• Sherrill Winters opublikował 1 rok, 8 miesięcy temu

    se than younger patients based on validated GC scores. PATIENT SUMMARY The presented clinical-genomic data demonstrate that elderly patients with low-risk prostate cancer might harbor more aggressive disease than their younger counterparts. This suggests that standard well-accepted paradigm of elderly prostate cancer patients not being aggressively treated, based solely on their chronological age, might need to be reconsidered. INTRODUCTION Cigarette smoking remains more common among individuals with depression. This study investigates whether cigarette quit ratios and cigarette use prevalence have changed differentially by depression status during the past decade. METHODS National Survey on Drug Use and Health data (2005-2017) were analyzed in 2019. Respondents aged ≥12 years were included in analyses of smoking prevalence (n=728,691) and respondents aged ≥26 years were included in analyses of quit ratio (n=131,412). Time trends in smoking prevalence (current, daily, and nondaily) and quit ratio (former/lifetime smokers) were estimated, stratified by past-year depression. Adjusted analyses controlled for demographics. RESULTS Smoking prevalence was consistently higher among those with depression than those without depression. From 2005 to 2017, nondaily smoking did not significantly change among individuals with depression (9.25% to 9.40%; AOR=0.995, 95% CI=0.986, 1.005), whereas it decreased from 7.02% to 5.85% among those without depression (AOR=0.986, 95% CI=0.981, 0.990). By contrast, daily smoking declined among individuals with (25.21% to 15.11%; AOR=0.953, 95% CI=0.945, 0.962) and without depression (14.94% to 9.76%; AOR=0.970, 95% CI=0.967, 0.973). The quit ratio increased among individuals with (28.61% to 39.75%; AOR=1.036, 95% CI=1.021, 1.052) and without depression (47.65% to 53.09%; AOR=1.013, 95% CI=1.009, 1.017), yet quit ratios were consistently lower for those with depression than those without depression. CONCLUSIONS Quit ratios are increasing and smoking prevalence is decreasing overall, yet disparities by depression status remain significant. Disparities in quit ratio may be one contributing factor to the elevated prevalence of smoking among those with depression. Innovative tobacco control approaches for people with depression appear long overdue. INTRODUCTION Suicidality is higher for gender minorities than the general population, yet little is known about suicidality in disabled or older adult gender minorities. METHODS This study used 2009-2014 Medicare claims to identify people with gender identity-related diagnosis codes (disabled, n=6,678; older adult, n=2,018) and compared their prevalence of suicidality with a 5% random non-gender minority beneficiary sample (disabled, n=535,801; older adult, n=1,700,008). Correlates of suicidality were assessed (via chi-square) for each of the 4 participant groups separately, and then disparities within eligibility status (disabled or older adult) were assessed using logistic regression models, adjusting first for age and mental health chronic conditions and then additionally for Medicaid eligibility, race/ethnicity, or U.S. region (each separately). The primary hypotheses were that gender minority beneficiaries would have higher suicidality but that suicidality disparities would persist after adjusting for covariates. Data were analyzed between 2017 and 2019. RESULTS Gender minority beneficiaries had higher unadjusted suicidality than non-gender minority beneficiaries in the disabled cohort (18.5% vs 7.1%, p less then 0.001). Significant suicidality predictors in all 4 groups included the following age (except in older adult gender minorities), Medicaid eligibility, depression or behavioral health conditions, avoidable hospitalizations, and violence victimization. In age- and mental health-adjusted logistic regression models, gender minorities had higher odds of suicidality than non-gender minority beneficiaries (disabled, OR=1.95, p less then 0.0001; older adult, OR=2.10, p less then 0.0001). Disparities were not attenuated after adjusting for Medicaid eligibility, race/ethnicity, or region. CONCLUSIONS Heightened suicidality among identified gender minority Medicare beneficiaries highlights a pressing need to identify and reduce barriers to wellness in this population. CONTEXT This scoping review examines the literature as it relates to autonomous vehicles and impact on movement behavior (i.e., physical activity, sedentary behavior, and sleep) or mode choice (e.g., public transit), beliefs about movement behavior or mode choice, or impact on environments that may influence movement behavior or mode choice. EVIDENCE ACQUISITION A search was conducted in June 2018 and updated in August 2019 of numerous databases (e.g., SPORTDiscuss, PubMed, and Scopus) and hand searching using terms such as autonomous cars and walking. Documents were included if they were databased studies, published in English, and related to the research question. They were then coded by 6 reviewers for characteristics of the document, design, sample, autonomous vehicles, movement behavior, and findings. The coding and analysis were conducted between August 2018 and September 2019. EVIDENCE SYNTHESIS Of 1,262 possible studies, 192 remained after a title and abstract scan, and 70 were included after a full-article scan. Most of the studies were conducted in Europe (42%) or North America (40%), involved simulation modeling (50%) or cross-sectional (34%) designs, and were published mostly in transportation (83%) journals or reports. Of the 252 findings, 61% related to movement behavior or mode choice. Though the findings were equivocal in some cases, impacts included decreased demand for active transportation, increased demand for autonomous vehicles, increased sitting and sleeping, and reduced