Tag: pubmed

Zhonghua Yan Ke Za Zhi. 2022 Jul 11;58(7):535-541. doi: 10.3760/cma.j.cn112142-20220104-00002.

ABSTRACT

Objective: To evaluate the perfusion features of the anterior segment in patients with different types of strabismus. Methods: A cross-sectional study. Sixteen strabismus patients (16 eyes) who received the examination of iris indocyanine green angiography (ICGA) in Tianjin Eye Hospital from November 2016 to December 2021 were enrolled and divided into two groups according to whether they had a history of extraocular muscle injury/rectus muscle surgery. All patients underwent routine ophthalmic examinations. Angiographic images were obtained by the anterior segment camera, and indicators such as arm to iris circulation time, whole iris filling time, regression onset time, and complete regression time were recorded. The independent sample t test or Mann-Whitney U test was used to compare iris perfusion aspects of the two groups, and the Pearson/Spearman correlation tests was used to analyze the correlation of arm to iris circulation time and whole iris filling time with age and course of strabismus. Results: Among the 16 patients, there were 10 males and 6 females. The mean age was (49.2±13.2) years, and the course of strabismus ranged from 2 to 31 months. There were 7 patients in the group of without extraocualr muscle injury and 9 patients in the extraocular muscle injury/surgery group. There was no significant difference in age and course of strabismus between the two groups (both P>0.05). The arm to iris circulation time [M (Q₁, Q₃)] of the group without extraocular muscle injury and the group with extraocular muscle injury/surgery were 18 (18, 21) and 22 (20, 24) s, respectively. The average whole iris filling time was (13.86±1.95) and (12.22±3.60) s, respectively. There was no statistical significance between the two groups (both P>0.05). Correlation analysis showed that arm to iris circulation time was not correlated with age and course of strabismus (r=-0.033, -0.079; both P>0.05). And the whole iris filling time was not correlated with age and course of disease (r=0.057, -0.119; both P>0.05). The matrix scatter plots showed that in the group of extraocular muscle injury/surgery, there were three patients who were older than the average (49.2 years) and above the median of arm to iris circulation time (20 s) (two cases with the vertical muscle involved), meanwhile, there were three patients (all with the vertical muscle involved) whose course of strabismus was longer than 6 months and above the median of arm to iris circulation time, which were more than those in the group of without extraocular muscle injury (1 case, respectively). Conclusions: ICGA in patients with strabismus show that a history of injury to the extraocular muscle or surgical treatment beyond 2 months had no effect on iris perfusion. Age and course have no correlation with iris reperfusion. The vertical muscle involvement has more effects on the blood supply to the anterior segment.

PMID:35796127 | DOI:10.3760/cma.j.cn112142-20220104-00002

Zhonghua Yan Ke Za Zhi. 2022 Jul 11;58(7):521-528. doi: 10.3760/cma.j.cn112142-20211103-00518.

