imaging results of MRNF-affected eyes were compared with the fellow eyes and myopic controls.Results:All patients had abnormal foveal reflex and/or ectopia. No significant difference in retinal thickness parameters were noted between the groups. In OCT scans, posterior vitreous detachment (PVD) was observed in 4 out of the 6 MRNF-affected eyes. Regarding OCTA parameters, only a significant increase in acircularity index was noted in myelinated eyes (p=0.01).Conclusion:All patients demonstrated normal foveal contours, macular structure, and OCTA features except for a higher acircularity index. The incidence of PVD was notably increased in the myelinated eyes

Determining The Pressure Combination During Mechanical Ventilation that is Best Compatible with the Rapid Shallow Breathing Index Calculated in Spontaneous Ventilation

Objective: The rapid shallow breathing index (RSBI) is relatively the best predictive parameter for initial assessment of readiness for the discontinuation of mechanical ventilation (MV) support. In this study, we aimed to determine the best pressure combinations that can predict successful RSBI closest to the values calculated in spontaneous ventilation (SV). Methods: Twenty-five mechanically ventilated patients were enrolled in the study. RSBI and other weaning parameters were calculated in different combinations (pressure support ventilation (PSV) 5 cm H2O / positive-end expiratory pressure (PEEP) 5 cm H2O; PSV 0 cm H2O/PEEP 5 cm H2O; PSV 5 cm H2O/PEEP 0 cm H2O; PSV 0 cm H2O/PEEP 0 cm H2O) before T-tube trial in all patients. Results: The mean age of the patients was 73±10 years. RSBI did not differ significantly between SV and other combinations. The best correlation with SV was found with 5 cm H2O PSV-0 cm H2O PEEP (p=0.0001, r=0.719) and the worst with 0 cm H2O PSV-5 cm H2O PEEP. RSBI showed no predictive value for weaning success. Respiration rate (f) was higher in failure than in the success group in PSV 0 cm H2O/PEEP 5 cm H2O and PSV 5 cm H2O/PEEP 0 cm H2O (p=0.030, p=0.030, respectively). f≤27 was considered as a predictive factor for spontaneous breathing trial (SBT) success (PSV 0 cm H2O/PEEP 5 cm H2O; sensitivity 93%, specificity 63%, PSV 15 cm H2O-PEEP 5 cm H2O; sensitivity 81%, specificity 75%). Conclusion: There was a good correlation between RSBI measured by T-tube and different pressure combinations

Incidence of Type-1 Retinopathy of Prematurity in Premature Babies Born Small for Gestational Age

Purpose: To compare the incidence of type retinopathy of prematurity (ROP) in patients small for gestational age (SGA) and in patients appropriate for gestational age (AGA) in a developing country. Material and Method: We included in this study infants (n=162) with gestational age (GA) ≤34 weeks who were screened for ROP in a neonatal intensive care unit between June 2007 and December 2011 and were followed up until the retina was completely vascularized or ROP was regressed. Type 1 ROP was defined according to the ETROP study. To describe the incidence of type 1 ROP, data were analyzed in two main groups: (A) SGA-group and (B) AGA-group. SGA was defined as birth weight below the 10th percentile for gestational age. GA in weeks, birth weight (BW) in grams (g), ROP at any stage, type 1 ROP, and post menstrual age (PMA) at type 1 ROP were evaluated for the two groups. Retrospective review of records was performed. Results: BW (in mean±SD) was 832.45±131.74 g in group A and 962.97±351.47 g in group B; GA (in mean±SD) was 29.27±2.4 weeks in group A and 27.36±2.8 weeks in group B, with significant difference between the groups (p=0.001 vs. p<0.0001). Overall incidence of any-stage ROP was 41.2% in group A and 45.9% in group B, while type 1 ROP was 17.6% in group A and 15.3% in group B. PMA at type 1 ROP detection was 35±3.6 weeks in group A and 33.83±2.7 weeks in group B, without significant difference (p=0.57 vs. 0.44 vs. 0.23). In group A, the earliest diagnosis of type 1 ROP was 31 weeks PMA, the latest diagnosis was 43 weeks PMA. In group B, the earliest diagnosis of type 1 ROP was 32 weeks PMA, the latest diagnosis was 42 weeks PMA. Discussion: In groups A and B, larger infants may develop type 1 ROP and require treatment. Overall incidence of type 1 ROP in groups A and B is without significant difference. (Turk J Ophthalmol 2013; 43: 340-4

Intravitreal Bevacizumab Injection Therapy in a Case with Choroidal Neovascular Membrane Secondary to Toxoplasmosis Retinochoroiditis

A 57-year-old male patient presenting with visual loss in the left eye was diagnosed as choroidal neovascular membrane secondary to inactive toxoplasmosis retinochoroiditis scar. He underwent intravitreal bevacizumab injection as primary therapy. The choroidal neovascular membrane regressed partially and the initial visual acuity improved from 1/10 to 3/10. Intravitreal bevacizumab injection appears to be effective in the treatment of choroidal neovascular membrane secondary to toxoplasma retinochoroiditis. (Turk J Ophthalmol 2014; 44: 237-9

What Does Change with Nutrition Team in Intensive Care Unit?

