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State of the art in breast intraoperative electron radiation therapy after intraoperative ultrasound introduction.

Radiol Oncol 2021 May 16. Epub 2021 May 16.

Department of Surgery, Azienda Sanitaria Universitaria Giuliano-Isontina Trieste, TriesteItaly.

Background: Breast intraoperative electron radiation therapy (B-IOERT) can be used in clinical practice both as elective irradiation (partial breast irradiation - APBI) in low risk breast cancer patients, and as an anticipated boost. The procedure generally includes the use of a shielding disk between the residual breast and the pectoralis fascia for the protection of the tissues underneath the target volume. The aim of the study was to evaluate the role of intraoperative ultrasound (IOUS) in improving the quality of B-IOERT. Read More

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Strength training in addition to neuromuscular exercise and education in individuals with knee osteoarthritis the effects on pain and sensitization.

Eur J Pain 2021 May 15. Epub 2021 May 15.

The Research Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Naestved-Slagelse-Ringsted Hospitals, Region Zealand, Slagelse, Denmark.

Background: There is a lack of evidence of the relative effects of different exercise modes on pain sensitization and pain intensity in individuals with knee osteoarthritis (KOA).

Methods: Ninety individuals with radiographic and symptomatic KOA, ineligible for knee replacement surgery, were randomized to 12 weeks of twice-weekly strength training in addition to neuromuscular exercise and education (ST+NEMEX-EDU) or neuromuscular exercise and education alone (NEMEX-EDU). Outcomes were bilateral, lower-leg, cuff pressure pain- and tolerance thresholds (PPT, PTT), temporal summation (TS), conditioned pain modulation (CPM), self-reported knee pain intensity, and number of painful body sites. Read More

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Neurocircuitry of Contingency Awareness in Pavlovian Fear Conditioning.

Cogn Affect Behav Neurosci 2021 May 15. Epub 2021 May 15.

Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, 3901 Chrysler Dr., Tolan Park Suite 2C Room 273, Detroit, MI, 48201, USA.

In Pavlovian fear conditioning, contingency awareness provides an indicator of explicit fear learning. A less studied aspect of fear-based psychopathologies and their treatment, awareness of learned fear is a common cause of distress in persons with such conditions and is a focus of their treatment. The present work is a substudy of a broader fear-conditioning fMRI study. Read More

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Modulation of sensorimotor cortical oscillations in athletes with yips.

Sci Rep 2021 May 14;11(1):10376. Epub 2021 May 14.

Havana Trainers Room, Tokyo, Japan.

The yips, an involuntary movement impediment that affects performance in skilled athletes, is commonly described as a form of task-specific focal dystonia or as a disorder lying on a continuum with focal dystonia at one end (neurological) and chocking under pressure at the other (psychological). However, its etiology has been remained to be elucidated. In order to understand sensorimotor cortical activity associated with this movement disorder, we examined electroencephalographic oscillations over the bilateral sensorimotor areas during a precision force task in athletes with yips, and compared them with age-, sex-, and years of experience-matched controls. Read More

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Elevated sweat chloride test: is it always cystic fibrosis?

Ital J Pediatr 2021 May 14;47(1):112. Epub 2021 May 14.

Department of Translational Medical Sciences, Cystic Fibrosis Center, University Federico II, Naples, Italy.

Background: The sweat chloride test (ST) is the gold standard for cystic fibrosis (CF) diagnosis in symptomatic patients, within the newborn screening and in the follow-up of CF patients during molecular therapies. However, false positives have been reported in patients with different diseases. We describe and discuss 4 cases due to different clinical conditions in which we recorded false positive ST, and the test remained altered for a period of varying length. Read More

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Evidence of Bilateral Localized, but Not Widespread, Pressure Pain Hypersensitivity in Patients with Upper Extremity Tendinopathy/Overuse Injury: A Systematic Review and Meta-Analysis.

Phys Ther 2021 May 13. Epub 2021 May 13.

Radiology, Rehabilitation and Physiotherapy Department, Universidad Complutense de Madrid, Madrid, Spain.

Objective: The presence of altered nociceptive pain processing in patients with upper extremity tendinopathy/overuse injury is conflicting. Our aim was to compare pressure pain thresholds (PPTs) in symptomatic and distant pain-free areas between patients with upper extremity tendinopathy/overuse injury and controls.

Methods: Five databases were searched from inception to October 15, 2020. Read More

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Catastrophic, Bilateral Retinal Vascular Occlusion after Intravitreal Bevacizumab Injection.

Retin Cases Brief Rep 2021 May 10. Epub 2021 May 10.

