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To evaluate efficacy and safety of trabeculectomy with mitomycin C (trab-MMC) for primary angle closure glaucoma (PACG) performed by ophthalmology trainees.

This was a six-year retrospective study of patients with primary trab-MMC with PACG performed by ophthalmology trainees in a tertiary urban eye center. Outcomes included intraocular pressure (IOP), number of medications, and complications.

There were 120 PACG eyes that underwent trab-MMC performed by trainees. The mean follow-up duration was 28.6 ± 20.8 months. At 24 months, postoperative IOP decreased from 32.1 ± 12.0 mm Hg to 14.8 ± 6.9 mm Hg (p<0.0001) with decrease in glaucoma medications [0 (0), 0-2; p<0.0001]. Half of surgeries, 64/120 (53.8%) utilized MMC-onlay and the other half, 55/120(46.2%) received MMC sub-tenon injection. Half 60/120 (50.4%) utilized releasable sutures. Majority 55/120 (46.2%) utilized conjunctival closure near the corneal limbus while 34/120 (28.6%) used a conjunctival skirt. Cumulative complete surgical success rates were 63.3%, 55.83%, and 42.5% at 6, 12, and 24 months, respectively. Most complications were minor, including high IOP (25.0%), bleb leaks (13.3%), and cystic blebs (15.0%). Bleb needling was the most common (24.2%) post-op surgical intervention.

Among supervised ophthalmology trainees in the Philippines, trab-MMC for PACG was effective in lowering IOP long term and decreasing glaucomamedications, and surgical success rates were generally comparable with trainee studies from first world nations. Complications were minor and not sight threatening.

Among supervised ophthalmology trainees in the Philippines, trab-MMC for PACG was effective in lowering IOP long term and decreasing glaucoma medications, and surgical success rates were generally comparable with trainee studies from first world nations. Complications were minor and not sight threatening.

The risk of sustaining a contra-lateral anterior cruciate ligament (C-ACL) injury after primary unilateral ACL injury is high. C-ACL injury often contributes to a further decline in function and quality of life, including failure to return to sport. There is, however, very limited knowledge about which risk factors that contribute to C-ACL injury.

To systematically review instrinsic risk factors for sustaining a C-ACL injury.

A systematic review with meta-analysis was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Four databases (MEDLINE, CINAHL, EMBASE, Sport Discus) were searched from inception to January 2020. Inclusion criteria were prospective or retrospective studies investigating any intrinsic risk factor for future C-ACL injury. Meta-analysis was performed and expressed as odds ratios (OR) if two or more articles assessed the same risk factor.

44 moderate-to-high quality studies were eventually included in this review, whereof 35 studiompared to other sports or timing of return to sport. No studies of neuromuscular function in relation to risk of C-ACL injury were eligible for meta-analysis according to our criteria.

This review provides evidence that demographic factors such as female sex, young age (≤ 18years) and family history of ACL injury, as well as early reconstruction and returning to a high activity level increase the risk of C-ACL injury. Given the lack of studies related to neuromuscular factors that may be modifiable by training, future studies are warranted that investigate the possible role of factors such as dynamic knee stability and alignment, muscle activation and/or strength and proprioception as well as sport-specific training prior to return-to-sport for C-ACL injuries.

CRD42020140129.

CRD42020140129.

SARS-COV-2 infection can develop into a multi-organ disease. Although pathophysiological mechanisms of COVID-19-associated myocardial injury have been studied throughout the pandemic course in 2019, its morphological characterisation is still unclear. With this study, we aimed to characterise echocardiographic patterns of ventricular function in patients with COVID-19-associated myocardial injury.

We prospectively assessed 32 patients hospitalised with COVID-19 and presence or absence of elevated high sensitive troponin T (hsTNT+ vs. hsTNT-) by comprehensive three-dimensional (3D) and strain echocardiography.

A minority (34.3%) of patients had normal ventricular function, whereas 65.7% had left and/or right ventricular dysfunction defined by impaired left and/or right ventricular ejection fraction and strain measurements. Concomitant biventricular dysfunction was common in hsTNT+ patients. We observed impaired left ventricular (LV) global longitudinal strain (GLS) in patients with myocardial injury (-13.9% vs. 5'-N-Ethylcarboxamidoadenosine supplier -17.7% for hsTNT+ vs. hsTNT-, p = 0.005) but preserved LV ejection fraction (52% vs. 59%, p = 0.074). Further, in these patients, right ventricular (RV) systolic function was impaired with lower RV ejection fraction (40% vs. 49%, p = 0.001) and reduced RV free wall strain (-18.5% vs. -28.3%, p = 0.003). Myocardial dysfunction partially recovered in hsTNT + patients after 52days of follow-up. In particular, LV-GLS and RV-FWS significantly improved from baseline to follow-up (LV-GLS -13.9% to -16.5%, p = 0.013; RV-FWS -18.5% to -22.3%, p = 0.037).

In patients with COVID-19-associated myocardial injury, comprehensive 3D and strain echocardiography revealed LV dysfunction by GLS and RV dysfunction, which partially resolved at 2-month follow-up.

COVID-19 Registry of the LMU University Hospital Munich (CORKUM), WHO trial ID DRKS00021225.

COVID-19 Registry of the LMU University Hospital Munich (CORKUM), WHO trial ID DRKS00021225.The purpose of this study was to identify distinct profiles of persons beginning alcohol addiction therapy with similar baseline configurations of spiritual coping, forgiveness, and gratitude. The associations between latent profile membership and the completion of therapy were also examined. The sample was composed of 358 alcohol-dependent persons receiving an outpatient treatment program. The Spiritual Coping Questionnaire, the Forgiveness Scale, and the Gratitude Questionnaire were used to assess the baseline levels of spirituality-related variables. Using latent profile analysis, five profiles were identified (1) both moderately positive and negative dimensions of spirituality (33.2%), (2) moderately positive dimensions of spirituality (21.0%), (3) predominantly negative dimensions of spirituality (20.2%), (4) mixed dimensions of spirituality with the lowest positive religious coping (14.0%), and (5) highly positive dimensions of spirituality (11.6%). Notably, the latent profiles differed in terms of the treatment completion rates.

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