Scotopic contrast sensitivity and glare after accelerated corneal cross-linking

Background: The aim was to assess one-year changes in uncorrected and corrected contrast sensitivity (CS) and glare under scotopic conditions after accelerated cross-linking (CXL) using the 18 mW/cm2 protocol for the treatment of progressive keratoconus and compare results with unoperated controls. Methods: In this non-randomised clinical trial, 30 eyes were enrolled in the CXL group and 30 were assigned to the control group. Scotopic CS at spatial frequencies (SFs) of 0.5, 1.1, 2.2, 3.4, 7.1 and 15 cycles per degree (cpd) were assessed using the MonCv3System (Metrovision, Pérenchies, France) under scotopic conditions (0.5 lux) at baseline and at six and 12 months. Results: The mean ages of the participants in the CXL and control groups were 24.32 ± 5.17 and 30.93 ± 7.43 years, respectively (p < 0.001). After adjusting for age, changes in uncorrected and corrected CS and glare were similar in the two groups (all p > 0.05) except for corrected CS at SF 7.1 cpd (1.45 ± 4.31 versus 3.21 ± 4.69 dB, p = 0.010) and 15 cpd (1.12 ± 4.63 versus 3.03 ± 5.48 dB, p = 0.007), which were reduced as an effect of CXL. Based on covariate analyses, among corrected CS indices, corrected CS7.1 and CS15 were related to CXL and their baseline values (all p < 0.050). Uncorrected CS in all SFs and uncorrected and corrected glare were related to their pre-operative values (all p < 0.001). Conclusion: Accelerated CXL can reduce scotopic corrected CS at SFs higher than 7.0 cpd in cases with better baseline values of these parameters. Changes in uncorrected CS and glare are only a factor of baseline values and the indices reduce in cases with better baseline values after one year. © 2017 Optometry Australi

Symptomatic lymphocele after kidney transplantation: a single-center experience.

INTRODUCTION: In a retrospective study, we evaluated the frequency, clinical presentation, and management of lymphocele in kidney transplant recipients operated on in a single center. MATERIALS AND METHODS: Between September 1984 and June 2005, we had 2147 kidney transplantations from living donors. During the follow-up period, ultrasonography was performed in symptomatic patients and those with elevated serum creatinine level postoperatively. Other radiological procedures were done in complicated cases. Patients with lymphocele were treated by percutaneous drainage with or without injection of sclerotizing agent (povidone iodine). If recurrence occurred, surgical intraperitoneal drainage was performed. In cases with multiloculated collection or inappropriate access for percutaneous drainage, the primary approach was surgical intraperitoneal drainage. RESULTS: Symptomatic lymphocele collection was seen in 17 kidney recipients of our series (0.8; 95 confidence interval, 0.4 to 1.2). It presented with elevation of serum creatinine concentrations (47.1), pain and abdominopelvic swelling (29.4), and lower extremity edema (23.5). Percutaneous drainage was used for the treatment of lymphocele in 11 patients, but recurrence occurred in 7 (63.6). These cases were treated with open surgical drainage. In 6 patients, the primary approach was surgical intraperitoneal drainage, because of multiloculated collection or inappropriate access for percutaneous drainage. All of the patients were treated successfully and no graft loss occurred during the follow-up period. CONCLUSION: Symptomatic lymphocele is an uncommon complication after kidney transplantation. Surgical intraperitoneal drainage is the most effective approach for the management of symptomatic lymphocele

Comparison of corneal thickness measurement with the Pentacam, the PARK1 and an ultrasonic pachymeter

Purpose: The aim was to determine the agreement between PARK1 pachymetric readings and measurements made with the Pentacam and ultrasonic pachymetry. Methods: In this prospective study, we enrolled refractive surgery patients free of other ocular conditions and performed Pentacam and PARK1 acquisitions followed by ultrasonic pachymetry. We recorded pachymetric readings on the centre, apex and thinnest point with the Pentacam, corneal thickness values of the apex and minimum readings from the PARK1, and the central corneal thickness with the ultrasonic system. Data were compared using t-tests, and the Pearson correlations and 95 limits of agreement (LoA) of all pairs were determined. Results: The mean age of the 47 participants was 32 ± 10.4years and data from their right eyes were used. Overall, ultrasonic measurements were significantly higher than all readings from the PARK1 and the Pentacam. The smallest difference was between the PARK-apex and Pentacam-apex readings (0.2 ± 11μm); the 95 LoA of this pair gave a width of 43.7μm (-21.7 to 22.0μm). The smallest width pertained to the Pentacam-centre and ultrasound-centre paired readings; the width was 32.5μm (-21.8 to 11.8μm), while the mean difference was -5.54 ± 8μm. Conclusion: The PARK1 measurements of the apical corneal thickness can be a substitute for central corneal pachymetry with an ultrasonic device, provided that the range of agreement is taken into consideration in the interpretation of the results. Similar studies on populations with different corneal conditions such as keratoconus are needed. © 2011 Optometrists Association Australia

Comparative performance of imagicides on Anopheles stephensi, main malaria vector in a malarious area, southern Iran

