Non-randomized Controlled Clinical Study Research Articles

Comparison of surgical outcomes between Kahook Dual Blade goniotomy and Trabectome surgery in patients with open-angle glaucoma

Objective: To compare the medium-term therapeutic effects of Kahook Dual Blade (KDB) goniotomy and Trabectome surgery in the treatment of patients with primary open-angle glaucoma (POAG). Methods: This study was a non-randomized prospective interventional controlled clinical study. POAG patients who underwent KDB goniotomy or Trabectome surgery at Beijing Tongren Hospital from May 2017 to April 2022 were enrolled. The definition of successful surgery was postoperative average intraocular pressure (IOP)≤21 mmHg (1 mmHg=0.133 kPa) and IOP decrease≥20%. Follow-up visits were conducted on the 1st day, 1st week, 1st, 3rd and 6th month after surgery. The IOP value, the number of IOP-lowering medications, the proportion of surgical success (average IOP≤21 mmHg at 6 months), and complications were evaluated. Statistical methods included independent sample t-test, Mann-Whitney rank sum test, χ2 test, repeated measures two-factor analysis of variance, Bonferroni, Friedman M test, Wilcoxon, and Log-rank. The Kaplan-Meier method was used to calculate the cumulative success rate of each group. Results: Seventeen male patients (17 eyes) and 10 female patients (10 eyes) were included. The mean age was (39.9±17.7) years old. There were 11 patients in the KDB group and 16 patients in the Trabectome group. There was no significant difference in clinical baseline conditions between the two groups (P>0.05). The IOPs in the KDB and Trabectome groups at postoperative 1 week [(16.6±6.3) and (16.4±4.1) mmHg) and 6 months [(17.8±5.3) and (19.9±4.4) mmHg) were lower than those before surgery [(25.1±9.3) and (27.4±9.1) mmHg) (all P<0.05). There was no significant difference in the overall IOP between groups (P>0.05). The IOP reduction rates in the KDB and Trabectome groups were 23.4% and 19.0%, with no significant difference (P=0.674). The numbers of IOP-lowering medications used in the KDB and Trabectome groups at 3 months [2.0 (1.0, 4.0) and 2.0 (1.0, 2.3)] and 6 months [2.0 (0.0, 4.0) and 2.0 (1.0, 3.0)] after surgery were not significantly different from those before surgery [4.0 (2.0, 4.0) and 3.0 (2.0, 4.0)] (both P>0.05). There was no statistical significance in the overall number of IOP-lowering medications used between the two groups (P>0.05). There was also no statistically significant difference in the proportion of patients with an IOP decrease of≥20% and the proportion of patients whose mean postoperative IOP was≤21 mmHg (all P>0.05). The proportions of IOP≤21 mmHg in the KDB group and the Trabectome group at 6 months after surgery were 81.8% and 68.8% (P>0.05). Serious intraoperative or postoperative complications occurred in neither group. Conclusions: Both KDB trabeculotomy and Trabectome surgery can effectively reduce IOP and have a good safety profile in treating POAG, with the same number of IOP-lowering medications.

Effect of dry eye on the reliability of keratometry for cataract surgery planning

This study aimed to evaluate the effects of dry eye on the reproducibility of keratometry (K) measurements in patients presenting for cataract surgery. A non-randomized controlled clinical study was performed. Eighty-three eyes of eighty-three patients with cataracts who were enrolled in our hospital from March 2020 to July 2020 were studied. The mean non-invasive tear film break-up time (NIBUT), corneal fluorescein staining score, and ocular surface disease (OSD) SPEED II questionnaire were measured and recorded prior to surgery, and the patients were assigned to a "dry eye" group (n=35) or a "non-dry eye" group (n=48). The K of the patients was measured twice by a Tomey OA-2000 (an average of three times each). The difference of the mean K (ΔKm) and astigmatism vector (ΔKvector) between the two measurements was calculated. The ΔKm and ΔKvector between the two groups were compared. The relationship between the measurement parameters of dry eyes and the accuracy of the preoperative K values was analyzed. ΔKm was 0.09 D [0.03; 0.19] in the non-dry eye control group and 0.28 D [0.18; 0.50] in the dry eye group, with a statistical difference between the two groups (P=0.005). The ΔKvector of the non-dry eye control group was 0.22 D [0.14; 0.42], and that of the dry eye group was 0.50 D [0.28; 1.06]. There was a significant difference between the two groups (P=0.010). Between the two groups, the percentage of the ΔKm and ΔKvector values greater than 0.5 D were statistically different (P<0.05). There was no significant difference in ΔKm between the groups with NIBUT>5s and NIBUT≤5s (P=0.537). There was no significant difference in ΔKm between groups≥2 and<2 on the OSD SPEED II questionnaire scores (P=0.442). Dry eye can affect the reliability of keratometry measurements before cataract surgery, thereby affecting the accuracy of intraocular lens power calculations. In cataract surgery planning, it is necessary to detect subjective and objective indicators of dry eye in patients and carry out effective intervention so as to avoid refractive errors caused by inaccurate keratometry measurements.

