Resistance Training-Induced Acute Hypoalgesia in Women With Persistent Pain After Breast Cancer Treatment.

ABSTRACT: Fogh Rasmussen, GH, Madeleine, P, Arroyo-Morales, M, Voigt, M, and Kristiansen, M. Resistance training-induced acute hypoalgesia in women with persistent pain after breast cancer treatment. J Strength Cond Res 37(3): e16-e24, 2023-The aim of this study was to determine whether a single bout of resistance training (RT) produces acute exercise-induced hypoalgesia (EIH) in breast cancer survivors (BCS) suffering from persistent pain ≥1.5 years after treatment. Twenty individuals with self-reported pain ≥3 on a 0-10 Numerical Rating Scale after treatment for breast cancer completed 3 experimental sessions, (a) familiarization; (b) 1 repetition maximum (1RM) normalization, and (c) training, consisting of 3 sets of 10 repetitions at 60% of 1 repetition maximum. Pressure pain thresholds (PPTs) were measured before and after training for the dorsal and ventral shoulder regions of the affected side. Movement-evoked pain (MEP) and rating of perceived exertion (RPE) were collected immediately after each set. A p -value less than 0.05 was considered statistically significant. The results demonstrated a significant increase in PPTs of the ventral shoulder region after a single bout of RT ( p ≤ 0.05), indicating a localized analgesic response for this area. By contrast, no change was detected in PPTs on the dorsal shoulder region. No significant differences were found in MEP between sessions despite a significant increase in load and RPE during 1RM assessment ( p ≤ 0.05), indicating that MEP was not affected by increase in absolute and relative intensity. In conclusion, a single bout of submaximal RT reduced PPTs for the ventral shoulder region of BCS with persistent pain after treatment and was well tolerated. Hence, RT may be a useful therapeutic tool for managing persistent pain after breast cancer treatment in clinical practice.

Pain sensitivity and shoulder function among breast cancer survivors compared to matched controls: a case-control study.

OBJECTIVE: Persistent pain and loss of shoulder function are common adverse effects to breast cancer treatment, but the extent of these issues in comparison with healthy controls is unclear for survivors beyond 1.5 years after treatment. The purpose of this study was to benchmark differences in pressure pain thresholds (PPT), maximal isokinetic muscle strength (MIMS), and active range of motion (ROM) of females with persistent pain ≥1.5 years after breast cancer treatment (BCS) compared with pain-free matched controls (CON), and examine the presence of movement-evoked pain (MEP) during assessment of MIMS. METHODS: The PPTs of 18 locations were assessed using a pressure algometer and a numeric rating scale was used to assess intensity of MEP. Active ROM and MIMS were measured using a universal goniometer and an isokinetic dynamometer, respectively. RESULTS: A two-way analysis of variance revealed that PPTs across all locations, MIMS for horizontal shoulder extension/flexion and shoulder adduction, active ROM for shoulder flexion, horizontal shoulder extension, shoulder abduction, and external shoulder rotation were significantly lower for BCS compared with CON (P < 0.05). MEP was significantly higher for BCS and MEP intensity had a significant, negative correlation with PPTs (P < 0.01). DISCUSSION/CONCLUSION: BCS with persistent pain ≥1.5 years after treatment demonstrates widespread reductions in PPTs and movement-specific reductions in MIMS and active ROM of the affected shoulder, along with MEP during physical performance assessment. IMPLICATIONS FOR CANCER SURVIVORS: BCS with persistent pain ≥1.5 years after treatment shows signs of central sensitization and may benefit from individualized rehabilitation.

Do patients need advice and information to prevent infections - results of a single centre structured survey.

