Frontiers in Medicine最新文献

{"title":"Case report: Brain infarction following percutaneous drainage of a liver abscess post-chemotherapy for pancreatic head cancer.","authors":"Wan-Qiu Deng, Bo Wei, Zheng-Yan Li, Kai Liu","doi":"10.3389/fmed.2024.1453533","DOIUrl":"10.3389/fmed.2024.1453533","url":null,"abstract":"<p><p>Bacterial liver abscesses commonly occur in patients with immune deficiencies such as diabetes, post-chemotherapy, or post-immunosuppressive therapy. The recommended treatment for liver abscesses exceeding 5 cm in a diameter is anti-infection therapy combined with percutaneous catheter drainage. Complications may include local spread to adjacent tissues or organs and thrombosis of the liver and portal veins. Rare hematogenous spread to distant sites, such as endophthalmitis and central nervous system embolism, have been reported, though such complications are uncommon post-drainage. This case report details a patient who suffered a brain infarction shortly after percutaneous drainage of a large liver abscess.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"11 ","pages":"1453533"},"PeriodicalIF":3.1,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11670067/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142893502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ANCA-associated vasculitis presenting with progressive binocular manifestations: a case report and literature review.","authors":"Lei Xi, Ying Cui, Zhilian Li","doi":"10.3389/fmed.2024.1525111","DOIUrl":"10.3389/fmed.2024.1525111","url":null,"abstract":"<p><p>This report primarily describes a rare case of an elderly male patient who initially presented with central retinal artery occlusion (CRAO) in the left eye and was ultimately diagnosed with anti-neutrophil cytoplasmic antibody (ANCA) -associated vasculitis involving the eyes, gastrointestinal tract, and kidneys. However, due to irregular treatment, both eyes developed progressive ocular manifestations later. This article emphasizes the importance of actively screening for and treating underlying conditions in cases of CRAO. A comprehensive assessment of the patient's medical history, systemic condition, and ocular examination can aid in early diagnosis, slow disease progression, and reduce mortality.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"11 ","pages":"1525111"},"PeriodicalIF":3.1,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11668744/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142893050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and safety of acupuncture in the treatment of Meniere's disease: a systematic review and meta-analysis.","authors":"Mingjie Tang, Yinghong Li, Man Lu, Tianchen Zhang, Yanhao Ge, Jie Han, Jiqin Tang, Zhaoming Chen","doi":"10.3389/fmed.2024.1463821","DOIUrl":"10.3389/fmed.2024.1463821","url":null,"abstract":"<p><strong>Background: </strong>Meniere's disease (MD) is an idiopathic chronic inner ear disease that seriously impacts patients' physical and mental health. Medications may be effective for a proportion of patients, and additional effective treatments are still needed. This review aimed to evaluate the efficacy of acupuncture treatment for MD.</p><p><strong>Methods: </strong>Eight databases were systematically searched from their inception to June 1, 2024, to identify randomized clinical trials on acupuncture treatment for MD. The Cochrane Risk of Bias 2.0 tool was used to assess the risk of bias in included studies, and meta-analysis was conducted by RevMan 5.4 and Stata 16.0 software.</p><p><strong>Results: </strong>Six studies were included in this review. The treatment group received acupuncture or acupuncture combined with Western medicine, while the control group was treated with Western medicine. The treatment group was superior to the control group in terms of efficacy rate (RR: 1.20; 95% CI: 1.11-1.29; <i>p</i> < 0.0001). The treatment group reduced dizziness handicap inventory (DHI) (MD: 6.94; 95% CI: 1.58-12.30; <i>p</i> = 0.01), tinnitus handicap inventory (THI) (MD: 6.52; 95% CI: 0.77-12.27; <i>p</i> = 0.03), stuffy ear visual analog scale (VAS) (MD: 0.87; 95% CI: 0.54-1.20; <i>p</i> < 0.0001) and pure tone audiometry score (MD: 6.57; 95% CI: 5.62-7.51; <i>p</i> < 0.0001) to a greater degree than those of the control group. There were some methodological shortcomings in the included studies, including failure to implement blinding, inappropriate outcome measures, and heterogeneity of clinical interventions, such as selected acupoints, acupuncture sessions, and therapist techniques.</p><p><strong>Conclusion: </strong>Acupuncture may improve the symptoms of vertigo, tinnitus, ear fullness and hearing loss in patients with MD. However, due to the lack of literature included in this study and methodological weaknesses like randomization, blinding, and clinical heterogeneity, more well-designed long-term follow-up RCTs are needed to evaluate the efficacy and safety of acupuncture.