Patient-reported outcomes of autologous serum tears for the treatment of dry eye disease in a large cohort.

PURPOSE: To assess patient satisfaction with autologous serum tears (AST) for the treatment of dry eye disease (DED). METHODS: A prospective, observational case-series, including 100 participants who were treated with AST for DED. The five-item Dry Eye Questionnaire (DEQ-5), Symptom Assessment in Dry Eye (SANDE) Questionnaire, and the Treatment Satisfaction Questionnaire for Medication (TSQM) were used to assess DED symptoms and patients' treatment satisfaction. RESULTS: The duration of AST treatment was 1-6 months in 25%, 6-12 months in 24%, 1-2 years in 22%, and 2-3 years in 29% of the participants. The mean cumulative DEQ-5 score was 12.7 ±â€¯3.8 and 65% of the participants scored ≥12, which may suggest an underlying diagnosis of Sjögren's syndrome. The use of other treatments was significantly reduced after the use of AST (P < 0.001). The mean total SANDE score improved from 79.5 ±â€¯21.8, 95% CI [75.2, 83.8] before to 42.2 ±â€¯23.2, 95% CI [37.6, 46.8] after using AST (P < 0.001). The mean TSQM treatment efficacy, convenience, and global satisfaction scores were 73.1 ±â€¯17.2, 95% CI [69.6, 76.5], 72.5 ±â€¯17.5, 95% CI [69.0, 76.0], and 74.6 ±â€¯22.7, 95% CI [70.1, 79.0]. No patients reported any side effects. CONCLUSION: Autologous serum tears treatment in severe dry eye disease significantly reduced dry eye symptoms, with high patients' satisfaction scores.

Genome-wide meta-analysis identifies novel loci associated with free triiodothyronine and thyroid-stimulating hormone.

PURPOSE: Thyroid hormones are essential for the normal function of almost all human tissues, and have critical roles in metabolism, differentiation and growth. Free triiodothyronine (fT3), free thyroxine (fT4) and thyroid-stimulating hormone (TSH) levels are under strong genetic influence; however, most of the heritability is yet unexplained. METHODS: In order to identify novel loci associated with fT3, fT4 and TSH serum levels we performed a genome-wide meta-analysis of 7 411 206 polymorphisms in up to 1731 euthyroid individuals from three Croatian cohorts from Dalmatia region: two genetically isolated island populations and one mainland population. Additionally, we also performed a bivariate analysis of fT3 and fT4 levels. RESULTS: The EPHB2 gene variant rs67142165 reached genome-wide significance for association with fT3 plasma levels (P = 9.27 × 10-9) and its significance was confirmed in bivariate analysis (P = 9.72 × 10-9). We also found a genome-wide significant association for variant rs13037502 upstream of the PTPN1 gene and TSH plasma levels (P = 1.67 × 10-8). CONCLUSION: We identified a first genome-wide significant variant associated with fT3 plasma levels, as well as a novel locus associated with TSH plasma levels. These findings are biologically relevant and enrich our knowledge about the genetic basis of pituitary-thyroid axis function.

The trigeminal sensory relay to reticulospinal neurones in lampreys.

This study was carried out to identify lamprey neurones relaying trigeminal sensory inputs to reticulospinal cells. Double labeling with fluorescent tracers was used in vitro. Fluorescein-conjugated dextran amines were applied to the proximal stump of the cut trigeminal nerve on both sides, and Texas Red-conjugated dextran amines were injected unilaterally in the middle (MRRN) or the posterior (PRRN) rhombencephalic reticular nuclei. Texas Red retrogradely labeled cells were found ipsi- and contralateral to each injection. Any of these cells with the soma or at least a major dendrite among the fluorescein-labeled trigeminal afferent axons was considered a candidate relay cell. Of these two possibilities, only cells with their soma among the fluorescein-labeled trigeminal afferents were found. The candidate relay cells projecting to the MRRN were mostly clustered at the caudal vestibular nerve level within the trigeminal descending tract, whereas the majority of those projecting to the PRRN were located more caudally. The diameter of candidate relay cells ranged from 9.2 to 24.6 mum and 9.2 to 46.1 mum, after MRRN and PRRN injections, respectively. A possible relay function for these cells was tested with electrophysiological experiments. The intracellular responses to trigeminal nerve stimulation were recorded in reticulospinal cells under control conditions and after ejections of a combination of glutamate ionotropic receptor antagonists over the candidate relay cells in small areas along the sulcus limitans. The synaptic responses elicited in MRRN reticulospinal cells were maximally depressed when ejections were made at the level of the vestibular nerve, in accord with the anatomical data. The synaptic responses in PRRN reticulospinal cells showed maximal depression when ejections were made slightly more caudally. Altogether, these results suggest that cells located within the trigeminal descending tract and projecting to reticular nuclei are likely to be the sensory trigeminal relays to reticulospinal neurones in lampreys.

[Cornea procurement and grafts and number of patients on waiting lists. Data collection in France between 1990 and 1994]. / Prélèvement et greffes de cornées et nombre de patients en attente de greffe. Recensement en France entre 1990 et 1994.

OBJECTIVES: Analyze annual corneal graft procurement and transplantation in France. METHODS: Data collected from all public and private health centers in France in a survey conducted in August 1994 by the general health directory were analyzed by the French Graft authorities. RESULTS: Between 1990 and the first semester 1994, an annual mean of 3205 corneal grafts were performed in France. The annual number of grafts fell by 27% between 1991 and 1992 then stabilized at 2700 grafts per year. Eighty percent of the grafts were performed in public institutions. Less than 4% of the patients were foreigners. The number of patients on waiting lists on June 30, 1994 was 7129, i.e. 2.7 times the number of transplantations in 1993. Mean annual cornea procurement between 1991 and the first semester 1994 was 2930. Corneas were removed at the morgue in 78% of the cases or in the operating room in 19% (multiple organ procurement) and 1.5% (cornea alone). Grafted corneas came from public hospitals in 72% of the cases. Fifty-seven percent of the grafts used in private institutions were imported. The mean annual number of imported corneas can be estimated at 280. This number has increased by 127% since 1990 and corresponds to 8% of the grafted corneas. CONCLUSION: The number of corneal grafts in France is similar to that in other European countries, but the number of patients on waiting lists is high and French eye banks had a restricted role.

[Histopathologic lesions of the accessory salivary glands in Gougerot-Sjögren syndrome: re-evaluation of the diagnostic criteria of Chisholm and Mason and of Chometter et al]. / Lésions histopathologiques des glandes salivaires accessoires (G.S.A.) au cours du syndrome de Gougerot-Sjögren: réévaluation des critères diagnostiques de Chisholm et Mason et de Chomette et coll.

In a retrospective study, we used a series of 29 patients with Sjögren's Syndrome diagnosed according to the new European criteria (Cl. Vitali, S. Bombardieri, H. M. Moutsopoulos et al.) (8). (Arthritis Rheum 1993; 36:340-7). A labial biopsy technique allowed to classify these patients into the anatomical "scores" formerly related by Chisholm and Mason and Chomette et al. Referring to these criteria, only 45% of patients presented a characteristic histopathological pattern. If another complementary criterium, i.e. ductal tropism of lymphoid infiltrates, was added, that percentage remained low (50% only). Thus, these results would suggest the following considerations: the classical histopathological criteria do not seem sufficiently specific; other histological criteria such as ductal lesions previously noted by Leroy et al. must in addition be looked for; thus it would seem to be of considerable value to use in the future complementary quantitative studies by means of morphometric methods.