简介：AIM:TodeterminethevisualoutcomesinadultpatientswhosustainedopenglobeinjuriesandtodeterminewhetherthevisualprognosisfollowinganeyeinjuryinanAfricansettingdiffersfromthepredictedoutcomesaccordingtotheOcularTraumaScore(OTS)study.AsecondaryaimwastoestablishtheeviscerationratefortheseinjuriesandassesshowthisformofinterventionaffectedoutcomesincomparisontotheOTS.·METHODS:Aprospectivecaseseriesofallpatientsadmittedwithopenglobeinjuriesoveratwo-year(July2009toJune2011)period.InjurieswerescoredusingtheOTSandthesurgicalinterventionwasrecorded.Thebestcorrectedvisualacuityatthreemonthswasregardedasvisualoutcome.·RESULTS:Therewere249openglobeinjuries,ofwhich169patients(169eyes)completedthe3-monthfollow-up.Allpatientsunderwentprimarysurgery,175(70.3%)repairs,61(24.5%)eviscerationsand13(5.2%)otherprocedures.GlobeeviscerationsweremainlydoneonOTSCategory1cases,butoutcomesinthiscategorywerenotfoundtobedifferentfromOTSoutcomes.OutcomesweresignificantlyworseinCategory2,butwhentheentiredistributionwastested,thedifferenceswerenotstatisticallysignificant.TheoverallassociationbetweenOTSoutcomesandthefinalvisualoutcomesinthisstudywasfoundtobeastrong(P<0.005).·CONCLUSION:Reliableinformationregardingtheexpectedoutcomesofeyeinjurieswillinfluencemanagementdecisionsandpatientexpectations.TheOTSisavaluabletool,theuseofwhichhasbeenvalidatedinmanypartsoftheworld-itmayalsobeavalidpredictorinanAfricansetting.

简介：BackgroundManypatientshavesymptomssuggestiveofcoronaryarterydisease(CAD)andareoftenevaluatedwiththeuseofdiagnostictesting,althoughtherearelimiteddatafromrandomizedtrialstoguidecare.MethodsWerandomlyassigned10,003symptomaticpatientstoastrategyofinitialanatomicaltestingwiththeuseofcoronarycomputedtomographicangiography(CTA)ortofunctionaltesting(exerciseelectrocardiography,nuclearstresstesting,orstressechocardiography).Thecompositeprimaryendpointwasdeath,myocardialinfarction,hospitalizationforunstableangina,ormajorproceduralcomplication.SecondaryendpointsincludedinvasivecardiaccatheterizationthatdidnotshowobstructiveCADandradiationexposure.ResultsThemeanageofthepatientswas60.8±8.3years,52.7%werewomen,and87.7%hadchestpainordyspneaonexertion.ThemeanpretestlikelihoodofobstructiveCADwas53.3±21.4%.Overamedianfollow-upperiodof25months,aprimaryend-pointeventoccurredin164of4996patientsintheCTAgroup(3.3%)andin151of5007(3.0%)inthefunctional-testinggroup(adjustedhazardratio,1.04;95%confidenceinterval,0.83to1.29;P=0.75).CTAwasassociatedwithfewercatheterizationsshowingnoobstructiveCADthanwasfunctionaltesting(3.4%vs.4.3%,P=0.02),althoughmorepatientsintheCTAgroupunderwentcatheterizationwithin90daysafterrandomization(12.2%vs.8.1%).ThemediancumulativeradiationexposureperpatientwaslowerintheCTAgroupthaninthefunctional-testinggroup(10.0mSvvs.11.3mSv),but32.6%ofthepatientsinthefunctional-testinggrouphadnoexposure,sotheoverallexposurewashigherintheCTAgroup(mean,12.0mSvvs.10.1mSv;P<0.001).ConclusionsInsymptomaticpatientswithsuspectedCADwhorequirednoninvasivetesting,astrategyofinitialCTA,ascomparedwithfunctionaltesting,didnotimproveclinicaloutcomesoveramedianfollow-upof2years.

