Comparative efficacy and safety of the fixed versus unfixed combination of latanoprost and timolol in Chinese patients with open-angle glaucoma or ocular hypertension

<p>Abstract</p> <p>Background</p> <p>A noninferiority trial was conducted to evaluate the efficacy of a single evening dose of fixed-combination latanoprost 50 μg/mL and timolol 0.5 mg/mL (Xalacom^®; LTFC), in Chinese patients with primary open-angle glaucoma (POAG) or ocular hypertension (OH) who were insufficiently controlled on β-blocker monotherapy or β-blocker-based dual therapy.</p> <p>Methods</p> <p>This 8-week, randomized, open-label, parallel-group, noninferiority study compared once-daily evening dosing of LTFC with the unfixed combination of latanoprost, one drop in the evening, and timolol, one drop in the morning (LTuFC). The primary efficacy endpoint was the mean change from baseline to week 8 in diurnal intraocular pressure (IOP; mean of 8 AM, 10 AM, 2 PM, 4 PM IOPs). LTFC was considered noninferior to LTuFC if the upper limit of the 95% confidence interval (CI) of the difference was < 1.5 mmHg (analysis of covariance).</p> <p>Results</p> <p>Baseline characteristics were similar for LTFC (N = 125; POAG, 70%; mean IOP, 25.8 mmHg) and LTuFC (N = 125; POAG, 69%; mean IOP, 26.0 mmHg). Mean diurnal IOP changes from baseline to week 8 were -8.6 mmHg with LTFC and -8.9 mmHg with LTuFC (between-treatment difference: 0.3 mmHg; 95%-CI, -0.3 to 1.0). Both treatments were well tolerated.</p> <p>Conclusions</p> <p>A single evening dose of LTFC was at least as effective as the unfixed combination of latanoprost in the PM and timolol in the AM in reducing IOP in Chinese subjects with POAG or OH whose IOP was insufficiently reduced with β-blocker monotherapy or β-blocker-based dual therapy. LTFC is an effective and well tolerated once-daily treatment for POAG and OH.</p> <p>Trial registration</p> <p>Clinicaltrials.gov registration: <a href="http://www.clinicaltrials.gov/ct2/show/NCT00219596">NCT00219596</a></p

Evaluation of chronotype and sleep quality in infertile population and comparison with fertile population: a cross-sectional study

PURPOSE: Infertility is a stressful condition for couples and can affect patients\" circadian rhythm and sleep quality. The goal of this study is to assess differences in chronotype and sleep quality between infertile and fertile people. METHODS: A cross-sectional study was conducted. The infertile patient population consisted study group. Primiparous patients without any known gynecological disease who presented for routine cervical cancer screening follow-up were included in the control group. The Turkish version of the Morningness-Eveningness Questionnaire (MEQ) and Pittsburg Sleep Quality Index (PSQI) scores were evaluated between groups. RESULTS: A total of 227 patients were assessed. There were 110 patients in the study (infertile) group and 117 patients in the control (fertile) group. The evening chronotype proportion (23.6 vs. 0.9%, p < 0.001) was higher in the infertile group. The median of MEQ score was significantly higher in the fertile patients (50, IQR = 43 - 55 vs. 56, IQR = 51 - 59; p < 0.001), and the median of PSQI score was significantly higher in the infertile patients (5, IQR = 4 - 6, vs. 4, IQR = 3 - 5; p < 0.001). CONCLUSIONS: In this study, we found significantly worse sleep quality, and more evening chronotype in the patients with infertility

Aqueous humor pentraxin-3 levels in patients with diabetes mellitus.