Immediate versus delayed implant placement in the esthetic zone: a prospective 3D volumetric assessment of peri-implant tissue stability

PurposeTo evaluate the volumetric stability of peri-implant soft and hard tissue prospectively, this study compared immediate versus delayed implants placed in the anterior esthetic region.MethodsThis non-randomized controlled clinical study included 25 patients, who received an immediate (type 1) or a delayed (type 4) implant placement for the replacement of a single anterior tooth. The anterior maxillae were intraorally scanned at three timepoints: before surgery (S0), 6 months (S1), and 12 months (S2) after surgery. A specific region of interest (ROI), divided into marginal and apical regions, was determined and superimposed for volumetric changes analysis. At 6 and 12 months, the probing depth (PD), bleeding/suppuration on probing (BOP/SUP), modified plaque index (PI), keratinized mucosa (KM) width, mucosal recession (MR), and implant stability (PTV) by means of periotest were recorded.ResultsBetween S0–S2, tissue surrounding immediate implants was reduced in 0.37 ± 0.31 mm, whereas delayed implants gained 0.84 ± 0.57 mm mean tissue volume. Peri-implant tissue loss at type 1 implants occurred primarily in the marginal section of the ROI (0.42 ± 0.31 mm), whereas tissue gain at type 4 implants occurred mainly in the apical section (0.83 ± 0.51 mm). These values were significantly different between both groups for the entire ROI (p = 0.0452) and the marginal region (p = 0.0274). In addition, the mean buccal KM width around type 1 implants was significantly wider in comparison with the type 4 implants group after 12 months (p = 0.046). There were no significant differences between groups regarding PD, BOP/SUP, or PTV.ConclusionsThe results suggest that type 1 implants placed in the esthetic region experience more tissue loss than type 4 implants, thus marginal tissue remodeling should be considered for planning immediate implants placement in the anterior maxillae.Graphical

A web app based-music intervention (MUSIC-CARE) reduces sedative requirement and anxiety during coronary angioplasty

Coronary angiography is a procedure in which patients tend to present with a moderately high level of stress and anxiety. The present investigation sought to examine the impact of a patient controlled music listening intervention by mobile application (Music-Care) on sedative consumption as primary endpoint, and on pain, anxiety and satisfaction levels. This is a prospective non-randomized controlled clinical study. Patients scheduled to undergo coronary angioplasty under local anesthesia and sedation were recruited. A 76 patients were included, 54 were assigned under the music arm and 22 under the control arm. Medication intake during the procedure has been reported as well as anxiety as measured by numeric rating score and APAIS, pain and satisfaction scores. Music group was administered "U" sequence during the procedure. Patients under music took significantly less midazolam medication (median 1 vs 3 mg in control, p&lt;0.01). Additionally, there was a significant difference (p&lt;0.01) on anxiety (Mmusic = 2.9, Mcontrol = 4.2, p &lt;0.01) but not in pain score. Almost all of the patients from the music group (98%) were satisfied (score ≥ 4) vs 91% in control group. Music-Care program application provides a 2/3 reduction in midazolam sedation during coronary angiography under local anesthesia and sedation. Furthermore, cardiologists appreciated this technique and suggested it to assist with their procedure in ambulatory practice.

Platelet Rich Fibrin (PRF) along with Coronally Repositioned Flap (CRF) compared with that of CRF alone in the management of isolated Miller class-I gingival recession defects: A non-randomized controlled clinical trial

Periodontal plastic surgical techniques for root coverage are aimed to attain optimal results with less patient discomfort. Platelet-rich fibrin (PRF) containing a wide array of growth factors within fibrin network has shown beneficial results in healing of tissues. Study evaluated clinical effects of PRF along with Coronally Repositioned Flap (CRF), test group, and compared it with CRF alone, control group, in the treatment of Miller Class I gingival recession. From the subjects who attended the out-patients clinic, a non-randomized controlled clinical study was done on those who satisfied the inclusion criteria. In the control group 29 patients and in the test group 27 patients completed six months of study period. Clinical parameters pertaining to periodontal health and recession anatomy were recorded. Student t-test was used for intra and inter-group comparison. Multiple linear regression model was developed using three predictor variables. Mean root cover percentage in PRF and CRF groups were 96.25±6.89 and 94.59±10.31 respectively. PRF group showed reduction in gingival thickness at sixth month. Linear regression model showed a negative association of baseline gingival recession value with complete root coverage. CRF+PRF as well as CRF alone are equally effective in attaining &amp;#62;90% root coverage in Miller Class I gingival recession. The observed clinical benefits along with less invasive procedure involved in PRF technique, shows that it is a promising biomaterial in terms of objective appraisal. However, additional studies overcoming the limitations noticed are needed to ascertain the findings.

