bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison of Postsurgical Scars Between Vegan and Omnivore Patients
Authors: Fusano Marta , Fusano Isabella , Galimberti Michela Gianna , Bencini Matelda , Bencini Pier Luca
Published: August 2020

BACKGROUND

Postsurgical skin healing can result in different scars types, ranging from a fine line to pathologic scars, in relation to patients' intrinsic and extrinsic factors. Although the role of nutrition in influencing skin healing is known, no previous studies investigated if the vegan diet may affect postsurgical wounds.

OBJECTIVE

The aim of this study was to compare surgical scars between omnivore and vegan patients.

METHODS AND MATERIALS

This is a prospective observational study. Twenty-one omnivore and 21 vegan patients who underwent surgical excision of a nonmelanoma skin cancer were enrolled. Postsurgical complications and scar quality were evaluated using the modified Scar Cosmesis Assessment and Rating (SCAR) scale.

RESULTS

Vegans showed a significantly lower mean serum iron level (p < .001) and vitamin B12 (p < .001). Wound diastasis was more frequent in vegans (p = .008). After 6 months, vegan patients had a higher modified SCAR score than omnivores (p < .001), showing the worst scar spread (p < .001), more frequent atrophic scars (p < .001), and worse overall impression (p < .001).

CONCLUSION

This study suggests that a vegan diet may negatively influence the outcome of surgical scars.
Is Opioid Use Safe in Women Trying to Conceive?
Authors: Flannagan Kerry S. , Mumford Sunni L. , Sjaarda Lindsey A. , Radoc Jeannie G. , Perkins Neil J. , Andriessen Victoria C. , Zolton Jessica R. , Silver Robert M. , Schisterman Enrique F.
Published: August 2020

Background:

Opioids are commonly prescribed to women of reproductive age, including after delivery and miscarriage. However, to our knowledge, opioid use has not been frequently studied in relation to the common reproductive complications of impaired fecundability and pregnancy. We examined the association of opioid use during the critical window of pregnancy establishment with fecundability and pregnancy loss.

Methods:

We measured opioid use by urine screening and self-report at multiple time points during preconception and early pregnancy in a prospective cohort of women attempting conception (n = 1228). The main outcomes included time to hCG-detected pregnancy and incidence of live birth and pregnancy loss. We estimated fecundability odds ratios and risk ratios (RR) with 95% confidence intervals (CI) adjusting for sociodemographic characteristics, reproductive characteristics, and use of antidepressants, tobacco, alcohol, and marijuana.

Results:

Prevalence of preconception opioid use was 18% (n = 226 of 1228), and in early pregnancy was 5% (n = 33 of 685). Opioid use while attempting pregnancy was associated with reduced fecundability (fecundability odds ratios: 0.71; 95% CI = 0.50, 1.0). Risk of pregnancy loss increased as opioid exposure was detected later in gestation, from the beginning of the cycle of conception (RR: 1.5; 95% CI 0.85, 2.6), to week 4 of pregnancy (RR: 2.1; 95% CI = 1.1, 4.1), and to week 4 and 8 of pregnancy (RR: 2.5; 95% CI = 1.3, 5.0).

Conclusions:

Our results are consistent with the hypothesis that opioid exposure while trying to conceive may be harmful, even among healthy, non-opioid-dependent women. Possible risks to fecundability and pregnancy viability are relevant to patients and providers when evaluating pain management approaches.
Advances in abortion care technology and management
Authors: Peterson Sarah F. , Lerma Klaira
Published: August 2020

Purpose of review

To review emerging evidence specific to abortion care, including diagnostic testing and pain management.

Recent findings

Recent advances in abortion care include improvements in gestational age dating, Rh status testing, and pain management methods. When ultrasound technology is available, the use of crown-rump length (CRL)-based dating is more accurate up to 13 weeks and composite CRL and biometry between 13 and 14 weeks. Evidence supports using updated fetal foot length-to-gestational age reference ranges for postprocedure gestational age confirmation. Serum tests for two placental proteins, pregnancy-associated plasma protein A and a disintegrin and metalloproteinase 12, show potential for identifying pregnancies with gestational age more than 70 days. Early research using flow cytometry demonstrates that fetal RBC exposure after first-trimester uterine aspiration is insufficient to cause maternal Rh-sensitization, supporting elimination of Rh testing and anti-D-immunoglobulin provision prior to 8 weeks gestation. Recent studies exploring pain management strategies have not generated a standardized approach. Auricular acupuncture appears to be promising.

Emerging data on improvements in gestational age dating and eliminating laboratory testing prior to early abortion procedures could have important implications for expanding access to early abortion care and telemedicine. Person-centered, novel pain management modalities, such as auricular acupuncture, help to improve client experience, by addressing both pain and anxiety.
Why Won't Emergency Physicians Discharge Patients With a Low HEART Score From an Observation Unit Without Further Evaluation?
Authors: Pena Margarita , Tsao Joseph , Falaiye Tunde , Kazan Viviane , Li Mitchell , Daouk Fadi , Pearson Claire
Published: August 2020

Background:

The History, Electrocardiogram, Age, Risk Factors, Troponin (HEART) score is a prospectively validated risk stratification tool for patients presenting to the emergency department (ED) with chest pain. Data demonstrate that patients with low HEART scores (0–3) can be safely discharged from the ED. ED physicians, however, may be reluctant to discharge patients based on the score.

Objective:

To identify specific factors why ED physicians are reluctant to discharge patients with low-risk HEART scores from an ED observation unit (EDOU) without further evaluation.