walking. CONCLUSIONS Though no experimental or longitudinal studies have been published to date, the available research suggests that autonomous vehicles will impact aspects of mode choice and the built environment of people residing in much of the developed world, resulting in reduced walking and more sitting. PURPOSE Analyze clinical features, management and outcomes of patients with sterile endophthalmitis associated with intravitreal antivascular endothelial growth factor. METHODS Observational retrospective case series of patients with sterile endophthalmitis following anti-VEGF intravitreal injections. Clinical data of patients treated with intravitreal anti-VEGFs during one year have been revised. Those who have presented an episode of sterile endophthalmitis are analyzed and their causality and management are studied. RESULTS Seven patients have had a sterile endophthalmitis onset within 4days after intravitreal injection (aflibercept n=5 and ranibizumab n=2). These patients have some active neovascular condition age related macular degeneration (n=4), myopic choroidal neovascularization (n=1) or macular edema diabetic macular edema (n=1), branch retinal vein occlusion (n=1). Shared signs and symptoms included painless vision loss, anterior chamber and vitreous cell and lack of hypopyon. In all patients, visual acuity returned to within one line of baseline acuity. CONCLUSION Differentiating cases of sterile from infectious endophthalmitis may be challenging. It is crucial to differentiate both entities as a good diagnosis determines the visual prognosis. We should be aware of minimal inflammation after repeated intravitreal injections in order to establish the adequate treatment. Phakic intraocular lenses (pIOL) are recommended when counselling refractive surgery candidates presenting with high ametropia or ocular surface and/or corneal conditions that contraindicate corneal refractive surgery. This review aims to present the state-of-the-art regarding pIOL models currently available in Europe, addressing their newer indications and recent design innovations. These include, in the case of posterior chamber pIOLs, the addition of a central hole to improve aqueous humour circulation, the availability of larger optical zones, and multifocal optics for the compensation of presbyopia. The review also highlights their good safety and efficacy results, as well as the role of patient education to ensure adequate outcomes in the medium-long term. The indications of pIOLs in special situations, as well as bi-lensectomy, a procedure that most pIOL patients may eventually require as they age and develop cataracts, are also addressed. L.U.The cases concern a corneal complication not previously described, to our knowledge, after the application of ultrasound-mediated circular cycloablation, in 2cases of primary open-angle glaucoma in patients diagnosed with rheumatoid arthritis. The lacrimal sac (LS) empties in the nasolacrimal duct to drain the tears in the inferior nasal meatus. Different studies indicated the role of the lacrimal pump in the lacrimal drainage. Although controversial, the lacrimal pump mechanism is an extrinsic one, either active, or passive. An intrinsic contractile potential of the LS was not documented previously. We thus aimed a retrospective immunohistochemical study to test the alpha-smooth muscle actin (α-SMA) and h-caldesmon expression in the LS wall. We used archived paraffin-embedded samples of LS from ten adult patients. The α-SMA + phenotype was detected in basal epithelial cells, in subepithelial ribbons of stromal cells, in vascular smooth muscle cells, as well as in pericytes. H-caldesmon was exclusively expressed in pericytes, vascular smooth muscle cells and myoepithelial cells of the subepithelial glands. The most striking feature we found in all samples was a consistent stromal network of α-SMA+/h-caldesmon- myofibroblasts. This finding supports an intrinsic scaffold useful for the lacrimal pump. BACKGROUD Osteoarthritis (OA) is a common disease caused by chondrocyte dysfunction. KLF10 is a member of the Sp1-like transcription factor family that is involved in regulating osteoblasts, but its expression and regulatory mechanism(s) in chondrocytes are unclear. In the present study, we aimed to investigate the regulatory role of KLF10 on the pathological process of OA. METHODS KLF10 expression in the cartilaginous tissue of patients with osteoarthritis (OA) was evaluated by immunohistochemistry (IHC). Next, we generated an OA mouse model, and the histological changes in cartilage tissue were verified using H&E staining, Safranin O-Fast Green staining, and IHC assays. KLF10 expression in the articular chondrocytes of OA mice was determined by qRT-PCR and Western blotting. To investigate the role of KLF10 in regulating cell proliferation and migration, a KLF10 overexpression plasmid was constructed and transfected into primary mouse chondrocytes. Subsequently, we used RNA sequencing (RNA-seq) to screen differentially expressed genes in chondrocytes with or without KLF10 overexpression. qRT-PCR was used for verification purposes. RESULTS We found that KLF10 was upregulated in the cartilaginous tissue of patients with OA as well as in cartilaginous tissue of the OA mouse model. KLF10 overexpression inhibited the proliferation and migration of chondrocytes. Furthermore, RNA sequencing results identified increased expression of Acvr1 and decreased expression of Inhbb in cells overexpressing KLF10. Changes in mRNA expression of Acvr1 and Inhbb were confirmed by qRT-PCR. CONCLUSIONS KLF10 inhibits chondrocyte proliferation and migration by regulating the expression of Acvr1 and Inhbb in both human and mouse OA. These data suggest that KLF10 may be a potential therapeutic target for the treatment of OA.

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