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PURPOSE: To evaluate the functional results of Phaco-emulsification cataract surgery performed by a Spanish medical mission in Guinea. PATIENTS AND METHOD: This is a descriptive cross-sectional prospective collection study from February 1 to April 30, 2019, in patients aged at least 40 years of age operated on by the phaco-E technique. Socio-demographic data, pre- and post-operative visual acuity, causes of poor functional outcomes and patient satisfaction were assessed. Functional outcomes were analyzed in accordasing with WHO guidelines and recommendations for post-operative functional outcomes of cataract surgery. RESULTS: We included 400 eyes from 368 patients. The average age was 65.53 years - 8.63 years with a male predominance of 67.4%. Preoperative visual acuity was in 75.75% - sees hands move (VBM). In biometrics, the average power was 21.50 dioptries. The implant installed was 100% adequate. Without correction, visual results were poor in less than 1.5%, limits in 9.5%, and good in 89% following World Health Organization standards. At J30, only 182 patients with 222 eyes had responded to the test with 198 eyes of good result, 18 eyes of average result and 6 eyes of poor results. The causes of poor visual acuities were dominated by ocular pathologies associated with cataracts (4 eyes), intraoperative complications (1 eye) and postoperative complications (1 eye). Almost all patients were satisfied with the functional outcome of the operated eye (354 patients out of 368, or 96.20%). CONCLUSION: Phacoemulsification, a technique used by this Spanish medical mission, gives excellent functional results, with few complications. Guinean ophthalmologists will have to make this technique the gold standard in cataract surgery.
BUT: Evaluer les résultats fonctionnels de la chirurgie de la cataracte par Phaco-émulsification réalisée par une mission médicale espagnole en Guinée. PATIENTS ET MÉTHODE: Il s'agit d'une étude transversale descriptive à collecte prospective allant du 1er Février au 30 Avril 2019, chez des patients âgés d'au moins 40 ansopérés par la technique de phaco-E.Les données sociodémographiques, l'acuité visuelle pré et post-opératoire, les causes de mauvais résultats fonctionnels et la satisfaction des malades ont été évalués. Les résultats fonctionnels ont été analysés selon les directives et recommandations de l'OMS concernant les résultats fonctionnels post-opératoires de la chirurgie de la cataracte. RÉSULTATS: Nous avons inclus 400 yeux de 368 patients. L'âge moyen était de 65,53 ans ± 8,63 ans avec une prédominance masculine de 67,4%. L'acuité visuelle préopératoire était dans 75,75% ≤ voit bouger les mains (VBM). En biométrie, la puissance moyenne était de 21,50 dioptries. L'implant posé a été adéquat dans 100%. Sans correction, les résultats visuels étaient mauvais dans 1,5%, limites dans 9,5%, et bons dans 89% suivants les normes de l'Organisation Mondiale de la Santé. A J30, seulement 182 patients avec 222 yeux avaient répondu au contrôle avec 198 yeux de bon résultat, 18 yeux de résultat moyen et 6 yeux de mauvais résultats. Les causes de mauvaises acuités visuelles ont été dominées par les pathologies oculaires associées à la cataracte (4 yeux), les complications peropératoires (1 Åil) et les complications post-opératoires (1 Åil). La quasi-totalité des patients était satisfaite du résultat fonctionnel de l'Åil opéré (354 patients sur 368, soit 96,20%). CONCLUSION: La Phaco-émulsification, technique utilisée par cette mission médicale espagnole donne d'excellents résultats fonctionnels, avec peu de complications. Les ophtalmologistes guinéens devront faire de cette technique le gold standard dans la chirurgie de la cataracte.
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The purpose of this work was to evaluate the results of phacoalternative. METHOD: This was a four-month analytical descriptive study. Our variables were socio-demographic, clinical, paraclinical and evolving. Patients operated by Phacoalternative during the study, having consented, were included. Not included were the operated patients who did not follow up. RESULT: The average age was 61.37 ± 8.3 years, the sex ratio 1.06 of which 63.9% came from Conakry, 57.6% were out of school and 39.9% were housewives. Diabetes was the most common comorbidity 23.75%. The fundus was inaccessible in 66.4%. The average biometrics were 22.60D. The right eye was more operated on or 53.5%. The most common postoperative complication was the 4.5% cloudy cornea. There were no complications at D1 in 88.3% and at D14 in 98.8%. The mean of preoperative Astigmatism 1.07D < to the mean of postoperative astigmatism 1.6D.Preoperative visual acuity was < 1/10 in 78.8%, between 1/10 - 2/10 in 11.5% and ≥ 3/10 in 9.7%. Postoperative visual acuity was < 1/10 in 2.0%, between 1/10 - 2/10 in 10.0% and ≥ 3/10 in 88.0%. CONCLUSION: The phacoalternative is the ideal method. However, the acquisition of Phacoemulsifiers could improve these results.
