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  • 1
    In: Veterinary Ophthalmology, Wiley, Vol. 23, No. 1 ( 2020-01), p. 44-51
    Abstract: To determine the efficacy of automated imaging software of the Nidek ConfoScan 4 confocal biomicroscope at analyzing canine corneal endothelial cell density and morphology in health and disease, by comparing to a manual analysis method. Animal studied Nineteen eyes of 10 dogs were evaluated and include three Beagles, three Jack Russell Terriers, and four miscellaneous breeds. Twelve clinically normal and seven eyes affected with corneal endothelial dystrophy (CED) were scanned and analyzed. Procedures Endothelial cell density (ECD), mean and standard deviation (SD) of cell area, percent polymegathism, mean and SD of the number of cell sides, and percent pleomorphism were calculated using automated and manual methods for each scan. Results The automated analysis showed significantly greater ECD in comparison with the manual frame method due to misidentification of cell domains in CED‐affected dogs. No significant differences in ECD were observed between normal and CED‐affected dogs in automated analysis, while CED‐affected dogs showed significantly lower ECD in manual frame method and planimetry. Using both automated and manual methods, CED‐affected dogs showed greater variability of cell area or the number of cell sides than normal dogs. Conclusion The automated imaging software is unable to accurately identify cell borders in CED‐affected dogs resulting in inaccurate estimates of ECD. Thus, manual analysis is recommended for use in clinical trials assessing adverse events associated with novel medical treatments and/or surgical procedures.
    Type of Medium: Online Resource
    ISSN: 1463-5216 , 1463-5224
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2020
    detail.hit.zdb_id: 2011043-1
    SSG: 22
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  • 2
    In: SSRN Electronic Journal, Elsevier BV
    Type of Medium: Online Resource
    ISSN: 1556-5068
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2022
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  • 3
    Online Resource
    Online Resource
    Asploro Open Access Publications ; 2021
    In:  Asploro Journal of Biomedical and Clinical Case Reports Vol. 4, No. 3 ( 2021-11-2), p. 184-190
    In: Asploro Journal of Biomedical and Clinical Case Reports, Asploro Open Access Publications, Vol. 4, No. 3 ( 2021-11-2), p. 184-190
    Abstract: Delayed hemothorax is a potentially life-threatening complication of thoracic trauma that should be carefully considered in all patients presenting with thoracic injury. We report a case of delayed hemothorax in a 77-year-old male presenting eleven days’ status post multiple right mid- to high-rib fractures. His case was complicated by retained hemothorax after CT-guided chest-tube with subsequent video-assisted tube thoracostomy (VATS) revealing fibrothorax necessitating conversion to open thoracotomy. Known risk factors for development of delayed hemothorax include older patient age, three or more rib fractures, and presence of mid- to high-rib fractures, and should be used in risk stratification of thoracic trauma. Tube thoracostomy is often sufficient in management of delayed hemothorax. In rare cases, hemothoraces can be complicated by retained hemothorax or fibrothorax, which require more invasive therapy and carry greater morbidity and mortality.
