Myopic maculopathy: Current status and proposal for a new classification and grading system (ATN)

Myopia is a highly frequent ocular disorder worldwide and pathologic myopia is the 4th most common cause of irreversible blindness in developed countries. Pathologic myopia is especially common in East Asian countries. Ocular alterations associated with pathologic myopia, especially those involving the macular area—defined as myopic maculopathy—are the leading causes of vision loss in patients with pathologic myopia. High myopia is defined as the presence of a highly negative refractive error (>−6 to −8 diopters) in the context of eye elongation (26–26.5 mm). Although the terms high myopia and pathologic myopia are often used interchangeably, they do not refer to the same eye disease. The two key factors driving the development of pathologic myopia are: 1) elongation of the axial length and 2) posterior staphyloma. The presence of posterior staphyloma, which is the most common finding in patients with pathologic myopia, is the key differentiating factor between high and pathologic myopia. The occurrence of staphyloma will, in most cases, eventually lead to other conditions such as atrophic, traction, or neovascular maculopathy. Posterior staphyloma is for instance, responsible for the differences between a myopic macular hole (MH)—with and without retinal detachment—and idiopathic MH. Posterior staphyloma typically induces retinal layer splitting, leading to foveoschisis in myopic MH, an important differentiating factor between myopic and emmetropic MH. Myopic maculopathy is a highly complex disease and current classification systems do not fully account for the numerous changes that occur in the macula of these patients. Therefore, a more comprehensive classification system is needed, for several important reasons. First, to more precisely define the disease stage to improve follow-up by enabling clinicians to more accurately monitor changes over time, which is essential given the progressive nature of this condition. Second, unification of the currently-available classification systems would establish standardized classification criteria that could be used to compare the findings from international multicentric studies. Finally, a more comprehensive classification system could help to improve our understanding of the genetic origins of this disease, which is clearly relevant given the interchangeable—but erroneous—use of the terms high and pathologic myopia in genetic researc

Socioeconomic inequalities in low birth weight risk before and during the COVID-19 pandemic in Argentina: A cross-sectional study