The Effectiveness of Maxillary Expansion in Wearers of Cleft Lip and Palate

Introduction: Cleft Lip and Palate (CLAP) is one of the most frequent craniofacial anomalies. The management of patients with CLAP requires several repair procedures for the soft palate, the primary and secondary bony palate, the alveolar ridge, the lips and the nose. These patients often present with a maxillary transverse deficit responsible for maxillary endognathy which must be corrected for a harmonious development of the maxillomandibular complex. The objective of our work was to evaluate the efficacy of slow, rapid and surgical maxillary expansion in patients with sequelae of CLAP following a systematic review protocol. Materials and methods: Four databases were searched: PubMed / MEDLINE, ScienceDirect, Cochrane Library and EBSCOhost, using the keywords present in the MeSH according to the equation [Maxillary expansion] AND [Cleft lip and palate]. The selection of articles included all studies published since January 2010 and for which the full text is available, such as meta-analyzes, randomized and non-randomized controlled clinical trials, case-control studies and prospective and retrospective studies. Results: Among 1107 references only 8 studies met our inclusion criteria. Following analysis of these, we concluded that there is no significant difference between rapid maxillary expansion and slow maxillary expansion in patients with unilateral CLAP, the expansion observed on the side of the cleft is larger than that seen on the healthy side. Surgically assisted expansion is much more reserved for subjects at the end of growth, having unilateral or bilateral CLAP and presenting anterior or posterior lateral crossbones. The results of our systematic review also showed that maxillary expansion in patients with CLAP results in substantial dentoalveolar compensation. Conclusion: The efficacy of maxillary expansion in patients with sequelae of CLAP is real and alone in some cases allows the restoration of a normal transverse dimension; sometimes in combination with maxillary protraction to correct the anteroposterior deficit.

Effectiveness of Vachadi Ointment in the management of Pama Kushta (Scabies): A Novel Research Protocol Using Science of Ayurveda

Background: Scabies is a common cause of itching is produced by infestation with the mite Sarcoptesscabiei var hominis. Poor hygienic condition and overcrowding, permitting close body contact favour thetransmission of the disease. Scabies is more prevalent in overcrowded communities with low socioeconomicconditions. The point prevalence in the general population of rural India is about 13%,In Maharashtra81% of inmates of an orphanage in rural area,[6] 72% of cases are seen in the age group of School goingchildren’s. Pama Kushtha characterized by many small Pitikas, Srava, Kandu, Toda and Daha that may beconsidered as scabies in contemporary science. Aim: The present study is aimed at evaluating the effect ofVachadi Ointment in the management of Pama Kushta. Material &amp; Methods: The present study is designedas a Non-randomized controlled clinical study, in which minimum of 30 patients will be enrolled. VachadiOintment will be administered external application 2-3 times in a day. Assessment will be recorded on 3rd,5th, 7th and 14th days. Results: Changes will be observed in subjective parameters such as Kandu (Itching),Toda (Pain), Daha (Burning) and objective parameters such as Pitika (Eruption) and Srava (Discharge).Conclusion: Suitable conclusion will be drawn post completion of the trial.

Application of Gunja (Abrus precatorius Linn.) Beeja lepa: An Ayurvedic protocol for the treatment of Gridhrasi (sciatica)

The most common musculoskeletal disorder affecting the movement of legs is low back pain. Among the affected patients, 40% have ridiculer pain, and these cases can be classified under the umbrella of the sciatic syndrome. Low back pain is extraordinarily common, frequently resulting from degenerative arthritis of the lumbosacral spine. The annual prevalence of disc-related sciatica in the general population is estimated at 2.2%. Sciatica is characterised by constant aching pain which felt in the lumbar region may radiate to the buttock, thigh, calf and foot. Acharaya Charaka explained Gridhrasi in eighty types of nanatmaja Vata vikara. The present study is aimed at evaluating the effect of Gunja (Abrus precatorius Linn.) Beeja lepa in the management of Gridhrasi (Sciatica) and thereby assessing the changes in quality life. The present study is designed as a Non-randomized controlled clinical study, in which a minimum of 30 patients will be enrolled. Gunja beej lepa will be administered external application two times in a day with lukewarm water. Assessment will be recorded on the 3rd, 5th, 7th, 14th and 28th day. Changes will be observed in subjective parameters such as Ruk (pain) Toda (pin pricking sensation) Stambha (Stiffness), Spandana (Fasciculation) and objective parameters such as measuring the changes in the angle of elevation of the leg by SLR Test, Sciatica Bothersomeness Index and Sciatica Frequency Index before and after the treatment. Suitable conclusion will be drawn post completion of the trial.