    Type of Medium: Online Resource
    ISSN: 2582-0370
    Language: English
    Publisher: Asploro Open Access Publications
    Publication Date: 2021
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  • 4
    In: Diabetes, American Diabetes Association, Vol. 73, No. Supplement_1 ( 2024-06-14)
    Abstract: Joslin Medalist Study identified Retinol Binding Protein 3 (RBP3) as a potential protective factor against advanced diabetic retinopathy (DR) in the vitreous and retina of people with type 1 diabetes for 50 years or longer. There is emerging interest in DR biomarker identification in aqueous due to its easier access compared to vitreous. Quantitive aqueous RBP3 concentration, in a pilot study, correlated inversely with DR severity, but positively with vitreous RBP3, suggesting it may be a clinically useful DR biomarker. This study measured RBP3 concentration in 153 aqueous samples from patients undergoing cataract surgery at the Joslin Beetham Eye Institute to characterize RBP3 concentrations in relation to DR progression. DR progression was defined as ≥2-step worsening on the Early Treatment Diabetic Retinopathy Study severity scale. At baseline, DR severity distribution was 36% no DR, 38% mild and 26% moderate DR. The average follow-up was 5.6±3.6yrs. Aqueous RBP3 concentration was highest in patients with no visible signs of DR (median 2.1nM) compared to mild and moderate DR (1.5nM, P=0.04). There was no significant difference between aqueous RBP3 concentration in those with type 1 or type 2 diabetes (P=0.55). DR progression was present in 28.1% (N=45). Elevated aqueous RBP3 concentration was associated with less frequent diabetic macular edema (Odd Ratio (OR) 0.20, 95% Confidence Interval (CI) 0.07;0.56, P=0.002). In unadjusted analyses, less DR progression was associated with older age (OR 0.87, CI 0.79;0.96, P=0.006), lower HbA1c (OR 1.88, 95% CI 1.01;3.49, P=0.05), and elevated RBP3 concentration (OR 0.51, 95% CI 0.28;0.93, P=0.029). The performance of an Area Under the Curve model including RBP3 was 0.69 for predicting DR progression. These findings indicate that elevated aqueous RBP3 concentration is associated with less DR progression, supporting its potential as a protective factor and retinal-specific DR biomarker. Disclosure T. Chokshi: None. W. Fickweiler: None. S. Jangolla: None. I. Wu: None. J.K. Sun: Research Support; Optovue, Boehringer-Ingelheim, Novo Nordisk, Roche Pharmaceuticals. Other Relationship; Roche Pharmaceuticals. Research Support; Physical Sciences, Inc, Boston Micromachines. L.P. Aiello: Advisory Panel; Novo Nordisk. Stock/Shareholder; Kalvista. Other Relationship; Optos. Consultant; Ceramedix. G.L. King: None. Funding American Diabetes Association (7-21-PDF-022); National Eye Institute (R01EYE26080-01), the National Institute of Diabetes and Digestive and Kidney Diseases and National Institutes of Health (DP3- DK-094333-01); JDRF (17-2013-310); the Dianne Nunnally Hoppes Fund; the Beatson Pledge Fund
    Type of Medium: Online Resource
    ISSN: 0012-1797
    Language: English
    Publisher: American Diabetes Association
    Publication Date: 2024
    detail.hit.zdb_id: 1501252-9
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  • 5
    In: Diabetes, American Diabetes Association, Vol. 73, No. Supplement_1 ( 2024-06-14)
    Abstract: Given the increasing prevalence of diabetes in the elderly, understanding factors that influence age-related macular degeneration (AMD) and diabetic retinopathy (DR) is crucial to target intervention for both. Previously, we found an inverse relationship between DR and AMD in the Joslin 50-Year Medalist Study composed of individuals who have had insulin-dependent diabetes for over 50 years. This study evaluated the relationship between AMD and DR in an age-matched cohort of people with type 1 diabetes from the Beetham Eye Institute (BEI) at Joslin Diabetes Center (N=1413) with the Medalist Study. The presence of AMD and DR severity were assessed from fundus photography. Advanced glycation endproducts (AGEs), specifically carboxymethyl-lysine, carboxyethyl-lysine, and methylglyoxal-derived hydroimidazolone 1, were quantified using high-performance liquid chromatography mass spectrometry and inflammatory cytokines by ELISA. We found an inverse association between DR severity and the presence of AMD in the BEI cohort (P & lt;0.0001), consistent with previous