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Purpose We aimed to identify potential clinical parameters that can be easily obtained by a pre-treatment clinicopathological evaluation and whole blood test to estimate the development of oxaliplatin-induced peripheral neuropathy (OIPN). Methods This study was conducted retrospectively. For the FOLFOX regimen, patients received oxaliplatin, 85 mg/m 2 , every 2 weeks for 12 courses, and with the XELOX regimen, oxaliplatin was 130 mg/m 2 , every 3 weeks for 6–8 courses. The incidence and degree of neuropathy (NCI-CTCAE v.3) were recorded. Results A total of 186 patients were included in the study. There were 108 (58%) patients in the grade 0–1 (G0–G1) neuropathy group (mean age 50.5 ± 11.5; 63% men), and 78 (42%) patients in the grade 2–3 (G2–G3) neuropathy group (mean age 58.0 ± 10.8; 46.2% men). The relationship between G2–G3 OIPN development and age ( p  < 0.001), gender ( p  = 0.02), and ECOG performance status ( p  = 0.007) was statistically significant. In the G2–G3 neuropathy group, serum gamma-glutamyl transferase (GGT) ( p  < 0.001) and glucose ( p  = 0.007) levels were higher, whereas vitamin D ( p  < 0.001), hemoglobin (Hgb) ( p  < 0.001), serum albumin ( p  = 0.001), and serum magnesium ( p  = 0.035) levels were lower compared with the G0–G1 neuropathy group. G2–G3 neuropathy was observed in 88% of patients with mucinous carcinoma pathologic type ( p  < 0.001). Conclusion This study demonstrated that age, histopathologic type, albumin, GGT, glucose, vitamin D, and Hgb levels were the effective factors in prediction of the development of OIPN. In addition, GGT, vitamin D, and Hgb levels were the most effective factor to predict development of OIPN.

Keratoconus had traditionally been considered a rare disease at a time when the imaging technology was inept in detecting subtle manifestations, resulting in more severe disease at presentation. The increased demand for refractive surgery in recent years also made it essential to more effectively detect keratoconus before attempting any ablative procedure. Consequently, the armamentarium of tools that can be used to diagnose and treat keratoconus has significantly expanded. The advances in imaging technology have allowed clinicians and researchers alike to visualize the cornea layer by layer looking for any early changes that might be indicative of keratoconus. In addition to the conventional geometrical evaluation, efforts are also underway to enable spatially resolved corneal biomechanical evaluation. Artificial intelligence has been exploited in a multitude of ways to enhance diagnostic efficiency and to guide treatment. As for treatment, corneal cross-linking treatment remains the mainstay preventive approach, yet the current main focus of research is on increasing oxygen availability and developing new strategies to improve riboflavin permeability during the procedure. Some new combined protocols are being proposed to simultaneously halt keratoconus progression and correct refractive error. Bowman layer transplantation and additive keratoplasty are newly emerging alternatives to conventional keratoplasty techniques that are used in keratoconus surgery. Advances in tissue engineering and regenerative therapy might bring new perspectives for treatment at the cellular level and hence obviate the need for invasive surgeries. In this review, we describe the advances in the diagnosis and treatment of keratoconus primarily focusing on newly emerging approaches and strategies.

Purpose In this study, it was aimed to determine the predictors of clinically relevant postoperative pancreatic fistula (CR-POPF) following pancreaticoduodenectomy (PD) and clinical significance of mean platelet volume (MPV)/total platelet count ratio (MPR) as a new predictor for CR-POPF. Methods A total of 105 patients who underwent PD consecutively due to periampullary located diseases were included in the study. Patients were divided into two groups as CR-POPF and no postoperative pancreatic fistula (No-POPF). Demographic parameters, preoperative serum-based inflammatory indicators, surgical procedures, intraoperative findings, and histopathological parameters were recorded retrospectively from prospectively recorded patient files and compared between the groups. Results CR-POPF occurred in 16 (15.2%) patients: 8 (7.6%) were grade B and 8 (7.6%) were grade C according to the ISGPF classification. In univariate analysis, intraoperative blood loss > 580 mL (OR: 5.25, p  = 0.001), intraoperative blood transfusion (OR: 5.96, p  = 0.002), intraoperative vasoconstrictor medication (OR: 4.17, p  = 0.014), benign histopathology (OR: 3.51, p  = 0.036), and poor differentiation in malignant tumors (OR: 4.07, p  = 0.044) were significantly higher in the CR-POPF group, but not significant in multivariate analysis. Soft pancreatic consistency (OR: 6.08, p  = 0.013), pancreatic duct diameter < 2.5 mm (OR: 17.15, p  < 0.001), and MPR < 28.9 (OR: 13.91, p  < 0.001) were the independent predictors of CR-POPF according to multivariate analysis. Neoadjuvant treatment history and simultaneous vascular resection were less likely to cause CR-POPF development; however, they were insignificant. Conclusion Soft pancreatic consistency, pancreatic duct diameter, and preoperative MPR were the independent predictors of CR-POPF following PD. Decreased MPR is a strong predictor for CR-POPF and should be considered when deciding treatment strategies.

