Clinic-based Retrospective Study Research Articles

Patterns of Pediatric and Adolescent Gynecologic Problems in China: A Hospital-Based Retrospective Study of 97,252 Patients

To describe the pattern and population characteristics of pediatric and adolescent gynecologic (PAG) problems in China DESIGN: A clinic-based retrospective study of gynecologic patients (aged 0-18 years) over a period of 13 years SETTING: Department of PAG in the Children's Hospital, Zhejiang University School of Medicine PARTICIPANT: The final analyses included 97,252 patients with gynecologic problems. Descriptive analysis was conducted to evaluate the pattern of PAG problems. Spectrum of PAG problems RESULTS AND CONCLUSIONS: The number of first-visit PAG patients increased from 4,582 to 11,876 from 2006 to 2018. Overall, genital inflammation was the most common presentation (57.0%), followed by precocious puberty (18.2%). The disease pattern varied across age groups; the most common problems were genital inflammation for age 0-6 years, genital inflammation and precocious puberty for age 7-9 years, and consultation, genital inflammation, and menstrual disorders for age 10-18 years. Overall, genital inflammation, precocious puberty, consultation, and menstrual disorders were common issues for pediatric and adolescent patients with gynecologic problems in China.

Age- and sex-related differences in the measures of anterior segment parameters in a myopic clinical sample using Pentacam Scheimpflug tomography.

To assess age-and sex-related differences of anterior segment parameters in a myopic clinical sample. This clinic-based retrospective study involved eligible subjects grouped into myopia (i.e., low-to-moderate) and high myopia. Demographics and anterior segment parameters measures were recorded and analyzed. Some 153 eligible eyes were analyzed-98 myopia and 55 high myopia-comprising 87 males and 66 females. The mean ages and ranges were 28.47years (SD = 9.59years), 8-50years, and 27.82years (SD = 9.69years), 10-51years, for the myopia and the high myopia groups, respectively. The means of the spherical equivalents were - 3.02 D (SD = 1.46 D, range: - 0.50 to - 5.85 D), for the myopia group and - 10.42 D (SD = 5.50 D, range: - 6.00 to - 21.86 D) for the high myopia group. No significant difference was found between degree of myopia and anterior segment measures. Males had larger anterior chamber volume (mean 175.71 ± 26.27, range: 124-225mm3); (P = 0.007) and deeper anterior chamber depth (3.73 ± 0.27, range: 3.06-4.41mm) (P = 0.017) than females in the myopia group. Females also had significantly steeper anterior corneal curvature, Km (ant.) but flatter posterior corneal curvature, Km (post.), (- 6.31 ± 0.25, range - 7.00 to - 5.90 D) in both the myopia group [Km (ant.): 44.06 D ± 1.33 D, range: 41.30-47.10; Km (post.): - 6.31 D ± 0.25 D, range: - 7.00 to - 5.90; P = 0.008, P = 0.002, respectively] and the high myopia group [Km (ant.): 43.79 D ± 0.33 D, range: 41.00-47.10; Km (post.): - 6.22 D ± 0.30 D, range: - 6.80 to - 5.60; P = 0.034, P = 0.049, respectively]. Age was not correlated with the anterior segment parameters in both degrees of myopia. Sex has significant influence on the corneal curvature, anterior chamber volume and anterior chamber depth regardless of the degree of myopia.

Clinical predictors of Alzheimer's disease progression.

