BackgroundAmblyopia is the interocular visual acuity difference of two lines or more with the best correction in both eyes. It is treated with ocular occlusion therapy, but its success depends on neuroplasticity, and thus is effective in children but not adults. Transcranial Direct Current Stimulation (tDCS) is suggested to increase neuroplasticity.ObjectiveTo determine if combined intervention of bilateral tDCS and ocular occlusion improves visual function in adults with amblyopia.MethodsA double-blind randomized, controlled pilot trial was conducted in 10 volunteers with amblyopia. While applying ocular occlusion and performing a reading task, participants received bilateral tDCS (n = 5) or sham stimulation (n = 5), with the anodal tDCS electrode in the contralateral visual cortex and the cathodal in the ipsilateral visual cortex in relation to the amblyopic eye. Visual function (through visual acuity, stereopsis, and contrast sensitivity tests) and visual evoked potential (with checkerboard pattern stimuli presentation) were evaluated immediately after.ResultsA total of 30 min after treatment with bilateral tDCS, visual acuity improved by 0.16 (± 0.025) LogMAR in the treatment group compared with no improvement (–0.02 ± 0.02) in five controls (p = 0.0079), along with a significant increase in the amplitude of visual evoked potentials of the amblyopic eye response (p = 0.0286). No significant changes were observed in stereopsis and contrast sensitivity. No volunteer reported any harm derived from the intervention.ConclusionOur study is the first to combine anodal and cathodal tDCS for the treatment of amblyopia, showing transient improved visual acuity in amblyopic adults.

Amblyopia is the interocular visual acuity difference of two lines or more with best correction in both eyes. Ocular occlusion therapy depends on neuroplasticity, and thus is effective in children but not in adult with later diagnoses. Transcranial Direct Current Stimulation (tDCS) is suggested to increase neuroplasticity. To determine if combined therapy of bilateral tDCS and ocular occlusion improves visual function in adults with amblyopia, we conducted a double blind randomized, controlled pilot trial in volunteers with amblyopia (ClinicalTrials.gov Identifier: NCT05016830). While applying ocular occlusion and performing a reading task, participants received sham bilateral tDCS or bilateral tDCS. Visual function and visual evoked potential were evaluated immediately after. 12 volunteers with amblyopia were randomized, 2 were excluded after misdiagnosis confirmation. A significant increase in visual acuity was observed after stimulation in the bilateral group (n = 5) versus the sham group (n = 5) along with a significant increase in visual evoked potentials amplitude in the amblyopic eye response. No significant changes were observed in stereopsis and contrast sensitivity. No volunteer reported any harm derived from the intervention. Our results suggest that bilateral tDCS might improve visual acuity in amblyopic adults through increasing neuroplasticity, which allows the therapeutic effect of ocular occlusion.

Introduction Mesenteric and portal venous thromboses are rare diseases with high mortality rates and are strongly associated with hepatic cirrhosis, and abdominal inflammatory or tumoral processes, but in some cases can be the first sign of myeloproliferative neoplasm (MPN) or hereditary thrombophilia. JAK2V617F mutation detection is an important diagnostic tool for MPN patients. The aim of this study was to describe the JAK2V617F mutation prevalence on Chilean patients suffering from a primary splanchnic venous thrombosis (SVT), in order to assess how it relates to primary MVT and PVT in our specific population. Methods A retrospective observational study was conducted in patients referred to the University of Chile Clinical Hospital with mesenteric and/or portal venous thrombosis diagnosis over a 7‐year period. Patients with primary thrombosis underwent hereditary thrombophilia study and JAK2V617F mutation screening. Results A total of 123 patients had splanchnic venous thrombosis (mesenteric and/or portal) as their main discharge diagnosis. Sixty patients (49%) had primary mesenteric or portal venous thrombosis (no attributable secondary cause). Hereditary thrombophilia and MPN were diagnosed in 21.6% and 43.3% of SVT patients, respectively. Twenty SVT patients remained without an etiologic diagnosis. In MPN patients, almost all had the JAK2V617F mutation (92.3%). About 16% of patients who had positive JAK2V617F mutation did not meet diagnostic criteria for MPN. Conclusions In this Chilean cohort, half of mesenteric or portal venous thrombosis showed no secondary cause. In this group, the main causes were MPN and hereditary thrombophilia. Nearly, all MPN patients had JAK2V617F mutation, but there was a group of patients having JAK2V617F mutation but did not meet MPN criteria.

Background: Acute myocardial infarction (AMI) is the leading cause of morbidity and mortality worldwide. The final infarct size (FIS) and left ventricular ejection fraction (LVEF) are the greatest predictors of post-AMI mortality, with cardiac magnetic resonance (CMR) being the gold standard method for their measurement. Myocardial damage biomarkers, such as creatine kinase (CK) and myocardial creatine kinase (CKMB) are currently used to diagnose AMI and estimate the myocardial damage extent. It would be plausible to use them as predictors of FIS and LVEF; however, current evidence is not available up to date.Objective: To determine the potential power of plasma CK and CKMB levels as predictors of FIS and LVEF impairment, respectively, on the basis of their correlation in patients undergoing primary coronary angioplasty (PCA) following ST-elevation acute myocardial infarction (STEMI).Methodology: A retrospective analysis of PREVEC Trial (ISRCTN registry: 56034553), a multicentric, randomized, double-blind clinical study was performed. Sixty-seven patients with STEMI scheduled for PCA were enrolled. The CMR was performed 7-15 days after the event. Three radiologists blinded to clinical information measured FIS and LVEF. Total CK and CKMB were measured in peripheral venous blood at 6-8 hours after PCA. Correlation coefficient were obtained, and the tests were considered significant with a p value <0.05. The software GraphPrism 6.0 was used for the statistical analysis.Results: A significant positive correlation was obtained between levels of cardiac biomarkers and FIS [total CK (r-square 0.3, p<0.0001) and CK MB (r-square 0.15, p<0.0027)]. In addition, the levels of these biomarkers showed a significant negative correlation with LVEF [total CK (r-square 0.3, p<0.0001) and CK MB (r-square 0.18, p<0.0012)]. Conclusion:These results are consistent with the view that the myocardial damage biomarkers CK and CKMB are reliable as predictors of FIS and LVEF measured by CMR in post-AMI patients. These data suggest that these biomarkers could be included in future Risk Scores.

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