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The long-term postoperative effect of the Baerveldt glaucoma drainage device and of a trabeculectomy on the corneal endothelium

Acta Ophthalmol. 2021 Feb 24. doi: 10.1111/aos.14815. Online ahead of print.

ABSTRACT

PURPOSE: To determine whether the postoperative corneal endothelial cell density (ECD) differs between glaucoma patients who underwent Baerveldt implant (BGI) surgery and patients who underwent a trabeculectomy (TE) over 5 years ago.

METHODS: Cross-sectional, observational study including 34 patients who underwent TE and 36 patients who underwent BGI surgery 5-11 years ago, as part of a randomized clinical trial. None of the patients had a history of intraocular surgery prior to their glaucoma surgery. Central and peripheral ECD was measured by using a non-contact specular microscope.

RESULTS: Central and peripheral ECD in the TE group was 2285 ± 371 cells/mm2 (mean ± SD) and 2463 ± 476 cells/mm2 , respectively. Central and peripheral ECD in the BGI group was 1813 ± 745 cells/mm2 and 1876 ± 764 cells/mm2 , respectively. The central and peripheral ECD was statistically significantly higher in the TE group than in the BGI group (p = 0.001 for both). Additional intraocular surgical interventions were more prevalent in the BGI group (23) than in the TE group (5) (p < 0.001). In a subanalysis, without eyes that had undergone additional surgical interventions, only the peripheral ECD was statistically significantly higher in the TE group compared with the BGI group (p = 0.011). For the BGI group, a longer postoperative period resulted in a lower central ECD (r = -0.614, p = 0.004).

CONCLUSION: Long-term ECD in eyes that underwent a BGI was considerably lower compared with eyes that underwent a TE, mainly in the peripheral cornea. This suggests that BGI causes a larger decrease of ECD than TE. Additionally, the decrease after BGI appears to continue for a longer period than after TE.

PMID:33629525 | DOI:10.1111/aos.14815

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The association between Sugars Sweetened Beverages (SSBs) and lipid profile among children and youth: A systematic review and dose-response meta-analysis of cross-sectional studies

Pediatr Obes. 2021 Feb 24:e12782. doi: 10.1111/ijpo.12782. Online ahead of print.

ABSTRACT

BACKGROUND: The relationship between sugar-sweetened beverages (SSBs) intake and serum lipids among children and youth has been reported in several studies, but the results are still controversial.

OBJECTIVE: In the current study, we summarized the results of studies that assessed the relationship between SSBs consumption and serum lipids among children and youth in a systematic review and dose-response meta-analysis.

METHODS: The PubMed, Web of Sciences, Cochrane and Scopus electronic databases were searched for observational studies reporting an association between SSBs intake and serum lipids among children and youth that were published before May 2020. For data extracted from cohort studies, only cross-sectional baseline data were included in the current meta-analysis. The Random effects model was used to estimate the pooled weighted mean difference (WMD) and 95% confidence intervals (CI). Heterogeneity was assessed with the Cochran Q test and I2 statistics.

RESULTS: In our search, 1845 studies were retrieved of which 13 studies (two cohorts and eleven cross-sectional) were included. High SSB consumption was associated with 1.21 mg/dL increase in low-density lipoprotein cholesterol (LDL-C; pooled WMD: 1.21 mg/dL; 95% CI: 0.23, 2.20; P = .01), 1.45 mg/dL decrease in high-density lipoprotein cholesterol (HDL-C, pooled WMD: -1.46 mg/dL; 95% CI, -2.25, -0.67; P < .0001) and 2.49 mg/dL decrease in total cholesterol (TC, pooled WMD: -2.49 mg/dL; 95% CI, -2.89, -2.10; P < .0001). In dose-response meta-analysis, there was an evidence of departure from linearity in the relationship between SSB consumption and change in LDL-C (P-nonlinearity = .03) and TC (P-nonlinearity = .01). However, no departure from linearity was observed between SSB intake and change in HDL-C (P-nonlinearity = .56) or triglyceride (TG) values (P-nonlinearity = .85).

