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Karger Kompass
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     ISSN (Print) 2296-0368 - ISSN (Online) 2296-0317
     Published by Karger Homepage  [104 journals]
  • Intravitreal Ranibizumab and/or Dexamethasone Implant for Macular Edema
           Secondary to Retinal Vein Occlusion
    • Abstract: Purpose: To investigate the outcome of intravitreal ranibizumab and/or dexamethasone implant treatment for treatment of macular edema (ME) secondary to central or branch retinal vein occlusion (CRVO or BRVO) in a clinical setting. Methods: Retrospective analysis of consecutive patients followed for at least 6 months. Data recorded included the type of occlusion, initial and final visual acuity, and number of injections. Results: Sixty-five patients were included, 26 had CRVO and 39 BRVO. Mean (±SD) follow-up duration was 16 (±7.7) months. Twenty-four (36.9%) patients received ranibizumab in monotherapy, 19 patients (29.3%) dexamethasone in monotherapy, and 22 patients (33.8%) received successively both treatments. In dexamethasone-treated patients, mean (±SD) visual acuity gain was 5.8 ± 10.7 letters for BRVO and 16.8 ± 15.6 letters for CRVO. In ranibizumab-treated patients, mean (±SD) visual acuity gain was 9.2 ± 10 letters for BRVO and 18.2 ± 20.5 letters for CRVO. Conclusion: Both intravitreal ranibizumab and dexamethasone intravitreal implant could be used as first-line therapy for patients with ME secondary to retinal vein occlusion.
      Ophthalmologica
       
  • Intravitreal Ranibizumab for Patients with Neovascular Age-Related Macular
           Degeneration with Good Baseline Visual Acuity
    • Abstract: Purpose: To report the 1-year results of intravitreal ranibizumab (IVR) injections for neovascular age-related macular degeneration (nAMD) in patients with good baseline visual acuity (VA). Methods: Thirty-six eyes of 36 patients with nAMD with best-corrected VAs (BCVAs) >0.6 (equal to 0.22 in the logarithm of the minimum angle of resolution unit) were enrolled. IVR was the primary treatment; additional treatment was administered as needed. BCVAs and central retinal thickness (CRT) were measured periodically. Results: The mean number of injections at month 12 was 3.3. The mean BCVAs were 0.11 ± 0.02 at baseline and 0.12 ± 0.03 at month 12, which did not significantly differ. The mean CRT significantly improved from 320 ± 15 to 254 ± 12 μm at month 12 (p < 0.01). Photodynamic therapy was applied in 2 cases because of frequent recurrences. Conclusions: IVR maintained VA and improved morphological changes in wet AMD with good baseline VA.
      Ophthalmologica
       
  • Novel TECTA Mutations Identified in
           Stable Sensorineural Hearing Loss and Their Clinical Implications
    • Abstract: TECTA is a causative gene of autosomal dominant (DFNA8/A12) and autosomal recessive (DFNB 21) nonsyndromic sensorineural hearing loss (NSHL). Mutations in TECTA account for 4% of all autosomal dominant NSHL cases in some populations and are thus thought to be one of the major causes of autosomal dominant NSHL. A genotype-phenotype correlation for autosomal dominant mutations in the TECTA gene has been proposed. Two families (SB146 and SB149), which segregated moderate NSHL in an autosomal dominant fashion, were included in this study. We performed targeted resequencing of 134 known deafness genes (TRS-134) and bioinformatics analyses to find causative mutations for NSHL in these 2 families. Through TRS-134, we detected 2 novel mutations, i.e. c.3995G>T (p.C1332F) and c.5618C>T (p.T1873I), in the TECTA gene. These mutations cosegregated with NSHL in the studied families and were not detected in normal controls. The mutations c.3995G>T and c.5618C>T reside in the von Willebrand factor type D3-D4 (vWFD3-D4) interdomain of the zonadhesin (ZA) domain and the zona pellucida (ZP) domain, respectively. p.C1332F is the first mutation detected in the vWFD3-D4 interdomain of the ZA domain. The mutations p.C1332F and p.T1873I were associated with stable high-frequency and mid-frequency hearing loss, respectively. Notably, the cysteine residue mutated to phenylalanine in SB146 was not related to progression of sensorineural hearing loss, which argues against the previous hypothesis. Here we confirm a known genotype-phenotype correlation for the ZP domain and propose a hypothetical genotype-phenotype correlation which relates mutations in vWFD3-D4 to stable high-frequency NSHL in Koreans. This clinical feature makes subjects with the missense mutation in the vWFD3-D4 interdomain of TECTA potentially good candidates for middle ear implantation.
      Audiol Neurotol 2015;20:17-25
       
  • Three Years Later: Report on the State of Well-Being of Patients with
           Chronic Tinnitus Who Underwent Modified Tinnitus Retraining Therapy
    • Abstract: Successful management of patients with chronic tinnitus is an important health issue. One of the tinnitus management strategies used at our Tinnitus Center is a combination of tinnitus retraining therapy (TRT) with physiotherapy and psychological management [called modified TRT (MTRT)]. We have used this type of management for over a decade and have described the protocol in detail elsewhere. In the present study, we wanted to determine the effect of MTRT on the well-being of tinnitus patients 3 years after treatment onset. One hundred and thirty patients with chronic tinnitus were assessed using psychometric instruments immediately before 7-day MTRT, immediately after the therapy and 3 years later. Patients with very severe tinnitus-related distress associated with major depression and a risk of suicide were excluded from this study. MTRT resulted in a sustained reduction of tinnitus-related distress. Moreover, the quality of life of patients had increased, as assessed by a separate questionnaire. The effect of MTRT was influenced by the degree of tinnitus-related distress and by the patients' age, the latter being gender dependent. Hearing loss and tinnitus duration had only a minor influence on the therapeutic effect. Taken together, we report a positive change in the state of well-being of patients with chronic tinnitus measurable with various psychometric instruments 3 years after the onset of MTRT.
      Audiol Neurotol 2015;20:26-38
       
