An uncommon cause of progressive visual loss in a heavy smoker

Loss of vision due to eye metastasis is generally uncommon, representing an ophthalmological diagnostic and therapeutic challenge. We here report a case of a smoker patient finally diagnosed with lung cancer, whose  initial symptom was visual loss due to choroidal metastasis. Given that the majority of subjects presenting with uveal metastasis have already developed other distant metastases as well, a complete diagnostic  work-up of these patients is always required. Despite being rare, eye metastasis from a lung malignancy  should always be suspected in smokers presenting with progressive vision deterioration.Key words: Lung cancer, metastasis, choroi

Preservative-free versus preserved latanoprost eye drops for reducing intraocular pressure: a non-inferiority phase III randomized, multi-center, single-blind, parallel-group controlled trial

Background: The aim of this study was to test the non-inferiority of preservative-free (PF) latanoprost 50 μg/mL multi-dose ophthalmic solution versus the marketed benzalkonium chloride (BAK)-preserved latanoprost 50 μg/mL ophthalmic solution in patients with open-angle glaucoma and patients with ocular hypertension. Methods: This was a prospective, national, randomized, multi-center, observer-blind, parallel-group controlled clinical trial. Patients were randomized to receive either PF or BAK-preserved latanoprost once daily for 12 weeks. The primary endpoint was the change in intraocular pressure (IOP) at 8:00 AM in the affected eye between the end of the treatment (week 12) and the baseline (week 0). Secondary measurements were taken at weeks 2 and 6, with IOP being recorded at 8:00 AM, 12:00 PM, and 4:00 PM. Results: A total of 158 patients were included in the per protocol (PP) population (77 in the PF latanoprost treatment arm and 81 patients in the BAK-preserved latanoprost treatment arm). PF latanoprost was non-inferior to BAK-preserved latanoprost in reducing IOP at 8:00 AM in the study eye from the baseline (week 0) to the end of the treatment (week 12). The point estimate of the between-treatment difference was 0.1 mmHg (95% confidence interval: -0.646, 0.847). Mean between-group differences in IOP reduction from the baseline to each of the secondary measurements were also similar between the two treatment arms. The two treatments were well tolerated and had comparable adverse event profiles. Conclusions: PF latanoprost was non-inferior to BAK-preserved latanoprost in reducing IOP in patients with open-angle glaucoma or ocular hypertension. Both treatments were well tolerated

Non-inferiority evaluation of preservative-free latanoprost/timolol eye drops solution versus preserved latanoprost/timolol eye drops in patients with high intraocular pressure and open-angle glaucoma

Background: This study aimed to evaluate the non-inferiority and safety of a newly developed preservative-free (PF) multi-dose latanoprost/timolol ophthalmic solution, compared with the benzalkonium chloride (BAK)-preserved fixed combination, in patients with open-angle glaucoma and ocular hypertension.Methods: A Phase III randomized multi-center observer-blind parallel-group clinical trial was conducted. A total of 210 adult patients (aged over 18 years) were randomly treated with the PF- or the BAK-preserved latanoprost/timolol solution once daily in the affected eye(s) for 12 weeks. Follow-up visits were scheduled at weeks 2, 6, and 12; intraocular pressure (IOP) was recorded at 8:00 AM, 12:00 PM, and 4:00 PM. The primary efficacy endpoint to prove non-inferiority was the IOP change at 8:00 AM (± 1 hour) from the baseline to the end of treatment (week 12) in the studied eye. Safety parameters were also assessed.Results: In total, 196 patients completed the study. The pressure-lowering effect of the PF eye drops was comparable to that of the preserved formulation at all time points. Latanoprost/timolol PF formulation was non-inferior to the BAK-preserved solution as shown by the change in IOP from day 0 to week 12. The point estimate of the inter-treatment difference was 0.624 mmHg (95% CI: -0.094, 1.341). Both treatments were well-tolerated during the study, and they had similar adverse event profiles.Conclusions: PF-latanoprost/timolol combination was found to be non-inferior to the BAK-preserved formulation based on the efficacy at all times, with similar local tolerance

Double auricles of the right atrium: a unique anatomic deformity

<p>Abstract</p> <p>Background</p> <p>Anatomic deviations, especially those detected during the course of an operation, are medically intriguing, as they raise concerns about their clinical significance and putative complications.</p> <p>Case presentation</p> <p>We present, to our knowledge, for the first time a case of an anatomic deviation in the form of a second right atrial auricle in a 70 year-old, coronary bypass-operated male Caucasian patient of Greek origin. No complications were noted intra-or postoperatively.</p> <p>Conclusions</p> <p>A second right atrial auricle was found intraoperatively, without causing any clinical complications, or obstructing the normal course of a surgical procedure.</p

