SMILE for the Treatment of Residual Refractive Error After Cataract Surgery.

INTRODUCTION: In the context of managing patients' expectations and satisfaction regarding visual acuity after cataract surgery, we aimed to investigate the improvement in visual acuity and patient satisfaction after small-incision lenticule extraction (SMILE) in pseudophakic (trifocal intraocular lens, IOL) patients with residual myopic refraction after cataract surgery. METHODS: Seventy-six patients (82 eyes) who underwent cataract surgery with ZEISS AT LISA tri 839MP IOL implantation were included in this retrospective study. The included patients were 56-79 years old, wanted spectacle independence, and had preoperative myopic refraction between - 1.0 and - 2.25 diopters (D) and astigmatism between - 0.75 and - 1.75 D. The treatment status of these patients was defined as trifocal IOL (n = 82). SMILE was performed in patients who were dissatisfied after cataract surgery, and these patients were followed up for 1 year on average. We evaluated visual acuity and satisfaction and further examined laser vision correction and satisfaction levels in patients who were dissatisfied after trifocal IOL implantation. RESULTS: The possible reasons for patient dissatisfaction were reading books, using a computer, and driving at night. After SMILE, the residual myopic refractive error (spherical) decreased significantly from - 2.08 ± 0.28 [- 2.25 to - 1.0] preoperatively to - 0.25 ± 0.20 - 0.5 to 0] 1 year postoperatively (p < 0.001). Additionally, the uncorrected distance visual acuity increased from 0.65 ± 0.08 [0.52-0.7] logMAR preoperatively to 0.09 ± 0.02 [0.05-0.1] logMAR at 1 month postoperatively (p < 0.001), 0.09 ± 0.02 [0.05-0.1] logMAR at 6 months postoperatively, and 0.06 ± 0.02 [0.05-0.1] logMAR at 12 months postoperatively (p < 0.001). Patient satisfaction measures after SMILE (reading, night driving, and using a computer) were significantly improved. CONCLUSION: SMILE is a reliable method for treating residual refraction after cataract surgery, as it provides results in the shortest time without complications and increases patient satisfaction. TRIAL REGISTRATION: The protocol was registered on clinicaltrials.gov (NCT04693663).

Assessment of resting electrocardiogram, P wave dispersion and duration in different genders applying for registration to the School of Physical Education and Sports - results of a single centre Turkish Trial with 2093 healthy subjects.

BACKGROUND: The 12-lead electrocardiogram shows a broad range of abnormal patterns in trained athletes. The primary end point of this study was to investigate P wave dispersion, and P wave durations and related factors in different genders applying for registration to the School of Physical Education and Sports. METHODS AND RESULTS: From 2006 to 2009, a total of 2093 students - 1674 boys with a mean age of 19.8 plus or minus 1.9 years and 419 girls with a mean age of 19.1 plus or minus 1.8 years - were included in the study. All 12 leads of the resting electrocardiogram were evaluated for P wave dispersion and electrocardiogram abnormalities. Baseline parameters such as age, body weight, body height, and body mass index, as well as electrocardiogram findings such as P wave maximal duration and P wave dispersion, were significantly higher in boys than in girls. Of all the parameters tested with correlation analysis, only gender (p = 0.03) (r = 0.04), body weight (p < 0.001) (r = 0.07), body height (p = 0.004) (r = 0.06), and body mass index (p = 0.01) (p = 0.05) were correlated with P wave dispersion. CONCLUSION: The frequencies of all electrocardiogram abnormalities, P wave dispersion, and P wave maximal duration were higher in boys as compared with girls in an unselected student population applying for registration to the School of Physical Education and Sports; in addition, P wave dispersion was correlated with gender, body weight, body height, and body mass index.

Assessment of P-wave dispersion on 12-lead electrocardiography in students who exercise regularly.

BACKGROUND: P-wave dispersion, an electrocardiographic marker, is an independent predictor of atrial fibrillation. P-wave dispersion is associated with inhomogeneous and discontinuous propagation of sinus impulses. The aim of this study was to investigate P-wave dispersion in students who apply for registration to School of Physical Education and Sports. METHODS: Totally 984 students (810 boys [mean age: 19.8 +/- 2.0 years] and 174 girls [mean age: 19.0 +/- 1.8 years]) who applied for registration to School of Physical Education and Sports with a training history of some years were included in the study. P-wave duration was calculated in all 12 leads of the surface electrocardiography, which were simultaneously recorded. The difference between P maximum and P minimum durations was defined as P-wave dispersion. RESULTS: Age, body mass index (BMI), systolic blood pressure, diastolic blood pressure, P-wave maximal duration, and P-wave dispersion were increased in boys as compared with girls. Of age (P = 0.53), systolic blood pressure (P = 0.42), diastolic blood pressure (P = 0.50), pulse pressure (P = 0.73), gender, heart rate, and BMI tested with univariate linear regression analysis in all subjects; only gender (P < 0.001), BMI (P = 0.01), and heart rate (P = 0.02) were associated with P-wave dispersion (F = 5.16, P < 0.001, R(2)= 0.03). CONCLUSIONS: P-wave dispersion was increased in boys as compared with girls who exercise regularly. P-wave dispersion is affected by gender, BMI, and heart rate in healthy students.