Effect of family presence on stress response after bypass surgery

BackgroundCoronary artery bypass grafting (CABG) is a major surgery that may cause severe surgical stress response (SR). Although the presence of family members in intensive care unit (ICU) is known to benefit intensive care patients socially and emotionally, its effects on surgical SR are unknown. ObjectivesTo investigate the effect of an informed family member (IFM)’s presence in the awakening process in ICU on patients’ SR after CABG. MethodsA nonrandomized controlled clinical study was completed with a total of 73 patients: 37 patients in the control (CG) and 36 in the intervention group (IG) underwent CABG surgery. In the CG patients, no family members were taken into the ICU during the awakening process and routine care and treatment practices were continued. In the IG patients, besides routine care and treatment practices, an IFM was taken into the ICU during the awakening process in accordance with the research method. Groups were statistically compared in terms of serum cortisol level which is the one of the main indicators of surgical SR, state anxiety, sedative drug requirements, and duration of intubation, sedation, and ICU stay. A p value <0.05 was accepted as statistically significant. ResultsPresence of an IFM in the ICU was found to be effective in decreasing serum cortisol level, state anxiety, sedative drug requirements, and the duration of intubation, sedation, and ICU stay (p<0.05). ConclusionsIn CABG, the presence of IFM in ICU is effective in reducing SR.

Comparative Study between the Effect of Dorzolamide/Timolol Fixed Combination and Brimonidine/Timolol Fixed Combination on Corneal Endothelium

Abstract Background: Glaucoma is one of the most important cause of irreversible blindness in the world. Elevated Intraocular Pressure (IOP) remains the main known risk factor for the development and progression of the disease. The main thera-peutic goal is to preserve visual function by reducing the IOP, which is the key modifiable risk factor. Aim of Study: Is to compare the effect and safety of Dorzolamide/Timolol-Fixed Combination (DTFC) and Bri-monidine/Timolol-Fixed Combination (BTFC), on corneal endothelium after 3 months. Patient and Methods: This comparative non-randomized controlled clinical trial study included 57 eyes of 57 patients which was conducted in Damietta Eye Hospital. Their age ranged from 20-70 years old. The study population was divided into two groups: First group receiving DTFC: Included 27 eyes of 27 patients with open angle glaucoma and second group receiving BTFC included 30 eyes of 30 patients with open angle glaucoma. Result: Show that this adjusted difference between group 1 and group 2 through 3 months follow-up had no statistical significance in all variables such as IOP (p=0.172), CCT (p=0.072) and CD (p=0.406). Conclusion: The patients that received two fixed-combination (dorzolamide/timolol) and (brimonidine/timolol) had no statistically significant effect on CCT and ECD after 3 months from using these drugs.

Characteristic of Clinical Studies on Baduanjin during 2000-2019: A Comprehensive Review.

To date, a growing number of clinical studies have demonstrated the safety and health benefits from Baduanjin intervention. Based on this, our objective is to systematically retrieve and summarize the clinical studies on Baduanjin, with a view to providing more evidence-based evidence in support of the application of Baduanjin for healthcare, and to identify the shortcomings of existing research and provide feasibility suggest for further clinical research. Both four English language and four Chinese language electronic databases were used to search articles related to Baduanjin during 2000–2019. SPSS 22.0 software was used to analyze the data, and the risk of bias tool in the RevMan 5.3.5 software was used to evaluate the methodological quality of randomized controlled trials. A total of 810 publications were identified, including 43 (5.3%) systematic reviews, 614 (75.8%) randomized controlled trials, 66 (8.1%) nonrandomized controlled clinical studies, 84 (10.4%) case series, and 3 (0.4%) case reports. The top 10 diseases/conditions included diabetes, chronic obstructive pulmonary disease, hypertension, low back pain, neck pain, stroke, coronary heart disease, cognitive impairment, insomnia, and osteoporosis or osteopenia. The style of State General Administration of Sport of China in 2003 was the most commonly used version of Baduanjin, and Baduanjin was practiced with an average of 35 minutes, 1 or 2 times a day, 3–5 days per week, and a 18-week average duration. It is also worth noting that there were no serious adverse events related to Baduanjin intervention. Most studies were small sample size research, and the methodological quality of randomized controlled trials is generally low. The clinical studies of Baduanjin have a substantial quantity and evidence base. However, there are significant differences among different studies in the specific intervention measures such as style, intensity, duration, learning, and practice methods, which need to be further standardized and unified. Further high-quality designed and reporting studies are recommended to further validate the clinical benefits of Baduanjin.