Le but de ce travail était d'évaluer les résultats de la phacoalternative. METHODE: Il s'agissait d'une étudedescriptiveanalytiquede quatre mois.Nosvariables étaient socio-démographiques, cliniques, paracliniques et évolutives.Ont été inclus, les patients opérés par Phacoalternative pendant l'étude, ayant consenti. N'étaient pas inclus, les patients opérés n'ayant pas respectéle suivi. RÉSULTAT: L'âge moyen était de 61,37 ± 8,3 ans, le sex-ratio 1,06 dont 63,9% provenaient de Conakry, 57,6% étaient non scolarisé et 39,9% étaient ménagères. L'hypertension artérielle était la comorbidité la plus fréquente 23,75%. Le fond d'Åil était inaccessible chez 66,4%. La moyenne de la biométrie était 22,60D. L'Åil droitétait plus opéré soit 53,5%. La complication post-opératoire la plus fréquente était la cornée trouble 4,5%. Il n'y avait pas de complication à J1 chez 88,3% et à J14 chez 98,8%. La moyenne d'Astigmatisme pré-opératoire 1,07D < à la moyenne d'astigmatisme post-opératoire 1,6D. L'acuité visuelle pré-opératoire était < 1/10 chez 78,8%, comprise entre 1/10 - 2/10 chez 11,5% et ≥ 3/10 chez 9,7%. L'acuité visuelle post-opératoire était < 1/10 chez 2,0%, comprise entre 1/10 - 2/10 chez 10,0% et ≥ 3/10 chez 88,0%. CONCLUSION: La phacoalternative est la méthode idéale. Cependant, l'acquisition de Phacoémulsificateurs pourrait améliorer ces résultats.
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This publisher's note amends the Funding section of a recent publication [Opt. Express24, 20685 (2016].
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Synthetic two-dimensional transition metal dichalcogenides such as, tungsten disulphide (WS2), tungsten diselenide (WSe2), molybdenum disulphide (MoS2) as well as mixed molybdenum tungsten disulphide (Mo0.5W0.5S2) single crystals were grown by the chemical vapor transport method using halogens (bromine or chlorine) as transport agents. Multi- layer samples were cleaved from the single crystals, and their nonlinear optical (NLO) properties were obtained from both open aperture and closed aperture Z-scan measurements using a picosecond mode-locked Nd: YAG laser operating at a wavelength of 1064 nm, with pulse duration of 25 ps, and 20 Hz repetition rate. Both WS2 and MoS2 exhibited nonlinear saturable absorption (SA), whereas WSe2 and Mo0.5W0.5S2 showed nonlinear two-photon absorption (2PA). A large 2PA coefficient ß as high as + 1.91x10-8 cm/W was obtained for the Mo0.5W0.5S2, and an index of refraction coefficient γ = -2.47x10-9 cm2/W was obtained for the WSe2 sample.
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The belief that an intervertebral disc must degenerate before it can herniate has clinical and medicolegal significance, but lacks scientific validity. We hypothesised that tissue changes in herniated discs differ from those in discs that degenerate without herniation. Tissues were obtained at surgery from 21 herniated discs and 11 non-herniated discs of similar degeneration as assessed by the Pfirrmann grade. Thin sections were graded histologically, and certain features were quantified using immunofluorescence combined with confocal microscopy and image analysis. Herniated and degenerated tissues were compared separately for each tissue type: nucleus, inner annulus and outer annulus. Herniated tissues showed significantly greater proteoglycan loss (outer annulus), neovascularisation (annulus), innervation (annulus), cellularity/inflammation (annulus) and expression of matrix-degrading enzymes (inner annulus) than degenerated discs. No significant differences were seen in the nucleus tissue from herniated and degenerated discs. Degenerative changes start in the nucleus, so it seems unlikely that advanced degeneration caused herniation in 21 of these 32 discs. On the contrary, specific changes in the annulus can be interpreted as the consequences of herniation, when disruption allows local swelling, proteoglycan loss, and the ingrowth of blood vessels, nerves and inflammatory cells. In conclusion, it should not be assumed that degenerative changes always precede disc herniation. Cite this article: Bone Joint J 2013;95-B:1127-33.