findings in Medalists. The presence of AMD was associated with less frequent diabetic macular edema (7.6% vs 16.7%, P=0.01). In Medalists, there was no correlation of plasma inflammatory cytokines including interleukin-6 with DR, AMD, or their vitreous concentrations, whereas serum AGE levels were positively associated with DR severity, but inversely with AMD (P & lt;0.05). Higher triglyceride/high-density lipoprotein ratio and lower systemic insulin sensitivity were associated with DR severity, but inversely with AMD (P & lt;0.05). These findings suggest that metabolic control of hyperglycemia and lipidemia can delay DR, but may worsen the progression of AMD. The inverse risk of AMD and DR suggests accelerated aging is not likely a major cause of DR. Studies are needed urgently to evaluate the distinct effects of glucose and lipid metabolism on their contribution to inverse risks for DR and AMD. Disclosure W. Fickweiler: None. T. Chokshi: None. E. O'Doherty: None. S. Jangolla: None. N.A. Ziemniak: None. I. Wu: None. C. Jacoba: None. S. Gulkas: None. A. Talaspayeva: None. J.D. Cavallerano: None. L.P. Aiello: Advisory Panel; Novo Nordisk. Stock/Shareholder; Kalvista. Other Relationship; Optos. Consultant; Ceramedix. J.K. Sun: Research Support; Optovue, Boehringer-Ingelheim, Novo Nordisk, Roche Pharmaceuticals. Other Relationship; Roche Pharmaceuticals. Research Support; Physical Sciences, Inc, Boston Micromachines. G.L. King: None. Funding American Diabetes Association (7-21-PDF-022), National Eye Institute (R01EYE26080-01), the National Institute of Diabetes and Digestive and Kidney Diseases and National Institutes of Health (DP3- DK-094333-01); JDRF (17-2013-310); the Dianne Nunnally Hoppes Fund; the Beatson Pledge Fund
    Type of Medium: Online Resource
    ISSN: 0012-1797
    Language: English
    Publisher: American Diabetes Association
    Publication Date: 2024
    detail.hit.zdb_id: 1501252-9
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  • 6
    In: Diabetes, American Diabetes Association, Vol. 71, No. Supplement_1 ( 2022-06-01)
    Abstract: Although inflammatory cytokines and vascular endothelial growth factor (VEGF) have been proposed to underlie the progression of diabetic retinopathy (DR) , there remains an important need to identify biomarkers for early stages of DR. Findings from the Joslin Medalist Study, composed of individuals who have had insulin-dependent diabetes for 50 years or longer, showed that Retinol Binding Protein 3 (RBP3) was significantly higher both in retina and vitreous samples with no to mild DR compared to those with proliferative DR (PDR) . In this study, we examined vitreous and plasma samples from 2people with type 1 and type 2 diabetes from the Joslin Beetham Eye Institute and Medalist Study to evaluate the relationship between vitreous RBP3, inflammatory cytokines, and DR severity and progression. PDR was associated with lower levels of IL- (P=0.007) , IFN-γ (P=0.001) , and higher levels of IL-15 (P=0.01) and IL-6 (P=0.02) in vitreous. Vitreous VEGF was positively associated with increasing DR severity in surgical samples (P & lt;0.05) . Plasma VEGF was not associated with vitreous VEGF concentration. No significant relationships were found between inflammatory markers in the vitreous and plasma from the same individual. Increased vitreous RBP3 concentration was associated with less severe DR in all eyes (P & lt;0.0001) , post-mortem (P & lt;0.0001) and surgical samples from type 1 and type 2 diabetic patients (P=0.03) with diabetes duration of & lt;50 years (mean±SD 27±13 years) . Higher vitreous RBP3 concentration was associated with lower risk of PDR onset (P & lt;0.0001) . Lower vitreous TNF-α, TNF-β, and VEGF were associated with increased vitreous RBP3 concentration (P & lt;0.05, all) . These findings suggest that inflammatory cytokines and risk of DR worsening may be decreased by RBP3, supporting its potential use as biomarker for severity and progression of DR. Disclosure W.Fickweiler: None. J.D.Cavallerano: None. L.P.Aiello: Consultant; KalVista Pharmaceuticals, Inc., Novo Nordisk, Stock/Shareholder; KalVista Pharmaceuticals, Inc. J.Sun: Consultant; American Diabetes Association, American Medical Association, Research Support; Adaptive Sensory Technology, Boehringer Ingelheim International GmbH, Genentech, Inc., Jaeb Center for Health Research, Janssen Pharmaceuticals, Inc., Novartis Pharmaceuticals Corporation, Novo Nordisk, Optovue, Incorporated, Physical Sciences, Inc, Roche Pharmaceuticals. G.L.King: Advisory Panel; Medtronic, Research Support; Janssen Pharmaceuticals, Inc. H.Park: None. K.Park: None. M.G.Mitzner: None. D.B.Robinson: None. T.Chokshi: None. T.Boumenna: None. J.Gauthier: None. I.Wu: None. Funding American Diabetes Association (7-21-PDF-022) ; National Eye Institute (R01EYE26080-01) , the National Institute of Diabetes and Digestive and Kidney Diseases and National Institutes of Health (DP3-DK-094333-01) ; JDRF (17-2013-310) ; the Dianne Nunnally Hoppes Fund; the Beatson Pledge Fund