Background: The coronavirus disease 2019 (COVID-19) pandemic may have exacerbated existing socioe- conomic inequalities in health. In Argentina, public hospitals serve the poorest uninsured segment of the population, while private hospitals serve patients with health insurance. This study aimed to assess whether socioeconomic inequalities in low birth weight (LBW) risk changed during the first wave of the COVID-19 pandemic. Methods: This multicenter cross-sectional study included 15929 infants. A difference-in-difference (DID) analysis of socioeconomic inequalities between public and private hospitals in LBW risk in a pandemic cohort (March 20 to July 19, 2020) was compared with a prepandemic cohort (March 20 to July 19, 2019) by using medical records obtained from ten hospitals. Infants were categorized by weight as LBW < 2500 g, very low birth weight (VLBW) < 1500 g and extremely low birth weight (ELBW) < 1000 g. Log binomial regression was performed to estimate risk differences with an interaction term representing the DID estimator. Covariate-adjusted models included potential perinatal confounders. Findings: Of the 8437 infants in the prepandemic cohort, 4887 (57 ? 9%) were born in public hospitals. The pandemic cohort comprised 7492 infants, 4402 (58 ? 7%) of whom were born in public hospitals. The DID estimators indicated no differences between public versus private hospitals for LBW risk ( −1 ? 8% [95% CI −3 ? 6, 0 ? 0]) and for ELBW risk ( −0 ? 1% [95% CI −0 ? 6, 0 ? 3]). Significant differences were found between public versus private hospitals in the DID estimators ( −1 ? 2% [95% CI, −2 ? 1, −0 ? 3]) for VLBW risk. The results were comparable in covariate-adjusted models. Interpretation: In this study, we found evidence of decreased disparities between public and private hos- pitals in VLBW risk. Our findings suggest that measures that prioritize social spending to protect the most vulnerable pregnant women during the pandemic contributed to better birth outcomes. Funding: No funding was secured for this study.Fil: Cuestas, Eduardo. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Instituto de Investigaciones en Ciencias de la Salud. Universidad Nacional de Córdoba. Instituto de Investigaciones en Ciencias de la Salud; ArgentinaFil: Gómez Flores, Martha E.. Gobierno de la Provincia de Buenos Aires. Hospital Doctor Ramón Carrillo; ArgentinaFil: Charras, María D.. Gobierno de la Provincia de Buenos Aires. Hospital Doctor Ramón Carrillo; ArgentinaFil: Peyrano, Alberto J.. Hospital Materno Provincial Dr. Raúl Felipe Lucini; ArgentinaFil: Montenegro, Clara. Hospital Materno Provincial Dr. Raúl Felipe Lucini; ArgentinaFil: Sosa Boye, Ignacio. No especifíca;Fil: Burgos, Verónica. Universidad Católica de Córdoba. Facultad de Medicina. Clínica Universitaria Reina Fabiola; ArgentinaFil: Giusti, Graciela. Clínica y Maternidad del Sol; ArgentinaFil: Espósito, Mario. Clínica y Maternidad del Sol; ArgentinaFil: Blanco Pool, Silvyana S.. Hospital Misericordia Nuevo Siglo ; Gobierno de la Provincia de Cordoba; ArgentinaFil: Gurevich, Debora P.. Hospital Misericordia Nuevo Siglo ; Gobierno de la Provincia de Cordoba; ArgentinaFil: Ahumada, Luis A.. Hospital Misericordia Nuevo Siglo ; Gobierno de la Provincia de Cordoba; ArgentinaFil: Pontoriero, Ricardo D.. Hospital Misericordia Nuevo Siglo ; Gobierno de la Provincia de Cordoba; ArgentinaFil: Rizzotti, Alina. Hospital Privado Universitario de Córdoba; ArgentinaFil: Bas, José I.. Hospital Privado Universitario de Córdoba; ArgentinaFil: Vaca, María B.. Hospital Universitario de Maternidad y Neonatología; ArgentinaFil: Miranda, María J.. Hospital Universitario de Maternidad y Neonatología; ArgentinaFil: Ferreyra, Mirta E.. Hospital Misericordia Nuevo Siglo ; Gobierno de la Provincia de Cordoba; ArgentinaFil: Moreno, Gabriela C.. Gobierno de la Provincia de Buenos Aires. Hospital Doctor Ramón Carrillo; ArgentinaFil: Pedicino, Héctor. Hospital Italiano; ArgentinaFil: Rojas Rios, Melvy. Hospital Italiano; Argentin

Association between COVID-19 mandatory lockdown and decreased incidence of preterm births and neonatal mortality