简介：AIM:ToevaluatetheoutcomesofAhmedglaucomavalve(AGV)implantationsurgeryforrefractoryglaucoma.METHODS:Thisone-armedhistoricalcohortstudywasconductedin2011.Refractoryglaucomawasdefinedaseyeswithanintraocularpressure(IOP)greaterthan21mmHgwithmaximallytoleratedglaucomamedications,failedsurgeries,orboth.ForalleyeswithrefractoryglaucomathatunderwentAGVimplantation,datawerecollectedonIOP,thebestcorrectedvisualacuity(BCVA)andglaucomamedicationspreoperativelyand4,6,12,24and56wkpostoperatively.LogarithmvaluesofIOPwerecalculatedandcompared.RESULTS:Thestudygroupwascomprisedof30patients(30eyes,16malesand14females)withrefractoryglaucoma.MeanpreoperativeIOPwas39.3±13.8mmHg.PostoperativemeanIOPwas15.7±7.1mmHg,19.6±12.8mmHgand13.9±14.2mmHgat12,24and56wkrespectively.BCVAwas≥6/60in11eyespreoperatively,andfiveeyeshadBCVA≥6/60at56wkpostoperatively.Preoperatively,morethanfourmedicationswereusedtotreatglaucomain21eyes.At12wkpostoperatively,nomedicationswererequiredtocontrolIOPin20eyes.At56wkpostoperatively,atleastonemedicationwasrequiredtocontrolIOPin10eyes.Overtheentirefollowupperiod,foureyesweretreatedwithyttriumaluminiumgarnet(YAG)laserand14eyesrequiredasecondsurgery.TheAGVwasremovedinfoureyes.CONCLUSION:AGVimplantationreducedIOPandthenumberofmedicationsrequiredtocontrolrefractoryglaucoma.However,therewasahigherriskofdecreasedvision.Long-termfollowupandpromptinterventionarerecommended.

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简介：AIM:Todeterminethelong-termeffectsofselectivelasertrabeculoplasty(SLT)onintraocularpressure(IOP)andthenumberofmedicationsusedupto5yfollowingtreatmentinglaucomapatientsreceivingmaximallytoleratedmedicaltherapy(MTMT).·METHODS:TheWillsEyeHospitalGlaucomaResearchCenterretrospectivelyreviewedthechartsofglaucomapatientswhounderwentSLTafterreceivingMTMT.Eyesthatdidnotachievetheirtargetpressurewithin3mofollowingSLTwereexcludedfromthestudy.ChangesinmeanIOPandnumberofglaucomamedicationsusedwereanalyzedat1,3,and5yfollowingSLT.·RESULTS:Seventy-fiveeyesof67patientswereincludedinthestudy.FifteeneyesthatreceivedSLTfailedtoachievetheirtargetpressurewithin3moandwereexcludedfromthestudy.Theaveragefollow-uptimewas37.4mo(±14.4).MeanIOPwassignificantlyreduced1yaftertreatment(P=0.005).Itwasalsoreduced3,5yaftertreatmentwithoutreachingstatisticalsignificance(P=0.20andP=0.072,respectively).Therewasasignificantdecreaseinmeannumberofmedicationsused1,3,5yaftertreatment(P<0.001,P<0.001,andP=0.039,respectively).Inthespanof5y,2eyes(2.7%)underwentrepeatSLT,7eyes(9.3%)underwentglaucomasurgeryandanadditional3eyes(4.0%)underwentboth.·CONCLUSION:SLTsignificantlyreducedthenumberofglaucomamedicationsused5yfollowingtreatmentinglaucomapatientsreceivingMTMT.SLTmaydelayoperating-roomsurgery.

