Orthokeratology (Ortho-K), atropine eye drops and combined atropine with Ortho-K are proven to be effective ways to prevent myopic progression in many studies, but there is scarce evidence regarding the comparative efficacy of different dosages of atropine,Ortho-K, and combined atropine with Ortho-K for childhood myopia. We performed a network meta-analysis (NMA) to assess the relative efficacy of the aforementioned interventions for myopic progression; moreover, we calculated the surface under cumulative ranking area (SUCRA) to determine the relative ranking of treatments. We identified 19 randomized controlled trials (3435 patients). NMA revealed that 0.01%-1% atropine, Ortho-K, and 0.01% atropine combined with Ortho-K inhibited axial elongation (AL) over one year. For refractive change, SUCRA analysis revealed that the hierarchy was high-dose (0.5%-1%), moderate-dose (0.1%-0.25%), and low-dose (0.01%-0.05%) atropine. Regarding AL, SUCRA analysis revealed the following hierarchy: Ortho-K combined with 0.01% atropine, high-dose atropine, moderate-dose atropine, Ortho-K, and low-dose atropine. In conclusion, we found that atropine (0.01%-1%), Ortho-K, and 0.01% atropine combined with Ortho-K could significantly slow down myopia progression. The atropine efficacy followed a dose-related pattern; moreover, Ortho-K and low-dose atropine showed similar efficacy. There was a synergistic effect of using 0.01% atropine combined with Ortho-K, and it showed comparable efficacy to that of high-dose atropine.

Introduction: Awareness of psoriasis-related comorbidities has been established in the current guidelines; however, evidence regarding the association of bone density or bone fragility with psoriatic disease remains inconclusive. Methods: We conducted a systematic review and meta-analysis to assess bone mineral density and the risk of osteoporosis and fractures in patients with psoriatic disease, including those with cutaneous psoriasis and psoriatic arthritis. We searched electronic databases for published observational studies. A meta-analysis was performed using the random-effect model. Pooled estimates and their confidence intervals (CIs) were calculated. Small-study effects were examined using the Doi plot and Luis Furuya–Kanamori index. Results: The analysis of the standardized mean difference in the absolute value of bone mineral density at different measuring sites (lumbar spine, femoral neck, and total hip) revealed no significant difference between patients with psoriatic disease and non-psoriatic controls. The pooled results of the adjusted odds ratios (ORs) demonstrated no increased risk of osteoporosis in patients with psoriatic disease. Notably, patients with psoriatic disease had a higher OR of developing bone fractures (adjusted OR: 1.09; 95% CI: 1.06 to 1.12; I²: 0%). Conclusion: Patients with psoriatic disease may be more likely to develop fractures compared with non-psoriatic controls. This higher risk for fracture may not necessarily be associated with lower bone mineral density nor a higher risk for osteoporosis.

This study aimed at comparing the inter-eye axial elongation difference in order to evaluate the change of anisometropia in unilateral myopic children wearing monocular orthokeratology (Ortho-K) lens. In this retrospective cohort study, we recruited monocular myopic subjects treated with monocular Ortho-K lens from May 2012 to January 2017. The axial length (AL) of both eyes was recorded, and we calculated the AL difference as our primary outcome, to evaluate myopia progression. High anisometropia was defined as anisometropia more than 2.50D. The generalized estimating equations (GEE) model was used to assess the related risk factors. A total number of 31 unilateral myopic patients were identified. The initial wearing age of the subjects was 12.32+/-3.07 years. In myopic eyes, the initial spherical equivalent was -2.73+/-0.95 diopter (D). The mean follow-up duration was 2.01+/-1.48 years. A significant reduction in the AL difference was found, from 0.83+/-0.45 millimeters at the baseline to 0.59+/-0.49 millimeters at 24 months (P = 0.039). Besides, after wearing Ortho-K lens for a long term, high anisometropic wearers showed more AL difference reduction than low anisometropic wearers in unilateral myopic children (P=0.002). This study demonstrated that the myopic eyes in unilateral myopic children had less AL growth than the companion emmetropic eyes when treated with monocular Ortho-K lenses. Wearing Ortho-K lens for a long time would present a more significant AL difference reduction in high anisometropic children.

