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  • Rivas McKenna posted an update 1 year, 6 months ago

    Of the 275 plaque procedures over a 30-year period that were reviewed, there were no internally or externally reportable patient or radiation safety events. read more There were no adverse events related to patient transportation to the hospital, the patient not returning for plaque removal, operative issues in removing the plaque on time due to cancelled or delayed cases, or loss of radioactive material. Additionally, our cost-benefit analysis estimates that outpatient brachytherapy reduced costs for USC’s patients in 2018 by an average of $24,722 per patient treated with ocular brachytherapy.

    With appropriate measures, outpatient ocular brachytherapy allows patients to safely return home with the added benefit of decreased financial burden for both patients and the broader health care system.

    With appropriate measures, outpatient ocular brachytherapy allows patients to safely return home with the added benefit of decreased financial burden for both patients and the broader health care system.As the coronavirus disease 2019 (COVID-19) pandemic continues to disrupt nearly all facets of daily life, residency programs must ensure the safety and wellness of their residents while maintaining a commitment to their training and advancement. In addition to standard clinical training, radiation oncology residency programs integrate highly specialized elements specific to the delivery of radiation therapy. Few publications have addressed the significant effects of the pandemic on medical training and even fewer have addressed concerns specific to radiation oncology. We report our experience developing a resident-led adaptation of our training program in response to the COVID-19 pandemic with the aim of assisting other programs to meet this challenge.The dorsal striatum forms part of the basal ganglia circuit that is a major regulator of voluntary motor behavior. Dysfunction in this circuit is a critical factor in the pathology of neurological (Parkinson’s and Huntington’s disease) as well as psychiatric disorders. In this study, we employed in vivo real-time monitoring of multiple unit neural activity (MUA) in the dorsal striatum of freely moving mice. We demonstrate that the striatum exhibits robust diurnal and circadian rhythms in MUA that peak in the night. These rhythms are dependent upon the central circadian clock located in the suprachiasmatic nucleus (SCN) as lesions of this structure caused the loss of rhythmicity measured in the striatum. Nonetheless, chronic treatment of methamphetamine (METH) makes circadian rhythms appear in MUA recorded from the striatum of SCN-lesioned mice. These data demonstrate that the physiological properties of neurons in the dorsal striatum are regulated by the circadian system and that METH drives circadian rhythms in striatal physiology in the absence of the SCN. The finding of SCN-driven circadian rhythms in striatal physiology has important implications for an understanding of the temporal regulation of motor control as well as revealing how disease processes may disrupt this regulation.

    To assess the short and long-term changes in Visual Field (VF) Mean Deviation (MD), Visual Field Index (VFI), and intraocular pressure (IOP) after femtosecond laser-assisted cataract surgery (FLACS) in glaucomatous eyes.

    Interventional, prospective case series. Patients with glaucoma, who required cataract surgery were included. All patients underwent a complete ophthalmologic assessment and Visual Fields. FLACS was performed in all patients by a single experienced surgeon. IOP was measured during surgery immediately before and after pretreatment suction docking. Changes from baseline in VF MD and VFI, IOP, visual acuity (VA), and number of glaucoma medications were evaluated up to one-year follow-up.

    Fourteen eyes of 11 patients were included. Eighty-five percent were female, with a mean age of 74.2±7.9 years. Nine (64.3%) and 5 (35.7%) were diagnosed with primary angle closure glaucoma (PACG) and primary open angle glaucoma (POAG), respectively. We found a slight IOP reduction after the docking phase at final follow-up showed a reduction from baseline. There was no change in VF MD and VFI from baseline to final one-year follow-up. FLACS appears to be well tolerated in early and moderate glaucoma and appears to be a safe tool for glaucoma patients undergoing cataract surgery. Similar results to traditional surgery can be obtained with the advantages of femtosecond laser precision.

    Cytomegalovirus (CMV) retinitis is one of the most common opportunistic infections in immunocompromised patients, including patients with acquired immunodeficiency syndrome (AIDS). CMV retinitis in non-human immunodeficiency virus (HIV)-infected patients has been reported with variable presentations. Significant intraocular inflammation is common, and visual prognosis is poor if not properly managed.

    We present a case of presumed CMV retinitis in a non-immunocompromised breast cancer patient that occurred during cancer treatment. The ocular symptoms developed one day after partial mastectomy with intra-operative radiotherapy following five months of chemotherapy treatment. Ocular manifestations included panuveitis with mild peripheral retinitis.

    Early diagnosis and prompt treatment with oral valganciclovir based on the clinical manifestation and serologic test findings helped to preserve vision.

    Early diagnosis and prompt treatment with oral valganciclovir based on the clinical manifestation and serologic test findings helped to preserve vision.

    We present a case of acute onset of bilateral choroidal effusions leading to angle closure glaucoma attributed to multiple mechanism of actions causing ciliary body and aqueous flow disruption in the setting of topical glaucoma therapy with latanoprost, brimonidine 0.2%, and Brinzolamide 0.1%.

