000) In all cases cells presented a flattened aspect; in 2 cases

000). In all cases cells presented a flattened aspect; in 2 cases cells were less efficiently adhered and in 1 case cells presented filipodia. Three cases showed contamination with cocobacteria.

Conclusions: Within the limits of the present

study, plasma of Argon may enhance cell adhesion to titanium abutments, even at the early stage of soft tissue healing. Further studies with greater samples are necessary to confirm these findings.”
“”"Hormesis: Background and Implication in the Biological Systems”". Specialization of some branches of science due to the scientific development resulted in the rise of different terminology to refer to the same effect. Hormesis is a dose-response relationship encompassing in a single concept several biological phenomena. This article provides an analysis of the origin of hormesis and the limitations Selleck Crenolanib https://www.selleckchem.com/products/mi-503.html of generalizing this concept. It also describes the main features of hormesis as a biological phenomenon, and its manifestations in daily life.”
“Hypothesis: Undesirable behaviors in young children with cochlear implants suggest device soft failure.

Background: Cochlear implant soft failure refers to nonoptimal performance not detectable with routine hardware checks. Pediatric failures may delay language development, but failure detection is difficult. A 2005 soft failure consensus statement recommended

a checklist for suspected device https://www.selleckchem.com/products/VX-770.html malfunctions. That checklist included the appearance of “”bad”" behaviors and aggression (externalizing behaviors) or self-injury and inattentiveness (internalizing behaviors) as indicators of soft failure. Accordingly, these behaviors should predict slowed language growth, and the analyses reported here sought evidence of that predictive power.

Methods: Data from a longitudinal study of 80 children with cochlear implants collected at 6 times between 18 and 48 months were reexamined. Language measures included auditory comprehension, expressive vocabulary, and unstructured language. A parent questionnaire,

the Child Behavior Checklist, examined externalizing and internalizing behaviors. Behavior measures were correlated with language measures in a series of analyses.

Results: Externalizing and internalizing behaviors did not consistently correlate with language at the ages tested. Additionally, early behaviors did not predict later language abilities. Individual language measures correlated best with overall language development 12 months later.

Conclusion: This study fails to support the hypothesis that externalizing and internalizing behaviors in pediatric cochlear implant users correlate with slowed language advance. These behaviors should not be seen as evidence of declining language performance as may be seen with device soft failure. Instead clinical assessments of language abilities are necessary.”
“Tooth agenesis is one of the most common congenital malformations in humans.

Methods: By adopting

the Self-Stigma in Mental Illness Sc

Methods: By adopting

the Self-Stigma in Mental Illness Scale (SSMI), we developed the Self-Stigma in Alcohol Dependence Scale (SSAD). The scale is based on a focus-group derived list of 16 negative stereotypes about alcohol dependent persons. It consists of four 16-item subscales measuring four hypothetical stages of self-stigma, stereotype awareness (aware), stereotype agreement (agree), self-concurrence (apply), and self-esteem decrement (harm). We employed the SSAD in a cross-sectional study of 153 patients hospitalized for alcohol detoxification to examine its reliability and validity. Results: The four stages of self-stigma could be reliably measured with the SSAD (Cronbach’s alpha, 0.86-0.93). LDN-193189 supplier Each step in the process of self-stigmatization was most closely associated with its preceding step. Other significantly related independent variables in multiple regression analyses included desire for social distance (associated

with agree), duration of drinking problems (associated with apply) and depressive symptoms (associated with apply and harm). Both apply and harm were significantly related to reduced drinking-refusal self-efficacy in analyses controlling for depressive symptoms and variables related to duration and severity of the drinking problem.

Discussion: The SSAD showed good validity and reliability Cell Cycle inhibitor measuring the stages of self-stigma in this group. Self-stigma appears to be associated with lower drinking-refusal self-efficacy. (C) 2010 Elsevier Ireland Ltd. All rights reserved.”
“Hepatitis B virus (HBV) infection may run undetected. Unawareness of an ongoing infection delays the

