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Radiographic and clinical outcomes of surgical treatment of Kummell’s disease with thoracolumbar kyphosis: a minimal two-year follow-up

BMC Musculoskelet Disord. 2021 Sep 6;22(1):761. doi: 10.1186/s12891-021-04640-8.

ABSTRACT

BACKGROUND: Up to now in the surgical treatment of Kümmell’s disease combined with thoracolumbar kyphosis, little research has focused on the evaluation of the imaging and clinical outcomes of restoring the normal alignment and sagittal balance of the spine. This study aimed to evaluate the short to mid-term radiographic and clinical outcomes in the treatment of Kümmell’s disease with thoracolumbar kyphosis.

METHODS: From February 2016 to May 2018, 30 cases of Kümmell’s disease with thoracolumbar kyphosis were divided into group A and B according to whether the kyphosis was combined with neurological deficits. All of the cases underwent surgical treatment to regain the normal spinal alignment and sagittal balance. The radiographic outcomes and clinical outcomes of the cases were retrospectively evaluated. The sagittal imaging parameters including sagittal vertebral axis (SVA),thoracic kyphosis (TK),thoracolumbar kyphosis (TLK),lumbar lordosis (LL),pelvic incidence (PI),pelvic tilt (PT),and sacral slope (SS) before operation,immediately after operation,and the last follow-up of each case were measured and evaluated. The clinical results included the Oswestry Disability Index (ODI) and the Numerical Rating Scale (NRS) of the two groups. Statistical software SPSS21.0 was used to analyze the data.

RESULTS: In group A: Mean SVA before operation was 75 mm and 26.7 mm at the final postoperative evaluation (P = 0.000); Mean TLK before operation was 39°, and 7.1° at the final postoperative evaluation (P = 0.000); Mean NRS before operation was 4.7, compared with 0.9 at the final postoperative evaluation (P = 0.000). In group B: Mean preoperative SVA was 62.5 mm and decreases to 30.7 mm at the final postoperative evaluation (P = 0.000); Mean TLK before operation was 33°, and 9.7° 2 years post-operation (P = 0.000); Mean NRS prior to surgery was 4.0, and 0.8 at the last follow-up evaluation (P = 0.000). The improvement of the NRS scores of groups A and B was related to the improvement of the cobb angle (P = 0.020); (P = 0.009) respectively.

CONCLUSION: In the treatment of Kümmell’s disease with thoracolumbar kyphosis,to restore the normal alignment and sagittal balance can obtain a satisfactory radiographic and clinical short and medium-term effects.

PMID:34488716 | DOI:10.1186/s12891-021-04640-8

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Comparisons of different exercise interventions on glycemic control and insulin resistance in prediabetes: a network meta-analysis

BMC Endocr Disord. 2021 Sep 6;21(1):181. doi: 10.1186/s12902-021-00846-y.

ABSTRACT

BACKGROUND: In order to recommend the optimal type of exercise for type 2 diabetes prevention, different exercise interventions were compared with respect to their effects on glycemic control and insulin resistance.

METHODS: Studies on the curative effect of aerobic exercise training (AET), resistance training (RT), or control training (CT) on prediabetes were retrieved from the PubMed, Embase, SPORTDiscus, and Cochrane Library databases. Body mass index (BMI); homeostasis model assessment of insulin resistance index (HOMA-IR); and fasting blood glucose (FBG), glycated hemoglobin (HbA1c), and insulin levels were used as outcome indicators. The Q statistic was calculated to evaluate heterogeneity within studies. A fixed- or random-effects model was used for pooling data based on nonsignificant or significant heterogeneities. A consistency test was conducted using a node-splitting analysis.

RESULTS: A total of 13 eligible studies were included. The results of the direct meta-analysis indicated that AET or RT could significantly reduce the HbA1c level in prediabetic individuals compared to CT [AET vs. CT: standardized mean difference (SMD) = – 0.6739, 95% confidence interval (CI) = – 0.9424 to – 0.4055 to RT vs. CT: SMD = – 1.0014, 95% CI = – 1.3582 to – 0.6446]. The findings from the network meta-analysis showed that there were no statistical differences among the four comparisons for all the indicators except for lower HbA1c level (SMD = – 0.75, 95% CI = – 1.31 to – 0.19) and HOMA-IR (SMD = – 1.03, 95% CI = – 1.96 to – 0.10) in the AET group than in the CT group. In addition, prediabetic individuals in the AET + RT group showed greater control of BMI and insulin and FBG levels than those in the other groups, whereas AET was the most effective in controlling HbA1c and HOMA-IR levels in prediabetic individuals.