Methods:

This was a single-center prospective, cross-sectional analysis of ED patients from an urban ED placed in an EDOU for evaluation of chest pain, from July 1, 2016, to August 31, 2016. ED physicians completed a questionnaire that included documentation of patient HEART score and if the patient would or would not be a good candidate for outpatient stress testing or follow-up within 72 hours without further EDOU testing or consultant evaluation. Providers selected reasons why patients were not a good candidate for outpatient stress testing/follow-up.

Results:

There were 279 patient questionnaires completed, 42% (117/279) had a HEART score of 0–3. Within this group, 54.7% (64/117) of the patients were identified as not being good candidates for outpatient stress testing/follow-up within 72 hours because of concerns for poor follow-up (n = 14), concerning risk factors (n = 14), concerning symptoms (n = 11), and other (n = 7).

Conclusions:

ED physicians in this urban ED felt that over half of patients with a low-risk HEART score were not good candidates for discharge from the EDOU without further evaluation due to poor follow-up, concerning risk factors or symptoms, or coexisting conditions.
Gender-related Disparities of Percutaneous Coronary Interventions in ST-elevation Myocardial Infarction: A Retrospective Chart Review of 500 Patients
Authors: Sleiman Elsa , Hosry Jeff , Caruana Lisa , Schwartz Moishe , Boutros Karam , Tabet Rabih , Salmane Chadi , Kandov Ruben , Royzman Roman , Tamburrino Frank , Lafferty James
Published: August 2020

Door-to-balloon (DTB) time of primary percutaneous coronary intervention in ST-elevation myocardial infarction (STEMI) is a predictive indicator of outcomes and mortality. Traditional gender-related differences that existed in the provision of DTB in STEMI had been allegedly improving until recent controversial data showed re-emergence of longer DTB in females. The objective of our study was to compare circadian disparities in percutaneous coronary intervention for STEMI according to gender in our institution. We compared DTB and symptom-to-balloon (STB) as well as mortality outcomes in a registry of 514 patients. We studied 117 females and 397 males. Baseline characteristics and cardiovascular risk factors were similar among both populations. Men used more self-transportation (51% vs. 38%) compared with women. Both had similar DTB median times: males, 63 (47–79) min; and females, 61 (44–76) min. In addition, STB median times were also similar: males, 155 (116–264) min; and females, 165 (115–261) min. Mortality outcomes at 1 month were comparable at 3% in males versus 0.9% in females (P = 0.164). In a review of a tertiary care center in New York, we observed no gender differences in DTB and STB, endorsing the role of emergency medical service transportation in eliminating disparities.
Concussion Symptom Treatment and Education Program: A Feasibility Study
Authors: Simpson Tess S. , Peterson Robin L. , Patrick Kristina E. , Forster Jeri E. , McNally Kelly A.
Published: August 2020

Objective:

To evaluate the feasibility and potential benefits of a manualized, brief cognitive-behavioral therapy–based intervention program for children and adolescents with persistent postconcussive symptoms.

Setting:

Two outpatient pediatric concussion programs in the United States.

Participants:

Patients aged 8 to 17 years who sustained concussions between 2 and 12 months prior to enrollment.

Design:

Pre-/postretrospective study.

Main Measures:

SCAT-3; HBI; PedsQL 4.0 Generic Core Scales; and RCADS.

Results:

Thirty children and adolescents completed the treatment program. Self- and parent-reported postconcussive symptoms, quality of life, and internalizing symptoms significantly improved with treatment. Mixed-effects models revealed a significant decline in self-reported postconcussive symptoms across treatment sessions, a = −2.07, SE = 0.25, P < .001. The largest change occurred between sessions 2 and 3, following the session focusing on concussion psychoeducation and sleep hygiene (estimated mean change between sessions 2 and 3 = −4.72, P < .0001).

Conclusions:

Our findings indicate that a 6-session manualized cognitive behavioral intervention is feasible to initiate in an outpatient clinic 1 to 12 months following a pediatric mild traumatic brain injury. With a manualized format, clinicians at most levels of training should be able to implement this treatment manual and flexibly adapt as needed when working with children and adolescents who are experiencing delayed symptom recovery following concussion.
Predictors of Intervention Adherence in Compensatory Cognitive Training for Veterans With a History of Mild Traumatic Brain Injury
Authors: Mahmood Zanjbeel , Clark Jillian M. R. , Jak Amy J. , Huckans Marilyn , O'Neil Maya E. , Roost Mai S. , Williams Rhonda M. , Pagulayan Kathleen F. , Turner Aaron P. , Storzbach Daniel , Twamley Elizabeth W.
Published: August 2020

Objective:

The purpose of this study was to determine modifiable predictors of intervention adherence in a study of group-based Compensatory Cognitive Training (CCT) for Iraq/Afghanistan War veterans with a history of mild traumatic brain injury (mTBI).

Methods:

One hundred twenty-three veterans enrolled in a randomized controlled trial of a 10-week CCT intervention (54 assigned to CCT) and were evaluated at baseline, 5 weeks, 10 weeks, and 15 weeks. CCT adherence was determined by the number of CCT sessions attended, with more sessions indicative of greater adherence. Baseline demographic and clinical characteristics, and subjective and objective neuropsychological performance, were examined in relation to CCT session attendance.

Results:

Older age and worse attention performance at baseline were associated with higher CCT attendance rates.