CONCLUSION: According to our results, high SSB consumption was significantly associated with higher LDL-C and lower HDL-C and TC among children and youth. However, owing to the limited number of the included studies, further well-designed interventional studies are needed to better elucidate causality.

PMID:33629539 | DOI:10.1111/ijpo.12782

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The roles of two HIV self-testing models in promoting HIV-testing among men who have sex with men

Zhonghua Liu Xing Bing Xue Za Zhi. 2021 Feb 10;42(2):263-268. doi: 10.3760/cma.j.cn112338-20200629-00893.

ABSTRACT

Objective: To evaluate the roles between two different HIV self-testing models in promoting HIV-testing among men who have sex with men (MSM). Methods: This paper focuses on two HIV self-testing service models. The first; is the online self-testing model (HIV self-testing conventional model) with the sexual health promotion network platform. The other one is an innovative HIV self-testing model (secondary distribution model), based on the previous program. The two different self-testing models, including the number of indexes and alters, the positive rate, and the demographics of indexes and alters, are compared. The influence of volunteers with or without leadership on the number of HIV self-test kits distributed or self-use is analyzed through the leadership survey scale. Results: The return rates of HIV self-testing results in the two models are 94.7%(323/341) and 99.2%(1 141/1 150), respectively, within 30 days. The proportion of alters in the secondary distribution is significantly higher (45.9%,281/612) than the conventional HIV self-testing (6.3%,20/318). In the secondary distribution model, the difference between the number of indexes and alters indicators including age, marital status, residence, sex orientation, anal sex with men in the past six months, and HIV test are statistically significant (χ2 test, all P<0.05). The opinion leader of MSM has significantly impacted the promotion of HIV self-testing (P<0.05). Conclusions: Both models can promote HIV self-testing, result return, and HIV positive detection among MSM. In terms of expanding the testing and detection of HIV positive, the secondary distribution mode shows more obvious advantages, which significantly promotes a large number of MSM who have never been tested for HIV to undergo HIV testing. Influential indexes have a significant effect on increasing the HIV testing rate and promoting HIV testing among MSM.

PMID:33626613 | DOI:10.3760/cma.j.cn112338-20200629-00893

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A Meta-analysis on the infection rates on Mycoplasma genitalium in the genitourinary tract of different populations in China

Zhonghua Liu Xing Bing Xue Za Zhi. 2021 Feb 10;42(2):335-342. doi: 10.3760/cma.j.cn112338-20200530-00791.

ABSTRACT

Objective: Mycoplasma genitalium (Mg) is an opportunity pathogenic microorganism mainly transmitted through sexual contact. In recent years, scholars have paid more attention to Mg infection and pathogenicity. This study was aimed to understand the condition of Mg in the genitourinary tract of different populations in China and provide evidence for further study of its pathogenic characteristics. Methods: Cross-section studies of Mg infection in the Chinese community were searched by China National Knowledge Infrastructure (CNKI), Wanfang digital database, SinoMed, Pubmed, and Web of Science from database construction to March 10th, 2020. Studies were sifted and screened independently by two evaluators based on inclusion and exclusion criteria, and Meta-analysis was conducted with R 1.1.463. If I2≤50%, the fixed-effect model should be adopted, if I2>50%, the random effect model should be adopted, and through subgroup analysis, the source of heterogeneity should be found out as far as possible. Results: A total of 47 research articles were included in this article, all of which were medium and high-quality articles. There was no obvious publication bias, and the results were more reliable. The research contained 19 provinces and Hong Kong Special administrative region, including 519 healthy people, 10 504 patients from clinics or hospitals of sexual transmitted disease (STD), 3 200 on Gynecology and 1 624 on Urology, 1 082 patients with men who have sex with men(MSM), 1 842 patients with Female sex worker(FSW), and 3 691 patients with HIV/AIDS. The infection rate of Mg in the genitourinary tract of the healthy population was 0.94% (95%CI: 0.07%-2.78%), the infection rate of Mg was 11.58% (95%CI: 8.57%-14.97%), 15.22% (95%CI: 7.99%-24.27%), 7.32% (95%CI: 4.24%-11.16%) among patients from clinics or hospitals of STD, gynecology and urology respectively. The infection rate of MSM was 9.70% (95%CI: 3.06%-19.52%),the infection rate of FSW was 13.49% (95%CI: 11.97%-15.08%). The infection rate of Mg among HIV infected patients was 20.46% (95%CI: 13.67%-28.22%). Conclusions: The infection rate of Mg in a healthy population was low. Mg infection rate in the genitourinary tract of other groups was still higher, which is worthy of further attention.