diagnosis of HBV-related liver disease and favours the spread of the virus. We have evaluated among hepatitis B surface antigen-positive (HBsAg) inpatients admitted to a Southern Italian hospital the proportion of those aware of their carrier status and correlated the status to signs of liver disease. All patients admitted to the San Giovanni Rotondo Hospital from March 2008 to July 2009 were tested for HBV and hepatitis C virus (HCV) markers, and those positive for HBsAg were interviewed and underwent examinations NSC23766 in vivo for liver function and abdominal ultrasound. Overall, of 25 000 patients admitted during the observation period 311 (1.2%) were positive for HBsAg, most of them (98%) being anti-HBe positive. HCV and HDV co-infections were ascertained in 2.9% and 0.6% of cases, respectively. Two hundred and fifty-three subjects (81%) agreed to undergo further investigation, 132 of them (52%) were HBV-DNA positive. One hundred and two patients (40.3%) were unaware of their infection; this was encountered among 29% of HBV-DNA-positive and 52% of HBV-DNA-negative subjects (P < 0.01). Subjects already aware of their infection were more likely to present with abnormal alanine aminotransferase (ALT) levels (27% vs 15%), serological presence of HBV-DNA (63.

All rights reserved “
“Many strategies, including intraopera

All rights reserved.”
“Many strategies, including intraoperative acute normovolemic hemodilution (ANH) and pharmacologic agents, exist to minimize the use of allogeneic blood products in pediatric congenital heart surgery. Recombinant activated factor VIIa (rFVIIa) is a hemostatic agent approved for the treatment of bleeding episodes and prevention DMXAA mouse of bleeding in surgical interventions in patients with hemophilia A or B with inhibitors, acquired hemophilia, or congenital factor VII deficiency. Off-label use in nonhemophilic

patients for uncontrolled hemorrhage is increasing although still under investigation. We present our experience with ANH and rFVIIa in nine patients. All were < 16 months of age and underwent complex cardiac surgery with

the end point of achieving hemostasis while decreasing or eliminating buy SNX-5422 the need for allogeneic blood products. Clinically, we have observed rapid hemostasis in patients who underwent ANH and then had autologous blood reinfused after cardiopulmonary bypass, along with rFVIIa, without any time delay. The patients required no allogeneic blood products and therefore results suggested the potential utility of this practice. The study group consisted of nine patients < 16 months of age who received rFVIIa in the operating room after open-heart surgery. Amount of autologous blood removed preoperatively, blood product use, time from protamine to rFVIIa administration, platelet count, INR, and fibrinogen

level were retrospectively obtained. Of the nine patients, the three who underwent the most aggressive hemodilution received rFVIIa most rapidly and required no allogeneic blood products to achieve hemostasis although DZNeP mw they had an average lower fibrinogen level on admission to the cardiothoracic intensive care unit. These preliminary data suggest that hemodilution before surgical stimulation and the rapid administration of rFVIIa, along with the reintroduction of autologous blood, may decrease or potentially eliminate the need for allogeneic blood products. Prospective trials are warranted to further explore this technique.”
“Dehydroepiandrosterone (DHEA) has been reported to improve oocyte/embryo yields and oocyte/embryo quality in women with diminished ovarian reserve. Whether DHEA objectively improves ovarian reserve is, however, unknown. This study investigated 120 consecutive patients with diminished ovarian reserve, supplemented for 30-120 days (mean 73 +/- 27) with DHEA (25 mg three times daily). Anti-Mullerian hormone (AMH) concentrations were determined in relationship to DHEA supplementation using linear regression and, longitudinally, by examining interaction between days of DHEA treatment and pregnancy success in respect to changes in AMH. AMH concentrations significantly improved after DHEA supplementation over time (P = 0.002). Women under age 38 years demonstrated higher AMH concentrations and improved AMH concentrations more than older females.

Although the use of natalizumab is cost saving, current funding a

Although the use of natalizumab is cost saving, current funding arrangements in the Health Service Executive do not allow for the transfer of money saved from drugs paid for in the hi-tech scheme, to hospitals who are supplying alternative

treatments.”
“Background: Health-state utilities for prisoners have not been described.

Methods: Stattic in vitro We used data from a 1996 cross-sectional survey of Australian prisoners (n = 734). Respondent-level SF-36 data was transformed into utility scores by both the SF-6D and Nichol’s method. Socio-demographic and clinical predictors of SF-6D utility were assessed in univariate analyses and a multivariate general linear model.

Results: The overall mean SF-6D utility was 0.725 (SD 0.119). When subdivided by various medical conditions, prisoner SF-6D utilities ranged from 0.620 for angina to 0.764 for those with

none/mild depressive symptoms. Utilities derived by the Nichol’s method were higher than SF-6D scores, often by more than 0.1. In multivariate analysis, significant independent predictors of worse utility included female gender, increasing age, increasing number of comorbidities and more severe depressive symptoms.