Previous studies suggest a decrease in preterm births (PTB) during de coronavirus disease 2019 (COVID-19), possibly due to the effect of the mandatory lockdown. Nevertheless, other reports have been unable to confirm this finding. Most of these studies originated in high-income countries and evaluated a limited number of potential confounders, and all of them assessed a short lockdown period. In addition, an important question remains unanswered: How can we be sure that the observed changes are due to lockdown, when most of the pregnancies delivered in the lockdown period were conceived prior to it?To date there is insufficient evidence to support the notion that public health interventions during the lockdown prevent PTB . The aim of this study was to compare the incidence of PTB, neonatal mortality (NM) and stillbirths adjusted by potential confounders during the lockdown period assessing a time window of nine and a half months during which all the pregnancies analyzed in the exposed group were conceived after the lockdown, with the corresponding incidence in the previous year where all the unexposed pregnancies analyzed were conceived before the lockdown.publishedVersionFil: Cuestas, Eduardo. Universidad Nacional de Córdoba. Facultad de Ciencias Médicas; Argentina.Fil: Cuestas, Eduardo. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Investigaciones en Ciencias de la Salud; Argentina.Fil: Gómez Flores, Martha E. Gobierno de la Provincia de Buenos Aires. Hospital Doctor Ramon Carrillo; Argentina.Fil: Charras, María D. Gobierno de la Provincia de Buenos Aires. Hospital Doctor Ramon Carrillo; Argentina.Fil: Peyrano, Alberto J. Hospital Materno Provincial Dr. Raúl Felipe Lucini; Argentina.Fil: Montenegro, Clara. Hospital Materno Provincial Dr. Raúl Felipe Lucini; Argentina.Fil: Sosa-Boye, Ignacio. Clínica Universitaria Reina Fabiola; Argentina.Fil: Burgos, Verónica. Clínica Universitaria Reina Fabiola; Argentina.Fil: Giusti, Graciela. Clínica y Maternidad del Sol; Argentina.Fil: Espósito, Mario. Clínica y Maternidad del Sol; Argentina.Fil: Blanco Pool, Silvyana S. Hospital Misericordia Nuevo Siglo; Argentina.Fil: Blanco Pool, Silvyana S. Sanatorio Allende; Argentina.Fil: Gurevich, Debora P. Sanatorio Allende; Argentina.Fil: Gurevich, Debora P. Hospital Misericordia Nuevo Siglo; Argentina.Fil: Ahumada, Luis A. Sanatorio Allende; Argentina.Fil: Ahumada, Luis A. Hospital Misericordia Nuevo Siglo; Argentina.Fil: Pontoriero, Ricardo D. Hospital Misericordia Nuevo Siglo; Argentina.Fil: Rizzotti, Alina. Hospital Privado Universitario de Córdoba; Argentina.Fil: Bas, José I. Hospital Privado Universitario de Córdoba; Argentina.Fil: Vaca, María B. Hospital Universitario de Maternidad y Neonatología; Argentina.Fil: Miranda, María J. Hospital Universitario de Maternidad y Neonatología; Argentina.Fil: Ferreyra, Mirta E. Sanatorio del Salvador; Argentina.Fil: Ferreyra, Mirta E. Hospital Misericordia Nuevo Siglo; Argentina.Fil: Moreno, Gabriela C. Sanatorio del Salvador; Argentina.Fil: Pedicino, Héctor. Instituto Universidad Escuela de Medicina del Hospital Italiano; Argentina.Fil: Rojas-Rios, Melvy. Instituto Universidad Escuela de Medicina del Hospital Italiano; Argentina

Consenso Mexicano para el Tratamiento de la Hepatitis C

El objetivo del Consenso Mexicano para el Tratamiento de la Hepatitis C fue el de desarrollar un documento como guía en la práctica clínica con aplicabilidad en México. Se tomó en cuenta la opinión de expertos en el tema con especialidad en: gastroenterología, infectología y hepatología. Se realizó una revisión de la bibliografía en MEDLINE, EMBASE y CENTRAL mediante palabras claves referentes al tratamiento de la hepatitis C. Posteriormente se evaluó la calidad de la evidencia mediante el sistema GRADE y se redactaron enunciados, los cuales fueron sometidos a voto mediante un sistema modificado Delphi, y posteriormente se realizó revisión y corrección de los enunciados por un panel de 34 votantes. Finalmente se clasificó el nivel de acuerdo para cada oración. Esta guía busca dar recomendaciones con énfasis en los nuevos antivirales de acción directa y de esta manera facilitar su uso en la práctica clínica. Cada caso debe ser individualizado según sus comorbilidades y el manejo de estos pacientes siempre debe ser multidisciplinario. Abstract The aim of the Mexican Consensus on the Treatment of Hepatitis C was to develop clinical practice guidelines applicable to Mexico. The expert opinion of specialists in the following areas was taken into account: gastroenterology, infectious diseases, and hepatology. A search of the medical literature was carried out on the MEDLINE, EMBASE, and CENTRAL databases through keywords related to hepatitis C treatment. The quality of evidence was subsequently evaluated using the GRADE system and the consensus statements were formulated. The statements were then voted upon, using the modified Delphi system, and reviewed and corrected by a panel of 34 voting participants. Finally, the level of agreement was classified for each statement. The present guidelines provide recommendations with an emphasis on the new direct-acting antivirals, to facilitate their use in clinical practice. Each case must be individualized according to the comorbidities involved and patient management must always be multidisciplinary

MUSiC : a model-unspecific search for new physics in proton-proton collisions at root s=13TeV

