RESUMO
BACKGROUND: The association between a history of pregnancy and liver fibrosis remains unclear. Herein, we investigated the association between reproductive factors, including a history of pregnancy and liver fibrosis, in postmenopausal Korean women. METHODS: This study used nationally representative, population-based data collected from the Korea National Health and Nutrition Examination Survey 2008-2017. Of 14,624 women with natural menopause, 11,085 with no previous history of any type of cancer, hepatitis, or chronic heavy alcohol consumption were enrolled. We investigated the reproductive factors, including a history of pregnancy, total reproductive years, age at menarche and menopause, and oral contraceptive use. Liver fibrosis was defined as a Fibrosis-4 index score ≥2.67 kg/m2. RESULTS: Of the study participants, 372 (3.3%) had advanced liver fibrosis. Multivariable logistic regression analysis showed that women with a history of more than one pregnancy were associated with a lower risk of liver fibrosis compared to women who had never been pregnant, after adjusting for potential confounders (adjusted odds ratio, 0.30; 95% confidence interval, 0.15-0.59). The risk of liver fibrosis did not increase significantly with an increasing number of pregnancies (P for trend=0.135). Other reproductive factors, including total reproductive years, age at menopause and menarche, and oral contraceptive use, were not significantly associated with liver fibrosis. CONCLUSION: Postmenopausal women who had experienced one or more pregnancies had a reduced risk of liver fibrosis. Our findings reveal a potential protective role of pregnancy against liver fibrosis.
RESUMO
BACKGROUND: Blindness caused by soft-tissue filler injection is the most tragic complication, with no standard treatments until recently. Retrobulbar hyaluronidase injection has been proposed as the treatment, but its effectiveness in visual compromise remains to be determined. The authors aimed to determine the effectiveness of retrobulbar hyaluronidase using soft-tissue filler in an iatrogenic blindness animal model. METHODS: New Zealand White rabbits were used to simulate the hyaluronic acid-associated vascular occlusion model. A volume of 0.7 to 1.6 ml of hyaluronic acid filler was injected into the internal carotid artery to create a retinal artery occlusion. The rabbits were administered retrobulbar hyaluronidase (3000 IU) at different postobstruction time points (5 and 10 minutes). No intervention was given to the control group. Fundus photography was performed before and immediately after the filler injection and immediately after the administration of retrobulbar hyaluronidase. Electroretinography was performed after 60 minutes to confirm the retinal reperfusion and electrophysiologic function. RESULTS: All of the experimental eyes recorded total occlusion after hyaluronic acid injection. Three eyes with a completely occluded retinal artery following retrobulbar hyaluronidase treatment showed improved retinal reperfusion by fundus photography and corresponding electroretinography. Despite administration of the retrobulbar hyaluronidase injection, one completely occluded eye showed no improvement in perfusion. All of the control eyes recorded complete occlusion 1 hour after hyaluronic acid filler injection. CONCLUSIONS: Retrobulbar hyaluronidase may be an effective evidence-based treatment option for humans. Hyaluronidase concentration and injection time are the important factors for faster recovery, but additional studies are still required.
