Current Issue : April - June Volume : 2020 Issue Number : 2 Articles : 5 Articles
Background: Repeated surgery excisions could induce obvious irregular astigmatism in patients with recurrent\npterygium. Our study is aimed to illustrate the effect of adjunct excimer laser phototherapeutic keratectomy (PTK) in\nlimbal-conjunctival autograft transplantation on visual quality for patients with recurrent pterygium.\nMethods: Retrospective case-control study. Eyes that underwent pterygium excision with (PTK group) or without\n(control group) PTK from 2006 to 2017 were retrospectively included. Recurrence rate, preoperative and\npostoperative surface regularity index (SRI), surface asymmetry index (SAI), cylinder and LogMAR vision were\ncollected. Postoperative anterior segment optical coherence topography and in vivo confocal microscopy were\nperformed to monitor the cornea epithelium healing and cellular recovery process respectively.\nResults: A total of 99 eyes of 99 patients were collected, of which 39 were treated with PTK and 60 without PTK.\nThe mean follow-up time was 50.4 ± 38.1 months. The recurrence rate was 10.3% (4 eyes) in the PTK group and\n13.3% (8 eyes) in the control group (p = 0.759). The SRI decreased 0.53 (range: - 0.88, 2.81), SAI decreased 0.53\n(range: - 0.64, 2.94), and the cylinder decreased 2.08 (range:-0.16, 9.40) D in the PTK group, and the corresponding\nvalues were 0.48 (range:-0.45, 2.27), 0.27 (range:-1.06, 2.21) and 0.71 (range:-1.75, 3.55) D in the control group,\nrespectively (Z = 1.76, 2.15, and 3.97, p = 0.005, 0.016, and 0.000 respectively). LogMAR vision improved in both\ngroups after surgery, with an improvement of 0.18 (range: 0.00, 0.70) in the PTK group and 0.06 (range: - 0.12, 0.50)\nin the control group (Z = 4.08, p = 0.000). Besides, the eyes treated with PTK showed faster re-epithelization and\nbetter cellular recovery.\nConclusions: For recurrent pterygium, surgical excision with adjunct PTK might be a better option with improved\ncorneal surface and vision outcomes....
HBV reactivation (HBVr) can occur due to the ability of HBV to remain latent in the liver\nas covalently closed circular DNA and by the capacity of HBV to alter the immune system of the\ninfected individuals. HBVr can occur in patients undergoing hematopoietic stem cell\ntransplantation (HSCT) with a clinical spectrum that ranges from asymptomatic infection to\nfulminant hepatic failure. The risk of HBVr is determined by a complex interplay between host\nimmunity, virus factors, and immunosuppression related to HSCT. All individuals who undergo\nHSCT should be screened for HBV. HSCT patients positive for HBsAg and also those HBcAbpositive/\nHBsAg-negative are at high risk of HBV reactivation (HBVr) due to profound and\nprolonged immunosuppression. Antiviral prophylaxis prevents HBVr, decreases HBVr-related\nmorbidity and mortality in patients with chronic or previous HBV. The optimal duration of antiviral\nprophylaxis remains to be elucidated. The vaccination of HBV-naïve recipients and their donors\nagainst HBV prior to HSCT has an important role in the prevention of acquired HBV infection. This\nnarrative review provides a comprehensive update on the current concepts, risk factors, molecular\nmechanisms, prevention, and management of HBVr in HSCT....
Heart transplantation (HT) is an accepted treatment for end-stage heart failure\n(HF). Heart transplantation significantly increases survival, exercise capacity,\nquality of life and return to work in selected patients with advanced\nheart failure compared with conventional treatment. The survival rates have\nimproved with the use of new immunosuppressive drugs, with a median survival\nafter transplantation of approximately 11 years. The shortage of donor\nhearts represents a major limitation in this field. In addition many are the\nconsequences of the limited effectiveness and complications of immunosuppressive\ntherapy (i.e. antibody-mediated rejection, infection, hypertension,\nrenal failure, malignancy and coronary artery vasculopathy). In particular,\nchronic rejection may occur months to years after the transplantation and is\nreferred to as cardiac allograft vasculopathy (CAV). CAV occurs in 32% of\nthe patients after 5 years and ensuing allograft failure from CAV eventually\naccounts for 30% of recipient deaths after transplantation. Cardiac allograft\nvasculopathy, involving coronary macro- and microcirculation, is caused by\ncomplicated interplay between immunologic and non-immunologic factors\nresulting in repetitive endothelial injury and localized sustained inflammatory\nresponse. Early diagnosis of microvascular dysfunction is substantial. In this\nreview we analyze signs and symptoms of CAV presentation and the different\nmethodologies to achieve an early and precise diagnosis. We will discuss invasive\nand non-invasive diagnostic tools and their specific role in evaluating\ngraftâ??s function, morphology, the presence of coronary artery disease and\npossible microcirculation involvement....
There is a changing trend in mortality causes in kidney transplant recipients (KTR), with\na decline in deaths due to cardiovascular causes along with a relative increase in cancer mortality\nrates. Vitamin C, a well-known antioxidant with anti-inflammatory and immune system\nenhancement properties, could offer protection against cancer. We aimed to investigate the\nassociation of plasma vitamin C with long-term cancer mortality in a cohort of stable outpatient\nKTR without history of malignancies other than cured skin cancer. Primary and secondary\nendpoints were cancer and cardiovascular mortality, respectively. We included 598 KTR (mean age\n51 ± 12 years old, 55% male). Mean (SD) plasma vitamin C was����...
Resting heart rate (rHR) and heart rate variability (HRV) are non-invasive measurements\nthat predict the risk of sudden cardiac death (SCD). Marine n-3 polyunsaturated fatty acid (PUFA)\nsupplementation may decrease rHR, increase HRV, and reduce the risk of SCD. To date, no studies\nhave investigated the effect of marine n-3 PUFA on HRV in renal transplant recipients. In a\nrandomized controlled trial, 132 renal transplant recipients were randomized to receive either three\n1 g capsules of marine n-3 PUFA, each containing 460 mg/g EPA and 380 mg/g DHA, or control\n(olive oil) for 44 weeks. HRV was calculated in the time and frequency domains during a\nconventional cardiovascular reflex test (response to standing, deep breathing, and Valsalva\nmaneuver) and during 2 min of resting in the supine position. There was no significant effect of\nmarine n-3 PUFA supplementation on time-domain HRV compared with controls. rHR decreased\n3.1 bpm (± 13.1) for patients receiving marine n-3 PUFA compared to 0.8 (± 11.0) in controls (p =\n0.28). In the frequency domain HRV analyses, there was a significant change in response to standing\nin both high and low frequency measures, 2.9 (p = 0.04, 95% CI (1.1;8)) and 2.7 (p = 0.04, 95% CI\n(1.1;6.5)), respectively. In conclusion, 44 weeks of supplemental marine n-3 PUFAs in renal\ntransplant recipients significantly improved the cardiac autonomic function, assessed by measuring\nHRV during conventional cardiovascular reflex tests....
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