Background: Healthcare-associated infections are a major burden for hospitals, leading to morbidity and mortality and unnecessary medical costs. They can probably be reduced through what is known as patient empowerment. This study aims to address the question of whether patients are interested in receiving infection prevention and control information. Methods: Patients were asked in structured interviews whether they would like more information on infection prevention and control. Inclusion criteria comprised 2 groups of patients. Group 1 were patients undergoing elective total endoprosthesis (TEP) and Group 2 were patients tested positive for meticillin-resistant Staphylococcus aureus (MRSA). Results: The response rate was 38.4 % (163/425 patients). Approximately 75 % of the patients were interested in information on infection prevention and control. The topics of interest differed between the two patient groups: MRSA patients had a higher need for infection prevention and control information. TEP patients showed a high acceptance of antiseptic body wash and a willingness to pay for it themselves. Information given to patients should be group-specific and timely. Conclusion: Our data suggest a lack of information on infection prevention and control among patients and underline the importance of patient empowerment. The willingness of patients to pay personally for antiseptic wash should be assessed further.

Long-term care, care needs and wellbeing of individuals after cancer in childhood or adolescence (VersKiK): study protocol of a large scale multi-methods non-interventional study.

BACKGROUND: It has been shown previously that a relevant proportion of childhood cancer survivors suffers from late effects, which are often directly related to the cancer itself or its therapy, resulting in particular follow-up needs, additionally burdening healthcare systems. Being diagnosed with cancer at a vulnerable stage of development, this group of cancer survivors is at comparatively higher risk of relapse or subsequent cancer. Although national and international follow-up guidelines based on treatment modalities have been developed, their implementation seems to leave room for improvement. Additionally, they lack a sufficient consideration of the survivors' psychosocial needs, affecting their adherence to them. The aim of the VersKiK study is to provide representative information on late effects in childhood and adolescence cancer survivors in Germany. The main research objectives are: (1) to describe the state of follow-up care among survivors after a cancer diagnosis in childhood or adolescence; (2) to quantify the occurrence of late effects among this group of survivors; (3) to examine the adherence to selected audiological and cardiological follow-up guidelines and to identify factors affecting it; (4) to explore actual follow-up needs of paediatric cancer survivors; (5) to review selected follow-up guidelines with the aim to improve and expand them. METHODS: VersKiK is designed as a mixed-methods non-interventional study. We will use claims data from statutory health insurance companies in combination with individually linked population-based registry data from the German Childhood Cancer Registry (GCCR). This data base will permit us to quantify diagnoses and procedures in comparison to the general population as well as the adherence to existing follow-up guidelines. Additional information will be obtained through interviews with childhood and adolescence cancer survivors and their informal caregivers, as well as in focus groups with healthcare professionals. DISCUSSION: The present study aims to research the actual needs of individuals after cancer diagnosis and treatment in childhood or adolescence - physical, psychological and organisational - in order to improve existing follow-up guidelines. These improvements might further positively affect not only actual care provided to paediatric cancer survivors, but also benefit healthcare systems in general while decreasing consequent medical visits in this group of patients. TRIAL REGISTRATION: Registered at German Clinical Trial Register (ID: DRKS00025960 and DRKS00026092).

SARS-CoV-2 infection prevalence in healthcare workers and administrative and support staff: The first-wave experience at three academic hospitals in the Tshwane district of Gauteng Province, South Africa.

BACKGROUND: The availability of well and functional healthcare workers (HCWs) and support staff is pivotal to a country's ability to manage the COVID-19 pandemic effectively. While HCWs have been identified as being at increased risk for acquisition of SARS-CoV-2 infection, there is a paucity of data pertaining to South African (SA) HCW-related infection rates. Global and provincial disparities in these numbers necessitate local data in order to mitigate risks. OBJECTIVES: To ascertain the overall SARS-CoV-2 infection rates and outcomes among all hospital staff at three hospitals in the Tshwane district of Gauteng Province, SA, and further determine associations with the development of severe COVID-19 disease. METHODS: This retrospective audit was conducted across three academic hospitals in the Tshwane district for the period 1 June - 31 August 2020. Deidentified data from occupational health and safety departments at each hospital were used to calculate infection rates. A more detailed analysis at one of the three hospitals included evaluation of demographics, work description, possible source of SARS-CoV-2 exposure (community or hospital), comorbidities and outcomes. RESULTS: The period prevalence of SARS-CoV-2 infections ranged from 6.1% to 15.4% between the three hospitals, with the average period prevalence being 11.1%. The highest incidence of SARS-CoV-2 infections was observed among administrative staff (2.8 cases per 1 000 staff days), followed by nursing staff (2.7 cases per 1 000 staff days). Medical doctors had the lowest incidence of 1.1 cases per 1 000 staff days. SARS-CoV-2 infections were categorised as either possibly community or possibly healthcare facility acquired for 26.6% and 73.4% of the infections, respectively. The administrative group had the highest proportion of possible community-acquired infections (41.8%), while doctors had the lowest (6.1%). The mean age of individuals with mild and severe disease was 41 years and 46.1 years, respectively (p=0.004). The presence of comorbidities was significantly associated with severity of disease (p=0.002). CONCLUSIONS: This study highlights that hospital staff, including administrative staff, are clearly at high risk for acquisition of SARS-CoV-2 infection during a surge.

