Search

Purpose: To evaluate the effects of dexamethasone intravitreal implant (Ozurdex) and identify risk factors for repeated treatment in patients with macula edema due to branch retinal vein occlusion (BRVO) or central retinal vein occlusion (CRVO).Methods: Patients followed up for at least 6 months were enrolled from 2013 to 2016. Dexamethasone intravitreal implant was given as the baseline treatment. For evaluation of dexamethasone intravitreal implant effects and complications, the demographics, medical history, best-corrected visual acuity (BCVA), intraocular pressure, and central retinal thickness (CRT) were recorded. Multivariate Cox proportional hazard model and logistic regression were used to identify factors for repeated treatment.Results: Twenty-three BRVO and 11 CRVO patients were enrolled. There were 15 males and 19 females. Fifteen (44.12%) patients needed only one dexamethasone intravitreal implant. The peak CRT and BCVA significantly improved. Comparing single-injection with multiple-injection group, age and initial CRT more than 400 μm were significantly higher in the multiple-injection group. From multivariate logistic regression and Cox proportional hazards analysis, patients with age older than 55 years and initial CRT more than 400 μm had higher risk for multiple injections.Conclusions: Patients receiving as-needed schedule of dexamethasone intravitreal implant had significant peak CRT and BCVA improvement. Age older than 55 years and initial CRT more than 400 μm were significant risk factors associated with repeated dexamethasone intravitreal implant treatment. [ABSTRACT FROM AUTHOR]

Highlights: [•] We propose a new approach for mobile users’ movement behavior mining and prediction and items recommendation. [•] We employ the notion of semantic trajectory similarity to cluster similar users together. [•] Based on the trajectory patterns and high utility itemsets, we propose a novel location-based recommendation strategy. [ABSTRACT FROM AUTHOR]

Background Maintenance of the optimal fluid status in hemodialysis patients is still a challenging task in daily clinical practice. A bioelectric impedance technique has been applied for evaluation of hydration status in the dialysis population in recent years, but serial observations of its role in clinical dry weight determination are lacking. In this study, serial follow-up data of a body composition monitor based on bioimpedance spectroscopy (BCM-BIS) applied in dialysis patients were analyzed to define the technique's feasibility, precision and possible role in dry weight determination. Methods BCM-BIS was applied monthly to 194 hemodialysis patients for 6 months. Intra-patient precision was analyzed. Bland–Altman analysis and repeated-measures analysis of variance (ANOVA) were used to define the relationship between the dry weights determined by BCM-BIS and by clinical judgment. Results The coefficients of variation (CVs) of fluid parameters were <5%. Serial changes in dry weight differences were compared in groups with different post-dialysis hydration status and dry weight differences decreased gradually. Bland–Altman analysis revealed that the range of these differences was significantly narrower towards the latter part of the study. The upper limit of agreement with 95% confidence interval (CI) was 1.47 L and the lower limit was −3.02 L. Conclusions BCM-BIS is precise and can be easily applied in the clinical setting. Discrepancy between the dry weights determined by BCM-BIS and by clinical judgment significantly decreased during the study. It is sensitive in dry weight determination, especially for those patients with obvious over-hydration (OH) by BCM-BIS. Patients with post-dialysis OH results beyond some critical values (>1.5 L or <−3 L) should be closely monitored. [ABSTRACT FROM PUBLISHER]

In this paper, a passive half-quadrature hybrid (HQH) is presented for multiphase signal generation at radio frequencies. Utilizing capacitance ratios as the primary design parameters, the proposed hybrid exhibits excellent magnitude and phase balance even in the presence of process and temperature variations. Therefore, it is well suited for integrated-circuit designs with on-chip capacitive elements. Using a standard 0.18-\mu\ m CMOS process, the HQH circuit is integrated with a 5.6-GHz quadrature voltage-controlled oscillator (QVCO) and four down-conversion mixers for demonstration. As the QVCO oscillation frequency sweeps from 5.4 to 5.8 GHz, the measurement results indicate a root-mean-square (rms) magnitude error less than 0.5 dB and an rms phase error ranging from 4^\circ to 7^\circ at the half-quadrature outputs without any feedback correction. [ABSTRACT FROM PUBLISHER]