Comparison of corneal ablation depth predictability between small incision lenticule extraction and femtosecond laser-assisted in situ keratomileusis for myopia

Background Recently, small incision lenticule extraction (SMILE) procedure is used to correct myopia.The clinical safety and efficiency of SMILE have been approved, but its predictability to corneal ablation depth is brought into focus. Objective This study was to compare the predictability of ablation depth in central cornea between SMILE and femtosecond laser-assisted in situ keratomileusis (FS-LASIK) for myopia. Methods A non-randomized controlled clinical study was performed.Two hundred and seventy eyes of 135 myopic patients who were going to receive corneal refractive surgery were included in Beijing Tongren Hospital from October 2015 to May 2016.SMILE and FS-LASIK were performed on 138 eyes of 69 patients and 132 eyes of 66 patients matched in demography respectively under the informed consent.Central corneal thickness was measured by RTVue FD-OCT before and 1 week after surgery.The refractive power, actual ablation depth (difference of central corneal thickness before and after surgery) and central corneal cutting error (difference between theoretically expected ablation depth and real ablation depth) were intergrouply compared, and the correlation of real ablation depth with theoretically expected ablation depth was assessed. Results No significant difference was found in spherical power, astigmatic power and spherical equivalent after surgery between SMILE group and FS-LASIK group (t=-1.826, -1.405, -1.420, all at P>0.05). The actual ablation depth was (76.96±15.27)μm in the SMILE group, which was significant lower than (96.76±16.52)μm of theoretically expected ablation depth (t=-23.016, P<0.01); however, there was no significant difference in the FS-LASIK group between actual and expected ablation depth([77.92±18.69] μm versus [77.42±15.60] μm) (t=-0.604, P=0.547). The central corneal cutting error was (20.55±8.51)μm in the SMILE group and (7.17±5.97)μm in the FS-LASIK group, showing a significant difference between them (t=14.950, P<0.01). The positive linear correlations were seen between actual and expected ablation depth in both SMILE group and FS-LASIK group (r=0.799, 0.867, both at P<0.01). The actual ablation depth was increased over expected ablation depth, with the regression equations of Y=3.892+ 0.749X in the SMILE group and Y=3.443+ 0.957X in the FS-LASIK group. Conclusions The actual corneal ablation depth is less than expected corneal ablation depth in SMILE procedure, while in FS-LASIK procedure, the actual corneal ablation depth appears to be consistent with the expected one, inferring a good predictability in corneal ablation depth in FS-LASIK surgery. Key words: Myopia/surgery; Corneal stroma/surgery; Lasers, excimer/therapeutic use; Central corneal thickness; Ablated depth; Predictability; Comparative study

Pilot study on dry eye affecting the accuracy of intraocular lens power measurement in age-related cataract

Background The incidence of dry eye is gradually increasing, and the aging of population is one of factors. Researches showed that the change of tear film stability leads to shift of corneal refractive power, which probably affects the measurement of intraocular lens (IOL) power. The influence of dry eye on the calculation of IOL power is worth paying close attention. Objective This study was to investigate the influence of dry eye on the accuracy of IOL power calculation in age-related cataractous patients. Methods A non-randomized controlled clinical study was performed. Two hundred and sixteen eyes of 216 cataract patients were enrolled in Yanbian Eye Ear Nose and Throat Hospital from May 2013 to February 2014. The visual acuity, intraocular pressure, break up time of tear film (BUT), SchirmerⅠtest (SⅠt) and corneal fluorescein staining were examined in all the eyes, and then the patients were assigned to mild dry eye group (73 eyes), severe dry eye group (68 eyes) and non-dry eye control group (75 eyes). The axial length (AL) and anterior chamber depth (ACD) were measured using IOL Master for the calculation of IOL power and K value (corneal curvature). Phacoemulsification with IOL implantation was performed on all the eyes, and the refractive power was measured with KR 8100 automatic optometry 2 months after operation. The mean absolute refractive error (MARE) between actual refraction and predicted refraction was calculated, and percentage of eyes in different refractive error ranges was compared between the dry eye group and non-dry eye control group. The correlations of dry eye-related parameters with peroperative K value and refractive error were analyzed. This study was approved by the Ethics of Yanbian University, and written informed consent was obtained from each subject prior to entering the cohort. Results No significant differences were found in age, gender, AL, ACD and MARE among the mild dry eye group, severe dry eye group and non-dry eye control group (all at P>0.05), and significant differences in BUT, SⅠt and corneal fluorescein staining scores were found among these three groups (F=5.460, 4.521, 3.572, all at P<0.05). The K values were (43.59±1.39), (44.66±1.53) and (43.42± 1.32)D in the mild dry eye group, severe dry eye group and non-dry eye control group, and the K value in the severe dry eye group was significantly higher than that in the non-dry eye control group (P=0.012). The percentage of eyes with + 0.50-+ 0.75 D deviation was significantly elevated(28.8% versus 13.3%), and that with -0.50--0.75 D deviation was significantly declined (17.3% versus 28.0%)in the dry eye group compared with non-dry eye control group (χ2=4.513, P=0.032; χ2=4.236, P=0.037). A negative correlation was found between BUT and K value (r=-0.204, P=0.011). Conclusions Dry eye affects the accuracy of the determination of IOL power. Compared with the preoperative refraction predictive value, the postoperative refraction shift toward hyperopia. Key words: [Key words] Biometry; Dry eye; Cataract; Refractive error; Intraocular lens power

