Non-randomized Experimental Study Research Articles

Impact of ophthalmology posting on the attitude and perception of senior medical students in a Nigerian medical school to ophthalmology as a specialty and a career choice

Background: Ophthalmology posting/clerkship is an integral part of the curriculum of medical schools globally. This provides ophthalmic educators an excellent opportunity to positively influence the medical students undergoing the posting. Materials and Methods: A pretest–posttest, noncontrolled, nonrandomized experimental study was conducted among 5th year medical students of the College of Medicine of the University of Lagos who underwent ophthalmology posting between November 2015 and February 2016. All respondents were requested to fill a semistructured questionnaire on the first and the last day of the posting. Information on sociodemographic data, perception and attitude toward ophthalmology, future practice plan, and a possibility of taking up a career in ophthalmology were obtained using a semistructured questionnaire. The data were analyzed using IBM Statistical Package for the Social Sciences version 20. Results: A total of 210 out of the 228 students participated in this study constituting a response rate of 92.1%. The mean age was 23.0 ± 2.3 years, and the male-to-female ratio was 1:1.1. There was a statistically significant improvement in the overall mean attitudinal scores after posting compared to the scores before posting (P < 0.01). Furthermore, there was a statistically significant improvement in the overall mean perception scores after posting compared to the scores before posting (P < 0.01). Although there was an increase in the mean score of disposition of respondents to ophthalmology as a future career from 2.18 before posting to 2.30 after posting, this was not statistically significant (P = 0.06). Conclusion: The 4-week ophthalmology posting impacted positively on the perception and attitude of respondents to ophthalmology as a discipline, but did not translate to a significant improvement in the consideration of ophthalmology as a future career.

Effects of needleless connectors on central venous catheter-related thrombotic occlusions: a systematic review

Objective To evaluate the influence of different types of needleless connector on central venous catheter-related thrombotic occlusions. Methods A detailed search was performed to identify literature about the impact of needleless connector on central venous catheter-related thrombotic occlusions, using the Cochrane Library and the databases of Pubmed, EMbase, CINAHL, CBM, CNKI and WanFang. The meta-analysis or descriptive review were performed after two authors independently searching databases, extracting data and assessing quality of included studies. Results Nine published studies were included for systematic review, which contained three randomized controlled trials, three non-randomized experimental studies and three retrospective observational studies. The results of meta-analysis for five studies showed that the split septum connector was associated with a significantly higher incidence of catheter-related thrombotic occlusions(complete occlusions and partial occlusions) than positive-displacement mechanical valve(RR=0.59, 95%CI0.39-0.91, P=0.02). Standard connector and negative-displacement mechanical valve had a higher occlusions rates than positive-displacement mechanical valve,but the difference did not reach statistical significance after merging the studies(P>0.05). Conclusion It is difficult to decide which needleless connector has the lowest rate of central venous catheter-related thrombotic occlusions because of the insufficient evidence. More large-scale and high-quality randomized controlled trials are required for further confirmation. Key words: Needleless connector; Central venous catheters; Catheter obstruction; Systematic review

Pilot Trial of an Acceptance-Based Behavioral Intervention to Promote Physical Activity Among Adolescents.

Prior interventions have shown limited efficacy in increasing the number of adolescents engaging in adequate physical activity (PA). Preliminary evidence suggests acceptance-based behavioral treatments (ABTs) may increase PA; however, this approach has not been tested in adolescents. This was a nonrandomized experimental pilot study that examined feasibility, acceptability, and treatment outcomes of a school-based, acceptance-based behavioral intervention for PA. Adolescents (n = 20) with low activity received a PA tracking device and were allocated to device use only or device use plus 10-weeks of ABT. PA, cardiovascular fitness, and physiological outcomes were measured pre- and postintervention. The intervention was found to be feasible and acceptable. PA, cardiovascular fitness, and physiological outcomes improved over time in the intervention group, but not in the comparison condition. This study demonstrated feasibility, acceptability, and preliminary treatment efficacy based on effect sizes for an acceptance-based behavioral intervention to increase PA in adolescents.

A cool response-The influence of ambient temperature on capillary refill time.