    Type of Medium: Online Resource
    ISSN: 0012-1797
    Language: English
    Publisher: American Diabetes Association
    Publication Date: 2022
    detail.hit.zdb_id: 1501252-9
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  • 7
    In: Neuro-Ophthalmology, Informa UK Limited
    Type of Medium: Online Resource
    ISSN: 0165-8107 , 1744-506X
    RVK:
    Language: English
    Publisher: Informa UK Limited
    Publication Date: 2023
    detail.hit.zdb_id: 1475815-5
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  • 8
    In: Diabetes, American Diabetes Association, Vol. 73, No. Supplement_1 ( 2024-06-14)
    Abstract: Purpose: Diabetic retinopathy disproportionately affects groups from disadvantaged backgrounds. Although teleophthalmology improves diabetic retinopathy (DR) screening rates, the impact of socioeconomic status on retinal disease severity and remote eye care access is unknown. Here, we investigate whether socioeconomic condition as measured by Area of Deprivation Index (ADI) impacts the prevalence and severity of ocular pathologies and eye care follow-up after remote eye screening. Methods: We reviewed medical records of patients from University of California, Davis Health who underwent remote diabetic retinopathy screening between 2018-2022 to collect demographic data, medical history, teleophthalmology findings, and in-person eye care follow-up reports. ADI is a composite measure of income, education, employment, and housing, which has been used to inform health policy. Patients with no census neighborhood level data were excluded. Results: Among 1533 patients who underwent remote DR screening (mean age 61.5, 46.4% female, 11.9% Black, 16.1% Hispanic, mean HbA1c 7.6), most patients had no (78%) or mild DR (11.7%), while some had more than mild non-proliferative DR (2.1% moderate, 0.3% severe, 0.3% proliferative, 1.2% diabetic macular edema). Patients with greater socioeconomic disadvantage was associated with worse DR severity (p & lt;0.001). For those who were referred for in-person eye care evaluation (n = 398), the most socioeconomically deprived individuals were also less likely to follow up within the recommended time frame (23.5% in 5th quintile vs. 65.6% in 1st quintile). Conclusion: Socioeconomic disadvantage as measured by ADI is independently associated with worse DR severity, and less likely to receive follow-up care within the recommended time frame after remote DR screening using teleophthalmology. Although remote DR screening improves overall screening rate, further investigation is needed to understand methods to best mitigate these disparities. Disclosure M. Cruz: None. T. Chokshi: None. L. Nguyen: None. T.G. Vargas-Ramos: None. A. Hang: None. B.M. Snyder: None. G. Yiu: Consultant; 4DMT, AbbVie Inc., Adverum Biotechnologies, Alimera Sciences, Bausch + Lomb, Boehringer-Ingelheim, Clearside, Endogena, Genentech, Inc., Gyroscope, Iridex, Janssen, jCyte, Myrobalan, NGM Bio, Novartis, Ray, RegenXBio, Stealth.
    Type of Medium: Online Resource
    ISSN: 0012-1797
    Language: English
    Publisher: American Diabetes Association
    Publication Date: 2024
    detail.hit.zdb_id: 1501252-9
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  • 9
    In: Diabetes, American Diabetes Association, Vol. 71, No. Supplement_1 ( 2022-06-01)