</p><p><strong>Systematic review registration: </strong>https://www.crd.york.ac.uk/PROSPERO/(CRD42024549261).</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"11 ","pages":"1463821"},"PeriodicalIF":3.1,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11669254/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142893467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Melatonin stabilizes atherosclerotic plaques: an association that should be clinically exploited.","authors":"Russel J Reiter, Ramaswamy Sharma, Alejandro Romero, Fedor Simko, Alberto Dominguez-Rodriguez, Daniel P Cardinali","doi":"10.3389/fmed.2024.1487971","DOIUrl":"10.3389/fmed.2024.1487971","url":null,"abstract":"<p><p>Atherosclerosis is the underlying factor in the premature death of millions of humans annually. The cause of death is often a result of the rupture of an atherosclerotic plaque followed by the discharge of the associated molecular debris into the vessel lumen which occludes the artery leading to ischemia of downstream tissue and to morbidity or mortality of the individual. This is most serious when it occurs in the heart (heart attack) or brain (stroke). Atherosclerotic plaques are classified as either soft, rupture-prone, or hard, rupture resistant. Melatonin, the production of which diminishes with age, has major actions in converting soft to hard plaques. Experimentally, melatonin reduces the ingrowth of capillaries from the tunica media into the plaque relieving pressure on the plaque, reducing intraplaque hemorrhage and limiting the size of the necrotic core. Moreover, melatonin promotes the formation of collagen by invading vascular smooth muscle cells which strengthen the plaque crown making it resistant to rupture. Melatonin is also a powerful antioxidant and anti-inflammatory agent such that is reduces oxidative damage to tissues associated with the plaque and limits inflammation both of which contribute to plaque cap weakness. Additional benefits of melatonin relative to atherosclerosis is inhibition of adhesion molecules on the endothelial cell surface, limiting the invasion of monocytes into the arterial intima, and reducing the conversion of anti-inflammatory M2 macrophages to pro-inflammatory M1 macrophages. Given the high physiological and financial cost of cardiac and neural ischemic events, this information should be given high priority in the clinical setting.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"11 ","pages":"1487971"},"PeriodicalIF":3.1,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11668786/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142893581","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Weakly supervised learning in thymoma histopathology classification: an interpretable approach.","authors":"Chunbao Wang, Xianglong Du, Xiaoyu Yan, Xiali Teng, Xiaolin Wang, Zhe Yang, Hongyun Chang, Yangyang Fan, Caihong Ran, Jie Lian, Chen Li, Hansheng Li, Lei Cui, Yina Jiang","doi":"10.3389/fmed.2024.1501875","DOIUrl":"10.3389/fmed.2024.1501875","url":null,"abstract":"<p><strong>Introduction: </strong>Thymoma classification is challenging due to its diverse morphology. Accurate classification is crucial for diagnosis, but current methods often struggle with complex tumor subtypes. This study presents an AI-assisted diagnostic model that combines weakly supervised learning with a divide-and-conquer multi-instance learning (MIL) approach to improve classification accuracy and interpretability.</p><p><strong>Methods: </strong>We applied the model to 222 thymoma slides, simplifying the five-class classification into binary and ternary steps. The model features an attention-based mechanism that generates heatmaps, enabling visual interpretation of decisions. These heatmaps align with clinically validated morphological differences between thymoma subtypes. Additionally, we embedded domain-specific pathological knowledge into the interpretability framework.</p><p><strong>Results: </strong>The model achieved a classification AUC of 0.9172. The generated heatmaps accurately reflected the morphological distinctions among thymoma subtypes, as confirmed by pathologists. The model's transparency allows pathologists to visually verify AI decisions, enhancing diagnostic reliability.</p><p><strong>Discussion: </strong>This model offers a significant advancement in thymoma classification, combining high accuracy with interpretability. By integrating weakly supervised learning, MIL, and attention mechanisms, it provides an interpretable AI framework that is applicable in clinical settings. The model reduces the diagnostic burden on pathologists and has the potential to improve patient outcomes by making AI tools more transparent and clinically relevant.