Mccullochcummings5072
Objective To analyze the ventilatory and alveolar-capillary diffusion dysfunctions in case of obesity with or without an OSAS. Methods It is a cross-sectional study of 48 obese adults (23 OSAS and 25 controls). Anthropometric data (height, weight, and body mass index (BMI)) were collected. All adults responded to a medical questionnaire and underwent polysomnography or sleep polygraphy for apnea-hypopnea index (AHI) and percentage of desaturation measurements. The following lung function data were collected pulmonary flows and volumes, lung transfer factor for carbon monoxide (DLCO), and fraction of exhaled nitric oxide (FeNO). Results Obesity was confirmed for the two groups with a total sample mean value of BMI = 35.06 ± 4.68 kg/m2. A significant decrease in lung function was noted in patients with OSAS compared with controls. Indeed, when compared with the control group, the OSAS one had a severe restrictive ventilatory defect (total lung capacity 93 ± 14 vs. 79 ± 12%), an abnormal DLCO (112 ± 20 vs. 93 ± 22%), and higher bronchial inflammation (18.40 ± 9.20 vs. 31.30 ± 13.60 ppb) (p less then 0.05). Conclusion Obesity when associated with OSAS increases the severity of pulmonary function and alveolar-capillary diffusion alteration. This can be explained in part by the alveolar inflammation. Copyright © 2020 Sonia Rouatbi et al.Background The relationship between presurgical psychopathology and weight loss following bariatric surgery is complex; previous research has yielded mixed results. The current study investigates the relationship among presurgical mental health diagnoses, symptom severity, and weight loss outcomes in an Appalachian population, where obesity-related comorbidities are prominent. Methods A retrospective chart review was performed on bariatric surgery patients in an accredited Appalachian centered academic hospital in northern West Virginia between 2013 and 2015 (n = 347). Data extraction included basic demographics, anthropometrics (percent excess weight loss (%EWL)) at six-month, one-year, and two-year postoperative visits, and two validated psychological questionnaires (Beck Depression Inventory (BDI-II) and Beck Anxiety Inventory (BAI)) from patient's presurgical psychological evaluation. Results Average patient population was 92.5% Caucasian, 81.5% female, 45 ± 11.5 years old, and 84.1% who underwent laparosollow-up. Copyright © 2020 Makenzie L. Barr et al.Objective The effect of pulmonary vein isolation (PVI) on fibrinolytic and endothelial activation with currently applied periprocedural anticoagulation has not been explored. We measured markers of fibrinolysis and endothelium activation before and after PVI with the second-generation cryoballoon (Cryo), pulmonary vein ablation catheter (PVAC-Gold), and irrigated radiofrequency (IRF). PHTPP Methods Markers of fibrinolysis and endothelium activation in left atrial (LA) blood samples were measured in 31 patients before and after PVI (Cryo10, PVAC-Gold 7, IRF 14). Periprocedural anticoagulation included uninterrupted vitamin K antagonist and iv heparin (ACT≥300 sec) during LA dwelling. Results Levels of D-dimer (median; interquartile range, mgFEU/L) increased with all techniques (PVAC 0.34; 0.24-0.50 versus 0.70; 0.61-1.31; p=0.0313, Cryo 0.33; 0.28-0.49 versus 0.79; 0.65-0.93; p=0.0313, Cryo 0.33; 0.28-0.49 versus 0.79; 0.65-0.93; p=0.0313, Cryo 0.33; 0.28-0.49 versus 0.79; 0.65-0.93; PAP complex level (ng/ml) increaopyright © 2020 Orsolya Hajas et al.Purpose To report the ratio of repeat-to-initial keratoplasty among patients who had underwent therapeutic keratoplasty for microbial keratitis in Southern China and to investigate the characteristics and risk factors of repeat keratoplasty. Methods A retrospective and inclusive review of the clinical records of patients who had received therapeutic keratoplasty for microbial keratitis, at Zhongshan Ophthalmic Center during December 2012 to January 2018, was performed. Patients who suffered coexistent endophthalmitis or underwent keratoplasty combined with other surgeries were excluded. Data on clinical characteristics of all eligible patients were collected. Results A total of 447 patients were identified. Their mean age was 48.7 ± 15.5 years, and 290 (64.9%) were male. Out of the 447 patients, 18 (4.0%) received repeat keratoplasty. Their mean age was 45.9 ± 11.3 years, and 14 (77.8%) were male. The most common indication of repeat keratoplasty (12/18) was refractory infectious keratitis. Most of the patients (15/18, 83.3%) received the second keratoplasty within 12 months after the initial keratoplasty. Factors, including age, gender, initial causative organism, presence of initial corneal perforation, ocular comorbidities, and surgical procedures were not found statistically significantly different between patients who received and not received repeat keratoplasty. Conclusion The ratio of repeat-to-initial keratoplasty for therapeutic keratoplasty is low, compared to a failure rate of the initial grafts of over 50% reported in previous studies. The low ratio and the most common indication of repeat keratoplasty, refractory infectious keratitis, reflect caution for performing regrafts in such patients. Copyright © 2020 Jifeng Wan et al.Purpose To report the long-term visual and anatomic outcomes of intravitreal injections for macular edema (ME) secondary to retinal vein occlusion (RVO) in a real-life clinical setting. Design Retrospective interventional case series. Methods A total of 223 consecutive eyes with ME secondary to RVO, treated with the first three intravitreal Ranibizumab or dexamethasone injections between August 2008 and September 2018, were enrolled in the study. Subsequent retreatment was guided by best-corrected visual acuity (BCVA) and central macular thickness (CMT) measurements, aimed at achieving macular fluid regression and BCVA stability. BCVA and CMT were recorded at baseline and at subsequent annual time points. The mean number of injections administered each year and the incidence of adverse events were recorded. Results The mean BCVA and CMT at baseline were 0.79 logMar (SD 0.71) and 615.7 μm (SD 257.5), respectively. The mean follow-up (FU) period was 47.8 months (min 12-max 120). At 12 months, the mean BCVA and CMT had significantly improved to 0.