Conclusions:

This study generates preliminary evidence for potential modifiable neuropsychological factors that may improve engagement in CCT interventions.
The Search for Antifungal Prophylaxis After Artificial Corneal Surgery—An In Vitro Study
Authors: Kim Sarah , Bispo Paulo J. M. , Tanner Eden E. L. , Mitragotri Samir , e Silva Rafaella N. , Gipson Ilene , Chodosh James , Behlau Irmgard , Paschalis Eleftherios I. , Gilmore Michael S. , Dohlman Claes H.
Published: August 2020

Purpose:

To evaluate the antifungal properties of topical antibiotics (already being used successfully to prevent bacterial endophthalmitis) and some promising antiseptics for antifungal prophylaxis in the setting of artificial corneal implantation.

Methods:

Several commonly used antibiotics for antimicrobial prophylaxis after artificial corneal implantation, in addition to antiseptics [benzalkonium chloride (BAK), povidone-iodine (PI), and some ionic liquids (ILs)], were tested in vitro against Candida albicans, Fusarium solani, and Aspergillus fumigatus. The time–kill activity was determined. Toxicity was assayed in vitro on human corneal epithelial cultures using trypan blue. Adhesion and tissue invasion experiments were also carried out on porcine corneas and commonly used contact lenses, with or without gamma irradiation, and by analysis with fluorescence microscopy.

Results:

Polymyxin B (PMB)/trimethoprim/BAK (Polytrim), PMB alone, gatifloxacin with BAK (Zymaxid), and same-concentration BAK alone exhibited antifungal activity in vitro. Moxifloxacin (MOX) or gatifloxacin without BAK—as well as trimethoprim, vancomycin, and chloramphenicol—had no effect. 1% PI and ILs had the highest efficacy/toxicity ratios (>1), and Polytrim was species dependent. Subfungicidal concentrations of Polytrim reduced adhesion of C. albicans to Kontur contact lenses. Gamma-irradiated corneas showed enhanced resistance to fungal invasion.

Conclusions:

Of antibiotic preparations already in use for bacterial prophylaxis after KPro surgery, Polytrim is a commonly used antibiotic with antifungal effects mediated by both PMB and BAK and may be sufficient for prophylaxis. PI as a 1% solution seems to be promising as a long-term antifungal agent. Choline-undecanoate IL is effective and virtually nontoxic and warrants further development.
Diagnostic Value of Corneal Epithelial and Stromal Thickness Distribution Profiles in Forme Fruste Keratoconus and Subclinical Keratoconus
Authors: Toprak Ibrahim , Vega Alfredo , Alió del Barrio Jorge L. , Espla Elias , Cavas Francisco , Alió Jorge L.
Published: August 2020

Purpose:

To assess the diagnostic values of corneal epithelial and stromal thickness distribution characteristics in forme fruste keratoconus (FFKC) and subclinical keratoconus (KC).

Methods:

This cross-sectional study was conducted at VISSUM Innovation and Miguel Hernandez University, Alicante, Spain. Twenty-seven eyes (27 subjects) with FFKC, 50 eyes (50 subjects) with subclinical KC with a best spectacle corrected distance visual acuity ≥20/20 (Snellen) (grade zero KC according to the Red Temática de Investigación Cooperativa en Salud classification), and 66 control eyes (66 subjects) were included. Epithelial and stromal thicknesses and epithelium/stroma (E/S) thickness ratio at center, thinnest point, 5-, and 8-mm circles obtained from the MS-39 device (CSO, Firenze, Italy) were compared among the control, FFKC, and subclinical KC groups.

Results:

The FFKC group had thinner 8-mm superior-nasal epithelium and higher central E/S ratio compared with the control group (P < 0.05). In the subclinical KC group, the E/S ratios in the 5-mm temporal and superior zones were higher than those in the control group (P < 0.05). The FFKC and subclinical KC groups had thinner stroma compared with the control group (P < 0.05). A two-parameter formula correctly classified 94% of the eyes with subclinical KC and 98.5% of the normals, whereas another three-parameter model had 75% sensitivity and 94.3% specificity for discriminating FFKC from normals.

Conclusions:

This study identified different epithelial distributional and behavioral patterns in eyes with FFKC and subclinical KC. Eyes with FFKC seem to have increased central E/S ratio and asymmetric superior-nasal epithelial thinning, whereas keratometric and volumetric alterations seem to be more prominent in subclinical KC.
The Effects of Trabecular Bypass Surgery on Conventional Aqueous Outflow, Visualized by Hemoglobin Video Imaging
Authors: Lusthaus Jed A. , Meyer Paul A.R. , Khatib Tasneem Z. , Martin Keith R.
Published: August 2020

Precis:

Hemoglobin Video Imaging (HVI) provides a noninvasive method to quantify aqueous outflow (AO) perioperatively. Trabecular bypass surgery (TBS) is able to improve, and in some cases re-establish, conventional AO.

Purpose:

The purpose of this study was to use HVI to illustrate and quantify effects of TBS on AO through the episcleral venous system.

Design:

This is a prospective observational cohort study.

Participants:

Patients were recruited from Sydney Eye Hospital, Australia. The study included 29 eyes from 25 patients, 15 with glaucoma and 14 normal controls. TBS (iStent Inject) was performed on 14 glaucomatous eyes (9 combined phacoemulsification/TBS and 5 standalone TBS). Cataract surgery alone was performed on the remaining eye from the glaucoma group and 2 eyes from the control group.

Methods:

We used HVI, a novel clinic-based tool, to visualize and quantify AO perioperatively during routine follow-up to 6 months. Angiographic blood flow patterns were observed within prominent aqueous veins on the nasal and temporal ocular surface. Aqueous column cross-section area (AqCA) was compared before and after surgery.

