The more common a disease is, the greater the difference between its OR and RR estimates. Because of this drawback, calculation of more intuitive risk estimates such as RRs and related statistics ...(eg, attributable risk, number needed to harm) may be preferred.4 Cardiovascular disease (CVD) is unlikely to be a rare event in the elderly—hence the possibility of ORs' overestimation of the risk factors' effect size. ...the addition of several risk factors can mean substantial increase in the overall risk. ...the combined effect of some factors may not be simply additive but rather synergistic.5 The use of multivariable logistic regression—a statistical analysis that simultaneously models several factors in an attempt to predict 1 binary multifactorial outcome—takes into account such pooled influence and also controls for potential confounding that may exist. Yet, findings of systematic reviews and meta-analyses are surely used to make clinical decisions. Besides the statistical significance and the magnitude of effect size, the range of confidence intervals, the method of evidence synthesis, the internal and external validity of the study, and the characteristics of the disease and target population, among other factors, are important determinants of clinical significance.
To compare visual and refractive outcomes, changes in intraocular pressure (IOP), and complications of femtosecond laser-assisted cataract surgery (FLACS) to conventional phacoemulsification surgery ...(CPS) in paired eyes from the same patients.
This is a secondary analysis of an intraindividual, randomised, controlled clinical trial including 110 paired eyes from 55 patients that were randomised into either FLACS or CPS groups. Outcomes were recorded at baseline and postoperatively during a 3-month follow-up period.
Uncorrected distance visual acuity and corrected distance visual acuity were similar between FLACS and CPS over the follow-up period (p>0.05). The mean absolute refractive error was not significantly different between the two groups at postoperative month 1 (POM1) (0.3±0.2 D in FLACS vs 0.4±0.3 D in CPS, p=0.18) and month 3 (POM3) (0.3±0.3 D in FLACS vs 0.3±0.3 D in CPS, p=0.71). IOP was statistically higher in the FLACS group on postoperative day 1 (20.6±5.7 mm Hg for FLACS and 18.0±4.9 mm Hg for CPS, p=0.01). However, it was similar between the two groups subsequently (p>0.05). Intraoperatively, one case of posterior capsular block syndrome was observed in the FLACS group. Postoperatively, one case of newly developed glaucoma was observed in the FLACS group and one case of retinal tears in the CPS group.
The 3-month postoperative refractive and visual outcomes were comparable between FLACS and CPS in paired eyes from the same patients. Complication rate was low in the study population.
The liver is a unique organ that has a phenomenal capacity to regenerate after injury. Different surgical procedures, including partial hepatectomy (PH), intraoperative portal vein ligation (PVL), ...and associated liver partition and portal vein ligation for staged hepatectomy (ALPPS) show clinically distinct recovery patterns and regeneration. The observable clinical differences likely mirror some underlying variations in the patterns of gene activation and regeneration pathways. In this study, we provided a comprehensive comparative transcriptomic analysis of gene regulation in regenerating rat livers temporally spaced at 24 h and 96 h after PH, PVL, and ALPPS. The time-dependent factors appear to be the most important determinant of post-injury alterations of gene expression in liver regeneration. Gene expression profile after ALPPS showed more similar expression pattern to the PH than the PVL at the early phase of the regeneration. Early transcriptomic changes and predicted upstream regulators that were found in all three procedures included cell cycle associated genes (E2F1, CCND1, FOXM1, TP53, and RB1), transcription factors (Myc, E2F1, TBX2, FOXM1), DNA replication regulators (CDKN1A, EZH2, RRM2), G1/S-transition regulators (CCNB1, CCND1, RABL6), cytokines and growth factors (CSF2, IL-6, TNF, HGF, VEGF, and EGF), ATM and p53 signaling pathways. The functional pathway, upstream, and network analyses revealed both unique and overlapping molecular mechanisms and pathways for each surgical procedure. Identification of molecular signatures and regenerative signaling pathways for each surgical procedure further our understanding of key regulators of liver regeneration as well as patient populations that are likely to benefit from each procedure.
