Notes

π-Stacking Stopper-Macrocycle Settled down Dynamically Interlocked [2]Rotaxanes.
nt difference in cranial index or revision procedures between the four groups was identified. Overall, the mean length of follow-up was 25.3 months. All procedures had similar results for cranial index with decreased surgical time, transfusion volume, and hospital stay seen in FLAG and endoscopic groups.
Pfeiffer syndrome is associated with a genetic mutation of the FGFR2 (or more rarely, FGFR1) gene, and features the combination of craniosynostosis, midface hypoplasia, broad thumbs and broad great toes. Previous research has identified a wide spectrum of clinical phenotypes in patients with Pfeiffer syndrome. This study aimed to investigate the multifactorial considerations for speech, language, hearing and feeding development in patients with severe genetically-confirmed Pfeiffer syndrome.

A 23-year retrospective case-note review of patients attending the Oxford Craniofacial Unit was undertaken. Patients were categorized according to genotype. Patients with mutations located in FGFR1, or outside the FGFR2 IgIII domain-hotspot, or representing known Crouzon/Pfeiffer overlap substitutions were excluded. Twelve patients with severe FGFR2-associated Pfeiffer syndrome were identified.

Patients most commonly had pansynostosis (n = 8) followed by bicoronal (n = 3), and bicoronal and sagittal synostosis (n = has identified important speech, language, hearing and feeding issues in patients with severe FGFR2-associated Pfeiffer syndrome. Results indicate that a high rate of motor-based oral stage feeding difficulties, and pharyngeal stage swallowing difficulties necessitating regular review by specialist craniofacial speech and language therapists.Petrous apex effusions are rare disorders and usually occur in the petrous apex (PA) having well-aerated cells and it may present with several symptoms or can be diagnosed incidentally on imaging methods obtained for another reason. If there are persistent symptoms despite the conservative treatment in symptomatic patients, a surgical attempt can be considered. In patients with favorable hearing levels and with the well-pneumatized petrous bone, PA cells may be effectively drained through subcochlear or supracochlear approaches by preserving patient's hearing levels. In this case report, the authors presented a severe symptomatic patient with petrous apex effusion who did not respond to conservative treatment and petrous apex drainage was performed via the subcochlear approach.
Several materials are available for cranioplasty reconstruction and consensus regarding the ideal material is lacking. The goal of this study is to present surgical and patient-reported outcomes with PEEK versus Titanium alloplastic cranioplasty.

A retrospective review of all patients who underwent alloplastic cranioplasty with PEEK or Titanium from 2010 to 2017 was conducted. Patient demographics and complications were abstracted and analyzed. Information regarding patient-reported outcomes was collected through a telephone survey.

A total of 72 patients (median age 55 years) who underwent 77 cranioplasties were identified (38% PEEK, n = 29; 62% Titanium, n = 48). Overall complication rates were similar between the PEEK (24%, n = 7) and Titanium groups (23%, n = 11), P = 0.902. Similarly, implant failure was similar between the 2 groups (7% in PEEK (n = 2), 13% in Titanium (n = 6), P = 0.703). History of radiation was associated with increased rate of infection in patients with Titanium mesh cranioplasents with history of radiotherapy demonstrated a higher infection rate when titanium mesh was used.
The COVID-19 pandemic, with its resultant social distancing, has disrupted the delivery of healthcare for both patients and providers. Fortunately, changes to legislation and regulation in response to the pandemic allowed Emory Healthcare to rapidly implement telehealth care. Beginning in early March 2020 and continuing through the initial 2-month implementation period (when data collection stopped), clinicians received telehealth training and certification. Standard workflows created by means of a hub-and-spoke operational model enabled rapid sharing and deployment of best practices throughout the system's physician group practice. Lean process huddles facilitated successful implementation. In total, 2,374 healthcare professionals, including 986 attending physicians, 416 residents and fellows, and 555 advanced practice providers, were trained and certified for telehealth; 53,751 new- and established-patient audio-video telehealth visits and 10,539 established-patient telephone visits were performed in 8 we similar to in-person visits. Initial patient satisfaction scores were equivalent to in-person visits. Celastrol We conclude that rapid deployment of virtual visits can be accomplished through a structured, organized approach including training, certification, and Lean principles. A hub-and-spoke model enables bidirectional feedback and timely improvements, thus facilitating swifter implementation and a quick rise in patient volume. Financial sustainability is achievable, but to sustain that, telehealth requires the support of continued deregulation by legislative and regulatory bodies.
To describe five representative cases of hemorrhagic Descemet's membrane detachment in glaucoma surgery that had different origins, mechanisms and treatments.

Clinical records of patients that had undergone a non-penetrating glaucoma surgery, with a diagnosis of hemorrhagic Descemet's membrane detachment were reviewed for demographic data, clinical findings and treatment applied.

