Difference In Gender Distribution Research Articles

MP54-09 TRENDS IN THE INFLUENCE OF GENDER, RACE, AND ETHNICITY ON THE PREVALENCE OF KIDNEY STONES: A MULTI-INSTITUTIONAL AND CLAIMS ANALYSIS

You have accessJournal of UrologyStone Disease: Epidemiology & Evaluation II (MP54)1 Sep 2021MP54-09 TRENDS IN THE INFLUENCE OF GENDER, RACE, AND ETHNICITY ON THE PREVALENCE OF KIDNEY STONES: A MULTI-INSTITUTIONAL AND CLAIMS ANALYSIS Joseph Crivelli, Naim Maalouf, Phyllis Yan, Amy Hughes, Ryan Hsi, Noah Canvasser, Naveen Kachroo, David Leavitt, Kyle Wood, Gabriela Oates, John Hollingsworth, and Dean Assimos Joseph CrivelliJoseph Crivelli More articles by this author , Naim MaaloufNaim Maalouf More articles by this author , Phyllis YanPhyllis Yan More articles by this author , Amy HughesAmy Hughes More articles by this author , Ryan HsiRyan Hsi More articles by this author , Noah CanvasserNoah Canvasser More articles by this author , Naveen KachrooNaveen Kachroo More articles by this author , David LeavittDavid Leavitt More articles by this author , Kyle WoodKyle Wood More articles by this author , Gabriela OatesGabriela Oates More articles by this author , John HollingsworthJohn Hollingsworth More articles by this author , and Dean AssimosDean Assimos More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002084.09AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Significant increases in kidney stone prevalence have been reported for Black and Hispanic individuals in the US, but the gender-specific contribution to this trend is unclear. We evaluated the distribution of prevalent stone disease by gender, race, and ethnicity in contemporary cohorts. METHODS: We identified patients with a kidney stone diagnosis between 2010-2019 from three centers (University of Alabama at Birmingham [UAB, n=32,745], University of Texas Southwestern [UTSW, n=51,354], and Parkland Memorial Hospital [PMH, n=22,967]). We also utilized a claims database (Optum Clinformatics Data Mart) to identify working-age adults with a kidney stone diagnosis from 2010-2019 (n=68,594). Differences in male-to-female ratio between groups across all datasets were assessed with the Mann-Whitney U test. In the Optum cohort, temporal trends in male-to-female ratio were modeled with linear regression. RESULTS: In each cohort, most Black stone formers were female, most White stone formers were male, and most non-Hispanic stone formers were male; in two of the four cohorts, most Hispanic stone formers were female (Figure 1). We observed a significant difference in male-to-female ratio between Black vs. White stone formers, but not between Hispanic vs. non-Hispanic stone formers (Figure 1). In the Optum cohort, a significant linear decline in male-to-female ratio was observed in White and non-Hispanic stone formers, but not in Black and Hispanic stone formers (Figure 2). CONCLUSIONS: An analysis of multi-institutional and claims data showed that most Black stone formers were female, whereas most White stone formers were male, demonstrating a significant difference in gender distribution. Based on insurance claims, the male-to-female ratio decreased in all groups over time, but most consistently among White and non-Hispanic patients. Further evaluation of these findings and their association with comorbidities and socioeconomic factors is needed to understand disparities in stone disease. Source of Funding: National Institutes of Health 1R01DK121709-01A1 © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e952-e952 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Joseph Crivelli More articles by this author Naim Maalouf More articles by this author Phyllis Yan More articles by this author Amy Hughes More articles by this author Ryan Hsi More articles by this author Noah Canvasser More articles by this author Naveen Kachroo More articles by this author David Leavitt More articles by this author Kyle Wood More articles by this author Gabriela Oates More articles by this author John Hollingsworth More articles by this author Dean Assimos More articles by this author Expand All Advertisement Loading ...

Minimally invasive mitral valve repair for degenerative etiology: a comparative study

BackgroundThere is a paucity of data comparing the minimally invasive mitral valve repair (MiMVr) to the conventional approach in patients with degenerative disease. Our objective was to compare the outcomes of MiMVr to the traditional mitral valve repair through median sternotomy in patients with degenerative mitral valve disease. We conducted a retrospective study on 215 patients classified into two groups. Group 1 (n = 80) included those who had mitral valve repair through a right anterolateral video-assisted mini-thoracotomy, and group 2 (n = 135) was approached through a conventional median sternotomy. We compared the preoperative, operative, and postoperative data between groups. Both groups had echocardiographic follow-ups after 6 and 12 months.ResultsThere was no difference in gender distribution between both groups, and patients who had median sternotomy were significantly older (median 37 (Q1-Q3, 29-44) vs. 54 (48-60) years; P < 0.001). Cardiopulmonary bypass (134.5 (130-138.5) vs. 99 (97-104) min; P < 0.001) and ischemic times (99 (95-105.5) vs. 78 (75-81) min; P < 0.001) were significantly shorter in patients who had median sternotomy. Patients with MiMVr had significantly lower blood loss (370 (315-390) vs. 550 (490-600) ml; P < 0.001) and ICU stay (5 (4.5-6) vs. 7 (7-8) days; P < 0.001). There was no difference between both groups regarding re-exploration for bleeding, postoperative stroke, wound infection, renal failure, and mortality. As regards postoperative echocardiography follow-up at 6 and 12 months after the operation, there were no significant changes in the mean mitral valve gradient within each group; however, the mean gradient was lower in the MiMVr group (3 (3-3.5) vs. 4 (3-5) mmHg; P < 0.001). There was no significant difference between both groups regarding mitral regurgitation severity during 6 and 12 months follow-up.ConclusionMinimally invasive mitral valve repair in patients with degenerative pathology could be an alternative to conventional mitral valve surgery with comparable short-term and long-term outcomes.

