Background: Hepatocellular carcinoma (HCC) is a leading cause of cancer and cancer-related mortality worldwide. Studies have suggested that aspirin (ASA) and statins may be associated with a decrease in incident HCC. Goals: We aimed to evaluate the effect of ASA and statin use on the incidence of HCC in a prospective cohort of patients with liver cirrhosis and to identify if there was an increased risk of esophageal variceal hemorrhage (VH) in patients with ASA use. Study: We conducted a retrospective study of 521 patients with data collected from July 1, 2012 to December 31, 2017. We used competing risk analysis to assess the association between risk factors and HCC; and the association between ASA and VH. Results: ASA use alone was associated with a decreased incidence of HCC in the univariate and multivariate models; [hazard ratio (HR) confidence interval (CI): 0.348 (0.124-0.976); P=0.0448] and [HR (CI): 0.266 (0.094-0.755); P=0.0129, respectively]. The combination of ASA and statin use was associated with a decreased hazard of HCC [HR (CI): 0.15 (0.036-0.624); P=0.0090] and this remained statistically significant in the multivariable model [HR (CI): 0.113 (0.026-0.483); P=0.0033]. Among daily ASA users compared with non-users, there was not a significant increase in risk of VH. Conclusions: Daily ASA use was associated with a decrease risk of incident HCC. The combination of daily ASA use and statin use decreased the risk of incident HCC suggesting there is beneficial interaction. Finally, no excess VH was observed in daily ASA users compared with non-users.

Five doses of oral moxifloxacin lead to higher intravitreal drug concentrations than single-dose administration. Both regimens, however, achieve levels that exceed the MIC90 of many bacteria implicated in postoperative endophthalmitis.

Twenty-three-gauge pars plana vitrectomy demonstrates short-term visual outcomes and complication rates that are comparable to those reported with 20- and 25-gauge systems.

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Background: Lipid management with statins is one of the mainstays of treatment for atherosclerotic cardiovascular disease. Statins are often discontinued by patients secondary to muscle-related complaints independent of elevations in creatine kinase. It has also been suggested that there is a link between mental health disorders and noncompliance. The associations between negative affect and somatization reported as medication-related side effects requires further clarification. One possible cause of statin discontinuation is perceived myopathy secondary to somatization.Objective: This study examines the relationship between affect in statin tolerant and statin intolerant (SI) groups.Methods: This study incorporated patients unable to tolerate at least two different statins (any statin or dosage prescribed) due to side effects or abnormal laboratory markers. Patients completed The Depression Anxiety Stress Scales, the McGill Pain Questionnaire, and the Somatosensory Amplification Scale.Results: There were 20 statin tolerant (ST) patients and 13 SI patients (n=36). There was a significant difference between SI and ST groups, respectively, in age (63 vs. 70 years, p=0.04), total cholesterol (204 vs.136, p <0.01), and LDL cholesterol (129 vs. 136, p < 0.05). There were no significant differences between ST and SI groups for somatic pain, affective pain, somatosensory amplification, depressive symptoms, anxiety symptoms, and stress scores. Conclusion:Our study suggests the discrepancy between statin intolerance in clinical trials and clinical practice cannot be explained solely by somatosensory amplification, anxiety, depression or pain disorders. Nevertheless, an affective and/or anxiety disorder will likely augment the pain perception and somatization in a SI patient.