West Coast Retina Medical Group, San Francisco, California. The Department of Ophthalmology, California Pacific Medical Center, San Francisco, California. Massachusetts Eye and Ear Infirmary, Harvard Medical School, Ocular Immunology and Uveitis Service, Boston, Massachusetts. The Department of Ophthalmology, Stanford University School of Medicine, Stanford, California. The Francis I. Proctor Foundation, UCSF School of Medicine, San Francisco, California. Massachusetts Eye and Ear Infirmary, Harvard Medical School, Vitreoretinal Service, Boston, Massachusetts. Ophthalmic Consultants of Boston, Vitreoretinal Service, Boston, Massachusetts. Ophthalmic Consultants of Boston, Uveitis Service, Boston, Massachusetts.

Purpose: To describe two cases of catastrophic, bilateral retinal vascular occlusion following intravitreal (IVT) bevacizumab injection.

Methods: Case series. Main outcome measures included clinical and fluorescein angiography (FA) findings. Read More

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Posteromedial quadratus lumborum block versus wound infiltration after caesarean section: A randomised, double-blind, controlled study.

Eur J Anaesthesiol 2021 May 11. Epub 2021 May 11.

From the Department of Anaesthesiology and Intensive Therapy, University Medical Centre Ljubljana (TSP, IB), the Institute of Anatomy, Faculty of Medicine, University of Ljubljana (TSP), the Department of Perinatology, Division of Obstetrics and Gynaecology, University Medical Centre Ljubljana (UV, ML), the Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia (MZ, AP, ML), the Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital/Harvard Medical School, Boston, Massachusetts, USA (KV).

Background: Reducing pain and minimising opioids after caesarean section are crucial to enhancing maternal recovery and promoting mother-newborn interaction. Various techniques have been implemented to improve analgesia. We compared the analgesic efficacy of posteromedial quadratus lumborum block with that of wound infiltration following elective caesarean section. Read More

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A rare case of bilateral occipital condyle fractures associated with inferior clivus separation fracture resulting in craniocervical dislocation: a case report and modification of the Anderson and Montesano classification is proposed.

Acta Neurochir (Wien) 2021 May 14. Epub 2021 May 14.

London Bridge Hospital, London, UK.

The authors report a very rare case of bilateral occipital condyle fractures (OCF) that was associated with complete separation fracture of the inferior clivus resulting in craniocervical dislocation alongside dissociation of C1-C2 joint complex. Also, a new type of the Anderson and Montesano classification system is presented with two subtypes of injuries. Type IVA occurs when the OCF is associated a clivus avulsion fracture, while Type IVB occurs when the OCF is associated with complete "en piece" separation fracture of the inferior clivus. Read More

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Styloidogenic-cervical spondylotic internal jugular venous compression, a vascular disease related to several clinical neurological manifestations: diagnosis and treatment-a comprehensive literature review.

Ann Transl Med 2021 Apr;9(8):718

Neurosurgery Department, Sant'Anna University Hospital, Ferrara, Italy.

Internal jugular vein (IJV) stenosis is associated with several central nervous system disorders such as Ménière or Alzheimer's disease. The extrinsic compression between the styloid process and the C1 transverse process, is an emerging biomarker related to several clinical manifestations. However, nowadays a limited number of cases are reported, and few information are available about treatment, outcome and complications. Read More

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Clinical features in coronavirus disease 2019 (COVID-19) patients with early clearance and prolonged shedding of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA.

Ann Transl Med 2021 Apr;9(8):665

Department of Respiratory and Critical Care Medicine, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

Background: Since the outbreak of coronavirus disease 2019 (COVID-19), the pattern of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA shedding has not been well characterized.

Methods: In our study, 652 patients in Wuhan Designated Hospital were recruited, and their clinical and laboratory findings were extracted and analyzed.

Results: The median duration of SARS-CoV-2 RNA detection was 23 days [interquartile range (IQR), 18 days] from symptom onset. Read More

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A Retrospective Cohort Study on the Clinical Course of Patients With Moderate-Type COVID-19.

Front Public Health 2021 26;9:593109. Epub 2021 Apr 26.

Department of Pulmonary and Critical Care Medicine, The Third Xiangya Hospital of Central South University, Changsha, China.

A large number of people contracted moderate-type COVID-19 around the world. However, to our knowledge no studies have covered the clinical course of patients with moderate-type COVID-19. This study describes the clinical course of moderate-type patients with COVID-19 from Wuhan City and Yiyang City, and explores factors relevant to the length of hospitalization and symptoms relief. Read More

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Should CD4 Levels be Monitored in a Patient on Temozolomide?