    The patient presented with ocular hypertension in the setting of bilateral choroidal effusions, leading to angle closure without pupillary block. After cessation of the glaucoma drops and starting steroids and cycloplegics, the patient’s symptoms resolved.

    This case report highlights the various physiological mechanisms of action that can induce angle closure glaucoma from commonly used topical medications for glaucoma treatment. Thus, a keen awareness is warranted of this idiosyncratic reaction in order to avoid morbidity and long term vision loss.

    This case report highlights the various physiological mechanisms of action that can induce angle closure glaucoma from commonly used topical medications for glaucoma treatment. link2 Thus, a keen awareness is warranted of this idiosyncratic reaction in order to avoid morbidity and long term vision loss.

    We present a novel case of a neurotrophic keratopathy associated inflammatory hypopyon that resolved after initiation of therapy with cenegermin (Oxervate; Dompe, Milan, Italy), a recombinant human nerve growth factor (rhNGF). link3 This finding illustrates the potential of cenegermin in advanced inflammatory neurotrophic disease.

    A 60-year-old female with a history of herpes zoster keratitis was evaluated in our clinic for stage 2 neurotrophic keratopathy. One month later, she presented emergently with a large epithelial defect, infiltrate, and hypopyon. Three separate sets of corneal cultures returned negative. She was treated with oral antivirals and aggressive topical antibiotics with no clinical improvement. Given the presumed diagnosis of stage 3 neurotrophic keratopathy with a sterile hypopyon, she was started on cenegermin 6 times daily for 8 weeks in the absence of a corticosteroid. By 2 weeks after starting cenegermin, the epithelial defect, infiltrate, and hypopyon sizes had improved. Within 4 weeks of starting cenegermin, the hypopyon had clinically resolved. The patient was subsequently started on topical corticosteroid drops for the last 4 weeks of cenegermin therapy. Examination at the conclusion of 8 weeks of cenegermin treatment revealed a closed epithelium and minimal scar. Best-corrected visual acuity with contact lens overrefraction was 20/70. Over the course of 7 months of continued follow-up, the cornea remained epithelialized without recurrent corneal infiltration or hypopyon.

    While cenegermin has been previously shown to be an effective treatment for neurotrophic keratopathy associated epithelial defects, resolution of a neurotrophic keratopathy associated inflammatory hypopyon with cenegermin is novel.

    While cenegermin has been previously shown to be an effective treatment for neurotrophic keratopathy associated epithelial defects, resolution of a neurotrophic keratopathy associated inflammatory hypopyon with cenegermin is novel.Northern Sudan is an important corridor cluster between pools of foot-and-mouth disease virus (FMDV) in East and North Africa. It involves almost the whole border area with Egypt and represents a considerable part of a projected disease-free zone in Sudan. The study monitored FMD infection between 2016 and 2018 in Northern Sudan. Clinical and serological surveillance were carried out. Results largely confirmed previous reports that have described the relatively lower circulation of FMDV in the area than in other parts of the country. Clinical FMD was confirmed, once in the three years period, as serotype O of an unnamed lineage within the topotype East Africa 3 (EA3). Using serial testing (the ID ELISA and virus neutralization test), sero-prevalence estimates of serotype-specific antibodies in the two States of Northern Sudan ranged between 15.4% (serotype A) in the River Nile State to 3.4% (serotype SAT2) in the Northern State. Striking disparities between patterns of FMD in Northern Sudan and the rest of Sudan were observed. Unlike Western, Eastern, Central and Southern Sudan, no predominance of serotype O antibodies was detected in Northern Sudan. Concurrently, a serotype O isolate from Northern Sudan in 2016 was found to be of transboundary nature circulating in East and North Africa and in the Middle East (nt. id. > 99%); like serotype O that caused the last episode of disease in Northern Sudan in 2012. Molecular findings were compatible with the inferred low circulation of FMDV in Northern Sudan. Elsewhere in Sudan, endogenous serotype O viruses seemed to be circulating more unabated. It was concluded that low animal density and limited animal movement in Northern Sudan together with the high antibody levels against serotype O in immediately neighbouring States (Khartoum and Kassala) effectively decreased infiltration of endogenous O viruses.The process by which funding organizations select among the myriad number of proposals they receive is a matter of significant concern for researchers and the public alike. Despite an extensive literature on the topic of peer review and publications on criteria by which clinical investigations are reviewed, publications analyzing peer review and other processes leading to government funding decisions on large multi-site clinical trials proposals are sparse. To partially address this gap, we reviewed the outcomes of scientific and programmatic evaluation for all letters of intent (LOIs) received by the Department of Veterans Affairs (VA) Cooperative Studies Program (CSP) between July 4, 2008, and November 28, 2016. If accepted, these LOIs represented initial steps towards later full proposals that also underwent scientific peer review. Twenty-two of 87 LOIs were ultimately funded and executed as CSP projects, for an overall success rate of 25%. Most proposals which received a negative decision did so prior to submission of a full proposal.