Main Outcome Measures:

AqCA, number of aqueous veins, intraocular pressure (IOP) before and after surgery, and number of IOP-lowering medications.

Results:

Patients with glaucoma had reduced AqCA compared with normal controls (P=0.00001). TBS increased AqCA in 13 eyes at 1 month (n=14; P<0.002), suggesting improved AO. This effect was maintained at 6 months in 7 eyes (n=9, P≤0.05). All patients with unrecordable AO before surgery (n=3; 2 standalone TBS, 1 combined cataract/TBS) established measurable flow after TBS. IOP and/or medication burden became reduced in every patient undergoing TBS. Cataract surgery alone (n=3) increased AqCA in nasal and temporal vessels at 4 weeks after surgery.

Conclusions:

HVI provides a safe method for detecting and monitoring AO perioperatively in an outpatient setting. Improvement of AO into the episcleral venous system is expected after TBS and can be visualized with HVI. TBS is able to improve, and in some cases re-establish, conventional AO. Cataract surgery may augment this. Some aqueous veins were first seen after TBS and these patients had unstable postoperative IOP control, which possibly suggests reorganization of aqueous homeostatic mechanisms. HVI may confirm adequacy of surgery during short-term follow-up, but further work is required to assess the potential of HVI to predict surgical outcomes and assist with personalized treatment decisions.
Is Netrin-1 Deficiency Responsible for Inflammation and Systemic Diseases Related to Pseudoexfoliation?
Authors: Okutucu Murat , Findik Hüseyin , Aslan Mehmet Gökhan , Arpa Medeni
Published: August 2020

Precis:

Serum netrin-1 levels are significantly lower in patients with pseudoexfoliation syndrome (PES) and pseudoexfoliative glaucoma (PEG) compared with the control group.

Purpose:

To investigate serum netrin-1 levels in PES and PEG patients and to determine the relevance of this molecule in the etiopathogenesis of PES-related and PEG-related diseases.

Materials and Methods:

This prospective study included 29 PES and 17 PEG patients in the study groups and age-sex matched 47 cataract patients without pseudoexfoliative accumulation as a control group. Serum netrin-1 levels were measured by enzyme-linked immunosorbent assay.

Results:

Serum netrin-1 level was significantly lower in the PES and PEG groups compared with the control group (P=0.007). Multinominal logistic regression analysis was performed in terms of netrin-1 levels ≤712.9 pg/mL, >712.9 pg/mL and sex which may affect PES and PEG. It were found that netrin-1 was a significant negative predictor for PES (odds ratio, 3.45; 95% confidence interval, 1.230-9.716; P=0.019) and PEG (odds ratio, 3.57; 95% confidence interval, 1.008-12.669; P=0.049), respectively.

Conclusions:

Decreased serum netrin-1 levels were detected in PES and PEG patients, similar to atherosclerosis and Alzheimer disease. Inflammation lays behind in the common pathogenesis of these diseases. Therefore, netrin-1 promises a potential anti-inflammatory role.
The Relationship Between Asymmetries of Corneal Properties and Rates of Visual Field Progression in Glaucoma Patients
Authors: Estrela Tais , Jammal Alessandro A. , Mariottoni Eduardo B. , Urata Carla N. , Ogata Nara G. , Berchuck Samuel I. , Medeiros Felipe A.
Published: August 2020

Précis:

In this study, asymmetries in corneal hysteresis (CH) between eyes of glaucoma patients were significantly associated with asymmetries in rates of visual field loss, suggesting a role of hysteresis as a risk factor for disease progression.

Purpose:

The purpose of this study was to investigate the relationship between asymmetries in rates of glaucoma progression and asymmetries of corneal properties between eyes of subjects with primary open-angle glaucoma.

Participants and Methods:

This prospective study followed 126 binocular subjects with glaucoma for an average of 4.3±0.8 years. CH was measured at baseline using the Ocular Response Analyzer. Standard automated perimetry (SAP) and intraocular pressure were measured at baseline and every 6 months. Rates of visual field progression were calculated using ordinary least square regression of SAP mean deviation (MD) values over time for each eye. Eyes were defined as “better” and “worse” based on the slopes of SAP MD. Pearson correlation test, and univariable and multivariable regression models were used to investigate the relationship between inter-eye asymmetry in CH and central corneal thickness and inter-eye differences in rates of visual field progression.

Results:

Only asymmetry of CH was significantly associated with the asymmetry in SAP MD rates of change between eyes (r=0.22; P=0.01). In a multivariable model adjusting for age, race, central corneal thickness, mean intraocular pressure and baseline disease severity, CH asymmetry remained significantly associated with asymmetric progression (P=0.032).

Conclusion:

CH asymmetry between eyes was associated with asymmetry on rates of visual field change, providing further support for the role of CH as a risk factor for glaucoma progression.
Factors Associated With Unqualified Success After Trabecular Bypass Surgery: A Case-control Study
Authors: Paletta Guedes Ricardo A. , Gravina Daniela M. , Paletta Guedes Vanessa M. , Chaoubah Alfredo
Published: August 2020

Precis:

An older age, a low number of baseline glaucoma medications, an early glaucoma stage, lower intraocular pressure (IOP) values during the first postoperative month, and combined surgery are possible predictors of unqualified success after a trabecular by-pass microinvasive glaucoma surgery (MIGS) procedure.

Purpose:

The purpose of this study was to identify the potential predictors of unqualified success (IOP<18 mm Hg with no glaucoma medication) after trabecular by-pass MIGS.