PurposeTo evaluate aqueous humor (AH) pentraxin-3 (PTX3) levels in diabetic patients with and without diabetic retinopathy (DR).MethodsIn this prospective study, patients undergoing cataract surgery were enrolled. The study group was composed of 26 type-2 diabetic patients without DR (group 1), 32 diabetic patients with DR (group 2) and 29 age-matched subjects without any systemic disease (group 3). Fifteen proliferative DR (PDR) and 17 non-proliferative DR (NPDR) patients were enrolled in Group 2. HbA1c levels and duration of diabetes were noted. AH samples were obtained from anterior chamber at the beginning of cataract surgery and PTX3 levels were analyzed with Elisa kit.ResultsBaseline demographic characteristics were similar between groups. The mean duration of diabetes was 11.9±7.9 years in group 1 and 15.8±7.8 years in group 2 (P=0.11). The mean plasma HbA1c levels in group 1 was 9.1±2.6 and 8.2±2.4 in group 2 (P=0.36). PTX3 levels were 5.75±0.41 in group 1, 6.11±1.47 in group 2 and 4.93±0.84 ng/ml in group 3 (P=0.01). PTX3 levels in group 2 were higher than in group 1 and 3 (P=0.06 and P=0.01, respectively). There was no correlation between HbA1c and PTX3 levels (P=0.06 r=0.57, P=0.19 r=0.3, respectively). The mean PTX3 was 6.6±0.3 in PDR group and 5.6±0.5 ng/ml in NPDR group (P=0.04).ConclusionsPTX3 is an important marker especially for vascular endothelial damage. Since diabetic vascular changes are dependent on endothelial cell damage, high levels of AH PTX3 of DR patients may indicate the importance of PTX3 protein in the pathogenesis of DR

The effects of maternal smoking on fetal cranial development. Findings from routine midtrimester sonographic anomaly screening

The aim of this study was to assess the effect of continued smoking before and during pregnancy on mid-trimester fetal head development. A total of 250 pregnant women enrolled in the study. All participants were confirmed to be smokers or non-smokers by verifying breath carbon monoxide readings. Biparietal diameter (BPD), head circumference (HC), lateral ventricle (LV), and cisterna magna (CM) were evaluated by ultrasound between 20-22 weeks of pregnancy. Gender and gestational age-adjusted BPD z- scores were not statistically different between smokers and non-smokers (-0.75 ± 1.6 vs -0.51 ± 1, p = .3). HC measurements and z- scores were significantly lower in the smoking group than in the non-smoking groups (183.38 ± 14.56 vs. 189.28 ± 12.53, p = .003, 0.18 ± 1.39 multiple of median (MoM) vs. 0.56 ± 0.92, respectively, p = .023). At linear regression analysis, maternal smoking was the only independent factor associated with fetal HC z score (p = .041). In conclusion, continued smoking during pregnancy reduces fetal HC and has no effect on BPD, LV, or CM measurements at mid-gestation.IMPACT STATEMENTWhat is already known on this subject? Smoking during pregnancy is one of the most common environmental factors affecting fetal and neonatal growth and well-being. Despite the well-known effects of smoking on somatic growth, current studies have shown that it selectively affects some parts of the fetal brain, even in appropriately growing fetuses.What do the results of this study add? Continued smoking during pregnancy reduces fetal HC and has no effect on BPD, LV or CM measurements at mid-gestation. Since smoking is well known for its early and late childhood behavioral and neurological consequences, smaller mid-trimester fetal HC measurements should bring maternal smoking to mind as one of the potentially reversible causes.What are the implications of these findings for clinical practice and/or further research? The harmful effects of smoking start before the third trimester and antenatal counseling should be started early in the gestation. Every effort should be made to quit smoking before or early in pregnancy

The Role of the Urine Dipstick Test in the Detection of Abnormal Proteinuria Using Different Cut-off Levels in Hypertensive Pregnancies Hipertansif Gebeliklerde Farklı Kesim Değerleri Kullanılarak Anormal Proteinüri Saptanmasında Spot İdrar Protein Ölçümünün Rolü