ABSTRACT

Objective: To compare the difference of decentration and tilt among 4 kinds of aspherical intraocular lenses (IOLs), and to analyze their objective visual quality. Methods: Prospective non-randomized controlled clinical trial. Age-related cataract patients who planned to undergo phacoemulsification and IOL implantation in the Affiliated Hospital of North Sichuan Medical College from April to June in 2020 were divided into ZCB00 group, SN60WF group, A1-UV group, and AO group according to IOL types. Thirty right eyes and thirty left eyes were selected in each group. Before operation and at 1 day, 1 week and 1 month postoperatively, decentration and tilt values were measured by a new swept-source anterior-segment optical coherence tomography device (CASIA2), and wavefront aberrations, objective scatter index (OSI), modulation transfer function cut off frequency (MTF cut off) and Strehl ratio (SR) were also examined. Values of decentration, tilt and visual quality compared among 4 groups were took from the right eye. One-way analysis of variance was used for inter-group comparison, and repeated measurement one-way analysis of variance was used for intra-group comparison. Data between right eyes and left eyes from all the individuals were compared by independent sample t-test. Results: A total of 181 patients (240 eyes) were enrolled, and 169 patients (224 eyes) completed the follow-up (114 right eyes and 110 left eyes). There were 77 males and 92 females, with an age of (69±9) years. There was no significant difference in gender, age, axial length, decentration and tilt of crystalline lens and IOL power among 4 groups (all P>0.05). At 1 day, 1 week and 1 month postoperatively, there was significant difference in decentration value among 4 groups (F=7.11, 6.12, 4.66; all P<0.05). For further pairwise comparison, the decentration value of SN60WF group was higher than that of the other 3 groups at 1 day and 1 week postoperatively, and the decentration value of SN60WF group was (0.259±0.101) mm at 1 month postoperatively, which was higher than that of ZCB00 group (0.177±0.099) mm and AO group (0.163±0.122) mm, and the differences were statistically significant (using SNK-q test, both P<0.05). The IOL tilt value in the ZCB00 group, SN60WF group, A1-UV group, and AO group at 1 month postoperatively were (4.806±1.129)°, (5.080±1.309)°, (4.586±1.338)°, (5.112±1.406)°, respectively. No significant difference in tilt value among 4 groups was found at any time after surgery (all P>0.05). In each group, there was no significant difference in decentration and tilt value at different postoperative time points (all P>0.05). At 1 month postoperatively, there was no significant difference in decentration and tilt at horizontal and vertical directions respectively among 4 groups (all P>0.05), and in each group, there was no significant difference in decentration and tilt value between right eyes and left eyes (all P>0.05), and IOLs tended to tilt towards the inferonasal or inferotemporal direction in both eyes. With 4-mm and 6-mm pupil diameter, there was significant difference in internal (F=131.32, 85.17) and ocular (F=46.64, 47.55) spherical aberration among 4 groups (all P<0.01). For further pairwise comparison, the spherical aberration of AO group was higher than that of the other 3 groups, and the difference was statistically significant (using SNK-q test, all P<0.05). There was no significant difference in OSI, MTF cut off and SR among 4 groups (all P>0.05). Conclusions: The four types of IOLs show decentration and tilt in varying degrees after implantation in the capsular bag, but this difference do not lead to clinical significance. Human eyes have tolerance to mild decentration and tilt of aspheric IOLs, showing good visual quality.

PMID:35796125 | DOI:10.3760/cma.j.cn112142-20211103-00518

Zhonghua Yan Ke Za Zhi. 2022 Jul 11;58(7):513-520. doi: 10.3760/cma.j.cn112142-20220403-00154.

ABSTRACT

Objective: To compare decentration and tilt tolerances between continuous range intraocular lens (IOL) and bifocal IOL in myopia during the early stages post intraocular implantation. Method: A retrospective cohort study was conducted using follow-up data of 145 patients (145 eyes) who underwent phacoemulsification combined with IOL implantation in the Eye & ENT Hospital of Fudan University from January 2018 to December 2020. According to whether the axial length was less than 24.5 mm, patients were divided into non-myopic and myopic groups. According to IOL type, patients were divided into extend depth of focus (EDOF) ZXR00 IOL group (myopic 38 eyes, non-myopic 41 eyes) and bifocal ZMB00 IOL group (myopic 23 eyes, non-myopic 43 eyes). The distance and near visual acuity (log of the minimum angle of resolution visual acuity), IOL tilt and decentration, intraocular high-order aberration (HOA), coma, trefoil, spherical aberrations, modulation transfer function (MTF), as well as VF-14 index and the incidence of dysphotopsia were compared between the 2 groups at 3 months after surgery. Statistics were performed using Student’s t-test, χ² test, Pearson correlation analysis and multiple linear regression analysis. Results: In either the myopic or non-myopic group, no significant differences were found in age, gender, eye laterality, axial length and IOL degree between eyes with the two different types of IOLs (all P>0.05). At 3 months after surgery, there was no significant difference in uncorrected and best-corrected distance visual acuity between the ZXR00 IOL group and the ZXR00 IOL group, while uncorrected near visual acuity was better in the ZMB00 IOL group than the ZXR00 IOL group (t=10.41, P<0.01). The total postoperative IOL decentration in the ZXR00 IOL group and ZMB00 IOL group in myopic eyes were (0.32±0.17) and (0.38±0.16) mm, respectively, which were greater than those in non-myopic eyes [(0.22±0.12), (0.28±0.12) mm; t=3.16, 2.57; both P<0.05]. However, there were no significant differences in IOL tilt between myopic and non-myopic eyes in the 2 groups (both P>0.05). There were no significant differences in postoperative IOL tilt and decentration between the 2 groups regardless of myopia or non-myopia (all P>0.05). In myopic eyes, HOA, coma aberration and spherical aberration in the ZXR00 IOL group were significantly lower than those in the ZMB00 IOL group, while the total ocular MTF (38.15±10.12) was significantly higher than that in the ZMB00 IOL group (30.46±10.53) (all P<0.05). Pearson correlation analysis and multiple linear regression analysis showed a positive correlation between postoperative HOA and both IOL tilt and decentration in the ZMB00 IOL group (r=0.627, 0.726; β=0.446, 0.587; all P<0.01). However, no such relationship was found in the ZXR00 IOL group (all P>0.05). In myopic eyes, when the IOL tilt aberration and decentration were greater than the median, the HOAs in the ZXR00 IOL group [(0.33±0.14), (0.27±0.11) μm] were lower than those in the ZMB00 IOL group [(0.88±0.56), (0.96±0.45) μm], while the total ocular MTF (42.87±10.97, 40.22±9.30) were higher than those in the ZMB00 IOL group (25.02±8.99, 29.87±10.19) (all P<0.05). In myopic eyes, the proportion of patients with visual interference symptoms in the ZXR00 IOL group [42.11% (16/38)] was significantly lower than that in the ZMB00 IOL group [78.26%(18/23), χ²=7.59, P<0.05]. Conclusion: During the early stages after IOL implantation in myopic eyes, EDOF IOL is more tolerant to decentration and tilt than bifocal IOL.