Eur J Case Rep Intern Med 2021 11;8(3):002276. Epub 2021 Mar 11.

John H Stroger Jr Hospital of Cook County, Chicago, Illinois, USA.

Introduction: Temozolomide is an alkylating agent, indicated in the treatment of refractory anaplastic astrocytoma and newly diagnosed glioblastoma. We describe a case of bacteraemia associated with septic arthritis in the setting of concurrent temozolomide use.

Case: A 67-year-old woman presented with acute onset of bilateral knee pain and swelling. Read More

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The Use of Dornase Alfa in the Management of COVID-19-Associated Adult Respiratory Distress Syndrome.

Crit Care Res Pract 2021 23;2021:8881115. Epub 2021 Apr 23.

Palm Beach Gardens Medical Center, Palm Beach Gardens, FL, USA.

Objective: Currently, management of acute respiratory distress syndrome (ARDS) in COVID-19 infection with invasive mechanical ventilation results in poor prognosis and high mortality rates. Interventions to reduce ventilatory requirements or preclude their needs should be evaluated in order to improve survival rates in critically ill patients. Formation of neutrophil extracellular traps (NETs) during the innate immune response could be a contributing factor to the pulmonary pathology. Read More

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Electroacupuncture Attenuates Cognitive Impairment in Rat Model of Chronic Cerebral Hypoperfusion via miR-137/NOX4 Axis.

Evid Based Complement Alternat Med 2021 19;2021:8842022. Epub 2021 Apr 19.

Department of Neurobiology and Acupuncture Research, The Third Clinical College, Zhejiang Chinese Medical University, Key Laboratory of Acupuncture and Neurology of Zhejiang Province, Hangzhou, Zhejiang, China.

Electroacupuncture has shown protective effects on cognitive decline. However, the underlying molecular mechanisms are not clear. The present study was conducted to determine whether the cognitive function was ameliorated in cerebral hypoperfusion rats following electroacupuncture and to investigate the role of miR-137/NOX4 axis. Read More

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Applications of Herbal Medicine to Treat Autosomal Dominant Polycystic Kidney Disease.

Front Pharmacol 2021 27;12:629848. Epub 2021 Apr 27.

State Key Laboratory of Natural and Biomimetic Drugs, Department of Pharmacology, School of Basic Medical Sciences, Peking University, Beijing, China.

Autosomal dominant polycystic kidney disease (ADPKD) is a common hereditary kidney disease, which is featured by progressively enlarged bilateral fluid-filled cysts. Enlarging cysts destroy the structure of nephrons, ultimately resulting in the loss of renal function. Eventually, ADPKD develops into end-stage renal disease (ESRD). Read More

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Convexal Subarachnoid Hemorrhage Caused by Infective Endocarditis in a Patient with Advanced Human Immunodeficiency Virus (HIV): The Culprits and Bystanders.

Am J Case Rep 2021 May 14;22:e931376. Epub 2021 May 14.

Department of Infectious Disease, Rockledge Regional Medical Center, Rockledge, FL, USA.

BACKGROUND Convexal subarachnoid hemorrhage (cSAH), a rare form of non-aneurysmal subarachnoid hemorrhage, is confined to cerebral convexities without extension into basal cisterns or ventricles. Typical presentation includes thunderclap/progressive headache or transient focal neurological symptoms; rare manifestations include seizures, intractable vomiting, or altered mental status. Here, we report the first case of convexal subarachnoid hemorrhage and multifocal ischemic lesions caused by infective endocarditis (IE) in a treatment-naïve advanced HIV patient. Read More

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Evaluation of a novel flow diverter, the DiVeRt system, in an animal model.

J Neurointerv Surg 2021 May 13. Epub 2021 May 13.

Institute of Neurointervention, Paracelsus Medical University, Salzburg, Austria

Background: Using a surgical aneurysm model, this study assessed the performance of a new flow diverter (FD), the DiVeRt, and evaluated the angiographic and histologic features at different periods after stent deployment.

Methods: Fifteen New Zealand White rabbits were treated 3 days prior to intervention and until euthanization with dual antiplatelets. DiVeRt was implanted in bilateral carotid aneurysms (n=30) as well as in the aorta (n=15). Read More

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BILATERAL EYE INJURY WITH BILATERAL BLOWOUT FRACTURE CAUSED BY A HIGH-PRESSURE WATER JET IN 16-YEARS-OLD FIREMAN GIRL. CASE REPORT.

