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Corneal Reflex

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163. The ANZICS statement on death and organ donation

and mechanical ventilation during which the preconditions for clinical determination of brain death are fulfilled and the patient is unresponsive (Glasgow Coma Score 3), has no pupil reaction to light, no cough reflex and no spontaneous breathing efforts, before clinical testing to determine brain death. Previously, a minimum of four hours was recommended, with a minimum of two hours before clinical testing was repeated. However, there has been no reported instance of clinical testing determining brain death (...) system activity in order to define criteria for abandoning ongoing intensive therapy. They referred to an isoelectric electro-encephalogram and absent evoked cerebral responses, reporting that the heart rate did not change after giving atropine while it increased after dextroamphetamine. Later in the same year, Mollaret and Goulon in Paris 14 described 23 patients with the same syndrome (deep coma with no spontaneous respiration, no reflexes, polyuria and low blood pressure if noradrenaline

2013 Clinical Practice Guidelines Portal

164. EFNS?ENS Guidelines on the diagnosis and management of disorders associated with dementia

limbs, usually of the limb‐kinetic type. During the evolution of the disease, postural and action tremor, limb dystonia, focal reflex myoclonus, postural instability and falls, alien hand‐like phenomenon, corticospinal signs, oculomotor and eyelid motor deficits and dysarthria develop in more than half of cases. CBD, the commonest cause of CBS, is a 4‐repeat tauopathy defined by unique neuropathological features including cortical atrophy, nigral degeneration, achromasia (swollen neurons (...) hallucinations . Genetic prion diseases Genetic prion diseases occurring in 10–15% of cases are caused by prion protein gene ( PRNP ) mutations, showing the patterns of autosomal‐dominant inheritance with incomplete penetrance. The disorders manifest as familial Creutzfeldt–Jakob disease (fCJD), Gerstmann–Sträussler–Scheinker disease (GSS) or fatal familial insomnia (FFI). Accidentally transmitted (iatrogenic) CJD has been related to corneal graft transplantation, contaminated human pituitary‐derived growth

2012 European Academy of Neurology

165. Spinal Disinhibition in Experimental and Clinical Painful Diabetic Neuropathy. Full Text available with Trip Pro

Spinal Disinhibition in Experimental and Clinical Painful Diabetic Neuropathy. Impaired rate-dependent depression (RDD) of the Hoffman reflex is associated with reduced dorsal spinal cord potassium chloride cotransporter expression and impaired spinal γ-aminobutyric acid type A receptor function, indicative of spinal inhibitory dysfunction. We have investigated the pathogenesis of impaired RDD in diabetic rodents exhibiting features of painful neuropathy and the translational potential (...) of this marker of spinal inhibitory dysfunction in human painful diabetic neuropathy. Impaired RDD and allodynia were present in type 1 and type 2 diabetic rats but not in rats with type 1 diabetes receiving insulin supplementation that did not restore normoglycemia. Impaired RDD in diabetic rats was rapidly normalized by spinal delivery of duloxetine acting via 5-hydroxytryptamine type 2A receptors and temporally coincident with the alleviation of allodynia. Deficits in RDD and corneal nerve density were

2017 Diabetes

166. Multifocal Chromatic Pupilloperimetry in Patients With Pseudotumor Cerebri and Healthy Subjects.

cloudy corneas. Any condition preventing accurate measurement or examination of the pupil. PTC patients Any other neurologic or ophthalmic disease other than PTC Use of any topical or systemic medications that could adversely influence pupillary reflex Intolerance to gonioscopy, slit lamp examination, Goldmann applanation tonometry or other schedule study procedure. Mental impairment or instability such as that informed consent may not be obtained or compliance with tester instructions is unlikely (...) typical for PTC Exclusion Criteria: Healthy subjects History of past (last 3 months) or present ocular disease or ocular surgery Use of any topical or systemic medications that could adversely influence pupillary reflex Intolerance to gonioscopy, slit lamp examination, Goldmann applanation tonometry or other schedule study procedure. Mental impairment or instability such as that informed consent may not be obtained or compliance with tester instructions is unlikely. Visual media opacity including

2017 Clinical Trials

167. Congenital Cavitary Optic Disc Anomaly and Axenfeld’s Anomaly in Wolf-Hirschhorn Syndrome: A Case Report and Review of the Literature Full Text available with Trip Pro

and Xp22.33-p22.2. Systemic findings included "Greek warrior helmet" facies, hypotonia, cleft palate, neonatal tooth eruption, talipes equinovarus, bilateral clinodactyly, clitoromegaly, partial agenesis of the corpus callosum, bilateral renal hypoplasia, and two atrial septal defects. Ocular findings included normal intraocular pressures and corneal diameters, large-angle exotropia, downward slanting of the palpebral fissures, absent eyelid creases, upper and lower eyelid retraction with shortage (...) of the anterior eyelid lamellae, euryblepharon, lagophthalmos with poor Bell's reflex and exposure keratopathy, hypertelorism, Axenfeld's anomaly, megalopapillae, and cavitary optic disc anomaly.We describe the ocular phenotype of a patient with Wolf-Hirschhorn syndrome, including the rare descriptions and photographs of Axenfeld's anomaly, megalopapilla, and cavitary optic disc anomaly in this condition.