Results of the Model Unspecific Search in CMS (MUSiC), using proton-proton collision data recorded at the LHC at a centre-of-mass energy of 13 TeV, corresponding to an integrated luminosity of 35.9 fb(-1), are presented. The MUSiC analysis searches for anomalies that could be signatures of physics beyond the standard model. The analysis is based on the comparison of observed data with the standard model prediction, as determined from simulation, in several hundred final states and multiple kinematic distributions. Events containing at least one electron or muon are classified based on their final state topology, and an automated search algorithm surveys the observed data for deviations from the prediction. The sensitivity of the search is validated using multiple methods. No significant deviations from the predictions have been observed. For a wide range of final state topologies, agreement is found between the data and the standard model simulation. This analysis complements dedicated search analyses by significantly expanding the range of final states covered using a model independent approach with the largest data set to date to probe phase space regions beyond the reach of previous general searches.Peer reviewe

Measurement of prompt open-charm production cross sections in proton-proton collisions at root s=13 TeV

The production cross sections for prompt open-charm mesons in proton-proton collisions at a center-of-mass energy of 13TeV are reported. The measurement is performed using a data sample collected by the CMS experiment corresponding to an integrated luminosity of 29 nb(-1). The differential production cross sections of the D*(+/-), D-+/-, and D-0 ((D) over bar (0)) mesons are presented in ranges of transverse momentum and pseudorapidity 4 < p(T) < 100 GeV and vertical bar eta vertical bar < 2.1, respectively. The results are compared to several theoretical calculations and to previous measurements.Peer reviewe

Development and validation of HERWIG 7 tunes from CMS underlying-event measurements

This paper presents new sets of parameters (“tunes”) for the underlying-event model of the HERWIG7 event generator. These parameters control the description of multiple-parton interactions (MPI) and colour reconnection in HERWIG7, and are obtained from a fit to minimum-bias data collected by the CMS experiment at s=0.9, 7, and 13Te. The tunes are based on the NNPDF 3.1 next-to-next-to-leading-order parton distribution function (PDF) set for the parton shower, and either a leading-order or next-to-next-to-leading-order PDF set for the simulation of MPI and the beam remnants. Predictions utilizing the tunes are produced for event shape observables in electron-positron collisions, and for minimum-bias, inclusive jet, top quark pair, and Z and W boson events in proton-proton collisions, and are compared with data. Each of the new tunes describes the data at a reasonable level, and the tunes using a leading-order PDF for the simulation of MPI provide the best description of the dat

Performance of the CMS muon trigger system in proton-proton collisions at √s = 13 TeV

The muon trigger system of the CMS experiment uses a combination of hardware and software to identify events containing a muon. During Run 2 (covering 2015-2018) the LHC achieved instantaneous luminosities as high as 2 × 10 cm s while delivering proton-proton collisions at √s = 13 TeV. The challenge for the trigger system of the CMS experiment is to reduce the registered event rate from about 40 MHz to about 1 kHz. Significant improvements important for the success of the CMS physics program have been made to the muon trigger system via improved muon reconstruction and identification algorithms since the end of Run 1 and throughout the Run 2 data-taking period. The new algorithms maintain the acceptance of the muon triggers at the same or even lower rate throughout the data-taking period despite the increasing number of additional proton-proton interactions in each LHC bunch crossing. In this paper, the algorithms used in 2015 and 2016 and their improvements throughout 2017 and 2018 are described. Measurements of the CMS muon trigger performance for this data-taking period are presented, including efficiencies, transverse momentum resolution, trigger rates, and the purity of the selected muon sample. This paper focuses on the single- and double-muon triggers with the lowest sustainable transverse momentum thresholds used by CMS. The efficiency is measured in a transverse momentum range from 8 to several hundred GeV

Search for long-lived particles decaying to jets with displaced vertices in proton-proton collisions at root s=13 Te V

A search is presented for long-lived particles produced in pairs in proton-proton collisions at the LHC operating at a center-of-mass energy of 13 TeV. The data were collected with the CMS detector during the period from 2015 through 2018, and correspond to a total integrated luminosity of 140 fb(-1). This search targets pairs of long-lived particles with mean proper decay lengths between 0.1 and 100 mm, each of which decays into at least two quarks that hadronize to jets, resulting in a final state with two displaced vertices. No significant excess of events with two displaced vertices is observed. In the context of R-parity violating supersymmetry models, the pair production of long-lived neutralinos, gluinos, and top squarks is excluded at 95% confidence level for cross sections larger than 0.08 fb, masses between 800 and 3000 GeV, and mean proper decay lengths between 1 and 25 mm.Peer reviewe