Conclusion: The utilities presented may prove useful for future economic and decision models evaluating prison-based health programs.”
“Various techniques have been proposed for the repair of abdominal wall defects (AWD) with LY2606368 inhibitor varying rates of success. Despite the development of new materials and modifications of surgical technique, no single approach has emerged as the optimum way to close Linsitinib manufacturer large AWD. We report a method for repairing large incisional and recurrent abdominal wall hernias using a double-mesh technique. The defect is closed using an underlay biological implant and an onlay synthetic mesh, which is ‘quilted’ to the underlying abdominal wall and biological implant. The current study reports our initial experience with this approach in ten consecutive patients operated on for large AWD.

In this prospective observational study the following data were collected: age, gender, previous surgery,

co-morbidities, situation and size of the defect, antibiotic therapy, hospital stay, postoperative complications and bacteriology in case of infection. The patients were reviewed at 1, 3 and 6 months, and 1-year postsurgery.

Overall all ten AWD of a parts per thousand yen75 cm(2) were reconstructed successfully using the quilting technique. Median age of patients was 61 years (range 47-73 years); male:female ratio was 3:2 and median weight was 107.5 kg. Two patients developed a wound infection and were treated successfully with antibiotics. At median follow-up of 15.5 months (range 6-29 months) there was no case of recurrence.

The use of double-layer of porcine acellular dermal collagen implant and polypropylene mesh in reconstruction of AWD can be considered a safe and effective treatment.

This study also aims to

This study also aims to Selleckchem KU57788 evaluate the possibility of dental practitioners collecting large quantities of reliable and accurate clinical data on oral mucosal lesions.

Study Design: Data from 6,448 adult Swedish patients were collected by general dental practitioners using a standardized registration method. A correlation analysis between a group with oral mucosal lesions and a control group, with no oral mucosal lesions, was performed

for various parameters such as symptoms from the oral mucosa, systemic diseases, medication, allergy history, tobacco habits and the patient’s own assessment of their general health. In addition, clinical photos were taken of all oral mucosal lesions in order to determine the degree of agreement between the diagnoses made by general dental practitioners and those made by oral medicine specialists.

Results: A total of 950 patients (14.7%) presented with some selleck products type of oral mucosal lesion and of these, 141 patients (14.8%) reported subjective symptoms. On a visual analogue scale, 43 patients (4.5%) scored their symptoms <30, 65 patients (6.8%) scored their symptoms >= 30, and 28 patients (2.6%) scored their symptoms >= 60. The most debilitating condition was aphthous stomatitis and the most common oral mucosal lesion was snuff dipper’s lesion (4.8%), followed by lichenoid lesions (2.4%)

and geographic tongue (2.2%). There was agreement between the oral BIX 01294 ic50 medicine specialists and the general practitioners over the diagnosis of oral mucosal lesions on the basis of a clinical photograph in 85% of the cases (n=803).

Conclusions: Nearly 15% of the patients with oral mucosal lesions reported symptoms.

General practitioners could contribute significantly to the collection of large quantities of reliable and accurate clinical data, although there is a risk that the prevalence of oral mucosal lesions may be underestimated.”
“Objective. To estimate the impact of obesity on cervical ripening with prostaglandin E2 (PGE2).

Materials and method. A retrospective study compared the cervical ripening efficiency of PGE2 on patients with BMI above 30 kg/m 2 and normal weight patients with BMI between 20 kg/m(2) and 25 kg/m(2). In case of a Bishop score (<= 3), a dinoprostone tampon was used over 12 h. In case of a Bishop score (4; 6), a dinoprostone gel was used over 6 h. Failure of first cervical ripening attempt was defined, as the persistence of a Bishop score < 6, 12 h after dinoprostone tampon or 6 h after dinoprostone gel.

Results. Ninety-five obese patients were matched according to parity to 190 non-obese patients. The failure rate of the first attempt at cervical ripening was significantly higher (P = 0.0016) among obese patients (53.7%) as compared to patients with a BMI in between 20 and 25 (34.2%). After multivariate analysis BMI >= 30 (OR = 2.

