Effect of Ex-PRESS glaucoma filtration device on corneal endothelium in primary open-angle glaucoma

Purpose The aim of this study is to compare the effect of Ex-PRESS minishunt versus standard trabeculectomy on corneal endothelial cell count (ECC) in cases of primary open-angle glaucoma. Setting This comparative prospective nonrandomized study was conducted at Mansoura Ophthalmic Center, Mansoura University, Mansoura, Egypt. Patients and methods The study included 36 eyes of 25 patients with uncontrolled primary open-angle glaucoma. Nineteen eyes had Ex-PRESS glaucoma minishunt and 17 eyes had trabeculectomy. Specular microscopy was used to measure ECC using TOMEY EM-3000. ECC was measured preoperatively and compared with postoperative values at 6 and 12 months. Results The mean endothelial cell density was 2493.2±246.8 cells/mm2 before the surgery in the Ex-PRESS group and 2473.8±259.8 cells/mm2 in the trabeculectomy group (P=0.82). This value decreased significantly in both groups at 12 months postoperatively to 2348.1±309.5 in the Ex-PRESS group and 2276.1±342.4 in the trabeculectomy group. ECC loss at 1 year was less in the Ex-PRESS group at 5.7 versus 8% in the trabeculectomy group (P=0.051). Conclusion Ex-PRESS minishunt is considered a safe procedure regarding corneal endothelium, showing less decrease in ECC than conventional trabeculectomy

Efficacy of Epicardially Delivered Adipose Stromal Cell Sheets in Dilated Cardiomyopathy

International audienceno abstrac

Inducción con anticuerpos antilinfocitarios y minimización de esteroides en trasplante renal

Steroid minimization after kidney transplantation has become more widely practiced as transplant clinicians seek the potential benefits such as reduced cardiovascular risk factors, improved growth in pediatric patients, and improved compliance with the immunosuppression regimen. Steroid avoidance (i.e. no steroids after the first week) is generally favored compared to later withdrawal. Induction therapy is routine in this setting, frequently rabbit antithymocyte globulin (rATG, Thymoglobulin®) or off-license use of alemtuzumab. Direct comparisons of steroid minimization regimens versus standard steroid regimens are rare. However, the available data show that the risk of acute rejection is low when rATG or alemtuzumab induction is given to support steroid-avoidance regimens after kidney transplantation. Steroid avoidance may be inadvisable in patients at high immunological risk or at risk of recurrent glomerular disease. Steroid withdrawal after day 8 may be possible without additional risk of rejection in patients iven rATG induction, but while encouraging, the data are too sparse for firm onclusions. In summary, steroid avoidance may be beneficial for patients after renal transplantation, with the potential to avoid or reduce steroid-related comorbidities. Whilst depleting induction therapy could be the treatment of choice, results of prospective randomized, controlled studies are eagerly awaitedJulio Pascual and Marta Crespo are supported by grants FIS PI13/00598 and Redinren RD12/0021/0024