Search

Purpose: To investigate differences between women and men in the repair of rhegmatogenous retinal detachments (RRDs) in the United States., Design: Retrospective cohort study., Methods: Setting: A large insurance claims database., Participants: Subjects with an incident RRD between 2007 and 2015., Data: Demographic data, comorbid ocular conditions associated with RRD, systemic comorbidities, and surgical intervention (pneumatic retinopexy [PR], pars plana vitrectomy [PPV], laser barricade, or scleral buckle [SB]) were collected., Main Outcome Measures: Odds of receipt of surgical intervention for incident RRD, time to repair, type of intervention, and the rate of reoperation by sex., Results: The study period included 133 million eligible records with 61,071 cases of incident RRD among which 43% (n = 26,289) were women. The primary outcome model had 23,933 confirmed RRD cases with a 93% retinal detachment repair rate. Women had 34% reduced odds of receipt of surgical repair of an RRD (odds ratio [OR] 0.66, 95% confidence interval [CI] 0.59, 0.73; P < .001) after adjusting for confounders. This effect persisted in all sensitivity models. Among patients who received repair, women were more often delayed (0.17 days, P = .04). Women were more likely to undergo primary laser barricade (relative risk ratio [RRR] 1.68, P < .001), primary SB (RRR 1.15, P < .001), and PR (RRR 1.07, P < .04) than men. The odds of reoperation were lower in women (OR 0.91, 95% CI 0.85, 0.96; P = .002) after adjustment., Conclusions: Insured women are less likely than insured men to receive surgical intervention for an RRD. Based on the results of this study, if the odds of repair were equal between women and men in the United States, then 781 more women would receive surgery each year, or 7,029 more during the study period. Women are more likely to have the repair performed with scleral buckle, laser barricade, and pneumatic retinopexy. The reason for these sex differences in RRD repair remains unknown and requires further investigation., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Objective: To determine national trends for patients with subarachnoid hemorrhage (SAH) and pulmonary complications including acute respiratory distress syndrome (ARDS)., Methods: The Nationwide Inpatient Sample database was used to sample 193,209 admissions for SAH with and without ARDS during the period 1993-2008 using International Classification of Diseases, Ninth Revision, Clinical Modification coding. A multivariate stepwise regression analysis was performed., Results: The incidence of ARDS in patients with SAH increased from 35.51% in 1993 to 37.60% in 2008. However, the overall mortality in patients with SAH and in patients with SAH and ARDS decreased in the same period, from 42.30% to 31.99% and from 75.13% to 60.76%, respectively. Multivariate analysis showed that the predictors of developing ARDS in patients with SAH include older age; larger hospital size; and comorbidities such as epilepsy, cardiac arrest, sepsis, congestive heart failure, hypertension, chronic obstructive pulmonary disease, hematologic dysfunction, renal dysfunction, and neurologic dysfunction. Predictors of mortality in patients with SAH include age and hospital complications, such as coronary artery disease, ARDS, cancer, hematologic dysfunction, and renal dysfunction., Conclusions: Patients with SAH are at increased risk of developing ARDS. The identification of certain risk factors may alert and aid practitioners in preventing worsening disease., (Copyright © 2014 Elsevier Inc. All rights reserved.)

A prerigor cut was made through the 12th thoracic vertebra of one side of the beef carcasses (Tendercut) studied (five unbranded), and the other sides served as the controls (C). After 48 h postmortem, the longissimus from each side was removed starting from the junction between the 5th and 6th lumbar vertebrae to the point between the 5th and 6th thoracic vertebrae. The longissimus muscle was cut into four equal boneless sections to determine the effectiveness of this treatment on improving tenderness at different locations along this muscle. The effects of Tendercut upon yield grade, sensory attributes, and tenderness of longissimus steaks were determined. This treatment did not affect (P > .05) yield grade, CIE L* a* b* values, chemical states of myoglobin, purge and cooking losses, and total collagen. Steaks located closer to the treatment site were more juicy than controls. Peak force values were not significantly different. Sarcomere length was longer (P < .05) and sensory panel ratings for myofibrillar tenderness, connective tissue, and overall tenderness were higher (P < .05), indicating that this skeletal alteration technique increased tenderness. Sensory data revealed that skeletal and connective tissue cuts at a single site (12th thoracic vertebrae) on the beef rib improved the tenderness along the entire length of the longissimus muscle. This study demonstrated that Tendercut, a simple process that does not require any new equipment or alterations to existing facilities to implement, is a viable tenderness enhancement technique.