To evaluate the correlation between foveal changes in the detached retina in macula-off rhegmatogenous retinal detachments (RRD) and visual acuity outcome following repair.
Retrospective, ...consecutive, observational case series.
Consecutive patients presenting with macula-off RRD between July 15 and September 15, 2017, underwent SD-OCT imaging and their medical records were reviewed. Specific OCT exam parameters were used to evaluate the fovea of the detached retina.
In total, 47 patients with macula-off RRD were treated from July 15 to September 15, 2017. Forty-four eyes of 44 patients could be imaged by SD-OCT and were included in the analysis. Univariate analysis demonstrated a correlation between the height of the detachment, the duration of symptoms, the presence of macular hole and epiretinal membrane to the final VA. Correlation was also found between the presence of MH and the height of the detachment. However, multiple regression analysis demonstrated only a statistically significant correlation between the presence of a macular hole or an epiretinal membrane to the final VA.
Our study is the first to demonstrate the significance of foveal changes in the pathogenesis of lost vision in macula-off retinal detachments. The high rate of macular holes and the correlation between the MH and the height of the detachment suggest that elevated tension in the fovea in high detachments might play a significant role in the visual outcome of macula-off RRD following repair.
Favipiravir is a repurposed drug to treat coronavirus 2019 (COVID-19). Due to a lack of available real-world data, we assessed its effectiveness and safety in moderately to critically ill COVID-19 ...patients.
This retrospective study was conducted in two public/specialty hospitals in Saudi Arabia. We included patients ≥18 years) admitted April-August 2020 with confirmed SARS-CoV-2 diagnosed by real-time polymerase chain reaction (RT-PCR) from nasopharyngeal swab. Patients received either favipiravir (1800 mg or 1600 mg twice daily loading dose, followed by 800 mg or 600 mg twice daily) or supportive-care treatment. Patients were excluded if they were outside the study period, classified as having a mild form of the disease per WHO criteria, or had an incomplete patient file. Kaplan-Meier (KM) models were used to estimate median time to discharge. Discharge ratios, progression to mechanical ventilation, and mortality outcomes were estimated across the severity spectrum using Cox proportional-hazards models. As a sensitivity analysis, we performed propensity score-matching (PSM) analysis.
Overall, median time to discharge was 10 days (95%CI = 9-10) in the favipiravir arm versus 15 days (95%CI = 14-16) in the supportive-care arm. The accelerated discharge benefit was seen across the COVID-19 spectrum of severity. The adjusted discharge ratio was 1.96 (95%CI = 1.56-2.46). Progression to mechanical ventilation was slower with favipiravir (HR
adj
= 0.10, 95%CI = 0.04-0.29). There was no significant effect on mortality (HR
adj
= 1.56, 95%CI = 0.73-3.36). There was a statistically non-significant trend toward worse outcomes in the critical category (HR
adj
= 2.80, 95%CI = 0.99-7.89). Age was an independent risk factor for mortality in mechanically ventilated patients. PSM analyses confirmed these findings.
Favipiravir was associated with clinical benefits, including accelerated discharge rate and less progression to mechanical ventilation; however, no overall mortality benefits were seen across the severity spectrum.
Članek temelji na raziskavi, ki so jo avtorji opravili leta 2021. V središče postavlja izkušnje otrok in staršev beguncev z vključevanjem v slovenski vzgojno-izobraževalni sistem. Sogovorniki iz ...dvanajstih družin so spregovorili o pozitivnih in negativnih vidikih vključevanja v vzgojno-izobraževalni sistem. Med njimi so prevladovale težave z učenjem jezika, učne težave, diskriminacija. Proces vključevanja, ki v zakonih in strategijah deluje kot enoznačen »postopek« prilagajanja otrok na nove jezikovne, kulturne, izobraževalne in institucionalne razmere, v raziskavi predstavljamo iz perspektive »subjektov vključevanja«. Ti proces doživljajo kot dolgotrajen, niansiran in težaven.
•Mpox in immunosuppressed hosts tends to cause severe disseminated infection.•Literature on mpox treatment in solid organ transplant recipients is limited.•Tecovirimat is the treatment of choice in ...severe disease.•Brincidofovir might be a reasonable alternative when tecovirimat is unavailable.
An mpox outbreak was declared in July 2022 by the world health organization (WHO). It causes a mild self-limiting disease however; in immunosuppressed hosts, it tends to cause severe disseminated infection. Most cases of mpox in sold organ transplant (SOT) recipients reported in the literature were treated with tecovirimat. Here we report two cases of severe disseminated mpox infection in renal transplant recipients that were successfully treated with brincidofovir. Both patients were discharged from the hospital with no immediate significant side effects from brincidofovir reported until the submission of this report.
To report the first series of retinoblastoma (RB) cases that were managed locally in Kuwait by the retinoblastoma team that was established during the COVID-19 pandemic.
Six cases with RB were ...included in this study. The ages ranged from 3 months to 2 years with a male to female ratio of 2:1. All cases presented with an abnormal pupillary reflex with or without strabismus. Examination findings mostly showed leukocoria and an intra-retinal mass with calcification with or without vitreous seeding. Most cases were unilateral except for one case, which had bilateral RB. International classification of RB staging ranged from group B to E. Multidisciplinary approach was followed to manage these cases by applying a well-set protocol created by the RB team. Each case was treated according to grade at presentation.
COVID-19 pandemic revolutionized the standard of care for RB in Kuwait and mandated the establishment of a multidisciplinary team to follow a standardized protocol to manage RB cases successfully.