CONCLUSION: AET, AET + RT, and RT exerted beneficial effects on insulin resistance and glycemic control in prediabetic patients. From the existing data, AET or AET + RT is preferentially recommended for these patients, although further studies may unveil RT as a promising therapy. Benefits from all types of exercise seem to occur in an intensity-dependent manner.

PMID:34488728 | DOI:10.1186/s12902-021-00846-y

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Coexistence of papillary thyroid carcinoma in secondary hyperparathyroidism

BMC Surg. 2021 Sep 6;21(1):335. doi: 10.1186/s12893-021-01330-z.

ABSTRACT

BACKGROUND: The coexistence of primary hyperparathyroidism and papillary thyroid carcinoma (PTC) is common and may be associative with more aggressive PTC, with higher rates of extrathyroidal extension and multicentricity. However, it is unclear whether secondary hyperparathyroidism (SHPT) is associated with more invasive PTC in terms of morbidity, tumor pathological characteristics, and prognosis. The aim of this study was to evaluate the rate and tumor characteristics of PTC in patients with SHPT.

METHODS: A total of 531 patients diagnosed with SHPT who underwent surgery from August 2013 to December 2018 at the First Affiliated Hospital of Zhejiang University were evaluated retrospectively. Patient demographics, surgical records, and follow-up information were recorded and analyzed. Control subjects were matched to the enrolled patients in a 1:4 ratio in terms of age, sex and pathological subtype.

RESULTS: Among the 531 patients with SHPT who underwent surgery, 34 had coexisting PTC and PTC + SHPT (6.4%). The mean tumor diameter in the PTC + SHPT group was smaller than that in the PTC group (5.57 mm vs 9.00 mm, p < 0.001). The proportion of papillary thyroid micro-carcinoma in the PTC + SHPT group was significantly higher than that in the PTC group (29 [85.29%] vs. 86[63.24%], p = 0.014). There were no statistically significant differences between groups in terms of tumor multicentricity (15 [44.12%] vs 39 [28.68%], p = 0.066), tumor bilaterality (9 [26.47%] vs. 29 [21.32%], p = 0.499), tumor extrathyroidal extension (2 [5.88%] vs. 19 [13.97%], p = 0.255), or lymph node (LN) metastasis rate (12 [35.29%] vs. 49 [36.03%], p = 1.000). However, the PTC + SHPT and PTC groups were significantly different in terms of contralateral thyroidectomy (10 [29.41%] vs. 70 [51.47%], p = 0.023) and lymph node dissection (22 [64.71%] vs. 125 [91.91%], p < 0.001).There was no significant difference between the PTC + SHPT and PTC groups in terms of prognostic staging (33 [97.06%] vs. 122 [89.71%], p = 0.309) or recurrence (mean follow-up time: 36 months vs. 39 months, p = 0.33).

CONCLUSIONS: The prevalence of PTC is high in patients with SHPT; compared with PTC in the general population, most papillary thyroid carcinomas with SHPT are occult thyroid carcinomas and present no significant difference in terms of tumor pathological features and prognostic staging. It is necessary for surgeons to perform more adequate preoperative examination and be more careful during surgery to avoid missing the coexistence of PTC in patients with SHPT.

PMID:34488715 | DOI:10.1186/s12893-021-01330-z

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The relationship between readiness to change pain-related exercise participation and perceived work ability: a cross-sectional study of factory workers

BMC Musculoskelet Disord. 2021 Sep 6;22(1):762. doi: 10.1186/s12891-021-04642-6.

