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To understand timing of complete polypoidal regression on indocyanine green angiography (ICGA) after aflibercept injections in polypoidal choroidal vasculopathy (PCV).

Multicenter prospective study PARTICIPANTS Adults with treatment-naïve PCV METHODS After IRB approval, participants were enrolled and followed for 1 year, Apr 1, 2016 to Dec 30, 2018 at two university-based centers in Thailand. PCV diagnosis was based on the EVEREST criteria. Eligible eyes received fixed-dosing aflibercept injections (3 monthly then every-8-week), or monthly if fluid persisted on OCT. Photodynamic therapy (PDT) was given when fluid persisted despite 6 consecutive injections. ICGA was performed at baseline then every 8 weeks. VFQ-25 was obtained at baseline, 6-months, and 1-year. Two retina specialists reviewed post-treatment ICGA, categorized into complete regression (complete disappearance of polypoidal lesions), partial regression (reduced in size or number), or no regression. Disagreements had open adjudications.

timin months after aflibercept injections. Most PCV eyes with complete polypoidal regression at one year already had complete regression within the first 6 months. These findings support consideration of aflibercept for PCV to achieve both anatomical and visual outcomes.

Complete polypoidal regression could occur as early as 2 months after aflibercept injections. Most PCV eyes with complete polypoidal regression at one year already had complete regression within the first 6 months. These findings support consideration of aflibercept for PCV to achieve both anatomical and visual outcomes.The mechanisms underlying ionoregulation in fishes have been studied for nearly a century, and reductionist methods have been applied at all levels of biological organization in this field of research. The complex nature of ionoregulatory systems in fishes makes them ideally suited to reductionist methods and our collective understanding has been dramatically shaped by their use. This review provides an overview of the broad suite of techniques used to elucidate ionoregulatory mechanisms in fishes, from the whole-animal level down to the gene, discussing some of the advantages and disadvantages of these methods. We provide a roadmap for understanding and appreciating the work that has formed the current models of organismal, endocrine, cellular, molecular, and genetic regulation of ion balance in fishes and highlight the contribution that reductionist techniques have made to some of the fundamental leaps forward in the field throughout its history.Protocol-mandated, outcome-driven treatment adaptations are common in many types of clinical trials, and a prominent feature of so-called treat-to-target trials. Successive treatment escalation (dosage increase or addition of a drug) if disease activity targets are not reached is a typical design element in these studies. Focusing on the first treatment escalation step, here we address ways of estimating the effect of this outcome-based intervention as well some issues pertaining to the design of such treatment changes in randomized trials. Estimating escalation effects requires to disentangle them from concurrent effects, including persisting effects of the randomized treatment and regression to the mean. A regression-based method and a likelihood ratio test were adapted and assessed in simulations and in data from a recent treat-to-target study in rheumatoid arthritis. In simulations, the procedures were satisfactory in terms of bias and sensitivity with some advantage for the likelihood ratio test. They were able to identify evidence for the escalation effect in the examined study. In summary, both analysis methods are useful, but are sensitive to key assumptions and rely on compliance to the protocol as well as frequent and complete assessments. Furthermore, we examined different treatment escalation designs, including escalation at multiple time points (early escalation). If a longitudinal model for the disease activity is available, we describe how early escalation strategies can decrease the overall disease burden. We provide recommendations for the design of treatment escalation procedures in typical settings.

Diabetes is a known risk factor for mortality in Coronavirus disease 2019 (COVID-19) patients. Our objective was to identify prevalence of hyperglycaemia in COVID-19 patients with and without prior diabetes and quantify its association with COVID-19 disease course.

This observational cohort study included all consecutive COVID-19 patients admitted to John H Stroger Jr. Hospital, Chicago, IL from March 15, 2020 to May 3, 2020 and followed till May 15, 2020. The primary outcome was hospital mortality, and the studied predictor was hyperglycaemia [any blood glucose ≥7.78 mmol/L (140 mg/dL) during hospitalization].

Of the 403 COVID-19 patients studied, 51 (12.7%) died; 335 (83.1%) were discharged while 17 (4%) were still in hospital. L-glutamate supplier Hyperglycaemia occurred in 228 (56.6%) patients; 83 of these hyperglycaemic patients (36.4%) had no prior history of diabetes. Compared to the reference group no-diabetes/no-hyperglycaemia patients the no-diabetes/hyperglycaemia patients showed higher mortality [1.8% versus 20.5%, adjusted odds ratio 21.94 (95% confidence interval 4.04-119.0), P < 0.001]; improved prediction of death (P = 0.01) and faster progression to death (P < 0.01). Hyperglycaemia within the first 24 and 48 h was also significantly associated with mortality (odds ratio 2.15 and 3.31, respectively).

Hyperglycaemia without prior diabetes was common (20.6% of hospitalized COVID-19 patients) and was associated with an increased risk of and faster progression to death. Development of hyperglycaemia in COVID-19 patients who do not have diabetes is an early indicator of progressive disease.

Hyperglycaemia without prior diabetes was common (20.6% of hospitalized COVID-19 patients) and was associated with an increased risk of and faster progression to death. Development of hyperglycaemia in COVID-19 patients who do not have diabetes is an early indicator of progressive disease.