Endometriosis is a common systemic chronic inflammatory disease. Inflammation is the key mechanism responsible for the development of endothelial dysfunction and atherosclerosis. We aimed to investigate the risk of coronary artery disease (CAD) among Asian women with endometriosis. This retrospective population-based cohort study included patients with endometriosis diagnosed from 2000 to 2012 and registered in the Longitudinal Health Insurance Database, Taiwan. The comparison cohort (those without endometriosis) were selected (1:4) by matching the age frequency and the index year. We followed up the patients until the diagnosis of CAD (ICD-9-CM codes: 410–414, A270, and A279), withdrawal from the National Health Insurance system, death, or the end of the study. We used a multivariable-adjusted Cox proportional hazard model for evaluating the risk of CAD. We included 19,454 patients with endometriosis and 77,816 women as a comparison group. The mean age of the women at the diagnosis of endometriosis was 37.4 years. A total of 3245 women developed CAD in both groups during a median follow-up of 7 years. The incidence of CAD was higher in women with endometriosis than in those without (5.96 vs. 4.38 per 10,000 person-years; adjusted hazard ratio [95% confidence interval], 1.34 [1.22–1.47]). In conclusion, Asian women with endometriosis had a significantly higher risk of CAD. Further large-scale studies are needed to elucidate the cause-effect relationship between endometriosis and CAD.

Vegetarian diets and lifestyle have been shown to reduce the risk of many chronic non-communicable diseases, which now accounts for the major global burden of diseases. We aimed to determine the contribution of vegetarian diets and lifestyle to the actual direct medical cost in a population-based study. Through linkage to the National Health Insurance Research Database of Taiwan, we compared the health care utilization and medical expenditure of 2166 vegetarians and 4332 age-sex-matched omnivores recruited from the Buddhist Tzu Chi Foundation. Diet and lifestyle questionnaires were self-administered and prospectively collected. We used the general linear model to estimate the 5-year average medical expenditure in vegetarians versus omnivores while adjusting for age, sex, education, exercise habits, smoking, and alcohol drinking. Medical expenses related to non-diet associated lifestyle factors (smoking, alcohol drinking, active community volunteering, and religious emotional support) were estimated through a comparison with the published population medical cost data standardized to match the age and sex characteristics of the cohort. Tzu Chi vegetarians had significantly lower outpatient visits. This translated into 13% lower outpatient (p = 0.007) and 15% lower total medical expenditures (p = 0.008) when compared with the Tzu Chi omnivores, who had an additional 10% lower medical expenditure when compared with the general population. No difference in dental visits and expenses were found between diet groups. Vegetarian diets are associated with significantly lower medical care expenditure and could be an effective strategy to alleviate the medical–economic burden in selected populations.

This study investigated the correlation of body mass index (BMI) and proinflammatory cytokine levels with hematopoietic stem cell (HSC) mobilization triggered by granulocyte colony-stimulating factor (G-CSF). Stem cell donors (n = 309) were recruited between August 2015 and January 2018 and grouped into four groups according to their BMI: underweight (BMI < 18.5 kg/m², n = 10), normal (18.5 kg/m² ≦ BMI < 25 kg/m², n = 156), overweight (25 kg/m² ≦ BMI < 30 kg/m², n = 102), and obese (BMI ≧ 30 kg/m², n = 41). The participants were then administered with five doses of G-CSF and categorized as good mobilizers (CD34 ≧ 180/μL, n = 15, 4.85%) and poor mobilizers (CD34 ≦ 25/μL, n = 14, 4.53%) according to the number of CD34⁺ cells in their peripheral blood after G-CSF administration. The correlation between BMI and HSC mobilization was then analyzed, and the levels of proinflammatory cytokines in the plasma from good and poor mobilizers were examined by ProcartaPlex Immunoassay. Results showed that BMI was highly correlated with G-CSF-triggered HSC mobilization (R² = 0.056, p < 0.0001). Compared with poor mobilizers, good mobilizers exhibited higher BMI (p < 0.001) and proinflammatory cytokine [interferon gamma (IFN-γ) (p < 0.05), interleukin-22 (IL-22) (p < 0.05), and tumor necrosis factor alpha (TNF-α) levels (p < 0.05)]. This study indicated that BMI and proinflammatory cytokine levels are positively correlated with G-CSF-triggered HSC mobilization.