Materials and Methods:

We designed a case-control study using logistic regression modeling that included all trabecular by-pass surgeries with at least 3 months of follow-up, performed at a single center from June 2017 to December 2019. Eyes that achieved an endpoint of unqualified success (dependent variable) were considered cases. All other eyes were used as the controls. Cases and controls were paired by sex and postoperative time. We tested the following independent variables: age, race, laterality (right eye or left eye), glaucoma stage, type of surgery (combined or stand-alone), type of trabecular bypass, intraoperative complications, baseline number of medications, baseline IOP, and postoperative IOP on days 1, 15, and 30. Additional analysis using IOP <15 mm Hg as a threshold and including eyes with at least 12 months of follow-up were performed.

Results:

One hundred ninety-four eyes were included in the analysis. We observed complete success in 56.7% of eyes. The mean follow-up time for the entire population was 12.3±6.8 months. All variables were considered in the first step of the modeling process; however, only age, day-15 IOP, day-30 IOP, baseline number of medications, glaucoma stage, and type of surgery remained until the completion of our model, with adequate significance (P<0.05). The additional analysis confirmed our results.

Conclusion:

We identified that an older age, a low number of baseline glaucoma medications, an early glaucoma stage, lower IOP values during the first postoperative month, and combined surgery were associated with a higher chance of unqualified success at 12 months after a trabecular by-pass MIGS procedure.
Comparison of Ab Externo and Ab Interno 360-degree Suture Trabeculotomy in Adult Open-angle Glaucoma
Authors: Yalinbas Duygu , Dilekmen Nilay , Hepsen Ibrahim Feyzi
Published: August 2020

Precis:

Ab interno (gonioscopy-assisted transluminal trabeculotomy) and ab externo 360-degree suture trabeculotomy (ST) achieved similar success rates for reducing intraocular pressure (IOP) without serious complications threatening visual acuity.

Purpose:

We aimed to compare the efficacy of ab externo and ab interno 360-degree ST in reducing IOP, decreasing the number of antiglaucoma medications required, and decreasing the rates of intraoperative/postoperative complications in adults with open-angle glaucoma (OAG).

Patients and Methods:

This retrospective study included 33 eyes of 33 patients who underwent ab externo 360-degree ST (group 1) and 23 eyes of 23 patients who underwent ab interno 360-degree ST for OAG (group 2). We analyzed demographics as well as preoperative and postoperative (1, 3, 6, and 12 mo) data related to IOP, the number of antiglaucoma medications, complications, and surgical success rates.

Results:

In group 1, the mean IOP was 26.2±10.4 mm Hg, and the mean number of antiglaucoma medications was 3.2±1.0 preoperatively, decreasing to 11.2±3.0 mm Hg and 0.1±0.4 at 12 months, respectively (P<0.001, <0.001). In group 2, the mean IOP was 28.3±10.4 mm Hg, and the mean number of antiglaucoma medications was 3.5±0.9 preoperatively, decreasing to 13.3±6.5 mm Hg and 0.8±1.0 at 12 months, respectively (P<0.001, <0.001). Decreases in IOP at 6 and 12 months were similar in groups 1 and 2 (50% vs. 47%, P=0.6; and 51% vs. 49%, P=0.7, respectively). At 12 months, complete and qualified success rates were 88% and 97% for group 1 and 57% and 87% for group 2, respectively. The most common complications in both groups were hyphema and transient IOP spikes.

Conclusion:

Ab interno 360-degree ST is similar to ab externo 360-degree ST in terms of safety and efficacy in patients with OAG.
Iris Stromal Cyst in a 6-Month-Old With Rapid Progression to Angle Closure
Authors: Santos Matthew C. , Lee Andrew R.
Published: August 2020

Case Report:

A 6-month-old female presented with an iris cyst in the left eye, first identified at age 4 months. The patient was seen by an ophthalmologist at age 6 months and referred for further management. Our examination 2 weeks later demonstrated a 6 mm diameter iris cyst originating from the anterior surface of the inferior iris, occupying the inferior two thirds of the anterior chamber and obscuring the pupil. Intraocular pressure was normal and the remainder of the anterior chamber was formed. Because of concern for the development of amblyopia, the patient was scheduled for an examination under anesthesia and iris cyst removal 2 days later. In the intervening 2 days, the patient’s mother noted worsening photophobia and tearing. At the time of surgery, the intraocular pressure was 51 mm Hg in the left eye. Anterior examination demonstrated interval development of shallowing of the anterior chamber with irido-corneal and cyst-corneal touch. The iris cyst had increased to 8 mm in size and filled the entire pupillary aperture. The iris cyst was excised, and histopathology confirmed the diagnosis of an iris stromal cyst.

Conclusions:

Congenital stromal cysts of the iris can enlarge, threatening amblyopia and secondary glaucoma in children. Although angle closure is a known theoretical complication of iris stromal cysts, actual cases are rare in the literature. This case demonstrates the importance of serial examinations to monitor progression of iris stromal cysts, particularly in young children.
Abnormal subgenual anterior cingulate circuitry is unique to women but not men with chronic pain
Authors: Osborne Natalie R. , Cheng Joshua C. , Rogachov Anton , Kim Junseok Andrew , Hemington Kasey S. , Bosma Rachael L. , Inman Robert D. , Davis Karen D.
Published: August 2020