Rates of disease progression differ among patients with Alzheimer's disease (AD), but prognostic predictions remain a challenge. We carried out a clinic-based retrospective study to investigate the clinical factors for AD progression. The 748 AD patients, who attended our hospital for >1 year and were given the Mini-Mental State Examination (MMSE) at least three times, were divided into three groups according to the annual change rate of MMSE score (G): Aggravater group (G < -2), Stabler group (-2 ≤ G ≤ 2) and Improver group (2 < G). We compared the three groups on cognitive, affective and activities of daily living functions, response to medication, clinical fluctuations, serum levels of metabolic factors, and neuroimaging data. We found no significant differences in age, sex, educational attainment or body mass index across the groups. The Aggravater group showed better baseline MMSE (P < 0.01) and Abe's behavioral and psychological symptoms of dementia (P < 0.01) scores than the Improver group, but its MMSE improvement after drug treatment was the worst among the three groups (P < 0.01 vs Stabler/Improver). Fluctuations in MMSE (P < 0.01), apathy scale (P < 0.05) and activities of daily living (P < 0.01) scores were smaller in the Improver group than in the Aggravater or Stabler groups. Serum docosahexaenoic acid levels tended to be lower (trend P < 0.05) and voxel-based specific regional analysis system for Alzheimer's disease Z-scores tended to be higher (trend P < 0.05) in the Improver group than in the Stabler or Aggravater groups. Initial responses to medication, fluctuations in cognitive, affective and activities of daily living functions, serum docosahexaenoic acid levels, and medial temporal atrophy are clinical factors related to AD prognosis. Geriatr Gerontol Int 2018; 18: 929-936.

Epidemiology of NMOSD in Catalonia: Influence of the new 2015 criteria in incidence and prevalence estimates

Background: Population-based studies on neuromyelitis optica spectrum disorders (NMOSD) are limited, and it is unclear whether the rates have changed with the implementation of the new 2015 criteria. Objectives: To estimate the incidence and prevalence of NMOSD in Catalonia (Spain), using both the 2006 and the 2015 criteria. Methods: In this clinic-based retrospective study, patients diagnosed with NMOSD between 2006 and 2015 were identified using multiple sources, including direct contact to all Catalan hospitals, identification of cases through the Catalan Health Surveillance System, and registry of antibodies to aquaporin-4 (AQP4-IgG) and myelin oligodendrocyte glycoprotein (MOG-IgG) in a reference laboratory. The incidence rate was calculated for the period 1 January 2006–1 January 2016 and prevalence for the date 1 January 2016. Results: We identified 74 patients (by the 2015 criteria). Most patients were Caucasian (81%), and female (76%) with a median age at disease onset of 42 years (range, 10–76 years). In total, 54 (73%) patients were positive for AQP4-IgG, 11 (15%) double-seronegative, and 9 (12%) MOG-IgG-positive. Rates of incidence and prevalence (0.63/1,000,000 person-years and 0.89/100,000, respectively) were 1.5-fold higher than those reported by the 2006 criteria. Lowest rates were seen in children and elder people and highest in women and middle-aged people (40–59 years). The female predominance was lost in incident AQP4-IgG-seronegative children and AQP4-IgG-positive elder people. MOG-IgG and double-seronegativity contributed similarly but did not influence the long-term outcome. Conclusion: The new criteria increase the estimates, but NMOSD remains as a rare disease. The differences in age- and sex-specific estimates highlight the importance of the serologic classification.

Ophthalmic manifestations of Paederus dermatitis

To report the pattern of ophthalmic manifestations associated with Paederus dermatitis (PD). Department of Ophthalmology, Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar, India. Clinic-based retrospective study. Medical charts of patients presenting to the eye clinic with clinical features consistent with the diagnosis of PD from May 1, 2014 to April 30, 2016 were retrospectively reviewed. Relevant demographic and clinical data of periocular and ocular findings were collected and analyzed. The patients with a history of chronic skin disorders or allergies were excluded from the study. A total of 56 patients were included in the study, of which 39 (69.6%) were males. The age range was 4-65years with a median of 27years. On presentation, common subjective symptoms were burning sensation in 49 (87.5%), itching in 37 (66.1%), watering in 25 (44.6%), foreign body sensation in 19 (33.9%), blurring of vision in 17 (30.4%), and photophobia in 12 (21.4%) patients. Visual acuity at presentation was 20/20 in 39 (69.6%) patients, between 20/30 and 20/80 in 9 (16.1%) patients, and less than 20/80 in 8 (14.3%) patients. Lid swelling, erythema, crusts, and vesicles were the common periocular findings; and conjunctival hyperemia, discharge, and corneal erosions were the common ocular findings. The current study shows that PD can cause significant ocular morbidity. Ophthalmologists, especially those who work in endemic areas, should be aware of this entity both in terms of management as well as for educating patients about the preventive measures.

