EPIDEMIOLOGY SECTION EDITOR: LESLIE HYMAN, PhD Visual Acuity Thresholds for Cataract Surgery and the Changing Australian Population

Objective: To examine the relation between visual acuity thresholds for cataract surgery for the changing Australian population. Methods: Population-based 5-year incidence data for 2594 people were used to calculate age-specific prevalence of incident cataract and existing cataract backlog. The cataract surgery rates (CSRs) per million people were estimated for different acuity thresholds for the Australian population at different times. Results: In 2005, after adjusting by age, the estimated CSRs for Australia were 1470, 3110, 5080, and 6440 for visual acuities of less than 6/60, less than 6/18, less than 6/12, and less than 6/9, respectively, whereas the actual CSR was 9000. Although the acuity threshold had the greatest impact, the CSR for less than 6/12 increased 3-fol

A proposal of multiplace hyperbaric chamber for animal experimentation and veterinary use

To develop a project of hyperbaric chamber that allows its safe and reliable use in veterinary and animal experimentation. Methods: Based on the technical specifications for the construction of hyperbaric chambers for human beings, it has been developed a design of a chamber with dimensions and characteristics for the use of a midsize animal, (dog or pig), as well as a multiple chamber for the use in small animals (mice, rats, hamsters, rabbits or cats). The technical specifications allowed that the chamber could be used both for veterinary use and for use in experiments on Health Sciences. Results: A chamber with the following characteristics was built: ASTM A36 steel for the manufacture of the master cylinder and rear cover; front door built in 5052 aluminum; internal diameter of 50.5 cm and 83.0 cm in length; weight 160Kg and internal area of 150cm3; internal space to accommodate 2 acrylic baskets; 150mm high, 280mm wide and 690mm in length. It was capable of supporting a maximum of hydrostatic pressure test of 3.0 to 4.0 BAR ACT and maximum working pressure of 2.0 BAR or 3.0 ACT; equipped with security devices and valves that triggers with load of 2.2 BAR or 3.2 ACT. Tests for engineering and biological use on animals showed the effectiveness of the device. Conclusion: The development of the project enabled the construction of a hyperbaric chamber with security features and reliability comparable to those required by the legal and technical specifications of a hyperbaric chamber human use.Desenvolver um projeto de câmara hiperbárica que permita o seu uso seguro e confiável em veterinária e em animais de experimentação de pequeno e médio porte. Métodos: Baseados em especificações técnicas de construção de câmaras hiperbáricas de seres humanos, foi desenvolvido uma adaptação de projeto de uma câmara com dimensões e características para uso em animal de médio porte (cão ou porco), assim como câmara múltipla para animais de pequeno porte (camundongos, ratos, hamsters, coelhos ou gatos). O atendimento às especificações técnicas deve permitir a sua utilização tanto para uso veterinário quanto para uso em experimentação em Ciências da Saúde. Resultados: Uma câmara com as seguintes características foi construída: aço ASTM A36 para a confecção do cilindro principal e tampo traseiro, tampo frontal (porta) construído em alumínio 5052, diâmetro interno de 50,5cm e 83,0cm de comprimento; peso de 160Kg e espaço interno de 150cm3; espaço para acomodar 2 cestas de acrílico de 150mm de altura, 280mm de largura e 690mm de comprimento; capacidade para suportar um máximo de pressão hidrostática teste de 3,0BAR ou 4,0 ACT e uma pressão máxima de trabalho de 2,0 BAR ou 3,0 ACT; equipado com dispositivos e válvulas de segurança que disparam com carga de 2,2 BAR ou 3,2 ACT. Os testes de engenharia e de uso biológico com animais mostraram a efetividade do equipamento. Conclusão: O desenvolvimento do projeto permitiu a confecção de uma câmara hiperbárica com características de segurança e confiabilidade comparável às exigidas pelas especificações técnicas e legais de uma câmara para tratamento hiperbárico

First Phase Development of a Patient-reported Outcome Measure for Midface Oncology

Background:. Facial cancer surgery involving the midface (comprising the lower eyelids, nose, cheeks, and upper lip) can have debilitating life-changing functional, social, and psychological impacts on the patient. Midface symptoms are inadequately captured by existing patient-reported outcome measures (PROMs). PROMs are increasingly used for individual patient care, quality improvement, and standardized reporting of treatment outcomes. This study aimed to present our findings from the first phase of the development of a midface, specifically periocular and nasal, PROM. Methods:. After international guidance for PROM development, the first phase comprised identification of salient issues and item generation. Fifteen patients who had midface surgery and 10 clinicians from various specialties with more than 5 years’ experience treating these patients were recruited. Semi-structured interviews explored aesthetic, functional, social, and psychological outcomes, with specific attention to deficiencies in current PROMs. Thematic analysis was used to develop an item pool, and group interviews with clinicians were carried out to create and refine PROM scales. Results:. Qualitative data from patient interviews were grouped into aesthetic, functional, and psychosocial domains for the eyelids and nose. Ninety-nine draft items were generated across these domains. Following focus group discussions, the final version of the midface-specific PROM contained 31 items (13 eye-specific, 10-nose-specific, eight general midface items). Conclusions:. This midface-specific PROM is valuable in assessing and comparing patient-reported outcomes in those who have undergone complex resection and reconstruction of the midface. This PROM is currently undergoing field testing