The subgenual anterior cingulate cortex (sgACC) plays an important role in pain modulation. We previously demonstrated sex differences in sgACC functional connectivity (FC) in healthy individuals. Given that many chronic pain conditions show sex differences in prevalence, here we tested the hypothesis that people with chronic pain exhibit a sex-specific pattern of abnormal sgACC FC. We acquired resting-state functional magnetic resonance imaging data from 156 (82 W: 74 M) healthy participants and 38 (19 W: 19 M) people with chronic low back pain resulting from ankylosing spondylitis, a condition that predominantly affects men. We confirmed that there are sex differences in sgACC FC in our large cohort of healthy adults; women had greater sgACC FC with the precuneus, a key node of the default mode network, and men had greater sgACC FC with the posterior insula and the operculum. Next, we identified an interaction effect between sex and pain status (healthy/chronic pain) for sgACC FC. Within the chronic pain group, women had greater sgACC FC than men to the default mode and sensorimotor networks. Compared to healthy women, women with chronic pain also had greater sgACC FC to the precuneus and lower FC to the hippocampus and frontal regions. No differences in sgACC FC were seen in men with vs without chronic pain. Our findings indicate that abnormal sgACC circuitry is unique to women but not men with ankylosing spondylitis-related chronic pain. These sex differences may impact the benefit of therapeutics that target the sgACC for chronic pain.
Double-blind, randomized, placebo-controlled crossover trial of alpha-lipoic acid for the treatment of fibromyalgia pain: the IMPALA trial
Authors: Gilron Ian , Robb Sylvia , Tu Dongsheng , Holden Ronald , Towheed Tanveer , Ziegler Dan , Wang Louie , Milev Roumen , Gray Christopher
Published: August 2020

Fibromyalgia is a common and challenging chronic pain disorder with few, if any, highly effective and well-tolerated treatments. Alpha-lipoic acid (ALA) is a nonsedating antioxidant with evidence of efficacy in the treatment of symptomatic diabetic neuropathy that has not been evaluated in the setting of fibromyalgia treatment. Thus, we conducted a single-centre, proof-of-concept, randomized, placebo-controlled, crossover trial of ALA for the treatment of fibromyalgia. Twenty-seven participants were recruited, and 24 participants completed both treatment periods of the trial. The median maximal tolerated dose of ALA in this trial was 1663 mg/day. Treatment-emergent adverse events with ALA were infrequent and not statistically different from placebo. For the primary outcome of pain intensity, and for several other validated secondary outcomes, there were no statistically significant differences between placebo and ALA. A post hoc exploratory subgroup analysis showed a significant interaction between gender and treatment with a significant favourable placebo–ALA difference in pain for men, but not for women. Overall, the results of this trial do not provide any evidence to suggest promise for ALA as an effective treatment for fibromyalgia, which is predominantly prevalent in women. This negative clinical trial represents an important step in a collective strategy to identify new, better tolerated and more effective treatments for fibromyalgia.
The α2/α3GABAA receptor modulator TPA023B alleviates not only the sensory but also the tonic affective component of chronic pain in mice
Authors: Neumann Elena , Küpfer Laura , Zeilhofer Hanns Ulrich
Published: August 2020

Diminished synaptic inhibition in the spinal dorsal horn is a major contributor to pathological pain syndromes of neuropathic or inflammatory origin. Drugs that enhance the activity of dorsal horn α2/α3GABAARs normalize exaggerated nociceptive responses in rodents with neuropathic nerve lesions or peripheral inflammation but lack most of the typical side effects of less specific GABAergic drugs. It is however still unknown whether such drugs also reduce the clinically more relevant conscious perception of pain. Here, we investigated the effects of the α2/α3GABAAR subtype-selective modulator TPA023B on the tonic aversive component of pain in mice with peripheral inflammation or neuropathy. In neuropathic mice with a chronic constriction injury of the sciatic nerve, TPA023B not only reversed hyperalgesia to tactile and heat stimuli but also was highly effective in the conditioned place preference test. In the formalin test, TPA023B not only reduced licking of the injected paw but also reversed facial pain expression scores in the mouse grimace scale assay. Taken together, our results demonstrate that α2/α3GABAA receptor subtype-selective modulators not only reduce nociceptive withdrawal responses but also alleviate the tonic aversive components of chronic pain.
Interrogating genome function using CRISPR tools: a narrative review
Authors: Ren Xingjie , Takagi Maya Asami , Shen Yin
Published: August 2020

Genome editing serves as a powerful approach to interrogate the functions of both coding and noncoding sequences. In particular, clustered regularly interspaced short palindromic repeat (CRISPR)/CRISPR associated protein 9 (Cas9) system-based editing tools have revolutionized the way we study genome function in mammalian cells, and are being widely used for interrogating critical genes and DNA elements essential for many biological processes. Here, we review CRISPR/Cas9-based genetic tools with an emphasis on CRISPR-mediated high throughput genetic screens in the mammalian genome.
A narrative review of single-nucleotide polymorphism detection methods and their application in studies of
Staphylococcus aureus
Authors: Jian Ying , Li Min
Published: August 2020

Single-nucleotide polymorphisms (SNPs) are the third generation of genetic markers, having been refined from the first generation of restriction fragment length polymorphisms and the second generation of microsatellite polymorphisms. SNPs represent a focal point of current studies of
Staphylococcus aureus
. On one hand, this review aims to summarize common methodologies for detecting SNPs. These methods have typically included DNA genome sequencing methods and PCR-based detection methods. Alternative methods, such as mass spectrometry, denaturing high-performance liquid chromatography, SNaPshot, and SNP array have also been employed for SNP analysis. On the other hand, we enumerate a series of applications of SNP analysis in investigations of
Staphylococcus aureus
. SNP analysis can be applied to investigate epidemiological outbreaks and transmission of
Staphylococcus aureus
infections, the transmission and evolution of antimicrobial resistance genes in
Staphylococcus aureus
isolates, interactions of
Staphylococcus aureus
with other bacteria, and the links between
Staphylococcus aureus
in humans and livestock.
Respiratory Health and Inflammatory Markers—Exposure to Cobalt in the Swedish Hard Metal Industry
Authors: Andersson Lena , Hedbrant Alexander , Bryngelsson Ing-Liss , Persson Alexander , Johansson Anders , Ericsson Annette , Vihlborg Per , Sjögren Bengt , Särndahl Eva , Stockfelt Leo , Westberg Håkan
Published: August 2020

Objective:

To study the relationship between inhalable dust and cobalt, and respiratory symptoms, lung function, exhaled nitric oxide in expired air, and CC16 in the Swedish hard metal industry.