2017 Ophthalmic genetics

168. External validation of prediction models for time to death in potential donors after circulatory death. Full Text available with Trip Pro

used the data of 92 potential cDCD donors. Multivariable regression analysis demonstrated that absent cough-, corneal reflex, lower morphine dosage, and midazolam use were significantly associated with death within 60 minutes (area under the curve [AUC] 0.89; 95% confidenence interval [CI] 0.87-0.91). External validation of the logistic regression models of de Groot et al (AUC 0.86; 95% CI 0.77-0.95), Wind et al (AUC 0.62; 95% CI 0.49-0.76), Davila et al (AUC 0.80; 95% CI 0.708-0.901) and the Cox

2017 American Journal of Transplantation

169. A prospective multicentre randomized placebo-controlled superiority trial in patients with suspected bacterial endophthalmitis after cataract surgery on the adjuvant use of intravitreal dexamethasone to intravitreal antibiotics. Full Text available with Trip Pro

, corneal oedema, the absence of a red fundus reflex on presentation, LP on presentation and culture of virulent pathogens from biopsy were statistically significantly associated with an unfavourable visual outcome.Intravitreal dexamethasone without preservatives as an adjuvant to intravitreal antibiotics does not improve visual acuity (VA) in patients treated for suspected bacterial endophthalmitis after cataract surgery.© 2017 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley

2017 Acta ophthalmologica Controlled trial quality: predicted high

170. Epidermoid cysts of the cavernous sinus: clinical features, surgical outcomes, and literature review. Full Text available with Trip Pro

with CS epidermoid cysts that had been surgically treated at the authors' hospital between 2001 and 2016. The patients' medical records, imaging data, and follow-up outcomes were retrospectively analyzed. The related literature from the past 40 years (18 articles, 20 patients) was also evaluated.The most common chief complaints were facial numbness or hypesthesia (64.5%), absent corneal reflex (45.2%), and abducens or oculomotor nerve deficit (35.5%). On MRI, 51.6% of the epidermoid cysts showed low

2017 Journal of Neurosurgery

171. Comparison Between Different Surgical Approaches for the Treatment of INVOLUTIONAL PTOSIS

or mullerectomy Outcome Measures Go to Primary Outcome Measures : MRD1 [ Time Frame: 6 months ] Distance in millimeters between corneal light reflex and upper eyelid margin surgery duration [ Time Frame: 3 hours ] Time from first incision to last suture (in minutes) Levator function [ Time Frame: 6 months ] change (in millimeters) in upper eyelid position from downgaze to maximal upgaze Secondary Outcome Measures : Need for additional eyelid surgery [ Time Frame: 6 months ] Any need for oculoplastic

2017 Clinical Trials

172. Quantification of rat supraglottic laryngeal sensation threshold. (Abstract)

, and 3) determine the ideal depth of anesthesia.Animal study.Rats were induced with ketamine/xylazine. The level of anesthesia was monitored by spontaneous glottic closure and corneal reflex testing. Air puffs were delivered to the epiglottis, arytenoid, and piriform sinus at varied pressures with pulse time kept constant. Sensation thresholds were determined by direct visualization of the larynx using a binocular microscope. Topical lidocaine was then applied to the larynx and ST was determined (...) . Trials were repeated in a small subset of animals.Twenty-six trials were performed in 14 rats. Mean STs were 39 ± 9.7 mm Hg at the epiglottis, 48.8 ± 10.5 at the arytenoid, and not detectable at the pyriform sinus. Repeated trials demonstrated consistent results. Lidocaine effectively ablated the LAR in each trial. The LAR was difficult to induce while corneal reflex was absent and was difficult to distinguish from spontaneous glottic closures while under lighter sedation.Air pulse stimulation

2017 Laryngoscope

173. A rare case of concomitant sicca keratopathy and ipsilateral central facial palsy in Wallenberg’s dorsolateral medullary syndrome Full Text available with Trip Pro

patient's current problems. One month after diagnosis of the right-sided dorsolateral medullary syndrome, there were complaints of ocular irritation and a diminished visual acuity in the right eye. Biomicroscopy showed a sicca keratopathy with nearly complete absence of tear secretion on the Shirmer I test, but with normal eye closure and preserved corneal reflexes and sensitivity. Conclusion: A dorsolateral medullary syndrome can have a variable expression in symptomatology. Our case is special because

2017 GMS Ophthalmology Cases

174. Trigeminal brainstem modulation of persistent orbicularis oculi muscle activity in a rat model of dry eye Full Text available with Trip Pro

Trigeminal brainstem modulation of persistent orbicularis oculi muscle activity in a rat model of dry eye Altered corneal reflex activity is a common feature of dry eye disease (DE). Trigeminal sensory nerves supply the ocular surface and terminate at the trigeminal interpolaris/caudalis (ViVc) transition and spinomedullary (VcC1) regions. Although both regions contribute to corneal reflexes, their role under dry eye conditions is not well defined. This study assessed the influence of local (...) in DE rats. Loss of GABAergic inhibition at the ViVc transition coupled with enhanced NMDA excitatory amino acid neurotransmission at the ViVc transition and the VcC1 region likely contribute to altered corneal reflexes under dry eye conditions.Published by Elsevier Ltd.

