- Cyst Masquerading as Inadvertent Bleb After a Scleral-Fixated Intraocular Lens in Marfan Syndrome: A Case Report. [Journal Article]
- OTOphthalmol Ther 2018 Aug 16
- CONCLUSIONS: Marfan syndrome is characterized by defects in the FBN1 gene and may theoretically lead to an abnormal sclera, increasing the risk of bleb formation after scleral incision. Distinguishing between a filtering bleb and an epithelial inclusion cyst is critical in patient care. Although retained keratin from a cyst may mimic a bleb with purulence, intraocular pressure, aqueous leakage, and response to topical antibiotics may help distinguish between the two.
- Micropulse Versus Continuous Wave Transscleral Cyclophotocoagulation in Refractory Pediatric Glaucoma. [Journal Article]
- JGJ Glaucoma 2018 Aug 14
- CONCLUSIONS: Both the micropulse and continuous wave cyclophotocoagulation are effective in lowering the IOP in children with refractory glaucoma. However, the rate of complications, pain and inflammation seem to be lower with the micropulse mode making it a safer alternative for cyclophotocoagulation, especially that retreatments are often needed.
- Safety and tolerability of lifitegrast ophthalmic solution 5.0%: Pooled analysis of five randomized controlled trials in dry eye disease. [Journal Article]
- EJEur J Ophthalmol 2018 Aug 16; :1120672118791936
- CONCLUSIONS: Lifitegrast ophthalmic solution 5.0% appeared to be safe and well tolerated for the treatment of dry eye disease. Drop comfort with lifitegrast improved within 3 min of instillation.
- Lung adenocarcinoma presenting with an orbital metastasis. [Journal Article]
- RMRespir Med Case Rep 2018; 25:116-118
- Orbital metastasis of lung adenocarcinoma is very rare. The incidence is only found to be approximately 7%-12% of lung cancer cases. The lack of knowledge about orbital metastasis results in misdiagn...
Orbital metastasis of lung adenocarcinoma is very rare. The incidence is only found to be approximately 7%-12% of lung cancer cases. The lack of knowledge about orbital metastasis results in misdiagnosis between malignant or benign lesion. This was a case of a 39-year-old woman complaining about a protruding left eye and a blind pain in the left eye characterized by hyperemesis eyeball. A CT scan of the orbital showed a soft tissue tumor in the fronto-naso-superomedial area of the left orbital with suspicion of infiltration of the medial rectus muscle, left bulbus oculi, lamina papyracea, and left frontal sinus wall which causes proptosis and soft tissue tumor in the left temporal region with suspicion of infiltration in the left sphenoid wing with an impression of metastasis. A Fine Needle Aspiration Biopsy (FNAB) in the temporal and intra-orbital region showed metastatic adenocarcinoma. Moreover, findings of the chest x-ray and chest CT scan concluded that there was a tumor in the left lung, and a bronchoscopy found adenocarcinoma as the biopsy results.
- Recurrent Ischemic Stroke: A Manifestation of a Sinus of Valsalva Pseudoaneurysm. [Case Reports]
- SDS D Med 2018; 71(8):346-348
- An 83-year-old female presented to the emergency department with bilateral eye pain, dizziness, and acute shortness of breath. Her blood pressure (BP) at presentation was 184/93 mmHg. She was admitte...
An 83-year-old female presented to the emergency department with bilateral eye pain, dizziness, and acute shortness of breath. Her blood pressure (BP) at presentation was 184/93 mmHg. She was admitted for hypertensive emergency and her symptoms improved with BP control. However, during hospitalization, she developed left-sided paresthesia which on investigation was found to be secondary to ischemic stroke. She had two previous aortic mechanical valve replacements for aortic stenosis. Transthoracic echocardiogram revealed a large pseudoaneurysm of the non-coronary sinus of Valsalva that we believe was the cause of her recurrent stroke. A sinus of Valsalva pseudoaneurysm is an uncommon complication of aortic valve replacement surgery which in turn has been associated with aortic rupture, myocardial infarction, and stroke. Our case identifies a situation where sinus of Valsalva pseudoaneurysm predisposed our patient to recurrent ischemic strokes and this should be kept in mind when evaluating a patient with ischemic stroke.
- Differences in clinical features and dengue severity between local and migrant Chinese with dengue infection in Singapore. [Journal Article]
- PlosPLoS One 2018; 13(8):e0201441
- Dengue is endemic in Singapore but not China. We compared clinical features and disease severity of dengue between local and migrant Chinese, most of whom were construction workers, in Singapore. A r...
Dengue is endemic in Singapore but not China. We compared clinical features and disease severity of dengue between local and migrant Chinese, most of whom were construction workers, in Singapore. A retrospective study with all hospitalized dengue patients from 2005 to 2008 were performed, including 2609 local and 1195 migrant Chinese. Compared with local Chinese, migrant Chinese were younger. There were more males, but fewer had comorbidities. Migrant Chinese had more headache, eye pain, nausea and myalgia. They had significantly lower median leukocyte count, ALT and AST, and higher platelet count nadir. Among warning signs, migrant Chinese had significantly less persistent vomiting, clinical fluid accumulation, hepatomegaly, hematocrit rise with rapid platelet drop, and more mucosal bleeding. Adjusted for age, gender and comorbidities, migrant Chinese were significantly at higher risk of dengue hemorrhagic fever (DHF) (adjusted odds ratio [aOR]: 1.20, 95% confidence interval [CI]: 1.03-1.41) and dengue shock syndrome (aOR: 1.49, 95% CI: 1.06-2.10), and had longer hospitalization (β coefficient value: 0.27, 95%CI: 0.09-0.44, p = 0.003). There was 1 death among migrant Chinese and 2 deaths among local Chinese. We documented differences in clinical and laboratory features, and dengue severity between local and migrant Chinese in Singapore. Migrant Chinese may need more medical attention given higher risk of DHF.