Absolute and relative reliability of pain sensitivity and functional outcomes of the affected shoulder among women with pain after breast cancer treatment.

OBJECTIVE: Breast cancer survivors (BCS) are often characterized by decreased pressure pain thresholds (PPT), range of motion (ROM) and strength in and around the shoulder affected by the treatment. This intra-rater reliability study was to establish the relative and absolute reliability of PPT's, active ROM and maximal isokinetic muscle strength (MIMS) of the affected shoulder in BCS with persistent pain after treatment. METHODS: Twenty-one BCS participated in the study. The PPTs of 17 locations and pain intensity were assessed using a pressure algometer and a numeric rating scale. The ROM was measured using a universal goniometer and MIMS was measured using an isokinetic dynamometer. Relative reliability was estimated using intra class correlation coefficient (ICC), and absolute reliability using standard error of measurement (SEM). Minimum detectable change (MDC) was calculated from SEM. RESULTS: The ICCs for PPTs ranged from 0.88-0.97, with SEM values ranging from 12.0 to 28.2 kPa and MDC ranging from 33.2 to 78.2 kPa. The ICCs for ROM ranged from 0.66-0.97, with SEM values ranging from 3.0 to 7.5° and MDC ranging from 8.4 to 20.8°. Finally, ICCs for MIMS ranged from 0.62-0.92, with SEM values ranging from 0.03 to 0.07 Nm/Kg FFM and MDC ranging from 0.09 to 0.19 Nm/kg FFM. CONCLUSION: The results of this study indicate that PPTs, ROM and MIMS can be measured reliably on the affected shoulder in BCS with pain after treatment. This offer the possibility of using these measures to assess the effectiveness of interventions in this population.

[Improved patient safety through a clinical decision support system in laboratory medicine]. / Verbesserte Patientensicherheit durch "clinical decision support systems" in der Labormedizin.

BACKGROUND: Laboratory diagnostics are essential for diagnosis, initiation of therapy, and monitoring of patients. Laboratory results that are overlooked or incorrectly interpreted lead to adverse events and endanger patient safety. Clinical decision support systems (CDSSs) may facilitate appropriate interpretation of results and subsequent medical response. OBJECTIVES: The research project on digital laboratory medicine (AMPEL) aims at developing a CDSS based on laboratory diagnostics, which supports practitioners in ensuring the necessary medical consequences. MATERIALS AND METHODS: A literature review of CDSSs describes the current state of research. The research project AMPEL is presented with its objectives, challenges, and first results. Furthermore, the development of a framework and reporting system is illustrated through the clinical example of severe hypokalemia. RESULTS AND CONCLUSION: Through interdisciplinary development and constant optimization, a specific CDSS with high acceptance among clinicians was developed. Initial results in the case of severe hypokalemia show a positive effect on patient care. Thereby, more complex frameworks such as sepsis diagnostics or acute coronary syndrome are implemented. The limited availability of standardized and digital clinical data is challenging. In addition to the application of classic decision trees in CDSS, the use of machine learning offers a promising perspective for future developments.

Human walk-to-run transition in the context of the behaviour of complex systems.