Clinical features of gastric duplications: evidence from primary case reports and published data

BackgroundAlimentary tract duplications are rare congenital lesions, and only 2–8% of them are located in the stomach. Gastric duplications (GD) can lead to severe adverse events. Thus, surgical resection is required once the disease is diagnosed. The main purpose of this study is to describe the clinical features of gastric duplications and to provide evidence for the diagnosis and treatment.MethodsA retrospective review of eight gastric duplications at two medical centers Peking University People’s Hospital (PKUPH) and Shandong Provincial Hospital from 2010 to 2020 was conducted. Furthermore, the literature search was also conducted by retrieving data from PubMed, EMBASE and Cochrane Library databases from the date of the database inception to January 15, 2021.ResultsEight patients who were diagnosed as gastric duplications and 311 published records were included in this study. In all, 319 patients were identified: Vomiting and abdominal pain were the most frequent clinical presentations among juveniles and adults respectively. There was no difference in gender distribution (F: 53.16% vs M: 46.84%), and the cystic gastric duplications were the most common type of the gastric duplications (87.04%). More than half (53.30%) of included cases were located in the greater curvature of stomach.ConclusionsGastric duplications could present with a wide spectrum of symptomatology, which might be misdiagnosed easily as other diseases. For cystic gastric duplications, the optimal treatment was a complete surgical removal. But conservative treatment might be an alternative strategy for tubular gastric duplications.

Epidemiological statistics of congenital thumb duplication in the Chinese population

BackgroundThumb duplication is a very common congenital malformation. This study describes and compares the phenotypic manifestations of polydactyly between southwest and northeast China. However, previous studies had a limited sample size. Therefore, this study used a large sample.MethodsA total of 3549 well-characterized thumb duplication cases were divided into group A (southwest China) and group B (northeast China).ResultsIn group A and group B, the left-to-right ratio was 1:1.5 and 1:1.75, respectively, and the female-to-male ratio was 1:1.5 and 1:1.58, respectively.ConclusionsThere were no significant differences in gender distribution or the distribution of left and right polydactyly between the two groups, but the distribution of bilateral polydactyly was significantly different.

Prevalence of Musculoskeletal Disorders in Germany—A Comparison between Dentists and Dental Assistants

Background: Dental professionals suffer frequently from musculoskeletal disorders (MSD). Dentists and dental assistants work closely with each other in a mutually dependent relationship. To date, MSD in dental assistants have only been marginally investigated and compared to their occurrence in dentists. Therefore, the aim of this study was to compare the prevalence of MSD between dentists and dental assistants by considering occupational factors, physical activity and gender. Methods: This was a cross-sectional observational study. A Germany-wide survey, using a modified version of the Nordic Questionnaire and work-related questions, was applied. In total, 2548 participants took part, of which 389 dentists (240 females and 149 males) and 322 dental assistants (320 females and 2 males) were included in the analysis. Data were collected between May 2018 and May 2019. Differences between the dentists and dental assistants were determined by using the Chi2 test for nominal and the Wilcoxon–Mann–Whitney U test for both ordinal and non-normally distributed metric data. Results: A greater number of dental assistants reported complaints than dentists in all queried body regions. Significant differences in the most affected body regions (neck, shoulders, wrist/hands, upper back, lower back and feet/ankles) were found for the lifetime prevalence, annual prevalence and weekly prevalence. Data from the occupational factors, physical activity and gender analyses revealed significant differences between dentists and dental assistants. Conclusions: Dental assistants appear to be particularly affected by MSD when compared to dentists. This circumstance can be explained only to a limited extent by differences in gender distribution and occupational habits between the occupations.

CLEARANCE BASED ON STANDARDIZED RETURN TO SPORTS ASSESSMENT FOLLOWING ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION IN PEDIATRIC AND ADOLESCENT PATIENTS

