ABSTRACT
Women with diabetes have a higher breast cancer incidence and mortality. They are also significantly less likely to undergo screening mammography and present with more advanced stage than women without diabetes. The purpose of this study was to examine if women with diabetes are more likely to have delays in follow-up of abnormal mammograms, compared to women without diabetes. Using population-based health databases, this retrospective cohort study examined women between the ages of 50 and 74, with and without diabetes, living in the province of Ontario, Canada, who underwent screening through a centralized program and who had an abnormal mammogram between 2003 and 2012. We compared rates of follow-up of a diagnostic test within 180 days, as well as likelihood of mastectomy or excision procedure and a diagnosis of breast cancer. Following an abnormal screening mammogram, 97.5% of women with diabetes had a diagnostic procedure within 180 days compared to 97.9% of women without diabetes. After adjustment for other factors, women with diabetes were only 3% less likely to have follow-up testing after an abnormal mammogram than women without diabetes (hazard ratio [HR] 0.97, 95% CI: 0.96-0.99, P < 0.001). The majority of Ontario women who underwent screening mammography through a centralized screening program had timely follow-up of an abnormal mammogram, with no meaningful delays in those who had diabetes. The results of this study suggest that diagnostic delays after screening do not significantly contribute to higher breast cancer mortality in women with diabetes.
Subject(s)
Breast Neoplasms/epidemiology , Breast Neoplasms/etiology , Mammography , Population Surveillance , Aged , Breast Neoplasms/diagnosis , Comorbidity , Diabetes Mellitus/epidemiology , Early Detection of Cancer , Female , Follow-Up Studies , Humans , Incidence , Middle Aged , Ontario/epidemiologyABSTRACT
OBJECTIVE: To confirm if using a neutral density filter (NDF) affects eyes with strabismic amblyopia differently compared to fellow non-amblyopic eyes, and to determine if a similar effect could be observed when using a NDF during peripheral visual field testing. DESIGN: Prospective controlled case series. PARTICIPANTS: 19 subjects with strabismic amblyopia with visual acuities between 20/400 and 20/40 in their affected eyes were recruited to the study. Fellow non-amblyopic eyes served as the control group. METHODS: Visual acuity in both eyes was assessed using a projected Snellen eye chart with two NDFs (0.4 and 3.0 densities). Visual fields were assessed using a Humphrey perimeter using one NDF (0.4 density). Best corrected visual acuity and visual fields were also recorded. RESULTS: When using a 3.0 NDF, visual acuity was reduced in all eyes (p < 0.0001). When using a 0.4 NDF, visual acuity was significantly improved in eyes with strabismic amblyopia compared to unfiltered conditions (p = 0.0011). There was no significant effect by NDFs on visual field testing in eyes with strabismic amblyopia or fellow non-amblyopic eyes. CONCLUSIONS: Neutral density filters affect eyes with strabismic amblyopia differently than they do non-amblyopic eyes. A significant improvement in visual acuity of eyes with strabismic amblyopia was observed when using a 0.4 NDF compared to non-amblyopic eyes. Visual acuity was reduced in amblyopic as well as non-amblyopic eyes when viewing through a 3.0 NDF. No significant change in visual fields was observed when using a 0.4 NDF in amblyopic or non-amblyopic eyes.
Subject(s)
Amblyopia/diagnosis , Optical Devices , Strabismus/diagnosis , Vision Tests/instrumentation , Adolescent , Adult , Aged , Amblyopia/physiopathology , Child , Humans , Middle Aged , Prospective Studies , Strabismus/physiopathology , Visual Acuity/physiology , Visual Field Tests , Visual Fields/physiologySubject(s)
Cataract/diagnosis , Coloring Agents , Corneal Opacity/complications , Lighting/methods , Phacoemulsification/methods , Trypan Blue , Anterior Capsule of the Lens/pathology , Anterior Chamber/pathology , Cataract/complications , Cicatrix/complications , Glaucoma, Angle-Closure/complications , Humans , Lens Implantation, Intraocular , Male , Middle Aged , Visual AcuityABSTRACT
PURPOSE: To determine if there is a correlation between cerebellar tonsillar descent in patients with and without Chiari I malformation and three skull morphometric measurements: clivus length, anteroposterior diameter of the foramen magnum, and Boogard's angle. METHODS: Cerebellar tonsillar descent, clivus length, anteroposterior diameter of the foramen magnum, and Boogard's angle were measured in mid-sagittal T1-weighted magnetic resonance images of 188 patients. The study included 81 patients with Chiari I malformations (CMI). Without identifiable pathology, 107 patients served as a comparison group. Two-sample t-tests were used to assess for significance. A Pearson correlation matrix was constructed to assess the strength of linear dependence between measured parameters for the study population. RESULTS: A negative correlation was found between tonsillar herniation and clivus length (r = -0.30, P < 0.001), while a positive correlation was found between tonsillar herniation and foramen magnum size (r = 0.15, P = 0.0431), and Boogard's angle (r = 0.23, P = 0.0014). Clivus length was shorter (P = 0.0009) in CMI patients (4.02 cm ± 0.45) than comparison patients (4.23 cm ± 0.42). In addition, the anteroposterior diameter of the foramen magnum was wider (P = 0.0412) (3.74 cm ± 0.40 compared to 3.63 ± 0.30) and Boogard's angle was larger (P = 0.0079) (123.58 degrees ± 8.27 compared to 120.62 degrees ± 6.79) with CMI. CONCLUSION: A greater degree of cerebellar tonsillar herniation is associated with a shorter clivus length, a wider anteroposterior diameter of foramen magnum, and a wider Boogard's angle.