PurposeTo investigate the risk factors and the clinical characteristics of the hypertensive phase (HP) after Ahmed glaucoma valve (AGV) implantation.MethodsThis retrospective study included 60 eyes of 57 patients who underwent AGV implantation and with at least 1-year follow-up. HP was defined as intraocular pressure (IOP) > 21 mmHg in the first 3 months after the surgery. Independent samples t-test and Chi-square test were used to compare differences in patients with the HP and the non-HP groups. Univariable and multivariable logistic regression analyses were used to determine the risk factors for the development of the HP. Statistical significance was assumed at p < 0.05 level.ResultsHP was observed in 31 eyes (51.7%) with an average peak IOP of 27.6 ± 4.5 mmHg (range 22–40 mmHg). The resolution of HP was noted in 27 eyes (87.1%) at the 3rd month postoperative visit. The number of glaucoma medications at the last postoperative visit and IOP values from 1 month to 1 year were significantly higher in the HP group (all p < 0.05). Patients with traumatic glaucoma showed the highest rate (83.3%) of HP development. In the multivariable analysis, a preoperative IOP > 30 mmHg (p = 0.03, OR:5.82; reference: ≤ 25 mmHg) and younger age (41–64 years, p = 0.02, OR:8.49; ≤ 40 years, p = 0.001, OR:19.62; reference: ≥ 65 years) were independently associated with the occurrence of HP.ConclusionHypertensive phase was observed in half of the patients undergoing AGV implantation. A higher mean preoperative IOP and younger age were risk factors for HP development. Although the majority resolved at the 3-month visit, eyes with HP had higher mean IOPs and required more IOP lowering medications.

Objectives: This study aimed to evaluate the long-term outcomes of limbal stem cell deficiency (LSCD) treated with various limbal stem cell transplantation (LSCT) techniques. Materials and Methods: This retrospective study included 32 eyes of 29 patients who underwent LSCT. Clinical evaluation was performed based on preoperative and postoperative best corrected visual acuity (BCVA, logarithm of the minimum angle of resolution [logMAR]), degree of corneal neovascularization, extent of corneal involvement, and clarity of the central visual axis. Human leukocyte antigen (HLA) compatibility in allograft recipients was assessed via HLA tissue typing. The Kruskal-Wallis and Wilcoxon tests were used to compare variables between groups. Results: A total of 84.4% (n = 27) of the eyes had LSCD secondary to chemical injury. Median preoperative and postoperative BCVA (logMAR) values were 2.1 and 1.8 (p = 0.01) in the conjunctival limbal allograft (CLAL) group (n = 22; 18 living-related, 4 deceased donors), 0.9 and 0.7 (p=0.11) in the conjunctival limbal autograft (CLAU) group (n=4), and 2.1 and 1.3 (p=0.04) in the simple limbal epithelial transplantation (SLET) group (n=6; 3 autografts, 3 allografts), respectively. There was no statistically significant difference in BCVA improvement between groups. Median clinical scores improved from 10 to 6 in the CLAL group (p<0.001), from 7 to 4 in the CLAU group (p = 0.11), and from 10 to 3 in the SLET group (p = 0.03). Preoperatively, a statistically significant difference in clinical scores was observed only between the CLAU and SLET groups (p=0.029); however, no significant difference was found between groups postoperatively. HLA compatibility was 75% in 15 eyes that received living-related CLAL, and 100% in all 3 eyes that underwent allogeneic SLET. Conclusion: Different LSCT techniques may be applied in LSCD depending on the underlying etiology and extent of involvement. Favorable outcomes can also be achieved with allogeneic approaches when HLA compatibility is ensured. Keywords: Limbal stem cell deficiency, limbal stem cell transplantation, simple limbal epithelial transplantation, conjunctival limbal allograft, conjunctival limbal autograft

The Silk Road Economic Belt is the key component of China’s Eurasian Pivot strategy. In this study, China’s Eurasian Pivot is approached as a creativity strategy from the perspective of social identity theory. In order to succeed in its creativity strategy, China is trying to create a common in-group identity with the Silk Road Economic Belt countries through the Chinese Dream. However, the Chinese Dream is not perceived as a common identity by Central Asians and Uyghurs. While Central Asians respond China’s economic presence in the region positively, they are afraid of demographic changes and cultural influences that Chinese migration will cause. Therefore, the Chinese Dream has been a common fear for Turkic societies along the Silk Road Economic Belt rather than common identity. This fear could be one of the most important factors that will prevent the success of China’s Eurasian Pivot in the long run.

Objectives: To investigate the role of oxidative stress on pseudoexfoliation formation and progression from pseudoexfoliation syndrome (XFS) to pseudoexfoliation glaucoma (XFG). Materials and Methods: This study investigated oxidative stress biomarkers in blood samples from 58 patients with XFG, 47 patients with XFS, and 134 healthy age- and sex-matched controls. Results: The highest serum malondialdehyde (MDA) levels were measured in XFG patients (p<0.001), and MDA level was higher in XFS patients than controls (p<0.001). Superoxide dismutase (SOD) and catalase (CAT) enzyme activities were significantly lower in XFS and XFG patients than in the control group, whereas a significant increase was observed in glutathione (GSH) levels (p<0.001 for all). However, levels of these three biomarkers did not differ significantly between XFS and XFG patients (p=0.188, p=0.185, and p=0.733, respectively). Nitric oxide (NO) concentration was significantly lower in XFG patients compared to XFS patients and controls (p<0.001) but did not differ between XFS patients and controls (p=0.476). Conclusion: Elevated MDA levels suggest that lipid peroxidation is important in XFS and XFG development and progression from XFS to XFG. In addition, reduction in SOD and CAT enzyme activities is considered a deficiency in the enzymatic antioxidant protection system. Furthermore, GSH values may be evaluated as a compensatory response to oxidative stress in XFS and XFG. Alterations in NO indicate the role of a vascular regulatory factor in the progression from XFS to glaucoma. Keywords: Pseudoexfoliation, glaucoma, oxidative stress