ABSTRACT

BACKGROUND: Healthy lifestyle behaviours are associated with protection against health disorders and pain. Exercise participation is one such behaviour, associated with improved outcomes in those experiencing pain. Musculoskeletal pain is highly prevalent in the workplace, particularly in factory workers and associated loss of work function is recognised as having a great impact on individuals, society and the economy. A worker’s ‘readiness to change pain behaviour’ is an important factor to consider in achieving a healthy lifestyle behaviour and potentially improved function. This study aimed to examine the relationship between a cohort of factory workers ‘readiness to change pain behaviour’ such as exercise and their ‘perceived work ability’.

METHODS: A cross-sectional study design was used to establish the relationship between ‘readiness to change pain behaviours’ and ‘perceived work ability’. The Multidimensional Pain Related Change Questionnaire 2 (MPRCQ2) was used to measure readiness to change various pain behaviours including exercise. The Work Ability Index (WAI) was used to assess ‘perceived work ability’. Seventy-five factory workers, aged over 18 (66 male, 9 female) were recruited using convenience sampling between September-November 2019. Correlation and multiple regression were used for statistical analysis.

RESULTS: Mean WAI, MPRCQ2 and MPRCQ2 exercise component were 41.89 (SD 5.28), 4.26 (SD 1.01) and 4.40 (SD 1.69). MPRCQ2 and MPRCQ2 exercise component were not significant predictors of WAI in factory workers (F (2, 72) = 2.17, p > 0.001). There was no significant relationship between MPRCQ2 and WAI (rs = .09, p > .05). However, there was a significant positive relationship between MPRCQ2 exercise component and WAI (rs = .23, p < .05).

CONCLUSIONS: This study suggests that readiness to change pain-related exercise participation has a positive association with ‘perceived work ability’. Further research should explore the causal relationship and consider strength training as a specific type of exercise.

PMID:34488707 | DOI:10.1186/s12891-021-04642-6

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Antibody seroprevalence and rate of asymptomatic infections with SARS-CoV-2 in Austrian hospital personnel

BMC Infect Dis. 2021 Sep 6;21(1):915. doi: 10.1186/s12879-021-06586-7.

ABSTRACT

BACKGROUND: The aims of this study are to determine (i) SARS-CoV-2 antibody positive employees in Austrian trauma hospitals and rehabilitation facilities, (ii) number of active virus carriers (symptomatic and asymptomatic) during the study, (iii) antibody decline in seropositive subjects over a period of around 6 months, (iv) the usefulness of rapid antibody tests for outpatient screening.

METHOD: A total of 3301 employees in 11 Austrian trauma hospitals and rehabilitation facilities of the Austrian Social Insurance for Occupational Risks (AUVA) participated in this open uncontrolled prospective cohort study. Rapid lateral flow tests, detecting a combination of IgM and IgM against SARS-CoV-2), two different types of CLIA (Diasorin, Roche), RT-PCR tests and serum neutralization tests (SNTs) were performed. The tests were conducted twice, with an interval of 42.4 ± 7.7 (Min = 30, Max = 64) days. Positive participants were re-tested with CLIA/SNT at a third time point after 188.0 ± 12.8 days.

RESULTS: Only 27 out of 3301 participants (0.82%) had a positive antibody test at any time point during the study confirmed via neutralization test. Among positively tested participants in either test, 50.4% did not report any symptoms consistent with common manifestations of COVID-19 during the study period or within the preceding 6 weeks. In the group who tested positive during or prior to study inclusion the most common symptoms of an acute viral illness were rhinitis (21.9%), and loss of taste and olfactory sense (21.9%). Based on the neutralization test as the true condition, the rapid antibody test performed better on serum than whole blood as 84.6% instead of 65.4% could be detected correctly. Concerning both CLIA tests overall the Roche test detected 24 (sensitivity = 88.9%) and the Diasorin test 22 positive participants (sensitivity = 81.5%). In participants with a positive SNT result, a significant drop in neutralizing antibody titre from 31.8 ± 22.9 (Md = 32.0) at T1 to 26.1 ± 17.6 (Md = 21.3) at T2 to 21.4 ± 13.4 (Md = 16.0) at T3 (χ2 = 23.848, df = 2, p < 0.001) was observed (χ2 = 23.848, df = 2, p < 0.001)-with an average time of 42.4 ± 7.7 days between T1 and T2 and 146.9 ± 13.8 days between T2 and T3.

