Orrdean1189

ring the combined ocular toxicity of BAK and solar radiation in the risk assessment of BAK-preserved ophthalmic solutions.To understand RS1 gene interaction networks in the X-linked retinoschisis (XLRS) mouse retina (Rs1-/y), we analyzed the transcriptome by RNA sequencing before and after in vivo expression of exogenous retinoschisin (RS1) gene delivered by AAV8. RS1 is a secreted cell adhesion protein that is critical for maintaining structural lamination and synaptic integrity of the neural retina. RS1 loss-of-function mutations cause XLRS disease in young boys and men, with splitting ("schisis") of retinal layers and synaptic dysfunction that cause progressive vision loss with age. Analysis of differential gene expression profiles and pathway enrichment analysis of Rs1-KO (Rs1-/y) retina identified cell surface receptor signaling and positive regulation of cell adhesion as potential RS1 gene interaction networks. Most importantly, it also showed massive dysregulation of immune response genes at early age, with characteristics of a microglia-driven proinflammatory state. Delivery of AAV8-RS1 primed the Rs1-KO retina toward stred before microglia activation and photoreceptor cell death. Clinical Trials. gov Identifier NTC 02317887.Background and purpose - The Netherlands Registry of Orthopedic Implants (LROI) uses audit and feedback (A&F) as the strategy to improve performance outcomes after total hip and knee arthroplasty (THA/TKA). BMS-536924 Effectiveness of A&F depends on awareness of below-average performance to initiate improvement activities. We explored the awareness of Dutch orthopedic surgeons regarding their performance on outcomes after THA/TKA and factors associated with this awareness.Methods - An anonymous questionnaire was sent to all 445 eligible Dutch orthopedic surgeons performing THA/TKA. To assess awareness on own surgeon-group performance, they were asked whether their 1-year THA/TKA revision rates over the past 2 years were below average (negative outlier), average (non-outlier), above average (positive outlier) in the funnel plot on the LROI dashboard, or did not know. Associations were determined with (1) dashboard login at least once a year (yes/no); (2) correct funnel-plot interpretation (yes/no) and; (3) recall of their 1-year THA/TKA revision rate (yes/no).Results - 44% of respondents started the questionnaire, 158 THA and 156 TKA surgeons. 55% of THA surgeons and 55% of TKA surgeons were aware of their performance. Surgeons aware of their performance more often logged in on the LROI dashboard, more often interpreted funnel plots correctly, and more often recalled their revision rate. 38% of THA and 26% of TKA surgeons scored "good" on all 3 outcomes.Interpretation - Only half of the orthopedic surgeons were aware of their performance status regarding outcomes after THA/TKA. This suggests that to increase awareness, orthopedic surgeons need to be actively motivated to look at the dashboard more frequently and educated on interpretation of funnel plots for audit and feedback to be effective.

There is a lack of consensus in the literature on how and when dermatologists should prescribe pain medications. As there is an ongoing opioid abuse epidemic driven by prescription opioids, it is important for all fields to investigate their own prescribing patterns.

We analyzed the National Ambulatory Medical Care Survey from 2007 to 2016 to assess the usage of systemic pain medications amongst dermatologists.

There were 16,777 total visits with dermatologists which represents 368 (95% confidence interval 363, 373) million estimated visits. Opioids were used at 1.4% (1.3, 1.6) of visits. As relative proportions, opioids were 35.6 (31.7, 39.6) of all systemic pain medication and non-opioids were 64.4% (53.8, 74.9). The use of opioid (

=.01 [odds ratio 1.08 (1.02, 1.14)]) and non-opioid (

<.001 [odds ratio 1.12 (1.07, 1.17)]) medications increased over the study interval.

Pain medications were used at a relatively small proportion of visits with dermatologists. Opioids were nearly half of all pain medications used. The use of opioids and non-opioids rose over the study interval, however, non-opioids rose at a faster rate. The faster rise of non-opioids may indicate that dermatologists are making an effort to use medications with less potential for abuse.

Pain medications were used at a relatively small proportion of visits with dermatologists. Opioids were nearly half of all pain medications used. The use of opioids and non-opioids rose over the study interval, however, non-opioids rose at a faster rate. The faster rise of non-opioids may indicate that dermatologists are making an effort to use medications with less potential for abuse.

This study aimed to investigate the demographics, treatment outcomes, and prognostic factors of salvage endoscopic nasopharyngectomy in recurrent nasopharyngeal carcinoma (NPC).

We conducted a retrospective analysis of 189 patients who underwent treatment for recurrent NPC from January 2006 to June 2018. The Kaplan-Meier method and log-rank test were used to assess survival rates. A Cox regression model was used for multivariate survival analyses.

We included 132 men and 57 women in the study, with a median age of 51 (range, 25-85) years. The overall 1-, 3-, and 5-year survival rates were 82.2%, 59.5%, and 43.6%, respectively, during a median follow-up of 24 (range, 2-111) months. In subjects over 50 years of age, diabetes, low body mass index (BMI < 20 kg/m

), low hemoglobin (<120 g/l) levels, increased neutrophil to lymphocyte ratio (NLR; ≥ 6), advanced T stage (rT3 and rT4), lymph node metastasis, and positive surgical margins were associated with a poor prognosis in terms of overall survival. Cox multivariate regression analyses showed significant differences in age, BMI, NLR, diabetes, T stage, N stage, and tumor necrosis.

In subjects over 50 years of age, diabetes, low BMI, increased NLR, advanced T stage, lymph node metastasis, and tumor necrosis were independent prognostic factors for overall survival.

In subjects over 50 years of age, diabetes, low BMI, increased NLR, advanced T stage, lymph node metastasis, and tumor necrosis were independent prognostic factors for overall survival.