Effect of nutritional supplement combined with exercise intervention on sarcopenia in the elderly:A meta-analysis

Objectives:This systematic review was conducted to explore whether nutritional supplement can improve the benefits of exercise intervention on sarcopenia in the elderly.Methods:Databases,including PubMed,Embase,Cochrane Library,Web of Science,CINAHL,CBM,CNKI,WANFANG,and VIP,were searched.All related papers with randomized controlled trials(RCT)meth-odology that were included in the databases from inception to 19 July 2016 were selected for the study.The tool"assessing risk of bias"from Cochrane Handbook 5.10 was used to evaluate the quality of included papers.A meta-analysis of eligible studies was performed using Stata12.0.Data that we were unable to convene or merge were subjected to descriptive analysis.Results:Six trials were included in our study,which included 429 elderly patients with sarcopenia.The overall methodological quality of the trials was moderate.Compared with the exercise group,patients who were given nutritional supplements gained a bigger boost in fat-free mass(standard mean differ-ence(SMD)=5.78,95%CI:5.17 to 6.40,P=0.000)and muscle mass(SMD=2.048,95%CI:0.907 to 3.189,P=0.000),as well as showed enhancement of keen extension strength(SMD=1.08,95%CI:0.71 to 1.45,P=0.000)and usual walk speed(SMD=0.570,95%CI:0.19 to 0.95,P=0.003).Conclusion:Nutritional supplementation may magnify the effect of exercise intervention on sarcopenia elderly in terms of muscle mass,muscle strength,and physical performance.Inconsistencies were pre-sent among research studies.More robust studies are needed to determine the most suitable type of nutrient and target population and to explore the actual role of combined intervention in managing sarcopenia in the elderly.

"I can fight it!": A qualitative study of resilience in people with inflammatory bowel disease

Objectives:This study aimed to understand the resilience experiences in patients with inflammatory bowel disease(IBD)and develop the resilience framework for them.Methods:Semistructured interviews were conducted with 15 patients with IBD who were purposefully recruited from the gastroenterology department of two hospitals in Jiangsu,China to gain diversity in the demographic and clinical characteristics.The data were analyzed using a directed content analysis approach based on the Kumpfer's resilience framework.Results:The resilience framework for patients with IBD was formed from the analysis.This framework was composed of four themes,as follows:(1)complicated factors in the environment,(2)change the environment into a protective one,(3)personality traits,and(4)resilience-related coping.Conclusions:The resilience framework for patients with IBD can effectively characterize the resilience experience of patients during the disease and assist healthcare professionals to understand how patients recover from the disease.More quantitative studies are needed to further explore the influencing factors of resilience and improve resilience in patient with inflammatory Bowel Disease.

An updated review of long-term outcomes from randomized controlled trials in approved pharmaceuticals for diabetic macular edema

Diabetic macular edema(DME) is a major sight-threatening cause in diabetic patients. We review the long-term outcome of four approved pharmacotherapy for treating DME, including intravitreal injections of corticosteroids(dexamethasone implants and fluocinolone acetonide inserts) and anti-vascular endothelial growth factor(VEGF)(ranibizumab and aflibercept). They all show superior ability to improve vision and reduce macular thickness, comparing with sham injections or macular focal/grid laser treatment. Anti-VEGF agents result in low incidence of severe ocular or systemic adverse effects, but glaucoma and cataract should be aware after intravitreal corticosteroids. Prompt treatment with these agents can lead to a better outcome.

Approved pharmacotherapy for macular edema secondary to branch retinal vein occlusion:A review of randomized controlled trials in dexamethasone implants,ranibizumab,and aflibercept

There are three approved pharmacotherapies for treating macular edema secondary to branch retinal vein occlusion(BRVO), including corticosteroids(dexamethasone implants) and anti-vascular endothelial growth factor(VEGF)(ranibizumab and aflibercept). They all show superior ability to improve vision and reduce macular thickness, comparing with sham injections or macular grid laser treatment. There is no severe ocular or systemic adverse reaction reported in studies associated with anti-VEGF for macular edema after BRVO. Intraocular pressure elevation and cataract aggravation should be addressed after intravitreal dexamethasone implants. Single intravitreal dexamethasone implant had effective duration as long as four to six months. Intravitreal anti-VEGF requires six monthly injections as loading doses, and then PRN regimen needed according to functional and anatomical changes. Ozurdex and ranibizumab reduce not only macular edema, but also the probability of retinal ischemia and neovascularization in patient s with BRVO. Prompt treatment with these agents can lead to a better outcome.