Intrroduction: Clinical nutrition is the nutrition support therapy provided to patients under medical supervision at the hospital or home setting. It is a multidisciplinary task performed under the control of the physician, dietician, pharmacist and nurse. In this study, the changes in the patient admission statistics to the general intensive care unit (GICU), the exitus ratios, decubitus ulcer formation rates, albumin use rates, duration of the hospital stay, Acute Physiology and Chronic Health Evaluation (APACHE) II scores, rate of usege of parenteral and enteral products, and the change in expenses per patient within the first year of activity of the nutrition team in comparison to the previous year was presented. Material and Method: In this study a 6-bed GICU was used. The patients who was admitted through retrospective file scanning between 1 January 2012 and 31 December 2012 and between 1 January 2013 and 31 December 2013 were compared. Results: The number of the patients admitted to the GICU was 341 in 2012 and 369 in 2013. The number of the patients who died in 2012 was 86 (25.2%), while it was 106 in 2013 (28.7%). In 2012, 122 patients (35.7%) had decubitus ulcers, while this number was 92 (24.7%) in 2013. Human albumin usage was reduced by 23% for the 100 mL (225 in 2012, 175 in 2013) and by 33% for the 50 mL doses (122 in 2012, 82 in 2013). Duration of stay in the hospital was 6.3±0.9 vs. 5.8±0.9 (days) (p=0.06). The mean APACHE II scores were observed to be 24.7±6.9 vs. 30.5±11.4 (p=0.03). When the distribution of product types were analyzed, it was observed that the ratio of parenteral products: enteral products was 2:1 in 2012, however the ratio of enteral products to parenteral products was 2:1 in 2013. The daily expense of a patient decreased from 100 TL to 55 TL. Conclusion: The nutrition team directly influences the clinical process outcomes of patients under treatment in the ICU. It was thought that using appropriate nutritional products and natural

Could Individuals From Countries Using BCG Vaccination Be Resistant to SARS-COV-2 Induced Infections?

The lower than expected number of SARS-CoV-2 cases in countries with fragile health systems is puzzling. Herein, we hypothesize that BCG vaccination policies and vaccine strain preferences adopted by different countries might influence the SARS-CoV-2 transmission patterns and/or COVID-19 associated morbidity and mortality. We also postulate that until a specific vaccine is developed, SARS-CoV-2 vulnerable populations could be immunized with BCG vaccines to attain heterologous nonspecific protection from the new coronavirus. In the lights of our investigations the most resistant countries appear to be the ones using Group I BCG strain. Within these countries, however, those who employs Russian strain is even more protected against COVID-19 infection

Development of Optic Neuropathy and Foveal Pseudocyst in a Case of High-Voltage Electrical Injury: A Three-Year Follow-Up

A 35-year-old male patient had a decreased vision in his right eye, with a visual acuity of 20/400, after a high-voltage electrical injury. Corneal edema, Descemet’s membrane folds, cataract, macular hole, and optic neuropathy were detected in his right eye. Intravenous pulse steroids were administered. On the third day of treatment, the visual acuity in the right eye improved to 20/200 and the corneal edema resolved. Two months later, the patient’s visual acuity was still 20/200, while optic disc pallor, epiretinal gliosis, a non-fullthickness macular hole, and pseudo-cyst formation were detected in his right eye. Three years later, the macular pseudo-cyst formation transformed into an atrophic scar, while the patient’s visual acuity was the same. In conclusion, as a result of high-voltage electrical injury, serious ocular complications may develop. It is sufficient to refer those patients to an ophthalmologist for appropriate treatment and follow-up. (Turk J Ophthalmol 2014; 44: 410-2

A facile synthesis and assembly of ultrasmall Pt nanoparticles on reduced graphene oxide‑carbon black hybrid for enhanced performance in PEMFC

A new and straightforwardapproach for the synthesis of ultrasmalland monodisperse Pt nanoparticles(NPs) andtheir controlled assembly on graphene based supports including reduced graphene oxide (rGO), commercial car-bon black (VC) and rGO-VC hybrid were reported. These supported NPs were utilized as the electrocatalysts forpolymer electrolyte membrane fuel cells (PEMFC). Surfactant-assisted reduction of platinum(II) acetylacetonatein hot organic solution yielded 1.2 nm Pt NPs. These ultrasmall Pt NPs were decorated on rGO, VC and the rGO-VChybrid by using a simple liquid-phase self-assembly method. In the previous studies on Pt/rGO-VC hybrids, onone hand, Pt NPs were synthesized in situ on support, on the other hand, VC was added to synthesized Pt/rGO,and their fuel cell performance have been rarely shown. In our study, rGO and VC were directly mixed and pre-pared Pt NPs were assembled on rGO-VC hybrid support. Pt/rGO-VC hybrid electrocatalyst possessed substan-tially better electrocatalytic activity owing to better utilization of Pt compared to Pt/rGO and Pt/VC. Membrane electrode assemblies based on resultant catalysts were characterized in-situ in PEMFC. A superior PEMFC performance of 857 mW cm−2(maximum power density) was achieved with the hybrid catalyst as compared to Pt NPs supported on rGO or VC