Wolffhussain2338
86.3% (69/80, P = 0.815) and 91.9% (68/74) vs. 91.8% (67/73, P = 0.980) as first-line therapies; 83.3% (25/30) vs. 83.3% (25/30, P = 1) and 89.3% (25/28) vs. 88.9% (24/27, P = 1) as second-line therapies. Symptom improvement rates were 96.1% and 97.0% for IDFA and IDFB (P = 1). The adverse event rates were 10.9% in IDFA and 14.5% in IDFB groups (P = 0.418). Nausea occurred frequently in IDFB than IDFA (1.8% vs. 8.2%, P = 0.030). Smoking and sharing utensils significantly affected the efficacy.
Allicin-containing quadruple therapy might be regarded as a promising alternative to bismuth-containing quadruple therapy in H. pylori eradication.
Allicin-containing quadruple therapy might be regarded as a promising alternative to bismuth-containing quadruple therapy in H. pylori eradication.Cannabinoids, cannabis, and cannabis-based medicines (CBMs) are increasingly used to manage pain, with limited understanding of their efficacy and safety. We summarised efficacy and adverse events (AEs) of these types of drugs for treating pain using randomised controlled trials in people of any age, with any type of pain, and for any treatment duration. Primary outcomes were 30% and 50% reduction in pain intensity, and AEs. We assessed risk of bias of included studies, and the overall quality of evidence using GRADE. Studies of 7 days (risk difference 0.06, 95% confidence interval 0.01-0.12; 6 trials, 1484 patients, very low-quality evidence). Caerulein purchase No other beneficial effects were found for other types of cannabinoids, cannabis, or CBM in our primary analyses; 81% of subgroup analyses were negative. Cannabis, nabiximols, and delta-9-tetrahydrocannabinol had more AEs than control. Studies in this field have unclear or high risk of bias, and outcomes had GRADE rating of low- or very low-quality evidence. We have little confidence in the estimates of effect. The evidence neither supports nor refutes claims of efficacy and safety for cannabinoids, cannabis, or CBM in the management of pain.Cannabinoids, cannabis, and cannabis-based medicines (CBM) are increasingly used to manage pain, with limited understanding of their efficacy and safety. We assessed methodological quality, scope, and results of systematic reviews of randomised controlled trials of these treatments. Several search strategies sought self-declared systematic reviews. Methodological quality was assessed using both AMSTAR-2 and techniques important for bias reduction in pain studies. Of the 106 articles read, 57 were self-declared systematic reviews, most published since 2010. They included any type of cannabinoid, cannabis, or CBM, at any dose, however administered, in a broad range of pain conditions. No review examined the effects of a particular cannabinoid, at a particular dose, using a particular route of administration, for a particular pain condition, reporting a particular analgesic outcome. Confidence in the results in the systematic reviews using AMSTAR-2 definitions was critically low (41), low (8), moderate (6), or high (2). Few used criteria important for bias reduction in pain. Cochrane reviews typically provided higher confidence; all industry-conflicted reviews provided critically low confidence. Meta-analyses typically pooled widely disparate studies, and, where assessable, were subject to potential publication bias. Systematic reviews with positive or negative recommendation for use of cannabinoids, cannabis, or CBM in pain typically rated critically low or low (24/25 [96%] positive; 10/12 [83%] negative). Current reviews are mostly lacking in quality and cannot provide a basis for decision-making. A new high-quality systematic review of randomised controlled trials is needed to critically assess the clinical evidence for cannabinoids, cannabis, or CBM in pain.
To assess the association between glycaemic variability (GV) and type 1 retinopathy of prematurity (ROP) in infants with birth weights of less than 1251 grams.
A case-control study of infants with birth weights of less than 1251g who developed type 1 ROP (n=20) was conducted. Controls had a less severe ROP or no eye disease and were individually matched for gestational age and birth weight (n=40). Odds ratios of ROP were calculated based on multiple factors including oxygen exposure, respiratory support, incidence of hyperglycaemia, and GV. For glucose measurements, a continuous glucose monitoring system was used.
There were no significant differences in gender, antenatal steroid administration, severity of illness, and Apgar score. Univariate analyses suggest increased risk for the development of type 1 ROP based on incidence of intraventricular haemorrhage (IVH) grade 3 or 4 (p=0.048), duration of oxygen exposure (p=0.003), incidence of hyperglycaemia over 150 mg/dL (p=0.01), and GV according to significantly higher standard deviation (SD) (p=0.002), coefficient of variation (CV) (p=0.001), and mean amplitude of glucose excursion (MAGE) (p=0.008). Using a multiple regression model, increased risk of type 1 ROP was only found to be associated with duration of oxygen exposure and higher GV.
Our study demonstrates a relationship between GV and the development of severe ROP.
Our study demonstrates a relationship between GV and the development of severe ROP.
The purpose of the current study was to evaluate possible changes in anterior scleral thickness and structure as well as changes in the anterior segment in eyes receiving multiple IVT injections using ultrasound biomicroscopy (UBM) imaging.