Abstract Background & objectives: Jiroft district has subtropical climate and prone to seasonal malaria transmission with annual parasite index (API) 4.2 per 1000 in 2006. Anopheles stephensi Liston is a dominant malaria vector. The monitoring of insecticide susceptibility and irritability was conducted using discriminative dose as described by WHO

Global mortality and readmission rates following COPD exacerbation-related hospitalisation: a meta-analysis of 65 945 individual patients

\ua9 2024, European Respiratory Society. All rights reserved.Background Exacerbations of COPD (ECOPD) have a major impact on patients and healthcare systems across the world. Precise estimates of the global burden of ECOPD on mortality and hospital readmission are needed to inform policy makers and aid preventive strategies to mitigate this burden. The aims of the present study were to explore global in-hospital mortality, post-discharge mortality and hospital readmission rates after ECOPD-related hospitalisation using an individual patient data meta-analysis (IPDMA) design. Methods A systematic review was performed identifying studies that reported in-hospital mortality, postdischarge mortality and hospital readmission rates following ECOPD-related hospitalisation. Data analyses were conducted using a one-stage random-effects meta-analysis model. This study was conducted and reported in accordance with the PRISMA-IPD statement. Results Data of 65 945 individual patients with COPD were analysed. The pooled in-hospital mortality rate was 6.2%, pooled 30-, 90- and 365-day post-discharge mortality rates were 1.8%, 5.5% and 10.9%, respectively, and pooled 30-, 90- and 365-day hospital readmission rates were 7.1%, 12.6% and 32.1%, respectively, with noticeable variability between studies and countries. Strongest predictors of mortality and hospital readmission included noninvasive mechanical ventilation and a history of two or more ECOPD-related hospitalisation

A Family of Measures of Noncompactness in the Locally Sobolev Spaces and Its Applications to Some Nonlinear Volterra Integrodifferential Equations

We study a new family of measures of noncompactness in the locally Sobolev space Wlocn,1(R+N), equipped with a suitable topology. As an application of the technique associated with this family of measures of noncompactness, we study the existence of solutions for a class of nonlinear Volterra integrodifferential equations. Further, we give an illustrative example to verify the effectiveness and applicability of our results

Distribution of angle kappa measurements with Orbscan II in a population-based survey

PURPOSE: To determine the mean angle kappa and its determinants in the population of Tehran, Iran. METHODS: In a cross-sectional survey with random cluster sampling, a total of 442 participants aged >14 years were selected from 4 municipality districts of Tehran for Orbscan acquisitions. Exclusion criteria were history of eye surgery for refractive errors, cataract or glaucoma, and use of topical medication or any type of contact lens at the time of the study. Mean angle kappa in different age and gender groups and its association with other factors was assessed. Considering the high correlation between the right and left eyes, only results of the right eyes are presented. RESULTS: After applying exclusion criteria, 800 eyes (399 right eyes and 401 left eyes) were examined. Mean participant age was 40.6±16.8 years (range: 14 to 81 years), and 38.8 of eyes were from men. Mean angle kappa was 5.46±1.33° in total; 5.41±1.32° in men and 5.49±1.34° in women (P=.558). It decreased significantly with age; 0.015°/year (P<.001). In individuals with myopia, emmetropia, and hypermetropia, the mean value was 5.13±1.50°, 5.72±1.10°, and 5.52±1.19°, respectively (P=.025); the post-hoc test indicated this was due to the difference between emmetropes and myopes. CONCLUSIONS: According to our results, angle kappa reduces with age, and the inter-gender difference is not significant. Largest angle kappas were seen among individuals with emmetropia. Angle kappas were larger in the hypermetropic population compared to the myopic population. Copyright © SLACK Incorporated

Anopheline species composition in borderline of Iran-Azerbaijan

Malaria is still one of the most important health-problems in the world and is endemic in Iran. Since 1994, after collapse of former Soviet Union, a new threat of malaria importation emerged from those countries into the northern Iran. This work was carried out to provide further evidence on the status of anopheline species composition, the malaria parasite species, and natural infectivity of mosquitoes distributed in Pars-Abad district, on the borderline of Azerbaijan in northwestern Iran. Mosquitoes were collected from May to December 2008 in anopheline seasonal activity and were identified at the species level. The genus- and species-specific primers against Plasmodium ssrDNA gene were used for specific amplification on female mosquito head. +. thorax. Members of the Anoheles maculipennis complex were identified by sequence analysis of the ribosomal internal transcribed spacer II (ITS2-rDNA). Morphological character-based identification showed that out of 1455 anopheline female specimens, 1121 (77) were of A. maculipennis s.l. and 334 (23) were of Anoheles hyrcanus. Molecular analysis of the species complex indicated the presence of Anoheles sacharovi 984 (67.6) and A. maculipennis 137 (9.4) in the region. None of themosquito's head-thorax was found to be naturally infected by malaria parasite. Results of this study, particularly high dominance of A. sacharovi, suggest a potential risk of malaria epidemic in the region, and the need for a continuous epidemiological surveillance. © 2011 Elsevier B.V