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Degeneración del Disco Intervertebral/complicaciones , Desplazamiento del Disco Intervertebral/complicaciones , Adulto , Anciano , Discitis/complicaciones , Discitis/patología , Femenino , Humanos , Disco Intervertebral/irrigación sanguínea , Disco Intervertebral/inervación , Degeneración del Disco Intervertebral/metabolismo , Degeneración del Disco Intervertebral/patología , Degeneración del Disco Intervertebral/cirugía , Desplazamiento del Disco Intervertebral/metabolismo , Desplazamiento del Disco Intervertebral/patología , Desplazamiento del Disco Intervertebral/cirugía , Vértebras Lumbares/patología , Masculino , Microscopía Confocal/métodos , Persona de Mediana Edad , Neovascularización Patológica/patología , Proteoglicanos/metabolismoRESUMEN
The metals pollution in the Sarno River and its environmental impact on the Gulf of Naples (Tyrrhenian Sea, Central Mediterranean Sea) were estimated. Eight selected metals (As, Hg, Cd, Cr, Cu, Ni, Pb and Zn) were determined in the water dissolved phase (DP), suspended particulate matter (SPM) and sediment samples. Selected metals concentrations ranged from 0.32 to 1,680.39 µg l(-1) in water DP, from 103.6 to 7,734.6 µg l(-1) in SPM and from 90.7 to 2,470.3 mg kg(-1) in sediment samples. Contaminant discharges of selected metals into the sea were calculated in about 13,977.6 kg year(-1) showing that this river should account as one of the main contribution sources of metals to the Tyrrhenian Sea.
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Ecosistema , Sedimentos Geológicos/química , Metales/análisis , Material Particulado/química , Agua de Mar/química , Contaminantes Químicos del Agua/análisis , Monitoreo del Ambiente/métodos , Monitoreo del Ambiente/normas , Guías como Asunto , Mar Mediterráneo , Metales/toxicidad , Modelos Estadísticos , Medición de Riesgo , Contaminantes Químicos del Agua/toxicidadRESUMEN
A widely tunable (30 nm) fiber laser based on a double Sagnac loop mirror configuration is proposed and demonstrated. A semiconductor optical amplifier (SOA) placed between the two loop mirrors acts as the gain medium. The fiber laser has two output ports with adjustable optical power outputs. Wavelength tunability is obtained through the use of a thin film tunable filter, while optical power adjustability is accomplished by proper adjustment of each of the loop mirror reflectivity via a polarization controller. A total output power of + 9 dBm is measured and the potential for higher output powers is discussed. Optical power stability of better than +/- 0.15 dB is measured for 6 hours.
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Óptica y Fotónica , Semiconductores , Simulación por Computador , Diseño de Equipo , Tecnología de Fibra Óptica , Rayos Láser , Factores de TiempoRESUMEN
OBJECTIVE: This study was conducted to determine the pattern and severity of poisoning cases in Emergency Department of Kathmandu Medical College Teaching Hospital, Kathmandu, Nepal (KMCTH). DESIGN: Retrospective observational study. MATERIALS AND METHODS: Hospital records of all admissions to the Emergency Department of Kathmandu Medical College Teaching Hospital (KMCTH) following acute poisoning were revised and all data from February 2007 to February 2008 were analyzed retrospectively. RESULTS: This retrospective observational study was performed on 148 cases of poisoning who attended Emergency Department of KMCTH over a period of one year. The overall male to female ratio was 1.05:1. Poisoning was most common in the age group 21-30 years (40.5%). The most common causes of poisoning in adults were organophosphorous compounds and in children was kerosene oil. Oral route (79.05%) was the most common route of administration. 66.2% of cases were intentional poisoning for suicidal attempt. Students (43.9%) and service holders (18.9%) were commonly involved in poisoning. CONCLUSION: It was seen that adult between 21-30 years of age were more prone to suicidal poisoning with organophosphorous compounds and children of 1-10 years of age were more susceptible to accidental poisoning with kerosene oil.
