Objective electrophysiological contrast sensitivity with monofocal and multifocal intraocular lenses:a prospective clinical study

Background:To compare objective electrophysiological contrast sensitivity function(CSF)in patients implanted with either multifocal intraocular lenses(MIOLs)or monofocal intraocular lenses(IOLs)by pattern reversal visual evoked potentials(prVEP)measurements.Methods:Fourty-five cataract patients were randomly allocated to receive bilaterally:apodized diffractive-refractive Alcon Acrysof MIOL(A),full diffractive AMO Tecnis MIOL(B)or monofocal Alcon Acrysof IOL(C).Primary outcomes:1-year differences in objective binocular CSF measured by prVEP with sinusoid grating stimuli of 6 decreasing contrast levels at 6 spatial frequencies.Secondary outcomes:psychophysical CSF measured with VCTS-6500,photopic uncorrected distance(UDVA),and mesopic and photopic uncorrected near and intermediate visual acuities(UNVA and UIVA respectively).Results:Electrophysiological CSF curve had an inverted U-shaped morphology in all groups,with a biphasic pattern in Group B.Group A showed a lower CSF than group B at 4 and 8 cpd,and a lower value than group C at 8 cpd.Psychophysical CSF in group A exhibited a lower value at 12 cpd than group B.Mean photopic and mesopic UNVA and UIVA were worse in monofocal group compared to the multifocal groups.Mesopic UNVA and UIVA were better in group B.Conclusions:Electrophysiological CSF behaves differently depending on the types of multifocal or monofocal IOLs.This may be related to the visual acuity under certain conditions or to IOL characteristics.This objective method might be a potential new tool to investigate on MIOL differences and on subjective device-related quality of vision.

Dismicrobism in inflammatory bowel disease and colorectal cancer: Changes in response of colocytes

Patients with inflammatory bowel disease(IBD)have an increased risk of 10%-15%developing colorectal cancer(CRC)that is a common disease of high economic costs in developed countries.The CRC has been increasing in recent years and its mortality rates are very high.Multiple biological and biochemical factors are responsible for the onset and progression of this pathology.Moreover,it appears absolutely necessary to investigate the environmental factors favoring the onset of CRC and the promotion of colonic health.The gut microflora,or microbiota,has an extensive diversity both quantitatively and qualitatively.In utero,the intestine of the mammalian fetus is sterile.At birth,the intestinal microbiota is acquired by ingesting maternal anal or vaginal organisms,ultimately developing into a stable community,with marked variations in microbial composition between individuals.The development of IBD is often associated with qualitative and quantitative disorders of the intestinal microbial flora(dysbiosis).The healthy human gut harbours about10 different bacterial species distributed in colony forming units which colonize the gastrointestinal tract.The intestinal microbiota plays a fundamental role in health and in the progression of diseases such as IBD and CRC.In healthy subjects,the main control of intestinal bacterial colonization occurs through gastric acidity but other factors such as endoluminal temperature,competition between different bacterial strains,peristalsis and drugs can influence the intestinal microenvironment.The microbiota exerts diverse physiological functions to include:growth inhibition of pathogenic microorganisms,synthesis of compounds useful for the trophism of colonic mucosa,regulation of intestinal lymphoid tissue and synthesis of amino acids.Furthermore,mucus seems to play an important role in protecting the intestinal mucosa and maintaining its integrity.Changes in the microbiota composition are mainly influenced by diet and age,as well as genetic factors.Increasing evidence indicates that dysbiosis favors the production of genotoxins and metabolites associated with carcinogenesis and induces dysregulation of the immune response whichpromotes and sustains inflammation in IBD leading to carcinogenesis.A disequilibrium in gut microflora composition leads to the specific activation of gut associated lymphoid tissue.The associated chronic inflammatory process associated increases the risk of developing CRC.Ulcerative colitis and Crohn’s disease are the two major IBDs characterized by an early onset and extraintestinal manifestations,such as rheumatoid arthritis.The pathogenesis of both diseases is complex and not yet fully known.However,it is widely accepted that an inappropriate immune response to microbial flora can play a pivotal role in IBD pathogenesis.