A microscopic survey on the efficiency of well-known routine chemical fixatives on cryosections.

This study was designed to analyze and compare tissue preservation efficiency of acetone (AC), formaldehyde (FA) and paraformaldehyde (PFA) on cryosections. Brain, kidney, heart and liver tissue of adult Balb/c mice were fixed with either FA or PFA prior to cryosectioning, or fixed with AC alone immediately after cryosectioning. Hematoxylin and eosin staining showed that AC is a poor fixative in preserving the general tissue and cellular organization. PFA, and to a lesser extent FA, produced significantly better results. Another set of cryosections were further analyzed to test the properties of those fixatives to preserve proteins from specific cell structures. Cytokeratin filaments, F-actin filaments and nuclei were immunolabeled and examined using confocal microscopy. Results demonstrated that, overall, PFA is the best fixative tested. However, FA fixation gave poor results in preserving neuronal tissues. Immunofluorescence confirmed the inefficiency of AC fixation, after which no specific labelling of cytokeratin filaments was detectable. Nevertheless, actin filaments were detectable on AC-fixed samples, a finding that was supported by the quantification of fluorescein-phalloidin binding to F-actin. Overall, the data suggest that AC fixation is unacceptable for preservation of most samples, whereas FA and PFA fixation should be chosen according to the tissues and proteins to be studied.

Carbofuran alters centrosome and spindle organization, and delays cell division in oocytes and mitotic cells.

Although many countries banned of its usage, carbofuran (CF) is still one of the most commonly used carbamate derivative insecticides against insects and nematodes in agriculture and household, threatening the human and animal health by contaminating air, water, and food. Our goal was to evaluate the potential toxic effects of CF on mammalian oocytes besides mitotic cells. Caspase-dependent apoptotic pathway was assessed by immunofluorescence and western blot techniques. Alterations in the meiotic spindle formation after CF exposure throughout the in vitro maturation of mice oocyte-cumulus complexes (COCs) were analyzed by using a 3D confocal laser microscope. Maturation efficiency and kinetics were assessed by direct observation of the COCs. Results indicated that the number of TUNEL-positive cells increased in CF-exposed groups, particularly higher doses (>250 µM) in a dose-dependent fashion. The ratio of anticleaved caspase-3 labeled cells in those groups positively correlated with TUNEL-positivity. Western blot analysis confirmed a significant increase in active caspase-3 activity. CF caused a dose-dependent accumulation of oocytes at prometaphase-I (PM-I) of meiosis. Partial loss of spindle microtubules (MTs) was noted, which consequently gave rise to a diamond shape spindle. Aberrant pericentrin foci were noted particularly in PM-I and metaphase-I (M-I) stages. Conclusively, CF (1) induces programmed cell death in a dose-dependent manner, and (2) alters spindle morphology most likely through a mechanism that interacts with MT assembly and/or disorientation of pericentriolar proteins. Overall, data suggest that CF could give rise to aneuploidy or cell death in higher doses, therefore reduce fertilization and implantation rates.

The adherence of Candida albicans to acrylic resin reinforced with different fibers.

One important aethiological factor in the pathogenesis of chronic atrophic candidosis is the presence of Candida albicans on the fitting surface of the dentures. Fibers may come into contact with oral mucosa during the finishing procedures of acrylic resins. The exposed fibers may provide mechanical retention for yeast cells at the interface of the components. The effect of two different glass fibers and two different environments were evaluated in respect of Candida albicans adhesion to the acrylic surface. Half of the acrylic samples reinforced with two different fibers (Sticknet and Eversticknet) were pretreated with phosphate-buffered saline (PBS) and the rest with unstimulated saliva. The test specimens were placed in yeast suspension. The adhered cells were examined with a scanning electron microscope. The amount of adhered cells in PBS was lower for Eversticknet but the difference was not significant (p > 0.05). The number of yeast cells decreased in saliva for both groups and the difference was statistically significant for the samples reinforced with Eversticknet (p < 0.01). The use of Sticknet or Eversticknet as reinforcing material for poly(methylmethacrylate) had no effect on surface topography due to the same adhesion state of Candida albicans. The presence of a salivary pellicle derived from unstimulated saliva reduced adhesion of Candida albicans.