This study had two main aims: 1) to investigate if the walk-to-run (WR-) transition occurs when the speed of locomotion is kept constant below the WR-transition speed (speed clamp) and the stride rate is increased monotonously using a metronome and 2) to investigate if diversion of attention and awareness from the locomotion process influences the position of the WR-transition in stride rate, stride length, and locomotion speed (SrSlLs) space. Eighteen healthy individuals (13 men and 5 women) were recruited (age: 23.9 ±â€¯1.5 years, height: 1.77 ±â€¯0.10 m and body mass: 77.3 ±â€¯12.8 kg). Stride-by-stride stride rates, stride lengths, locomotion speeds, and duty factors were determined on a treadmill in 4 different tests: 1) reference WR-transition, 2) preferred walking speed, 3) dual-task test including arithmetic calculations and 4) four speed clamp bouts with different initial velocities. Walk-to-run transitions were elicited in all participants in the speed clamp bouts. When the stride rate ramp was clamped at preferred walking speed the WR-transition stride rate was not significantly different from the WR-transition stride rate during the reference test (t = 2.2, p = 0.312). However, in the SrSlLs space the speed clamp WR-transitions all deviated from the position of the reference WR-transition. Additionally, it was demonstrated that intensive attentional diversion using a dual-task paradigm had very little influence on the position of the WR-transition in the SrSlLs space. It is argued that these observations can be explained in the context of the behavior of complex systems.

The association between eccentric hip abduction strength and hip and knee angular movements in recreational male runners: An explorative study.

Weak hip abductors may be related with increased hip adduction and knee abduction angular movement, which may be risk factors of lower extremity injuries. As the role of eccentric hip abduction strength (EHAS) on hip adduction angular movement and knee abduction angular movement (KABD) remains unclear, the purpose of this study was to explore the association between EHAS and hip and knee angular movement. In 100 healthy male recreational runners, EHAS was quantified using an isokinetic dynamometer, while hip and knee angular movements were collected using pressure-sensitive treadmill and Codamotion active marker system. Using multiple linear regression models (n=186 legs), no relationships between EHAS and hip and knee kinematics were found. A possible reason for the lack of relationship between EHAS and hip and knee kinematics may be owing to differences in the running kinematics. Some runners with weak EHAS may compensate the weakness by leaning toward the stance limb and thereby reduces the demand on the hip abductors with the consequence of increased knee abduction moment, which may lead to an increased knee abduction angular excursion. Possible, others mechanism as the quadriceps strength and activity in the hip and thigh muscles may also be able to explain the lack of relationship that may or may not exist. Despite the inconclusive results of this study, the findings may suggest that weak hip abductor muscles may be a relevant factor to focus on in future studies.

The effect of type of afferent feedback timed with motor imagery on the induction of cortical plasticity.

A peripherally generated afferent volley that arrives at the peak negative (PN) phase during the movement related cortical potential (MRCP) induces significant plasticity at the cortical level in healthy individuals and chronic stroke patients. Transferring this type of associative brain-computer interface (BCI) intervention into the clinical setting requires that the proprioceptive input is comparable to the techniques implemented during the rehabilitation process. These consist mainly of functional electrical stimulation (FES) and passive movement induced by an actuated orthosis. In this study, we compared these two interventions (BCIFES and BCIpassive) where the afferent input was timed to arrive at the motor cortex during the PN of the MRCP. Twelve healthy participants attended two experimental sessions. They were asked to perform 30 dorsiflexion movements timed to a cue while continuous electroencephalographic (EEG) data were collected from FP1, Fz, FC1, FC2, C3, Cz, C4, CP1, CP2, and Pz, according to the standard international 10-20 system. MRCPs were extracted and the PN time calculated. Next, participants were asked to imagine the same movement 30 times while either FES (frequency: 20Hz, intensity: 8-35mAmp) or a passive ankle movement (amplitude and velocity matched to a normal gait cycle) was applied such that the first afferent inflow would coincide with the PN of the MRCP. The change in the output of the primary motor cortex (M1) was quantified by applying single transcranial magnetic stimuli to the area of M1 controlling the tibialis anterior (TA) muscle and measuring the motor evoked potential (MEP). Spinal changes were assessed pre and post by eliciting the TA stretch reflex. Both BCIFES and BCIpassive led to significant increases in the excitability of the cortical projections to TA (F(2,22)=4.44, p=0.024) without any concomitant changes at the spinal level. These effects were still present 30min after the cessation of both interventions. There was no significant main effect of intervention, F(1,11)=0.38, p=0.550, indicating that the changes in MEP occurred independently of the type of afferent inflow. An afferent volley generated from a passive movement or an electrical stimulus arrives at the somatosensory cortex at similar times. It is thus likely that the similar effects observed here are strictly due to the tight coupling in time between the afferent inflow and the PN of the MRCP. This provides further support to the associative nature of the proposed BCI system.