Background:Return to sports (RTS) is often the primary concern of patients following anterior cruciate ligament reconstruction (ACLR). Unfortunately, RTS at the preinjury level is not commonplace in pediatric patients despite advances in rehabilitation and measures of recovery, and second injury rates are highest among the young adolescent population. RTS criteria have become more rigorous in recent years. The impact of these new RTS assessments (RTSA) is still unfolding, and their application in a mixed pediatric and adolescent population is unclear.Purpose:To assess whether adolescent patients who undergo standard ACLR pass a rigorous RTSA sooner than those undergoing pediatric ACLR.Methods:This study was a retrospective chart review of patients ages >5 and <18 with primary, unilateral ACL tear who underwent ACLR from January 2017 to December 2019. Subjects were identified using current procedural terminology codes from the hospital electronic medical record then grouped based on ACL reconstruction technique: Adolescent (transphyseal approach) and Pediatric (complete or partial physeal-sparing approach). All subjects underwent a rigorous and standardized RTSA used by the operating surgeons to guide clearance to RTS. The primary outcome measure was post-operative time to clearance for RTS, with secondary analyses controlling for sex, concomitant pathology at the time of ACLR, number of RTSAs prior to clearance, and physical therapy provider. Parametric and nonparametric statistical comparisons were respectively performed via unpaired Student t-tests and Mann-Whitney U tests (p<0.05).Results:Of 426 identified ACLR patients, 97 (84 Adolescent, 13 Pediatric) met the inclusion criteria for the final analysis (39 M, 58 F; Adolescent mean age 16.44 ± 1.7 years, Pediatric mean age 13.21 ± 1.4 years). There were no significant differences in gender distribution or concomitant pathology between the groups. Median post-operative time to clearance for RTS was 12.2 months in the Pediatric group (95% CI: 10.9-12.7) and 9.3 months in the Adolescent group (95% CI: 8.9-9.8) (p<0.001). This difference in time to RTS between groups remained statistically significant after adjusting for the secondary variables described above (all p≤0.002).Conclusions:When applying a rigorous and standardized RTSA to determine readiness for RTS, Pediatric subjects who underwent a partial or complete physeal-sparing technique took nearly 3 months longer to be cleared than Adolescent subjects who underwent a standard transphyseal approach. Notably, Adolescent subjects averaged more than 9 months of rehabilitation prior to RTS. These findings help inform patient expectations for a safe recovery period following ACLR.

Comparison of Self-Reported Empathy Levels among Dental Undergraduate Students in Northern India: A Questionnaire-Based Cross-Sectional Study.

Context:Empathy is one of the fundamentals of communication relevant within the practice of dentistry, and the research is limited in this field.Aims:The present study was conducted to assess the self-reported empathy levels among dental undergraduate students in Lucknow city of Northern India.Settings and Design:A descriptive cross-sectional study was conducted among three dental colleges of Lucknow city during July 2019–September 2019.Subjects and Methods:E-survey link was circulated among 790 students through e-mails. It has two parts. The first part included sociodemographic information, wherein the second part, the empathy level of students was assessed using the Jefferson Scale of Physician Empathy-Health Profession Students Version Questionnaire. The possible score range is 20–140: the higher the mean score, the higher the self-reported empathy level.Statistical Analysis Used:The data collected were analyzed using SPSS software version 24. Chi-square test was used to test gender distribution differences among different years. One-way analysis of variance including post hoc tests was used to compare the differences between study variables.Results:The mean ± standard deviation empathy score was 92.55 ± 11.85, 91.85 ± 12.23, 93.25 ± 11.24, 93.37 ± 12.31, and 88.34 ± 12.01 among the first-year, second-year, third-year, final-year, and interns' students, respectively, with a statistically significant difference.Conclusion:It can be concluded from the results of the present study that the mean empathy score was highest among final-year students which is suggestive of the impact of education in behavioral sciences.

Comparative Study of Cardiovascular Co-Morbidities between Ibrutinib and Non-Ibrutinib-Treated Chronic Lymphocytic Leukemia (CLL) Patients

OBJECTIVESCardiovascular disease (CV) is a common co-morbidity in CLL patients, especially as the median age at diagnosis is >70 years. Clinical trials that led to ibrutinib approval for CLL have suggested an incidence of atrial fibrillation (A-FIB) of 9-11% with a long-term follow-up. We aimed to study whether the risk of CV disease, including A-FIB, is associated with the use of ibrutinib in a large cohort of real world patients.METHODSNewly diagnosed CLL patients initiating any therapy between 01/01/2014-09/30/2016 were selected from the Inovalon Medical Outcomes Research for Effectiveness and Economics (MORE²) Registry payer claims and remittance dataset. CLL patients receiving ibrutinib (case) and those not being treated with ibrutinib (control) were matched on a 1:5 ratio using propensity matching based on age, gender, region and payer at the time of initiation of their first cycle of therapy. Incidence of CV morbidities was assessed from the date of their first cycle of therapy (or a proxy date for controls based on the distribution of ibrutinib start dates) to the date of the last administrative claim and reported as per-patient per-month (PPPM). Patients were required to be free of a CV event 3 years prior to the initiation of their first cycle of therapy to assure capture of incident CV events. We compared the incidence of atrial fibrillation (A-FIB), hypertension (HTN), peripheral vascular disease (PVD), coronary artery disease (CAD) and mycoradial infarction (MI). P-values were calculated using chi-square tests for categorical measures and t-tests for continuous measures.RESULTSAmong the 1,488 matched CLL patients, 248 were treated with ibrutinib and 1,240 were treated with alternate therapies. Median age for all patients was 67 years (median 65 in ibrutinib patients and 68 in the control group); No differences in gender distribution between both cohorts and similar percentages of patients in both cohorts were on Medicare (56-57%). Median follow-up for the entire cohort was 183 days. Ibrutinib-treated patients had a slightly shorter median follow up than controls (174 days vs 185 days). There was a significantly higher incidence of HTN (16.1% vs 5.6%, p <0.001) and A-FIB (6.5% vs 3.1% p=0.009) in the ibrutinib-treated versus non-ibrutinib treated patients. There was also a higher incidence of PVD and CAD in the ibrutinib population (4% vs 2% and 2% vs.1%, respectively; p= NS). The incidence of MI was higher in the non-ibrutinib population (2.3 vs 0.8, p=NS)CONCLUSIONSCLL patients treated with ibrutinib in the real world have higher incidence of HTN and A-FIB compared with CLL patients not treated with ibrutinib. These data confirm results of 3 randomized clinical trials demonstrating increased incidence of A-FIB and HTN. More importantly these data are the first to demonstrate an increase in vascular-related (PVD, CAD but not acute MI) events in ibrutinib treated patients (vs. controls). These findings support implementing screening and therapeutic strategies for ibrutinib-treated patients to diminish adverse events and minimize any potential serious sequelae from HTN and/or A-FIB. DisclosuresMato:AbbVie: Consultancy, Research Funding; Celgene: Consultancy, Membership on an entity's Board of Directors or advisory committees; Acerta: Research Funding; Pharmacyclics: Research Funding; Regeneron: Research Funding; DTRM: Research Funding; Portola: Research Funding; Gilead Sciences, Inc.: Membership on an entity's Board of Directors or advisory committees; TG Therapeutics: Membership on an entity's Board of Directors or advisory committees, Research Funding; Janssen: Consultancy; AstraZeneca: Consultancy; Kite: Consultancy.

