Evaluating the small aperture intraocular lens: depth of focus and the role of refraction and preoperative corneal astigmatism in visual performance.

Purpose: To evaluate depth of focus (DOF) and visual acuities (VAs) by manifest refractive spherical equivalent (MRSE) and degree of preoperative corneal astigmatism with the IC-8 small aperture intraocular lens (SA IOL) (Apthera).

Setting: 21 investigational sites in the United States.

Design: Prospective, multicenter, open-label, parallel-group, nonrandomized, examiner-masked, 1-year clinical study.

Diagnosis and management of postrefractive surgery ectasia.

Postrefractive surgery ectasia is a serious, sight-threatening complication seen after the following procedures: laser in situ keratomileusis, photorefractive keratectomy, small-incision lenticule extraction, radial keratotomy, and/or arcuate keratotomy. Specific risk factors may include age, corneal thickness, degree of refractive error, corneal topographic changes including irregular astigmatism, percent tissue ablation, and residual stromal bed. Biomarkers may be a new option to help indicate who is at greatest risk for ectasia.

Calcineurin signaling as a target for the treatment of alcohol abuse and neuroinflammatory disorders.

Converging lines of evidence point to a significant role of neuroinflammation in a host of psychiatric conditions, including alcohol use disorder, TBI, and PTSD. A complex interaction of both peripheral and central signaling underlies processes involved in neuroinflammation. Calcineurin is a molecule that sits at the nexus of these processes and has been clearly linked to a number of psychiatric disorders including alcohol use disorder (AUD).

EBV-Associated Lymphoproliferative Disorder and Hemophagocytic Lymphohistiocytosis in a Patient with Severe Celiac Disease.

Background: Epstein-Barr virus- (EBV-) associated lymphoproliferative disease (LPD) is a rare condition, usually occurring in immunocompromised patients. We report a case of EBV-associated LPD in a patient with severe celiac disease, the first report to describe this syndrome in a patient with this diagnosis.

Case Summary: A 69-year-old Caucasian woman with recent diagnosis of celiac sprue presented to our hospital with persistent diarrhea, abdominal pain, weight loss, and fatigue despite adherence to gluten-free diet for a number of weeks prior to presentation.

Central Administration of Cyclosporine A Decreases Ethanol Drinking.

Aims: Abstinence among alcohol dependent liver graft recipients is remarkably high. The routine use of anti-immune agents in these patients led to rodent studies showing that immunosuppressants acting through inhibition of calcineurin (CLN) are highly effective in decreasing alcohol consumption. It remained unclear, however, whether the decreased alcohol consumption in rodent models is mediated through peripheral suppression of immune response or centrally through direct inhibition of cyclophilin-CLN in the brain.

Shear accumulation as a means for evaluating risk of thromboembolic events in novel endovascular stent graft designs.

Objective: This study proposes to establish a simulation-based technique for evaluating shear accumulation in stent grafts and to use the technique to assess the performance of a novel branched stent graft system.

Methods: Computational fluid dynamics models, with transient boundary conditions, particle injection, and rigid walls, simplifying assumptions were developed and used to evaluate the shear accumulation in various stent graft configurations with a healthy aorta as comparison.

Results: Shear streamlines are presented for the various configurations.

Glycogenic Hepatopathy: Thinking Outside the Box.

Glycogenic hepatopathy (GH) remains underrecognized in adults as most clinicians mistake it for the more common hepatic abnormality associated with uncontrolled diabetes mellitus in this age group, non-alcoholic fatty liver disease. This is also complicated by the fact that both entities are indistinguishable on liver ultrasound. We herein describe a similar predicament in which a young adult female presented with bilateral upper quadrant abdominal pain, tender hepatomegaly, lactic acidosis and a >10-fold increase in liver enzymes, which worsened after the administration of high-dose steroids.

Hydration and thermal strain during tennis in the heat.

Competitive tennis in the heat can prompt substantial sweat losses and extensive consequent body water and electrolyte deficits, as well as a level of thermal strain that considerably challenges a player's physiology, perception of effort, and on-court well-being and performance. Adequate hydration and optimal performance can be notably difficult to maintain when multiple same-day matches are played on successive days in hot weather. Despite the recognised effects of the heat, much more research needs to be carried out to better appreciate the broader scope and full extent of the physiological demands and hydration and thermal strain challenges facing junior and adult players in various environments, venues and competition scenarios.

Consortium for health and military performance and American College of Sports Medicine Summit: utility of functional movement assessment in identifying musculoskeletal injury risk.

Prevention of musculoskeletal injuries (MSKI) is critical in both civilian and military populations to enhance physical performance, optimize health, and minimize health care expenses. Developing a more unified approach through addressing identified movement impairments could result in improved dynamic balance, trunk stability, and functional movement quality while potentially minimizing the risk of incurring such injuries. Although the evidence supporting the utility of injury prediction and return-to-activity readiness screening tools is encouraging, considerable additional research is needed regarding improving sensitivity, specificity, and outcomes, and especially the implementation challenges and barriers in a military setting.

