Smartphone Fundus Photography

Smartphone fundus photography is a simple technique to obtain ocular fundus pictures using a smartphone camera and a conventional handheld indirect ...

University of Texas Medical Branch

university of texas medical branch

Neurological complications such as inflammation, failure of the blood-brain barrier (BBB), and neuronal death contribute to the mortality and morbidity associated with WNV-induced meningitis. Compromised BBB indicates the ability of the virus to gain entry into the CNS via the BBB, however, the underlying mechanisms, and the specific cell types associated with WNV-CNS trafficking are not well understood. Brain microvascular endothelial cells, the main component of the BBB, represent a barrier to virus dissemination into the CNS and could play key role in WNV spread via hematogenous route. To investigate WNV entry into the CNS, we infected primary human brain microvascular endothelial (HBMVE) cells with the neurovirulent strain of WNV (NY99) and examined WNV replication kinetics together with the changes in the expressions of key tight junction proteins (TJP) and cell adhesion molecules (CAM). WNV infection of HBMVE cells was productive as analyzed by plaque assay and qRT-PCR, and did not induce cytopathic effect. Increased mRNA and protein expressions of TJP (claudin-1) and CAM (vascular cell adhesion molecule and E-selectin) were observed at days 2 and 3 after infection, respectively, which coincided with the peak in WNV replication. Further, using an in vitro BBB model comprised of HBMVE cells, we demonstrate that cell-free WNV can cross the BBB, without compromising the BBB integrity. These data suggest that infection of HBMVE cells can facilitate entry of cell-free virus into the CNS without disturbing the BBB, and increased CAM may assist in the trafficking of WNV-infected immune cells into the CNS, via 'Trojan horse' mechanism, thereby contributing to WNV dissemination in the CNS and associated pathology.

West Nile virus infection modulates human brain microvascular endothelial cells tight junction proteins and cell adhesion molecules: Transmigration across the in vitro blood-brain barrier.

Current American football helmet design has a rigid exterior with a padded interior. Softening the hard external layer of the helmet may reduce the impact potential of the helmet, providing extra head protection and reducing its use as an offensive device. The objective of this study is to measure the impact reduction potential provided by external foam. We obtained a football helmet with built-in accelerometer-based sensors, placed it on a boxing mannequin and struck it with a weighted swinging pendulum helmet to mimic the forces sustained during a helmet-to-helmet strike. We then applied layers of 1.3 cm thick polyolefin foam to the exterior surface of the helmets and repeated the process. All impact severity measures were significantly reduced with the application of the external foam. These results support the hypothesis that adding a soft exterior layer reduces the force of impact which may be applicable to the football field. Redesigning football helmets could reduce the injury potential of the sport.

External foam layers to football helmets reduce head impact severity.

Visualization of the fundus is an important component of any ophthalmologic exam. Students are taught to visualize the fundus using a direct handheld ophthalmoscope. However, this device has many limitations, which may be a detriment to medical education and patient care. The invention of the non-mydriatic automatic fundus camera could significantly improve medical education. Our study examined the ability of a group of 5 medical students to visualize pathology and form a diagnosis with a traditional handheld ophthalmoscope and an automatic fundus camera. With the direct ophthalmoscope, none of the students were able to visualize the macula, a crucial aspect of the ophthalmologic exam. With the automatic fundus camera, all students were able to visualize the fundus. The latter modality also increased the proportion of students that was able to correctly diagnose the patients with diabetic retinopathy, 100% vs 40%. On average, students were also more confident in their ability to visualize basic retinal anatomy with the automatic fundus camera, 9.6/10 vs 6.4/10. Thus, incorporating the non-mydriatic automatic fundus camera into medical education, alongside the handheld ophthalmoscope, has the potential to improve both learning outcomes and patient care.

Comparing the utility of the non-mydriatic fundus camera to the direct ophthalmoscope for medical education.

A 41-year-old man with a history of gout presented with an enlarging eyelid growth. Clinical examination revealed a mildly indurated nodule at the lateral canthus. Following resection, histopathological examination revealed needle-shaped, crystalline material surrounded by multinucleated giant cells, findings consistent with gouty tophus. This represents just the sixth case of gouty tophus of the eyelid reported in the literature.

A Rare Case of Lateral Canthal Gouty Tophus Presenting as an Eyelid Mass.

There is greater attention to head-related injuries and concussions in American football. The helmet's structural safety and the way that football players use their helmets are important in preventing head injuries. Current strategies include penalizing players for high-risk behavior such as leading with their helmet or hitting an opposing player above the shoulder. Passive strategies include helmet modification to better protect the head of the players or to change the playing style of the players. Hawai'i high school varsity football players were surveyed to determine how they use their helmets and how a new helmet design would affect their style of play. One hundred seventy-seven surveys were completed; 79% said that they used their helmet to hit an opposing player during a tackle and 46% said they made this contact intentionally. When asked about modifying helmets with a soft material on the outside, 48% said they thought putting a soft cover over a regular helmet would protect their head better. However, many participants said that putting a soft cover over their regular helmet was a bad idea for various reasons. Most young football players use their helmets to block or tackle despite being taught they would be penalized or potentially injured if they did so. By gaining a better understanding of why and how players use their helmets and how they would respond to new helmet designs, steps can be taken to reduce head injuries for all levels of play.

Austin Nakatsuka

Department of Ophthalmology and Visual Sciences

University of Texas Medical Branch

Smartphone Fundus Photography