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"11 ","pages":"1501875"},"PeriodicalIF":3.1,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11668976/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142893608","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acupuncture and moxibustion as adjunctive therapy for postoperative gastrointestinal dysfunction in gastric cancer: a systematic review and network meta-analysis.","authors":"Yangxu Ou, Dezhi Lin, Xixiu Ni, Chengzhi Feng, Jing Rong, Xiaoyu Gao, Yang Yu, Xinrui Liu, Zhiyang Zhang, Wang Xiao, Zili Tang, Ling Zhao","doi":"10.3389/fmed.2024.1464749","DOIUrl":"10.3389/fmed.2024.1464749","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to evaluate and compare the efficacy and safety of different acupuncture and moxibustion techniques as adjunctive therapy in addressing Postoperative gastrointestinal dysfunction (PGD) associated with gastric cancer (GC).</p><p><strong>Methods: </strong>Eight medical databases were comprehensively searched for relevant randomized controlled trials (RCTs) as of October 2024. A network meta-analysis (NMA) was performed using frequency models, combining all available direct and indirect evidence from RCTs. Time of first bowel sounds (TFBS) was set as the primary outcome, and time to first defecation (TFD) and time to first flatus (TFF) were set as the secondary outcomes. All outcomes were ranked using surface under the cumulative ranking curve (SUCRA) probabilities to determine a hierarchy of treatments, and the probability that the intervention will be in one of the top ranks increases with a higher SUCRA value.</p><p><strong>Results: </strong>With 28 randomized controlled trials (RCTs) and 2,459 patients, 18 of which involved adjuvant acupuncture treatments. NMA based on SUCRA rankings showed that routine care (RC) with acupuncture (ACU), with acupressure (ACUP), with moxibustion (MOX) and acupoint injection (AI) were the top-ranked therapies for shortening TFBS and TFF in patients with GC compared with RC; additionally, RC + MOX + CUP and RC + MOX were the relatively best therapies for TFD. No serious adverse events were reported in the studies assessing the safety of adjunctive acupuncture therapy. Our study found that ST36, ST37, ST39, and PC6 were the most commonly used acupoints for adjuvant acupuncture treatments in treating PGD associated with GC.</p><p><strong>Conclusion: </strong>Acupuncture and moxibustion, when used as supplementary therapies, demonstrated efficacy and relative safety in managing PGD associated with GC. The recommended order for adjunctive acupuncture- and moxibustion-related therapies for PGD in patients with GC, in terms of conservativeness, is as follows: RC + ACU, RC + MOX + AI, RC + ACUP, RC + MOX + CUP and RC + MOX. Despite their inclusion, the overall methodological quality of the studies was poor, which need for further high-quality randomized controlled trials to support existing results.</p><p><strong>Systematic review registration: </strong>https://www.crd.york.ac.uk/PROSPERO.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"11 ","pages":"1464749"},"PeriodicalIF":3.1,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11668611/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142893106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The endothelial activation and stress index is a potential prognostic indicator for patients with acute pancreatitis managed in the intensive care unit: a retrospective study.","authors":"Jianjun Wang, Xi Chen, Chuan Qin, Xintao Zeng, Xiaobo Du, Decai Wang","doi":"10.3389/fmed.2024.1498148","DOIUrl":"10.3389/fmed.2024.1498148","url":null,"abstract":"<p><strong>Background: </strong>The endothelial activation and stress index (EASIX) serves as a dependable and efficient surrogate marker for endothelial dysfunction, which plays an essential role in the pathophysiology of acute pancreatitis (AP). Hence, we investigated the prognostic value of EASIX in AP.</p><p><strong>Methods: </strong>This was a retrospective study, using patient information obtained from the Medical Information Market for Intensive Care-IV (MIMIC-IV) database. EASIX was calculated using lactate dehydrogenase, serum creatinine, and platelet counts obtained during the first measurement within 24 h of admission. Patients were grouped into three cohorts based on log2-transformed EASIX. The main endpoint of the study was 28-day all-cause mortality (ACM) in AP patients, with the secondary endpoint being 90-day ACM. The relationship between EASIX and prognosis in patients with AP was evaluated using Cox proportional hazards models, Kaplan-Meier curves, restricted cubic spline (RCS) curves, and subgroup analyses. Receiver operating characteristic (ROC) curves were constructed to evaluate the predictive performance of EASIX compared to other indicators.