Endophthalmitis after pars plana vitrectomy: Results of the pan American collaborative retina study group

Purpose: To determine the incidence of endophthalmitis after 20-, 23-, and 25-gauge pars plana vitrectomies (PPVs). Methods: Retrospective comparative case series of consecutive patients who underwent 20-, 23-, or 25-gauge PPV at 11 centers from Latin America between 2005 to 2009. Pars plana vitrectomy cases were identified through a search of the billing records of each institution. Cases of PPV performed in the management of trauma, endophthalmitis, and combined PPV phacoemulsification cases were excluded. Endophthalmitis was diagnosed by clinical criteria regardless of the microbiologic results. The incidence of post-PPV endophthalmitis was compared between 20-, 23-, and 25-gauge PPVs. Results: A total of 35,427 cases of PPV were identified during the study period (n = 19,865 for 20 gauge, n = 10,845 for 23 gauge, and n = 4,717 for 25 gauge). The 5-year post-PPV endophthalmitis incidence rates were 0.020% (4 of 19,865), 0.028% (3 of 10,845), and 0.021% (1 of 4,717) for 20 gauge, 23 gauge, and 25 gauge, respectively (P = 0.9685). Conclusion: Small-gauge transconjunctival PPV does not appear to increase the rates of post-PPV endophthalmitis. © The Ophthalmic Communications Society, Inc

Intravitreal bevacizumab in diabetic retinopathy. Recommendations from the Pan-American Collaborative Retina Study Group (PACORES): The 2016 knobloch lecture

The advent of intravitreal anti-vascular endothelial growth factor (anti-VEGF) medications has revolutionized the treatment of diabetic eye diseases. Herein, we report the outcomes of clinical studies carried out by the Pan-American Collaborative Retina Study Group (PACORES), with a specific focus on the efficacy of intravitreal bevacizumab in the management of diabetic macular edema and proliferative diabetic retinopathy. We will also discuss the use of intravitreal bevaci-zumab as a preoperative, adjuvant therapy before vitrectomy for prolif-erative diabetic retinopathy. Copyright © 2017 by Asia Pacific Academy of Ophthalmology

Intravitreal bevacizumab (Avastin®) for diabetic retinopathy at 24-months: The 2008 Juan Verdaguer-planas lecture

Diabetic retinopathy (DR) remains the major threat to sight in the working age population. Diabetic macular edema (DME) is a manifestation of DR that produces loss of central vision. Proliferative diabetic retinopathy (PDR) is a major cause of visual loss in diabetic patients. In PDR, the growth of new vessels is thought to occur as a result of vascular endothelial growth factor (VEGF) release into the vitreous cavity as a response to ischemia. Furthermore, VEGF increases vessel permeability leading to deposition of proteins in the interstitium that facilitate the process of angiogenesis and macular edema. This review demonstrates multiple benefits of intravitreal bevacizumab (IVB) on DR including DME and PDR at 24 months of follow up. The results indicate that IVB injections may have a beneficial effect on macular thickness and visual acuity (VA) in diffuse diabetic macular edema. Therefore, in the future this new therapy could replace or complement focal/grid laser photocoagulation in DME. In PDR, this new option could be an adjuvant agent to pan-retina photocoagulation so that more selective therapy may be applied. In addition, we report a series of patients in which tractional retinal detachment developed or progressed after adjuvant preoperative IVB in severe PDR. © 2010 Bentham Science Publishers Ltd

Cognitive, Behavioral and Goal Adjustment Coping and Depressive Symptoms in Young People with Diabetes: A Search for Intervention Targets for Coping Skills Training

The aim of the present study was to find relevant coping factors for the development of psychological intervention programs for young people with Type 1 (T1) diabetes. A wide range of coping techniques was studied, including cognitive coping, behavioral coping and goal adjustment coping. A total of 78 young people with T1 diabetes participated. They were contacted through a social networking website, several Internet sites, and flyers. A wide range of coping techniques appeared to be related to depressive symptoms. Especially the cognitive coping strategies self-blame, rumination, refocus positive, and other-blame, together with goal adjustment coping, were of importance. A large proportion of the variance of depressive symptoms could be explained (65 %). These findings suggest that these specific coping strategies should be part of coping skills trainings for young people with T1 diabetes

Three-dimensional seismic investigations of the Sevastopol mud volcano in correlation to gas/fluid migration pathways and indications for gas hydrate occurrences in the Sorokin Trough (Black Sea)

New 3-D seismic investigations carried out across the Sevastopol mud volcano in the Sorokin Trough present 3-D seismic data of a mud volcano in the Black Sea for the first time. The studies allow us to image the complex three-dimensional morphology of a collapse structured mud volcano and to propose an evolution model. The Sevastopol mud volcano is located above a buried diapiric structure with two ridges and controlled by fluid migration along a deep fault system, which developed during the growth of the diapirs in a compressional tectonic system. Overpressured fluids initiated an explosive eruption generating the collapse depression of the Sevastopol mud volcano. Several cones were formed within the depression by subsequent quiet mud extrusions. Although gas hydrates have been recovered at various mud volcanoes in the Sorokin Trough, no gas hydrates were sampled at the Sevastopol mud volcano. A BSR (bottom-simulating reflector) is missing in the seismic data; however, high-amplitude reflections (bright spots) observed above the diapiric ridge near the mud volcano at a relatively constant depth correspond to the approximate depth of the base of the gas hydrate stability zone (BGHSZ). Thus we suggest that gas hydrates are present locally where gas/fluid flow occurs related to mud volcanism, i.e., above the diapir and close to the feeder channel of the mud volcano. Depth variations of the bright spots of up to 200 ms TWT might be caused by temperature variations produced by variable fluid flow

“As a Parent You Become a Tiger”: Parents Talking about Bullying at School

Bullying at school can be a distressing experience for children. It is also likely to be distressing for their parents. In spite of this, research in the field of school bullying and peer victimisation has tended to overlook the experience of parents when their child is bullied. This study explored school bullying from the parent’s perspective. Twenty-one parents took part in semi-structured focus groups and interviews to share their experiences. Thematic analysis of the interview transcripts identified two main themes: ’perceived institutional factors’ and ’being a good parent’. It was found that parents viewed their principal role as protecting their child; they referred to this as an instinct and fundamental to them being a good parent. However, during their attempts to help their child, many parents talked about difficulties working with schools and this triggered frustration and distrust towards teachers. The findings highlight the importance of communication between parents and teachers and ensuring that parents are kept informed of progress when teachers are trying to address the problem. Additionally, the findings indicate that parents may hold different views to teachers about their role in school bullying situations. This would suggest that parents looking at the situation from the teacher’s perspective, and vice versa, could help to build better parent-teacher relationships when tackling school bullying