PMID:35796124 | DOI:10.3760/cma.j.cn112142-20220403-00154

Zhonghua Yan Ke Za Zhi. 2022 Jul 11;58(7):506-512. doi: 10.3760/cma.j.cn112142-20220113-00013.

ABSTRACT

Objective: To investigate the effect of phacoemulsification on the Berger space (BS). Methods: A prospective cohort study. Patients with cataract who underwent phacoemulsification and intraocular lens implantation in the Department of Ophthalmology, Affiliated Hospital of Nantong University from May 2021 to October 2021 were enrolled. The BS was observed by slit-lamp microscopy and anterior segment optical coherence tomography (AS-OCT) before and 1 month after operation. Intraoperative optical coherence tomography with a 25G optical fiber was performed to observe the BS. The number of eyes with the BS and materials in the BS (MIB) detected perioperatively was counted, and the width of the BS was measured. Statistical analysis was carried out by the Chi-square test, generalized estimating equations, Mann-Whitney U test and binary logistic regression analysis. Results: A total of 119 patients (119 eyes) were included [44 males, 75 females; mean age, (65±12) years]. Preoperatively, the BS was identified in only 4 eyes (3.4%), and no MIB was found. Intraoperatively, the BS was identified in 47 eyes (39.5%), and the MIB was observed in 20 eyes (16.8%). At one month postoperatively, the BS was identified in 33 eyes (27.7%), of which 16 eyes (13.4%) still had MIB. There were significant differences in the detection rates of the BS and MIB between intraoperative and preoperative groups (both P<0.001). The difference in the detection rate of the BS postoperatively compared to intraoperatively was statistically significant (P=0.001), while the difference in the detection rate of MIB was not statistically significant (P>0.05). The intraoperative and postoperative width of the BS [M (Q₁, Q₃)] was 160.3 (61.6, 273.1) μm and 106.8 (0, 259.4) μm, respectively, and the difference was statistically significant (Z=-2.28, P=0.023). In addition, the detection rate of the BS and MIB in patients with a high risk of zonular fiber weakness [60.7% (17/28) and 42.9% (12/28)] was significantly higher than that in patients without this risk factor [33.0% (30/91) and 8.8% (8/91)] (χ²=6.90, P=0.009; P<0.001). In the multivariable model, weakness of zonular fibers (OR=0.214, 95%CI: 0.081 to 0.561) and higher cumulative dissipated energy (OR=1.255, 95%CI: 1.047 to 1.504) were the main risk factors for structural changes of the BS intraoperatively. Conclusion: Phacoemulsification can damage the normal anatomical structure of the BS, resulting in intraoperative entrance of fluid and particulates to the BS.

PMID:35796123 | DOI:10.3760/cma.j.cn112142-20220113-00013

Radiat Oncol J. 2022 Jun;40(2):103-110. doi: 10.3857/roj.2021.00864. Epub 2022 May 25.

ABSTRACT

PURPOSE: This study aims to assess the locoregional efficacy of postoperative vaginal brachytherapy (VBT) alone in patients undergoing surgical staging for early-stage high-intermediate-risk (HIR) and high-risk (HR) endometrial cancer.

MATERIALS AND METHODS: One hundred and four patients with early-stage HIR and HR endometrial cancer who underwent surgical staging were treated with adjuvant VBT alone. The patients with stage Ib, grade I-III, stage Ia, grade III, lower uterine segment involvement, and lymphovascular invasion (LVI) were included to study.