Prevalence of corneal astigmatism before cataract surgery in Indian population.

The purpose of the study was to assess the prevalence of corneal astigmatism before cataract surgery in Indian population. The setting of this study was at the Sant Sarwan Dass Charitable Eye Hospital, Jalandhar, India. This is a clinic-based retrospective study. Charts of patients who underwent cataract surgery over a two-year period were retrospectively reviewed, and preoperative keratometric measurements were collected and analyzed. The mean age of 2316 patients (2502 eyes) was 59.54±10.96years. The corneal astigmatism was less than 1.0 Dioptre (D) in 796 eyes (59.37%), 1.0-1.99D in 716 eyes (28.62%), 2.0-2.99D in 187 eyes (7.47%) and more than 3.0 D in 114 eyes (4.56%). The mean corneal astigmatism was 1.04±1.04 D and showed a gradual increase with age after the fourth decade. The astigmatism was with-the-rule in 709 (28.34%), against-the-rule in 1298 (51.88%), and oblique in 598 (23.9%) eyes. There was a shift in astigmatism from with-the-rule to against-the-rule with increase in age. Over 40% of the Indian patients undergoing cataract surgery have more than 1.0 D of corneal astigmatism and may benefit from the use of toric intraocular lenses. These data can be useful in planning to make this technology available for the patients.

Follow-up study on multifocal electroretinogram of acute and convalescence stage of Vogt-Koyanagi-Harada syndrome

Background Researches showed that multifocal electroretinogram （mfERG） is able to assess the retinal function in the eyes with acute Vogt-Koyanagi-Harada （VKH） syndrome. But the mfERG characteristics of convalescence stage of VKH are still below clear. Objective Present study was to compare and follow up the variation process of visual acuity and mfERG in acute and recovery stages of VKH syndrome. Methods This was a clinic-based retrospective study. Visual acuity, mfERG and fundus fluorescence angiography （FFA） were recorded from 35 eyes of 18 acute VKH cases. The period of follow-up in recovery stage lasted about 18 months with the repetitive recording results for 4 times. Results In this study,the visual acuity range in acute stage VKH was 0.01 to 1.0, and 91.4% （32/35 eyes） was below 0.6. Compared with normal control group, the visual acuity wassignificantly decreased （ P〈0. O1 ）. The response densities （amplitudes） of N,, PI waves of the first-order kernel were significantly lowed in all the 6 rings,and the implicit times of 1-4 rings of both waves were significantly prolonged in acute VKH eyes（P〈0.05 ）. The abnormalities of retinal function showed a regional difference at the posterior pole retina with the dominant change in the first ring,showing a cutting off 78% in the PI amplitude. The abnormal degree of mfERG was more serious as the the increase of retinal eccentricity. In 2 months of convalescence after glucocorticosteroids therapy, the range of visual acuity were 0. 1-1.2, and the amplitudes of N1 ,Pl of 1-2 rings were greatly elevated in comparison with acute on-set （P〈0.05）. However, there was still a remarkable difference in the amplitudes of from 1 through 6 rings,comparing with normal. The response density of Pl wave from whole recording region was only 44% of normal. Though the visual acuity was stable during the follow-up duration, a decreasing tendency in NI and PI amplitudes were seen. The implicit times of both wave shortened only in 1-3 rings in recovery stages of VKH （ P 〈 0. 05 ）. Conclusion VKH syndrome cause serious damage of posterior retinal function. Macular region is the site with greater retinal functional lesion and restore before and after medication. This hardly recovery of retinal function can last over one and half year, even satisfied visual acuity is stable after proper treatment. Key words: Vogt-Koyanagi-Harada syndrome; Visual acuity; Multifocal electroretinogram