To describe the effect of low ambient temperature on skin temperature and capillary refill (CR) time in forehead, sternum and finger pulp. An observational, nonrandomized experimental study on 15 healthy subjects (6 females) in a cold room (8°C). Outcome measures were skin temperature and quantified CR test after application of a standardized blanching pressure (9 N/cm2 ) using digital photographic polarization spectroscopy to generate CR times. The finger pulp showed marked temperature fall and prolonged CR times (>10 seconds). The CR registrations of the forehead and sternum were more comparable to curves observed in a control material at room temperature, and skin temperature falls were less marked. CR times were not prolonged in forehead measurements. At the sternum, some individuals showed CR times beyond guideline recommendations despite only a marginal reduction in skin temperature. Low ambient temperature is a strong independent factor for CR time at peripheral sites. Reservation about sternum as a site of measurement is warranted since cold provocation produced prolonged CR times in some individuals. We found that the forehead is the most thermostable of the 3 sites and thus the preferred site to avoid ambient temperature artifact in measuring CR time.

Problem solving, biofeedback, and severe brain injury: The moderating role of positive affect.

To examine how positive affect influences ability to benefit from heart rate variability (HRV) biofeedback treatment for individuals with severe brain injury. Secondary data analysis of a nonrandomized experimental study that assessed the efficacy of biofeedback treatment for executive dysfunction in 13 individuals with chronic severe brain injury. Bivariate correlations between the predictors (levels of HRV and positive affect) and the outcome (change in Category Test errors) showed large effect sizes for higher levels of HRV coherence (r = -.495, p = .085) but not for positive affect (r = .069, p = .824). Although positive affect had a negligible effect on Category Test improvements by itself, positive affect played a moderating role that complemented the effect of HRV coherence. HRV coherence had a stronger effect on Category Test performance among those participants who demonstrated higher positive affect. A regression model was fit that included main effects for HRV coherence and positive affect, as well as their interaction. The interaction term was significant in a 1-tailed test (b = -3.902, SE = 1.914, p = .072). Participants who had the most positive emotions made the most gains in the HRV biofeedback training and performed better posttreatment on a test designed to measure problem-solving ability. Results indicate that positive affect can improve cognition, specifically mental flexibility and abstract thinking. Addressing factors that shape negative affect such as irrational beliefs and self-doubt is an important target for therapeutic intervention even in those with severe, chronic deficits. (PsycINFO Database Record

&lt;b&gt;Expression of bradykinin in human placenta from healthy and preeclamptic women

This study evaluated the expression of bradykinin (BK) in human placenta from healthy and preeclamptic women. This is a non-randomized experimental study, in which we performed histological analysis of placental tissue to observe changes that occur in each kind of placenta as well as immunohistochemical analysis to investigate the expression of bradykinin. We used ‘Paleontological Statistics software package for education and data analysis’ 3.06 and R for the statistical analysis. The Ethics Committee of the University of Rio Grande do Norte State approved this experiment under protocol number 166370, according to the determinations established by Resolutions 466/12 and 441/11.We found differences between the two kinds of placenta concerning the diameter of the vessels and the rate of cytotrophoblastic invasion. Student’s t-test evidenced significant difference (p = 7.6395 x 10 -5 ) indicating greater marking of BK per section in the healthy placenta group. The result of more significant expression of bradykinin in healthy placenta can be used as a starting point for deeper researches aiming to better characterize and quantify this expression.

The effects of physical activity interventions on glycated haemoglobin A1c in non-diabetic populations: a protocol for a systematic review and meta-analysis

IntroductionEpidemiological evidence suggests that physical activity has a positive effect on reducing glycated haemoglobin A1c (HbA1c) levels not only in diabetics, but also in healthy subjects. Moreover, a positive association...

Cardioprotective potential of N-acetyl cysteine against hyperglycaemia-induced oxidative damage: a protocol for a systematic review