Gender distribution in emergency medicine journals: editorial board memberships in top-ranked academic journals.

Despite an established gender gap in academic medicine, evidence on gender diversity in emergency medicine is scarce. In the present study, gender distribution of editorial boards and among editors-in-chief of 31 emergency medicine journals was investigated in 2020/2021 and compared to 2015 and 2010. Additionally, gender distribution in editorial boards of emergency medicine journals was compared to editorial boards in five different medical specialties. In this cross-sectional analysis, gender of editorial board members and editors-in-chief of journals ranked in the Clarivate Analytics 'Journal Citation Report' (JCR) of 2019 in the sections 'Emergency Medicine', 'Medicine General and Internal', 'Surgery', 'Obstetrics and Gynecology', 'Pediatrics' and 'Orthopedics' were analyzed. In the investigated 31 emergency medicine journals, three out of 35 editors-in-chief (9%) and 299 out of 1810 editorial board members (17%) were women in 2020/2021. In 2015 and 2010, two editors-in-chief were women (13% vs. 15%). In 2015, 19% of editorial board members were women and in 2010 it was 18%, respectively. There was no significant difference in gender distribution among editors-in-chief and editorial board members comparing 2020/2021 with 2015 and 2010 (P = 0.76 vs. P = 0.40, respectively). There was a lower percentage of women in editorial boards of emergency medicine journals compared to the top five JCR-ranked journals in the categories 'Medicine General and Internal', 'Surgery', 'Gynecology and Obstetrics' and 'Pediatrics'. The gender gap in editorial boards and among editors-in-chief of emergency medicine journals seems to be consistent for the last 10 years. Gender disparity appears to be substantial in academic emergency medicine: The percentage of women in emergency medicine editorial boards was lower compared to editorial boards of four other medical specialties.

Benchmarking of Neurosurgery Training in Pakistan.

Introduction:Neurosurgery is a challenging field of surgery. A neurosurgeon has to be trained with the finest skills, knowledge, and competencies necessary to provide high-quality patient care. Maintaining postgraduate training standards is a challenge in Pakistan due to low budget allocation to the health sector. This study aims to assess the difference in parameters among different institutes in different sectors and provinces offering neurosurgery training in Pakistan.Methods:A nationwide survey was conducted by the Neurosurgery Department at Liaquat National Hospital Karachi, from November 2019 to February 2020. Data were collected through a questionnaire from neurosurgery trainees from all over the country. The questionnaire was divided into the following sections: Sociodemographics and infrastructure of training site, clinical skills training and exposure, knowledge-based education, and workload. The data were kept confidential and institutional names were not inquired or disclosed.Results:The response rate was 85.3% (151/177), with more males (80%) than females. The total number of trainees was higher in government than private institutions (P < 0.005). The frequency (P = 0.030) and number of trainees (P < 0.005) inducted per cycle was more among government institutions. Participation in international conferences was higher among trainees in private sector (P = 0.006). The frequency of clinics was significantly higher in private institutions (P < 0.005), though the number of patients seen per clinic was lower than in government sector (P < 0.005). At a provincial level, there was a significant difference in gender distribution (P = 0.020), total number of trainees (P < 0.005), number of residents per induction (P < 0.005), frequency of mortality and morbidity meetings (P < 0.005), morning meetings (P < 0.005), number of calls per week (P < 0.005), number of workshops attended (P < 0.005), exposure to radiation (P = 0.003), frequency of outpatient departments (OPDs) attended per week (P = 0.002), and number of patients seen per OPD (P 0.02).Conclusion:This study reported variability in the quality of neurosurgery training programs within public and private sector with even greater differences between the four provinces of Pakistan. We recommend continuous assessments and re-accreditation of these training programs through subject experts and health-care educationists to improve the quality of training programs; hence the quality of service and patient care.