PMID:33626625 | DOI:10.3760/cma.j.cn112338-20200530-00791

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A Meta-analysis on association between statins and colorectal cancer

Zhonghua Liu Xing Bing Xue Za Zhi. 2021 Feb 10;42(2):343-350. doi: 10.3760/cma.j.cn112338-20200119-00045.

ABSTRACT

Objective: To explore the association between statins and colorectal cancer and provide evidence for the prevention of colorectal cancer. Methods: Literatures about statins and colorectal cancer published from January 2000 to January 2020 were retrieved from CNKI, Wanfang data, PubMed and Cochrane Library database. The literatures which met the inclusion criteria were collected, and the Newcastle-Ottawa Scale and Jadad score were used to assess the studies. Meta-analysis was performed with statistical software Revman 5.0 and Stata 12.1. Results: A total of 31 studies, involving more than 1.62 million subjects, were included in the analysis. The case-control study (RR=0.93, 95%CI: 0.88-0.98), the cohort study (RR=0.75, 95%CI: 0.63-0.88) and the randomized controlled trial (RR=0.79, 95%CI: 0.65-0.97) showed moderate protective effect of statins. Using statin <5 years (RR=0.86, 95%CI: 0.76-0.96), average daily dosage ≥34 mg (RR=0.81, 95%CI: 0.66-0.98) and lipid-soluble statins (RR=0.86, 95%CI: 0.74-0.99) also had preventive effect on colorectal cancer; while lovastatin (RR=1.07, 95%CI: 1.00-1.14) increased the risk of colorectal cancer. Conclusion: Statins have protective effect on colorectal cancer.

PMID:33626626 | DOI:10.3760/cma.j.cn112338-20200119-00045

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Individual risk calculator to predict lymph node metastases in patients with submucosal (T1b) esophageal adenocarcinoma: a multicenter cohort study

Endoscopy. 2021 Feb 24. doi: 10.1055/a-1399-4989. Online ahead of print.

ABSTRACT

Background and study aims: There is a risk for lymph node metastases (LNM) after endoscopic resection of early esophageal adenocarcinoma (EAC). The aim of this study was to develop and internally validate a prediction model that estimates the individual metastases risk in patients with pT1b EAC. Patients and methods: This is a nationwide, retrospective, multicenter cohort study. Patients with pT1b EAC and treated with endoscopic resection and/or surgery between 1989 and 2016 were included. Primary endpoint was the presence of LNM in surgical resection specimen or the detection of metastases during follow-up. All resection specimens were histologically reassessed by specialized gastrointestinal pathologists. Subdistribution hazard regression analysis was used to develop a prediction model. The discriminative ability of this model was assessed using the c-statistic. Results: 248 patients with pT1b EAC were included. Metastases were seen in 78 patients, and the 5-year cumulative incidence was 30.9% (95% CI 25.1%-36.8%). The risk for metastases increased with submucosal invasion depth (subdistribution hazard ratio [SHR] 1.08, 95% CI 1.02-1.14, for every increase of 500 μm), for tumors with lymphovascular invasion (SHR 2.95, 95% CI 1.95-4.45) and for larger tumors (SHR 1.23, 95% CI 1.10-1.37, for every increase of 10 mm). The model demonstrated a good discriminative ability (c-statistic 0.81, 95% CI 0.75-0.86). Conclusions: One third of patients with pT1b EAC experienced metastases within 5 years. The probability for developing post resection metastases can be estimated with a personalized predicted risk score incorporating tumor invasion depth, tumor size and lymphovascular invasion. This model needs to be externally validated before implementation into clinical practice.