At optimized conditions,

the maximum grafting efficiency

At optimized conditions,

the maximum grafting efficiency and grafting ratio was similar to 50% and 51%, respectively with the presence of AM, whereas they decreased to check details 19% and 23%, respectively, without the presence of AM. Thermogravimetric analysis showed that as-resulted graft copolymer had a lower thermal stability than homopolymer PVA. FTIR and (1)H-NMR confirmed chemical structure of as-synthesized graft copolymer. (C) 2009 Wiley Periodicals, Inc. J Appl Polym Sci 113: 3954-3962, 2009″
“In order to better utilize a fish by-product, the enzymatic hydrolysis of tuna liver was performed using commercially available proteases such as Flavourzyme, Alcalase, Protamex, and Neutrase. The hydrolysates were prepared as both first step hydrolysates and second step hydrolysates. The molecular weight distribution of the hydrolysates was determined by size exclusion chromatography and matrix-assisted laser desorption ionization-time of flight (MALDI-TOF) mass spectrometry, which analyzed a representative hydrolysate type with a weight range of 1000-3000 Da. The antioxidant activities of the tuna liver hydrolysates against 2,2-diphenyl-1-picrylhydrazyl

(DPPH). hydroxyl radical, and GSK1120212 research buy hydrogen peroxide, along with a reducing power assay, showed that the second step hydrolysates had more potent antioxidant activity than the first

step hydrolysates. However, the first step hydrolysates exhibited more effective chelating activity. Furthermore, the protection ability of the hydrolysates toward hydroxyl radical-induced oxidative DNA damage was evaluated by measuring the conversion of supercoiled pBR322 plasmid DNA to the open circular form. In addition, an angiotensin 1-converting enzyme (ACE) inhibition assay revealed that SN-38 chemical structure all hydrolysates had similar ACE-inhibitory properties. These findings suggest that tuna liver hydrolysates may be a beneficial ingredient to use in functional foods. (C) 2009 Elsevier Ltd. All rights reserved.”
“An investigation was undertaken on application of dilute chitosan solutions modified by tyrosinase-catalyzed reaction with 3,4-dihydroxyphenetylamine (dopamine) to adhesion of the low-density polyethylene (LDPE) plates surface-grafted with hydrophilic monomers. Tensile shear adhesive strength effectively increased with an increase in the grafted amount for methacrylic acid-grafted and acrylic acid-grafted LDPE (LDPE-g-PMAA and LDPE-g-PAA) plates. In particular, substrate breaking was observed at higher grafted amounts for LDPE-g-PAA plates. The increase in the amino group concentration of the chitosan solutions and molecular mass of the chitosan samples led to the increase in adhesive strength.

Recent evidence indicates that PDPN is also expressed in keratino

Recent evidence indicates that PDPN is also expressed in keratinocytes especially of sebaceous selleck glands.

Objective: To verify expression-pattern

and the regulatory mechanism of PDPN in human epidermal keratinocytes.

Methods: PDPN-expression pattern was analyzed in normal and psoriatic epidermis by immunostaining. The regulatory mechanism of PDPN-expression of keratinocytes by cytokines was analyzed using specific inhibitors, siRNA, and adenoviral shRNA of signaling pathways.

Results: In normal skin. PDPN was expressed on the basal cell layer of sebaceous glands and on the outer root sheath of hair follicles. While no expression was detected in the normal interfollicular epidermis, PDPN was detected in the basal cell layer of wound and hyperproliferative Citarinostat chemical structure psoriatic epidermis, where the granular layer is lacking. TGF-beta 1 and IFN-gamma independently upregulated PDPN-expression of keratinocytes via TGF-beta receptor-Smad pathway and JAK-STAT pathway, respectively. IL-6 and IL-22 also stimulated

PDPN-expression of keratinocytes accompanied by STAT-3 phosphorylation. siRNA of STAT-1, inhibitors of STAT-3 signaling, AG490, STAT-3 inhibitor VI, and si/shRNA of STAT-3 inhibited the PDPN-expression of keratinocytes induced by IFN-gamma, IL-6 and IL-22 but not by TGF-beta 1.

Conclusion: These results indicate that TGF-beta 1, IFN-gamma, IL-6, and IL-22 induce PDPN-expression of keratinocytes, which might be significantly involved in the wound healing GSI-IX mouse process as well as in the pathomechanism of hyperproliferative psoriatic epidermis. (C) 2011 Japanese Society for Investigative Dermatology. Published by Elsevier Ireland Ltd. All rights

reserved.”
“Hydrodynamic simulations of dynamic compression experiments reveal that heating as well as entropy production in the target are much lower along quasi-isentropes, generated using impactors employing functionally graded material (FGM), than in shock compression. The possibility of achieving quasi-isentropic compression using FGM, in both gas gun and explosive driven systems, was explored in a recent paper. Qualitative analyses of temporal profiles of pressure pulse generated in the target, obtained with various density distributions within FGM impactors, showed that quadratic density variation is most suitable. This paper attempts to re-establish this finding by identifying the signatures of quasi-isentropic compression from basic thermodynamic aspects. It is shown that quadratic density variation is most suitable candidate as it leads to least entropy increase for a specific peak pressure. Further, the optimum density profile, found by genetic algorithm based optimization tool, with density of individual layers as variables, is shown to have good agreement with quadratic density function. Finally, we explore the possibility of using layers of commonly available materials with increasing shock impedances for a generation of isentropic compression.

