To compare the accuracy of the Barrett toric calculator with and without posterior corneal astigmatism and the Kane toric calculator.

Retrospective cross-sectional study METHODS The study included a total of 79 eyes of 79 patients who underwent toric IOL insertion during uncomplicated cataract surgery by a single surgeon. Using vector analysis, the mean absolute prediction error, the standard deviation of the prediction error, and the percentage of eyes with a prediction error within ± 0.50 diopter (D), ± 0.75 D, and ± 1.00 D were calculated. The IOL Master 700 (Carl Zeiss Meditec AG, Jena, Germany) was used for measuring biometry including posterior corneal astigmatism. Main analysis was designed to provide the clinical outcomes with each formula using the postoperative keratometry values and the measured postoperative IOL axis. Real-world analysis was performed using the preoperative keratometry values and the intended IOL axis.

There was no significant difference in mean absolute prediction errors calculated with two versions of the Barrett toric formula (predicted posterior corneal astigmatism and measured posterior corneal astigmatism) and Kane toric formula (P > 0.05). The Barrett toric calculator with predicted and measured posterior corneal astigmatism yielded the best results, with 60.8% less than 0.50 D prediction error in main analysis. In real-world analysis, the Barrett toric calculator with predicted posterior corneal astigmatism showed the best result, with 53.2% less than 0.50 D prediction error.

The Barrett toric formula with and without posterior corneal astigmatism measurements using the IOL Master 700 and the Kane toric formula yielded accurate and comparable outcomes in this single-surgeon analysis.

The Barrett toric formula with and without posterior corneal astigmatism measurements using the IOL Master 700 and the Kane toric formula yielded accurate and comparable outcomes in this single-surgeon analysis.

To assess the reliability and reproducibility of a new semi automated evaluation method Rotix for intraocular lens rotation (IOL) and to define a standardized evaluation method for future toric IOL studies.

Reliability and reproducibility study SETTING Department of Ophthalmology, Medical University of Vienna PATIENT POPULATION A dataset of 25 patients with 2 consecutive follow-up visits was created to test the intra- and inter-rater reliability. A datatest set of 10 patients including 30 pictures taken 5 minutes apart was created to test the short-term reproducibility.

Evaluation of IOLs rotational stability using non-toric implants in 25 × 2 consecutive follow-up visits. Two experienced graders performed axis evaluation 3 times in a randomized order. One experienced grader performed axis evaluation for the short-term reproducibility study. Reference landmarks at the end of operation were used to assess the IOL axis.

Intra-, inter-rater reliability and short-term reproducibility of axis measurements.

Mean standard deviation for intra-rater reliability was 0.16 degrees. The intra-class correlation coefficients (ICC) were 0.97 for grader 1 and 0.96 for grader 2, respectively. A very high inter-rater correlation of 0.95 was found. The mean individual difference between grader 1 and grader 2 was 0.061± 0.28 degrees. Short-term reproducibility showed a mean standard deviation of 0.22±0.14 degrees.

The novel semi automated evaluation method showed an accurate inter- and intra-rater reliability. Short-term reproducibility was below 0.25 degrees. The method of using non-movable reference landmarks showed reliable results and should be used as a standard in future toric IOL studies.

The novel semi automated evaluation method showed an accurate inter- and intra-rater reliability. Short-term reproducibility was below 0.25 degrees. The method of using non-movable reference landmarks showed reliable results and should be used as a standard in future toric IOL studies.

To assess the diagnostic accuracy of optical coherence tomography angiography (OCTA) compared with multimodal imaging for CNV in CSC eyes and to determine the features that predicted CNV.

Prospective cross-sectional study.

Consecutive CSC patients were recruited from retina clinic. The reference standard for CNV was determined by interpretation of multimodal imaging with OCTA, structural OCT line scan, fluorescein angiography (FA), indocyanine green angiography (ICGA), ultra-widefield fundus photography and fundus autofluorescence (FAF). Two independent masked graders examined OCTA without FA and ICGA to diagnose CNV. Univariate and multivariate analyses were performed to evaluate factors associated with CNV.

CNV was detected in 69 eyes in 64 out of 277 CSC patients according to reference standard. The two masked graders who examined OCTA had sensitivity of 81.2% (95% Confidence Interval [CI], 71.9%-90.4%) and 78.3% (95% CI, 68.5%-88.0%), specificity of 97.3% (95% CI, 95.9%-98.8%) and 96.2% (95% CI, 9 lesions and retinal pigment epithelial alterations. Comprehensive interpretation of OCTA with dye angiography and structural OCT is recommended.The involvement of metabolic reprogramming has been suggested to contribute to the pathophysiology of rheumatoid arthritis (RA). Glycolysis is enhanced in synovial cell metabolism in RA patients. Inhibitors of glycolysis are known to have anti-inflammatory effects. But, changes in the metabolism of normal synovial membranes or synovial cells during the early stages of inflammation remains unknown. Moreover, there are still many aspects of inflammatory signaling pathways altered by glycolysis inhibitors, that remain unclear. In this study we found that, in normal, non-pathological bovine synovial cells, most of ATP synthesis was generated by mitochondrial respiration. However, during the early of stages inflammation, initiated by lipopolysaccharide (LPS) exposure, synovial cells shifted to glycolysis for ATP production. The glycolysis inhibitor 2-deoxyglucose (2DG) reversed LPS induced increases in glycolysis for ATP production and suppressed the expression of inflammatory cytokines and proteolytic enzymes. 2DG suppressed the phosphorylation of the transcription factor cAMP response element binding protein (CREB) enhanced by LPS. Treatment with a CREB inhibitor reversed the expression of LPS-stimulated inflammatory cytokines and proteolytic enzymes. This study showed that changes in metabolism occur during the early stages of inflammation of synovial cells and can be reversed by 2DG and signaling pathways associated with CREB phosphorylation.