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Accidentes Domésticos/estadística & datos numéricos , Servicio de Urgencia en Hospital/estadística & datos numéricos , Queroseno/envenenamiento , Intoxicación/epidemiología , Intento de Suicidio/estadística & datos numéricos , Adolescente , Adulto , Distribución por Edad , Niño , Preescolar , Femenino , Hospitales de Enseñanza/estadística & datos numéricos , Humanos , Incidencia , Lactante , Masculino , Nepal/epidemiología , Intoxicación por Organofosfatos , Estudios Retrospectivos , Adulto JovenRESUMEN
BACKGROUND: Postoperative nausea and vomiting (PONV) is a common distressing experience in patients following laparoscopic surgeries. This study was aimed at comparing the efficacies of Ondansetron-Dexamethasone combination with each drug alone as a prophylaxis against PONV in patients after elective laparoscopic cholecystectomy done under general anaesthesia. MATERIALS AND METHODS: Hundred and fifty ASA I and II patients, aged 23 to 65 yrs, were enrolled in this prospective, randomized, double-blind trial to receive one of three treatment regimens: 4 mg Ondansetron (Group O), 8 mg Dexamethasone (Group D) or 4 mg Ondansetron plus 8 mg Dexamethasone (Group OD) (n=50 for each). A standardized balanced general anaesthetic technique was employed. Any episode of PONV and need for rescue antiemetic were assessed at six, 12 and 24 hrs post operation. Complete response was defined as no PONV in 24 hrs and need for rescue antiemetic was considered as failure of prophylaxis. Pain scores, time to first analgesia demand, amount of Meperidine consumption, adverse event(s) and duration of hospital stay were recorded. RESULTS: Complete response occurred in 66.7, 66.0 and 89.4% in Groups O, D and OD respectively. Rescue antiemetics were required in 29.2, 31.9 and 8.5% of patients in Groups O, D, and OD respectively. Significantly high incidence of vomiting and failure of prophylaxis (19.1%) occurred in group D during the fi rst six hrs (P=0.023 versus O & 0.008 versus OD). More frequent antiemetic rescue was required in group O at 6 to 24 hr interval as compared to group OD (P=0.032). CONCLUSION: Combination of Ondansetron and Dexamethasone is better than each drug alone in preventing PONV after laparoscopic cholecystectomy. Dexamethasone alone is significantly less effective in preventing early vomiting compared to its combination with Ondansetron; whereas Ondansetron alone is less effective against late PONV as compared with combination therapy.
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Antieméticos/administración & dosificación , Colecistectomía Laparoscópica , Dexametasona/administración & dosificación , Ondansetrón/administración & dosificación , Náusea y Vómito Posoperatorios/tratamiento farmacológico , Adulto , Método Doble Ciego , Quimioterapia Combinada , Femenino , Humanos , Masculino , Estudios Prospectivos , Resultado del TratamientoRESUMEN
Inserting a retrograde wire into the pharynx through a cricothyroid puncture can facilitate tracheal intubation in difficult situations where either a flexible fiber-optic bronchoscope or an expert user of such a device is not available. Even in cases when fibropric can not be negotiated for the purpose, this method has been claimed to be useful to manage the airway. Some mouth opening is essential for the oral or nasal retrieval of the wire from the pharynx. Here, a case of post mandibular reconstructed wound infection required surgical debridement and plate removal from reconstructed lower mandible under general anesthesia. We retrieved the guide wire passed through a cricothyroid puncture and subsequently accomplished wire-guided oro-tracheal intubation. In the absence of a flexible fiber-optic bronchoscope, this technique is a very useful aid to intubate patients with limited mouth opening.
