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This prospective, experimental study aims to evaluate the association between administration of α-blocker, 5α-reductase inhibitor, or anxiolytic medications and intraoperative floppy iris syndrome (IFIS) using a rabbit animal model. A total of 31 Metis rabbits were distributed into four groups as follows: 10 rabbits given tamsulosin, 10 rabbits given finasteride, 5 rabbits who received lorazepam, and 6 treatment-naive animals in the control group. Dosing was calculated according to body surface area ratio of man to rabbit, with a dosing duration of 43 days for all groups. Phacoemulsification maneuvers were performed by a single surgeon, who was blinded to group allocation. Any intraoperative billowing of the iris was noted and subsequently graded from 0 to 3. Higher incidences of iris billowing were found in the tamsulosin-dosed animals [OR = 8.33 (CI 95% 0.63–110.09)], (p = 0.13), the finasteride group [OR = 11.6 (CI 95% 0.92–147.6)], (p = 0.11), and the lorazepam group [OR = 7.5 (CI 95% 0.45–122.8)], (p = 0.24), as opposed to the control. Administration of α-blocker tamsulosin, 5α-reductase inhibitor finasteride, or anxiolytic medication lorazepam induces altered intraoperative iris behavior. These results correspond with previous studies and further solidify the hypothesis that systemic medication, administered both long and short-term, influences surgical parameters in cataract surgery. The present study can become the basis for further clinical or experimental research. [ABSTRACT FROM AUTHOR]

Diabetic retinopathy (DR) is a microvascular disorder caused by the long-term effects of diabetes mellitus and among the primary causes of blindness worldwide. Early detection of DR is the key to its effective treatment and subsequent reduction of associated economic burden, but manual screening is time-consuming and of limited availability. A highly sensitive and specific automatic diagnostic tool would significantly improve screening programs and allow referring for further evaluation and treatment in an ophthalmology clinic only patients with significant lesions or with changes between two successive evaluations. Several deep learning-based automated diagnosis tools have been proposed to aid screening but their implementation with minimal costs is not accessible to physicians with no coding knowledge. We aimed to develop a fundus images classification model with no coding knowledge by using generative artificial intelligence (AI) implemented in Windows 11 operating system under subscription (Copilot Pro), a free image analysis tool (Fiji ImageJ2), and Vertex AI, a machine learning (ML) platform launched by Google in 2021. For this purpose, we selected a total of 2961 labelled cases from the APTOS 2019 database of DR fundus images. Images were batch segmented using a Java ImageJ script generated by Copilot Pro and based on the Contrast Limited Adaptive Histogram Equalization (CLAHE) algorithm. Segmented images were used to train an automated ML classification model to detect DR severity (5 classes - no DR, mild non-proliferative DR, moderate DR, severe DR, proliferative DR). The model achieved an area under the precision-recall curve of 0.889, with a precision rate of 83.8% and a recall rate of 77%. In conclusion, generative AI implemented into Windows operating system together with a free imaging processing tool and Vertex AI allow ophthalmologists with no coding knowledge to benefit from publicly available image databases (thousands of cases) to develop accurate automated diagnostic tools. Such tools have the potential to facilitate screening especially in areas with few specialists. [ABSTRACT FROM AUTHOR]

Fatal hemoptysis secondary to severe pulmonary veins stenosis and fibrosing mediastinitis is an exceptional late complication of radiofrequency ablation for atrial fibrillation. We report the case of a 53-year-old male with a history of atrial fibrillation treated by radiofrequency ablation and admitted in our center 6 months after the procedure because of aggravating dyspnea and fatigability. Transthoracic echocardiography showed moderate dilation of right heart cavities, severe pulmonary hypertension and a turbulent flow in superior pulmonary veins. The cardiologist suspected pulmonary vein(s) stenosis and so cardiac computed tomography (CT) angiography was performed, with findings of severe stenosis of the right superior, right inferior and left inferior pulmonary veins, near-occlusion of the left superior pulmonary vein and the vein draining the apical segment of the right lower lobe. The CT scan also revealed soft tissue attenuation of the mediastinum posterior to the left atrium suggesting fibrosing mediastinitis together with parenchymal findings consistent with pulmonary veno-oclusive disease and an area of hemorrhagic infarction. Fatal hemoptysis occurred 3 days later, before treatment was attempted. In conclusion, severe pulmonary vein stenosis and fibrosing mediastinitis are rare but devastating complications of radiofrequency ablation. Prevention and early diagnosis are the key elements as these entities are potentially life-threatening. [ABSTRACT FROM AUTHOR]

Congenital heart defects (CHD) are a congruent group of complex pathologies associated with heteromorphic deviations of cardiac development; such maladies are present at birth and constitute the most commonly encountered type of human birth defect. The aim of the current study is to investigate abnormal aspects of cardiac development and the segmental approach in describing CHD based on the medical records of 68 patients aged 1 week - 44 years, diagnosed (all cases) and surgically treated (51 cases) for CHD at the Cardiovascular Diseases Institute (Iasi, Romania) between January 1rst - December 31rst 2015. Pediatric patients were treated as part of the project „100 hearts for 100 children". Out of the 51 patients surgically treated, 4 cases (7.84%) had undergone prior palliative or interventional procedures, 4 cases (7.84%) benefited from palliative interventions (shunts, pulmonary artery banding, atrial septectomy) and the rest of 43 cases (84.31%) were corrected per primam. Unoperated cases consisted in complex CHD with irreversible pulmonary arterial hypertension and neonates with critical CHD. In 14 cases (20.59%) CHD were part of syndromes like Down, di George, Noonan, heterotaxy or Williams. The type of embryological defect and the segmental classification were further correlated with the presence of associated malformations and the result of the surgical treatment in terms of palliative versus corrective surgery, single step correction, number of surgical procedures. Close cooperation between cardiac surgeons, anatomists, embryologists, and pathologists is crucial for further increase of knowledge in the field of cardiac morphogenesis explaining cardiac defects. Detailed knowledge of cardiac embryology and anatomy allows accurate diagnosis and successful management of CHD. [ABSTRACT FROM AUTHOR]