Phacoemulsificator and sterile drapes contamination during cataract surgery: a microbiological study.

Purpose. To determine the microbial contamination of the irrigating fluids at the time of phacoemulsification after the use of topical povidone-iodine and antibiotics prophylaxis. Methods. A total of 119 patients undergoing cataract surgery were enrolled in this prospective study. All patients received 5 mg/mL levofloxacin starting from the day prior to surgery and topical and 5% povidone-iodine drops starting from 30 minutes before the surgery. At the end of each surgery, 2 samples of drainage liquids were sterilely collected from the drainage bags (DBL) and from the peristaltic pump single-cassettes (PCL) of the phacoemulsification machine. Search for aerobic and anaerobic bacteria and fungi was performed. Results. Seventy-five patients (31.5%) revealed a growth of at least one microbial species (53 DBL and 22 PCL, 44.5% vs 18.5%; p<0.001). Sixty-six patients (55.5%) had at least one positive intraoperative solution. Overall, 111 microbial strains were collected: 82 (74%) Gram-positive bacteria, 20 (18%) fungi, and 9 (8%) Gram-negative bacteria. Thirteen staphylococcal isolates from PCL, compared with 52 out of DBL (11% vs 43.7%, p<0.001), fungi were essentially isolated from PCL. No significant correlation was found between microbial isolation and risk factors. No postsurgical infective complication occurred in the follow-up. Conclusions. Evaluation of intraoperative fluids can provide evidence on sources or vehicles of postsurgical infections. Antibiotic prophylaxis and topical povidone-iodine can significantly contribute to minimize the risk of endophthalmitis

DTT: Divertor Tokamak Test facility Project Proposal

One of the main challenges in the European fusion roadmap is to design a heat and power exhaust system able to withstand the large loads expected in the divertor of a DEMO fusion power plant. Therefore, in parallel with the programme to optimise the operation with a conventional divertor based on detached conditions to be tested on the ITER device currently under construction in Cadarache, a specific project has been launched to investigate alternative power exhaust solutions for DEMO, aimed at the definition and the design of a Divertor Tokamak Test facility. This tokamak should be capable of hosting scaled experiments integrating most of the possible aspects of the DEMO power and particle exhaust. DTT should retain the possibility to test different divertor magnetic configurations, liquid metal divertor targets, and other possible solutions for the power exhaust problem. The DTT design proposal refers to a set of parameters selected so as to have edge conditions as close as possible to DEMO (in terms of the temperature and the normalized collisionality, pressure and ion gyro radius), while remaining compatible with DEMO bulk plasma performance in terms of dimensionless parameters within a set of constraints related to flexibility and costs