    Abstract: The Joslin Medalist Study identified Retinol-binding protein 3 (RBP3) as a potential protective factor against diabetic retinopathy (DR) in the vitreous and retina of individuals with type 1 diabetes for 50 years or longer. This study evaluated the association of aqueous RBP3 concentration to vitreous RBP3 concentrations and DR severity. We measured 131 aqueous samples from patients with type 1 and 2 diabetes undergoing cataract surgery at the Joslin Beetham Eye Institute (BEI) and postmortem samples of Medalists. Aqueous RBP3 concentrations in BEI and Medalists samples were similar for eyes with proliferative DR (PDR, P=0.11) and were well correlated between fellow eyes (r=0.65, P & lt;0.0001) . With an average 12-fold decreased concentration compared to vitreous samples, RBP3 concentrations in aqueous and vitreous samples were correlated within the same individual (r=0.32, P=0.003, N=89) . Aqueous RBP3 was not associated with A1c (P=0.60) , however, RBP3 concentration was inversely associated with the presence of pan-retinal laser photocoagulation scars (β estimate −22.0, 95% CI −31.9;−12.0, P & lt;0.0001) . With increasing DR severity, aqueous RBP3 levels decreased from mild DR (median 0.7nM ± 0.2) , moderate-severe (0.65nM ± 0.3, P=0.0092 vs. PDR) , to PDR (0.5nM ± 0.2, P=0.0vs. mild DR) . Individual retinal layer thicknesses measured by optical coherence tomography (Heidelberg v6.0c, Germany, N=45) showed that higher aqueous concentrations were associated with increased thickness of the ganglion cell layer (β estimate 0.002, 95% CI 0.0019;0.0023, P & lt;0.0001) and inner nuclear layer (0.0026, 0.0025;0.0028, P & lt;0.0001) . The retinal pigment epithelium was inversely associated with aqueous RBP3 levels (−0.001, −0.0017;0.0003, P=0.004) . These findings indicate that aqueous RBP3 concentrations are correlated to vitreous fluids and reduced in people with advanced DR, supporting its potential use as a biomarker for DR severity in people with type 1 and 2 diabetes. Disclosure T.Chokshi: None. J.Sun: Consultant; American Diabetes Association, American Medical Association, Research Support; Adaptive Sensory Technology, Boehringer Ingelheim International GmbH, Genentech, Inc., Jaeb Center for Health Research, Janssen Pharmaceuticals, Inc., Novartis Pharmaceuticals Corporation, Novo Nordisk, Optovue, Incorporated, Physical Sciences, Inc, Roche Pharmaceuticals. G.L.King: Advisory Panel; Medtronic, Research Support; Janssen Pharmaceuticals, Inc. W.Fickweiler: None. M.G.Mitzner: None. I.Wu: None. T.Boumenna: None. D.B.Robinson: None. H.Park: None. K.Park: None. L.P.Aiello: Consultant; KalVista Pharmaceuticals, Inc., Novo Nordisk, Stock/Shareholder; KalVista Pharmaceuticals, Inc. Funding American Diabetes Association (7-21-PDF-022) ; National Eye Institute (R01EYE26080-01) , the National Institute of Diabetes and Digestive and Kidney Diseases and National Institutes of Health (DP3-DK-094333-01) ; JDRF (17-2013-310) ; the Dianne Nunnally Hoppes Fund; the Beatson Pledge Fund
    Type of Medium: Online Resource
    ISSN: 0012-1797
    Language: English
    Publisher: American Diabetes Association
    Publication Date: 2022
    detail.hit.zdb_id: 1501252-9
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  • 10
    In: Diabetes Care, American Diabetes Association, Vol. 45, No. 9 ( 2022-09-01), p. 2159-2162
    Abstract: To correlate inflammatory cytokines and vascular endothelial growth factor (VEGF) in vitreous and plasma with vitreous retinol binding protein 3 (RBP3), diabetic retinopathy (DR) severity, and DR worsening in a population with type 1 and type 2 diabetes. RESEARCH DESIGN AND METHODS RBP3, VEGF, and inflammatory cytokines were measured in plasma and vitreous samples (n = 205) from subjects of the Joslin Medalist Study and Beetham Eye Institute. RESULTS Higher vitreous RBP3 concentrations were associated with less severe DR (P & lt; 0.0001) and a reduced risk of developing proliferative DR (PDR) (P & lt; 0.0001). Higher RBP3 correlated with increased photoreceptor segment thickness and lower vitreous interleukin-12 (IL-12), tumor necrosis factor-α (TNF-α), and TNF-β (P & lt; 0.05). PDR was associated with lower vitreous interferon-γ and IL-10 and higher VEGF, IL-6, and IL-15 (P & lt; 0.05), but was not associated with their plasma concentrations. CONCLUSIONS Higher vitreous RBP3 concentrations are associated with less severe DR and slower rates of progression to PDR, supporting its potential as a biomarker and therapeutic agent for preventing DR worsening, possibly by lowering retinal VEGF and inflammatory cytokines.
    Type of Medium: Online Resource
    ISSN: 0149-5992
    Language: English
    Publisher: American Diabetes Association
    Publication Date: 2022
    detail.hit.zdb_id: 1490520-6
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