Five patients with hemorrhagic Descemet's membrane detachment were included in this case series. They all had different causes, namely a massive hemorrhage at the end of a canaloplasty procedure, a needling maneuver, autologous blood injection, Swan syndrome and frequent eye rubbing. Hematoma evacuation was performed in four eyes, one of them from under the scleral flap of the deep sclerectomy and three of them through a surgical or laser perforation in Descemet's membrane. link2 Air tamponade was done in most of these cases. One of these cases required transcorneal suture fixation. One case was observed expectantly. All cases successfully recovered but peripheral corneal stain was persistent in two cases.

Hemorrhagic Descemet's membrane detachment is a rare but potential vision-threatening complication in glaucoma surgery. Different mechanisms may cause the bleeding and there are several techniques available to approach this complication. Pre-Descemet hematoma should be drained to avoid permanent corneal stain and air/gas tamponade may help to prevent recurrences.
Hemorrhagic Descemet's membrane detachment is a rare but potential vision-threatening complication in glaucoma surgery. Different mechanisms may cause the bleeding and there are several techniques available to approach this complication. Pre-Descemet hematoma should be drained to avoid permanent corneal stain and air/gas tamponade may help to prevent recurrences.Although numbers of studies have addressed this question, the relationship between diabetes mellitus and primary open-angle glaucoma is still unclear. This article discusses progress in understanding the complex relationship between these 2 entities and recent shifts in perspective that challenge the traditional dogma regarding diabetes mellitus and primary open-angle glaucoma. There are still many unanswered questions.
Patients with ocular hypertension (OHT) do not show impaired cerebral vasodilation responses to hypercapnia but patients with primary open-angle glaucoma (POAG) do. Impaired vasoreactivity in patients with POAG may have neuronal or vascular origins and increase stroke risk.

To investigate changes in cerebral blood flow and cerebral vasomotor reactivity using the breath-holding index in patients with POAG and OHT, to examine whether these parameters contribute to the risk of ischemic stroke.

Thirty patients with POAG, 30 patients with OHT, and 30 age- and sex-matched healthy control subjects were included in this university hospital-based, cross-sectional, and observational study. Eyes with a greater degree of visual field loss and/or more severe optic disc damage were selected for the study in patients with POAG, whereas in patients with OHT and controls, the study eye was chosen randomly. link3 The mean blood flow velocity and breath-holding index were measured in the middle cerebral artery ipsilaterally in ctional insufficiency on vasoreactivity. Moreover, impaired cerebral vascular regulation may contribute to the increased risk of stroke in patients with POAG.
Dry eye disease (DED) observed in this study is associated with ocular surface abnormalities as shown by specific dry eye tests. Changes in tear quality may be responsible for dry eye symptoms among the participants.

This study sought to evaluate DED in glaucoma patients in Ghana.

This was a hospital-based descriptive cross-sectional study involving glaucoma patients on topical glaucoma treatment for at least 6 months. The medical records of participants were thoroughly reviewed for information on demographics, ocular history, medical history, number of topical antiglaucoma medications used within the last 6 months, and any other ophthalmic medications used by the participants. An Ocular Surface Disease Index (OSDI) questionnaire was administered to each participant, after which Schirmer test and tear break-up time (TBUT) were performed on each participant in a controlled environment.

A total of 100 individuals participated in the study. The mean±SD age of participants was 60.44±14.05 years. The majorts in Ghana and is associated with age, duration of glaucoma medication, type of preservatives, and number of topical glaucoma medications.
DED is prevalent among glaucoma patients in Ghana and is associated with age, duration of glaucoma medication, type of preservatives, and number of topical glaucoma medications.
Some patients with glaucoma report difficulties to recognize faces when they are far away. We show that this deficit could result from a higher sensitivity to crowding in central vision.

The aim of the study is to investigate whether face recognition difficulties reported by some patients with glaucoma result from a greater sensitivity to inner crowding in central vision.

Seventeen patients with glaucoma and 17 age-matched normally sighted controls participated in the study. An isolated mouth (uncrowded condition) or a mouth within a face (crowded condition) was randomly displayed centrally for 200 ms. For each condition, participants were asked to decide whether the mouth was closed or open. The stimuli were presented at 3 angular sizes (0.6×0.4, 1×0.72, and 1.5×1.08 degrees). Accuracy was measured.

Crowding affected performance differentially for patients and controls. Consistent with previous studies controls exhibited a "face superiority effect," with a better accuracy when the mouth was located w underlying this excessive sensitivity must be elucidated to improve central perception in glaucoma.
The aim of this study was to analyze perceptions and experiences of clinicians implementing the patient-centered medical home (PCMH).

The PCMH model focuses on several important concepts, including team-based care management as well as care coordination and continuity among providers and across settings of care.

A qualitative analysis of data collected in 2016 from primary care personnel through a national survey was conducted.

Four themes were found consistent with care management and care coordination the importance of teamwork and optimized team member roles, need for adequate prioritization of care management and care coordination, need to refine tools and resources supporting care management and care coordination, and challenges with managing and coordinating care with and across complex systems.

Successful implementation requires adequate support for teamwork and ensuring team members can work according to their clinical competency. Nurses practicing in expanded roles need clear role guidelines and adequate time to function in these roles.
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