© 2022, Duzce University Medical School. All rights reserved.Aim: The aim of this study was to determine the diagnostic accuracy of different urine dipstick protein threshold levels in predicting the presence of abnormal proteinuria in pregnant women with hypertension. Material and Methods: A total of 326 singleton pregnant women who underwent 501 urine protein tests and who had suspected preeclampsia were included in this retrospective study. Patient data was taken including medical and obstetric history. The results of dipstick urinalysis and concurrent 24-hour urine protein excretion measurements were compared to determine the accuracy of urinalysis. Results: A dipstick result of 1+ was found to be the best cut-off to predict 500 mg of protein excretion per day, with sensitivity and specificity of 62.09% and 88.97%, respectively. A 2+ proteinuria dipstick cut-off had high specificity and positive predictive value (PPV) (99.05% and 98.84%, respectively) for the prediction of 300 mg of protein excretion per day; this cut-off had low sensitivity (21.46%). A cut-off of 1+ also provided satisfactory specificity and PPV (91.43% and 94.48%, respectively) for the detection of 300 mg of protein excretion per day, but sensitivity was compromised (38.89%). Among 301 patients with negative dipstick results, 212 had a 24-hour urine protein extraction greater than 300 mg, with a false negative rate of 70.43%. Conclusion: The results suggest that the urine protein dipstick measurement has limited quantitative ability for the prediction of abnormal proteinuria. Additionally, the use of 500 mg 24-hours protein excretion as a cut-off value for abnormal proteinuria may provide useful data

Efficacy of fetal left ventricular modified myocardial performance index in predicting adverse perinatal outcomes in intrahepatic cholestasis of pregnancy

© 2022 Associacao Medica Brasileira. All rights reserved.OBJECTIVE: This study aimed to evaluate the effectiveness of fetal left ventricular modified myocardial performance index in predicting adverse perinatal outcomes for intrahepatic cholestasis of pregnancy. METHODS: A cross-sectional study was conducted, including 51 women with intrahepatic cholestasis of pregnancy and 80 healthy controls. Using Doppler ultrasonography, E-wave, A-wave, isovolumetric contraction time, isovolumetric relaxation time, and ejection time were recorded and the left ventricular modified myocardial performance index was measured. RESULTS: Findings showed that the mean left ventricular modified myocardial performance index, isovolumetric contraction time, and isovolumetric relaxation time values were statistically significantly higher while the ejection time and E/A ratios were statistically significantly lower in the intrahepatic cholestasis of pregnancy group than the control group. In the intrahepatic cholestasis of pregnancy group, a statistically significant positive correlation was found between left ventricular modified myocardial performance index and adverse perinatal outcomes in the intrahepatic cholestasis of pregnancy group (r=0.478, p<0.001), while a statistically significant negative correlation was found between the E/A ratio and adverse perinatal outcomes (r=-0.701, p<0.001). CONCLUSIONS: For intrahepatic cholestasis of pregnancy cases, high fetal left ventricular modified myocardial performance index values were an indicator of ventricular dysfunction, and this correlated with negative perinatal outcomes

Generating Image Descriptions via Sequential Cross-Modal Alignment Guided by Human Gaze

When speakers describe an image, they tend to look at objects before mentioning them. In this paper, we investigate such sequential cross-modal alignment by modelling the image description generation process computationally. We take as our starting point a state-of-the-art image captioning system and develop several model variants that exploit information from human gaze patterns recorded during language production. In particular, we propose the first approach to image description generation where visual processing is modelled sequentially. Our experiments and analyses confirm that better descriptions can be obtained by exploiting gaze-driven attention and shed light on human cognitive processes by comparing different ways of aligning the gaze modality with language production. We find that processing gaze data sequentially leads to descriptions that are better aligned to those produced by speakers, more diverse, and more natural—particularly when gaze is encoded with a dedicated recurrent component

Refer, Reuse, Reduce: Generating Subsequent References in Visual and Conversational Contexts

Dialogue participants often refer to entities or situations repeatedly within a conversation, which contributes to its cohesiveness. Subsequent references exploit the common ground accumulated by the interlocutors and hence have several interesting properties, namely, they tend to be shorter and reuse expressions that were effective in previous mentions. In this paper, we tackle the generation of first and subsequent references in visually grounded dialogue. We propose a generation model that produces referring utterances grounded in both the visual and the conversational context. To assess the referring effectiveness of its output, we also implement a reference resolution system. Our experiments and analyses show that the model produces better, more effective referring utterances than a model not grounded in the dialogue context, and generates subsequent references that exhibit linguistic patterns akin to humans