RESULTS: The 5- and 10-year overall survival (OS) rates were 87% and 76%, respectively. The 5- and 10-year DFS rates were 86% and 86%, respectively. Among the patients, 92% had endometrioid adenocarcinoma, 2% had undifferentiated carcinoma, 2% had serous papillary carcinoma, and 4% had clear-cell carcinoma. Of the patients, 63% had stage Ib disease, while 37% had stage Ia disease. None of the patients had vaginal or pelvic lymph node recurrence, whereas two had para-aortic lymph node metastasis, one had surgical scar recurrence, one had para-aortic lymph node and brain metastasis, and one had lung metastasis. The presence of lymphatic invasion was found to be a statistically significant prognostic factor for increased distant metastasis rates (p = 0.020). Lymphatic invasion was also regarded as an independent prognostic factor for metastasis-free survival (p = 0.044).

CONCLUSION: Our study results suggest that postoperative VBT alone is an effective and safe treatment modality with low complication in patients undergoing surgical staging for HIR and HR endometrial cancer.

PMID:35796113 | DOI:10.3857/roj.2021.00864

BJS Open. 2022 Jul 7;6(4):zrac077. doi: 10.1093/bjsopen/zrac077.

ABSTRACT

BACKGROUND: Varicose vein (VV) treatments have changed significantly in recent years leading to potential disparities in service provision. The aim of this study was to examine the trends in VV treatment in England and to identify disparities in the provision of day-case and inpatient treatments related to deprivation, ethnicity, and other demographic, and geographical factors.

METHOD: A population-based study using linked hospital episode statistics for England categorized VV procedures and compared population rates and procedure characteristics by ethnicity, deprivation quintile, and geographical area.

RESULTS: A total of 311 936 people had 389 592 VV procedures between 2006/07 and 2017/18, with a further 63 276 procedures between 2018/19 and 2020/21. Procedure rates have reduced in all but the oldest age groups, whereas endovenous procedures have risen to more than 60 per cent of the total in recent years. In younger age groups there was a 20-30 per cent reduction in procedure rates for the least-deprived compared with the most-deprived quintiles. Non-white ethnicity was associated with lower procedure rates. Large regional and local differences were identified in standardized rates of VV procedures. In the most recent 5-year interval, the North-East region had a three-fold higher rate than the South-East region with evidence of greater variation between commissioners in overall rates, the proportion of endovenous procedures, and policies regarding bilateral treatments.

CONCLUSIONS: There are substantial geographical variations in the provision of treatment for VVs, which are not explained by demographic differences. These have persisted, despite the publication of guidelines from the National Institute for Health and Care Excellence, and many commissioners, and providers would seem to implement policies that are contrary to this guidance. Lower rates of procedures in less-deprived areas may reflect treatments carried out in private practice, which are not included in these data.

PMID:35796069 | DOI:10.1093/bjsopen/zrac077

J Exp Biol. 2022 Jul 7:jeb.244471. doi: 10.1242/jeb.244471. Online ahead of print.

ABSTRACT

The U-shaped net cost of transport (COT) curve of walking has helped scientists understand the biomechanical basis that underlies energy minimization during walking. However, to produce an individual’s net COT curve, data must be analyzed during periods of steady-rate metabolism. Traditionally, studies analyze the last few minutes of a 6-10 min trial, assuming that steady-rate metabolism has been achieved. Yet, it is possible that an individual achieves steady rates of metabolism much earlier. However, there is no consensus on how to objectively quantify steady-rate metabolism across a range of walking speeds. Therefore, we developed a simple slope method to determine the minimum time needed for humans to achieve steady rates of metabolism across slow to fast walking speeds. We hypothesized that a shorter time window could be used to produce a net COT curve that is comparable to the net COT curve created using traditional methods. We analyzed metabolic data from twenty-one subjects who completed several 7-min walking trials ranging from 0.50-2.00 m/s. We partitioned the metabolic data for each trial into moving 1-min, 2-min, and 3 min intervals and calculated their slopes. We statistically compared these slope values to values derived from the last 3-min of the 7-min trial, our ‘gold’ standard comparison. We found that a minimum of 2 min is required to achieve steady-rate metabolism and that data from 2-4 min yields a net COT curve that is not statistically different from the one derived from experimental protocols that are generally accepted in the field.

PMID:35796105 | DOI:10.1242/jeb.244471

Nurse Res. 2022 Jul 7. doi: 10.7748/nr.2022.e1835. Online ahead of print.

