Novel tactile bottle neck adaptor facilitates eye drop adherence in visually impaired patients

PURPOSE

To test the use of Ring-IT, a novel 3D tactile bottle neck adaptor in topical eye drop adherence in visually impaired patients.

METHODS

Bottle neck ring adaptors with either one, two or three protrusions with cube or sphere endings were designed. In phase 1, low vision was simulated in healthy subjects (n=20) with a 20/200 vision simulator; while in phase 2, visually impaired patients (n=26; 20/70 or worse) were recruited. Subjects were randomised to six combinations of varying protrusions and shapes on medication bottles and asked to identify these traits at different presentations. Responses and time to identify were recorded.

RESULTS

Phase 1: 98.3% of subjects correctly identified the number of protrusions. Mean time to identify was 4.5±6.1 s. Identification success for cube and sphere end pieces were 91.7% and 73.3%, with average time for identification of 9.9±7.6 and 10.9±9.0 s. In phase 2, 92.3% of subjects correctly identified the number of protrusions. Mean time to identify was 6.0±3.0 s. Identification success for cube and sphere end pieces were 78.2% and 74.4%; with average time for identification of 7.5±4.8 and 8.5±5.6 s, respectively.

CONCLUSIONS

Ring-IT was identified with accuracy and speed by both low vision simulated subjects, and by patients with true limited visual capabilities. These tactile bottle neck ring adaptors can be used as an assistive low vision aid device and may increase eye drop regimen adherence in visually impaired patients.

Detection of Malpositioned VP Shunt Catheter by Radionuclide CSF Cisternography

ABSTRACT

A 37-year-old man presented with a 2-week history of abdominal pain, headaches, nausea, vomiting, and leukocytosis. Medical history includes congenital hydrocephalus, with a ventriculoperitoneal shunt placed several years ago. Radionuclide cerebrospinal fluid cisternography shows curvilinear activity in the abdomen, in the pattern of small and large bowel loops, suggesting that the tip of the catheter is inside a small bowel loop. No activity is seen in the intraperitoneal compartment. CT of the abdomen and pelvis followed by laparoscopic surgery confirmed the findings.

Computed tomography findings in septic pulmonary embolism: A case report and literature review

This case report describes the findings of septic pulmonary embolism (SPE) in a young adult male with a history of intravenous drug use who initially presented with signs and symptoms of acute sepsis. The patient underwent evaluation by computed tomography (CT) imaging as well as blood cultures and echocardiography, which confirmed the diagnosis of SPE secondary to Staphylococcus aureus positive bacterial endocarditis. In this case report, we discuss the presentation and characteristic CT imaging findings of SPE as well as highlight the value of this imaging modality in the timely diagnosis and management of this urgent condition.

The History of Discovery of Adult Neurogenesis

The scientific community's understanding of neuronal plasticity has evolved considerably over recent decades, thanks largely to Josef Altman. Altman's findings laid the groundwork for an entire subfield of neuroscience research dedicated to exploring the potential of the adult brain to create new neurons, which until then had been considered impossible. From the formative years of this field until the 1990s, when adult neurogenesis was finally accepted as a legitimate topic of study, Altman's work was followed by a series of pivotal discoveries by a handful of other dedicated neuroscientists such as Shirley Bayer, Michael Kaplan, and Fernando Nottebohm. In any sphere of activity, some wish to maintain the status quo when change occurs; science is no different. For many years, influential figures in neuroscience dismissed and marginalized the concept of adult neurogenesis, sometimes going so far as to censor the studies and launch personal attacks against their proponents. Nevertheless, despite obstacles to their research, these scientists persisted and built upon one another's work. During the 1970s, Kaplan confirmed neurogenesis in the adult mammalian neocortex and also performed some of the first neurogenesis studies on primates. During the 1980s, Nottebohm drew on his fascination with the songs of canaries and finches to show that neurogenesis happens on a grand scale in the avian brain as well, regardless of age. Today, more than half a century after Altman's discovery, the adult neurogenesis field is growing rapidly and new research is realizing its potential to revolutionize treatment for neurodegenerative disorders and brain injuries. Clin. Anat. 32:41-55, 2019. © 2019 Wiley Periodicals, Inc.

Robotic-Assisted Inferior Vena Cava Filter Retrieval

Although anticoagulation remains the mainstay of therapy for patients with venous thromboembolism, guidelines recommend the use of inferior vena cava (IVC) filters in those who fail anticoagulation or have contraindications to its use. Short-term use of filters has proven effective in reducing the rate of pulmonary embolism. However, their extended use is associated with a variety of complications such as thrombosis, filter migration, or caval perforation, thus making a case for timely filter retrieval. This is the case of a 68-year-old female with a history of chronic oral anticoagulation use for multiple deep venous thrombi (DVT) and pulmonary emboli (PE) who required cervical and thoracic spinal intervention for spondylosis and foramina stenosis. Given her increased risk of recurrent DVT and PE perioperatively, we elected to place a Cook Celect^™ IVC filter (Cook Medical, Bloomington, IN) after oral anticoagulation was stopped for the procedure. Her treatment course was prolonged due to wound-healing complications. We elected to use the Magellan Robotic Catheter System (Hansen Medical, Mountain View, CA) for filter retrieval when she presented 6 months later with caval perforation from the filter struts. With its ease of use, superior mechanical stability, and maneuverability, robot-assisted IVC filter retrieval may be a safer and more reliable substitute for traditional navigation techniques when presented with challenging filter retrievals.