An estimated 38 million and 50 million individuals will have cataract in the U.S. alone by 2030 and 2050, respectively. Breastfeeding is known to improve a number of health outcomes in both breastfed ...children and breastfeeding mothers. However, little is known about the relationship between breastfeeding and cataract, the leading cause of blindness worldwide, in breastfeeding mothers. This study was conducted to investigate the relationship between breastfeeding and maternal cataract extraction history in a nationally representative sample of the U.S. population.
A 10-year multistage, probability-sampling survey data was used to identify parous women aged ≥50 years who provided breastfeeding history and cataract extraction history (n = 4897). Breastfeeding history was considered positive if a participant reported breastfeeding at least one child for ≥1 month. The main outcome was cataract extraction history. Estimates are presented in odds ratios (OR) and 95% confidence intervals (95%CI).
Approximately half of the studied women breastfed at least one child ≥1 month, and about 18% reported cataract extraction history. Participants with a positive breastfeeding history were less likely to have a positive cataract extraction history in both age-adjusted (OR = 0.814, 95%CI = 0.670-0.989) and multivariable logistic regression (OR = 0.794, 95%CI = 0.639-0.988). Higher number of breastfed children was also associated with a lower risk of cataract extraction history (OR = 0.934, 95%CI = 0.883-0.988).
The findings suggest that breastfeeding may be associated with a decrease in the likelihood of age-related cataract extraction in parous women from the U.S. population.
Celotno besedilo
Dostopno za:
DOBA, IJS, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
Membrane trafficking is a complex, essential process in eukaryotic cells responsible for protein transport and processing. Deficiencies in vacuolar protein sorting (VPS) proteins, key regulators of ...trafficking, cause abnormal intracellular segregation of macromolecules and organelles and are linked to human disease. VPS proteins function as part of complexes such as the homotypic fusion and vacuole protein sorting (HOPS) tethering complex, composed of VPS11, VPS16, VPS18, VPS33A, VPS39 and VPS41. The HOPS-specific subunit VPS41 has been reported to promote viability of dopaminergic neurons in Parkinson's disease but to date has not been linked to human disease. Here, we describe five unrelated families with nine affected individuals, all carrying homozygous variants in VPS41 that we show impact protein function. All affected individuals presented with a progressive neurodevelopmental disorder consisting of cognitive impairment, cerebellar atrophy/hypoplasia, motor dysfunction with ataxia and dystonia, and nystagmus. Zebrafish disease modelling supports the involvement of VPS41 dysfunction in the disorder, indicating lysosomal dysregulation throughout the brain and providing support for cerebellar and microglial abnormalities when vps41 was mutated. This provides the first example of human disease linked to the HOPS-specific subunit VPS41 and suggests the importance of HOPS complex activity for cerebellar function.
To report the indications, visual outcomes, and intra-operative and post-operative complications of iris-sutured posterior chamber intraocular lens (IOL) in eyes with inadequate capsular support and ...complex ocular history.
A chart review and data analysis of eyes that underwent iris fixation of posterior chamber (PC) IOL for correction of aphakia, dislocated and subluxed IOLs, ectopia lentis, and IOL exchange. Data included clinical risk factors, associated eye conditions, previous surgeries, and concomitant procedures. The pre-operative and post-operative vision, manifest refraction, endothelial cell density, intraocular pressure (IOP), as well as intra-operative and post-operative complications were also recorded.
One hundred and seventeen eyes from 114 patients were examined with a mean follow-up of 22.4 months. The most common identifiable predisposing risk factor was high myopia in 23 eyes. A significant improvement in uncorrected and best corrected visual acuity compared with baseline was observed. The most common post-operative complications included recurrent IOL subluxation in 16 (13.7%) eyes, IOP spike in 7 (5.9%) eyes, cystoid macular oedema in 5 (4.3%) eyes, and epiretinal membrane formation in 4 (3.4%) eyes. There was one (0.85%) case of sterile endophthalmitis.