BackgroundHyperglycaemia-induced oxidative damage is a well-established factor implicated in the development of diabetic cardiomyopathy (DCM) in diabetic individuals. Some of the well-known characteristics of DCM include increased myocardial left ventricular wall thickness and remodelling that result in reduced cardiac efficiency. To prevent this, an increasing number of pharmacological compounds such as N-acetyl cysteine (NAC) are explored for their antioxidant properties. A few studies have shown that NAC can ameliorate hyperglycaemia-induced oxidative damage within the heart. Hence, the objective of this review is to synthesise the available evidence pertaining to the cardioprotective role of NAC against hyperglycaemia-induced oxidative damage and thus prevent DCM.MethodsThis systematic review protocol will be reported in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) 2015 statement. We will perform a comprehensive search on major databases such as EMBASE, Cochrane Library, PubMed and Google scholar for original research articles published from January 1960 to March 2017. We will only report on literature that is available in English. Two authors will independently screen for eligible studies using pre-defined criteria, and data extraction will be done in duplicate. All discrepancies will be resolved by consensus or consultation of a third reviewer. The quality of studies will be checked using Cochrane Risk of Bias Assessment Tool and The Joanna Briggs Institute (JBI) Critical Appraisal tools for non-randomised experimental studies. Heterogeneity across studies will be assessed using the Cochrane Q statistic and the inconsistency index (I2). We will use the random effects model to calculate a pooled estimate.DiscussionAlthough several studies have shown that NAC can ameliorate hyperglycaemia-induced oxidative damage within the heart, this systematic review will be the first pre-registered synthesis of data to identify the cardioprotective potential of NAC against hyperglycaemia-induced oxidative damage. This result will help guide future research evaluating the cardioprotective role of NAC against DCM and better identify possible mechanisms of action for NAC to prevent oxidative damage with a diabetic heart.Systemic review registrationPROSPERO CRD42017055851.

The impact of science-based knowledge on attitudes towards sex offenders

Background. The general public often holds negative attitudes towards sex offenders, which could result in an exclusion of sex offenders from society. Since lack of social support is a known risk factor for relapse, it is highly desirable that interventions target to reduce the negativity of attitudes against sex offenders. Therefore, the current study aims at exploring the effectiveness of an intervention based on the provision of in-depth scientific knowledge on existing attitudes and degree of dehumanization towards sex offenders in undergraduates that are expected to work with sex offenders in their future careers. Methods. A non-randomized experimental study was conducted, involving an experimental group (n = 9) and a control group (n = 5). In a pre- and posttest measurement participants’ attitudes and degree of dehumanization towards sex offenders were measured. During the interval, the experimental group took a four-week course about sex offending, wherein in-depth scientific knowledge was provided, whereas the control group received no scientific information. Comparisons were made between the attitudes towards sex offenders, and between the degree of dehumanization towards sex offenders, between the pre- and post-test measurement within and between the participant groups. Results. A significant difference was found for attitudes between the pre- and post-test measurement within the experimental group. The degree of dehumanization towards sex offenders has not decreased during the intervention within both participant groups. Conclusion. This study suggests that in-depth scientific knowledge has a positive influence on attitudes towards sex offenders, but not on the degree of dehumanization in future professionals within the field of forensics and psychology. However, the study’s small sample size suggests for more extensive research on the subject. Nevertheless, the present findings provide a method for the improvement of treatment and rehabilitation of sex offenders by influencing impeding, negative attitudes.

Diabetes Mellitus as a Risk Factor in Glaucoma's Physiopathology and Surgical Survival Time: A Literature Review.

ABSTRACTGlaucoma is a multifactorial condition under serious influence of many risk factors. The role of diabetes mellitus (DM) in glaucoma etiology or progression remains inconclusive. Although, the diabetic patients have different healing mechanism comparing to the general population and it has a possible-negative role on surgical outcomes.This review article attempts to analyze the association of both diseases, glaucoma and DM, before and after the surgery.The epidemiological studies, based mainly in population prevalence analyzes, have shown opposite outcomes in time and even in the most recent articles also the association remains inconclusive. On the contrary, the experimental models based on animal induced chronic hyperglycemia have shown an important association of both diseases, explained by common neurodegenerative mechanisms.Diabetic patients have a different wound healing process in the eye viz-a-viz other organs. The healing process is more and it results in lower surgical survival time, higher intraocular pressure (IOP) levels and, therefore, these patients usually need more medication to lower the IOP. Both randomized and nonrandomized retrospective and experimental molecular studies have shown the association between DM and glaucoma.Further studies are needed to get better explanations about outcomes on more recent surgical procedures and with the exponential use of antifibrotics.How to cite this article: Costa L, Cunha JP, Amado D, Pinto LA, Ferreira J. Diabetes Mellitus as a Risk Factor in Glaucoma’s Physiopathology and Surgical Survival Time: A Literature Review. J Curr Glaucoma Pract 2015;9(3):81-85.

