Evaluation of the "Freiburg Acuity VEP" on Commercial Equipment.

PURPOSE: To assess the implementation and outcome quality of the Freiburg Acuity VEP methodology (Bach et al. in Br J Ophthalmol 92:396-403, 2008) on the Diagnosys Espion Profile and E3 electrophysiology systems. METHODS: We recorded visual evoked potentials (VEPs) from both eyes of 24 participants, where visual acuity (VA) was either full or reduced with scatter foils to approximately 0.5 and 0.8 LogMAR, resulting in a total of 144 recordings. Behavioral VA was measured in each case under the same conditions using the Freiburg Acuity Test (FrACT); VEP-based acuity was assessed with the "heuristic algorithm," which automatically selects points for regression to zero amplitude. RESULTS: Behavioral VA ranged from - 0.2 to 1.0 LogMAR. The fully automatic heuristic VEP algorithm resulted in 8 of 144 recordings (6%) that were scored as "no result." The other 136 recordings (94%) had an outcome of - 0.20 to 1.3 LogMAR (which corresponds to a range of 20/12.5-20/400, or 6/3.8-6/120, in Snellen ratios; or 1.6-0.1 in decimal acuity). The heuristic VEP algorithm agreed with the behavioral VA to within ± 0.31 LogMAR (95% limits of agreement), which is equivalent to approximately three lines on a VA chart. CONCLUSIONS: The successful implementation of the Freiburg Acuity VEP "heuristic algorithm" on a commercial system makes this capability available to a wider group of users. The limits of agreement of ± 0.31 LogMAR are close to the original implementation at the University of Freiburg and we believe are clinically acceptable for a fully automatic, largely objective assessment of visual acuity.

Genomic signatures of a global fitness index in a multi-ethnic cohort of women.

The rates of obesity and sedentary lifestyle are on a dramatic incline, with associated detrimental health effects among women in particular. Although exercise prescriptions are useful for overcoming these problems, success can be hampered by differential responsiveness among individuals in cardiovascular fitness indices (i.e. improvements in strength, lipids, VO(2) max). Genomic factors appear to play an important role in determining this inter-individual variation. We performed microarray analyses on mRNA in whole blood from 60 sedentary women from a multi-ethnic cohort who underwent 12 weeks of exercise, to identify gene subsets that were differentially expressed between individuals who experienced the greatest and least improvements in fitness. We identified 43 transcripts in 39 unique genes (FDR<10%; FC>1.5) whose expression increased the most in "high" versus "low" pre-menopausal female responders. These 39 genes were enriched in six biological pathways, including oxidative phosphorylation (p = 8.08 × 10(-3)). Several of the 39 genes (i.e. TIGD7, UQCRH, PSMA6, WDR12, TFB2M, USP15) have previously reported associations with fitness-related phenotypes. In summary, we identified gene signatures based on mRNA analysis that define responsiveness to exercise in a largely minority-based female cohort. Importantly, this study validates several genes/pathways previously associated with exercise responsiveness and extends these findings with additional novel genes.

Whole body irrigation for contraband bodypackers.

GOALS: Investigate outcomes of contraband body packers treated with whole bowel irrigation (WBI) using oral polyethylene glycol (PEG). Compare with prior studies of treatments using mild laxatives and/or observation. BACKGROUND: Drug smuggling via the gastrointestinal tract has risks including sudden death. Other studies have reported complication rates between 4% and 22%. STUDY: Retrospective case series of patients body packing contraband, and treated with WBI using PEG solution. Outcome measures include length of hospital stay (LOS) and complications. Statistical inferences using Spearman rank correlation and Fisher Exact tests. RESULTS: Sixteen patients with mean age 27.9 (SD 8.8). There were 2 complications (12.5%) and no deaths. There was no significant difference in complication frequency when compared with other reported treatment methods (P = 0.57, P = 0.48, P = 1.0). Mean LOS was 49.4 hours (SD 29.6). There was no correlation between mean LOS and either PEG dose (P = 0.89), drug type (P = 0.76), packet quantity (P = 0.34), or packet weight (P = 0.99). CONCLUSIONS: In this limited case series, WBI with PEG was used to treat contraband body packers with no higher complication frequency than other reported methods. The drug type, packet quantity, packet weight, and PEG dose did not correlate with the length of hospital stay.