RESUMO
This study aimed to determine whether there is an association between the age at menopause (AM) and diabetic microvascular complications. This cross-sectional study included 298 postmenopausal women with type 2 diabetes mellitus. They were divided into 3 groups according to AM (in years; group 1: AM < 45 years, n = 32; group 2:45 ≤ AM < 50 years, n = 102; group 3: AM ≥ 50 years, n = 164). Clinical data related to the duration of type 2 diabetes, body mass index, smoking status, hypertension status, AM, biochemical indices, and diabetic microvascular complications (retinopathy, nephropathy, and neuropathy) were collected. Logistic regression analysis was performed to identify the association between the AM and diabetic microvascular complications. No statistical differences were observed in the prevalence of diabetic retinopathy, chronic kidney disease, or diabetic peripheral neuropathy between the groups. After adjusting for possible confounders, AM did not correlate with the presence of diabetic retinopathy (ß = 1.03, 95% confidence interval [CI]: 0.94-1.14, P = .511), chronic kidney disease (ß = 1.04, 95% CI: 0.97-1.12, P = .280), and diabetic peripheral neuropathy (ß = 1.01, 95% CI: 0.93-1.09, P = .853). Our findings suggest that early menopause (age < 45 years) was not associated with microvascular diabetic complications. Further prospective studies are needed to clarify this issue.
Assuntos
Diabetes Mellitus Tipo 2 , Neuropatias Diabéticas , Retinopatia Diabética , Insuficiência Renal Crônica , Humanos , Feminino , Pessoa de Meia-Idade , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/epidemiologia , Neuropatias Diabéticas/epidemiologia , Neuropatias Diabéticas/etiologia , Estudos Transversais , Retinopatia Diabética/epidemiologia , Retinopatia Diabética/etiologiaRESUMO
OBJECTIVE: To analysis the clinical characteristics of corneal interface fluid syndrome (IFS). METHODS: This is a retrospective study. During Jun. 2007 to Oct. 2011. Eight cases (12 eyes) of IFS were diagnosed at Henan Eye Institute. The history and complete ophthalmic examination that include Slit-lamp examination, Slit-lamp photography, IOP, anterior segment OCT (AS-OCT), confocal microscopic exams were recorded. RESULTS: In total 8 cases (12 eyes), 4 cases were bilateral, 4 cases were unilateral. Six patients were male and 2 were female. The age of the patients ranged from 19 to 35 years. Post-lasik steroid-induced elevated IOP was 4 eyes in 2 patients. Primary open angle glaucoma was 4 eyes in 2 patients. 1 patient (1 eye) was Posner-Shlossman syndrome, 1 patient (1 eye) was pigmented glaucoma, 1 patient (1 eye) was post-lasik traumatic iritis. 1 patient (1 eye) got IFS after repeated flap reposition because of epithelium ingrowth. Slit-lamp exam indicated edematous corneal, lamellar haze, interface fluids accumulation. AS-OCT showed obvious interface dark area. Confocal microscopy exam showed edematous corneal flap, more oval and large keratocytes' nuclei but no inflammatory cells. CONCLUSIONS: IFS is a rare but serious complication after LASIK. The main causes are high intraocular pressure and/or dysfunction of corneal endothelium. Careful exam by slit-lamp may help diagnosis, and further AS-OCT and/or in vivo confocal microscopy exam will confirm it.
Assuntos
Edema da Córnea , Adulto , Edema da Córnea/diagnóstico , Edema da Córnea/etiologia , Feminino , Humanos , Ceratomileuse Assistida por Excimer Laser In Situ/efeitos adversos , Masculino , Estudos Retrospectivos , Adulto JovemRESUMO
PURPOSE/AIM OF THE STUDY: To identify the causative fungi of fungal keratitis, test their susceptibility to antifungal agents with the disk diffusion method and study the relationship between the organisms, the inhibition zones and the clinical outcomes. MATERIALS AND METHODS: 535 patients with fungal keratitis in one eye were included in this study. Pathogenic fungi were isolated by corneal scraping, identified by fungal cultivation and subjected to drug sensitivity tests conducted with the disk diffusion method. The patients were treated initially with voriconazole, terbinafine and natamycin eye drops for one week. Further treatment continued using the most effective drug according to the drug sensitivity results. The patients were followed up every week until three months after cured. The inhibition zones of fungi cultured with voriconazole, terbinafine and natamycin were compared. The relationship between inhibition zones and organism, organism and treatment results measure, and each treatment results measure and inhibition zones were evaluated. RESULTS: Of 535 patients, 53.84%, 19.25% and 26.91% were infected with Aspergillus, Fusarium and other fungi, respectively. Keratitis patients infected with Aspergillus keratitis had the worst outcome. The size of the inhibition zones of Aspergillus spp., Fusarium spp. and other fungal genera differed significantly in response to voriconazole, terbinafine and natamycin. The inhibition zone associated with natamycin correlated significantly with the clinical outcome of fungal keratitis (OR = 0.925), but no other such correlations were found for the other drugs tested. CONCLUSIONS: Aspergillus and Fusarium were the predominant pathogenic genera causing fungal keratitis in our patients. Among the causative fungi, infections due to Aspergillus spp. were associated with the worst outcomes. The inhibition zones of fungal isolates in response to natamycin significantly correlated with the treatment outcomes of keratitis. Specifically, the smaller the natamycin inhibition zone, the lower the probability that the fungal keratitis had been eliminated.