Histologic Evidence of New Collagen Formulation Using Platelet Rich Plasma in Skin Rejuvenation: A Prospective Controlled Clinical Study.

BackgroundPlatelet-rich plasma (PRP) is an autologous concentration of human platelets contained in a small volume of plasma and has recently been shown to accelerate rejuvenate aging skin by various growth factors and cell adhesion molecules.ObjectiveThis study was conducted to evaluate the efficacy and safety of intradermal injection of PRP in the human facial rejuvenation.MethodsThis study was a prospective, single-center, single-dose, open-label, non-randomized controlled clinical study. PRP injected to the upper site of this right infra-auricular area and all face. Saline was injected to the left infra-auricular area. Histopathological examinations were performed before PRP treatment, 28 days after the PRP, and saline (control) treatments.ResultsTwenty women ranging in age from 40 to 49 years (mean age, 43.65±2.43 years) were enrolled in the study. The mean optical densities (MODs) of collagen in the pre-treatment, control, and PRP-treated area were measured. They were 539±93.2, 787±134.15, 1,019±178, respectively. In the MOD of PRP, 89.05 percent improvement was found when MOD of PRP was compared with MOD of pre-treatment. The mean MOD of collagen fibers was clearly highest on the PRP side (p<0.001). The PRP-to-saline improvement ratio (89.05% to 46.01%) was 1.93:1. No serious side effects were detected.ConclusionPRP increases dermal collagen levels not only by growth factors, but also by skin needling (the mesotherapy technique 'point by point'). PRP application could be considered as an effective (even a single application) and safety procedure for facial skin rejuvenation.

Albumin in Burn Shock Resuscitation: A Meta-Analysis of Controlled Clinical Studies.

Critical appraisal of outcomes after burn shock resuscitation with albumin has previously been restricted to small relatively old randomized trials, some with high risk of bias. Extensive recent data from nonrandomized studies assessing the use of albumin can potentially reduce bias and add precision. The objective of this meta-analysis was to determine the effect of burn shock resuscitation with albumin on mortality and morbidity in adult patients. Randomized and nonrandomized controlled clinical studies evaluating mortality and morbidity in adult patients receiving albumin for burn shock resuscitation were identified by multiple methods, including computer database searches and examination of journal contents and reference lists. Extracted data were quantitatively combined by random-effects meta-analysis. Four randomized and four nonrandomized studies with 688 total adult patients were included. Treatment effects did not differ significantly between the included randomized and nonrandomized studies. Albumin infusion during the first 24 hours showed no significant overall effect on mortality. However, significant statistical heterogeneity was present, which could be abolished by excluding two studies at high risk of bias. After those exclusions, albumin infusion was associated with reduced mortality. The pooled odds ratio was 0.34 with a 95% confidence interval of 0.19 to 0.58 (P < .001). Albumin administration was also accompanied by decreased occurrence of compartment syndrome (pooled odds ratio, 0.19; 95% confidence interval, 0.07–0.50; P < .001). This meta-analysis suggests that albumin can improve outcomes of burn shock resuscitation. However, the scope and quality of current evidence are limited, and additional trials are needed.

Evidence base of clinical studies on Tai Chi: a bibliometric analysis.