In this paper, a novel circuit topology of aCMOS divide-by-4 direct injection-locked frequency divider is presented for millimeter-wave applications. To enhance the locking range for circuit operations with a division ratio of 4, a series peaking technique is introduced in the proposed divider structure such that improved input injection efficiency can be achieved. Using a standard 0.18-\mu\ m CMOS process, a V-band frequency divider is fabricated for demonstration. Operated at a supply voltage of 1.8 V, the divider core consumes a dc power of 12.6 mW. At an incident power of 0 dBm, the fabricated circuit exhibits an input locking range of 2.44 GHz in the vicinity of 60 GHz. The measured output power and locked phase noise at 1-MHz offset are -\7 dBm and -\133 dBc/Hz, respectively. [ABSTRACT FROM AUTHOR]

Background Methods Results Conclusion Tinnitus and uveitis have shared commonality in pathophysiology in terms of autoimmunity. However, no studies that have linked any association between the conditions of tinnitus and uveitis.This is a retrospective study conducted from the Taiwan National Health Insurance database in order to investigate whether tinnitus patients are at increased risk of uveitis. Patients newly diagnosed with tinnitus between 2001 and 2014 were recruited and followed up until 2018. The endpoint of interest was a diagnosis of uveitis.A total of 31,034 tinnitus patients and 124,136 matched comparisons were analyzed. Tinnitus patients were found to have a significantly higher cumulative incidence for uveitis than those without the diagnosis of tinnitus with incidence rate of 1.68 (95% CI 1.55–1.82) per 10 000 person-months for tinnitus group and 1.48 (95% CI 1.42–1.54) per 10 000 person-months for non-tinnitus group.Tinnitus patients were found to have increased risk of developing uveitis. [ABSTRACT FROM AUTHOR]

To investigate whether patients with chronic kidney disease (CKD) are at increased risk of uveitis. Data was collected from the Taiwan National Health Insurance system and included patients newly diagnosed with CKD between 2000 and 2012. The endpoint of interest was a diagnosis of uveitis. 30,256 CKD patients and 121,024 matched comparisons were analyzed. CKD patients were found to have a significantly higher cumulative uveitis incidence. Through multivariate Cox regression analysis, the CKD group was found to have higher risk of developing uveitis (adjusted hazard ratio 1.51). After stratified by gender, age, and comorbidities (hypertension, diabetes, and hyperlipidemia), the increased risk of uveitis in CKD patients remained significant. Patients with CKD were found to have higher risk of developing uveitis. For patients over 18 years old and with hypertension, diabetes, or hyperlipidemia, the presence of CKD was demonstrated as an additional crucial factor for uveitis development. [ABSTRACT FROM AUTHOR]

A 61-year-old male suffered from sudden blurred vision and superior visual field defect oculus dexter. His vision was counting fingers at 20 cm. Fundoscopy demonstrated inferior pale retina and a large embolus located at the proximal inferior retinal artery. Branch retinal artery occlusion (BRAO) was diagnosed. Initial paracentesis, topical brimonidine tartrate, oral pentoxifylline, and hyperbaric oxygen therapy were performed but showed limited improvement. Hence, he received 25-gauge vitrectomy, artificial posterior vitreous detachment, blocked retinal artery massage, and bloodletting 5 days after onset. After the surgery, his vision improved to 20/25. Fundoscopy showed reperfused retina, and optical coherence tomography revealed resolved retinal edema. RAO is an ophthalmological emergency; however, no standard guideline is available. Vitrectomy with blocked retinal artery massage and bloodletting showed favorable results in this case of BRAO with a large embolus. More prospective clinical trials are needed for setting up the standard treatment. [ABSTRACT FROM AUTHOR]

Purpose: To investigate whether patients with thyroid disease are at increased risk of uveitis.Methods: Data was collected from the Taiwan National Health Insurance system and included patients newly diagnosed with thyroid disease from 2000 to 2012. The endpoint of interest was a diagnosis of uveitis.Results: In analyzing 21,396 patients with thyroid disease, yielding 85,584 matched comparisons, patients with thyroid disease to have a significantly higher cumulative incidence of uveitis when compared to the control cohort with the Kaplan-Meier analysis. This result was further confirmed by Cox regression analysis. The increased risk was persistent in both genders. The association between thyroid disease and uveitis was stronger in patients without diabetes or hypertension.Conclusion: Patients with thyroid disease were found to have a higher risk for uveitis. For certain age groups or patients without diabetes or hypertension, the role of thyroid disease might be more crucial for uveitis development. [ABSTRACT FROM AUTHOR]