ABSTRACT

BACKGROUND: Self-administered questionnaires are efficient and low-cost ways of collecting data with wide cohorts. Nonetheless, their use in studies can result in a high occurrence of missing data, which can affect the statistical power, representativeness and generalisability of the findings. Imputation methods have been considered efficient statistical techniques for managing missing data. However, they have also been associated with limits, such as the risk of under-estimation of the effect, lower statistical power and decrease of correlation among variables. Recent studies have highlighted the importance of using prevention strategies to avoid missing data before the data are analysed.

AIM: To identify strategies for preventing the occurrence of missing data and to discuss their effects, as well as their methodological and statistical considerations.

DISCUSSION: The article discusses prevention strategies related to the administration format and follow-up and reminders. Strategies such as the use of electronic tablets, email and telephone reminders are associated with lower rates of missing data in self-administered questionnaires. However, methodological and statistical limits, including the absence of a comparison group and statistical validation of the reported results, limits the capacity to establish robust consensus.

CONCLUSION: Prevention strategies represent relevant and feasible avenues for handling missing data in a wide range of clinical, nursing and epidemiological research. More projects based on robust design are needed to ensure accurate and reliable data are collected from patients, families, communities and clinicians.

IMPLICATIONS FOR PRACTICE: It is important for clinicians and nurses to understand the phenomenon of missing data and the strategies available to prevent missing data, to collect data representing the patients’ and families’ perspectives and experiences.

PMID:35796061 | DOI:10.7748/nr.2022.e1835

Elife. 2022 Jul 7;11:e72602. doi: 10.7554/eLife.72602.

ABSTRACT

Analysis of the content of medical journals enables us to frame the shifting scientific, material, ethical, and epistemic underpinnings of medicine over time, including today. Leveraging a dataset comprised of nearly half-a-million articles published in the Journal of the American Medical Association (JAMA) and the New England Journal of Medicine (NEJM) over the past 200 years, we (a) highlight the evolution of medical language, and its manifestations in shifts of usage and meaning, (b) examine traces of the medical profession’s changing self-identity over time, reflected in its shifting ethical and epistemic underpinnings, (c) analyze medicine’s material underpinnings and how we describe where medicine is practiced, (d) demonstrate how the occurrence of specific disease terms within the journals reflects the changing burden of disease itself over time and the interests and perspectives of authors and editors, and (e) showcase how this dataset can allow us to explore the evolution of modern medical ideas and further our understanding of how modern disease concepts came to be, and of the retained legacies of prior embedded values.

PMID:35796055 | DOI:10.7554/eLife.72602

Clin Exp Dent Res. 2022 Jul 7. doi: 10.1002/cre2.623. Online ahead of print.

ABSTRACT

OBJECTIVES: Dental implants are a known treatment today. It is necessary to have at least 2 mm of bone around the implant, especially in the buccal aspect of the anterior maxilla (esthetic zone). Some systemic conditions, such as menopause, can affect the body’s bone mass as well as the alveolar bone. Considering that few studies have been carried out on the effect of menopause on the thickness and topography of alveolar bone, we decided to investigate the effect of menopause on buccal alveolar bone thickness in the anterior maxillary teeth in menopausal women. MATERIAL AND METHODS: In this descriptive-analytical cross-sectional study, two subgroups of menopausal women and nonmenopausal women were considered. Data were extracted from 30 patients referred to a private radiology center in Mashhad for CBCT imaging. In addition, the buccal bone thickness in the crest and middle areas of the anterior maxillary teeth was measured and the difference between the two groups was investigated. The buccal bone thickness of the aesthetic area was evaluated with CBCT Planmeca ProMax 3D Max (Planmeca) by Planmeca Romexis 5.3.4 software, with 200 μm Voxel size and Fov 90 × 60 mm.

RESULTS: In this study, 30 women with a mean age of 49.75 ± 3.65 years in the nonmenopausal and menopausal groups were examined. It was found that the mean buccal bone thickness of the anterior maxilla in the nonmenopausal group (0.65 ± 0.25 mm) was higher than in the menopausal group (0.56 ± 0.20 mm), but the difference was not statistically significant (p = .2999). Only in the crestal bone of the right canine, the average bone thickness in nonmenopausal group (0.77 ± 0.33 mm) was significantly higher than the menopausal group (0.49 ± 0.22 mm) (p = .011).

CONCLUSIONS: Owing to changes in the volume and thickness of alveolar bone in menopausal women, the thickness of the buccal bone in the aesthetic area decreases, but this is not statistically significant.

PMID:35796053 | DOI:10.1002/cre2.623