BackgroundThe safety and health benefits of Tai Chi mind-body exercise has been documented in a large number of clinical studies focused on specific diseases and health conditions. The objective of this systematic review is to more comprehensively summarize the evidence base of clinical studies of Tai Chi for healthcare.Methods and FindingsWe searched for all types of clinical studies on Tai chi in PubMed, the Cochrane Library and four major Chinese electronic databases from their inception to July 2013. Data were analyzed using SPSS17.0 software. A total of 507 studies published between 1958 and 2013 were identified, including 43 (8.3%) systematic reviews of clinical studies, 255 (50.3%) randomized clinical trials, 90 (17.8%) non-randomized controlled clinical studies, 115 (22.7%) case series and 4 (0.8%) case reports. The top 10 diseases/conditions was hypertension, diabetes, osteoarthritis, osteoporosis or osteopenia, breast cancer, heart failure, chronic obstructive pulmonary disease, coronary heart disease, schizophrenia, and depression. Many healthy participants practiced Tai Chi for the purpose of health promotion or preservation. Yang style Tai Chi was the most popular, and Tai Chi was frequently practiced two to three 1-hour sessions per week for 12 weeks. Tai Chi was used alone in more than half of the studies (58.6%), while in other studies Tai Chi was applied in combination with other therapies including medications, health education and other physical therapies. The majority of studies (94.1%) reported positive effects of Tai Chi, 5.1% studies reported uncertain effects and 0.8% studies reported negative effects. No serious adverse events related to Tai Chi were reported.ConclusionsThe quantity and evidence base of clinical studies on Tai Chi is substantial. However, there is a wide variation in Tai Chi intervention studied and the reporting of Tai Chi intervention needs to be improved. Further well-designed and reported studies are recommended to confirm the effects of Tai Chi for the frequently reported diseases/conditions.

Prevalence of Sexually Transmitted Diseases and Blood-Borne Transmitted Infections among Male Patients with Antisocial Personality Disorder

Eskisehir Asker Hastanesi, Deri ve Zuhrevi Hastaliklari Klinigi, Eskisehir, Turkiye *Eskisehir Asker Hastanesi, Psikiyatri Klinigi, Eskisehir, Turkiye **Yunus Emre Devlet Hastanesi, Deri ve Zuhrevi Hastaliklari Klinigi, Eskisehir, Turkiye ***Eskisehir Asker Hastanesi, Mikrobiyoloji Klinigi, Eskisehir, Turkiye ****GATA Haydarpasa Egitim Hastanesi, Deri ve Zuhrevi Hastaliklari Klinigi (Emekli Ogretim Uyesi), Istanbul, Turkiye @Telif Hakki 2015 Turk Dermatoloji Dernegi Makale metnine www. turkdermatolojidergisi.com web sayfasindan ulasilabilir. @Copyright 2015 by Turkish Society of Dermatology Available on-line at www.turkdermatolojidergisi.com Hamza Yildiz, Eskisehir Asker Hastanesi, Deri ve Zuhrevi Hastaliklari Klinigi, Eskisehir, Turkiye E-posta: hamzayildiz@gmail.com Gelis Tarihi/Submitted: 06.05.2014 Kabul Tarihi/Accepted: 26.11.2014 Yazisma Adresi/ Correspondence: Objective: The aim of this study was to compare the patients who have antisocial personality disorder (ASPD) and the healthy individuals in terms of sexually transmitted diseases (STDs) and Blood-Borne Transmitted Infections (BTIs) prevalences. Methods: This study is a prospective, single-center, open-label, non-randomized controlled clinical study. There were two groups in the study. The patient group consistsed of 100 males who were diagnosed as ASPD with a clinical interview form. The control group consisted of 98 healthy males who did not have any psychiatric disorder. Dermatologic examination was performed, and clinical findings were recorded. Results: The mean age of the patient group was 21.96±2.40 (range 20-37) years. The mean age of the control group was 24.20±2.88 (21-36) years. The most common disease was gonorrhea (25%) followed by genital wart (11%), molluskum contagiosum (5%), HBsAg (4%), and HSV-2 seropositivity (4%) in the patients group. In the control group, HSV-2 seropositivity (4.08%), genital wart (3.06%), molluskum contagiosum (3.06%), and gonorrhe (1.02%) were commonly seen in the control group. STDs and/or BVTIs were found more common in the patients group (82%) than that in the control group (45.91%) (X2=30.62, p=0.000). Ozgun Arastirma / Original Investigation 18 Turk J Dermatol 2015; 1: 18-22 • DOI: 10.4274/tdd.2291

Neuroimaging and Neuromonitoring Effects of Electro and Manual Acupuncture on the Central Nervous System: A Literature Review and Analysis.

The aim of this review is to provide an overview of the different effects of manual and electroacupuncture on the central nervous system in studies with different neuroimaging interventions. The Database PubMed was searched from 1/1/2000 to 1/6/2014 with restriction to human studies in English language. Data collection for functional magnetic resonance (fMRI) studies was restricted to the period from 1/1/2010 to 1/6/2014 due to a recently published review which included all published randomized and nonrandomized controlled clinical studies as well as observational studies with control groups, no blinding required. Only studies comparing manual or electroacupuncture with sham acupuncture were eligible. All participants were healthy adult men and women. A majority of 25 studies compared manual versus sham, a minority of 7 trials compared electro versus sham and only 1 study compared electro versus manual acupuncture. In 29 out of 33 studies verum acupuncture results were found to present either more or different modulation effects on neurological components measured by neuroimaging and neuromonitoring methods than sham acupuncture. Only four studies reported no effects of verum in comparison to sham acupuncture. Evaluation of the very heterogeneous results shows evidence that verum acupuncture elicits more modulation effects on neurological components than sham acupuncture.