[Percentile Values for the Anthropometric Dimensions of Triplet Neonates - Analysis of German Perinatal Survey Data of 2007-2011 from all States of Germany]. / Perzentilwerte für die Körpermaße neugeborener Drillinge - Ergebnisse der deutschen Perinatalerhebung der Jahre 2007-2011 unter Beteiligung aller Bundesländer.

AIM: We aimed to develop national reference values for birth weight, length, head circumference, and weight for length for newborn triplets based on data from the German perinatal survey of 2007-2011. MATERIAL AND METHODS: Perinatal survey data of 3,690 newborn triplets from all the states of Germany were kindly provided to us by the AQUA Institute in Göttingen, Germany. Data of 3,567 newborn triplets were included in the analyses. Sex-specific percentile values were calculated using cumulative frequencies. Percentile values at birth were computed for the 3rd, 10th, 25th, 50th, 75th, 90th, and 97th percentiles for 21-36 completed weeks of gestation. RESULTS AND CONCLUSIONS: We present the first German reference values (tables and curves) for the anthropometric dimensions of triplet neonates and compare selected birth weight and length percentiles of triplets (after 32 and 34 completed weeks of gestation) to those of singletons and twins. The differences in the 50th birth weight percentiles between singletons and triplets after 32 completed weeks of gestation were 180 g for girls and 210 g for boys; after 34 weeks of gestation the differences were 320 and 325 g, respectively. The differences between twins and triplets after 32 weeks of gestation were 100 g for girls and 120 g for boys; after 34 weeks of gestation they were 130 and 135 g, respectively. The data presented here enable the classification of newborn triplets according to somatic parameters making reference to German perinatal data.

[New percentile values for the anthropometric dimensions of twin neonates: analysis of perinatal survey data of 2007-2011 from all 16 states of Germany]. / Neue Perzentilwerte für die Körpermaße neugeborener Zwillinge: Ergebnisse der deutschen Perinatalerhebung der Jahre 2007-2011 unter Beteiligung aller 16 Bundesländer.

AIM: The aim of this study was to develop new national standards for birth weight, length, head circumference, and weight for length for newborn twins based on the German perinatal survey of 2007-2011. We also assessed trends in anthropometric measurements by comparing these new percentile values with the percentile values of 1990-1994. MATERIAL AND METHODS: Perinatal survey data of 110,313 newborn twins from all the states of Germany collected in the years 2007-2011 were kindly provided by the AQUA Institute in Göttingen, Germany. Sex specific percentile values were calculated using cumulative frequencies. Percentile values at birth were computed for the 3rd, 10th, 25th, 50th, 75th, 90th, and 97th percentiles for 21-40 completed weeks of gestation. Percentile curves and tabulated values for the years 2007-2011 were compared with the published values of 1990-1994. RESULTS AND DISCUSSION: The new percentile curves (2007-2011) closely resemble the previous ones (1990-1994). Small differences can nonetheless be found. For example, for birth weight the new values for the 10th percentile are a little higher. CONCLUSIONS: We recommend using the new percentile values instead of the old ones.