Prospective interventional non-randomized cross-sectional study. Both eyes from thirty-three patients previously treated by at least 15 IVT injections in one eye only for retinal diseases. Intravitreal injections were performed by Ophthalmologists using an aseptic standardized procedure.UBM examination was performed in all eyes, and scleral thickness was measured at the pars plana in four quadrants. Anterior chamber depth, and ciliary body size were measured.
Scleral thickness in the study eye compared to the fellow eye. Secondary outcome measures were (1) anterior chamber depth, (2) ciliary body size, (3) scleral qualitative changes in the study eye compared to the fellow eye, and (4) risk factors for scleral thinning.
There was no statistically significant difference in scleral thickness between the study and fellow eyes when comparing each quadrant between the two eyes (p=0.86 superotemporal; p=0.76 superonasal; p=0.72 inferonasal; p=0.55 inferotemporal). Scleral thickness was neither related to the number of injections, nor to the duration of treatment in the treated eye.
Multiple repeated IVT injections do not impact scleral thickness in a clinical practice using different injection sites.
Multiple repeated IVT injections do not impact scleral thickness in a clinical practice using different injection sites.
To evaluate the earliest spectral-domain optical coherence tomography markers in fellow eyes of asymmetric Type-2 macular telangiectasia (MacTel).
A multicentered case-control study of spectral-domain optical coherence tomography images captured on Spectralis Heidelberg Engineering, Germany, comparing features of fellow eyes of patients with asymmetric clinical presentation of MacTel with 50 age-matched control subjects.
Of 649 patients, 28 (4.3%) with MacTel presented with asymmetric features. The mean age of the MacTel patients was 63.5 (12.4) years with female predilection (41). Mean best-corrected visual acuity of the unaffected eye was 0.2 logarithm of the minimum angle of resolution (20/32 Snellen equivalent). The mean central subfoveal thickness in the unaffected MacTel eyes was 194 (SD, 38) µm, and the temporal retinal thickness was 204 (SD, 43) µm. These parameters were significantly thinner than those of control subjects in whom mean central subfoveal thickness was 273 (SD, 26) µm (P = 0.001). Presence of hyperreflective outer retinal dots was found in 92.8% of the unaffected MacTel eyes. These hyperreflective dots were scattered, punctate, nonconfluent, and confined to the outer retinal layers of foveal and parafoveal region.
Although these cases presented with advanced presentation of MacTel features in only one eye, temporal retinal thinning and presence of hyperreflective outer retinal dots in the fellow eye can be considered as the earliest signs of MacTel.
Although these cases presented with advanced presentation of MacTel features in only one eye, temporal retinal thinning and presence of hyperreflective outer retinal dots in the fellow eye can be considered as the earliest signs of MacTel.
To describe the differential response of two distinct inflammatory signs occurring in eyes with punctate inner choroidopathy (PIC).
Retrospective, observational case series utilizing multimodal imaging (MMI).
Four eyes of 4 myopic female patients (mean age 35 years, range 31-42) presenting with retinal manifestations of PIC. All study eyes had 2 distinct signs of active disease 1) acute focal hyperreflective lesions splitting the retinal pigment epithelium/Bruch's membrane (RPE/BrM) complex on optical coherence tomography (OCT) which appeared hypoautofluorescent on fundus autofluorescence (FAF), and 2) more diffuse areas of outer retinal disruption (ORD) limited to the ellipsoid zone and interdigitation zone on OCT and corresponding to hyperautofluorescence on FAF. All patients were treated with oral prednisone and demonstrated prompt regression of the RPE/BrM complex lesions with a concurrent, paradoxical centrifugal expansion of ORD. The ORD eventually resolved in all eyes (mean time 6 weeks, range 4-10 weeks).
In patients with PIC, two distinct inflammatory signs observed with MMI display a differential response to systemic corticosteroids. Whereas focal inflammatory lesions splitting the RPE/BrM complex appear to respond rapidly, the more diffuse, transient ORD shows little response. This difference in treatment response may reflect different immunological phenomena with independent natural history.
In patients with PIC, two distinct inflammatory signs observed with MMI display a differential response to systemic corticosteroids. Whereas focal inflammatory lesions splitting the RPE/BrM complex appear to respond rapidly, the more diffuse, transient ORD shows little response. This difference in treatment response may reflect different immunological phenomena with independent natural history.
To investigate the correlation between postoperative metamorphopsia and macular deformation after macular hole (MH) surgery.
This study included 28 eyes of 28 patients who underwent vitrectomy and internal limiting membrane (ILM) removal for idiopathic MH. The retinal vasculatures were compared between preoperative and postoperative photographs, and postoperative deformation of the macula was assessed as deformation of the square grid. The displacement of each node was measured, and deformation of the grid was calculated as differences in the coordinates of the adjacent nodes. These parameters were analyzed to find correlation with metamorphopsia measured using the M-charts after 6 postoperative months.
The average deformations in the vertical and horizontal lines of the grid were 94.29 µm and 49.72 µm, respectively. Perifoveal deformation was significantly greater than parafoveal deformation (P = 0.001∼0.019). The multiple regression analysis demonstrated that the vertical M-score correlated with superior perifoveal deformation of the vertical line on the fovea (P = 0.