Intravitreal aflibercept for macular oedema secondary to central retinal vein occlusion in patients with prior treatment with bevacizumab or ranibizumab.

PurposeTo report the visual and anatomic outcomes in eyes with macular oedema (MO) secondary to central retinal vein occlusion (CRVO) that were switched from either intravitreal bevacizumab or ranibizumab to intravitreal aflibercept.MethodsTwo-center retrospective chart review. Eyes with MO secondary to CRVO that received a minimum of three intravitreal injections of bevacizumab or ranibizumab and were switched to intravitreal aflibercept for persistent or recurrent MO not responding to either bevacizumab and/or ranibizumab.ResultsIn all 42 eyes of 42 patients were included in the study. The median visual acuity before the switch was 20/126, 1 month after the first injection of aflibercept 20/89 (P=0.0191), and at the end of the follow-up 20/100 (P=0.2724). The median CRT before the switch was 536 µm, 1 month after the first injection of aflibercept 293.5 µm (P=0.0038), and at the end of the follow-up 279 µm (P=0.0013 compared to before the switch). The median number of weeks between injections before the switch was 5.6 and after the switch was 7.6 (P<0.0001).ConclusionConverting eyes with refractory MO due to CRVO to aflibercept can result in stabilization of the vision, improved macular anatomy, and extension of the injection interval.

[Modernization of methods for tissue sampling and preparation for a histological study at autopsy].

Preparation of autopsy material for a histological study for correct diagnosis is not less important than that of a biopsy specimen. Based on their accumulated experience, the authors propose a number of modernizations to prepare autopsy material for the study of lung, bone marrow, and intestinal abnormalities, which require no higher work intensity, but at the same time contribute to a unified approach to investigating tissues and organs in certain pathological processes in pediatric care.

[Clinicomorphological characteristics of colonic circulatory changes in children with organic and functional colostasis].

Acute colonic perfusion impairments (thrombosis, infarction, and ischemia) have evident clinical manifestations and are reasonably well described in the literature. At the same time, the problems of chronic peripheral circulatory disorder in the large bowel and the impact of the disorder on its motility are inadequately considered. By summarizing the data available in the literature and their findings, the authors consider the etiology and pathogenesis of organic and functional colostasis in the context of changes in the colonic angioarchitectonics.

Hemodynamics and wall mechanics in human carotid bifurcation and its consequences for atherogenesis: investigation of inter-individual variation.

Finite element simulations of fluid-solid interactions were used to investigate inter-individual variations in flow dynamics and wall mechanics at the carotid artery bifurcation, and its effects on atherogenesis, in three healthy humans (normal volunteers: NV1, NV2, NV4). Subject-specific calculations were based on MR images of structural anatomy and ultrasound measurements of flow at domain boundaries. For all subjects, the largest contiguous region of low wall shear stress (WSS) occurred at the carotid bulb, WSS was high (6-10 Pa) at the apex, and a small localized region of WSS > 10 Pa occurred close to the inner wall of the external carotid artery (ECA). NV2 and NV4 had a "spot" of low WSS distal to the bifurcation at the inner wall of the ECA. Low WSS patches in the common carotid artery (CCA) were contiguous with the carotid bulb low WSS region in NV1 and NV2, but not in NV4. In all three subjects, areas of high oscillatory shear index (OSI) were confined to regions of low WSS. Only NV4 exhibited high levels of OSI on the external adjoining wall of the ECA and CCA. For all subjects, the maximum wall shear stress temporal gradient (WSSTG) was highest at the flow divider (reaching 1,000 Pa/s), exceeding 300 Pa/s at the walls connecting the ECA and CCA, but remaining below 250 Pa/s outside of the ECA. In all subjects, (maximum principle) cyclic strain (CS) was greatest at the apex (NV1: 14%; NV2: 11%; NV4: 6%), and a second high CS region occurred at the ECA-CCA adjoining wall (NV1: 11%, NV2: 9%, NV4: 5%). Wall deformability was included in one simulation (NV2) to verify that it had little influence on the parameters studied. Location and magnitude of low WSS were similar, except for the apex (differences of up to 25%). Wall distensibility also influenced OSI, doubling it in most of the CCA, separating the single high OSI region of the carotid bulb into two smaller regions, and shrinking the ECA internal and external walls' high OSI regions. These observations provide further evidence that significant intra-subject variability exists in those factors thought to impact atherosclerosis.

[The mechanism of death in whole-body overheating]. / Mekhanizm smerti pri obshchem peregrevanii organizma.

Data on anatomo-clinical analysis of 36 cases of death due to general overheating of a body are presented. On the basis of these data can be stated that in most cases the effect of high ambient temperature combined with great physical exercise and prolonged exposure to the caused death within short (up to 3 days) periods of time as a result of cessation of CNS functioning. Without physical exercise and direct insolation death usually occurred later (on the average of 5-9 days) from acute renal and renal-hepatic failure. Morphologic changes were unspecific.