2017 Neuroscience

175. The Preferential Impairment of Pupil Constriction Stimulated by Blue Light in Patients with Type 2 Diabetes without Autonomic Neuropathy Full Text available with Trip Pro

The Preferential Impairment of Pupil Constriction Stimulated by Blue Light in Patients with Type 2 Diabetes without Autonomic Neuropathy The main aim of the present paper is to examine whether the pupillary light reflex (PLR) mediated by intrinsically photosensitive retinal ganglion cells (ipRGCs) is impaired in type 2 diabetic patients. One hundred and three diabetic patients without diabetic autonomic neuropathy (DAN) and 42 age-matched controls underwent a series of detailed neurological (...) examinations. The patients were stratified into three groups: stage I, no neuropathy; stage II, asymptomatic neuropathy; stage III, symptomatic but without DAN. The PLR to 470 and 635 nm light at 20 cd/m2 was recorded. Small fiber neuropathy was assessed by corneal confocal microscopy and quantifying corneal nerve fiber (CNF) morphology. The 470 nm light induced a stronger and faster PLR than did 635 nm light in all subjects. The PLR to both lights was impaired equally across all of the diabetic subgroups

2017 Journal of diabetes research

176. Early predictors of poor outcome after out-of-hospital cardiac arrest Full Text available with Trip Pro

predictive of a poor outcome (CPC 3-5). On the basis of these factors, a risk score for poor outcome was constructed.We identified ten independent predictors of a poor outcome: older age, cardiac arrest occurring at home, initial rhythm other than ventricular fibrillation/tachycardia, longer duration of no flow, longer duration of low flow, administration of adrenaline, bilateral absence of corneal and pupillary reflexes, Glasgow Coma Scale motor response 1, lower pH and a partial pressure of carbon

2017 Critical Care

177. Oral manifestations, dental management, and a rare homozygous mutation of the PRDM12 gene in a boy with hereditary sensory and autonomic neuropathy type VIII: a case report and review of the literature Full Text available with Trip Pro

manifestations and dental management of an 8-month-old white boy with hereditary sensory and autonomic neuropathy-VIII over a period of 16 years. Our patient was homozygous for a mutation of PR domain-containing protein 12 gene and was characterized by insensitivity to pain and thermal stimuli, self-mutilation behavior, reduced sweat and tear production, absence of corneal reflexes, and multiple skin and bone infections. Oral manifestations included premature loss of teeth, associated with dental traumata

2017 Journal of medical case reports

178. Ophthalmic manifestations in Rothmund–Thomson syndrome: Case report and review of literature Full Text available with Trip Pro

Ophthalmic manifestations in Rothmund–Thomson syndrome: Case report and review of literature A 24-year-old male patient presented to us with diminution of vision in both eyes with watering and photophobia for the past 8 years. General physical examination showed short stature and poikiloderma. Ocular findings include photophobia with reflex tearing, dry eye, cicatricial ectropion, symblepharon approaching pupillary area of cornea, and multiple superficial punctuate erosions on the cornea (...) . Both eyelids showed scanty meibomian glands on infrared meibography. The rest of the anterior and posterior segment was normal. The patient was treated with topical lubricants which reduced photophobia and corneal erosions. He then underwent symblepharon release with buccal mucosal grafting, which improved ectropion. Patient improved symptomatically with reduction of photophobia and improvement in vision as well.

2017 Indian journal of ophthalmology

179. Principles of pharmacology in the eye Full Text available with Trip Pro

to many physical and biochemical barriers including the pre-corneal tear film, the structure and biophysiological properties of the cornea, the limited volume that can be accommodated by the cul-de-sac, the lacrimal drainage system and reflex tearing. The tissue layers of the cornea and conjunctiva are further key factors that act to restrict drug delivery. Using carriers that enhance viscosity or bind to the ocular surface increases bioavailability. Matching the pH and polarity of drug molecules

2017 British journal of pharmacology

180. Riley-Day Syndrome in a Hispanic Infant of Non-Jewish Ashkenazi Descent Full Text available with Trip Pro

of strabismus, absence of fungiform papillae, feeding difficulty, gastroesophageal reflux and episodes of self-mutilation. Deep tendon reflexes were depressed, the blinking rate and corneal reflex were diminished as well and corneas were opaque due to corneal erosions. Reduced lacrimal production was confirmed by the Schirmer test. Eye drops were recommended every 2-3 hours for corneal erosion and the patient was referred to the genetics department for further diagnostic confirmation.

2017 Journal of clinical and diagnostic research : JCDR

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