Jyh Haur Woo et al assessed the outcomes and complications of hybrid Descemet membrane endothelial keratoplasty (H-DMEK) utilizing a Descemet stripping automated endothelial keratoplasty (DSAEK) pull-through donor inserter and donor stroma as a carrier. The sample consisted of eyes with bullous keratopathy (BK) and Fuchs endothelial corneal dystrophy (FECD), which had H-DMEK, performed using a bimanual pull-through technique using DSAEK-prepared donor stroma as carrier and the EndoGlide Ultrathin DSAEK donor insertion device. Of the 85 eyes from 79 individuals, 43.5% (n = 37) had BK, 28.2% (n = 24) had FECD while 24.7% (n = 21) had failed grafts. According to results, hybrid DMEK provides a controlled ‘pull-through’ technique of donor insertion in the ‘endothelium-in’ configuration, which can be helpful particularly in complicated eyes. In order to confirm the long-term endothelial cell loss and graft survival related to this technique, more studies are required.
Amelie Pham, MD et al investigated the rate of preeclampsia resolution in multifetal gestation after fetal death, spontaneous or induced via performing a systematic literature review of all published reports of multifetal gestation complicated by preeclampsia with fetal death and assessing two additional cases from their institution. They recognized 14 studies and added 2 case reports from their institution for a total of 19 cases. Prior to or at the time of fetal death, an abnormality in anatomy, fetal growth, amniotic fluid, or umbilical artery Doppler of at least 1 fetus was reported in all 19 cases (100.0%). A high rate of 88% of preeclampsia resolution and a 7 week gain in gestation for the surviving fetus were reported, in this work. Inherent publication bias is the limitation of this study. Expectant management of pregnancies complicated by preeclampsia is potentially associated with serious maternal risks, even after fetal death.
Shilan Seyed Ahmadi et al assessed the incidence of atrial fibrillation in individuals with type 2 diabetes compared with age- and sex-matched controls from the general population, and evaluated its variation in relation to glycemic control and renal function. From the Swedish National Diabetes Registry, they identified 421,855 patients with type 2 diabetes. From the Swedish Population Registry, they selected 2,131,223 controls, who were matched for age, sex, and county. These individuals were followed from January 1, 2001, to December 31, 2013. Findings revealed an overall 35% higher risk of atrial fibrillation among people with type 2 diabetes vs age- and sex-matched controls. An uptick in the excess risk for atrial fibrillation was observed in relation to the presence of renal complications or poor glycemic control. A slightly increased risk was observed in people with type 2 diabetes with good glycemic control and normoalbuminuria.
Given the link between stress-induced hyperglycemia (SIH) and long-term results, as well as the influences of baseline diabetic status on this link continue to be elusive in patients with ST-segment elevation myocardial infarction (STEMI), so, Takayuki Kojima, MD et al performed this study to gain clarity on the link between SIH and long-term results, and the influences of baseline diabetic status on this link among STEMI patients (n = 6,287) who were discharged alive. They used the stress hyperglycemia ratio (SHR) to estimate SIH. All-cause mortality and admission for heart failure (HF) were assessed as endpoints. A follow-up of 5 years revealed 464 (7.4%) cases of all-cause death and 401 (6.4%) cases of HF admission. Among STEMI patients discharged alive, findings revealed a significant link of high SHR with worse long-term prognosis in the nondiabetic population. There was no significant link of high SHR with worse long-term prognosis in the diabetic population
Considering that areflexia or hyporeflexia is a necessary clinical criterion for Guillain-Barré syndrome (GBS) diagnosis, researchers conducted this systematic review to analyze hyper-reflexia in GBS. According to results, 73.3% of individuals were from Japan, 6.7% from the USA, 6.7% from India, 4.4% from Italy, 4.4% from Turkey, 2.2% from Switzerland and 2.2% from Slovenia, implying a considerable geographical variation. Hyper-reflexia was linked to antecedent diarrhea more often than upper respiratory tract infection and the electrodiagnosis of acute motor axonal neuropathy than acute inflammatory demyelinating polyneuropathy. Electrophysiological studies displayed high soleus maximal H-reflex amplitude to maximal compound muscle action potential amplitude ratio, indicative of spinal motoneuron hyperexcitability, and increased central conduction time, indicative of corticospinal tract involvement, though structural damage was never shown by MRI. Hyperreflexia does not contradict the GBS diagnosis and should not postpone treatment. Hyper-reflexia can occur in all GBS variants and subtypes, and this eventuality should be mentioned in future GBS diagnostic criteria.
Brivaracetam is a new antiepileptic drug with limited data in children. Sara McGuire et.al. conducted a study to assess the efficacy/tolerability of brivaracetam. The researchers concluded that brivaracetam is an effective therapy for refractory focal epilepsy in children older than 4 years of age.
Monika Przewlocka-Kosmala et.al. conducted a study to assess the prognostic utility of left ventricular untwisting in the elderly patients at risk of heart failure. The researchers concluded that The inclusion of apical untwisting to the diagnostic algorithm may improve the prognostication process in this population.
Soo Lim et.al. conducted a study to understand the efficacy of intensive and conventional glucose‐lowering treatment in post‐stroke management. The researchers concluded that the overall evidence for a beneficial effect of intensive glycaemic control on risk of stroke is limited.
Antoine Martin et.al. conducted a study to assess the risk of relapse after vedolizumab therapy was discontinued. The researchers concluded that two-thirds of patients with IBD treated with vedolizumab experienced relapse within the first year after vedolizumab discontinuation. Re-treatment with vedolizumab was effective in two-thirds of patients.
Benjamin C. Tendler et.al. conducted a study to provide a frame-work to define an effective b‐value in Diffusion‐weighted steady‐state free precession. The researchers concluded that Diffusion‐weighted steady‐state free precession can be used to investigate non‐Gaussian diffusion by varying the flip angle.