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Quemaduras/cirugía , Cartílago Cricoides/cirugía , Traumatismos Mandibulares/cirugía , Adulto , Quemaduras/complicaciones , Humanos , Masculino , Traumatismos Mandibulares/etiología , Procedimientos de Cirugía Plástica , TraqueostomíaRESUMEN
La Enfermedad por Arañazo de Gato (EAG) es una enfermedad autolimitada, relativamente benigna. Sus manifestaciones clínicas presentan una gran variabilidad existiendo una forma típica: linfoade nopatía regional subaguda, y un amplio abanico de formas atípicas con manifestaciones sistémicas.Los estudios microbiológicos, serológicos y moleculares han demostrado que la Bartonella henselae es el agente etiológico de la EAG.Los resultados serológicos, que deben interpre tarse con precaución y cojuntamente con la clínica y epidemiología, posibilitan un diagnóstico rápido, evitando investigaciones invasivas. Su utilización como criterio posibilita el manejo de esta enferme dad desde Atención Primaria.Se presentan dos casos reflejando las consideraciones previas (AU)
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Adolescente , Femenino , Masculino , Niño , Humanos , Bartonella henselae/patogenicidad , Enfermedad por Rasguño de Gato/sangre , Enfermedad por Rasguño de Gato/diagnósticoAsunto(s)
Enfermedad de Lyme/complicaciones , Trastornos de la Visión/etiología , Enfermedad de Whipple/complicaciones , Oftalmopatías/etiología , Humanos , Enfermedad de Lyme/diagnóstico , Enfermedad de Lyme/prevención & control , Enfermedad de Lyme/terapia , Enfermedades del Sistema Nervioso/etiología , Enfermedad de Whipple/diagnóstico , Enfermedad de Whipple/terapiaAsunto(s)
Conjuntiva/cirugía , Migración de Cuerpo Extraño/etiología , Implantes de Drenaje de Glaucoma/efectos adversos , Glaucoma de Ángulo Abierto/cirugía , Pericardio/trasplante , Anciano , Anciano de 80 o más Años , Segmento Anterior del Ojo/cirugía , Femenino , Migración de Cuerpo Extraño/cirugía , Humanos , Reoperación , Esclerótica/trasplante , Elastómeros de Silicona , Colgajos QuirúrgicosRESUMEN
Assessment of the optic nerve head for structural changes is critical for the detection of glaucoma and for following progression in patients with established glaucoma. Qualitative optic nerve analysis can be obtained via methods such as disc drawings and stereo disc photography. However, these methods are limited by significant interobserver and intraobserver variability. Disc photographs can also vary greatly according to the camera angle, photographic technique, lighting, and magnification. The need for accurate, reproducible, and quantitative, cost-effective techniques of assessing the optic disc and appreciation of the limitations of subjective clinical observation stimulated the development of new technologies.
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Glaucoma/diagnóstico , Rayos Láser , Disco Óptico/patología , Tomografía/métodos , Pruebas del Campo Visual/métodos , Diagnóstico Diferencial , Progresión de la Enfermedad , Humanos , Variaciones Dependientes del Observador , Oftalmoscopía/métodos , Reproducibilidad de los Resultados , Agudeza Visual , Campos VisualesRESUMEN
PURPOSE: To assess the allergenic potential of topical brimonidine 0.2% in patients shown to be allergic to apraclonidine 0.5%. METHODS: Eighteen glaucoma patients who developed allergy to apraclonidine were enrolled. Allergy was graded and documented photographically. Apraclonidine was then discontinued until the allergy resolved. Grading and photography were repeated, following which treatment with brimonidine was initiated. Patients were examined 1 h after the initial drop of brimonidine, twice weekly for 6 weeks, and at 3 monthly intervals thereafter. All other anti-glaucoma medications were continued. RESULTS: Mean patient age was 66.3 +/- 14.9 years (range 33.5-89.3 years). The mean time to apraclonidine allergy from initial exposure was 12.9 +/- 12.9 months (range 2.1-46.8 months). For the 10 patients rechallenged with apraclonidine, the mean time to allergy was 13.6 +/- 10.2 days (range 3-32 days). Mean duration of brimonidine therapy was 140.7 +/- 66.2 days (range 14-286 days), with 11 patients reaching at least 150 days of follow-up. Two patients developed symptomatic brimonidine allergy at 138 and 201 days respectively. For those patients who did not develop symptoms of allergy to brimonidine, there was no significant change in any of the parameters by which allergy was graded throughout the study. CONCLUSIONS: Patients with known apraclonidine allergy do not develop an early allergic response to brimonidine. These data rule against a cross-reactive allergic response between these two alpha 2-adrenoreceptor agonists.