Characterizing neonatal vitamin D deficiency in the modern era : a maternal-neonatal birth cohort from Southern Europe

International audienc

Vitamin D Receptor Fokl polymorphism is a determinant of both maternal and neonatal Vitamin D concentrations at birth

© 2019 Elsevier Ltd Maternal vitamin D deficiency is considered to be the key determinant of the development of neonatal vitamin D deficiency at birth and during early infancy. Specific vitamin D receptor (VDR) gene polymorphisms have been associated with adverse pregnancy and offspring outcomes. The aim of this study was to evaluate the effect of maternal and neonatal VDR polymorphisms (ApaI, TaqI, BsmI, FokI, Tru9I) on maternal and neonatal vitamin D status. VDR polymorphisms were genotyped in 70 mother-neonate pairs of Greek origin, and classified according to international thresholds for Vitamin D status. Mean neonatal and maternal 25-hydroxy-vitamin D [25(OH)D] concentrations were 35 ± 20 and 47 ± 26 nmol/l, respectively. Neonatal VDR polymorphisms were not associated with neonatal 25(OH)D concentrations. In contrast, mothers with the Fokl FF polymorphism had a 70 % lower risk of vitamin D deficiency [25(OH)D \u3c30 nmol/l] compared with ff ones, after adjustment for several confounders. They were also in 73 % and 88 % lower risk of giving birth to vitamin D deficient [25(OH)D \u3c30 nmol/l] neonates compared with Ff and ff mothers, respectively. These results suggest a protective role of maternal Fokl FF genotype against both maternal and neonatal vitamin D deficiency. Further studies are needed to clarify the complex gene-gene and gene-environment interactions that determine vitamin D status at birth

Pertussis Reinfection in an Adult: A Cause of Persistent Cough Not to Be Ignored

Pertussis is traditionally considered as a disease of the childhood; however, accumulating evidence suggests a stable increase of its incidence among adults and adolescents, during the last decades. Despite the fact that reinfection after natural disease or vaccination is not uncommon, the index of clinical suspicion of pertussis diagnosis in adults remains low. In this article, we report a case of pertussis reinfection 30 years after natural infection, which was complicated by pneumonia, and we discuss our diagnostic and therapeutic approach, aiming to raise clinicians’ degree of suspicion regarding pertussis diagnosis in adults. Prompt recognition and appropriate therapy of adult patients can result in the effective control of the symptoms, prevention of severe complications, and spread of the infection to children; thus, they are of great clinical and public health importance

Functional, Flavor and Visual Traits of Hydroponically Produced Tomato Fruit in Relation to Substrate, Plant Training System and Harvesting Time

Currently, a great portion of tomatoes is produced by soilless cultivation systems and the substrate selection among the various materials is one of the most important factors affecting yield and quality traits. On the other hand, grafting has been successfully used in soilless systems to ensure long-term cultivation. However, due to the high cost of grafted seedlings, plant training systems are sought. Given the fact that most literature refers to studies intended to mainly reveal production differences among treatments and the quality aspect was secondary, the present study was focused on the evaluation of tomato fruit functionality, flavor and visual traits. Tomato plants cv ‘Beef Bang F1’ were cultivated in a glasshouse hydroponic culture in four substrates: rockwool slabs, perlite in sacks, pumice in sacks and pumice in 9 L pots. The type of cultivated plants used were self-rooted or grafted onto ‘Defensor’ trained in single and double stems. Tomato fruit were harvested three times during the season (6 June, 31 July, 6 November). The fruit quality was measured based on visual (average fruit mass, and Minolta color values), flavor (dry mass, soluble solids content, titratable acidity, pH, flesh firmness) as well as functional traits (total phenolic content, ascorbic acid, lycopene, β-carotene, total carotenoid content and antioxidant capacity). Harvest time was the most important factor followed in many of these cases by the substrate (flavor and functional traits), as well as in certain cases by the plant grafting/training (flavor traits and antioxidants) or by both in some flavor traits and antioxidants. Correlation of color values with lycopene, though significant, was weak. Each individual harvest time revealed the rise in different parameters. Pumice, whether used in pot or in sack, enhanced the visual and flavor attributes the most, self-rooted plants and mid-summer harvest resulted in the highest tomato fruit quality