</p><p><strong>Results: </strong>The study cohort comprised 620 patients in total. Multivariate Cox proportional hazards analysis indicated that an increased log2 (EASIX) was linked to a higher risk of 28-day ACM in AP patients (HR, 1.32; 95% CI: 1.14-1.52; <i>p</i> < 0.001). The risk of 28-day ACM was higher in Tertiles 2 and 3 compared with Tertile 1 [(HR, 2.80; 95% CI: 1.21-6.45); (HR, 3.50; 95% CI: 1.42-8.66)]. Comparable findings were noted for 90-day ACM. Kaplan-Meier curves demonstrated that patients with elevated log2 (EASIX) had lower 28- and 90-day survival rates. The RCS curves suggested a non-linear relationship between log2 (EASIX) and 28- and 90-day ACM. ROC curves indicated that log2 (EASIX) was not inferior to sequential organ failure assessment and systemic inflammatory response syndrome scores in predicting the prognosis of patients with AP. Subgroup analyses demonstrated no interaction between log2 (EASIX) and any subgroup.</p><p><strong>Conclusion: </strong>Elevated EASIX levels were significantly correlated with a heightened risk of 28- and 90-day ACM in AP patients.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"11 ","pages":"1498148"},"PeriodicalIF":3.1,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11668595/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142893606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative analysis of SDC2 and SEPT9 methylation tests in the early detection of colorectal cancer: a systematic review and meta-analysis.","authors":"Jie Zhang, Chenhui Li, Yu An, Bing Wang, Guowei Liang","doi":"10.3389/fmed.2024.1460233","DOIUrl":"10.3389/fmed.2024.1460233","url":null,"abstract":"<p><strong>Purpose: </strong>This meta-analysis aimed to evaluate the comparative diagnostic efficacy of Syndecan-2(SDC2) and Septin-9(SEPT9) in the early detection of colorectal cancer (CRC).</p><p><strong>Methods: </strong>We searched PubMed, Embase, Web of Science, and Cochrane Library databases to identify available publications up to October 2024. A direct head-to-head comparator analysis were performed using the random-effects model. Subgroup analyses and corresponding meta-regressions focusing on sample source, number of patients, region, study design, and methylated detection methods were conducted. Intra-group and inter-group heterogeneity were assessed by Cochrane Q and I² statistics.</p><p><strong>Results: </strong>Eleven articles involving 1,913 CRC patients and 2,851 healthy people were included in the meta-analysis. The sensitivity of SDC2 was similar compared to SEPT9 for CRC patients (0.67 vs. 0.71, <i>p</i> = 0.61), SDC2 has a similar specificity in comparison to SEPT9 for CRC patients (0.90 vs. 0.91, <i>p</i> = 0.86). In subgroup analysis, stool SDC2 was similar compared to stool SEPT9 for CRC patients (sensitivity of 0.81 vs. 0.80, <i>p</i> = 0.92; specificity of 0.93 vs. 0.91, <i>p</i> = 0.73), plasma SDC2 was similar compared to plasma SEPT9 for CRC patients (sensitivity of 0.57 vs. 0.72, <i>p</i> = 0.27; specificity of 0.90 vs. 0.89, <i>p</i> = 0.89). In the subgroup analysis of clinical staging for colorectal cancer (CRC), the results indicate that there is no significant difference in sensitivity between the two markers for both early (0.7 vs. 0.67, <i>p</i> = 0.64) and advanced (0.76 vs. 0.70, <i>p</i> = 0.23) stages of CRC.</p><p><strong>Conclusion: </strong>In our head-to-head comparison meta-analysis, it was found that SDC2 and SEPT9 have similar sensitivity and specificity in the diagnosis of colorectal cancer. However, this result may be influenced by high heterogeneity and further confirmation of this finding is needed through large-scale prospective studies.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"11 ","pages":"1460233"},"PeriodicalIF":3.1,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11666333/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142881782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Challenging perceptions about rural practice using narratives: a living library approach in medical education.","authors":"Grace Perez, Rebecca Malhi, Kamiko Bressler, Melissa Monaghan, Aaron Johnston","doi":"10.3389/fmed.2024.1452932","DOIUrl":"10.3389/fmed.2024.1452932","url":null,"abstract":"<p><strong>Introduction: </strong>The shortage of physicians in rural Canada is a continuing challenge. Canadian medical schools have adapted strategies to increase the supply of rural physicians. This study appraises the effectiveness of the living library (also called Human Library©) in medical education, as an avenue for medical and pre-medical students to engage in dialogue with rural health professionals. Similar to a conventional library, readers check out books, except that \"books\" are human volunteers willing to share relevant personal experiences, and \"readers\" are the learners. The reading is the personal interaction between human books and students through narratives of experiences. The program \"The Library of Life-Stories of Rural Medicine\" (TLoL), was developed to provide students with better understanding of rural life and practice through narratives.