Visual quality after implantation of a rotational asymmetric refractive intraocular lens in patients with high myopia and cataract

Objective: To evaluate the visual quality after phacoemulsification and implantation of a rotational asymmetric refractive intraocular lens in patients with high myopia and cataract. Methods: A retrospective cohort study. Sixty-two patients (92 eyes) of the First Affiliated Hospital of Zhengzhou University from June 2017 to December 2019 were evaluated after phacoemulsification and implantation of a rotational asymmetric refractive intraocular lens (LS-313 MF30). According to the axial length, the participants were allocated to either a control group or a high myopia group. Among the 33 patients (46 eyes) in the control group, the axial length was shorter than 26 mm; among the 29 patients (46 eyes) in the high myopia group, the axial length was more than 26 mm. The high myopia group was further divided into two subgroups. The super high myopia subgroup included 12 patients (18 eyes), and the axial length was ≥30 mm; the high myopia subgroup consisted of 17 patients (28 eyes), and the axial length was<30 mm and ≥26 mm. Uncorrected distance visual acuity, uncorrected intermediate visual acuity and uncorrected near visual acuity were recorded after surgery. The follow-up time was more than 6 months. At the end of the follow-up, patients' contrast sensitivity (CS), reading acuity, reading speed and visual quality questionnaire results were assessed. The main statistical methods were two-way repeated measures analysis of variance, independent sample t-test, one-way analysis of variance and Kruskal-Wallis test. Results: There were no significant differences in gender distribution, age, or follow-up time between the control and high myopia groups, the control and high myopia subgroup, or the super high myopia subgroup (all P>0.05). At the end of the follow-up, the uncorrected distance, intermediate and near visual acuity of the super high myopia subgroup was 0.07±0.11, 0.34±0.08 and 0.20±0.09, respectively. The difference in postoperative visual acuity was not statistically significant (all P>0.05). The CS and CS with glare of the high myopia group (3 cpd: 1.48±0.18, 1.42±0.16; 6 cpd: 1.75±0.18, 1.76±0.15; 12 cpd: 1.44±0.24, 1.43±0.19; 18 cpd: 0.90±0.23, 0.85±0.20) were significantly different from the control group (3 cpd: 1.66±0.18, 1.62±0.16; 6 cpd: 1.88±0.14, 1.85±0.11; 12 cpd: 1.54±0.18, 1.53±0.14; 18 cpd: 1.06±0.18, 1.01±0.15) (P<0.05), except at 12 cpd (P=0.05). The CS and CS with glare of the super high myopia subgroup (3 cpd: 1.39±0.21, 1.31±0.13; 6 cpd: 1.66±0.16, 1.64±0.12; 12 cpd: 1.32±0.23, 1.31±0.18; 18 cpd: 0.75±0.16, 0.73±0.15) were worst (all P<0.05). A significant difference between the high myopia subgroup and the control group was only found at 3 cpd (1.53±0.13 vs. 1.66±0.18, 1.50±0.13 vs. 1.62±0.16; both P<0.05). The reading acuity and reading speed of the super high myopia subgroup were lower than the high myopia subgroup and the control group, while the differences were not statistically significant (all P>0.05). The questionnaire survey showed that there was no significant difference in the proportion of glare and halo between the two subgroups and the control group (both P>0.05). No patients reported dissatisfaction. The rate of glasses independents was 11/12 in the super high myopia subgroup, 15/17 in the high myopia subgroup and 31/33 in the control group, with no significant difference (P>0.05). Conclusions: The rotational asymmetric refractive intraocular lens is suitable for patients with high myopia and cataract, and has good far and near vision after operation. However, it could result in relatively low CS for super high myopia patients, so rigorous preoperative examination must be done. (Chin J Ophthalmol, 2021, 57: 358-365).

Analysis of clinicopathological features of primary diaphragm tumors: A single-center study.

Background and ObjectivesPrimary diaphragm tumors are rare. The aim of this study was to explore the clinicopathological features of primary diaphragm tumor patients who underwent surgical treatment in our center to improve the diagnosis and treatment of this disease.MethodsClinical data of patients with primary diaphragm tumor who underwent surgery in our hospital from 2004 to 2019 were reviewed and analyzed.ResultsA total of 18 patients were enrolled. The male:female ratio was 8:10, and the median age was 58 years old (35–74 years old). Most patients included in this study had no typical clinical symptoms. Nine tumor cases were distributed in the left and right diaphragms separately, whereas 11 cases were located at the diaphragm angle. The diaphragm of 12 patients was reconstructed by direct suture. All postoperative pathologies showed that the tumors were benign, and cysts were observed in most of the cases (5/18).ConclusionsThere are no difference in distribution of gender and distribution on both sides of the diaphragm. In addition, primary diaphragm tumor is common in middle‐age patients. Most cases occur in the diaphragm angle and are characterized by cyst lesions. Surgical resection is an effective treatment option for primary diaphragm tumor.