Therefore, the literature focuses clearly on the atypical nevi of

Therefore, the literature focuses clearly on the atypical nevi of the female genitalia. In the present case, we describe

a unique case of a combined perianal melanocytic nevus with architectural and cytologic atypia that differ from the histopathologic features of accepted criteria for atypical genital nevi. A suspicion of malignant melanoma was raised, but few pivotal histological features, the age of the patient and the clinical follow-up for 10 years proved otherwise. This case contributes to the collection of necessary information about perianal nevi that show obvious variations in site-related histological atypia compared with atypical genital nevi. Although the malignant potential of such lesions remains unclear, it is important to prevent Quizartinib datasheet overdiagnosis of malignant melanoma with the associated devastating surgery, especially in young patients.”
“The aim of this study was to determine the efficacy of routine upper gastrointestinal imaging following the three forms of laparoscopic bariatric surgery completed at our institution (laparoscopic Roux en Y gastric bypass (LRYGB), laparoscopic sleeve gastrectomy AMN-107 Angiogenesis inhibitor (LS), and laparoscopic adjustable gastric banding (LAGB)).

Radiograph reports were reviewed from the period of January 2005

to July 2010. During that time, 129 patients underwent LRYGB, 209 underwent LS, and 12 patients underwent LAGB. Of those patients, 120 LRYGB patients, 188 LS patients, and 11 LAGB patients underwent upper gastrointestinal studies on postoperative days (POD) 1 or 2.

Of the 319 total patients who underwent UGI, no contrast leaks were found. One LRYGB patient was found to have stenosis of the jejunojejunal

anastomosis and was taken to the operating room for revision. A total of ten patients went on to develop leaks: four LRYGB patients, six LS patients, and zero LAGB patients.

The results of our study show that a positive UGI study for stricture has a specificity of 100 %. In terms of leak, which offers a much higher risk of significant morbidity and mortality, UGI was unable to find any on postoperative days 1 or 2. Based on the results of this study, our institution has stopped completing routine UGI on POD 1 following bariatric surgery.”
“Papillary fibroelastomas are rare benign tumours of the endocardium, find more accounting for the most common primary valvular tumours of the heart. They typically originate from left-sided heart valves, whereas pulmonary valve involvement is anecdotal. They rarely cause valvular dysfunction, but they can cause turbulent flow and thrombus formation with consequent cerebral, retinal, coronary and pulmonary embolic disease and obstruction. We present here the case of a 56-year old man who was referred to our institution with an accidental finding, at transthoracic echocardiogram, of a mobile, pedunculated mass on the pulmonary valve, confirmed at cardiac magnetic resonance.

Objectives: The objective was to investigate associations between

Objectives: The objective was to investigate associations between dietary fats and early kidney disease.

Design: We examined cross-sectional associations between dietary fats and the presence of high albuminuria (an established independent predictor of kidney function decline, cardiovascular disease, and mortality) or estimated glomerular filtration rate (eGFR) <60 mL . min(-1) . 1.73 m(-2) at baseline HDAC inhibitor review in 19,256 participants of the REGARDS (Reasons for Geographic and Racial Differences in Stroke) study, an ongoing cohort study in US adults aged >= 45 y at time of enrollment. We used logistic regression to assess associations between quintiles of total fat and subtypes of dietary fat (saturated,

monounsaturated, polyunsaturated, and trans fat) and presence of high albuminuria or eGFR <60 mL . min(-1) . 1.73 m(-2).

Results: After multivariable adjustment, only saturated fat intake was significantly associated with high albuminuria [for quintile 5 compared with quintile 1, odds ratio (OR): 1.33; 95% CI: 1.07, 1.66;

P for trend = 0.04]. No significant associations between any type of fat and eGFR <60 mL . min(-1) . 1.73 m(-2) were observed. ORs between the highest quintile CH5183284 price of saturated fat and eGFR <60 mL . min(-1) . 1.73 m(-2) varied by race with a borderline significant interaction term (ORs: 1.24 in whites compared with 0.74 in blacks; P for interaction = 0.05) in multivariable-adjusted https://www.selleckchem.com/products/epz-6438.html models, but no other associations were significantly modified by race or diabetes status.