PMID:33626582 | DOI:10.1055/a-1399-4989

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An Evaluation of the Relationship between Retinal Nerve Fiber Thickness, Cochlear Nerve Thickness, the Level of Tinnitus, and Hearing Loss in Unilateral Tinnitus Patients

Audiol Neurootol. 2021 Feb 24:1-8. doi: 10.1159/000512004. Online ahead of print.

ABSTRACT

BACKGROUND: In this study, optic coherence tomography (OCT) examination was performed to check whether there was any interaction between ophthalmic axonal structures in unilateral tinnitus patients, and the relationship between optic nerve thickness and cochlear nerve thickness was evaluated.

OBJECTIVE: The aim of the study was to evaluate the relatioship between hearing loss, tinnitus, and nerve thicknesses.

STUDY DESIGN: Prospective study.

SETTING: Tertiary referral university hospital.

PATIENTS: The study included 88 patients with unilateral tinnitus, for which no organic cause could be found in physical examination, psychiatric evaluation, or with imaging methods. Study groups were formed of the tinnitus side and control groups were formed of the healthy side as follows: Group 1 (Non-tinnitus side normal hearing values – n = 30), Group 2 (non-tinnitus side minimal hearing loss – n = 27), Group 3 (non-tinnitus side moderate hearing loss – n = 31), Group 4 (tinnitus side normal hearing values – n = 25), Group 5 (tinnitus side minimal hearing loss – n = 25), and Group 6 (tinnitus side moderate hearing loss – n = 38).

INTERVENTION: Retinal nerve fiber layer (RNFL) thickness was evaluated with OCT, and the cochlear nerve cross-sectional area was evaluated with MRI.

MAIN OUTCOME MEASURES: RNFL measurements were taken with OCT from the subfoveal area (RNFL-SF) and 1.5 mm temporal to the fovea (RNFL-T µm) and nasal (RNFL-N µm) sectors. On MRI, 3 measurements were taken along the nerve from the cerebellopontine angle as far as the internal auditory canal, and the mean value of these 3 measurements was calculated.

RESULTS: When the groups were evaluated in respect of cochlear nerve thickness, a significant difference was seen between Group 1 and both the groups with hearing loss and the tinnitus groups. In the subgroup analysis, a statistically significant difference was determined between Group 1 and Groups 3, 4, 5, and 6 (p = 0.013, p = 0.003, p < 0.001, and p < 0.001, respectively). When the groups were evaluated in respect of the RNFL-SF (µm), RNFL-T (µm), and RNFL-N (µm) values, the differences were determined to be statistically significant (p < 0.001 for all). In the correlation analysis, a negative correlation was determined between hearing loss and cochlear nerve diameter (r: -0.184, p = 0.014), and RNFL-N (r: -0.272, p < 0.001) and between tinnitus and cochlear nerve diameter (r: -0.536, p < 0.001), and RNFL-T (r: -0.222, p < 0.009).

CONCLUSION: The study results clearly showed a relationship between cochlear nerve fiber thickness and hearing loss and the severity of tinnitus in cases with unilateral tinnitus and that there could be neurodegenerative factors in the disease etiology. A similar relationship seen with the RNFL supports the study hypothesis.

PMID:33626543 | DOI:10.1159/000512004

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The Perceived Value of Certification of Plastic and Aesthetic Nurses

Plast Surg Nurs. 2021 Jan-Mar 01;41(1):6-17. doi: 10.1097/PSN.0000000000000360.

