Brownesherman4920

To characterize the clinical features of idiopathic intracranial hypertension (IIH) in patients >50 years of age compared to the typical IIH population and existing data for this older cohort.

Retrospective, clinical cohort study.

Medical records of 65 patients >50 years of age at first diagnosis of IIH were reviewed based on the Modified Dandy Criteria from 4 academic centers. Each center provided randomly selected controls from IIH patients <50 years of age for each study patient at their location. Data recorded included patient demographics, presenting symptoms, medications, coexisting medical conditions, cerebrospinal fluid (CSF) opening pressure, treatments, and neuro-ophthalmic data from initial and final visits.

Compared to controls, the older cohort showed the following characteristics fewer females (n= 51 [78.5%] vs. controls n= 60 [92.3%]; P= .045), fewer headaches (n= 33 [50.8%] vs. controls 52 [80.0%]; P= .001), more frequent incidental discoveries of papilledema (n= 19 [29.2%] vs. controls 7 [10.8%]; P= .015), and lower CSF opening pressure [median 33cm H

O [range 21-58cm H

O] vs. the median for controls 34cm H

O [range 24-67cm H

O; P= .029).

Patients with IIH diagnosed at >50 years of age were less often female and had lower CSF opening pressure, fewer headaches, a higher chance of incidentally identified papilledema, and body mass index similar to that of younger IIH patients. Older IIH onset was not associated with worse visual outcome.

50 years of age were less often female and had lower CSF opening pressure, fewer headaches, a higher chance of incidentally identified papilledema, and body mass index similar to that of younger IIH patients. Older IIH onset was not associated with worse visual outcome.

To compare the double-Maddox rod test with other methods of measuring cyclodeviation DESIGN Retrospective cohort study.

We retrospectively identified 153 adults in a clinical practice with cyclodeviation assessed using double-Maddox rods, of whom 105 were also assessed using fusible synoptophore targets, 73 using nonfusible synoptophore targets, 118 using single-Maddox rod, and 43 using fundus photography. Relationships between double-Maddox rod and other tests were evaluated by calculating mean differences with 95% confidence intervals (CI), intraclass correlation coefficients (ICC), and Bland-Altman plots with linear regression.

Synoptophore cross-in-circle targets and the largest (of right or left) single-Maddox rod values were similar to double-Maddox values (mean differences-1.2° and 0.1°, respectively; ICC 0.79 and 0.82, respectively). Synoptophore house targets measured less excyclodeviation (mean difference-2.7°; ICC 0.71). Mean summed single-Maddox rod values were somewhat similar to double-Madrue cyclodeviation and relationships with symptoms.

Peritoneal recurrence of gastric cancer after curative surgical resection is common and portends a poor prognosis. Early studies suggest that extensive intraoperative peritoneal lavage (EIPL) might reduce the risk of peritoneal recurrence and improve survival. We aimed to evaluate the survival benefit of EIPL in patients with gastric cancer undergoing curative gastrectomy.

In this open-label, phase 3, multicentre randomised trial, patients aged 21-80 years with cT3 or cT4 gastric cancer undergoing curative resection were enrolled at 22 centres from South Korea, China, Japan, Malaysia, Hong Kong, and Singapore. Patients were randomly assigned to receive surgery and EIPL (EIPL group) or surgery alone (standard surgery group) via a web-based programme in random permuted blocks in varying block sizes of four and six, assuming equal allocation between treatment groups. Randomisation was stratified according to study site and the sequence was generated using a computer program and concealed until the interventi [95% CI 0·78-1·52; p=0·62). 3-year overall survival was 77·0% (95% CI 71·4-81·6) for the EIPL group and 76·7% (71·0-81·5) for the standard surgery group. 60 adverse events were reported in the EIPL group and 41 were reported in the standard surgery group. The most common adverse events included anastomotic leak (ten [3%] of 346 patients in the EIPL group vs six [2%] of 362 patients in the standard surgery group), bleeding (six [2%] vs six [2%]), intra-abdominal abscess (four [1%] vs five [1%]), superficial wound infection (seven [2%] vs one [<1%]), and abnormal liver function (six [2%] vs one [<1%]). Ten of the reported adverse events (eight in the EIPL group and two in the standard surgery group) resulted in death.

EIPL and surgery did not have a survival benefit compared with surgery alone and is not recommended for patients undergoing curative gastrectomy for gastric cancer.

National Medical Research Council, Singapore.

National Medical Research Council, Singapore.The COVID-19 zoonosis is bringing about a number of lessons to humanity. One is that of transforming our links with nature and, particularly, wildlife given the likely COVID-19 origin from illegal wildlife trading. Similar to vector borne diseases (VBD, diseases transmitted by vectors), the COVID-19 pandemic follows related patterns (e.g. no effective or available vaccines, difficult to diagnose, highly localized infection geographical foci, non-human reservoirs) for which we urgently need preventive measures. Towards this aim, governments worldwide must strive to prevent further devastation of natural environments that serve as buffer areas to humans against zoonotic agents (among other health risks), protecting biodiversity and its concomitant causes (e.g. global change), and banning use of wildlife of illegal origin. We herein state that some VBD prevention strategies could also be applied to zoonotic disease prevention, including COVID-19 or any type likely to be related to environmental conditions. The occurrence of future pandemic occurrence will depend on whether governments embrace these aims now.Increasing evidence exisits for the role that shellfish play in the epidemiology of Toxoplasma gondii in marine environment. However, limited information is available on the level of T. gondii infection in wild marine snails, which can play a role in the transmission of T. selleck chemicals gondii to other marine organisms and humans. In this study, the prevalence of T. gondii DNA in wild marine snails collected from three coastal cities in China was determined. Between January 2018 and November 2019, 1,206 wild marine snails were randomly collected and examined for the presence of T. gondii DNA using a nested polymerase chain reaction (PCR) targeting T. gondii B1 gene. The amplified products were genotyped using multilocus PCR-restriction fragment length polymorphism analysis. We also examined whether species of snail, sampling region, sampling season, surface runoff near samplic site, residential water discharge near samplic site, and proximity to livestock farms are associated with the occurrence of T. gondii DNA in marine snails.