Iris suture fixation of PC IOLs is a good treatment option for eyes with inadequate capsular support and complex ocular history.
A recent increase in the use of unmanned aerial vehicles (UAVs)—also known as remotely piloted aircraft (RPA)—in the Antarctic in private, commercial and scientific sectors suggests that operational ...guidelines are urgently needed. One of the factors inhibiting adoption of such guidelines is the lack of knowledge about the impact of UAVs on wildlife. During the austral summer field season of 2014/15, data were gathered on the behavioural reactions to UAVs of Gentoo (
Pygoscelis papua
) and Adélie penguins (
Pygoscelis adeliae
), both resident breeding species on Ardley Island, King George Island, South Shetland Islands. A series of overflights at different altitudes above the nesting penguins were conducted with a small octocopter UAV, and their behaviour was recorded by video. Penguin behaviour altered as a result of the UAV flights, and behavioural reactions were more pronounced when the UAV was flown at lower altitudes. In Adélie penguins, behavioural reactions caused by the UAV were evident at the highest tested altitude of 50 m, while in Gentoo penguins reactions were evident from 30 m downwards. For both species, the reactions increased markedly when the UAV was flown at low altitudes of 10–20 m. Gentoo penguins showed significant reactions when the UAV was launched at distances closer than 20 m. There was some evidence of habituation to the UAV at some altitudes for horizontal flights, but no evidence of habituation in vertical flights.
Background. Galactose accumulation in the lens tissue is known to be cataractogenic. Whether consistent dietary intake of lactose—which consists of glucose and galactose—predisposes to senile ...cataract remains unclear. This study was conducted to investigate the association between a number of dietary milk intake indicators and cataract extraction history in a representative sample of older adults from the US population. Methods and Materials. This is a cross-sectional, population-based study. Participants of the United States National Health and Nutrition Examination Survey 2001–2008 who were ≥50 years old and provided a complete history of their usual daily dietary intake were included. Exclusion criteria were special diets, extreme daily energy intake, and missing outcome (i.e., cataract extraction history). Indicators of milk intake used were early-life intake regularity, current daily milk/total dairy intake amounts, and estimated lifelong milk exposure. Odds ratios (OR) and 99% confidence intervals (99% CI) were calculated with fitting weights to better represent the population-based estimates. Results. Among the 5930 studied participants, early-life milk intake regularity was not associated with cataract extraction history in age/sex/ethnicity-adjusted and multivariable-adjusted models (p trend = 0.064 and 0.094, respectively). Current daily milk intake was associated with a slight reduction in the likelihood of cataract extraction in the age/sex/ethnicity-adjusted model (OR = 0.885 per cup equivalents, 99% CI = 0.795–0.986) and in the multivariable model (OR = 0.871 per cup equivalents, 99% CI = 0.746–0.993). However, no such association was observed between quartiles of current dietary milk intake and cataract extraction history (p=0.154 and p=0.317 for age/sex/ethnicity-adjusted and multivariable-adjusted models, respectively). Neither current total dairy intake nor estimated lifelong milk exposure was significantly associated with the outcome in the final multivariable models. Conclusion. There appears to be no direct relationship between several indicators of dietary milk consumption and cataract extraction history in the general American population.
Purpose:
To describe a clinical case of corneoscleral xanthogranuloma, a rare manifestation of juvenile xanthogranuloma, and xanthoma disseminatum, which responded well to chemotherapy.
Methods:
...Interventional case report and literature search.
Results:
A 9-year-old female patient with a disseminated disease showed complete regression of her corneoscleral xanthogranuloma with methotrexate and azathioprine therapy.
Conclusion:
Since they are potentially blinding, corneoscleral xanthogranulomas are commonly surgically excised. While surgical resection has been widely advocated in the literature, immunosuppressive therapy alone may be a pertinent management line of corneoscleral xanthogranuloma, especially with systemic involvement.
PDF