New therapeutic perspectives in irritable bowel syndrome: Targeting low-grade inflammation, immuno-neuroendocrine axis, motility, secretion and beyond

Irritable bowel syndrome(IBS)is a chronic,recurring,and remitting functional disorder of the gastrointestinal tract characterized by abdominal pain,distention,and changes in bowel habits.Although there are several drugs for IBS,effective and approved treatments for one or more of the symptoms for various IBS subtypes are needed.Improved understanding of pathophysiological mechanisms such as the role of impaired bile acid metabolism,neurohormonal regulation,immune dysfunction,the epithelial barrier and the secretory properties of the gut has led to advancements in the treatment of IBS.With regards to therapies for restoring intestinal permeability,multiple studies with prebiotics and probiotics are ongoing,even if to date their efficacy has been limited.In parallel,much progress has been made in targeting low-grade inflammation,especially through the introduction of drugs such as mesalazine and rifaximin,even if a better knowledge of the mechanisms underlying the low-grade inflammation in IBS may allow the design of clinical trials that test the efficacy and safety of such drugs.This literature review aims to summarize the findings related to new and investigational therapeutic agents for IBS,most recently developed in preclinical as well as Phase 1 and Phase 2clinical studies.

Inflammation in irritable bowel syndrome:Myth or newtreatment target?

Low-grade intestinal inflammation plays a key role in the pathophysiology of irritable bowel syndrome(IBS), and this role is likely to be multifactorial. The aim of this review was to summarize the evidence on the spectrum of mucosal inflammation in IBS, highlighting the relationship of this inflammation to the pathophysiology of IBS and its connection to clinical practice. We carried out a bibliographic search in Medline and the Cochrane Library for the period of January 1966 to December 2014, focusing on publications describing an interaction between inflammation and IBS. Several evidences demonstrate microscopic and molecular abnormalities in IBS patients. Understanding the mechanisms underlying low-grade inflammation in IBS may help to design clinical trials to test the efficacy and safety of drugs that target this pathophysiologic mechanism.

缩小精神病生物学模型与社会心理学模型研究间的差距（英文）

Paul Bebbington最近发表的专题文章对精神病的社会心理学研究的最新进展做了一个极好的综述。然而,我们对一个仅仅基于社会流行病学和认知理论的模型可以完全描述精神病持有疑虑,并且公平地说,Bebbington也不认为这个模型可以完全描述。一个完整的模型必须纳入我们从非社会流行病学、神经科学和遗传学中汲取的经验教训。有证据表明,Bebbington感兴趣的社会风险因素,和诸如滥用兴奋剂和大麻之类的生物危险因素都可以通过纹状体多巴胺失调而激发精神病症状。在精神分裂症样精神病的病因学中,我们也需要考虑神经发育异常。此外,我们对精神病的遗传学理解上的惊人进展为研究探讨基因-环境相关性和基因-环境相互作用打开一扇令人兴奋的大门。总之,Bebbington阐述了认知领域的学者与社会研究者互相交流的价值,但偶尔更倾向于生物学方面的角度可能发展出一个更全面的模型。

Favorable Outcome in Open Globe Injuries with Low OTS Score

Purpose:Open globe eye injuries can have profound social and economic consequences. Here, we describe two cases of war and outdoor activity open globe eye injury where, despite a low OTS score,.current microsurgical technology allowed for a favorable outcome.Case report 1: A 33-year-old Libyan soldier had been treated for an open-globe grenade blast trauma to his left eye, which showed light perception and OTS score 2..He had undergone a lensectomy and PPV with silicone oil tamponade. Surgical treatment included scleral buckling,.cornea trephination, temporary Eckardt keratoprosthesis, PPV revision, intraocular lens(IOL) implantation, and corneal grafting. Six months later, his VA was improved to 20 / 70.Case report 2:.A 35-year-old man presented with a corneal laceration in his left eye from a meat skewer,.with marked hypotony and LP..After primary corneal wound closure,.Bscan ultrasonography revealed massive vitreous hemorrhage(OTS score 2). The patient underwent open cataract extraction with IOL implantation, 23 gauge PPV, laser photocoagulation of the retinochoroidal laceration, and a gas tamponade. After three weeks,.the patient underwent a 2nd 23 G PPV due to a fibrinous reaction. Six month later, the patients exhibited 20 /25 VA.Conclusion:.These cases confirm that even for patients with a low OTS and poor visual prognosis,.an up-to-date surgery protocol may achieve visual results adequate for leading an autonomous daily life.