This study reports the surgical outcomes of evisceration with primary orbital implant placement in patients with endophthalmitis and analyses the association with implant exposure and extrusion.
A ...retrospective, multicentre, Chinese cohort study. Review of medical records and orbital images of patients who underwent evisceration with primary orbital implant placement between January 2005 and January 2021.
Out of 79 patients who underwent orbital evisceration with primary orbital implant placement, 26 (26 eyes) of them (male = 13) suffered from endophthalmitis. The duration from endophthalmitis diagnosis (19 = exogenous, 7 = endogenous) to evisceration was 9 standard deviation ± 5 (range: 1-15) days. The follow-up was 70 ± 46 (24-180) months after operation. The orbital implant size was 17 ± 3 (14-20) mm, and silicone was the most used material (69%, 18/26 of patients). The most frequent post-operative complication was orbital implant exposure (42%, 11/26), followed by orbital implant extrusion (12% 3/26) and ptosis (8%, 2/26). Implant exposure or extrusion was more commonly associated with endophthalmitis in comparison to non-endophthalmitis patients that required evisceration and primary orbital implant placement (54% versus 17%, P < 0.05). Univariate analysis showed single scleral closure technique (100% versus 58%, P < 0.05) and endogenous endophthalmitis (50% versus 0%, P < 0.05) were associated with implant exposure or extrusion, and only endogenous endophthalmitis was significant with multivariate analysis (P < 0.05).
Primary implant placement during evisceration should be avoided in eyes with endophthalmitis especially in those with an endogenous source, and double scleral closure technique may be a better alternative for primary orbital implant placement in infected eyes.
Purpose
We compared the rates of implant exposure and extrusion after evisceration with single and double scleral closure techniques.
Methods
This retrospective cohort study included all patients who ...underwent evisceration with an implant insertion over the past 18 years at Tung Wah Eastern Hospital and Pamela Youde Nethersole Eastern Hospital. Clinical documents and operation records were reviewed.
Results
A total of 81 ethnic Chinese patients (44 male) who underwent evisceration with primary implant insertion were reviewed. 39 (48%) patients underwent the double scleral closure technique with an implant placed posterior to the posterior sclera, and 42 (52%) patients underwent the single scleral closure technique with an implant inserted in the intra-scleral cavity. The follow-up interval was 70 months. The surgical indications were endophthalmitis (35%), painful blind eye (23%), traumatic disfigured globe (22%) and phthisis bulbi (20%). Silicone was the most used implant material (69%). The patients who underwent double scleral closure had a larger size of the implant (19.7 vs 17.9 mm,
p
< 0.05). Both implant exposure (26% vs 3%,
p
< 0.05) and implant extrusion (26% vs 0%,
p
< 0.05) were more common in patients who underwent single scleral.
Conclusions
Double scleral closure technique allows a larger implant, and it is associated with a lower rate of implant exposure and extrusion. The double scleral closure technique is a superior technique of choice in these patients with primary implant placement.
The CONNIE experiment Aguilar-Arevalo, A.; Bertou, X.; Bonifazi, C. ...
Journal of physics. Conference series,
10/2016, Letnik:
761, Številka:
1
Journal Article
Recenzirano
Odprti dostop
The CONNIE experiment uses fully depleted, high resistivity CCDs as particle detectors in an attempt to measure for the first time the Coherent Neutrino-Nucleus Elastic Scattering of antineutrinos ...from a nuclear reactor with silicon nuclei. This talk, given at the XV Mexican Workshop on Particles and Fields (MWPF), discussed the potential of CONNIE to perform this measurement, the installation progress at the Angra dos Reis nuclear power plant, as well as the plans for future upgrades.
The CONNIE detector prototype is operating at a distance of 30 m from the core of a 3.8 GW sub(th) nuclear reactor with the goal of establishing Charge-Coupled Devices (CCD) as a new technology for ...the detection of coherent elastic neutrino-nucleus scattering. We report on the results of the engineering run with an active mass of 4 g of silicon. The CCD array is described, and the performance observed during the first year is discussed. A compact passive shield was deployed around the detector, producing an order of magnitude reduction in the background rate. The remaining background observed during the run was stable, and dominated by internal contamination in the detector packaging materials. The in-situ calibration of the detector using X-ray lines from fluorescence demonstrates good stability of the readout system. The event rates with the reactor ON and OFF are compared, and no excess is observed coming from nuclear fission at the power plant. The upper limit for the neutrino event rate is set two orders of magnitude above the expectations for the standard model. The results demonstrate the cryogenic CCD-based detector can be remotely operated at the reactor site with stable noise below 2 e super(-) RMS and stable background rates. The success of the engineering test provides a clear path for the upgraded 100 g detector to be deployed during 2016.