Retinal vessel density in primary open-angle glaucoma with a hemifield defect

Objective: To evaluate the retinal vessel density in eyes with primary open-angle glaucoma (POAG) with single-hemifield visual field (VF) defects and its relationship to retinal nerve fiber layer (RNFL) thickness and visual field indices. Methods: Cross-sectional study. Twenty-eight POAG patients with single-hemifield VF defects and 31 normal controls were recruited from October 2015 to October 2018 in the Eye, Ear, Nose and Throat Hospital of Fudan University. All subjects underwent complete ophthalmological examinations, including RNFL, retinal ganglion cell complex (GCC) thickness and visual field tests, and the general information was collected. The peripapillary radial peripapillary capillaries (RPC) and macular superifical retinal capillary plexus (SCP) were derived from optical coherence tomography angiography. The retinal vessel density, structural values, and VF values were compared among the corresponding hemifields of POAG and healthy eyes using the Rank Sum test. Results: There were 16 males and 12 females in POAG patients, with the age of (47±12) years; there were no significant differences in gender distribution, age, intraocular pressure, central corneal thickness, axial length and intraocular perfusion pressure between POAG patients and the normal controls (all P>0.05). Among POAG patients, there were 19 cases with upper and 9 cases with lower visual field defect. In the POAG eyes, the vascular density of peripapillary RPC and macular SCP were 45.86% (34.92%-52.78%) and 39.31% (32.55%-46.79%), respectively. In the normal eyes, the vascular density of peripapillary RPC and macular SCP were 56.90% (51.69%-60.84%) and 47.48% (37.95%-52.25%), respectively. The difference was statistically significant (Z=-6.56, -5.86; both P<0.01). The RNFL and GCC thicknesses in the POAG group were 84.4 (62.1-97.1), 76.4 (60.3-92.5) μ m, respectively, which were smaller than those in normal controls [110.6 (95.7-131.6), 98.1 (84.0-109.2) μm; Z=-6.57, -6.36; both P<0.01]. In the POAG eyes, the peripapillary RPC [44.12% (34.73%-53.20%) vs. 51.85% (38.64%-61.02%); Z=-4.62; P<0.01] and macular SCP [36.81% (29.73%-47.82%) vs. 41.78% (33.93%-49.22%); Z=-4.12; P<0.01] vessel densities were reduced in the abnormal hemisphere compared with the opposite hemisphere. Compared with the normal eyes, the normal hemisphere of the POAG eyes had lower peripapillary RPC and macular SCP vessel densities (Z=-5.08, -4.95; both P<0.01), a thinner RNFL and a thinner retinal GCC [93.0 (61.9-116.5) μm vs. 110.6 (95.7-131.6) μm, Z=-5.15; 86.3 (67.2-98.2) μm vs. 98.1 (84.0-109.2) μm, Z=-5.35; both P<0.01]. But the mean deviation and pattern standard deviation values of the VF were not significantly different between them (both P>0.05). Conclusions: The retinal vessel density reduce in eyes with POAG with single-hemifield VF defects. The normal hemisphere of POAG eyes have a reduced retinal microcirculation along with the thinning of the RNFL and GCC, suggesting that vascular dysfunction and structural changes preceded VF loss in POAG. (Chin J Ophthalmol, 2021, 57: 201-206).

Analysis on the Clinical Characteristics of 10 Cases of Asymptomatic SARS-CoV-2 Novel Coronavirus Infection

Objective: To analyze the clinical features of asymptomatic patients infected with the SARS-CoV-2 novel coronavirus. Methods: The clinical data of 10 asymptomatic cases and 12 symptomatic cases of COVID-19 diagnosed during February 2020 to April 2020 was collected and the clinical features of the two groups of patients were compared. Results: 10 cases of asymptomatic infection and 12 cases of symptomatic patients were tested positive for the novel coronavirus nucleic acid test. There was no significant difference in gender distribution between the two groups (P?0.05); the average age of patients in the asymptomatic group was lower than that of the symptomatic group ( P?0.05), the difference in clinical classification between the two groups was statistically significant (P?0.05); there was no statistically significant difference in the results of chest CT examination involving lung lobes between the two groups (P?0.05), and there was no statistically significant difference in mortality between the two groups (P&gt;0.05). Conclusion: The average age of asymptomatic novel coronavirus infections was lower than that of confirmed cases of COVID-19, mainly among young people. There was no significant difference in clinical classification, mortality and chest CT examination results between symptomatic and asymptomatic cases.

Patients with infective endocarditis and history of injection drug use in a Swedish referral hospital during 10\u2009years