CONCLUSIONS: During the study period (May 11th-August 3rd) only 0.82% were tested positive for antibodies in our study cohort. The antibody concentration decreases significantly over time with 14.8% (4 out of 27) losing detectable antibodies.

PMID:34488680 | DOI:10.1186/s12879-021-06586-7

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Optimizing experimental conditions of graphite furnace atomic absorption spectrometer using orthogonal design for determination of cobalt in urine

Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi. 2021 Aug 20;39(8):616-618. doi: 10.3760/cma.j.cn121094-20200413-00192.

ABSTRACT

Objective: To select and optimize the conditions of urine cobalt determination by graphite furnace atomic absorption spectroscopy and establish a method for urine cobalt determination. Methods: In April 2020, the matrix modifier and spectrum wavelength were selected by mathematical statistics method, the heating procedure of graphite furnace was optimized, the variance of orthogonal test results was analyzed, and the working curve was quantified by external standard method. Results: The results showed that the diammonium hydrogen phosphate was a matrix modifier with a wavelength of 240.7 nm, and the optimized graphite furnace heating procedure showed a good linear relationship at 5-80 μg/L. The correlation coefficient was 0.9991. The detection limit was 0.9 μg/L, the lowest detection concentration was 1.8 μg/L. The recovery was 94.0%-101.4%, and the precision was 2.6%-5.8%. Conclusion: The orthogonal design method can efficiently and scientifically optimize the optimal combination of the various factor levels of graphite furnace atomic absorption spectrometry. The determination method established based on this has high precision and good accuracy, and can be applied to the determination of cobalt in urine.

PMID:34488274 | DOI:10.3760/cma.j.cn121094-20200413-00192

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Research progress of the role of iodide transporters and its regulatory signal pathways in carcinomas

Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi. 2021 Aug 20;39(8):635-640. doi: 10.3760/cma.j.cn121094-20200401-00165.

ABSTRACT

Iodine transporters of basement membrane of thyroid follicular epithelial cells can participate and exchange the iodine ions across intracellular and extracellular. Among all of the iodine rich organs, iodine ions which only exist in colloidal of thyroid follicular epithelial cells can be functioned as the raw materials, which after oxidation, iodization and coupling, to synthesize thyroid hormone (TH) and to exert its biological functions. Therefore, the iodine transported function of iodide transporters plays a pivotal role for TH biosynthesis. Furthermore, functional studies show that the abnormal expression or dysfunction of iodide transporters might serves as tumor promoters or inhibitors via regulated the mTOR signal pathway, the MAPKs signal pathway, and the NF-κB signal pathway, together contributed to the regulation of cell proliferation, invasion, metastasis and apoptosis, in which plays the role of non iodide transported function. Therefore, the non iodine transported function of iodide transporters may plays the crucial role of tumor occurrence and progression of carcinoma. Based on this information, present study was devoted to systematic summarize the iodine transported function and non iodine transported function (may affects occurrence and progression of carcinoma) of the classical iodide transporters [sodium iodide symporter (NIS) and pendrin] and novel iodine transporters[ (cystic fibrosis transmembrane conductance regulator (CFTR) , sodium multivitamin transporter (SMVT) , and anoctamin 1 (ANO1) ], respectively, in order to provide a theoretical basis and literature review reference for underlying the mechanism of iodine transporters and its regulated signal pathways for the occurrence and progression of carcinomas.

PMID:34488281 | DOI:10.3760/cma.j.cn121094-20200401-00165

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Role of NF-κB p65 and related cytokines in rats with liver function injury induced by dibutyl phthalate and benzo (a) pyrene

Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi. 2021 Aug 20;39(8):561-567. doi: 10.3760/cma.j.cn121094-20200914-00529.