Proximal urea cycle disorders (PUCDs) are not included in most newborn screening programs due to the lack of adequate markers to monitor. Failure to alter citrulline and glutamine levels, the prognostic markers commonly used, can results in high false negative. Therefore, new biomarkers, prognostic of PUCDs, are strongly desirable.

We used tandem mass spectrometry to analyze blood spot from PUCDs patients during their follow up in our referral center focusing on glutamine to glutamate (Gln/Glu) ratio. We reanalyzed the same specimens of three patients after two months and the specimen of a new patient with suspicious of PUCD disorder.

Specimens of our patients shown a significant elevation of the ratio Gln/Glu compared to that of a healthy population (p<0.05) as well as the specimens analyzed after two months, while the glutamine concentration dropped. New patient, showing high value of the ratio, was molecularly confirmed as PUCD patient. We further analyzed the blood spots from a neonatal population in order to fix a cut-off value and include it in a newborn screening panel.

Our preliminary results suggest that the Gln/Glu ratio could be a very useful diagnostic marker, more stable over time than glutamine, which could improve the performance in early PUCDs identification.

Our preliminary results suggest that the Gln/Glu ratio could be a very useful diagnostic marker, more stable over time than glutamine, which could improve the performance in early PUCDs identification.Renal function is associated with postoperative residual hypertension in aldosterone-producing adenoma(APA) patients. Cystatin C-based glomerular filtration rate (GFR) can more accurately estimate renal function than creatinine-based methods. check details However, which renal function estimation method can more accurately predict postoperative hypertension in APA patients is still unknown. We recruited 180 APA patients who underwent adrenalectomy. Preoperative creatinine and cystatin C-based GFRs were calculated. Residual hypertension was defined as persistent hypertension > 140/90 mmHg or requiring anti-hypertensive medications 1 year after surgery. Sixty-five(36.1%) of the 180 APA patients had residual hypertension. Multivariate logistic regression and receiver operating characteristic (ROC) curve analysis showed a combination of creatinine and cystatin method CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration) creatinine-cystatin GFR was significantly associated with residual postoperative hypertension and had the largest area under the ROC curve, which was statistically larger than that of Cockcroft-Gault creatinine-based GFR. In both net reclassification index and integrated discrimination index models, CKD-EPI creatinine-cystatin GFR significantly improved the discriminatory power of CG-GFR. Among these renal function estimations used in the presented study, creatinine-cystatin combined GFR was a precise method to predict residual postoperative hypertension in APA patients received adrenalectomy. These finding may help identify those patients with higher risk of residual hypertension after operation.

For the >40,000 US children undergoing congenital heart surgery annually, the relationship between hospital quality and costs remains unclear. Prior studies report conflicting results and clinical outcomes have continued to improve over time. We examined a large contemporary cohort, aiming to better inform ongoing initiatives seeking to optimize healthcare value in this population.

Clinical information (Society of Thoracic Surgeons Congenital Database) was merged with standardized cost data (Pediatric Health Information Systems) for children undergoing heart surgery from 2010-2015. In-hospital cost variability was analyzed using Bayesian hierarchical models adjusted for case-mix. Quality metrics examined included in-hospital mortality, post-operative complications, length of stay (PLOS), and a composite.

Overall 32 hospitals (n=45,315 patients) were included. Median adjusted cost/case varied across hospitals from $67,700 to $51,200 in the high vs. low cost tertile (ratio 1.32, 95% credible interval 1ated to ICU PLOS and high-risk cases. Care processes influencing PLOS may provide targets for value-based initiatives in this population.Noonan Syndrome is a disorder characterized by central and peripheral lymphatic conducting anomalies, leading to chylothorax, chylous ascites, and metabolic derangement. Novel imaging modalities including dynamic contrast magnetic resonance lymphangiography (DCMRL) and intranodal lymphangiography have allowed for increased visualization of lymphatic pathology. We describe the first study of a 61-year-old male with Noonan syndrome who developed severe pulmonary insufficiency and chylothoraces. DCMRL and intranodal lymphangiography demonstrated central thoracic duct (TD) occlusion. The patient’s condition significantly improved following microsurgical TD-venous anastomosis assisted by TD catherization for imaging guidance, resulting in decompression of the lymphatic system and resolution of the pulmonary symptoms.