Background: and Purpose In patients with ischemic stroke and isolated cervical internal carotid artery occlusion (c-ICA-O), endovascular therapy (EVT) can improve cerebral perfusion. To maintain vessel patency, EVT is frequently combined with carotid artery stenting (CAS). We assessed the efficacy and safety of emergent CAS during EVT for isolated c-ICA-O. Methods: This retrospective multinational cohort study (42 centers) included consecutive patients who underwent EVT for isolated c-ICA-O within 24 hours from the time last seen well. Patients who underwent emergent CAS were compared with those who did not. Co-primary outcomes were c-ICA vessel patency and symptomatic intracerebral hemorrhage (sICH) 24 hours post-EVT. Secondary outcomes included any intracerebral hemorrhage (ICH) at 24 hours and disability at 3 months (modified Rankin Scale [mRS] shift). Outcomes were adjusted using inverse probability of treatment weighting. Results: Of 317 patients (mean age, 68.6 years [standard deviation, 12.9]; median National Institutes of Health Stroke Scale 11 [interquartile range, 6–17]; 26.8% female), 219 (69.1%) underwent CAS, whereas 98 (30.9%) did not. At 24 hours, vessel patency was more common after CAS (83.5% vs. 40.7%; adjusted odds ratio [aOR], 9.45; 95% confidence interval [CI], 4.91–18.17); sICH rates did not differ (2.3% vs. 3.1%; aOR, 0.92; 95% CI, 0.18–4.73). Any ICH was more common after CAS (19.3% vs. 9.3%; aOR, 2.50; 95% CI, 1.12–5.60). CAS was not associated with mRS at 3 months (adjusted common odds ratio, 0.98; 95% CI, 0.62–1.56). Conclusions In patients undergoing EVT for isolated c-ICA-O, emergent CAS was technically effective and reasonably safe. More frequent vessel patency in patients who underwent CAS did not translate into improved functional outcome at 3 months.

Food allergy has an estimated prevalence of 6%–8% in children. Meat allergy and multiple food allergy due to sensitization to cross-reactive components in infancy is, however, less frequent. A 5-year-old girl was referred to our department with a multiple food allergy history. She had severe immediate worsening of her atopic dermatitis with hen's egg (6 months) and cow's milk introduction (7 months). At the age of 9 months, she presented with recurrent and reproducible atopic dermatitis' worsening and lip edema with the introduction of different meats (chicken, turkey, cow, pork, and rabbit), having the same complaints with fish at 12 months (salmon and hake). At her first appointment she was avoiding hen's egg, cow's milk, meat, and fish (except fresh tuna, codfish, and pollock). We performed skin prick tests (commercial extract and prick-to-prick with whole food) and specific IgE, which revealed sensitization to hen's egg, raw meat (cow, pork, chicken, turkey, duck, lamb, goat, and rabbit; negative for cooked meat), codfish and cow's milk (mild). ISAC was performed, revealing sensitization to 3 cross-reactive components (serum albumins Bosd6, Canf3, and Feld2) and specific food components of chicken's egg/meat (Gald1, 2, 3, and 5), cod (Gadc1), hazelnut (Cora9), and kiwi (Actd1). We present a rare case of multiple food allergy in infancy, where sensitization to cross-reactive components was responsible for most of the children complaints. The detection of serum albumins' involvement was especially important, because it can possibly mean tolerance to these foods in well-cooked forms, substantially improving patient and family's quality of life.
Albumins ; Chickens ; Child ; Child, Preschool ; Corylus ; Dermatitis, Atopic ; Ducks ; Edema ; Female ; Food Hypersensitivity ; Goats ; Humans ; Hypersensitivity ; Immunoglobulin E ; Lip ; Meat ; Milk ; Ovum ; Prevalence ; Quality of Life ; Red Meat ; Serum Albumin ; Skin ; Tuna ; Turkey

·AIM: To analyze the management of patients with macula- on retinal detachment who received surgical treatment in our department. Placing special emphasis on the time elapsed between diagnosis and surgery, we sought to establish whether a relationship exists between time to surgery and loss of visual acuity.·METHODS: A retrospective study in which the medical records of 77 patients with macula-on retinal detachment who underwent surgery in Hospital Universitario Fundación Jiménez Díaz were reviewed.·RESULTS:A total of 77 patients, 72 were included in the study. The primary anatomic success rate was 94. 44%(68/72), and the success rate in all patients after either 1 or 2 interventions was 98. 61% ( 71/72 ) . The mean time before surgery was 5. 3 ± 2. 26d. Seven patients ( 9. 72%) lost two or more lines of vision. A statistically significant relationship was found between loss of visual acuity and patient age ( P = 0. 001 ) . Our findings also suggest a possible link between the need for further surgical intervention to reattach the retina and decline in visual acuity test ( P= 0. 045 ) . We failed to find a statistically significant relationship between loss of visual acuity and days until surgery ( P= 0. 100 ) or type of surgery ( P=0. 578) or status of the crystalline lens (P=0. 413).·CONCLUSION: It is important that each hospital study how this type of retinal detachment is being managed in order to optimize the use of available resources and guarantee the most favorable anatomic and functional outcomes possible.

Introduction : The increasing aging population of the Philippines impacts on the socioeconomic development of the country, prompting a deeper look into their quality of life. This study sought to determine the effect of the Elderly Development Program on the quality of life of the elderly population of Los Baños. Methods : A 4-month prospective cohort study of the elderly population in Los Baños, Laguna compared the quality of life scores of a group enrolled in the Elderly Development Program and an unexposed control, using the World Health Organization Quality of Life Abbreviated Version for Filipino Older Persons questionnaire. Results : Quality of life scores where higher for the EDP group during the four months of observation. In Month 2, significant differences were found in all domains except for the psychological domain. Only the physical health domain score was significant in the EDP group for Month 3 (p = 0.003) and Month 4 (p = 0.029). Both the EDP and control groups had higher overall and domain scores in Month 4 compared with baseline. Conclusion The Elderly Development Program may improve the overall quality of life of elderly persons, specifically in the physical health domain. These improvements are likely due to the focus of the program on the physical aspect of the elderly.
Aged ; Quality of Life

Introduction：Given the significant burden that emerging infectious diseases place on global economies and public health, the monitoring and mitigation of, and early response to, potential infectious diseases are of the highest priority. The objective of this study was to survey for known and other potential arboviral zoonoses in multiple bird species at four locations in New Zealand.Methods：Common bird species were targeted for blood sampling during two southern hemisphere summers. Sera from each period ( n = 185 and n = 693) were screened in an epitope blocking enzyme immunoassay for flavivirus antibody detection. In the first season, testing for antibodies to specific alphaviruses was conducted on samples with sufficient sera ( n = 22). In the second season, blood clots ( n = 544) were screened for viral presence by polymerase chain reaction (PCR) for alphaviral and flaviviral RNA, and virus isolation ( n = 146) was conducted. Results：Flavivirus antibodies were detected in 13 species, and one Australasian gannet ( Morus serrator ) from one site was positive for antibodies to Ross River virus. PCR tests and virus isolation were all negative.Discussion: Evidence for flavivirus exposure in seabirds at Kaikoura Peninsula and Cape Kidnappers suggests that viruses isolated from seabirds and associated ticks in New Zealand in the late 1970s are still present. Evidence for flavivirus exposure in passerines at Kaikoura Peninsula, Cape Kidnappers and Mokoia Island is novel. The Ross River virus finding is also new and supports the hypothesis that migratory seabirds are an import pathway for such agents into New Zealand.