</p><p><strong>Methods: </strong>This is a mixed methods study, using pre- and post-event surveys. Statistical comparisons were done using Wilcoxon and McNemar's tests. Thematic analysis was used to explore students' expectations of TLoL and to describe their experience and key takeaways.</p><p><strong>Results: </strong>Most of the participants were from an urban background, had low familiarity with rural medicine and only 44% would consider a rural career prior to TLoL. After TLoL, improvements were observed in: (i) envisioning rural medicine as career option (<i>p</i> = 0.009), (ii) appreciation of rural living (<i>p</i> = 0.013), (iii) need for rural physicians (<i>p</i> < 0.001). and (iv) rural practice consideration (<i>p</i> = 0.001). Themes from students' motivations for participation were: (i) students' curiosity, interest, and (ii) their willingness to engage in dialogue with the human books. Themes from the key takeaways were that TLoL allowed students: (i) to walk in a rural professional's shoes, enabling them to see \"rural\" in a new light, and (ii) to self-reflect and gain a sense of personal growth.</p><p><strong>Conclusion: </strong>Students made gains in attitudes and perceptions toward rural practice. Narratives have the power to challenge held beliefs around rural practice and life, and can encourage students to consider things that traditional medical teaching may not. TLoL can be an effective learning modality in medical education to provide information about rural medicine, in combination with learning opportunities such as rural block rotations and longitudinal clinical clerkship immersions.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"11 ","pages":"1452932"},"PeriodicalIF":3.1,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11667788/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142885533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of computer-generated patterns with different temporal and spatial frequencies on choroidal thickness, retinal dopamine and candidate genes in chickens wearing lenses.","authors":"Hong Liu, Frank Schaeffel, Marita Pauline Feldkaemper","doi":"10.3389/fmed.2024.1469275","DOIUrl":"10.3389/fmed.2024.1469275","url":null,"abstract":"<p><strong>Purpose: </strong>Changes in choroidal thickness (ChT) are proposed to predict myopia development but evidence is mixed. We investigated time courses of choroidal responses, following different types of dynamic artificial stimulation in chicks with and without spectacle lenses, as well as changes in retinal dopamine metabolism and expression of candidate genes.</p><p><strong>Methods: </strong>Chicks were kept in an arena surrounded by computer monitors presenting dynamic checkerboard fields of small, medium and large size. Fields were displayed with different cycle frequencies, as ON (rapid rise, slow decay) or OFF (slow rise, rapid decay) temporal luminance profile. Refractive errors, ocular biometry and ChT were assessed. Dopamine metabolism and candidate gene expression levels were also measured. Stimuli were applied for (1) 3 h with no lens, (2) 3 h and monocular treatment with -7D or +7D lenses, (3) 3 or 7 days.</p><p><strong>Results: </strong>(1) The smallest fields caused the largest decrease in ChT. (2) Negative lens treatment induced on average 11.7 μm thinner choroids. ChT thinning was enhanced by 10 Hz-ON medium field size flicker which also reduced choroidal thickening with positive lenses. (3) With prolonged treatment, the choroid recovered from initial thinning in all groups although to varying degrees which were dependent on stimulus parameters. Relative ChT changes were positively correlated with the vitreal level of dopamine metabolites. Retinal <i>EGR-1</i> mRNA level was positively correlated with choroidal thickness. Retinal melanopsin mRNA was increased by 10 Hz-ON stimulation and choroidal <i>BMPR1A</i> mRNA increased with 10 Hz-OFF stimulation. On average, early choroidal thinning did not predict the amount of negative lens-induced eye growth changes after 7 days, whereas later ChT changes showed a weak association.</p><p><strong>Conclusion: </strong>Negative lenses caused long-lasting choroidal thinning, with some recovery during lens wear, especially after stimulation with 10 Hz. The dynamic stimuli modulated choroidal thinning but effects were small. There was little difference between ON and OFF stimulation, perhaps because the checkerboard patterns were too coarse. 10 Hz cycle frequency increased dopamine release. Less dopamine was correlated with thinner choroids. Result do not exclude a predictive value of choroidal thickening for future refractive development since we almost exclusively tested choroidal thinning effects.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"11 ","pages":"1469275"},"PeriodicalIF":3.1,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11666368/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142885551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}