ABSTRACT
Objective:To evaluate the efficacy and safety of limited pars plana vitrectomy(LPPV), pressure-controlled phacoemulsification(PCP), intraocular lens implantation(IOL), and posterior capsulotomy (PC) in treatment of nanophthalmic glaucoma eyes which intraocular pressure(IOP) were still out of control after peripheral iridectomy.Methods:All 24 patients(29 eyes) with nanophthalmic glaucoma whose IOP failed to be reduced after peripheral iridectomy and needed LPPV plus PCP plus IOL plus PC were recruited from July 2017 to April 2021. The age of these patients was(44.6±11.0) years old. Preoperative and postoperative IOP, best corrected visual acuity(BCVA), anterior chamber depth(ACD) and number of glaucoma medications were recorded by chart review and compared by using paired t-test or Wilcoxon signed rank-sum test. P<0.05 was considered as statistical significant. IOP could be controlled in normal range(≥5 mmHg and≤21 mmHg), without both of disease progression and serious complications were regarded as the success criteria of the operation. Surgical success rate was evaluated. Surgery-associated complications were recorded. Results:The average follow-up time was(11.52±12.44) months. After the microsurgery, IOP decreased from(33.12±9.25) mmHg to(14.23±3.44) mmHg( P<0.01); The ACD increased from(1.23±0.46) mm to(2.86±0.62) mm, and the median number of glaucoma medications dropped from 3(3,4) to 3(0,3) at final follow-up visit( P<0.05). There were no significant differences in BCVA( P=0.196) and the degrees of angle closure(AC) ( P=0.478) before and after operation. The total surgical success rate was 86.2%(25/29) at the final follow-up visit. Two eyes suffered from local choroidal detachment which recovered within 2 weeks with medical treatment. Conclusion:LPPV plus PCP plus IOL plus PC is a safe and effective novel surgical procedure in the treatment of nanophthalmic glaucoma patients with uncontrolled IOP after peripheral iridectomy. It could significantly decrease IOP, increase the depth of ACD, reduce the number of glaucoma medications and maintain BCVA. It can be considered as a first choice for the surgical management for patients with a such condition.
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ObjectiveWe sought to understand how U.S. residents responded to COVID-19 as it emerged, and the extent to which spatial-temporal factors impacted response. Materials and MethodsWe mined and reverse-geocoded 269,556 coronavirus-related social media postings on Twitter from January 23rd to March 25th, 2020. We then ranked tweets based on the socioeconomic status of the county they originated from using the Area Deprivation Index (ADI); that we also used to identify areas with high initial disease counts ("hotspots"). We applied topic modeling on the tweets to identify chief concerns and determine their evolution over time. We also investigated how topic proportions varied based on ADI and between hotspots and non-hotspots. ResultsWe identified 45 topics, which shifted from early-outbreak-related content in January, to the presidential election and governmental response in February, to lifestyle changes in March. Highly resourced areas (low ADI) were concerned with stocks, social distancing, and national-level policies, while high ADI areas shared content with negative expression, prayers, and discussion of the CARES Act economic relief package. Within hotspots, these differences stand, with the addition of increased discussion regarding employment in high ADI versus low ADI hotspots. DiscussionTopic modeling captures the major concerns in COVID-19-related discussion on a social media platform in the early months of the pandemic. Our study extends previous studies that utilized topic modeling on COVID-19 related tweets and linked the identified topics to socioeconomic status using ADI. Comparisons between low and high ADI areas indicate differential Twitter discussions, corresponding to greater concern with economic hardship and impacts of the pandemic in less resourced communities, and less focus on general public health messaging. ConclusionThis work demonstrates a novel framework for assessing differential topics of conversation correlating to income, education, and housing disparities. This, with integration of COVID-19 hotspots, offers improved analysis of crisis response on Twitter. Such insight is critical for informed public health messaging campaigns in future waves of the pandemic, which should focus in part specifically on the interests of those who are most vulnerable in the lowest resourced health settings.
ABSTRACT
OBJECTIVE@#To conduct signature analysis for splenic trauma in canines during hemorrhagic shock and resuscitation by contrast enhanced ultrasonography (CEUS).@*METHODS@#Forty grade III-IV traumatic splenic lesions were established in 15 mongrel dogs. Hemorrhagic shock was induced in these animals by using the modified Wiggers's method. Animals in shock were then resuscitated with 6% hydroxyethyl starch. The features of splenic trauma during hemorrhagic shock or resuscitation were assessed by CEUS, which were compared with the data collected by contrast-enhanced computed tomography (CECT). Acoustic quantification of CEUS was performed to assess splenic blood perfusion in different stages.@*RESULTS@#There was no significant difference in detection rate between CEUS and CECT during hemorrhagic shock and resuscitation. Before hemorrhagic shock, there were 40 traumatic bleeding lesions and 85% of them were revealed by CEUS (34/40). With the progress in shock, CEUS revealed that the numbers of tiny branches of splenic arteries were decreased, which became thinner with no active bleeding. After fluid resuscitation, rebleeding was occurred in 30 traumatic lesions, and 28 (93.3%) of them were captured by CEUS. CEUS could also visualize the changes in splenic perfusion in different stages. During the shock, the arrival time (AT), time to peak intensity (TTP), peak intensity (PI) were significantly lower and the washout time (WT) were significantly higher than those at other stages (P<0.01).@*CONCLUSION@#CEUS not only can dynamically monitor the changes in spleen traumatic hemorrhage and recurrent hemorrhage, but also can quantitatively study the changes in spleen blood perfusion in different stages.