Pregnancy complications in women with polycystic ovary syndrome.

The great majority of studies performed so far concerning women diagnosed with polycystic ovary syndrome (PCOS) have focused on diagnosis, menstrual cycle abnormalities, hirsutism and infertility. Although progress has been made in developing methods for achieving a pregnancy and reducing multiple gestations in women with PCOS, little attention has been paid to pregnancy complications and subsequent child outcomes. This review aims to summarize current knowledge regarding the clinical and pathophysiological features of pregnancy and children in women with PCOS. A literature search up to April 2015 was performed in PubMed, Medline, the Cochrane Library and Web of Science without language restriction. All articles were initially screened for title and abstract and full texts of eligible articles were subsequently selected. Systematic reviews with meta-analysis were initially included for each specific subject. Recent randomised controlled trials (RCTs), which were not included in the systematic reviews, were also included. In addition to evidence from meta-analyses or RCTs, we used non-randomized prospective, uncontrolled prospective, retrospective and experimental studies. When specific data for patients with PCOS were lacking, results from general population studies were reported. Women with PCOS exhibit a clinically significant increased risk of pregnancy complications compared with controls. Data which were not adjusted for BMI or other confounders demonstrated in PCOS a 3-4-fold increased risk of pregnancy-induced hypertension and pre-eclampsia, a 3-fold increased risk of gestational diabetes and 2-fold higher chance for premature delivery. Features characteristic of PCOS, such as hyperandrogenism, obesity, insulin resistance and metabolic abnormalities, may contribute to the increased risk of obstetric and neonatal complications. Limited available data suggest that offspring of women with PCOS have an increased risk for future metabolic and reproductive dysfunction. Underlying pathophysiological mechanisms of pregnancy complications along with its association with health of offspring remain uncertain. To date, the strategies for prevention and management of pregnancy complications in women with PCOS, and whether long-term health of these women is influenced, and to what extent, by pregnancy and/or pregnancy complications, remain to be elucidated. Women with PCOS show an increased risk of pregnancy complications. Heterogeneous aetiological factors involved in PCOS and associated co-morbidities may all be involved in compromised pregnancy and child outcomes. In women with PCOS, a possible relationship with genetic, environmental, clinical and biochemical factors involved in this complex condition, as well as with pregnancy complications and long-term health for both mother and child, remains to be established.

Effectiveness of Interventions Targeting Health Behaviors in University and College Staff: A Systematic Review

Evaluate the literature on interventions targeting tertiary education staff within colleges and universities for improvements in health behaviors such as physical activity, dietary intake, and weight loss. One online database, Medline, was searched for literature published between January 1970 and February 2013. All quantitative study designs, including but not limited to randomized controlled trials, quasi-experimental studies, nonrandomized experimental trials, cohort studies, and case-control studies, were eligible. Data extraction was performed by one reviewer using a standardized form developed by the researchers. Extraction was checked for accuracy and consistency by a second reviewer. Data in relation to the above objective were extracted and described in a narrative synthesis. Seventeen studies were identified that focused on staff within the tertiary education setting. The review yielded overall positive results with 13 reporting significant health-related improvements. Weight loss, physical activity and fitness, and/or nutrition were the focus in more than half (n = 9) of the studies. This appears to be the first review to examine health interventions for tertiary education staff. There is scope to enhance cross-disciplinary collaboration in the development and implementation of a "Healthy University" settings-based approach to health promotion in tertiary education workplaces. Universities or colleges could serve as a research platform to evaluate such intervention strategies.

Corneal collagen cross-linking for keratoconus: Results of 3-year follow-up in Pakistani population

