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Evaluate the improvement in clinical signs and symptoms in patients with moderate-to-severe meibomian gland dysfunction (MGD) treated with intense pulsed light (IPL) using an acne filter. A retrospective chart review of 70 eyes of 35 patients with moderate-to-severe MGD treated with IPL using the acne filter was performed. IPL treatment was administered using the acne filter four times at 2- to 3-week intervals to upper and lower eyelids. We evaluated tear break-up time (TBUT), matrix metalloproteinase (MMP)-9, Sjögren's International Clinical Collaborative Alliance (SICCA) staining score, and Oxford staining grade. We performed Schirmer's test I without topical anesthesia, slit-lamp microscopic examination of lid margin and meibomian gland, and patient's symptom score assessment and evaluated the incidence of adverse effects in the ocular and periocular areas at baseline and 30 days after the final treatment. Significant improvements (P  less then  0.001) were observed in TBUT, SICCA staining score, Oxford staining grade, quality of meibum, consistency of meibum, lid margin telangiectasia, MGD grade, and patient's symptom scores after acne filter IPL treatment. Furthermore, the positivity (100 to 71.43%, P = 0.002) and level (2.43 ± 0.98 to 1.14 ± 0.78, P  less then  0.001) of MMP-9 significantly decreased after treatment. However, there was no significant improvement in Schirmer's test I (P = 0.224). No systemic or regional adverse effects were observed in any patient. IPL treatment using the acne filter is an effective and safe therapeutic modality for treating moderate-to-severe MGD, especially for lid margin telangiectasia and MMP-9.
Psychological distress is considered a threat to the mental health of human beings. This research was conducted at the beginning of the emerging COVID-19 pandemic, when most people had limited knowledge about coronavirus, mode of transmission, associated manifestations, with uncertainty about treatment, vaccine, future life, and coping capacity. This study examined the nature of the psychological distress related to the emergence of the coronavirus disease 2019 (COVID-19) pandemic and coping strategies adopted among the general population in Egypt.

This was a descriptive, cross-sectional study assessing a convenience sample consisting of 312 participants from the general population in Egypt. Data were gathered as online responses to a questionnaire which incorporated a sociodemographic datasheet, psychological distress scale, and ways of coping scale.

Forty-two percent of the participants showed severe psychological distress and 26% showed mild to moderate psychological distress. There was a strong posi of psychological distress, the greater their adaptation ability was. This study focuses light on the importance to provide appropriate interventions against COVID-19-related stresses and equipping people with suitable strategies for coping with the COVID-19 pandemic.
Most of the study population as a sample of the general population in Egypt reported suffering from varying degrees of psychological distress during the COVID-19 crisis. However, the more severe an individual's level of psychological distress, the greater their adaptation ability was. This study focuses light on the importance to provide appropriate interventions against COVID-19-related stresses and equipping people with suitable strategies for coping with the COVID-19 pandemic.
National comprehensive cancer network guidelines recommend delivery of adjuvant chemotherapy in node-negative triple-negative breast cancer (TNBC) if the tumor is > 1cm and consideration of adjuvant chemotherapy for T1b but not T1a disease. These recommendations are based upon sparse data on the role of adjuvant chemotherapy in T1a and T1b node-negative TNBC. Our objective was to clarify the benefits of chemotherapy for patients with T1N0 TNBC, stratified by tumor size.

We performed a retrospective analysis of survival outcomes of TNBC patients at two academic institutions in the United States from 1999 to 2018. Primary tumor size, histology, and nodal status were based upon surgical pathology. The Kaplan-Meier plot and 5-year unadjusted survival probability were evaluated.

Among 282 T1N0 TNBC cases, the status of adjuvant chemotherapy was known for 258. Mean follow-up was 5.3years. Adjuvant chemotherapy was delivered to 30.5% of T1a, 64.7% T1b, and 83.9% T1c (p < 0.0001). On multivariable analysis, factors associated with delivery of adjuvant chemotherapy were tumor size and grade 3 disease. Improved overall survival was associated with use of chemotherapy in patients with T1c disease (93.2% vs. 75.2% p = 0.008) but not T1a (100% vs. 100% p = 0.3778) or T1b (100% vs. 95.8% p = 0.2362) disease.

