Efficacy and safety of non-penetrating glaucoma surgery with phacoemulsification versus non-penetrating glaucoma surgery: a Meta-analysis

AIM: To compare the clinical efficacy and safety of non-penetrating glaucoma surgery (NPGS) plus phacoemulsification (Phaco-NPGS) and NPGS-alone. METHODS: We systematically searched various databases and reviewed studies that had evaluated the effects of Phaco-NPGS or NPGS-alone for patients with glaucoma. Primary outcomes included postoperative intraocular pressure (IOP) and the number of postoperative antiglaucoma medications. Secondary outcomes were the prevalence of complications, incidence of needling or goniopuncture, and surgical success rate. RESULTS: In total, 380 and 424 eyes in NPGS-alone and Phaco-NPGS groups respectively were included. Both postoperative IOP and number of medications were significantly lowered in the Phaco-NPGS group than that in the NPDS-alone group [weighted mean difference (WMD)=-1.12, 95% confidence interval (CI): -2.11 to -0.12, P=0.03; WMD= -0.31, 95%CI: -0.53 to -0.09, P=0.006]. Moreover, Phaco-NPGS had a significantly lower prevalence of complications and postoperative procedures compared to NPGS-alone, while no significant difference existed for surgical success. CONCLUSION: Phaco-NPGS superior to NPGS-alone in the reduction of IOP and medications. Phaco-NPGS can be recommended for glaucoma patients with coexisting cataracts owing to its superior efficacy, fewer complications, and postoperative procedures.

Heterologous Vaccination for Preparing COVID-19 Pandemic

Infectious disease pandemics are characterized by extreme uncertainty. From the more predictable response to seasonal influenza, which occurs each year, we have learned the importance of effective universal vaccines and therapeutic agents to protect high-risk groups. Heterologous vaccination with different types of vaccines to prevent COVID-19 is already recommended for various reasons: shortages of mass vaccine supply; critical adverse events, and potential superior efficacy as a booster dose. However, very few studies have examined the efficacy and safety of heterologous vaccination with mixed types. This review discusses the efficacy of vaccines currently approved in the Republic of Korea, including heterologous vaccination options.

Ribociclib-associated organising pneumonia

A 63-year-old woman with grade 2 infiltrating left breast carcinoma who was started on ribociclib complained of exertional dyspnoea along with dry cough. There were bilateral interscapular crackles and chest X-ray evidence of bilateral mid and lower zone non-homogeneous opacity. The patient’s pulmonary function test (PFT) showed moderate restrictions and desaturation. CT was suggestive of organising pneumonia and drug administration was stopped. The patient was treated with steroids in tapering doses, which led to improvements. The drug was restarted with the probability of other aetiologies for interstetial lung disease (ILD). It was also considered the superior efficacy of ribociclib in managing breast cancer. But due to evidence indicating the reappearance of organising pneumonia following drug administration, it was again stopped, and steroid use was restarted for treatment. The patient showed improvements in subsequent follow-ups.

Clinical Progress of Adjuvant Chemotherapy in Locoregionally Advanced Nasopharyngeal Carcinoma

Concurrent chemoradiotherapy (CCRT) is the foundational standard-of-care for patients with locoregionally advanced nasopharyngeal carcinoma (LANPC). Adding adjuvant chemotherapy (AC) or induction chemotherapy (IC) to CCRT has been shown to benefit LANPC patients. During recent five years, large numbers of prospective randomized controlled clinical trials have demonstrated the superior efficacy of IC+CCRT than CCRT alone in LANPC patients. However, prospectively designed studies concerned with AC are limited. The efficacy of CCRT+AC in treating LANPC remains unclear. For better understanding and more properly clinical usages of AC, we reviewed the studies of CCRT+AC in the treatments for LANPC patients. In summary, adding AC to CCRT is a feasible therapeutic strategy for patients with EBV positive LANPC.

Low Dose Risperidone Every 3.8 Hours: Superior Efficacy In Treatment of Bipolar Disorders

Background: This paper presents a previously unpublished Bipolar Disorder treatment using low-dose Risperidone that gives superior-efficacy, prevents overmedication, and prevents medication-induced anxiety and irritability. Standardized other Bipolar Disorder treatments have a failure rate of 82% to 87.1%. When dropouts and poor adherence are combined, only 12.9% to 18% of Bipolar patients adhere to medications within three years. Self-defensive providers primarily blame Bipolar patients for treatment failures. When that bias is removed, failure is due to overmedication and anxiety and irritability caused by medications. This paper shows the neurobiochemical processes that cause those problems. Published prescription-guidelines recommend Risperidone in high amounts that intentionally activate its 9-Hydroxyrisperidone metabolite under auspices that it is virtually the same as Risperidone and lasts for 24 hours. In truth, however, the beneficial Risperidone chemical lasts for four hours and 9-Hydroxyrisperidone agonizes Bipolar-toxic Serotonin. Low-dose Risperidone neutralizes 9-Hydroxyrisperidone.Methods: Low doses of Risperidone were calculated to be therapeutic amounts without causing overmedication, anxiety, and irritability. Doses were calculated to metabolize low plasma concentrations of 9-Hydroxyrisperidone that stay below the neural-activation threshold level. Four-hour-duration low doses of Risperidone were administered every 3.8 hours.Results: 3.8-hour dosing sustained steady benefits by overlapping 15-minute efficacy-onset with the 15-minute termination of each previous dose. Steady transitions between doses and five administrations per day gave therapeutic efficacy for 16 hours. Taking dose #5 at bedtime gave improved sleep.Conclusions: Low doses of Risperidone activate its therapeutic benefits while neutralizing Bipolar-toxic Paliperidone. Low-dose Risperidone every 3.8 hours maintains stability with room for adding occasional extra doses to control exacerbations of symptoms. This study provides a new biochemistry-based Bipolar Disorder treatment that is vitally needed because the failure rate of traditional treatments is too high. Traditional treatments and research are guided by commercial drug manufacturers’ recommendations and data. Traditional treatment dropout and non-adherence rates attest to the immediate need for this paper’s new paradigm of analytic neurobiochemistry.