Cesk Slov Oftalmol 2021 ;77(2):88-93

Purpose: The aim is to present a report of a case of bilateral eye injury with bilateral blowout fracture caused by a high-pressure water jet from a fire hose in a 16-year-old girl during a competition for young firefighters.

Methods: We present a case report of a 16-year-old female patient with bilateral extensive eyelid contusion, oedema and lacerations of upper eyelids, lacerations of bulbar conjunctiva, contusion of both eyes, left optic nerve and bilateral blowout fractures of orbits.  Results: The initial ocular examination revealed "hand motion" in the right eye and no light perception in the left eye. Read More

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January 2021

A pilot study for treatment of COVID-19 patients in moderate stage using intravenous administration of ozonized saline as an adjuvant treatment-registered clinical trial.

Int Immunopharmacol 2021 Apr 30;96:107743. Epub 2021 Apr 30.

Department of Medical Services and Clinical Research, NeuroGen Brain & Spine Institute, Navi Mumbai, India.

Objective: Ozone therapy has tremendous therapeutic potential owing to its antiviral, anti-inflammatory and antioxidant properties, and potential to improve oxygenation. A pilot clinical trial was conducted to evaluate the safety and efficacy ofintravenous ozonised saline treatment in patients with moderate COVID-19 pneumonia.

Patients And Methods: 10 patients were administered 200 ml freshly prepared ozonised saline intravenously over 1 h once a day for 8 days along with standard medical treatment. Read More

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Multisystemic Inflammatory Syndrome in Children Associated With SARS-CoV-2 Infection: A Case Series Report in a Pediatric Center in Mexico.

J Med Cases 2020 Dec 21;11(12):375-378. Epub 2020 Oct 21.

Evidence-Based Medicine Department, Hospital Pediatrico de Sinaloa, Culiacan, Mexico.

We report four cases of patients with multisystem inflammatory syndrome in children (MIS-C) associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, of which three patients presented characteristics of Kawasaki disease (KD). All presented fever of more than 3 days, and gastrointestinal involvement, significant increase in C-reactive protein (CRP), polymorphonuclear cells, procalcitonin, D-dimer, fibrinogen and troponin, lymphopenia and hypoalbuminemia. Myocardial involvement was observed in two patients. Read More

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December 2020

Effect of belt electrode-skeletal muscle electrical stimulation on immobilization-induced muscle fibrosis.

PLoS One 2021 13;16(5):e0244120. Epub 2021 May 13.

Institute of Biomedical Sciences (Health Sciences), Nagasaki University, Nagasaki, Japan.

Purpose: Macrophage accumulation in response to decreasing myonuclei may be the major mechanism underlying immobilization-induced muscle fibrosis in muscle contracture, an intervention strategy suppressing these lesions is necessary. Therefore, this research investigated the effect of belt electrode-skeletal muscle electrical stimulation (B-SES), a new electrical stimulation device, to the macrophage accumulation via myonuclei decrease in immobilization-induced muscle fibrosis.

Materials And Methods: 18 Wistar male rats were divided into the control group, immobilization group (with plaster cast fixation to immobilize the soleus muscles in a shortened position for 2 weeks), and B-SES group (with muscle contractile exercise through B-SES during the immobilization period). Read More

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Sacral dural arteriovenous fistula supplied by bilateral lateral sacral arteries: case report and literature review.

Br J Neurosurg 2021 May 13:1-4. Epub 2021 May 13.

Department of Neurosurgery, West China Hospital of Sichuan University, Chengdu, PR China.

Sacral dural arteriovenous fistulas (DAVFs) with bilateral arterial supplies are extremely rare. To date, only two cases with arterial supply from bilateral lateral sacral arteries (LSAs) were reported. We report a rare case of sacral DAVF with arterial supply from bilateral LSAs. Read More

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Single-dose intravesical amikacin instillation for pyocystis in a patient with autonomic dysreflexia: A case report.

J Spinal Cord Med 2021 May 13:1-4. Epub 2021 May 13.

College of Pharmacy, University of Tennessee Health Science Center, Memphis, Tennessee, USA.

Context: Pyocystis is an infection of the epithelium of the bladder and a frequent complication of anuria. Patients with spinal cord injury (SCI) at the sixth thoracic vertebra (T6) or higher are at a greater risk for autonomic dysreflexia (AD), which can be induced by infections such as pyocystis. Cases of pyocystis treatment with aminoglycoside instillations have been reported in the literature. Read More

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Is the Preoperative Use of Antidepressants and Benzodiazepines Associated with Opioid and Other Analgesic Use after Hip and Knee Arthroplasty?

Clin Orthop Relat Res 2021 05 10. Epub 2021 May 10.