Optic disc pits are a rare but significant anomaly of the optic nerve head that can lead to visual impairment and associated complications. These pits are characterized by a small, oval-shaped ...depression in the disc, which can cause fluid accumulation and subsequent damage to the adjacent retina. Although the etiology and pathogenesis of optic disc pits are not fully understood, several theories have been proposed, including abnormal embryonic development and degenerative changes. Diagnosis is typically made through a comprehensive eye examination, including a dilated fundus exam and optical coherence tomography. Management options vary depending on the severity of the condition and associated complications, ranging from observation to surgical intervention.
Antibiotics have played a pivotal role in modern medicine, drastically reducing mortality rates associated with bacterial infections. Despite their significant contributions, the emergence of ...antibiotic resistance has become a formidable challenge, necessitating a re-evaluation of antibiotic use practices. The widespread belief in clinical practice that bactericidal antibiotics are inherently superior to bacteriostatic ones lacks consistent support from evidence in randomized controlled trials (RCTs). With the latest evidence, certain infections have demonstrated equal or even superior efficacy with bacteriostatic agents. Furthermore, within clinical practice, there is a tendency to indiscriminately order urine cultures for febrile patients, even in cases where alternative etiologies might be present. Consequently, upon obtaining a positive urine culture result, patients often receive antimicrobial prescriptions despite the absence of clinical indications warranting such treatment. Furthermore, it is a prevailing notion among physicians that extended durations of antibiotic therapy confer potential benefits and mitigate the emergence of antimicrobial resistance. Contrary to this belief, empirical evidence refutes such assertions. This article aims to address common myths and misconceptions within the field of infectious diseases.
Background and objective. An abnormal vaginal discharge and an increase in intestinal aerobic bacteria indicate a vaginal infection. The aim of this study was to assess the antimicrobial ...susceptibility profiles of bacterial species present in the vaginal microbiota of both non-pregnant and pregnant women. Material and method. A total of 211 vaginal swabs were collected from 120 pregnant and 91 non-pregnant women. The VITEK 2 Compact Automated System validates bacterial isolate diagnosis and antibiotic susceptibility. Results. Out of 120 vaginal samples of pregnant women, 105 samples were identified as Gram-positive (GP) (79) and Gram-negative (GN) (26) while 15 samples were unidentified by VITEK®. The 91 nonpregnant samples comprised identified GP (53), GN (23) and unidentified samples (15). The GP bacteria were highly resistant to Oxacillin (OX1) in both groups, while the GN bacteria were resistant to Ceftazidime (CAZ) and ticarcillin (TIC) in non-pregnant group and TIC in the pregnant groups. The GP bacteria in both groups were sensitive to Tigecycline (TGC). Pregnant and non-pregnant GN bacteria were sensitive to Meropenem (MEM) (61.5%) and Piperacillin/Tazobactam (TZP) (91.3%), respectively. Conclusion. The current study showed that TZP and MEM were both groups' most effective antibiotics against GN isolates. GP bacteria were significantly TGC-sensitive.
The effects of measuring devices/sensors on improving the power quality (PQ) of electric networks are studied in this paper. In this context, improving the performance of an LCL-type grid connected ...to a three-phase three-wire shunt active filter (SAF) in the presence of voltage perturbations is studied. In order to ensure the high-quality performance of LCL-SAF in the presence of voltage perturbations, the robust continuous second-order sliding mode controller (2-SMC), including twisting and super-twisting controllers, and continuous higher-order sliding mode controller (C-HOSMC)-based approaches are employed. These controllers, whose outputs are processed by pulse-width modulation (PWM), allow minimization of the phase shift and prevent the generation of discontinuous chattering commands, which can severely damage the VSI components. Moreover, an integration of a generalized instantaneous power identification algorithm with an advanced phase locked loop (PLL) was proposed and experimentally tested to validate the effective performances of SAF under severe perturbations. Additionally, the studied approaches were tested via simulations taking into account a conventional nonlinear industrial load in a real textile factory environment, using measurements provided by power quality analyzers. Finally, the effects of the measuring devices, including the current and voltage sensors, on the accuracy and reliability of the SAF and, consequently, on the PQ of the electric power grid were studied via simulations and experimentally. The results of this study support the validity of the recently published patent.
An LCL grid-connected three-phase and three-wire shunt active filter (SAF) is studied and controlled. It is known that SAFs generate distortive components caused by the high switching frequency of a ...voltage source inverter (VSI). In order to prevent the spread of these distortive components to the grid, the LCL filter (usually controlled by a linear control feedback) is used; while a parasitic phase shift/lag between the reference and injected currents emerges and severely deteriorates the filtration quality. In this study, the inherently robust sliding mode controller (SMC) is used in the SAF, for reducing the phase-shift effects over the broad bandwidth, while improving robustness to system's disturbances. Furthermore, in order to prevent very high frequency switching of the SMC that can severely hurt the switching elements, two different continuous SMCs are employed and studied. In the first solution, a signum function used in discontinuous SMC is replaced by a continuous sigmoid function. The second proposed solution uses an artificial increase of input-output relative degree that allows designing the SMC in terms of the control derivative, while the actual SMC function becomes continuous by integrating the discontinuous SMC. The output of the continuous SMC is pulse width modulated (PWM) in order to provide a fixed given frequency of control switching, required for the VSI safe operation. The proposed approach was validated on a mathematically modeled conventional nonlinear load and a real textile factory (Aleppo, Syria) via simulation based on real measurements coming from power quality analyzers. A new modeling approach of nonlinear loads is proposed and the efficacy of the proposed controllers for SAF/ LCL filter, even under unbalanced conditions, is validated via simulations.
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