  • Incidence of Developmental Speech Dysfluencies in Individuals with
           Parkinson's Disease
    • Abstract: Objective: The aim of this study was to investigate the incidence of developmental speech dysfluencies in individuals with Parkinson's disease (PD). Background: The possible relationship between PD and dysfluencies such as stuttering has engaged researchers for many years. However, whether there is a higher-than-expected incidence of reported childhood stuttering in adults with a diagnosis of PD is unknown. Participants and Methods: A questionnaire including items regarding present and former speech difficulties was answered by 280 individuals with PD. Results: The total number of persons who reported that they had stuttered (often or sometimes) before the age of 10 years was 11, corresponding to 3.9%. The number of persons who reported unusually fast speech before the age of 10 years was 17, corresponding to 6.1%. The reported incidence of childhood stuttering in this group was consequently not higher than that in previously published reports on childhood stuttering (approx. 5%). The frequency of unusually fast speech was notable, but the lack of a control group made it difficult to conclude on the significance of that finding. Conclusion: Although no direct comparison between self-reported incidences of childhood dysfluencies and published incidence figures regarding childhood stuttering can be made, different possible relationships between speech dysfluency and basal ganglia dysfunction are discussed.
      Folia Phoniatr Logop 2014;66:132-137
       
  • Neopterin: A Potential Biomarker for Delirium in Elderly Patients
    • Abstract: Background/Aims: The diagnosis of delirium is not supported by specific biomarkers. In a previous study, high neopterin levels were found in patients with a postoperative delirium. In the present study, we investigated levels of neopterin, interleukin-6 (IL-6) and insulin-like growth factor-1 (IGF-1) in acutely ill admitted elderly patients with and without a delirium. Methods: Plasma/serum levels of neopterin, IL-6 and IGF-1 were determined in patients aged ≥65 years admitted to the wards of Internal Medicine and Geriatrics. Differences in biomarker levels between patients with and without a delirium were investigated by the analysis of variance in models adjusted for age, gender, comorbidities and eGFR (when appropriate). Results: Eighty-six patients were included; 23 of them with a delirium. In adjusted models, higher mean levels of neopterin (70.5 vs. 45.9 nmol/l, p = 0.009) and IL-6 (43.1 vs. 18.5 pg/ml, p = 0.034) and lower mean levels of IGF-1 (6.3 vs. 9.3 nmol/l, p = 0.007) were found in patients with a delirium compared to those without. Conclusions: The findings of this study suggest that neopterin might be a potential biomarker for delirium which, through oxidative stress and activation of the immune system, may play a role in the pathophysiology of delirium.
      Dement Geriatr Cogn Disord 2015;39:116-124
       
  • Longitudinal Analysis of Reticular Drusen Associated with Age-Related
           Macular Degeneration Using Combined Confocal Scanning Laser Ophthalmoscopy
           and Spectral-Domain Optical Coherence Tomography Imaging
    • Abstract: Purpose: To evaluate longitudinal variations of reticular drusen (RDR) in age-related macular degeneration using confocal scanning laser ophthalmoscopy (cSLO), near-infrared reflectance (NIR) and spectral-domain optical coherence tomography (SD-OCT) imaging. Methods: Eighteen eyes of 12 patients with RDR (median observational time 5 months, range 3-10) were included. Changes over time in the en face cSLO NIR images, the identical SD-OCT B scan (simple approach) and the dense SD-OCT volume scans (11 µm between B scans, detailed approach) for 5 preselected RDR lesions were analysed, respectively. Results: Nineteen of 90 (21%) lesions were no longer detectable at the follow-up examination with the simple SD-OCT approach (increase 7/decrease 48/unchanged 15/not gradable 1). By contrast, no disappearance of single lesions was noted for both cSLO (3/8/61/18) and detailed SD-OCT image analysis (67/22/1/0). Within the dense SD-OCT volume scan, a median change of individual lesion height of 10 µm/year was determined. Conclusions: The findings indicate a recordable progression of RDR lesions in lateral and vertical dimensions. Using dense SD-OCT volume scans, individual RDR lesion progression can be quantified and may be applied in future longitudinal studies.
      Ophthalmologica
       
  • Population-Based Prediction of Fitting Levels for Individual Cochlear
           Implant Recipients
    • Abstract: Objectives: This study analyzed the predictability of fitting levels for cochlear implant recipients based on a review of the clinical levels of the recipients. Design: Data containing threshold levels (T-levels) and maximum comfort levels (M-levels) for 151 adult subjects using a CII/HiRes 90K cochlear implant with a HiFocus 1/1 J electrode were used. The 10th, 25th, 50th, 75th and 90th percentiles of the T- and M-levels are reported. Speech perception of the subjects, using a HiRes speech coding strategy, was measured during routine clinical follow-up. Results: T-levels for most subjects were between 20 and 35% of their M-levels and were rarely (
       
  • Effect of Intravitreal Bevacizumab Injection before Ahmed Glaucoma Valve
           Implantation in Neovascular Glaucoma
    • Abstract: Ophthalmologica 2013;229:94–100
       
  • Long-Term Outcome of Polymyositis Treated with High Single-Dose
           Alternate-Day Prednisolone Therapy
    • Abstract: Eur Neurol 2012;68:117–121
       
 
 
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