ObjectiveTo assess the effectiveness and safety of corneal collagen cross-linking with riboflavin and ultraviolet A (UV-A) light in arresting the progression of keratoconus. DesignProspective, nonrandomized experimental study. ParticipantsSeventy-one eyes of 66 patients with progressive keratoconus. MethodsCorneal cross-linking was carried out with riboflavin and UV-A light in patients with progressive keratoconus at Al-Shifa Trust Eye Hospital, Pakistan. Standard protocol of cross-linking comprising epithelial debridement, instillation of isotonic riboflavin (0.1%) for 30 minutes, followed by application of UV-A light for 30 minutes with riboflavin was followed. Variables of interest were uncorrected and best corrected visual acuity (BCVA) with spectacles, spherical equivalent refraction, maximum keratometric reading, and central corneal thickness. Three-year results of these variables after cross-linking were analyzed. ResultsMean age of patients was 19.79 ± 3.71 years; 75.8% were male and 24.2% were female. After 3 years, uncorrected visual acuity improved in 31.0% by mean 2.0 ± 1.06 Snellen lines, remained same in 64.8%, and deteriorated in 4.2% by mean 1.33 ± 0.57 lines. BCVA improved in 56.3% by mean 2.37 ± 1.10 Snellen lines, remained the same in 40.8%, and deteriorated in 2.8% by mean 1.50 ± 0.70 lines. Spherical equivalent refraction decreased in 33.8% by mean 2.29 ± 1.48 D, remained stable in 60.6%, and increased in 5.6% by mean 1.43 ± 0.42 D. Maximum keratometric reading showed mean regression of 2.64 ± 1.42 D in 60.6%, stabilization in 35.2%, and mean progression of 2.0 ± 0.17 D in 4.2%. In 95.8% of cases, progression of keratoconus halted. Central corneal thickness was decreased by mean 10.32 ± 21.19 µm. ConclusionsCross-linking is an effective and safe treatment option in halting the progression of keratoconus.

The use of systematic review to develop a self-management program for CKD

Chronic kidney disease (CKD) has become a public health issue of international concern due to its high prevalence. The concept of self-management has been comprehensively applied in education programs that address chronic diseases. In recent years, many studies have used self-management programs in CKD interventions and have investigated the pre- and post-intervention physiological and psychological effectiveness of this approach. However, a complete clinical application program in the self-management model has yet to be developed for use in clinical renal care settings. A systematic review is used to develop a self-management program for CKD. Three implementation steps were used in this study. These steps include: (1) A systematic literature search and review using databases including CEPS (Chinese Electronic Periodical Services) of Airiti, National Digital Library of Theses and Dissertations in Taiwan, CINAHL, Pubmed, Medline, Cochrane Library, and Joanna Briggs Institute. A total of 22 studies were identified as valid and submitted to rigorous analysis. Of these, 4 were systematic literature reviews, 10 were randomized experimental studies, and 8 were non-randomized experimental studies. (2) Empirical evidence then was used to draft relevant guidelines on clinical application. (3) Finally, expert panels tested the validity of the draft to ensure the final version was valid for application in practice. This study designed a self-management program for CKD based on the findings of empirical studies. The content of this program included: design principles, categories, elements, and the intervention measures used in the self-management program. This program and then was assessed using the content validity index (CVI) and a four-point Liker's scale. The content validity score was .98. The guideline of self-management program to CKD was thus developed. This study developed a self-management program applicable to local care of CKD. It is hoped that the guidelines developed in this study offer a reference for clinical caregivers to improve their healthcare practices.

The clinical effectiveness of intra-articular corticosteroids for arthritis of the lower limb in juvenile idiopathic arthritis: a systematic review.

BackgroundJuvenile Idiopathic Arthritis (JIA) commonly affects joints of the lower limb including the knee, ankle, subtalar and other foot joints. Intra-articular corticosteroid injections (IACIs) are considered to be effective for short-term relief of synovitis, however, there appears to be a significant lack of published evidence from comparative effectiveness studies. The aim of this study was to identify and critically appraise the evidence for the efficacy of lower limb IACIs in children/adolescents with JIA.MethodsStudies were identified in databases Medline, Embase, CINAHL, AMED, PEDro, the Cochrane Library and TRIP, with no date restrictions. The primary search terms ‘juvenile idiopathic arthritis’, ‘lower limb’, ‘knee’; ‘ankle’, ‘foot’ and ‘intra-articular steroid injections’ and related synonyms were used to develop a comprehensive pragmatic literature search strategy. Included studies were quantitative longitudinal design such as randomised controlled trials, pseudo-randomised and non-randomised experimental studies, cohort studies, and case-control studies. All outcomes measures were subject to analysis. Quality assessment was conducted using the Cochrane Collaboration criteria with additional criteria for sample population representativeness, quality of statistical analysis and compliant intervention use and presence of co-interventions. Qualitative data synthesis was conducted for the outcome domains. Meta-analyses were not possible as multiple randomised controlled trials for outcome measures were not available. Levels of evidence were assigned to each outcome measure.ResultsThe inclusion criteria were met by twenty-one studies. One study had high quality for internal validity and nine studies had high quality for external validity. No studies had high quality for both internal and external validity. Four outcome domains were identified. There was weak evidence for IACIs decreasing clinical signs and symptoms in the lower leg, improving joint range of motion, decreasing leg length discrepancy, and for imaging techniques detecting the effects of IACIs.ConclusionsThere is some weak evidence for the efficacy of IACIs improving certain outcome measures. However, there is also some inconclusive evidence due to a lack of quality studies. More high quality evidence is necessary to definitely determine the efficacy of IACIs for JIA in the lower leg.

