Accessibility and Cultural Inclusivity of Online Glaucoma-Based Video Content for Patient Education.

PRCIS: This study is the first to evaluate the ease of access, understandability, and cultural inclusivity of online glaucoma-related video content for patient education. Overall, materials were found to be poorly understandable and not culturally representative. PURPOSE: The purpose of this study is to assess the ease of access, readability, actionability, and cultural inclusivity of glaucoma-specific patient education videos found online. DESIGN: Cross-sectional study. SUBJECTS: Twenty-two glaucoma-based patient education videos were reviewed for this study. METHODS: A survey of glaucoma specialists identified commonly recommended patient education Web sites, which were analyzed for video content. Web sites were reviewed by 2 independent reviewers for glaucoma-based patient education videos. Videos with content designated for medical providers, dedicated to research, or affiliated with private practices were excluded. Videos that were not glaucoma-specific or longer than 15 minutes were also excluded. The Patient Education Materials Assessment Tool was used to score videos for understandability and actionability reviewing content, word choice, organization, layout, and use of visual aids. Videos were also reviewed for cultural inclusivity and accessibility measures including language availability. Agreement analysis with a kappa coefficient (κ) over 0.6 was established with the first 5 videos between 2 independent reviewers and scoring discrepancies were resolved via a third independent reviewer. RESULTS: From 10 recommended Web sites, 22 videos met inclusion criteria for evaluation. The average Patient Education Materials Assessment Tool score was 68.3% (SD = 18.4) for understandability (κ=0.63). Most videos (64%) were accessed within 3 clicks from the homepage. Only 3 videos were available in another language (Spanish). Most actors and images were White individuals (68.9%), followed by Black (22.1%), then Asian (5.7%) and other/ambiguous (3.3%). CONCLUSIONS: There is room for improvement regarding language accessibility, understandability, and cultural inclusivity of glaucoma-based, publicly available patient education video content.

A Comprehensive Systemic Literature Review of Pericardial Decompression Syndrome: Often Unrecognized and Potentially Fatal Syndrome.

BACKGROUND: Pericardial Decompression Syndrome (PDS) is defined as paradoxical hemodynamic deterioration and/or pulmonary edema, commonly associated with ventricular dysfunction. This phenomenon was first described by Vandyke in 1983. PDS is a rare but formidable complication of pericardiocentesis, which, if not managed appropriately, is fatal. PDS, as an entity, has discrete literature; this review is to understand its epidemiology, presentation, and management. METHODOLOGY: Medline, Science Direct and Google Scholar databases were utilized to do a systemic literature search. PRISMA protocol was employed. Abstracts, case reports, case series and clinical studies were identified from 1983 to 2019. A total of 6508 articles were reviewed, out of which, 210 were short-listed, and after removal of duplicates, 49 manuscripts were included in this review. For statistical analysis, patient data was tabulated in SPSS version 20. Cases were divided into two categories surgical and percutaneous groups. t-test was conducted for continuous variable and chi-square test was conducted for categorical data used for analysis. RESULTS: A total of 42 full-length case reports, 2 poster abstracts, 3 case series of 2 patients, 1 case series of 4 patients and 1 case series of 5 patients were included in the study. A total of 59 cases were included in this manuscript. Our data had 45.8% (n=27) males and 54.2% (n=32) females. The mean age of patients was 48.04 ± 17 years. Pericardiocentesis was performed in 52.5% (n=31) cases, and pericardiostomy was performed in 45.8% (n=27). The most common identifiable cause of pericardial effusion was found to be malignancy in 35.6% (n=21). Twenty-three 23 cases reported pre-procedural ejection fraction, which ranged from 20%-75% with a mean of 55.8 ± 14.6%, while 26 cases reported post-procedural ejection fraction which ranged from 10%-65% with a mean of 30% ± 15.1%. Data was further divided into two categories, namely, pericardiocentesis and pericardiostomy. The outcome as death was significant in the pericardiostomy arm with a p-value of < 0.00. The use of inotropic agents for the treatment of PDS was more common in needle pericardiocentesis with a p-value of 0.04. Lastly, the computed recovery time did not yield any significance with a p-value of 0.275. CONCLUSION: Pericardial decompression syndrome is a rare condition with high mortality. Operators performing pericardial drainage should be aware of this complication following drainage of cardiac tamponade, since early recognition and expeditious supportive care are the only therapeutic modalities available for adequate management of this complication.

Investigating Molecular Connections of Non-alcoholic Fatty Liver Disease with Associated Pathological Conditions in West Virginia for Biomarker Analysis.

Non-alcoholic fatty liver disease (NAFLD) is a disease characterized by a steatosis of the liver that may progress to more serious pathological conditions including: nonalcoholic steatohepatitis (NASH), fibrosis, and cirrhosis. As the prevalence of NAFLD has increased worldwide in recent years, pathophysiology and risk factors associated with disease progression of NAFLD are at the focus of many studies. NAFLD is related to and shares common serum biomarkers with cardiovascular disease (CVD), type 2 diabetes mellitus (T2DM), obesity, and metabolic syndrome (MetS). West Virginia (WV) is a state with some of the highest rates of CVD, obesity and diabetes mellitus. As NAFLD is closely related to these diseases, it is of particular interest in WV. Currently there is no cost-effective, standardized method used clinically to detect NAFLD prior to the onset of reversible complications. At this time, the diagnosis of NAFLD is made with costly radiologic studies and invasive biopsy. These studies are only diagnostic once changes to hepatic tissue have occurred. The diagnosis of NAFLD by traditional methods may not allow for successful intervention and may not be readily available in areas with already sparse medical resources. In this literature review, we identify a list of biomarkers common among CVD, T2DM, obesity, MetS and NAFLD. From this research we propose the following biomarkers are good candidates for inclusion in a panel of biomarkers for the early detection of NAFLD: adiponectin, AST, ALT, apo-B, CK18, CPS1, CRP, FABP-1, ferritin, GGT, GRP78, HDL-C, IGF-1, IL-1ß, 6, 8, 10, IRS-2PAI-1, leptin, lumican, MDA SREBP-1c and TNF-α. Creating and implementing a biomarker panel for the early detection and attenuation of NAFLD, prior to the onset of irreversible complication would provide maximum benefit and decrease the disease burden on the patients and healthcare system of WV.