[New percentile values for the anthropometric dimensions of singleton neonates: analysis of perinatal survey data of 2007-2011 from all 16 states of Germany]. / Neue Perzentilwerte für die Körpermaße neugeborener Einlinge: Ergebnisse der deutschen Perinatalerhebung der Jahre 2007-2011 unter Beteiligung aller 16 Bundesländer.

AIM: The aim of this study was to derive percentile values for birth weight, length, head circumference, and weight for length for singleton neonates based on the German perinatal survey of 2007-2011 (using data from all 16 states of Germany). We also compared these new percentile values with the percentile values of 1995-2000 that so far have been considered standard values. MATERIAL AND METHODS: Data of 3 187 920 singleton neonates from the German perinatal survey of the years 2007-2011 were kindly provided to us by the AQUA Institute in Göttingen, Germany. Sex specific percentile values were calculated using cumulative frequencies. Percentile values at birth were computed for the 3(rd), 10(th), 25(th), 50(th), 75(th), 90(th), and 97(th) percentiles for 21-43 completed weeks of gestation. Percentile curves and tabulated values for the years 2007-2011 were compared with the published values of 1995-2000. RESULTS AND DISCUSSION: Overall the new percentile curves closely resemble the previous ones. Minimal differences can be found for the 10(th) percentile and generally for early weeks of gestation. Values for the 10(th) percentile in the 2007-2011 dataset are somewhat higher than values of 1995-2000 for birth weight, length, and weight for length. CONCLUSIONS: We recommend the use of these new percentile values instead of the old ones.

Short communication: Changes in gait symmetry in healthy and lame dairy cows based on 3-dimensional ground reaction force curves following claw trimming.

Lameness is a frequent health problem in dairy cows. This preliminary study aimed to detect gait differences between healthy and lame walking cows using 3-dimensional force plates. We examined left-right leg symmetry changes of healthy and lame Holstein dairy cows following claw trimming. Gait scoring (GS) was performed on d -5, 0, 1, and 7 relative to claw trimming. Before the experiment, 5 cows walked normally (initial GS=1) and 4 cows limped moderately on a hind leg (initial GS=3). Gait was measured on d -2, -1, 0, 1, and 7 relative to trimming by obtaining ground reaction forces as cows walked repeatedly across 2 parallel 3-dimensional force plates. From the ground reaction forces, stance phase data were derived using computerized procedures. Left-right leg symmetries of entire curves in the 3 force directions were calculated. Effects of lameness and trimming were analyzed in a mixed model, using a low lameness threshold (GS>1). One week after claw trimming, only one cow was mildly lame. In addition, the symmetries of all 3 dimensions were significantly improved shortly after trimming. Importantly, lameness significantly worsened vertical symmetry. Lame cows walked significantly more slowly than healthy cows. In conclusion, all force symmetries seemed capable of detecting gait responses to claw trimming. Although our results are based on a small number of animals, vertical leg symmetry was affected by lameness.

Frequency and pattern of voluntary pedalling is influenced after one week of heavy strength training.

Changes in voluntary rhythmic leg movement characteristics of freely chosen cadence (reflecting movement frequency) and tangential pedal force profile (reflecting movement pattern) were investigated during 4weeks of (i) heavy hip extension strength training (HET, n=9), (ii) heavy hip flexion strength training (HFT, n=9), and (iii) no intervention (CON, n=9). Training consisted of three 5RM-10RM sets per session, with two sessions/week. Submaximal ergometer cycling was performed before the training period (pretest) and after every week of training (test A1, A2, A3, and posttest). Strength increased by on average 25% in HET and 33% in HFT. Freely chosen cadence was only changed in HET, occurring already after 1week of training. Thus, percentage reductions of cadence in HET at test A1, A2, A3, and posttest, with respect to the pretest value, amounted for maximally on average 17%, or 14rpm, and were larger than the corresponding changes in CON (p=.037). Percentage increases in minimum tangential pedal force in HET at test A1, A2, A3, and posttest, with respect to the pretest value, were larger than the corresponding changes in CON (p=.024). Heavy hip flexion strength training did not cause such alterations.

