[Visual field loss in eyes undergoing minimally invasive glaucoma surgery in Iceland].

INTRODUCTION: Glaucoma is a degenerative disease of the optic nerve and is marked by visual field defects (VFD). The only approved treatment is IOP lowering, either with eye drops, laser or surgery. Minimally invasive glaucoma surgery (MIGS) has become an appealing treatment modality, offering IOP lowering effect without the complication rates of trabeculectomy or the patient adherence required for pharmacologic therapy. In this study we aim to describe the severity of VFD in patients undergoing their first MIGS surgery. METHODS: Retrospective study reviewing the medical records of all patients that underwent MIGS surgery at the University Hospital of Iceland from January 2019 to June 2020. Eyes with previous glaucoma surgeries and secondary glaucomas were excluded. The results were divided into two groups, MIGS with phacoemulsification and standalone MIGS. RESULTS: 112 eyes included in the study. Mean age 74.5 ± 10.6 years. The mean defect (MD) score was 8.8 ± 6.4 and the number of glaucoma medications 1.8 ± 1.0 for the group as a whole. Significant difference (p<0.01) was between the age, MD score and the number of glaucoma medications between the two groups. Looking at the eyes that did not undergo phacoemulsification a significant difference (p<0.05) was between the MD score of primary open angle glaucoma eyes, 11.2 ± 6.5 dB and pseudoexfoliation glaucoma, 6.0 ± 3.3 dB. CONCLUSION: Visual field defect and the number of glaucoma medications at referral to surgery was markedly less compared to a trabeculectomy study done in Iceland 3 years prior. Few comparable studies include MD score in their results, most focus on changes in intraocular pressure. Comparing the MD score to three studies from Germany and Austria the MD score seems to be similar. In our study a lower MD score for pseudoexfoliation glaucoma implies that Icelandic ophthalmologists send pseudoexfoliation eyes earlier for an operation.

Geometrical accuracy of metallic objects produced with additive or subtractive manufacturing: A comparative in vitro study.

OBJECTIVE: To evaluate the accuracy and precision of objects produced by additive manufacturing systems (AM) for use in dentistry and to compare with subtractive manufacturing systems (SM). METHODS: Ten specimens of two geometrical objects were produced by five different AM machines and one SM machine. Object A mimics an inlay-shaped object, while object B imitates a four-unit bridge model. All the objects were sorted into different measurement dimensions (x, y, z), linear distances, angles and corner radius. RESULTS: None of the additive manufacturing or subtractive manufacturing groups presented a perfect match to the CAD file with regard to all parameters included in the present study. Considering linear measurements, the precision for subtractive manufacturing group was consistent in all axes for object A, presenting results of <0.050mm. The additive manufacturing groups had consistent precision in the x-axis and y-axis but not in the z-axis. With regard to corner radius measurements, the SM group had the best overall accuracy and precision for both objects A and B when compared to the AM groups. SIGNIFICANCE: Within the limitations of this in vitro study, the conclusion can be made that subtractive manufacturing presented overall precision on all measurements below 0.050mm. The AM machines also presented fairly good precision, <0.150mm, on all axes except for the z-axis. Knowledge regarding accuracy and precision for different production techniques utilized in dentistry is of great clinical importance. The dental community has moved from casting to milling and additive techniques are now being implemented. Thus all these production techniques need to be tested, compared and validated.

Association between Pain in Adolescence and Low Back Pain in Adulthood: Studying a Cohort of Mine Workers.

Purpose. To study the association of self-reported pain in adolescence with low back pain (LBP) in adulthood among mine workers and, also, study associations between the presence of LBP over 12-month or one-month LBP intensity during a health examination and daily ratings of LBP three and nine months later. Methods. Mixed design with data collected retrospectively, cross-sectionally, and prospectively. Data was collected using a questionnaire during a health examination and by using self-reported daily ratings of LBP three and nine months after the examination. Results. Pain prevalence during teenage years was 55% and it was 59% at age 20. Pain during teenage years had a relative risk of 1.33 (95% confidence interval 1.03-1.73) of LBP 12 months prior to the health examination, but with no associations with LBP intensity or LBP assessed by text messaging. Pain at age 20 years was not associated with any measure of LBP in adulthood. Daily ratings of LBP were associated with LBP during the health examination three and nine months earlier. Conclusions. There were no clear associations between self-reported pain in adolescence and LBP in adulthood. Self-reported daily ratings of LBP were associated with LBP from the health examination. Possible limitations for this study were the retrospective design and few participants.

Declining coastal piscivore populations in the Baltic Sea: Where and when do sticklebacks matter?

