Future Problems of Uncorrected Refractive Errors in Children

Visual impairment secondary to uncorrected refractive errors in childhood is an important health problem, and can lead social, educational and economical disability in adulthood. In this study, we reviewed the literature to reveal future effects of refractive errors in children on social life. Refractive problems can be easily corrected with spectacles as a cost effective treatment modality. However, recognizing refractive errors in children at family or school level is critical. Screening programs are valuable to prevent refractive error related vision loss in children. Moreover, awareness campaigns and education can help to overcome all barriers against visual rehabilitation. In conclusion, collaboration among teacher, parents, ophthalmologist and child should be well established to prevent visual disability and related socio-economical problems. (C) 2014 The Authors. Published by Elsevier Ltd

Factors affecting outcomes of corneal collagen crosslinking treatment

PurposeTo assess the effects of preoperative patient characteristics on clinical outcomes of corneal crosslinking (CXL) treatment in patients with progressive keratoconus.MethodsThis retrospective study comprised 96 eyes of 96 patients who had unilateral CXL treatment for progressive keratoconus. All patients underwent a complete ophthalmological examination and corneal topography at baseline and 1 year. Subgroup analyses were performed according to the age (0.05).ConclusionsIn patients with progressive keratoconus, age, baseline visual acuity, and baseline thinnest pachymetry seem to affect the success of the CXL treatment. © 2014 Macmillan Publishers Limited All rights reserved

Fuchs endothelial corneal dystrophy and keratoconus: A very rare coincidence

It was aimed to represent a case with concurrent Fuchs endothelial corneal dystrophy (FECD) and keratoconus (KC) as a rare entity. A 35-year-old woman had a best-corrected visual acuity was 20/20 in the right eye and 20/60 in the left eye (Snellen). Biomicroscopy revealed bilateral cornea guttata and Fleischer ring in the left eye. Corneal topography demonstrated early KC in the right eye and advanced KC in the left eye. Maximum keratometry (Kmax) and pachymetry at the thinnest location were 46.2 diopters (D) in the right eye and 56.3 D in the left eye, and 530 and 495 microns, respectively. Corneal thinning in KC and subclinical corneal thickening in FECD might lead delay in disease diagnosis

Increased systemic oxidative stress in patients with keratoconus

PurposeTo establish the effect of systemic oxidative stress on the pathogenesis of keratoconus by measuring serum total oxidant status (TOS) and total antioxidant status (TAS) in patients with keratoconus.MethodsTwenty-five patients with keratoconus (keratoconus group) and 25 age-sex-matched healthy subjects (control group) were enrolled in the study. Exclusion criteria were smoking habit, history of any other corneal pathology, systemic disease or inflammation, and current antioxidant or anti-inflammatory therapies. All participants underwent a detailed ophthalmological examination and corneal topography. Serum samples were obtained from all participants. Oxidative stress markers (TAS and TOS) were measured using a commercial kit and oxidative stress index (OSI) was calculated.ResultsThe study comprised 25 patients with keratoconus (mean age of 26.4±1.7 years) and 25 healthy control subjects (mean age of 26.6±1.7 years) (P>0.05). The serum TOS and OSI values were significantly higher in patients with keratoconus compared with those of the controls (P=0.036 and 0.037, respectively). However, serum TAS did not show significant difference between the keratoconus and control groups (P=0.497).ConclusionsThe higher levels of serum oxidant status and OSI in patients with keratoconus suggest that systemic oxidative stress might be involved in the pathogenesis of keratoconus. © 2014 Macmillan Publishers Limited

Lacrimal Gland Fistula following Severe Head Trauma

We aim to present a unique case with discharging lacrimal gland fistula secondary to severe head trauma by an animal. A 9-year-old girl presented with serous fluid discharge from a cutaneous fistula in the left orbital region. The patient had history of surgery for traumatic frontal bone fracture and skin laceration in the superior orbital rim three weeks earlier. She underwent a complete ophthalmological examination and there was no anterior segment or fundus pathology. The orifice of the fistula was detected in mediolateral part of the left superior orbital rim and fluid secretion was increasing with irritation of the left eye. Neurosurgical complications were excluded and radiological assessment was nonremarkable. The patient’s legal representatives were informed and lacrimal gland fistulectomy was planned. However, the fistula was self-closed one week after initial ophthalmological examination, and the patient had no symptoms. In conclusion, traumatic injuries of superior orbital region should be carefully evaluated and wounds should be well closed to prevent consecutive lacrimal gland fistula