Investigation into the effect of closed-system suctioning on the frequency of pediatric ventilator-associated pneumonia in a developing country*

To investigate the effect of closed-system vs. open endotracheal suctioning on the frequency of ventilator-associated pneumonia and outcome in a pediatric intensive care unit in a developing country. Prospective observational and nonrandomized controlled clinical study. A 20-bed pediatric intensive care unit in a tertiary pediatric hospital. Infants and children mechanically ventilated for >24 hrs. : Pediatric intensive care unit suctioning systems were alternated monthly. An 8-month interim analysis was planned with a priori efficacy and futility study termination boundaries set at p < .006 and p > .52, respectively. Demographic, clinical, and laboratory data were prospectively recorded. Ventilator-associated pneumonia was diagnosed using the Clinical Pulmonary Infection Score, and the results were confirmed retrospectively using Centers for Disease Control criteria. A total of 250 patients (median [interquartile range] age of 3.8 [1.2-15.0] months) in 263 pediatric intensive care unit admissions were included. Fifty-nine admissions developed ventilator-associated pneumonia, with a calculated rate of 45.1 infections per 1000 ventilated days. There was no difference in characteristics or outcome between patients on closed-system suctioning (n = 83) and those on open endotracheal suctioning (n = 180). The frequencies of ventilator-associated pneumonia for patients on closed-system suctioning and open endotracheal suctioning were 20.5% and 23.3%, respectively (p = .6), reaching the a priori set limit of futility. Patients who developed ventilator-associated pneumonia spent a median (interquartile range) of 22 (13-37) and 11 (8-16) days in the hospital and pediatric intensive care unit, respectively, compared to 14.5 (10-24) and 6 (4-8) days for those without ventilator-associated pneumonia (p < .001). A 22% proportion of patients who developed ventilator-associated pneumonia died compared to 11.3% of those without ventilator-associated pneumonia (p = .03). Risk factors for ventilator-associated pneumonia identified on multiple logistic regression were duration of mechanical ventilation, transport out of the pediatric intensive care unit, and blood transfusion. Closed-system suctioning did not affect the frequency of ventilator-associated pneumonia or patient outcome in this setting.

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Objective: To investigate the effect of closed-system vs. open endotracheal suctioning on the frequency of ventilator-associated pneumonia and outcome in a pediatric intensive care unit in a developing country. Design: Prospective observational and nonrandomized controlled clinical study. Setting: A 20-bed pediatric intensive care unit in a tertiary pediatric hospital. Patients: Infants and children mechanically ventilated for >24 hrs. Intervention: Pediatric intensive care unit suctioning systems were alternated monthly. An 8-month interim analysis was planned with a priori efficacy and futility study termination boundaries set at p < .006 and p > .52, respectively. Measurements and Main Results: Demographic, clinical, and laboratory data were prospectively recorded. Ventilator-associated pneumonia was diagnosed using the Clinical Pulmonary Infection Score, and the results were confirmed retrospectively using Centers for Disease Control criteria. A total of 250 patients (median [interquartile range] age of 3.8 [1.2–15.0] months) in 263 pediatric intensive care unit admissions were included. Fifty-nine admissions developed ventilator-associated pneumonia, with a calculated rate of 45.1 infections per 1000 ventilated days. There was no difference in characteristics or outcome between patients on closed-system suctioning (n = 83) and those on open endotracheal suctioning (n = 180). The frequencies of ventilator-associated pneumonia for patients on closed-system suctioning and open endotracheal suctioning were 20.5% and 23.3%, respectively (p = .6), reaching the a priori set limit of futility. Patients who developed ventilator-associated pneumonia spent a median (interquartile range) of 22 (13–37) and 11 (8–16) days in the hospital and pediatric intensive care unit, respectively, compared to 14.5 (10–24) and 6 (4–8) days for those without ventilator-associated pneumonia (p < .001). A 22% proportion of patients who developed ventilator-associated pneumonia died compared to 11.3% of those without ventilator-associated pneumonia (p = .03). Risk factors for ventilator-associated pneumonia identified on multiple logistic regression were duration of mechanical ventilation, transport out of the pediatric intensive care unit, and blood transfusion. Conclusion: Closed-system suctioning did not affect the frequency of ventilator-associated pneumonia or patient outcome in this setting.