Our data support current guidelines indicating benefit from adjuvant chemotherapy in node-negative TNBC associated with T1c tumors but excellent outcomes were observed in the cases of T1a and T1b disease, regardless of whether adjuvant chemotherapy was delivered.
Our data support current guidelines indicating benefit from adjuvant chemotherapy in node-negative TNBC associated with T1c tumors but excellent outcomes were observed in the cases of T1a and T1b disease, regardless of whether adjuvant chemotherapy was delivered.In cardiology, magnetic resonance imaging (MRI) provides a clinical standard for measuring ventricular volumes. Owing to their reliability, volumetric measurements with cardiac MRI have become an essential tool for quantitative assessment of ventricular function. However, as volumetric indices are indirectly related to myocardial motion that drives ventricular filling and ejection, cardiac MRI cannot provide comprehensive evaluation of ventricular performance. To overcome this limitation, the presented work sought to measure ventricular wall motion directly with optical flow analysis of real-time cardiac MRI. By modeling left ventricle (LV) walls in real-time images based on myocardial architecture, we developed an optical flow approach to analyzing LV radial and circumferential wall motion for improved quantitative assessment of ventricular function. For proof-of-concept, a cardiac MRI study was conducted with healthy volunteers and heart failure (HF) patients. It was found that, as real-time images provided sufficient temporal information for correlation analysis between different LV wall motion velocity components, optical flow assessment detected the difference of ventricular performance between the HF patients and the healthy volunteers more effectively than volumetric measurements. We expect that this model-based optical flow assessment with real-time cardiac MRI would offer intricate analysis of ventricular function beyond conventional volumetric measurements.
In preventing Chronic Postoperative Inguinal Pain (CPIP) after inguinal herniorrhaphy, mesh position and mesh fixation seem important factors. The SOFTGRIP trial compared the TransInguinal PrePeritoneal (TIPP) repair to Polysoft mesh, to the Open anterior repair (Lichtenstein) using the self-gripping ProGrip mesh. Since CPIP might resolve and recurrence rate increase, this study reports the SOFTGRIP trial's long-term results (with a minimal follow-up of 5years).

All patients initially randomized in the SOFTGRIP trial were contacted if not deceased. Patients were invited for an interview and physical examination. The procedures and methodology of this randomized clinical trial have been published together with the short-term results. The main outcomes for this long-term follow-up study were chronic pain, recurrences, re-operations and numbness.

A total of 193 patients (81.4% of the initially randomized patients) were included for long-term follow-up analyses, 96 after TIPP, 97 after ProGrip Lichtenstein.harms of the different inguinal hernia repair techniques.

Registered on August 25, 2009 at the Dutch Trial Registry ( www.trialregister.nl ) NTR1853.
Registered on August 25, 2009 at the Dutch Trial Registry ( www.trialregister.nl ) NTR1853.
Chronic upper airway obstruction caused by adenotonsillar hypertrophy is one of the major cause of morbidity in children. It can lead to Obstructive Sleep Apnoea Syndrome, Pulmonary Hypertension, Cor Pulmonale and right heart failure. The study aimed to evaluate and compare various parameters of cardiac function with the help of echocardiography preoperatively and postoperatively in children undergoing adenotonsillectomy.

A prospective cohort study was conducted on 23 patients at an apex care institute, under the age group of 4-12years, who were diagnosed with adenotonsillar hypertrophy. Preoperative symptom analysis and Echocardiographic examination were done. After the assessment, all patients underwent surgery in the form of adenotonsillectomy. Follow-up symptom analysis and echocardiographic examination was done after 3months postoperatively.

Significant improvement in the obstructive symptoms were noted in postoperative group as expected (p =  < 0.001) and also in parameters such as mPAP (p =  &e helpful in identifying and preventing the development of cardiopulmonary complication. These changes can be reversed by performing adenotonsillectomy.
The aim of the study was to investigate the listening comprehension (LC) skills in deaf and hard of hearing children (DHH) using cochlear implants (CI). Besides, personal and audiological variablesthat could influence the levels of competence reached were analyzed.

Thirty-four children using CI were enrolled. LC skills were assessed through the standardized Italian test "Comprensione Orale-Test e Trattamento" (CO-TT). A univariate analysis was conducted to compare LC with gender, listening mode (unilateral or bilateral), maternal level of education and family income. A bivariate analysis was performed to search possible connections between children's performances and their individual characteristics, audiological conditions, and language levels. Finally, a multivariate analysis was performed using a stepwise hierarchical linear regression model which included all variables whose p value resulted  ≤ 0.05.

Twenty-one children using CI (61.8%) showed adequate performances in terms of chronological age, while 13 (38.2%) showed difficulties in LC. Maternal level of education, age at diagnosis and non-verbal cognitive level accounted for 43% of the observed variance. Auditory attention skills explained an additional 15% of variance. Morphosyntactic comprehension added a further 12% of variance.

CI can really help many DHH children to reach adequate LC skills, but in some cases difficulties remain. Factors influencing LC need to be early investigated and considered when planning an appropriate rehabilitative intervention.
CI can really help many DHH children to reach adequate LC skills, but in some cases difficulties remain. Factors influencing LC need to be early investigated and considered when planning an appropriate rehabilitative intervention.
Ingestion of a toothbrush is an unusual event but may occur either accident or by intent. learn more Radiological examinations play a crucial role in determining the exact location of the object within the gastrointestinal tract and in planning for its removal by endoscopic or surgical intervention.

Medical and radiological records of 8 patients who had swallowed the broken heads or entire toothbrush were retrospectively reviewed. This series included 4 men and 4 women, ranging in age from 21 to 57 years (mean 34 years).

Radiographs and computed tomography of the abdomen demonstrated the ingested toothbrushes within the stomach in 3, lodged in the duodenum in 1, and entrapped in various parts of the colon in 4 patients. They were removed by laparotomy in 3, laparoscopy in 2, colonoscopy in 2, and upper gastrointestinal endoscopy in 1 patient. There were no perforations or associated complications, and all patients had uneventful recoveries.

Ingested toothbrushes can be easily identified on radiological studies because of the radiopaque wires holding the nylon bristles.
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