Aim: To investigate the potential advantage of an enhanced corneal compensation algorithm (ECC) compared with variable corneal compensation (VCC) in the analysis of scanning laser polarimetric (SLP) images with atypical retardation pattern (ARP). Methods: SLP-VCC images with ARP (typical scan score (TSS) ,80) of one eye of each of 27 glaucoma patients and 19 healthy subjects were compared with the corresponding SLP-ECC images obtained at the same session. Results: ARP was present in 10.4% of the normals and 15.5% of the glaucoma patients imaged with SLP-VCC over 9 months. In both groups TSS was higher for ECC than for VCC (p,0.001). In glaucoma TSNIT, superior and inferior average thickness values were significantly lower, and TSNIT (measuring ellipse around the optic nerve head in the four (temporal, superior, nasal, inferior) quadrants) standard deviation was significantly higher with ECC than with VCC (p,0.001). In the normal group nerve fibre indicator (NFI) was lower with ECC than with VCC (p = 0.007). TSNIT average was smaller and TSNIT standard deviation was higher with ECC (p,0.001). Superior and inferior average thickness did not differ between VCC and ECC in the normal group. Conclusions: The new ECC software substantially improves polarimetric image analysis on eyes showing atypical polarisation pattern. S canning laser polarimetry (SLP) with variable corneal compensation (VCC) has become a widely used noninvasive clinical method to measure the retinal nerve fibre layer thickness (RNFLT) and to detect glaucoma.1-5 As VCC compensates for the true anterior segment retardation, measurements with SLP-VCC are more exact than those obtainable with the earlier instrument which had a fixed corneal polarisation compensator.
Previous studies have demonstrated that periconceptional folic acid/multivitamin supplementation reduced the occurrence of neural tube defects. A case control analysis has been conducted in the dataset of the Hungarian Case Control Surveillance of Congenital Abnormalities, 1980–1991. In the study period, 54.9% of 30 663 pregnant women who had healthy babies (negative control group) were supplemented with high doses (in general 2×3 mg) of folic acid per day. In those 17,300 pregnant women who had offspring with congenital abnormalities, the rate of folic acid supplementation was 50.4%. Exposure histories: preconceptional, I, II, III, and IV–IX post‐conceptional months were determined by record reviews and questionnaire assessment. The case control pair analysis showed a significant protection after folic acid supplementation during the critical period of cardiovascular defects, neural tube defects, cleft lip with or without cleft palate and posterior cleft palate. © 1996 Wiley‐Liss, Inc.
IMPORTANCE Glaucoma affects more than 75 million people worldwide. Intraocular pressure (IOP)-lowering surgery is an important treatment for this disease. Interest in reducing surgical morbidity has led to the introduction of minimally invasive glaucoma surgeries (MIGS). Understanding the comparative effectiveness and safety of MIGS is necessary for clinicians and patients. OBJECTIVE To summarize data from randomized clinical trials of MIGS for open-angle glaucoma, which were evaluated in a suite of Cochrane reviews. DATA SOURCES The Cochrane Database of Systematic Reviews including studies published before June 1, 2021. STUDY SELECTION Reviews of randomized clinical trials comparing MIGS with cataract extraction alone, other MIGS, traditional glaucoma surgery, laser trabeculoplasty, or medical therapy.DATA EXTRACTION AND SYNTHESIS Data were extracted according to Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines by one investigator and confirmed by a second. Methodologic rigor was assessed using the AMSTAR 2 appraisal tool and random-effects network meta-analyses were conducted. MAIN OUTCOMES AND MEASURESThe proportion of participants who did not need to use medication to reduce intraocular pressure (IOP) postsurgery (drop-free). Outcomes were analyzed at short-term (<6 months), medium-term (6-18 months), and long-term (>18 months) follow-up.RESULTS Six eligible Cochrane reviews were identified discussing trabecular bypass with iStent or Hydrus microstents, ab interno trabeculotomy with Trabectome, subconjunctival and supraciliary drainage devices, and endoscopic cyclophotocoagulation. Moderate certainty evidence indicated that adding a Hydrus safely improved the likelihood of drop-free glaucoma control at medium-term (relative risk [RR], 1.6; 95% CI, 1.4 to 1.8) and long-term (RR, 1.6; 95% CI, 1.4 to 1.9) follow-up and conferred 2.0-mm Hg (95% CI, −2.7 to −1.3 mm Hg) greater IOP reduction at long-term follow-up, compared with cataract surgery alone. Adding an iStent also safely improved drop-free disease control compared with cataract surgery alone (RR, 1.4; 95% CI, 1.2 to 1.6), but the short-term IOP-lowering effect of the iStent was not sustained. Addition of a CyPass microstent improved drop-free glaucoma control compared with cataract surgery alone (RR, 1.3; 95% CI, 1.1 to 1.5) but was associated with an increased risk of vraision loss. Network meta-analyses supported the direction and magnitude of these results. CONCLUSIONS AND RELEVANCEBased on data synthesized in Cochrane reviews, some MIGS may afford patients with glaucoma greater drop-free disease control than cataract surgery alone. Among the products currently available, randomized clinical trial data associate the Hydrus with greater drop-free glaucoma control and IOP lowering than the iStent; however, these effect sizes were small.
Repeatability characterized by CV of RNFLT measurement with the RTVue Optic Nerve Head Map scan and GDx-VCC/GDx-ECC was similar, and sufficient for clinical purposes, both in normal subjects and in glaucoma patients with different disease severity. For average peripapillary RNFLT and temporal quadrant RNFLT, repeatability of RTVue was better than that of GDx-ECC, and tended to be better than that of GDx-VCC.
Although farming has been linked to prostate cancer mortality, few investigations have addressed its association with prostate cancer incidence. We followed a population-based cohort of 1,177 cancer-free men for up to 9 years and identified 81 incident prostate cancers. Men whose usual occupation was farmer were at an increased risk of prostate cancer after adjustment for age, smoking, alcohol, and dietary factors (RR = 1.7; 95% CI = 1.0-2.7). Exclusion of well-differentiated, localized tumors slightly strengthened the association (RR = 2.0; 95% CI = 1.1-3.6). Risk was confined to older (age 70+ years) farmers (RR = 2.2; 95% CI = 1.1-4.3); we found no evidence of an effect among younger farmers (RR = 1.0; 95% CI = 0.4-2.1).
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