In the development of three-dimensional printable materials for high-speed and high-resolution printing, UV-curing polymers can guarantee fast and precise printing of high performance load-bearing ...structures, but the injected drops of the monomers tend to spread over the substrates due to their low viscosity. In this study, we imposed the self-standing and shape-memorable capability of an epoxy acrylate (EA) monomer to ensure continuous filamentary 3D printing while maintaining its low viscosity nature. Using octadecanamide (ODA) with EA, strong hydrogen-bond networks (−N−H⋯OC−, −N−CO⋯H–O–, –N–H⋯N–) were additionally achieved in the material system and the developed material distinctively exhibited rheological duality at different processing stages: a low-viscosity liquid-like behavior (viscosity of ∼50 Pa) while passing through the nozzle and a self-standing solid-like behavior (static yield stress of ∼364 Pa) right after being printed. This reversible liquid-to-solid transitional capability was quantified by viscoelastic complex moduli provided a dynamic yield stress ( τ y,G ) of 210 Pa corresponding to the upright stacking up to ∼3.2 cm (3 wt% of ODA). The time ( t y,G ) required for conformational rearrangement was evaluated to be as fast as ∼10 −2 s. After UV curing, the 3D printed layers exhibited no air pockets or weld lines at the stacked interfaces, which could guarantee excellent mechanical performance and structural integrity.
PURPOSE OF REVIEWTo review the current surgical practices in endoscopic endonasal dacryocystorhinostomy (EN-DCR) from the studies of last 12 months.
RECENT FINDINGSSuccess rates in EN-DCR now rival ...those of the conventional external approach. Indications are expanding beyond primary acquired nasolacrimal duct obstruction to include DCR revisions, acute lacrimal sac abscesses, nasolacrimal duct obstructions in patients who have received chemotherapy or radiation, and common canalicular obstructions. There is limited evidence that intubation with silicone stents improves the outcomes. Mitomycin C appears to improve the success rates of EN-DCR, especially revision surgery. Concomitant procedures, such as septoplasty and anterior middle turbinectomy, are sometimes required in primary as well as revision EN-DCR to achieve high success rates. There is increasing evidence that silicone stents are of limited benefit, whereas mucosal flap formation has been of benefit in case series.
SUMMARYWith innovations and improvements in the endonasal approach, EN-DCR has become a viable alternative to external DCR for primary acquired nasolacrimal duct obstruction. EN-DCR has the distinct advantages of no surface scar and a lack of damage to the pump mechanism that often occur with external DCR. Recent evidence indicates a comparable success rate to external DCR.
To determine the association between dementia and age-related macular degeneration (AMD) using meta-analysis.
We searched in the MEDLINE, EMBASE, Web of Knowledge, PsycInfo and Cochrane database of ...systematic reviews for studies published from March 1959 to March 2018. We included cross-sectional, case-control and cohort studies that evaluated the association of dementia/Alzheimer's disease (AD) with AMD (as outcome) and the association of AMD with dementia/AD (as outcome). Studies that compared cognitive functions between AMD and controls were also included. The summary outcomes, namely odds ratio (OR), relative risk, mean differences and corresponding 95% CIs, were estimated using random effects models. We performed sensitivity analysis based on study quality and individual study effect to control for potential biases.
Among 2159 citation records, we identified 21 studies consisting of 7 876 499 study subjects for meta-analysis. Patients with dementia (p
≤0.017, OR≥1.24, I
≤9%) or AD (p=0.001, OR
=2.22, I
=50%) were at risk for AMD, particularly for late AMD (p
<0.001, OR=1.37, I
=0). AMD was also significantly associated with increased risk of AD/cognitive impairment (p
=0.037, OR=2.42, I
=38%). Moreover, patients with AMD had poorer cognitive functions when compared with controls, including Mini-Mental State Examination (p<0.001, I
≤79%) and Trail Making Test A (p<0.001, I
=0). Sensitivity analysis and Egger's test indicated our results were less likely biased.
A significant association between dementia/AD and AMD calls for greater clinical awareness. The cost-effectiveness of routine screening for the other condition in patients with primary diagnosis of dementia/AD or AMD requires further study.
The CONNIE Experiment (Coherent Neutrino Nucleus Interaction Experiment) is currently collecting reactor neutrino data to search for the undiscovered standard model process of coherent ...neutrino-nucleus scattering (CNNS). The detector is composed of a silicon target of thick, fully-depleted, low-noise CCD detectors. Results from data collected in 2015 indicate backgrounds are controlled, and allow an estimate of sensitivity to be presented for a larger scale detector. A 2016 upgrade, adding additional target mass, and reducing readout noise, has been performed, increasing the total yield of signal events by a factor of 30, and already yielding science-quality data. Low-energy nuclear calibrations have been performed, enabling calibration down to the device energy threshold. An estimate of the sensitivity expected for measuring the coherent neutrino process is presented. Future prospects with improved detector energy thresholds are estimated.
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