Methods:

Personal sampling of inhalable dust and cobalt, and medical examination including blood sampling was performed for 72 workers. Exposure-response relationships were determined using logistic, linear, and mixed-model analysis.

Results:

The average inhalable dust and cobalt concentrations were 0.079 and 0.0017 mg/m3, respectively. Statistically significant increased serum levels of CC16 were determined when the high and low cumulative exposures for cobalt were compared. Nonsignificant exposure-response relationships were observed between cross-shift inhalable dust or cobalt exposures and asthma, nose dripping, and bronchitis.

Conclusions:

Our findings suggest an exposure-response relationship between inhalable cumulative cobalt exposure and CC16 levels in blood, which may reflect an injury or a reparation process in the lungs.
Morphine Equivalent Dose-Days (MED-D)
Authors: Merris Joshua , Phillips Andrew L. , Hegmann Kurt T. , Owens James D. , Amoafo Linda A. , Thiese Matthew S.
Published: August 2020

Objective:

To assess the effect of morphine equivalent dose-days (MED-D) on the total cost for acute low back pain (LBP) workers’ compensation claims.

Methods:

Simple random samples of 123 opioid and 141 nonopioid acute LBP claims were obtained. Opioid claims were divided into low, medium, and high subgroups for MED-D, MED, and prescription duration. Subgroup mean total costs were compared to the nonopioid group using multivariate regression analyses.

Results:

MED-D and prescription duration were each, respectively, associated with significantly increased total costs at both medium and high levels. Increasing MED had a negative association with total cost, though stratification by duration abrogated this perceived trend. Interaction testing indicated MED and duration together better explained cost than MED alone.

Conclusion:

MED-D is a better predictor of total cost in acute LBP claims than MED alone.
Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio as Inflammatory Markers in Patients With Welders’ Lung Disease
Authors: Karataş Mevlüt , Büyükşekerci Murat , Gündüzöz Meşide , Özakinci Gökhan , Öziş Türkan Nadir
Published: August 2020

Objective:

To investigate neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) in patients with welders’ lung disease (PWLD) and its relation with pulmonary function parameters.

Methods:

One hundred sixteen male PWLD and 118 healthy non-exposed individuals were recruited. Pulmonary function tests (PFTs), complete blood count, erythrocyte sedimentation rate (SED), c-reactive protein (CRP), NLR and PLR of both groups were retrospectively analyzed.

Results:

NLR, PLR, WBC, ESR, and CRP were significantly higher in PWLD compared to controls (allP < 0.001). All PFTs, except for FEV1/FVC, significantly decreased in PWLD compared to controls as. NLR correlated positively with ESR (r = 0.241 andP < 0.001).

Conclusion:

Our results show that NLR and PLR can be considered as new inflammatory markers in PWLD with their cheap, fast and easily measurable feature with routine blood count analysis.
Biomonitoring of DNA Damage in Photocopiers’ Workers From Peshawar, Khyber Pakhtunkhwa, Pakistan
Authors: Khisroon Muhammad , Khan Ajmal , Hassan Nazia , Zaidi Farrah , Farooqi Javeed
Published: August 2020

Objectives:

The study was performed to know about the extent of occupational DNA damage in photocopiers’ workers.

Methods:

Blood samples were collected from 136 exposed group and 74 control group. Comet assay was performed to assess the DNA damage caused by emissions from photocopiers.

Results:

The results indicated that there was a significant increase (P < 0.05) in DNA damage in persons working in photocopiers (122.1 ± 60.7) than the controls (56.6 ± 17.2). Duration of occupational exposure had positive correlation (r = 0.793, P 
< 0.001) with DNA damage. Age had significant effects on the total comet score (TCS) of the exposed group as compared to the control group (P < 0.05).

Conclusions:

In conclusion, these findings indicate significant genotoxicity in photocopiers’ workers.
Parental Occupational Exposure is Associated With Their Children's Psychopathology
Authors: Kishon Ronit , Geronazzo-Alman Lupo , Teichman Meir , Teichman Yona , Cheslack-Postava Keely , Fan Bin , Duarte Cristiane S. , Wicks Judith , Musa George J. , Djalovski Amir , Tadmor Boaz , Moreno Diana Rodriguez , Cycowicz Yael , Amsel Lawrence , Bresnahan Michaeline , Hoven Christina W.
Published: August 2020

Objective:

To examine the association between parental occupational exposure to traumatic events and their children's mental health in families of First Responders (FRs), a neglected area of research.

Methods:

In 208 families of Israeli FRs, children's symptoms and comorbidity patterns of seven psychiatric disorders were regressed on parental work-related variables, controlling for relevant covariates.