ABSTRACT

Objective: To explore the role of nuclear factor-κB (NF-κB) p65 and related cytokines in rats with liver function injury induced by dibutyl phthalate (DBP) and benzo (a) pyrene (BaP) , in order to provide support for enriching the mechanism of liver injury induced by DBP and BaP. Methods: In September to December of 2019, a total number of 160 specific pathogen free Sprague Dawley rats were numbered in order of sex and body weight, then using the statistical table of random numbers, they were randomly divided into eight groups and each group consists of twenty animals (10 male and 10 female rats) , including blank control group, vehicle control group (given corn oil) , DBP 50 mg/kg (DBP(50)) group, DBP 250 mg/kg (DBP(250)) group, BaP 1 mg/kg (BaP(1)) group, BaP 5 mg/kg (BaP(5)) group, DBP 50 mg/kg plus BaP 1 mg/kg (DBP(50)+BaP(1)) group and DBP 250 mg/kg plus BaP 5 mg/kg (DBP(250)+BaP(5)) group, then DBP and BaP were administered to rats as a homogenous mixture in corn oil by gavage. After exposure for 90 days, liver was separated to test the mRNA and protein expression levels of NF-κB p65 by Real-time fluorescence quantitative polymerase chain reaction and Western blotting. Then serum of rats was collected to detect the levels of CXCL-13, interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α) by Enzyme-Linked Immunosorbent Assay, and the levels of alanine aminotransferase (ALT) , aspartate aminotransferase (AST) , albumin (ALB) and total protein (TP) were detected by Reitman-Frankel assay. Results: The protein expression of NF-κB p65 in BaP(1) group was not statistically significant, but the mRNA and protein expression levels of NF-κB p65 in the liver tissues of rats in other exposure group were higher than those in the blank control group (P<0.05) , and the expression levels of NF-κB p65 increased more obvious in the DBP and BaP co-exposed groups than those in the low and high dose groups that single-exposed to DBP and BaP (P<0.05) . The serum levels of CXCL-13 and IL-6 of rats in other group were obviously higher than those of the blank control group except for the BaP(1) group, and the increase was more obvious in the high-dose group that co-exposed to DBP and BaP (P<0.05) . While the level of TNF-α in each exposure group was higher than those in the blank control group and the levels of TNF-α in the DBP and BaP co-exposed groups were strongly augmented compared to those in the low and high dose groups that single-exposed to DBP and BaP (P<0.05) . What’s more, compared with the blank control group, the level of ALT in each exposure group was increased significantly. Except for the BaP(1) group, the levels of AST in other exposed groups were increased (P<0.05) , and the levels of ALT and AST in the DBP and BaP co-exposed groups were significantly elevated in comparison to the low and high dose groups that single-exposed to DBP and BaP (P<0.05) . On the contrary, the level of ALB in each exposure group was significantly lower than that in the blank control group, especially decreased significantly in the DBP and BaP co-exposed group (P<0.05) . The level of TP decreased only in the high-dose group that single and co-exposed to DBP and BaP, and the decrease was more significant in the DBP and BaP co-exposed group (P<0.05) . When DBP exposed alone, Pearson correlation analysis showed that NF-κB p65 protein expression level was positively correlated with IL-6, TNF-α and ALT (r=0.762, 0.951, and 0.924, P<0.05) . After BaP exposed alone, the NF-κB p65 protein expression level was positively correlated with TNF-α and ALT (r=0.911 and 0.910, P<0.05) . When DBP and BaP exposed together, NF-κB p65 protein expression level was positively correlated with CXCL-13, IL-6, TNF-α, ALT and AST (r=0.711, 0.764, 0.955, 0.903 and 0.827, P<0.05) . In addition, Pearson correlation analysis showed a positive correlation between TNF-α and ALT (r=0.833 and 0.894, P<0.05) when DBP or BaP exposed alone. Furthermore, when DBP and BaP exposed together, CXCL-13, IL-6 and TNF-α were positively correlated with ALT (r= 0.871, 0.925 and 0.942, P<0.05) , and also positively correlated with AST (r=0.910, 0.892 and 0.890, P<0.05) . Conclusion: Single and co-exposed to DBP and BaP may regulate the abnormal secretion of related cytokines by upregulating the expression level of NF-κB p65 in rat liver tissue, thus leading to hepatocyte injury in rats, and the damage effect may be enhanced when DBP and BaP are exposed together.

PMID:34488261 | DOI:10.3760/cma.j.cn121094-20200914-00529

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Investigation of occupational noise exposure and hearing loss among automobile manufacturing workers

Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi. 2021 Aug 20;39(8):593-597. doi: 10.3760/cma.j.cn121094-20200527-00287.