BackgroundPatients with injection drug use (IDU) have increased risk of developing infective endocarditis (IE). Previous studies have reported recurrent IE, increased duration of hospital stay, poor adherence and compliance as well as higher mortality and worse outcomes after surgery in the IDU-IE patient group. Further studies are needed to provide a basis for optimized care and prevention of readmissions in this population. This study aims to describe the clinical characteristics and outcomes among patients with IDU-IE.MethodsData of adults with IDU-IE and non-IDU-IE, treated between 2008 and 2017 at the Karolinska University Hospital in Stockholm were obtained from the Swedish National Registry of Infective Endocarditis. Clinical characteristics, microbiological results, treatment durations, results from echocardiography and in-hospital mortality were compared between the groups.ResultsOf the total 522 patients, 165 (32%) had IDU-IE. Patients with IDU-IE were younger than the patients with non-IDU-IE (mean age IDU-IE: 41.6 years, SD 11.9 years; non-IDU-IE: 64.3 years, SD 16.4 years; P < 0.01). No difference in distribution of gender was observed, 33% were females in both the IDU-IE and the non-IDU-IE group. History of previous IE (IDU-IE: n = 49, 30%; non-IDU-IE: n = 34, 10%; P < 0.01) and vascular phenomena (IDU-IE: n = 101, 61%; non-IDU-IE: n = 120, 34%; P < 0.01) were more common among patients with IDU-IE while prosthetic heart valves (IDU-IE: n = 12, 7%; non-IDU-IE: n = 83, 23%; P < 0.01) and known valvular disease (IDU-IE: n = 3, 2%; non-IDU-IE: n = 78, 22%; P < 0.01) were more common among patients with non-IDU-IE. Aetiology of Staphylococcus aureus (IDU-IE: n = 123, 75%; non-IDU-IE: n = 118, 33%; P < 0.01) as well as tricuspid (IDU-IE: n = 91, 55%; non-IDU-IE: n = 23, 6%; P < 0.01) or pulmonary valve vegetations (IDU-IE: n = 7, 4%; non-IDU-IE: n = 2, 1%; P < 0.01) were more common in the IDU-IE group. The overall incidence of IDU-IE decreased during the study period, while the incidence of definite IE increased (P < 0.01).ConclusionsThis study presents that patients with IDU-IE were younger, less frequently treated with surgery and had higher prevalence of vascular phenomena and history of previous IE, aspects that are important for improved management of this population.

Stress and Basic Need Satisfaction of First-Year Healthcare Professional Students.

Transitioning to graduate-level professional school can trigger stressful feelings for many students. The purpose of this study was to determine the stress levels and unmet basic needs of first-year graduate healthcare students during their transition from undergraduate institutions to professional school. The study was conducted at Midwestern University, a private, graduate-level, professional health sciences university located in the Midwest, during the 2018-2019 academic year. The survey was administered to all first-year students within the colleges of dentistry, medicine, optometry, and pharmacy. The Perceived Stress Scale (PSS-10) was used to evaluate participants' stress levels and the Basic Need Satisfaction Inventory (BNSI) was used to evaluate unmet basic needs. Of the 523 prospective participants, 404 survey responses were included (77.2% response rate). Female students showed higher perceived stress and lower basic need satisfaction. Perceived stress levels did not differ by professional program when taking into consideration the differences in gender distribution by program. A regression model indicated that gender and basic need satisfaction were the main predictors of perceived stress for healthcare professional students. Higher basic need satisfaction was predictive of lower perceived stress in healthcare professional students. Perceived stress levels remain higher for female students compared to male students.

Clinical and Cardiorespiratory Polygraphy Profile in Children with Obstructive Sleep Apnoea Syndrome: A Cross-sectional Study

Introduction: Cardiorespiratory Polygraphy (CRP) is a less costly and simplified alternative to time consuming and laborious over night polysomnography for diagnosis of Obstructive Sleep Apnoea Syndrome (OSAS) in children. The Apnoea Hypopnea Index (AHI) is simple and useful index that can be estimated by using CRP. The magnitude of AHI which reflects severity of OSAS is unknown in the paediatric population. Aim: To describe the clinical characteristics and to estimate AHI in a population of children with obstructive sleep apnoea and hypopnea syndrome. Materials and Methods: This cross-sectional observational study was conducted on 1500 children, below 12 years of age, from January 2018 to November 2018. They were screened using Paediatric Sleep Questionnaire (PSQ) in the Outpatient Departments of General Paediatrics and Pulmonology respectively, at the Institute of Child Health and Hospital for Children, Chennai, Tamil Nadu, India. Those children identified to have probable OSAS were made to undergo cardiorespiratory assessment. Children with craniofacial syndromes and congenital heart disease were excluded from the study. Anthropometric parameters, vital signs, and Body Mass Index (BMI) were recorded. AHI and oxyhaemoglobin desaturation index were estimated in CRP. After descriptive analysis, non parametric Mann-Whitney test was used to find out any significant difference in median values of AHI in clinical subgroups. Regression analysis was done between AHI values and BMI. Results: Total 47 children were subjected to cardiorespiratory polygraphy. There was no statistically significant difference in gender distribution and prevalence of adenoid enlargement (p-value=0.1447 and 0.7705, respectively). It was found that maximum occurrence of OSAS was at the age of 6 years (25.5%). Based on AHI score 44.7% children fell in moderate to severe OSAS category. There was a poor correlation between BMI scores and AHI, though no significant difference was observed (r=-0.266, p-value=0.07087). The difference in median AHI between males and females was not statistically significant (p-value=0.5256), while that between children with/without adenoid enlargement was statistically significant (p-value ≤0.001). Conclusion: Children with adenoid hypertrophy have higher AHI than children without adenoid hypertrophy. There is lack of evidence for male predominance in the study. Obesity poorly correlated with AHI score.

