Associations between alcohol intake and diabetic retinopathy risk: a systematic review and meta-analysis.

BACKGROUND: Some previous studies have reported inconsistent results on the association between alcohol intake and diabetic retinopathy (DR) risk. This study aimed to evaluate the potential effects of alcohol intake on subsequent DR risk using a meta-analytic approach. METHODS: Three electronic databases (PubMed, EmBase, and the Cochrane library) were systematically searched for observational studies from their inception till November 2019. The pooled odds ratio (OR) with 95% confidence interval (CI) were applied for the summary effect estimate using a random-effects model. RESULTS: A total of 15 studies (5 cohort studies, 4 case-control studies, and 6 cross-sectional studies) with 37,290 participants and 12,711 DR cases were selected for the final meta-analysis. The pooled OR indicated no significant association between alcohol intake and DR risk (OR: 0.91; 95%CI: 0.78-1.06; P = 0.225), irrespective of the studies being pooled cohort (OR: 0.95; 95%CI: 0.66-1.36; P = 0.761), case-control (OR: 0.97; 95%CI: 0.77-1.23; P = 0.818), or cross-sectional (OR: 0.86; 95%CI: 0.69-1.08; P = 0.190) ones. However, this association might have been affected by the type of diabetes mellitus and the adjusted status. CONCLUSION: The results of this study showed that the potential impact of alcohol intake on DR risk may differ according to the type of diabetes mellitus and adjusted status. Further large-scale, prospective cohort studies should be conducted to verify the findings of this study and to evaluate DR risk in relation to the dose and type of alcohol intake.

Prevalence of unruptured cerebral aneurysms in Chinese adults aged 35 to 75 years: a cross-sectional study.

BACKGROUND: The reported prevalence of unruptured cerebral aneurysms (UCAs) varies widely. OBJECTIVE: To measure the prevalence of UCAs by using 3-dimensional time-of-flight magnetic resonance angiography in adults aged 35 to 75 years. DESIGN: Cross-sectional study done between June 2007 and June 2011. SETTING: Two communities chosen at random from 2 districts (1 urban and 1 suburban) in Shanghai, China. PARTICIPANTS: 4813 adults aged 35 to 75 years. MEASUREMENTS: Three-dimensional time-of-flight magnetic resonance angiography, interpreted by 3 observers blinded to the participants' information, was used to identify the location and size of UCAs and to estimate the overall, age-specific, and sex-specific prevalence. RESULTS: 369 UCAs were found in 336 participants (130 men and 206 women); 4477 participants had no evidence of UCAs. The prevalence was 7.0% overall (95% CI, 6.3% to 7.7%), with 5.5% for men (CI, 4.6% to 6.4%) and 8.4% for women (CI, 7.3% to 9.5%). The overall prevalence of UCAs was higher in women than in men (P < 0.001) and peaked at ages 55 to 64 years in men and women. The UCAs were mostly located in the internal carotid artery (81%), and 90.2% had a maximum diameter less than 5 mm. Mean diameter was larger in women than in men (3.7 mm vs. 3.2 mm; P < 0.009). LIMITATION: Participants were from 2 communities selected from 2 districts in Shanghai, and adults older than 75 years were not studied. CONCLUSION: The overall prevalence of UCAs was 7.0% in Chinese adults aged 35 to 75 years, and most lesions had a diameter less than 5 mm. PRIMARY FUNDING SOURCE: National Natural Science Foundation of China.

Grid-based implementation of XDS-I as part of image-enabled EHR for regional healthcare in Shanghai.

PURPOSE: Due to the rapid growth of Shanghai city to 20 million residents, the balance between healthcare supply and demand has become an important issue. The local government hopes to ameliorate this problem by developing an image-enabled electronic healthcare record (EHR) sharing mechanism between certain hospitals. This system is designed to enable healthcare collaboration and reduce healthcare costs by allowing review of prior examination data obtained at other hospitals. Here, we present a design method and implementation solution of image-enabled EHRs (i-EHRs) and describe the implementation of i-EHRs in four hospitals and one regional healthcare information center, as well as their preliminary operating results. METHODS: We designed the i-EHRs with service-oriented architecture (SOA) and combined the grid-based image management and distribution capability, which are compliant with IHE XDS-I integration profile. There are seven major components and common services included in the i-EHRs. In order to achieve quick response for image retrieving in low-bandwidth network environments, we use a JPEG2000 interactive protocol and progressive display technique to transmit images from a Grid Agent as Imaging Source Actor to the PACS workstation as Imaging Consumer Actor. RESULTS: The first phase of pilot testing of our image-enabled EHR was implemented in the Zhabei district of Shanghai for imaging document sharing and collaborative diagnostic purposes. The pilot testing began in October 2009; there have been more than 50 examinations daily transferred between the City North Hospital and the three community hospitals for collaborative diagnosis. The feedback from users at all hospitals is very positive, with respondents stating the system to be easy to use and reporting no interference with their normal radiology diagnostic operation. CONCLUSIONS: The i-EHR system can provide event-driven automatic image delivery for collaborative imaging diagnosis across multiple hospitals based on work flow requirements. This project demonstrated that the grid-based implementation of IHE XDS-I for image-enabled EHR could scale effectively to serve a regional healthcare solution with collaborative imaging services. The feedback from users of community hospitals and large hospital is very positive.