T. J. Rajamäki, A. Hietaharju, E. Jämsen, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland T. J. Rajamäki, T. Moilanen, E. Jämsen, Coxa Hospital for Joint Replacement, Tampere, Finland P. A. Puolakka, Department of Anaesthesia, Tampere University Hospital, Tampere, Finland A. Hietaharju, Department of Neurology, Tampere University Hospital, Tampere, Finland.

Background: Mental health disorders can occur in patients with pain conditions, and there have been reports of an increased risk of persistent pain after THA and TKA among patients who have psychological distress. Persistent pain may result in the prolonged consumption of opioids and other analgesics, which may expose patients to adverse drug events and narcotic habituation or addiction. However, the degree to which preoperative use of antidepressants or benzodiazepines is associated with prolonged analgesic use after surgery is not well quantified. Read More

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Acute posterior multifocal placoid pigment epitheliopathy associated with CN III palsy.

Am J Ophthalmol Case Rep 2021 Jun 16;22:101102. Epub 2021 Apr 16.

Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.

Purpose: To report a case of acute posterior multifocal placoid pigment epitheliopathy (APMPPE) associated with cranial nerve (CN) III palsy.

Observations: A 20-year-old woman developed bilateral anterior uveitis, which resolved with topical steroids. Three weeks later she exhibited posterior pole lesions in both eyes, corresponding with a diagnosis of APMPPE, as confirmed by multimodal imaging. Read More

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Fundus albipunctatus photoreceptor microstructure revealed using adaptive optics scanning light ophthalmoscopy.

Am J Ophthalmol Case Rep 2021 Jun 16;22:101090. Epub 2021 Apr 16.

Icahn School of Medicine at Mount Sinai and New York Eye and Ear Infirmary of Mount Sinai, Department of Ophthalmology, New York, NY, USA.

Purpose: Fundus albipunctatus is an inherited cause of congenital stationary night blindness. The objective of this report is to describe structural changes occurring in a macular phenotype of a novel RDH5 mutation producing fundus albipunctatus using high-resolution imaging. A 62-year-old male with longstanding night blindness underwent imaging and genetic evaluation. Read More

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Apraxia of Lid Opening in Subthalamic Nucleus Deep Brain Stimulation for Parkinson's Disease-Frequency, Risk Factors and Response to Treatment.

Mov Disord Clin Pract 2021 May 12;8(4):587-593. Epub 2021 Apr 12.

Comprehensive Care Centre for Movement Disorders Sree Chitra Tirunal Institute for Medical Sciences and Technology Thiruvananthapuram Kerala India.

Background: New-onset apraxia of lid opening (ALO) is reported to occur in Parkinson's disease (PD) patients following Deep Brain Stimulation (DBS). There are only few systematic studies on this uncommon disorder of eyelid movements.

Objectives: We aimed to examine the frequency, temporal evolution, predisposing factors and response to treatment, of new-onset ALO in PD patients who underwent bilateral subthalamic nucleus (STN) DBS. Read More

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Synapsin-caveolin-1 gene therapy preserves neuronal and synaptic morphology and prevents neurodegeneration in a mouse model of AD.

Mol Ther Methods Clin Dev 2021 Jun 29;21:434-450. Epub 2021 Mar 29.

Veterans Affairs San Diego Healthcare System, San Diego, CA, USA.

Alzheimer's disease (AD) is the most common form of neurodegeneration and cognitive dysfunction in the elderly. Identifying molecular signals that mitigate and reverse neurodegeneration in AD may be exploited therapeutically. Transgenic AD mice (PSAPP) exhibit learning and memory deficits at 9 and 11 months, respectively, with associated decreased expression of caveolin-1 (Cav-1), a membrane/lipid raft (MLR) scaffolding protein necessary for synaptic and neuroplasticity. Read More

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Segmental Scleral Buckle Surgical Technique for Repair of a Rhegmatogenous Retinal Detachment in Retinoblastoma: A Case and Review of the Literature.

Ocul Oncol Pathol 2021 Mar 22;7(2):91-96. Epub 2020 Dec 22.

Cizik Eye Clinic, University of Texas Health Science Center, Houston, Texas, USA.

Purpose: The aim of this study was to describe the surgical repair of a rhegmatogenous retinal detachment (RRD) with a posterior break in a child with retinoblastoma (RB).

Methods: Retrospective case report and review of the English language literature. Retrospective review of an 11-month-old male with bilateral retinoblastoma who developed a RRD with a posterior retinal break in his better-seeing eye after treatment with cryotherapy. Read More

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