Results:

Having a father working as a FR and higher paternal exposure were associated with a greater number of separation anxiety and posttraumatic stress symptoms, respectively. Maternal exposure was associated with a greater number of symptoms of generalized anxiety, panic disorder, depression, and oppositional defiant disorder, and with increased odds of comorbid internalizing symptomatology.

Conclusions:

Additional research on children of FRs is encouraged. An adaption to this understudied population of family-centered interventions available for military families could inform targeted prevention efforts.
Association Between Fine Particulate Matter and Fatal Hemorrhagic Stroke Incidence
Authors: Cai Binxin , Xia Tian , Qian Yifeng , Lu Huiping , Cai Renzhi , Wang Chunfang
Published: August 2020

Objectives:

Evidence of the association between fine particulate (PM2.5, particles ≤2.5 μm in aerodynamic diameter) air pollution and fatal hemorrhagic stroke incidence is limited. This study aims to document the relationship between PM2.5 exposure and fatal hemorrhagic stroke incidence.

Methods:

The time-stratified case-crossover approach was applied for the analysis.

Results:

The mean concentration of PM2.5 is 75.33 μg/m3. Fatal hemorrhagic stroke incidence was significantly associated with PM2.5 exposure. Exposure to PM2.5 led to a 5% (2%–9%) and 5% (1%–10%) increase in fatal hemorrhagic stroke incidence in lag2 and lag03 respectively. An increased risk was observed especially in men and subjects with hypertension.

Conclusions:

This study provides evidence for the association between PM2.5 exposure and fatal hemorrhagic stroke incidence. Men and subjects with hypertension have increased risks, overweight may further increase their susceptibility to PM2.5 exposure related hemorrhagic stroke.
Workplace Violence and Long-term Sickness Absence
Authors: Hoffmann Sofie Have , Bjorner Jakob Bue , Xu Tianwei , Mortensen Jesper , Török Eszter , Westerlund Hugo , Persson Viktor , Aust Birgit , Rod Naja Hulvej , Clark Alice Jessie
Published: August 2020

Objectives:

We aimed to determine the effect of workplace violence on long-term sickness absence, and whether social support from supervisors and colleagues buffer this effect.

Methods:

Information on workplace violence and social support were derived from the Danish Work Environment Cohort Study in 2000, 2005, and 2010 and the Swedish Longitudinal Occupational Survey of Health in 2006 and 2008. Individual- and joint-effects on register-based long-term sickness absence were determined using logistic regression models for repeated measurements. Cohort-specific estimates were combined in random effect meta-analyses.

Results:

Workplace violence and low social support were independently associated with a higher risk of long-term sickness absence, and we did not find evidence of an interaction.

Conclusion:

Exposure to workplace violence is a risk factor for long-term sickness absence while social support is associated with a lower risk of long-term sickness absence.
Work Engagement and Work Performance Among Japanese Workers
Authors: Eguchi Hisashi , Inoue Akiomi , Kachi Yuko , Miyaki Koichi , Tsutsumi Akizumi
Published: August 2020

Objective:

We carried out a prospective study to investigate the association between work engagement and work performance in a group of Japanese workers.

Methods:

Our cohort included 1632 men and 192 women aged 65 years or younger who worked at a manufacturing company in Japan. Multiple regression analysis was conducted.

Results:

Higher work engagement at baseline was significantly associated with better work performance at follow-up (β = 0.159, P < 0.001). A sex-stratified analysis showed that the impact of work engagement at baseline on work performance at follow-up was stronger among women than among men (β = 0.242, P < 0.001 and β = 0.153, P < 0.001, respectively).

Conclusions:

Higher work engagement may have beneficial effects on work performance. The impact of work engagement on work performance may be greater among women than among men.
Evaluation of a Caregiver-Friendly Workplace Program Intervention on the Health of Full-Time Caregiver Employees
Authors: Ding Regina , Dardas Anastassios , Wang Li , Williams Allison
Published: August 2020

Objective:

To evaluate effectiveness of a workplace educational intervention at improving health-related outcomes in carer-employees.

Methods:

A pre-post test design compared with health of a sample (n = 21) of carer-employees before (T1) and after (T2) a workplace intervention, as well as a final timepoint (T3) 12 months after T1. An aggregate health score was used to measure health and consisted three scales; depression (CES-D), psychosocial (CRA), and self-reported health (SF-12), where higher scores indicated higher frequency of adverse health symptoms. Three random-slope models were created via the linear mixed modeling method (LMM) to illustrate changes in reported health.

Results:

All three LMM models reported a reduction in participants’ health score, particularly between T1 and T2, indicating a decrease in reported adverse health symptoms.

Conclusion:

The intervention was successful in improving the health of carer-employees.
Occupational Injuries of Latinx Child Farmworkers in North Carolina: Associations With Work Safety Culture
Authors: Arcury Thomas A. , Quandt Sara A. , Arnold Taylor J. , Chen Haiying , Daniel Stephanie S.
Published: August 2020

Objective:

This paper examines the association of occupational injuries with work safety culture among Latinx child farmworkers.

Methods:

Interviews were conducted in 2017 with 202 Latinx farmworkers aged 10 to 17 years.

Results:

Occupational injuries were common among the child farmworkers: for example, 66.8% reported any work injury and 45.5% reported heat-related illness. Work safety culture was inadequate; for example, most did not receive safety training, one-third reported having worked piece-rate; only a few field sanitation services were available, and perceived work safety climate was low. Work safety culture had a mixed association with occupational injuries, with safety training and a better perceived work safety climate having a direct association with occupational injuries.

Conclusions:

Policy is needed to reduce child farmworker injuries. Strategies to improve the predictive value of the work safety culture model are required.