- StatPearls [BOOK]
- BOOKStatPearls Publishing: Treasure Island (FL)
- The FDA-approved indication for intravenous (IV) phenylephrine hydrochloride is for increasing blood pressure in adults with clinically significant hypotension resulting primarily from vasodilation i...
The FDA-approved indication for intravenous (IV) phenylephrine hydrochloride is for increasing blood pressure in adults with clinically significant hypotension resulting primarily from vasodilation in such settings as septic shock or anesthesia. Phenylephrine HCL is also used over-the-counter in ophthalmic formulations to promote mydriasis and conjunctival blood vessel vasoconstriction, intranasal administration as a treatment for uncomplicated nasal congestion, and as an over-the-counter additive to topical hemorrhoid medications. Phenylephrine is less commonly used in an off-label fashion as an additive to neuraxial/peripheral nerve blockade, to treat priapism and other conditions where local vasoconstrictive effects and reduced blood flow are desired. In the setting of IV administration, phenylephrine is a commonly used anesthetic vasopressor for patients with normal cardiac function and hypotension secondary to the vasodilatory effect of anesthetic medications or non-cardiac shock states.
- Benign episodic unilateral mydriasis in children: presentation and features in 2 young siblings. [Letter]
- CJCan J Ophthalmol 2018; 53(6):e255-e256
- How pupil responses track value-based decision-making during and after reinforcement learning. [Journal Article]
- PCPLoS Comput Biol 2018 Nov 30; 14(11):e1006632
- Cognition can reveal itself in the pupil, as latent cognitive processes map onto specific pupil responses. For instance, the pupil dilates when we make decisions and these pupil size fluctuations ref...
Cognition can reveal itself in the pupil, as latent cognitive processes map onto specific pupil responses. For instance, the pupil dilates when we make decisions and these pupil size fluctuations reflect decision-making computations during and after a choice. Surprisingly little is known, however, about how pupil responses relate to decisions driven by the learned value of stimuli. This understanding is important, as most real-life decisions are guided by the outcomes of earlier choices. The goal of this study was to investigate which cognitive processes the pupil reflects during value-based decision-making. We used a reinforcement learning task to study pupil responses during value-based decisions and subsequent decision evaluations, employing computational modeling to quantitatively describe the underlying cognitive processes. We found that the pupil closely tracks reinforcement learning processes independently across participants and across trials. Prior to choice, the pupil dilated as a function of trial-by-trial fluctuations in value beliefs about the to-be chosen option and predicted an individual's tendency to exploit high value options. After feedback a biphasic pupil response was observed, the amplitude of which correlated with participants' learning rates. Furthermore, across trials, early feedback-related dilation scaled with value uncertainty, whereas later constriction scaled with signed reward prediction errors. These findings show that pupil size fluctuations can provide detailed information about the computations underlying value-based decisions and the subsequent updating of value beliefs. As these processes are affected in a host of psychiatric disorders, our results indicate that pupillometry can be used as an accessible tool to non-invasively study the processes underlying ongoing reinforcement learning in the clinic.
- Ophthalmic Insert versus Eye Drops for Mydriasis in Neonates: A Randomized Clinical Trial. [Journal Article]
- NNeonatology 2018 Nov 27; 115(2):142-148
- CONCLUSIONS: The degree of mydriasis achieved with Mydriasert® was noninferior to that obtained with eye drops. The insert appears to be safe to use in neonates without a history of increased vagal tone or gastrointestinal reflux.
- Factors influencing pupil behaviour during femtosecond laser assisted cataract surgery. [Journal Article]
- CLCont Lens Anterior Eye 2018 Nov 14
- CONCLUSIONS: FLACS can result in significant pupil miosis. Eyes particularly at risk are ones with smaller pre-operative pupils and shallower anterior chambers and those subjected to longer suction on time. Well-timed NSAIDs application could be protective against this phenomenon.
- Pharmacokinetics of low-dose and high-dose buprenorphine in cats after rectal administration of different formulations. [Journal Article]
- JFJ Feline Med Surg 2018 Nov 14; :1098612X18810933
- CONCLUSIONS: The rectal application of buprenorphine at a dose of 0.1 mg/kg revealed a potential but weak uptake in cats. Regarding effective concentrations in previous pharmacokinetic investigations, rectal administration is currently not recommended for good provision of opioid analgesia in cats. Pharmacological investigations of formulation and galenics in order to improve the rectal bioavailability of buprenorphine remain to be clarified before further dose-finding and pharmacokinetic/pharmacodynamic studies are performed.
- Phakic intraocular lens as a temporary barrier in aphakic Descemet's membrane endothelial keratoplasty. [Journal Article]
- EJEur J Ophthalmol 2018 Nov 13; :1120672118811743
- Descemet's membrane endothelial keratoplasty has a lower risk of endothelial rejection than Descemet's stripping automated endothelial keratoplasty. In aphakic eyes requiring endothelial transplantat...
Descemet's membrane endothelial keratoplasty has a lower risk of endothelial rejection than Descemet's stripping automated endothelial keratoplasty. In aphakic eyes requiring endothelial transplantation, approaches aimed at reducing the risk of posterior graft dislocation in Descemet's stripping automated endothelial keratoplasty are not transferable to Descemet's membrane endothelial keratoplasty.
- Systematic review and meta-analysis of diagnostic accuracy of detection of any level of diabetic retinopathy using digital retinal imaging. [Journal Article]
- SRSyst Rev 2018 Nov 07; 7(1):182
- CONCLUSIONS: Non-mydriatic two-field strategy could be a more pragmatic approach in starting DRS programmes for facility-based PwDM in low-income settings, with dilatation of the pupils of those who have ungradable images. There was insufficient evidence in primary studies to draw firm conclusions on how graders' background influences DTA. Conducting more context-specific DRS validation studies in low-income and non-ophthalmic settings can be recommended.
- Toy gun eye injuries - eye protection needed Helsinki ocular trauma study. [Journal Article]
- AOActa Ophthalmol 2018 Nov 02
- CONCLUSIONS: Toy guns cause serious eye traumas. No glaucoma was found. Proper use of toy guns and protective eyewear during the whole game should be emphasized to both players and bystanders. We recommend that in Finland the selling of airsoft guns be placed under the Firearms Act to make the hazards of airsoft guns known.
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- A Rare Cause of Acute Anisocoria in a Child: The Angel's Trumpet Plant. [Case Reports]
- JPJ Pediatr Ophthalmol Strabismus 2018 Nov 02; 55:e33-e35
- Anisocoria is a significant finding in several ocular and potentially life-threatening neurological disorders. The angel's trumpet (Datura suaveolens), widely used as a garden plant, is a natural alk...
Anisocoria is a significant finding in several ocular and potentially life-threatening neurological disorders. The angel's trumpet (Datura suaveolens), widely used as a garden plant, is a natural alkaloid with anticholinergic effects containing high levels of scopolamine. The authors present a pediatric case of acute anisocoria secondary to contact with the angel's trumpet plant. This case report emphasizes the importance of considering herbal mydriatics in patients with acute, isolated, unilateral mydriasis. It is also important to raise public awareness about the potential risks of the angel's trumpet plant, particularly in areas close to schools and playgrounds. [J Pediatr Ophthalmol Strabismus. 2018;55:e33-e35.].