Influence of Febrile Neutropenia Period on Plasma Viscosity at Malignancy

Cancer, chemotherapy, and infections all together make changes in blood rheology and may affect the defense mechanisms by changing the thrombocyte function and endothelial cell. We have examined changes of blood rheology on plasma viscosity to put on probable following criteria for starting the treatment of febrile neutropenia immediately. A total of 27 postchemotherapy patients (16 males and 11 females) with febrile neutropenia diagnosed according to international guidelines have been included into the study. The plasma viscosity of the patients whose febrile neutropenia has been successfully treated was also measured to assess the impact of the duration of neutropenia on viscosity. The plasma viscosities of the patients were significantly higher during neutropenic episode than in nonneutropenic state () except for alkaline phosphatase. All study parameters, particularly acute phase reactants, were statistically similar during both states. In the correlation of analysis with study parameters and stages, significant correlation was not observed between plasma viscosity alteration and leukocyte-neutrophil alteration, also other study parameters. We have demonstrated significantly elevated plasma viscosity in our patients during febrile neutropenic episode. Despite normal values of various parameters known to trigger plasma viscosity, particularly fibrinogen, it can be easily argued that the main mechanism may be the endothelial injury during infectious process and immune response mediated microcirculatory blood flow alterations

Chemerin as a marker of subclinical cardiac involvement in psoriatic patients

Background: Chemerin has been associated with psoriasis and inflammation, but there are no studies demonstrating an association between chemerin and subclinical cardiac involvement in psoriatic patients. Therefore, the present study aimed to evaluate whether psoriatic patients with increased epicardial fat tissue, impaired flow-mediated dilatation, and diastolic dysfunction have higher serum chemerin levels than a healthy control group. Methods: The study included 60 psoriatic patients and 32 healthy controls. Echocardiographic parameters, epicardial fat tissue, flow-mediated dilatation, and chemerin levels were recorded for both groups. Results: The serum levels of chemerin in the psoriatic patients were significantly higher than in the control group. The diastolic function parameters, including isovolumic contraction and relaxation time, E’/A’ (early diastolic mitral annular velocity/late diastolic mitral annular velocity), and E/E’ (early diastolic peak velocity of mitral inflow/early diastolic mitral annular velocity) values, differed significantly between the groups. Epicardial fat tissue was significantly higher and flow-mediated dilatation was significantly lower in psoriatic patients than in the controls. Chemerin was significantly positively correlated with age, body mass index, systolic and diastolic blood pressures, waist circumference, E/E’, and epicardial fat tissue. Serum chemerin was significantly negatively correlated with E’, E’/A’, and flow-mediated dilatation. A multiple linear regression analysis showed that chemerin was independently correlated with E/E’. Conclusions: Psoriatic patients exhibit early subclinical atherosclerosis and diastolic dysfunction. Chemerin can be used as a marker to screen for patients with subclinical cardiac involvement

Effects of Storage Temperature and Time on Stability of Serum Tacrolimus and Cyclosporine A Levels in Whole Blood by LC-MS/MS

Tacrolimus and cyclosporine A are immunosuppressant drugs with narrow therapeutic windows. The aim of this study was to investigate the stability of tacrolimus and cyclosporin A levels in whole blood samples under different storage conditions. Whole blood samples were obtained from 15 patients receiving tacrolimus and 15 patients receiving cyclosporine A. Samples were immediately analyzed and then stored at different conditions (room temperature (24°C−26°C) for 24 hours, +4°C for 24 and 48 hours, and −20°C for one month) and then analyzed again. For tacrolimus, there was a significant difference between samples analyzed immediately and those kept 24 hours at room temperature (P=0.005) (percent change 32.89%). However, there were no significant differences between the other groups. For cyclosporine A, there was a significant difference between samples analyzed immediately and those kept 24 hours (P=0.003) (percent change 19.47%) and 48 hours (P=0.002) (percent change 15.38%) at +4°C and those kept 24 hours at room temperature (P=0.011) (percent change 9.71%). Samples of tacrolimus should be analyzed immediately or stored at either +4°C or −20°C, while samples of cyclosporine A should be analyzed immediately or stored at −20°C

Lateral gene transfer acts as an evolutionary shortcut to efficient C4 biochemistry

The adaptation of proteins for novel functions often requires changes in their kinetics via amino acid replacement. This process can require multiple mutations, and therefore extended periods of selection. The transfer of genes among distinct species might speed up the process, by providing proteins already adapted for the novel function. However, this hypothesis remains untested in multicellular eukaryotes. The grass Alloteropsis is an ideal system to test this hypothesis due to its diversity of genes encoding phosphoenolpyruvate carboxylase (PEPC), an enzyme that catalyses one of the key reactions in the C4 pathway. Different accessions of Alloteropsis either use native isoforms relatively recently co-opted from other functions or isoforms that were laterally acquired from distantly related species that evolved the C4 trait much earlier. By comparing the enzyme kinetics we show that native isoforms with few amino acid replacements have substrate KM values similar to the non-C4 ancestral form, but exhibit marked increases in catalytic efficiency. The co-option of native isoforms was therefore followed by rapid catalytic improvements, which appear to rely on standing genetic variation observed within one species. Native C4 isoforms with more amino acid replacements exhibit additional changes in affinities, suggesting that the initial catalytic improvements are followed by gradual modifications. Finally, laterally acquired genes show both strong increases in catalytic efficiency and important changes in substrate handling. We conclude that the transfer of genes among distant species sharing the same physiological novelty creates an evolutionary shortcut toward more efficient enzymes, effectively accelerating evolution