ABSTRACT

Objective: To investigation the situation of occupational noise exposure and hearing loss among workers in automobile manufacturing enterprise during 2017-2019 in Wuhan. Methods: Workers in automobile manufacturing who underwent physical examination in Wuhan Hospital for the Prevention and Treatment of Occupational Diseases from 2017 to 2019 were included as subjects in the cross-sectional survey. Questionnaire survey, noise detection and pure tone threshold test were used. Excluding individuals with working time less than 3 years and information deficiency, 3 948 individuals were finally included in the study. Results: Among 3 948 workers, 128 workers had hearing loss and the rate of hearing loss was 3.24%, among which 101 workers had high-frequency hearing loss and 27 workers were diagnosed as occupational noise deafness. The prevalence of hearing loss among workers previously exposed to noise was significantly higher than that without prior exposure (12.10%, 0.96%, P<0.05) . The prevalence of hearing loss among workers with occupational noise exposure <80 dB (A) , 80~<85 dB (A) and ≥85 dB (A) was 1.83%, 2.69% and 5.09%, respectively. The prevalence of high frequency hearing loss was 1.60%, 2.05% and 3.71%, respectively. The prevalence of occupational noise deafness was 0.23%, 0.64% and 1.38%, respectively. The prevalence of hearing loss and high frequency hearing loss among workers exposed to different occupational noise was statistically significant (P<0.05) , while the prevalence of occupational noise deafness was not statistically significant (P>0.05) . There were statistically significant differences in the prevalence of hearing loss (2.88%, 4.45%) and occupational noise deafness (0.46%, 1.41%) between those who used protective equipment and those who did not (P<0.05) . Compared with workers exposed to occupational noise <80 dB (A) , workers exposed to occupational noise ≥85 dB (A) had A 3.16-fold increased risk of hearing loss (OR=3.16, 95%CI: 1.44~6.95, P<0.05) . Compared to workers using hearing protective equipment, the risk of hearing loss (OR=1.96, 95%CI: 1.25~3.06, P<0.05) and occupational noise deafness (OR=3.46, 95%CI: 1.51-7.96, P<0.05) significantly increased among those without using hearing protective equipment. Conclusion: The risk of hearing loss in automobile manufacturing workers is significantly associated with occupational noise exposure and the use of hearing protective equipment. Good hearing protection may reduce the risk of occupational noise-induced hearing loss and occupational noise deafness.

PMID:34488268 | DOI:10.3760/cma.j.cn121094-20200527-00287

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The intra-operative corneal pachymetry changes during accelerated corneal cross-linking in progressive keratoconus patients with thin corneas

Korean J Ophthalmol. 2021 Sep 6. doi: 10.3341/kjo.2021.0111. Online ahead of print.

ABSTRACT

PURPOSE: To report the intra-operative corneal pachymetry changes during accelerated corneal cross-linking (A-CXL) in progressive keratoconus patients with thin corneas.

METHODS: Thirty-six eyes (mean age: 22.26 ± 4.02 years) with progressive keratoconic thin corneas (< 400 µm without epithelium) who underwent A- CXL with ultraviolet A (9 mW/cm2) using isotonic RF-HPMC (riboflavin5-phosphate 0.1% with 1.1% hydroxypropyl methycellulose/Mediocross M®) were included in this retrospective study. Intra-operative corneal pachymetric changes were noted before the procedure, after removal of epithelium, after RF-HPMC instillation, before and after UV irradiation. The mean of corneal pachymetric values were compared statistically.

RESULTS: The mean corneal pachymetry reduced from 415.72±29.66 µm to 369.50±23.45 µm after removal of the epithelium (p<0.05). After the application of RF-HPMC solution the mean TCP increased to 412.89±26.94 µm. Statistically significant increase was observed in TCP after saturation with RF-HPMC (p=0.001). The mean corneal pachymetry was before and after UV-A irradiation respectively 419.86±10.41 µm, 417.47±8.25 µm (p>0.05).

CONCLUSION: Isotonic RF-HPMC lead to a significant increase in intra-operative mean TCP. RF-HPMC seems to be a favorable riboflavin option in keratoconus patients with thin corneas.

PMID:34488256 | DOI:10.3341/kjo.2021.0111