Use of near infrared spectroscopy to detect impaired tissue oxygen saturation in patients with complex regional pain syndrome type 1

Deep tissue hypoxia has been hypothesized in the pathogenesis of complex regional pain syndrome type 1 (CRPS 1) for some patients. The purpose of this study was to determine if near-infrared spectroscopy (NIRS) could detect differences in deep tissue oxygen saturation (StO2) and microcirculatory function in the hands of patients with CRPS 1. Tissue oxygen saturation was evaluated at baseline and during an ischemia reperfusion challenge using vascular occlusion testing (VOT) in affected vs unaffected hands of patients with unilateral upper limb CRPS 1. A non-randomized experimental study design was used with baseline StO2 as the primary outcome measure. Secondary outcome measures were occlusion and reperfusion slopes from VOT. Values were compared with the unaffected, contralateral hand and with the dominant and non-dominant hands of sex and age-matched volunteers. Correlations between values derived from NIRS and measures of pain and function from the Brief Pain Inventory (BPI) and the Disability of the Arm, Shoulder and Hand (DASH) questionnaires were explored. Independent of handedness, the baseline StO2 of the affected hands of ten CRPS 1 patients was significantly lower than that of their unaffected hands (-5.8%; 95% confidence interval [CI] -10.6 to -1.0; P = 0.02). The baseline StO2 of affected CRPS 1 hands was also significantly lower than the non-dominant hands of ten volunteers (-7.3%; 95% CI -12.4 to -2.3; P = 0.007). Differences in VOT occlusion and reperfusion slopes did not reveal changes that could be uniquely attributed to CRPS 1. No significant correlations were detected between values derived from VOT and values for pain and function obtained from BPI and DASH questionnaires for patients with CRPS 1. Hands of patients affected by CRPS 1 of the upper limb showed significantly lower StO2 compared with their unaffected contralateral hand as well as the hands of control subjects. This trial was registered at: ClinicalTrials.gov: NCT01586377.

Visual acuity dynamics after phacoemulsification in patients with “wet” form of age-related macular degeneration, treated by intravitreal angiogenesis inhibitor injections

Design: prospective non-randomized experimental longitudinal cohort study. The aim of the study: to evaluate the visual acuity after phacoemulsification in patients with the “wet” form of age-related macular degeneration, treated by intravitreal angiogenesis inhibitor injections. Materials: 48 patients (48 eyes) with the “wet” form of AMD, treated by intravitreal angiogenesis inhibitor injections, and incipient cataract. All eyes in the study had a diagnosis of “wet” AMD and underwent cataract surgery. They were followed for a minimum of two years after the cataract surgery. The mean age of patients was 78.16 ± 5 years. There were 36 female (75 %) and 12 male (25 %) patients. Results: All patients were retrospectively divided into two groups. Group No. 1 consisted of 23 patients — operated within a year of the diagnosis of “wet” AMD, and group No. 2 which consisted of 25 patients who had a diagnosis of “wet” AMD for longer than one year prior to the cataract surgery. The mean preoperative visual acuity in the 1st group was 0.16 ± 0.07 (median 0.15), and in patients of group 2 — 0.23 ± 0.06 (median 0,2). Mean visual acuity immediately before surgery in the 1st group was 0.13 ± 0.04 (median 0.09), in the 2nd group — 0.12 ± 0.04 (median 0,08). After surgery, in the 1st group, mean visual acuity was — 0.28 ± 0.08 (median 0.25), in the 2nd group —0.18 ± 0.07 (median 0,15). The difference between the two groups was statistically significant, p 0.01, t-test. Statistically significant visual acuity increase after surgery was registered in both groups and was preserved after one and two years, when compared to the data before surgery: for the 1st group — 0.13 and 0.1; for the 2nd group — 0,1 and 0.07, respectively (p 0,01, Wilcoxon criterion). Conclusions: Phacoemulsification is reasonable for eyes with the “wet” form of age-related macular degeneration. Patients with shorter “wet” AMD duration obtain a higher visual acuity increase after cataract surgery. Statistically significant visual acuity increase after surgery is preserved in the majority of patients during next 2 years of follow-up.