Acute immune thrombocytopenic purpura in children and adolescents in South Dakota 1998-2004.

Immune thrombocytopenic purpura (ITP), also known as idiopathic thrombocytopenic purpura, is a rare bleeding disorder caused by increased peripheral platelet destruction. The laboratory and clinical criteria for establishing the diagnosis of acute ITP in children and adolescents are widely accepted. Treatment options for ITP remain controversial.

Medical students learn policy and advocacy through annual Legislative Day.

Through the collaborative relationship of the South Dakota State Medical Association (SDSMA) and the University of South Dakota School of Medicine (USDSM), there has been increased awareness and interest among medical students in the legislative process and its effect on the practice of medicine and delivery of care. As a result of this educational interest, and through the collaboration of these organizations, a formal "Legislative Day" has been added to the USDSM curriculum.

Foreign accent syndrome: anatomic, pathophysiologic and psychosocial considerations.

The appearance of new onset accented speech after brain insult has been rarely reported. Stroke is often responsible for the development of what has been termed foreign accent syndrome (FAS). Foreign Accent Syndrome was initially described by Pick in 1919, and further elaborated on by Monrad-Krohn in 1947.

Microscopic colitis: a report of two cases.

Microscopic colitis is characterized by chronic, watery, secretory diarrhea, with a normal or near-normal gross appearance of the colonic mucosa. Biopsy is diagnostic and usually reveals either lymphocytic colitis or collagenous colitis. The symptoms of collagenous colitis appear most commonly in the sixth decade.

Pulmonary lymphangioleiomyomatosis in a postmenopausal woman: case report with review of literature.

Lymphangioleiomyomatosis (LAM) is a rare disorder that occurs almost exclusively in young females and characterized by peribronchial, perivascular, and perilymphatic non-neoplastic proliferation of smooth-muscle cells. These changes may precipitate chylous effusions, pulmonary hemorrhage, bronchial cyst formation, progressive loss of lung function, and ultimately death. Most patients die within eight to ten years of the time of diagnosis.

Aggressive systemic mastocytosis: a case report and brief review of the literature.

Aggressive Systemic Mastocytosis (ASM), a rare subtype of Systemic Mastocytosis (SM), results from clonal proliferation and invasion of multiple organs by neoplastic mast cells. The clinical presentation varies, dependent on which organ systems are involved, and may take an indolent or rapidly fatal course. Several treatment strategies have been proposed.

Ischemic nephropathy in South Dakota: case reports and review.

Ischemic nephropathy, a relatively new term coined to describe renal insufficiency due to renal artery disease, is neither a new subject for medicine throughout the country, nor a new problem here in South Dakota. It is an important and overlooked cause of renal insufficiency and is almost certainly under-diagnosed. Five case reports and a review of the entity are described to illustrate the diversity of this clinical presentation.

Incidence of hyperkalemia in high risk patients during treatment with an angiotensin converting enzyme inhibitor (Lisinopril) versus an angiotensin II receptor blocker (Losartan).

Hyperkalemia is a known side effect during treatment with Angiotensin Converting Enzyme Inhibitors (ACEIs). The purpose of this study was to compare the effect of an ACEI (Lisinopril) to an Angiotensin II Receptor Blocker (Losartan) on serum potassium (K) level in patients with known history of high normal serum K (mean = 4.8) while on treatment with ACEIs or Angiotensin II Receptor Blockers (ARBs).

Infectious mononucleosis presenting as postpartum fever.

Infectious Mononucleosis and pregnancy are common conditions seen by obstetricians and family physicians. However, infectious mononucleosis in the postpartum period has not been reported in the literature. A 20 year-old woman presented with a four-day history of fever of 40 degrees C, and chills at her six-week postpartum visit, which prompted an evaluation of the cause of the fever.

Hypothyroid acute renal failure.

Muscular disorders and even hypothyroid myopathy with elevated muscle enzymes are commonly seen in hypothyroidism. In this paper, we report a case of acute renal failure in a 35-year old male patient with myalgia. His serum creatinine reached a level of 2.

Molecular medicine: a primer for clinicians. Part XIV: Stem cells.

Earlier papers in this series have described many of the tools of molecular biology that are finding practical bedside applications. We have reviewed how molecular diagnostics, genetic testing, and DNA and protein microarrays all have become part of clinical medicine. We have also described the potential of the human genome project to impact the practice of medicine.

Appendicitis due to tongue stud ingestion: a case study and review of management plans.

Among the causes of appendicitis, foreign body obstruction of the appendiceal lumen is one of the rarest. In the majority of cases, swallowed foreign bodies pass through the alimentary system without causing any significant disease manifestation. Of those items that are swallowed, rigid and/or sharp ones, such as needles, have the greatest potential to enter the appendiceal lumen and cause an inflammatory reaction with or without perforation.