Background: To compare refractive outcomes after phacoemulsification and toric IOL implantation using two different toric calculators for initial astigmatism assessment in a real-world setting. Methods: This was a retrospective, comparative, interventional case series. Patients over 30-year-old who underwent phacoemulsification and toric IOL implantation (AcrySof® Toric IOL) by the same surgeon between 2017 and 2018 were included. Eyes with irregular astigmatism, previous corneal refractive surgery, intraocular surgery, corneal pathology, macular pathology and pupil abnormalities were excluded. IOL toricity was determined by using a calculator provided by the AcrySof Toric calculator before 2018 and Barrett Toric Calculator after 2018. Patient demographics, corneal topography, vector and preoperative and postoperative refraction were collected and analyzed at three months postoperative. Results: Thirty-two eyes of 32 patients were included in the final analysis. 0.1D for surgically induced astigmatism was used. Group 1 included 14 eyes assessed with the original (AcrySof) toric IOL calculator, and group 2 included 18 eyes assessed with the Barrett toric IOL calculator. In group 1, postoperative astigmatism less than − 1.00D, − 0.75 D, and − 0.5D was achieved in 88.2%, 76.1% and 53.7% of eyes, respectively, while, in group 2, 89% eyes achieved postoperative residual astigmatism less than 0.5D and all eyes achieved postoperative residual astigmatism less than 0.75D. The proportion of patients with lower postoperative astigmatism was significantly higher in Group 2 (p< 0.05 by chi-square test), a pattern that still held when we divided patients into multiple groups. Vector analysis with the Alpins methods also supported better outcomes in the Barrett group (0.71 D vs 0.35 D). Conclusion: The Barrett Toric calculator resulted in better results in the prediction of residual astigmatism than original (AcrySof) toric calculators. [ABSTRACT FROM AUTHOR]

The study was designed to determine whether hemodialysis patients in Taiwan had a different antibody response to common virus infections compared to the normal population. Serum samples from 18 hemodialysis patients and 21 healthy volunteers were obtained every 3 months for 2 years. Geometric mean titers (GMTs) of immunoglobulin G (IgG) antibodies to cytomegalovirus (CMV), herpes simplex virus (HSV), varicella-zoster virus (VZV), Epstein-Barr virus (EBV), as well as Type A and Type B influenza viruses (Inf. A, Inf. B) were compared between the patient and the control groups. The prevalence rates and the rates of recurrent infection were similar in both groups. However, the patient group had a higher percentage of persons having persistent EBV and CMV infections (p < 0.05) and also higher GMTs of antibodies nearly the whole year round, especially significant in September and December (p < 0.05). In patients with hepatitis C, their GMTs of EBV, VZV, Inf. A, and Inf. B were higher than those without (p < 0.05). [ABSTRACT FROM AUTHOR]

Background: To evaluate the efficacy of micro-incision vitrectomy surgery using a non-contact wide-angle viewing system for fovea-attached type epiretinal membrane, and to report the factors influencing the outcome. Methods: A retrospective, comparative case series that included 50 patients with fovea-attached type epiretinal membrane who received micro-incision vitrectomy surgery using a non-contact wide-angle viewing system. Results: All patients were followed-up for a minimum of 12 months. Seven cases were classified as group 1A (mainly outer retinal thickening), 17 were group 1B (more tenting of outer retina and distorted inner retina), and 26 were group 1C (prominent inner retina thickening and inward tenting of outer retina). Outcome measures included operation time, recurrent rate, postoperative BCVA, and CRT. The mean operative time was 26.2 minutes. The mean change of BCVA (LogMAR) was − 0.43 (p< 0.001). The mean change of CRT was 135.3 μm (p< 0.001). The mean change of CRT was significantly higher in group 1C. Worse preoperative BCVA, male gender, and longer operative time can predict better postoperative BCVA found by multivariate logistic regression and multiple regression models. Conclusion: Significant improvement in BCVA and CRT is noted after micro-incision vitrectomy surgery to operate fovea-attached type epiretinal membranes. Worse preoperative BCVA, male, and longer operation time could predict better improvement. These findings may assist surgeons in better evaluating the potential of this method to help their patients with epiretinal membranes. [ABSTRACT FROM AUTHOR]