„Potentielle Kontamination von Vorderkammerproben während intraokulärer Eingriffe“

Ziel der hier vorliegenden Studie war der Nachweis und die Evaluation einer potentiellen bakteriellen Kontamination des Vorderkammerwassers. Ebenso sollten die Wege einer bakteriellen Kontamination untersucht werden. Es wurden prä- und postoperative Bindehautabstriche, Kammerwasserproben sowie Entnahmekanülen von 100 Patienten, die sich einem intraokularen Eingriff unterzogen, einer mikrobiologischen Untersuchung zugeführt. Verschiedene Kontaminationswege konnten tendenziell aufgezeigt, aber nicht sicher nachgewiesen werden. Aus diesen Befunden ergibt sich, dass der präoperativen Prophylaxe einer potentiellen bakteriellen Kontamination eine überragende Bedeutung zukommt. Nicht zuletzt durch die akribische Durchführung der Infektionsprophylaxe mit 1-/10%iger Polyvidon-Jod-Lösung in der vorliegenden Studie scheinen die Kontaminationsraten im Vergleich zu anderen Studien geringer zu sein

Patterns of Retinal Damage Facilitate Differential Diagnosis between Susac Syndrome and MS

Susac syndrome, a rare but probably underdiagnosed combination of encephalopathy, hearing loss, and visual deficits due to branch retinal artery occlusion of unknown aetiology has to be considered as differential diagnosis in various conditions. Particularly, differentiation from multiple sclerosis is often challenging since both clinical presentation and diagnostic findings may overlap. Optical coherence tomography is a powerful and easy to perform diagnostic tool to analyse the morphological integrity of retinal structures and is increasingly established to depict characteristic patterns of retinal pathology in multiple sclerosis. Against this background we hypothesised that differential patterns of retinal pathology facilitate a reliable differentiation between Susac syndrome and multiple sclerosis. In this multicenter cross-sectional observational study optical coherence tomography was performed in nine patients with a definite diagnosis of Susac syndrome. Data were compared with age-, sex-, and disease duration-matched relapsing remitting multiple sclerosis patients with and without a history of optic neuritis, and with healthy controls. Using generalised estimating equation models, Susac patients showed a significant reduction in either or both retinal nerve fibre layer thickness and total macular volume in comparison to both healthy controls and relapsing remitting multiple sclerosis patients. However, in contrast to the multiple sclerosis patients this reduction was not distributed over the entire scanning area but showed a distinct sectorial loss especially in the macular measurements. We therefore conclude that patients with Susac syndrome show distinct abnormalities in optical coherence tomography in comparison to multiple sclerosis patients. These findings recommend optical coherence tomography as a promising tool for differentiating Susac syndrome from MS

Efficiencies of Internet-based digital and paper-based scientific surveys and the estimated costs and time for different-sized cohorts.

To evaluate the relative efficiencies of five Internet-based digital and three paper-based scientific surveys and to estimate the costs for different-sized cohorts.Invitations to participate in a survey were distributed via e-mail to employees of two university hospitals (E1 and E2) and to members of a medical association (E3), as a link placed in a special text on the municipal homepage regularly read by the administrative employees of two cities (H1 and H2), and paper-based to workers at an automobile enterprise (P1) and college (P2) and senior (P3) students. The main parameters analyzed included the numbers of invited and actual participants, and the time and cost to complete the survey. Statistical analysis was descriptive, except for the Kruskal-Wallis-H-test, which was used to compare the three recruitment methods. Cost efficiencies were compared and extrapolated to different-sized cohorts.The ratios of completely answered questionnaires to distributed questionnaires were between 81.5% (E1) and 97.4% (P2). Between 6.4% (P1) and 57.0% (P2) of the invited participants completely answered the questionnaires. The costs per completely answered questionnaire were $0.57-$1.41 (E1-3), $1.70 and$0.80 for H1 and H2, respectively, and $3.36-$4.21 (P1-3). Based on our results, electronic surveys with 10, 20, 30, or 42 questions would be estimated to be most cost (and time) efficient if more than 101.6-225.9 (128.2-391.7), 139.8-229.2 (93.8-193.6), 165.8-230.6 (68.7-115.7), or 188.2-231.5 (44.4-72.7) participants were required, respectively.The study efficiency depended on the technical modalities of the survey methods and engagement of the participants. Depending on our study design, our results suggest that in similar projects that will certainly have more than two to three hundred required participants, the most efficient way of conducting a questionnaire-based survey is likely via the Internet with a digital questionnaire, specifically via a centralized e-mail

Number of participants and effective survey responses; ^aoccasionally, computers were professionally used by several employees.

<p>Number of participants and effective survey responses; ^aoccasionally, computers were professionally used by several employees.</p

Financial costs of our surveys and estimated costs based on ^a77.8/h,8hprofessionalworktoestablishadigitalquestionnaire,^b77.8/h, 8 h professional work to establish a digital questionnaire, ^b0.05/copy-page, $17.4/h, students working hours (q = questions, p = participants).

<p>Financial costs of our surveys and estimated costs based on ^a$77.8/h, 8 h professional work to establish a digital questionnaire, ^b$0.05/copy-page, $17.4/h, students working hours (q = questions, p = participants).</p

Responses to nonscaled^‡ and Likert-scaled* questions for the three survey methods (E₁, H₁, and P₁).

<p>Responses to nonscaled^‡ and Likert-scaled* questions for the three survey methods (E₁, H₁, and P₁).</p

Demographic overview of Susac patients included in the study.

<p><i>Abbreviations:</i> BRAO  =  branch retinal artery occlusion, SD  =  standard deviation.</p

Child Income Appropriations as a Disease-Coping Mechanism: Consequences for the Health-Education Relationship

<p>This paper analyses the relationships between HIV/AIDS and education taking into account the appropriative nature of child income. Using a theoretical model, we show that considering remittances from one’s child as an insurance asset can reverse the usual negative relationship between disease prevalence and educational investment. This prediction confirms the results of an empirical study conducted on data compiled from the Demographic and Health Survey (DHS) database for 12 sub-Sahara African countries for children aged between 7 and 22-years-old. Using regional HIV prevalence as a measure of health risk, we find that the ‘sign of the slope’ between health risk and the enrolment of children is not constant. Splitting the data based on expected remittance patterns (for example rural versus urban), we obtain that the effect is most likely driven by household characteristics related to child income appropriation.</p

Macular and ring scans from patients with Susac syndrome and matched RRMS patients.

<p>Shown are only the left eyes (randomly selected to save space) from each Susac patient (P1-9) and the corresponding left eyes from RRMS patients without history of optic neuritis (MS-NON) and RRMS patients with history of optic neuritis (MS-ON). On the bottom, a comparison of scans from one of the healthy controls is given. A) Colour coded is the calculated macular thickness from the device's segmentation algorithm with black to blue for reduced thickness and yellow to green for normal thickness (left legend on the bottom). The macular thickness map is calculated from six linear scans through the centre of the macula. Of note is the different distribution of the damage. B) For RNFLT scans, the thickness from 12 clock-hour segments of the circular scan is given. Colour coded is the thickness relative to the normative database with green and white meaning normal values above the 5^th or 95^th percentile and yellow and red meaning reduction of thickness below the 5^th or 1^st percentile (right legend on the bottom). Whereas some Susac patients' eyes show striking sectoral damage, eyes from RRMS patients show an even thinning with an accentuation in the outer temporal areas, that is further pronounced with a history of optic neuritis. Three Susac patients (P6, 7, 9) show a similar pattern.</p