Characterizing Alcohol Expectancies in the ABCD Study: Associations with Sociodemographic Factors, the Immediate Social Environment, and Genetic Propensities.

Alcohol expectancies (AEs) are associated with likelihood of alcohol initiation and subsequent alcohol use disorders. It is unclear whether genetic predisposition to alcohol use and/or related traits contributes to shaping how one expects to feel when drinking alcohol. We used the Adolescent Brain Cognitive Development study to examine associations between genetic propensities (i.e., polygenic risk for problematic alcohol use, depression, risk-taking), sociodemographic factors (i.e., parent income), and the immediate social environment (i.e., peer use and disapproval toward alcohol) and positive and negative AEs in alcohol-naïve children (max analytic N = 5,352). Mixed-effect regression models showed that age, parental education, importance of the child's religious beliefs, adverse childhood experiences, and peer disapproval of alcohol use were associated with positive and/or negative AEs, to varying degrees. Overall, our results suggest several familial and psychosocial predictors of AEs but little evidence of contributions from polygenic liability to problematic alcohol use or related phenotypes.

Superior versus inferior conjunctival autografts combined with fibrin glue in the management of primary pterygia.

PURPOSE: To compare the outcomes of superior versus inferior conjunctival autograft (CAU) in the prevention of recurrence after performing a pterygium surgery in patients with primary pterygia. METHODS: This was a prospective randomized study of 60 eyes of 60 patients with primary pterygium. All the eyes underwent pterygium excision and were assigned randomly to receive either superior (30 eyes) or inferior (30 eyes) CAU. All grafts were attached with fibrin glue. The patients were followed up on postoperative day 1, day 7, 1 month, 3 months, and 6 months. RESULTS: Outcome measures included rate of recurrence, mean surgical time, visual analog scale pain score, and amount of pain medication required in the first postoperative week. The mean surgical time, visual analog scale pain score, and amount of pain medication required in both groups were not statistically different. A follow-up of at least 6 months (mean 5.5 ± 1.1 months) was achieved in 49 eyes of 49 patients (24 eyes in the superior CAU group and 25 eyes in the inferior CAU group). One eye in the superior CAU group (4.2%) and 1 eye in the inferior CAU group (4.0%) developed pterygium recurrence. There was no statistically significant difference in the recurrence rates between the 2 groups. In the inferior CAU group, mild localized donor site scarring was noted in 2 patients (8.3%). CONCLUSIONS: Pterygium excision with superior or inferior CAU secured with fibrin glue is safe and effective. There was no significant difference in surgical time, pain, and recurrence rates of pterygium after excision with superior or inferior CAU.

Shifting trends in bacterial keratitis in Toronto: an 11-year review.

OBJECTIVE: To review the distribution, current trends, and resistance patterns of bacterial keratitis isolates in Toronto over the last 11 years. DESIGN: Retrospective, observational, case series. PARTICIPANTS: Microbiology records of suspected bacterial keratitis cases that underwent a diagnostic corneal scraping and cultures from January 1, 2000, through December 31, 2010, were reviewed. METHODS: Culture results and antibiotic sensitivity profiles were reviewed and analyzed. MAIN OUTCOME MEASURES: Distribution of the main isolated pathogens as well as in vitro laboratory minimum inhibitory concentration testing results to identify resistance patterns. RESULTS: A total of 1701 consecutive corneal scrapings were taken during the 11 years of the study. A pathogen was recovered in 977 samples (57.4%), with bacterial keratitis accounting for 897 of the positive cultures (91.8%). The total number of Gram-positive and Gram-negative isolates was 684 and 213, respectively. We identified a decreasing trend in Gram-positive isolates (P = 0.016). The most common isolate overall was coagulase-negative Staphylococcus (CNS) and the most common Gram-negative bacteria isolated was Pseudomonas aeruginosa. Methicillin-resistant Staphylococcus aureus (MRSA) was present in 1.3% of the S aureus isolates, whereas methicillin-resistant CNS (MRCNS) was present in 43.1% of the CNS isolates. There was a trend toward increasing laboratory resistance to methicillin from 28% during the first 4 years of the study to 38.8% for the last 3 years (P = 0.133). When analyzing the sensitivities of MRSA and MRCNS isolates to other antibiotics, there was resistance to cefazolin and sensitivity to vancomycin in all isolates, whereas resistance to other antibiotics was variable. CONCLUSIONS: There was a significant decrease in the percentage of Gram-positive microorganisms over time. The sensitivity of Gram-negative isolates to tested antimicrobials was >97% response for all the reported antibiotics; this was not the case for Gram-positive isolates, in which resistance to the antibiotics was more common. Methicillin-resistant organisms accounted for 29.1% of all Gram-positive cultures in our series, suggesting that the empiric use of vancomycin in the setting of severe suspected bacterial keratitis may be justified.