[Changes in the somatic classification according to birth weight and duration of pregnancy of newborn girls when maternal height is considered]. / Veränderungen in der somatischen Klassifikation weiblicher Neugeborener nach Geburtsgewicht und Schwangerschaftsdauer unter Berücksichtigung der Körperhöhe der Mutter.

This study examines the quantitative changes in the somatic classification according to birth weight and duration of pregnancy of German neonates when maternal height is considered (5 maternal height groups). Our calculations were performed using data of 319 884 girls born in 2010. Overall, about 6% (18 792 girls) are classified differently (more appropriately) when group-specific norm values were used.

[Primary open-angle glaucoma (POAG), retinal vein occlusions (RVO) and central corneal thickness (CCT): what is the relationship?]. / Glaucomes primitifs à angle ouvert (GPAO), occlusions veineuses rétiniennes (OVR) et pachymétrie : quelle relation ?

PURPOSE: To investigate the relationship between various types of glaucoma, retinal vein occlusion (RVO), and central corneal thickness (CCT) METHODS: We followed 48 known glaucoma patients who developed any type of retinal vein occlusion. Mean follow-up was 4.2 years. At all visits, patients had a detailed ocular history, as well as thorough bilateral evaluation, including dynamic gonioscopy, CCT measurement, retinal nerve fiber layer (RNFL) measurement by OCT, and automated visual field. Student's t-test and Chi(2) test were used to evaluate continuous and categorical data, respectively, with comparison of the means of paired series. RESULTS: Mean age at time of diagnosis was 68.1 ± 11.8 years (range 40-85 years). Six patients were black (12.5%), while the others were white (87.5%, P=0,0001). Various types of glaucoma were found in the 48 patients (22 men, 26 women, P=0.564) who developed RVO. No significant difference was found between mean CCT of eyes with RVO and fellow eyes (537.7 ± 39.8 µM and 538.4 ± 36.4 µM, respectively) (P=0.527). By stratifying our results according to the various types of glaucoma, mean CCT of involved and fellow eyes was 542.7 ± 37.6 µM and 540.6 ± 33.2 µM, respectively in the primary open-angle glaucoma (POAG) group, 530.4 ± 45.2 µM and 535 ± 43.6 µM in the chronic angle-closure glaucoma (CACG) group, 549.3 ± 24.8 µM and 558 ± 37.3 µM in the pseudo-exfoliation glaucoma (PXG) group, and 490 ± 56.6 µM and 495 ± 35.4 µM in the normal-tension glaucoma (NTG) group. CONCLUSIONS: Contrary to some recently-published studies, our results showed no statistically significant difference between CCT of eyes involved with RVO and fellow eyes. The NTG group seems to have the thinnest CCT.

Effects of smoking specified as cigarettes per day and maternal body mass index on hypertensive disorders of pregnancy.

BACKGROUND: We have previously described the prevalence in pregnancy of hypertension, proteinuria, oedema and preeclampsia/eclampsia according to maternal body mass index (BMI) and smoking status. We found that these disorders were less frequent among smoking women. To investigate whether this relationship is causal or a chance finding, we here present an analysis according to BMI and smoking specified according to the number of cigarettes consumed per day. MATERIALS AND METHODS: Data were from the German Perinatal Survey of 1998-2000. We classified women by BMI as underweight (BMI<18.5 kg/m2), normal weight (BMI 18.5-24.99 kg/m2), overweight (25.0-29.99 kg/m2), or obese (BMI≥30 kg/m2). Smoking was categorised as being a non-smoker or smoking 1-7, 8-14 or ≥ 15 cigarettes per day. Datasets from 433 669 singleton pregnancies with information on maternal BMI and smoking were included in the analysis. RESULTS: In all BMI categories hypertension, moderate to severe oedema, and preeclampsia/eclampsia became less prevalent with increasing maternal cigarette consumption. CONCLUSIONS: Dose-dependence was not convincing for proteinuria.Dose-dependence in the relationship between smoking and hypertensive disorders of pregnancy argues against a chance finding and for a causal relationship.