简介：Objective:Differentiatedthyroidcarcinomas(DTCs)areclassifiedintopapillarythyroidcarcinoma(PTC)andfollicularthyroidcarcinoma(FTC).DTCsareanalyzedasasinglegroupinclinicalstudiesthatinvestigatedtheprognosticfactorsandprognosisofthesemalignancies.However,thebiologicalbehaviorsofthesecarcinomassignificantlydiffer.Inthepresentstudy,weaimedtodetectdifferencesintheoutcomesbetweenPTCandFTCinMansouraUniversityHospitalinEgypt.Methods:Atotalof558patientswithhistologicallyproventhyroidcarcinomasfromJanuary2003toDecember2012wereretrospectivelyenrolled.Theclinicalandpathologicaldataofpatientswerereviewed.Results:Largeprimarytumorsize,lymphnodeinvolvement,extrathyroidextension,anddistantmetastasisweresignificantpoorprognosticfactorsforoverallsurvival(OS)inoldPTCpatients.Coxhazardanalysisshowedthatthepatient'sage,extrathyroidextension,anddistantmetastasisweretheonlyindependentprognosticfactors.InFTCpatients,onlythedistantmetastasisanddegreeoftumorinvasionweresignificantpoorprognosticfactorsinOSunivariateanalysis.However,thesefactorswerenonsignificantinmultivariateanalysis.The10-yearOSrateswere97%and89%forPTCandFTC,respectively(P=0.003).The10-yeardisease-freesurvival(DFS)rateswere77.2%inPTCvs.65%inFTC(P=0.179).Conclusion:ThesignificantprognosticfactorsvarybetweenthetwotypesofDTCs.Therefore,PTCandFTCpatientsneedtobeanalyzedandreportedindependently.PTCsurvivaliswidelyandsignificantlyaffectedbyage,extrathyroidextension,anddistantmetastasis.Bycontrast,thesefactorswerenonsignificantinFTC,whichshowedpoorersurvivalthanPTC.

简介：AIM:Todescribetheclinicalfeatures,systemicassociations,treatmentandvisualoutcomesinSaudipatientswithscleritis.·METHODS:AretrospectivechartreviewwasperformedforpatientswithscleritispresentingtotwotertiarycareeyehospitalsinRiyadh,SaudiArabia,from2001to2011.Datawerecollectedontheclinicalfeaturesofscleritis,subtypesofscleritis,associatedsystemicdisease,historyofpreviousocularsurgeryandmedicaltherapy,includingtheuseofimmunosuppressants.Treatmentoutcomeswereevaluatedbasedonbest-correctedvisualacuity(BCVA)andresponsetotreatment.·RESULTS:Ofthe52patientsincludedinthestudy,non-necrotizinganteriorscleritiswasthemostcommontypeofscleritisin22patients(42.3%),followedbyposteriorscleritisin14patients(26.9%).Themajorityofcases,31patients(59.6%),wereidiopathicinnature.Systemicassociationswerepresentin12patients(23.1%).Infectiousscleritiswasconfirmedin6patients(11.5%):3withbacterialscleritisafterpterygiumexcision,2patientswithscleritisrelatedtotuberculosisand1patientwithscleritisresultingfromherpessimplexinfection.Forthevarioussubtypesofscleritis,BCVAvaluesaftertreatmentandtimetoremissionsignificantlydiffered(P<0.05,allcases).Systemicimmunosuppressivetherapiesinadditiontosteroidswereadministeredto46.2%ofallpatients.TheT-signwaspresentonB-scanultrasonographyin9(64.3%)ofthe14posteriorscleritispatients.·CONCLUSION:Non-necrotizinganteriorscleritiswasthemostcommonsubtypeofscleritis.Finalvisualoutcomeandtimetoremissiondifferedamongthevariousscleritissubtypes.

简介：Therearefewpopulation-baseddataininvestigatingtheimpactofdiabetesonchemotherapyadverseeffectsandtreatmentoutcomesofnon-metastaticbreastcancer.Thepurposeofthisstudyistoevaluatewhetherdiabetesaffectsthepatternsofuseinchemotherapy,toxiceffectsofchemotherapy,andtreatmentoutcomesfornon-metastaticbreastcancerinTaiwan.Thestudyresultscanprovidephysiciansformakingadecisionwhetherornottousechemotherapybasedontheindividualpatients’condition.

简介：AIM:ToevaluatethecompletionrateanddiagnosticyieldofthePillCamSB2-exincomparisontothePillCamSB2.METHODS:Twohundredcasesusingthe8-hPillCamSB2wereretrospectivelycomparedto200casesusingthe12hPillCamSB2-exatatertiaryacademiccenter.Endoscopicallyplacedcapsuleswereexcludedfromthestudy.Demographicinformation,indicationsforcapsuleendoscopy,capsuletype,studylength,completionofexam,clinicallysignificantfindings,timestampofmostdistantfinding...