Comparison of high-resolution melting analysis with direct sequencing for detection of FLT3-TKD, FLT3-ITD and WT1 mutations in acute myeloid leukemia

BackgroundAcute Myeloid Leukemia (AML) is a group of hematologic diseases characterized by a variety of clinically important genetic alterations. Genetic mutations affecting the FMS-like receptor tyrosine kinase-3 (FLT3) and Wilm's tumor (WT-1) genes are associated with poor prognosis in AML. In this work, efficiency of HRM method for detection of FLT3-ITD, FLT3-TKD, and WT-1 mutations was assessed in comparison with direct sequencing. MethodA total of 58 formalin-fixed, paraffin-embedded BM biopsy specimens of AML patients were analyzed. Mutation detection was performed by HRM method and the results were consequently compared with direct sequencing ResultsFLT3 and WT-1 mutations were detected in 21 (36.2%) and 3 (5.17%) samples, respectively. Among all FLT3 mutations, 10 (17.2%) and 11 (18.2%) samples were harboring the FLT3-ITD and-TKD gene mutations, respectively. Frequency of the FLT3-ITD was not statistically different in females (51%) and males (49%). Also, FLT3-TKD was more common in males although the differences in gender distribution were not statistically significant (P = 0.721 and P = 0.626, respectively). ConclusionsRegarded as the desirable characteristic, the present study is generally distinguished by the similar previous ones due to assessing the FFPE BM tissue from the perspective of the type of assessed sample. This discrepancy between our results and those in prior studies may be due to the disparity of the studied population size, adopted methods as well as the sample type. In this survey, regarding to low amount of extracted DNA from the paraffinized samples, the HRM method was efficient in determining the mentioned mutations.

Diagnostic and therapeutic considerations in biopsy-proven type 2 autoimmune pancreatitis: comparative analysis with biopsy-proven type 1 autoimmune pancreatitis.

Autoimmune processes are now an increasingly recognized cause of acute and chronic pancreatitis. Autoimmune pancreatitis is a rare, benign pathology with two distinct clinicopathologic subtypes. The aim of this study was to compare the presentation, diagnostic considerations and outcomes of patients with biopsy-proven type 1 and 2 autoimmune pancreatitis (AIP). A retrospective review of the Queensland Health pathology database of histologically proven AIP was conducted. Parameters compared included demographics, diagnostic criterion and post-treatment outcomes. Twenty-three patients had a confirmed histological diagnosis of AIP (type 1=13, type 2=10). Patients with type 2 AIP were younger (median age 49 versus 59 years, P< 0.05). There was no significant difference in gender distribution of disease at presentation. Type 2 AIP presented with significant increased focal pancreatic changes on cross-sectional imaging (80% versus 54%, P< 0.05). Serum IgG4 levels were raised (>1.40 g/L) in 69% of patients with type 1 AIP and not detected in type 2 (P< 0.01). Concurrent underlying inflammatory bowel disease was present in a higher proportion of type 2 AIP (40% versus 15%, P< 0.05). A significantly increased proportion of patients with type 2 AIP underwent surgical resection (70% versus 30%, P< 0.05). Conservative management was utilized in more patients with type 1 disease (54% versus 30%). On follow-up, two patients have experienced symptomatic relapse at 6-18 months. Diagnostic challenges do exist and clinicians must suspect 2 type AIP in young, serum IgG4-negative inflammatory bowel disease patients with recurrent pancreatitis.

Prevalência da esclerodermia localizada em um serviço de referência em dermatologia do Estado do Ceará

Introdução: A esclerodermia abrange amplo espectro de manifestações clínicas, sendo subdividida em forma localizada e sistêmica. A forma localizada, com acometimento exclusivamente cutâneo e de tecidos circunvizinhos, apresenta fisiopatologia e epidemiologia parcialmente conhecidas pela comunidade científica, com a maioria dos estudos epidemiológicos se concentrando na forma generalizada e extrapolando seus resultados para a outra forma. Este estudo tem o intuito de esclarecer a epidemiologia da esclerodermia localizada no estado do Ceará, visando compreender seus fatores de risco na população brasileira. Trata-se do primeiro estudo epidemiológico brasileiro acerca da esclerodermia localizada. Metodologia: Delineou-se um estudo retrospectivo quantitativo, no qual foram analisados todos os registros das consultas médicas realizadas no Centro de Referência em Dermatologia Dona Libânia (CDERM), Fortaleza, Ceará, em 2015, através das variáveis: nome, sexo, idade, data da consulta, número do prontuário, diagnóstico presuntivo ou confirmado e a frequência do paciente no CDERM. Resultados: Dos 19.576 pacientes analisados, 124 pacientes foram diagnosticados com esclerodermia localizada, representando uma incidência aproximada de 0,62% no serviço. Dentre estes pacientes, 96 (77,42%) eram do sexo feminino e 28 (22,58%) do sexo masculino. A idade média dos pacientes foi de 29,7 anos. Discussão: A prevalência e distribuição por sexo obedeceram às tendências mundiais relatadas em outros trabalhos. Entretanto, constatou-se elevada prevalência de diagnóstico no sexo feminino na faixa etária pediátrica, o que contrasta com dados na literatura que afirmam que as diferenças na distribuição de gênero começam a existir no início da adolescência. Esta diferença pode dever-se a fatores culturais, subdiagnóstico na população masculina ou uma tendência regional na epidemiologia da esclerodermia localizada. Conclusão: Este estudo corresponde ao primeiro estudo epidemiológico brasileiro acerca da esclerodermia localizada, sendo necessários estudos mais amplos e multicêntricos que permitam entender melhor a doença na nossa população e, assim, possam servir de base para futuras ações assistenciais.