ABSTRACT

There is no quantitative evidence as to how plastic and aesthetic nurses perceive the value of certification. The aim of this study was to determine how certified and noncertified plastic and aesthetic registered nurses (RNs), who are members of the International Society of Plastic and Aesthetic Nurses (ISPAN), perceive the value of certification. A secondary study aim was to compare perceptions of nurses who hold a CPSN (Certified Plastic Surgical Nurse), CANS (Certified Aesthetic Nurse Specialist), or both certifications with nurses who do not hold these certifications. Upon approval of the ISPAN Board of Directors, the researchers prepared a survey. The survey collected demographic information sufficient to capture a picture of the nurses participating in the survey and to compare profiles of certified and noncertified nurses. The Perceived Value of Certification Tool (PVCT)-12 was used to obtain information about the nurses’ perceived extrinsic and intrinsic values of certification. Overall, the highest level of agreement was found with the intrinsic value statements. Across all 12 items of the PVCT-12, participants who held a CPSN and/or CANS certification reported greater perceptions of the value of the CPSN and CANS certifications than participants who did not hold a CPSN or CANS certification. Certified participants’ intrinsic and extrinsic value scores were found to be significantly higher than noncertified participants’ scores. The extrinsic value statements of the PVCT-12 were the least endorsed. Extrinsic rewards in combination with added support and recognition for nurses may be what is necessary to increase the proportion of certified nurses.

PMID:33626555 | DOI:10.1097/PSN.0000000000000360

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Treatment Evaluation in Inpatient Psychiatry: Transdiagnostic Factors as Correlates of Treatment Outcome – Implications for Clinical Practice and for Effectiveness Research

Psychiatr Prax. 2021 Feb 24. doi: 10.1055/a-1348-9358. Online ahead of print.

ABSTRACT

AIM: An inpatient psychiatric-psychotherapeutic treatment was evaluated in a naturalistic setting (effectiveness research). Transdiagnostic factors were examined as correlates of treatment outcome.

METHODS: Self-report questionnaires were administered at the beginning and the end of the inpatient treatment. The sample (N = 378) consisted of women and men (16-80 years, M = 40.4, SD = 15.8) with primary diagnoses of depressive, anxiety or eating disorders. The average treatment duration was 8.2 weeks (SD = 3.8). Primary outcome variables were severity of symptoms and level of psychosocial functioning. As transdiagnostic correlates, self-esteem, self-efficacy, and emotion regulation were included in the regression analyses.

RESULTS: The change in transdiagnostic factors explained a significant proportion of the treatment outcome (explained variance: 8-27 % self-efficacy, 23-42 % self-esteem, 10-26 % emotion regulation).

DISCUSSION/CONCLUSION: The present study shows that the evaluation of a treatment in a naturalistic clinical setting is feasible. Transdiagnostic factors explained a substantial part of the statistical variance in treatment outcome across all disorders. Even if the present study design does not allow conclusions about causality, the results underline the relevance of transdiagnostic trainings (e. g., in emotion regulation) to improve effectiveness of treatment approaches.

PMID:33626578 | DOI:10.1055/a-1348-9358

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Continued decline in the prevalence of the Clostridioides difficile BI/NAP1/027 strain across the United States Veterans Health Administration

Diagn Microbiol Infect Dis. 2021 Jan 22;100(2):115308. doi: 10.1016/j.diagmicrobio.2021.115308. Online ahead of print.

ABSTRACT

In 2018, we demonstrated a decreased prevalence of the hypervirulent Clostridioides difficile BI/NAP1/027 strain across the United States (US) Veterans Health Administration (VHA) from 2011 through 2016. The objective of this retrospective study was to update the prevalence of the BI/NAP1/027 strain within the VHA from 2017 through 2020. Patients with positive tests for the presence of toxigenic C. difficile at any Veterans Affairs Medical Center found to also routinely test for BI/NAP1/027 strain presence were included between July 1, 2016 and June 30, 2020. In total, 7490 patients had 8148 positive C. difficile tests that had a corresponding BI/NAP1/027 test. Of those, there were 1031 (12.6%) presumptive positive tests for the BI/NAP1/027 strain. The overall prevalence of BI/NAP1/027 decreased from a high of 15.4% in 2017 to 8.21% in 2020. Statistically significant reductions in rates from 2017 to 2020 occurred in 4 of 9 US Census Bureau regions.

PMID:33626478 | DOI:10.1016/j.diagmicrobio.2021.115308