Neurotrophic keratopathy is a corneal disease characterized by impaired corneal innervation. It can lead to corneal epithelial defects, ulcerations, and perforations. Topical insulin has been shown to be effective in treating this disorder. Insulin is a growth factor that can promote corneal epithelial cell proliferation and migration. In addition, it can also inhibit corneal epithelial cell apoptosis. Topical insulin has previously been found to enhance corneal wound healing. This article reviews the current understanding of the mechanism of action of topical insulin in the treatment of neurotrophic keratopathy.
1 June 2018 in Turkish Journal of Anesthesia and Reanimation
There is limited literature on non-invasive mechanical ventilation (NIMV) in patients with polytrauma-related acute respiratory failure (ARF). Despite an increasing worldwide application, there is still scarce evidence of significant NIMV benefits in this specific setting, and no clear recommendations are provided. We performed a systematic review, and a search of clinical databases including MEDLINE and EMBASE was conducted from the beginning of 1990 until today. Although the benefits in reducing the intubation rate, morbidity and mortality are unclear, NIMV may be useful and does not appear to be associated with harm when applied in properly selected patients with moderate ARF at an earlier stage of injury by experienced teams and in appropriate settings under strict monitoring. In the presence of these criteria, NIMV is worth attempting, but only if endotracheal intubation is promptly available because non-responders to NIMV are burdened by an increased mortality when intubation is delayed.
The aim of this study was to explore the efficacy, repeatability, and efficiency of a new intraoperative contactless device (INTEGRA Optomed, Chorzów, Poland) for determining the axis for toric intraocular lens implantation and then to compare this with that determined using a manual method. This study was conducted at the Ophthalmological Center for Children and Adults Optomed, Chorzów, Poland. This nonrandomized, retrospective, observational study included 20 eyes of 12 patients (5 males and 7 females) who had toric intraocular lens implanted. A video recording of each surgery using the INTEGRA system was made showing the analysis. The surgeon and one of the researchers then independently assessed the location of the implant axes determined with both digital and manual slit-lamp methods, and compared them. The implantation axes suggested for both the manual and INTEGRA methods were similar. The median axis disparities were 0.0 degree and 0.5 degree, and standard deviations were 0.61 and 0.81 for researcher 1 and 2, respectively. The dominant value was 0.0 in both groups. The INTEGRA axis designation was not statistically different from the manual method (level of significance: α < 0.01). The INTEGRA system is a digital ink-free device for image tracking scleral vessels. It was helpful for determining the implantation axis in a precise and repeatable manner, and measurements were comparable with a manual technique.
(1) Background: To compare the results of a new intraoperative contactless device (INTEGRA Optomed, Poland) with the result of a manual method for determining the axis for toric intraocular lens implantation. (2) Material and Methods: This retrospective observational study included 60 eyes of 40 patients (17 men, 23 women) who had toric intraocular lenses implanted. A video recording of each surgery that used the INTEGRA system was made for the analysis. Two researchers then independently assessed the location of the implant axes determined with both digital and manual slit-lamp methods, and compared the results between methods. (3) Results: The implantation axes suggested through the manual and INTEGRA methods were similar. The median axis disparities were 0.0 degrees for both groups. The standard deviation was 0.63 and 0.75 for researcher 1 and 2, respectively. The dominant value was 0.0 in both groups. The INTEGRA axis designation was statistically significantly different from the manual method for researcher 1 (p < 0.05), but it was statistically insignificant for researcher 2 (p = 0.79). (4) Conclusions: The INTEGRA system is a digital ink-free device for image tracking scleral vessels. It was helpful for determining the implantation axis in a precise manner, and the measurements were comparable with those obtained through a manual technique.