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Agonistas alfa-Adrenérgicos/efectos adversos , Antihipertensivos/efectos adversos , Clonidina/análogos & derivados , Hipersensibilidad a las Drogas/etiología , Oftalmopatías/inducido químicamente , Quinoxalinas/efectos adversos , Adulto , Anciano , Anciano de 80 o más Años , Tartrato de Brimonidina , Clonidina/efectos adversos , Reacciones Cruzadas , Estudios de Seguimiento , Glaucoma/tratamiento farmacológico , Humanos , Persona de Mediana Edad , Factores de TiempoRESUMEN
The intention of this series of semiannual reviews of systemic diseases is not to develop an annual encyclopedic compendium of every article published in the prior calendar year on each systemic illness but rather to select for each issue a few systemic diseases of import to the neuro-ophthalmologist, and to summarize the literature that has developed over the past few years. For each systemic disease selected, the review will cover new developments in its epidemiology; new reports of its neuro-ophthalmic, ocular, and neurologic manifestations; unique clinical presentations; radiologic and laboratory diagnostic tools; and new therapies available to the neuro-ophthalmologist. If appropriate, new information on the etiology of the illness will be reported. In this installment, progress in the clinical recognition and treatment of tuberculosis, sarcoidosis, and human immunodeficiency virus- (nonretinal) related illness is discussed.
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Oftalmopatías/etiología , Infecciones por VIH/complicaciones , Sarcoidosis/complicaciones , Tuberculosis Ocular/etiología , Oftalmopatías/diagnóstico , Oftalmopatías/tratamiento farmacológico , Infecciones Virales del Ojo/diagnóstico , Infecciones Virales del Ojo/tratamiento farmacológico , Infecciones Virales del Ojo/etiología , Infecciones por VIH/diagnóstico , Infecciones por VIH/tratamiento farmacológico , Humanos , Sarcoidosis/diagnóstico , Sarcoidosis/tratamiento farmacológico , Tuberculosis Ocular/diagnóstico , Tuberculosis Ocular/tratamiento farmacológicoRESUMEN
Systemic illnesses, such as vasculitides and systemic lupus erythematosus, may have ocular symptoms, or they may present with ocular signs and undiagnosed or occult systemic signs. The recently described ophthalmic and neurologic presentations and new diagnostic modalities for Wegener's granulomatosis, giant cell arteritis, and systemic lupus erythematosus are reviewed. Hypercoagulable states and their role in visual diseases are assessed, and strategies for evaluating patients with hypercoagulable states are described.
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Trastornos de la Coagulación Sanguínea/diagnóstico , Oftalmopatías/diagnóstico , Lupus Eritematoso Sistémico/diagnóstico , Vasculitis/diagnóstico , Trastornos de la Coagulación Sanguínea/complicaciones , Trastornos de la Coagulación Sanguínea/terapia , Oftalmopatías/etiología , Oftalmopatías/terapia , Humanos , Lupus Eritematoso Sistémico/complicaciones , Lupus Eritematoso Sistémico/terapia , Vasculitis/complicaciones , Vasculitis/terapiaRESUMEN
Specific and localized lesions of the 5-HT fibers in the hippocampus induce homotypic collateral sprouting and enhance serotonergic fiber outgrowth from adult neurons and transplanted fetal tissue. In this study, hippocampal extracts were prepared and applied to primary cultures of fetal serotonergic neurons. The effects of plating density and serum additives were examined. The growth of the serotonergic neurons in the rostral brainstem dissociated cultures were estimated by measuring the specific uptake of [3H]5-HT. The results indicate the presence of a trypsin-sensitive factor which is active when prepared fresh at dilutions up to 1/10,000. The factor is higher in hippocampus than cerebellum. Young male tissue contained more activity than either female or aged hippocampus. Although both positive and negative effects are described, higher dilutions of factor (1/1,000) were generally stimulatory in high density cultures while lower dilutions (1/10) were inhibitory in low density cultures. Specific removal of 5-HT hippocampal afferents with fornix-fimbria microinjections of 5,7-dihydroxytryptamine resulted in an initial loss of activity (2 days and 2 weeks) followed by an enhanced activity (2 months) compared to normal hippocampal extract. Several possibilities are discussed as to the identity of the serotonergic growth factor from hippocampal supernatant.