Intraguild predation interactions make fish communities prone to exhibit alternative stable states with either piscivore or prey fish dominance. In the Baltic Sea, local declines of coastal piscivores like perch (Perca fluviatilis) have been observed to coincide with high densities of sticklebacks (Gasterosteus aculeatus). Mechanisms behind this shift between piscivore and stickleback dominance were studied both experimentally and in field. Results showed that predation by sticklebacks has a strong negative effect on perch larvae survival, but this effect rapidly decreases with increasing perch size, likely due to gape limitations and digestion constraints in sticklebacks. Large spatial and temporal variations in patterns of stickleback migration into perch spawning sites were observed. Whether or not high density of sticklebacks will cause declines in coastal piscivore populations is suggested to depend on the availability of spawning sites in which sticklebacks do not migrate into or arrive late in the reproduction season of coastal piscivores.

The fit of cobalt-chromium three-unit fixed dental prostheses fabricated with four different techniques: a comparative in vitro study.

OBJECTIVES: This study sought to evaluate and compare the marginal and internal fit in vitro of three-unit FDPs in Co-Cr made using four fabrication techniques, and to conclude in which area the largest misfit is present. METHODS: An epoxy resin master model was produced. The impression was first made with silicone, and master and working models were then produced. A total of 32 three-unit Co-Cr FDPs were fabricated with four different production techniques: conventional lost-wax method (LW), milled wax with lost-wax method (MW), milled Co-Cr (MC), and direct laser metal sintering (DLMS). Each of the four groups consisted of eight FDPs (test groups). The FDPs were cemented on their cast and standardised-sectioned. The cement film thickness of the marginal and internal gaps was measured in a stereomicroscope, digital photos were taken at 12× magnification and then analyzed using measurement software. Statistical analyses were performed with one-way ANOVA and Tukey's test. RESULTS: Best fit based on the means (SDs) in µm for all measurement points was in the DLMS group 84 (60) followed by MW 117 (89), LW 133 (89) and MC 166 (135). Significant differences were present between MC and DLMS (p<0.05). The regression analyses presented differences within the parameters: production technique, tooth size, position and measurement point (p < 0.05). SIGNIFICANCE: Best fit was found in the DLMS group followed by MW, LW and MC. In all four groups, best fit in both abutments was along the axial walls and in the deepest part of the chamfer preparation. The greatest misfit was present occlusally in all specimens.

Beneficial effects of a new fluid regime on kidney function of donor and recipient during laparoscopic v open donor nephrectomy.

BACKGROUND AND PURPOSE: Laparoscopic donor nephrectomy (LDN) has been associated with delayed graft function compared with open donor nephrectomy (ODN). We have recently shown that the adverse effect of pneumoperitoneum (PP) on hemodynamics could be prevented by a new fluid regime. The aim of this study was to test the effect of this fluid regime on the kidney function of the donor and recipient after LDN and ODN. PATIENTS AND METHODS: We prospectively collected data of 51 donors undergoing ODN and 59 donors undergoing LDN as well as data from the corresponding recipients. All donors and recipients were treated with a standardized anesthesia and fluid regime. This fluid regime consisted of preoperative overnight hydration together with a bolus of colloid administered before induction of anesthesia and before introduction of PP. Follow-up was 2 years. RESULTS: Baseline characteristics of the two groups were comparable. Hemodynamics and urine output until nephrectomy were comparable between both groups. Donor kidney function did not differ after ODN and LDN. Estimated glomerular filtration rate, graft survival, and recipient survival did not differ between open and laparoscopically procured transplants. No adverse effects of the novel fluid regime (eg, pulmonary edema or additional oxygen supply) were observed in the donors. CONCLUSION: In contrast to our earlier findings, the kidney function of the donor and recipient is comparable between ODN and LDN after introduction of a new fluid regime.

Propofol-induced injection pain: comparison of a modified propofol emulsion to standard propofol with premixed lidocaine.

Propofol is well known for its association with pain on injection. The most frequently used method to reduce this pain is premixture with lidocaine. Recently, a modified lipid emulsion of propofol containing medium-chain triglycerides (MCT) with long-chain triglycerides (LCT), in contrast to the usual LCT formulation, has been advocated to alleviate pain. In a randomized, prospective, controlled, double-blind study on 222 surgical patients, we compared the effect of the two solutions on the incidence and intensity of injection pain. Patients were randomly allocated to receive either propofol MCT/LCT (group M; n = 109) or standard propofol LCT with the addition of 20 mg of lidocaine (2 mL of lidocaine 1%) to 200 mg of propofol (group L; n = 113). Pain scores were assessed using a verbal analog scale (VAS) ranging from 0-10. Group L was found to have significantly less pain on the injection of propofol (mean VAS, 2.5 +/- 2.9) (mean +/- sd) than group M (mean VAS, 3.8 +/- 3.2; P = 0.002). Regarding postoperative recall of pain on injection, patients in group L indicated significantly less pain (mean VAS, 2.2 +/- 2.4) than patients in group M (mean VAS, 3.0 +/- 2.7; P = 0.02). Premixing of 20 mg of lidocaine (2 mL of lidocaine 1%) to 200 mg of standard propofol LCT causes less pain on injection than propofol MCT/LCT and thus increases patient comfort.