Sudden bilateral loss of vision in a 19-year-old man

Introduction: Posterior Reversible Leukoencephalopathy Syndrome (PRES) is caused by ischaemia commonly affecting the posterior cerebral vasculature. It presents with sudden decreased vision, headaches, nausea, vomiting, seizures, and altered mental status. Case presentation: A 19-year-old male presented to the ophthalmic emergency complaining of sudden bilateral loss of vision, which was down to light perception He reported headaches, nausea, and drowsiness since the previous day. He was a known case of hypertension secondary to IgA nephropathy. Magnetic resonance imaging (MRI) with STIR and FLAIR sequences showed foci of hyperintensity within the occipital lobes bilaterally. This confirmed the suspected diagnosis of PRES. Discussion: Aetiological factors of PRES include sudden increase in blood pressure, eclampsia, porphyria, renal disease, and Cushing syndrome. These lead to blood-brain barrier injury either by hyper- or hypoperfusion, endothelial dysfunction, changes in blood vessel morphology, hypocapnea, or immune system activation. Histopathological changes in PRES include activated astrocytes, scattered macrophages and lymphocytes, often in the absence of inflammation or neuronal damage. Conclusion: PRES is usually a reversible neuroophthalmological condition, however prompt recognition and appropriate management is important to prevent permanent brain injury or even death.peer-reviewe

Genetic basis of between-individual and within-individual variance of docility

Funded by Alces Software UCLA Academic Senate Division of Life Sciences National Geographic Society National Science Foundation. Grant Numbers: IDBR-0754247, DEB-1119660, DBI-0242960, DBI-0731346 University of Aberdeen Data deposited at Dryad: doi:10.5061/dryad.11vf0.Peer reviewedPostprin

An upper limb Functional Electrical Stimulation controller based on Reinforcement Learning: A feasibility case study.

Controllers for Functional Electrical Stimulation (FES) are still not able to restore natural movements in the paretic arm. In this work, Reinforcement Learning (RL) is used for the first time to control a hybrid upper limb robotic system for stroke rehabilitation in a real environment. The feasibility of the FES controller is tested on one healthy subject during elbow flex-extension in the horizontal plane. Results showed an absolute position error <1.2° for a maximum range of motion of 50°

Skin reactions triggered by the use of cosmetic products in nonspecific lipid transfer protein-sensitive patients.

Nonspecific lipid transfer proteins (nsLTPs) are members of the prolamine superfamily and they are found in pollen and food, as well as in latex. Due to the strong stability both against pepsin digestion and thermal denaturation, sensitisation towards these proteins is often associated with severe systemic reactions (angioedema, urticaria, asthma, anaphylaxis, etc.) following the ingestion of both raw or fresh food and cooked or preserved food. Many studies have shown reactivity towards nsLTPs both via inhalation and orally and in this study we present two cases of nsLTPs-sensitive patients who manifested the immediate onset of skin reactions following the use of cosmetic products containing these proteins. Thus, in order to prevent immediate reactions linked to their use, it is necessary to recommend nsLTPs-sensitive patients to avoid the topical use of products containing these proteins (and obviously the ingestion of foods containing these proteins)

Can pterygium excision with mitomycin C leaving bare sclera be salvaged?

Purpose The aim of this study was to analyze the recurrence rate of pterygium following excision with intra-operative mitomycin C (MMC) and post-operative scraping of the perilimbal conjunctival defect, and the patients’ satisfaction with this technique. Methods This is a retrospective analysis of a cohort of 33 eyes of 28 patients with primary or recurrent pterygium who underwent simple excision with MMC. They were followed up after a mean of 27.8 months. The main outcomes considered were the recurrence rate and patient satisfaction. A recurrence was defined as any regrowth of conjunctiva over the limbus and any complications were considered significant. The patients were interviewed with a standard questionnaire and examined. Results An objective recurrence was noted in 55% (18 out of 33 eyes). The recurrence rate after excision of primary pterygia was 46% (13 out of 28 eyes), and for recurrent pterygia it was 80% (four out of five eyes). In this study the complications included: six eyes that developed a granuloma, one case of bleeding which persisted for three days post-op, and one eye in which there was a suspected scleral melt at five weeks. 79% of the procedures resulted in a good patient satisfaction (26 out of 33 eyes), and only in 15% (five eyes) was there a subjective recurrence. Conclusions This technique in our study resulted in an unacceptably high recurrence rate, especially in the case of recurrent pterygia. However patients still tended to be satisfied with the outcome.peer-reviewe