Conclusion: Higher saturated fat intake is significantly associated with the presence of high albuminuria, but neither total nor other subtypes of dietary fat are

associated with high albuminuria or eGFR <60 mL . min(-1) . 1.73 m(-2). Am J Clin Nutr 2010;92:897-904.”
“The arcus tendineus fascia pelvis (ATFP) and arcus tendineus levator ani (ATLA) are elements of anterior vaginal support. This study describes their geometry in women with unilateral levator ani muscle defects and associated “”architectural distortion.”"

Fourteen subjects with unilateral defects underwent MRI. 3D models of the arcus were generated. The locations of these relative to an ilial reference line were compared between the unaffected and affected sides.

Pronounced changes occurred on the defect sides’ ventral region. The furthest point of the ATLA lays up to a mean of 10 mm (p = 0.01) more inferior and 6.5 mm (p = 0.02) more medial than that on the intact side. Similarly, the ATFP lays 6 mm (p = 0.01) more inferior than on the unaffected side.

The ventral arcus anatomy is significantly altered in the presence of levator defects and architectural distortion. Alterations of these key fixation points will change the supportive force direction along the lateral anterior vaginal wall, increasing the risk for anterior vaginal wall prolapse.

Within 1 year of initial listing, deterioration to status 1B occu

Within 1 year of initial listing, deterioration to status 1B occurred,frequently (63%), while delisting as too well occurred rarely (2%-7%). Death or delisting as too ill occurred among 27% at 2 years after initial ABT-737 Apoptosis inhibitor status 2 listing. Mortality

at 2 years after status 2 transplantation was 13%. The hazard ratio (FIR) after 180 days of status 2 transplantation vs waiting during or after initial status 2 listing was 0.41 (95% confidence interval, 0.31-0.55). The likelihood of transplantation was markedly diminished for women (odds ratio, 0.71; p < 0.001) and congenital heart disease (odds ratio, 0.24; p < 0.001). Death or delisting as too ill for women (HR, 1.7; p < 0.001) and congenital heart disease (HR, 3.2; p < 0.001) were substantially higher than in other groups.

CONCLUSIONS: Escalation of UNOS status is common and delisting as too well is uncommon after initial status 2 listing. Despite the decreasing number of transplants provided to status 2 registrants, sub-groups of patients may NSC 66389 be at high risk of waiting at status 1A, justifying the continued use of the

status 2 designation. J Heart Lung Transplant 2011;30:1169-74 (C) 2011 International Society for Heart and Lung Transplantation. All rights reserved.”
“PURPOSE: To evaluate differences in visual recovery after phacoemulsification with direct or tilted surgical microscope illumination using a macular photostress test.

SETTING: Western Eye Hospital, Imperial College Health Care National Health Service Lapatinib price Trust, London, United Kingdom.

METHODS:

This randomized double-masked controlled trial enrolled patients presenting to a daycare unit for single-eye cataract surgery. Inclusion criteria were no ocular pathology other than cataract, corneal keratometric astigmatism less than 1.50 diopters, intended target of emmetropia in the operated eye, and cataract grade 1 to 3 (Lens Opacification Classification System II). Exclusion criteria were an abnormal preoperative photostress test. Patients were randomized to have phacoemulsification with the operating microscope angled 15 degrees nasal to the fovea (study group) or with the operating microscope directly overhead around the optic disc region (control group). The same surgeon performed all phacoemulsification procedures using a standardized technique and topical anesthesia. Outcome measures were uncorrected (UDVA) and corrected (CDVA) distance visual acuity 10 minutes and 60 minutes postoperatively.

RESULTS: In the 30 patients evaluated, the mean UDVA 10 minutes postoperatively was 0.40 logMAR +/- 0.26 (SD) in the study group and 0.72 +/- 0.36 logMAR in the control group (P<.01). The mean CDVA was 0.18 +/- 0.26 logMAR and 0.44 +/- 0.30 logMAR, respectively (P = .016). There was no significant between-group difference in acuity at 60 minutes.

CONCLUSION: Tilting the microscope beam away from the fovea resulted in faster visual recovery and less macular photic stress.