The use of aflibercept in ophthalmology:a review of randomized controlled trials

We reviewed randomized controlled trials associated with the intravitreal use of aflibercept for this article. These studies proved that aflibercept is an effective anti-vascular endothelial growth factor agent for the treatment of neovascular age-related macular degeneration (nAMD), myopic choroidal neovascularization (mCNV), diabetic macular edema (DME), and macular edema associated with retinal vein occlusion. The incidence of severe ocular or systemic complications after intravitreal administration of aflibercept was low.

Compressive Optic Neuropathy Caused by Cholesterol Granuloma in the PosteriorEthmoid Sinus

Purpose:.Cholesterol granuloma is usually associated with chronic middle ear disease..Involvement of the ethmoid sinus by cholesterol granuloma is rare..We describe a case with cholesterol granuloma of the posterior ethmoid sinus causing optic nerve compression..No previous reports were found in our review of the literature.Case report:.A 48-year-old man had impaired visual acuity and a relative afferent pupillary defect in the right eye. Fundus fluorescein angiography showed a swollen optic nerve head and optic disc leakage. Automated perimetry revealed a severe peripheral visual field defect with tunnel vision. Computerized tomography demonstrated an expansile,.isodense mass in the right posterior ethmoid sinus, remodeling of the bony walls of the right sphenoid sinus, and lateral displacement of the optic nerve in the right orbit..Compressive optic neuropathy caused by posterior ethmoid sinus lesion was diagnosed..A transnasal endoscopic exploration of the right ethmoid sinuses demonstrated a soft expansile cystic lesion with a thick yellow cap sule that filled the inside of the posterior ethmoid sinus.Brownish fluid with shiny crystals was drained by fine needle aspiration. The capsule was removed completely, and the mucociliary clearance of the sinus was reestablished..The pathologic pictures confirmed the diagnosis of cholesterol granuloma, which included typical cholesterol clefts surrounded by inflammatory cells with focal multi-nucleated giant cells. Visual function fully recovered without recurrent lesions after a three-year follow-up.Conclusion:.Compressive optic neuropathy can be rarely caused by cholesterol granuloma in the posterior ethmoid sinus. The visual prognosis may be good after transnasal endoscopic decompression in such patients.

Intravitreal Aflibercept for Macular Edema Secondary to Branch Retinal Vein Occlusion in Chinese Patients

Purpose: To investigate the short-term efficacy and safety of intravitreal aflibercept in a case series of patients from Taiwan, China, with macular edema secondary to branch retinal vein occlusion(BRVO).Methods: A total of 32 patients with macular edema associated with BRVO,.without prior macular laser or other intervention, were enrolled consecutively from September 2013 to February 2015..The cases received single 2 mg injections of intravitreal aflibercept..Primary outcome measures included changes in central foveal thickness.(CFT;.1 mm increments by spectral-domain optic coherence tomography).and best corrected visual acuity.(BCVA),.determined at 1,.2,.and 3months after the injection. Complications after injections were recorded. The changes in CFT and BCVA were compared with Wilcoxon sign-rank tests.Results:.The CFT was significantly reduced and the BCVA was significantly improved at 1, 2, and 3 months after injection(all P < 0.05). Tomography findings revealed no recurrence within 3 months. No systemic thromboembolic events,elevated intraocular pressure, retinal detachment, or infectious endophthalmitis occurred following injection.Conclusion:.Single intravitreal aflibercept may be useful in treating macular edema associated with BRVO within 3months. No adverse systemic or ocular effects were found in this case series.

Factors Affecting Corneal Hysteresis in Taiwan Residents Adults

Purpose: To investigate the correlation of various corneal hysteresis(CH) factors in Chinese adults.Methods: From January 2009 to November 2011, the healthy right eyes of a total of 292 adults were recruited into the study. Goldmann-correlated intraocular pressure(IOPG) and CH were measured using an ocular response analyzer(ORA).Central corneal thickness was measured using the ORA's integrated handheld ultrasonic pachymeter. The IOLMaster was used to obtain the ocular biometric measurements including axial length, anterior chamber depth, and keratometric values.The Pearson correlation coefficient was used to test correlations between CH and quantitative factors. The chi-square test was used to detect differences in categorical values.Results: Longer axial length(P =0.0001), lower IOPG(P =0.03), older age(P=0.003),and thinner central corneal thickness(P=0.0001) were significantly associated with lower CH.The anterior chamber depth(P=0.34), gender(P =0.23), and corneal curvature(P=0.18) had no relationship to CH.Conclusion: Various factors including axial length, intraocular pressure, age, and central corneal thickness can affect measurement of corneal biomechanical properties in Chinese adults.But the anterior chamber depth, gender, and corneal curvature were irrelevant to CH.