Validation of tissue quality parameters for donor corneas, designated for emergency cases: corneal graft survival.

PURPOSE: To validate tissue quality parameters for donor corneas designated for emergency grafting for corneal graft survival. METHODS: In a longitudinal cohort follow-up study, 131 emergency penetrating grafts were studied. Grafts were performed with a pool of organ-cultured donor corneas designated for emergency grafting and prepared for immediate use with all safety tests performed. Assignation criteria were: corneas with a small superficial stromal opacity but meeting all selection criteria for PKP tissue and corneas without stromal opacity, but an endothelial cell density from 1800 to 2300 cells/mm(2) or mild polymegathism or pleomorphism. Cox multivariate regression analysis, Kaplan-Meier survival and log rank test were applied. RESULTS: Of the 131 keratoplasties, 115 could be followed. One eye was lost during surgery because of an expulsive bleeding. In 15 cases, a conjunctival transplantation finished off the penetrating graft. Corneal graft survival was not significantly related to the presence of PKP quality of the donor endothelium, neither with a cloudy graft nor with endothelial decompensation as the cause of failure. Main risk factors for a failed graft were vascularization of the host cornea (p=0.0001), the presence of a systemic auto immune disease in the recipient (p=0.003) and the disease leading to the (imminent) perforation and emergency graft (p=0.021). CONCLUSION: A selected pool of donor corneas designated for emergency grafting that does not interfere with the scheduled procedures allows more efficient and safe use of donor tissue in case of a(n) (imminent) perforation. Corneal graft survival rates justify the criteria for selection.

Validation of tissue quality parameters for donor corneas designated for emergency use in preservation of the globe.

PURPOSE: To validate tissue quality parameters for donor corneas designated for emergency grafting to preserve the globe. METHODS: In a longitudinal cohort follow-up study, 151 emergency grafts in the Netherlands were studied. Grafts were performed with a pool of organ-cultured donor corneas designated for emergency grafting and prepared for immediate use with all safety tests performed. Assignation criteria were corneas with a small superficial stromal opacity but meeting all selection criteria for penetrating keratoplasty tissue and corneas without stromal opacity but an endothelial cell density from 1800 to 2300 cells per square millimeter or mild polymegethism or pleomorphism. Cox multivariate regression analysis, Kaplan-Meier survival, and log rank test were applied. RESULTS: All requests for corneal tissue were honored within 24 hours. Ninety-one patients showed a complete and 60 an imminent perforation. One hundred thirty-one penetrating grafts and 20 lamellar grafts have been used. The globes were saved in 140 of the 151 patients (92.7%). Globe preservation was not significantly related to the absence of penetrating keratoplasty quality of the donor endothelium, the type of grafting, the degree of vascularization in the host cornea, or diabetic disease in the recipient. The main risk factor for globe preservation was the presence of a systemic autoimmune disease in the recipient (P = 0.0021). CONCLUSIONS: A selected pool of donor corneas designated for emergency grafting, that does not interfere with the scheduled procedures, allows more efficient and safe use of donor tissue in case of an imminent perforation. Globe preservation rates justify the quality criteria for designation of this tissue.