Downregulated Expression of Inhibitor of Growth 4 (ING4) in Advanced Colorectal Cancers: A Non-Randomized Experimental Study

Colorectal cancer has a high cure rate if it can be detected early. Identifying and understanding the genes involved may enable early diagnosis and reduce mortality. The aim of our study was to investigate the correlation between the expression of ING4 and the pathological features in patients with colorectal cancer. We assayed ING4 protein expression levels in tumor samples from 97 patients diagnosed with colorectal cancer between January 2001 and January 2002. The patients received no other treatments except surgery. ING4 protein expression was downregulated in adenoma relative to normal mucosa and further reduced in colorectal cancer tissues. Furthermore, the suppression of ING4 expression was also related to the more advanced Dukes' stages. We observed that ING4 expression levels in patients with lymphatic metastasis were lower than those without metastasis. Together, our results indicate that ING4 play a role in colorectal carcinoma progression.

Correlation Between the Peak Nasal Inspiratory Flow and the Visual Analogue Scale Before and After Using a Nasal Decongestant

Summary Introduction: The measurement of the peak nasal inspiratory flow (PNIF) is easily and swiftly obtained, but hardly spread in Brazil though. On the other hand, the visual analogue scale (VAS) for nasal obstruction is a subjective measurement that can also be used. Objective: To evaluate the correlation between PNIF and VAS for nasal obstruction before and after occurring a change in the nasal patency caused by the topic vasoconstriction. Study outline: Non-randomized clinical and experimental study. Method: 60 volunteers, including patients, doctors, nurses and administrative assistants of the institution were submitted to PNIF and VAS examinations before and after the nasal vasoconstriction with oxymetazoline chloride at 0.05%. Results: The average value found for pre-vasoconstriction VAS was 4.1 and, for post-vasoconstriction, it was 2. This represented a 44% range between the measurements. With regard to PNIF values, the average found when measuring the vasoconstriction was 151 l/min and 178 l/min after vasoconstriction, showing a 20% increase. At the pre-vasoconstrictor moment, increasing a point in average VAS value corresponds to a 3.8% decrease in average PNIF value. In the post-vasoconstriction, each increase of a point in average VAS value corresponds to a 4.5% decrease in average PNIF value. Conclusion: There was an important correlation between the objective measurement of the nasal obstruction through PNIF and the subjective measurement provided by VAS before nasal vasoconstriction. A similar correlation could also be observed after using the decongestant.

An introduction to the speechBITE database: Speech pathology database for best interventions and treatment efficacy

This paper describes the development of the Speech Pathology Database for Best Interventions and Treatment Efficacy (speechBITE) at The University of Sydney. The speechBITE database is designed to provide better access to the intervention research relevant to speech pathology and to help clinicians interpret treatment research. The challenges speech pathologists face when locating research to support evidence-based practice have been well documented and include inadequate time resources and difficulties in navigating and using a multiplicity of electronic databases. These barriers are addressed by speechBITE by providing the first open-access database on the internet that solely indexes treatment in the area of communication and swallowing disorders. The database includes the bibliographic details from systematic reviews, randomized controlled trials, nonrandomized controlled trials, case series, and single-case experimental design studies. At present, randomized and nonrandomized controlled trials are rated with the Physiotherapy Evidence Database (PEDro) scale to assist clinicians with interpreting the methodological quality of the clinical studies of relevance to speech pathologists. Source of funding: Speech Pathology Australia, the Motor Accidents Authority of NSW, Guild Insurance, the American Speech-Language-Hearing Association, and the Canadian Association of Speech-Language Pathologists and Audiologists.