- Cervical C2 to C4 schwannoma with intratumoral hemorrhage presenting as acute spastic quadriparesis: A rare case report. [Journal Article]
- SNSurg Neurol Int 2018; 9:142
- CONCLUSIONS: Spinal schwannomas rarely present with intratumoral hemorrhage and acute spastic quadriparesis. Immediate operative decompression may lead to excellent postoperative neurological recovery.
- Content Validity of Anatomic Site-Specific Patient-Reported Outcomes Version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE) Item Sets for Assessment of Acute Symptomatic Toxicities in Radiation Oncology. [Journal Article]
- IJInt J Radiat Oncol Biol Phys 2018 Sep 01; 102(1):44-52
- CONCLUSIONS: PRO-CTCAE demonstrates strong content validity as a measure of symptomatic toxicities in patients receiving radiation. These results provide empirical support for the definition of site-specific PRO-CTCAE item sets to assess the symptomatic toxicities of radiation therapy. The site-specific PRO-CTCAE item sets developed herein are currently being deployed in our department via an electronic platform to capture treatment-related toxicity.
- Rutin protects against lipopolysaccharide-induced mastitis by inhibiting the activation of the NF-κB signaling pathway and attenuating endoplasmic reticulum stress. [Journal Article]
- IInflammopharmacology 2018 Aug 11
- Rutin, found widely in traditional Chinese medicine materials, is used to treat eye swelling and pain, hypertension, and hyperlipidemia. In the present study, a mouse mastitis model induced by lipopo...
Rutin, found widely in traditional Chinese medicine materials, is used to treat eye swelling and pain, hypertension, and hyperlipidemia. In the present study, a mouse mastitis model induced by lipopolysaccharide (LPS) was established to explore rutin's inhibitory mechanism on mastitis via nuclear factor kappa B (NF-κB) inflammatory signaling and the relationship between NF-κB signaling and endoplasmic reticulum (ER) stress. Mice were divided into six groups: Control group, LPS model group, LPS + rutin (25, 50, and 100 mg/kg) and LPS + dexamethasone (DEX) group. DEX, rutin, and PBS (control and LPS groups) were administered 1 h before and 12 h after perfusion of LPS. After LPS stimulation for 24 h, to evaluate rutin's therapeutic effect on mastitis, the mammary tissues of each group were collected to detect histopathological injury, tumor necrosis factor alpha (TNF-α), interleukin (IL)-1β, and IL-6 mRNA and protein levels; and glucose-regulated protein, 78 kDa (GRP78) protein levels. The protein and mRNA levels of TNF-α, IL-1β, and IL-6 in the LPS + rutin group were significantly lower than those in the LPS model group. Similarly, p50/p105, phosphorylated (p)-p65/p65 and p-inhibitor of nuclear factor kappa b kinase subunit beta (p-IKKβ)/IKKβ ratios in the LPS + rutin group (50 mg/kg) and LPS + rutin group (100 mg/kg) decreased significantly. GRP78 protein expression was significantly higher in LPS + rutin group (100 mg/kg). The structure of mammary tissue became gradually more intact and vacuolization of acini decreased as the rutin concentration increased. The nuclear quantity of p65 in the LPS + rutin group decreased significantly in a rutin dose-dependent manner. Rutin had an anti-inflammatory effect in the LPS-induced mouse mastitis model, manifested by inhibition of NF-κB pathway activation and attenuation of ER stress.
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- Long-acting liposomal corneal anesthetics. [Journal Article]
- BBiomaterials 2018 Aug 09; 181:372-377
- Eye drops producing long-acting ocular anesthesia would be desirable for corneal pain management. Here we present liposome-based formulations to achieve very long ocular anesthetic effect after a sin...
Eye drops producing long-acting ocular anesthesia would be desirable for corneal pain management. Here we present liposome-based formulations to achieve very long ocular anesthetic effect after a single eye drop instillation. The liposomes were functionalized with succinyl-Concanavalin A (sConA-Lip), which can bind corneal glycan moieties, to significantly prolong the dwell time of liposomes on the cornea. sConA-Lip were loaded with tetrodotoxin and dexmedetomidine (sConA-Lip/TD), and provided sustained release for both. A single topical instillation of sConA-Lip/TD on the cornea could achieve 105 min of complete analgesia and 608 min of partial analgesia, which was significantly longer than analgesia with proparacaine, tetrodotoxin/dexmedetomidine solution or unmodified liposomes containing tetrodotoxin and dexmedetomidine. sConA-Lip/TD were not cytotoxic in vitro to human corneal limbal epithelial cells or corneal keratocytes. Topical administration of sConA-Lip/TD provided prolonged corneal anesthesia without delaying corneal wound healing. Such a formulation may be useful for the management of acute surgical and nonsurgical corneal pain, or for treatment of other ocular surface diseases.