Toric implantable collamer lens for moderate to high myopic astigmatism: 3-year follow-up

Background To evaluate the 3-year clinical outcomes after toric implantable collamer lens (ICL) implantation for the management of moderate to high myopic astigmatism. Methods Thirty-four eyes of 20 patients who underwent toric ICL implantation were reviewed. All eyes completed 3-year follow-up. Uncorrected (UDVA) and corrected (CDVA) distance LogMAR visual acuities, refraction, endothelial cell density (ECD), and surgical complications were evaluated. Vectorial analysis of astigmatic correction was also done. Results A significant improvement in UDVA, CDVA, manifest spherical and cylindrical refraction was observed at 1 week and remained stable after 3 years. Twenty-six eyes (76.5 %) gained lines of CDVA, and two eyes (5.9 %) showed a loss of 1 line of CDVA. The spherical equivalent (SE) was within ±0.50 D of emmetropia in 18 eyes (52.9 %) and within ±1.00 D in 28 eyes (82.4 %). Differences between target-induced astigmatism (TIA) and surgically-induced astigmatism (SIA) were statistically significant (p < 0.01), and a trend to undercorrection of the refractive astigmatism was present after 3 years. The magnitude of flattening effect (FE) was found to be significantly lower than the magnitude of TIA (p < 0.01). The magnitude of the torque vector was always positive, with a value below 0.50 D in all cases. No vision-threatening complications were observed during the follow-up. Conclusion Toric ICL implantation is an effective and safe surgical option that provides a relatively predictable and stable refractive correction of myopic astigmatism. Further improvements are needed to minimize the degree of undercorrection.

Deep Anterior Lamellar Keratoplasty versus Penetrating Keratoplasty for Macular Corneal Dystrophy: A Randomized Trial

Purpose: To compare outcomes of big-bubble deep anterior lamellar keratoplasty (DALK) and penetrating keratoplasty (PK) for macular corneal dystrophy. Design: Prospective, randomized, interventional case series. Methods: Setting: Single hospital. Patients: Eighty-two eyes of 54 patients requiring keratoplasty for the treatment of macular corneal dystrophy without endothelial involvement were included. Main outcome measures: Operative complications, uncorrected visual acuity, best-corrected visual acuity, contrast sensitivity function, higher-order aberrations, and endothelial cell density were evaluated. Results: The DALK and PK group consisted of 35 and 41 eyes, respectively. Best-corrected visual acuity after surgery was 20/40 or better 68.5% and 70.7% of the eyes in the DALK and PK groups, respectively (P > .05). No statistically significant differences between groups were found in contrast sensitivity function with and without glare for any spatial frequency (P > .05). Significantly higher levels of higher-order aberrations were found in the DALK group (P < .01). In both groups, a progressive and statistically significant reduction in endothelial cell density was found (P < .01). At the last follow-up, the mean endothelial cell loss was 18.1% and 26.9% in DALK and PK groups, respectively (P = .03). Graft rejection episodes were seen in 5 eyes (12.1%) in the PK group, and regrafting was necessary in 3 eyes (7.3%). Recurrence of the disease was documented in 5.7% and 4.8% of the eyes in the DALK and PK groups, respectively. Conclusions: Deep anterior lamellar keratoplasty with the big-bubble technique provided comparable visual and optical results as PK and resulted in less endothelial damage, as well as eliminating endothelial rejection in macular corneal dystrophy. Deep anterior lamellar keratoplasty surgery is a viable option for macular corneal dystrophy without endothelial involvement.

ConfChem Conference on A Virtual Colloquium to Sustain and Celebrate IYC 2011 Initiatives in Global Chemical Education—The Global Experiment of the IYC2011: Creating Online Communities for Education and Science

The Global Experiment, Water: A Chemical Solution, was one of the flagship activities of the International Year of Chemistry (IYC). During the virtual colloquium of the spring 2012 online ConfChem conference, the main results of this year-long experiment were presented and discussed online for a week. Some of the main conclusions of the virtual conversations relate to the benefits of creating online communities of people sharing similar interests, the use of online educational platforms to gather massive amounts of data, and specific questions about the development of this IYC initiative. The activities of the global water experiment (GWE) were designed by a team of experts and the protocols are available online on the GWE Web site. The results were shown in one interactive world map that allowed students to learn about data visualization, validation, and interpretation. The feedback obtained from the participants of the GWE and later by the contributors of the virtual colloquium was very positive. Many participants asked specific and technical questions about the development of this experiment, while others excitedly endorsed the convenience of these large open-access activities to promote chemistry worldwide. The estimate is that over 2 million people took part in the GWE during the IYC. This communication summarizes one of the invited papers to the ConfChem online conference: A Virtual Colloquium to Sustain and Celebrate IYC 2011 Initiatives in Global Chemical Education, held from May 18 to June 29, 2012 and hosted by the ACS DivCHED Committee on Computers in Chemical Education and the IUPAC Committee on Chemistry Education.

Catheter-related bloodstream infection: burden of disease in a tertiary hospital

Background: Surveillance programmes have become the most effective tool for controlling catheter-related bloodstream infections (CRBSI). However, few studies have investigated programmes covering all hospital settings. Aim: To describe the results of a control and prevention programme for CRBSI based on compliance with recommendations for insertion and maintenance, using annual burden of disease in a tertiary level hospital. Methods: A CRBSI control and prevention programme involving all hospital settings was implemented. The programme consisted of CRBSI surveillance, direct observation of insertion and maintenance of catheters to determine performance, and education for healthcare workers. Findings: In total, 2043 short-term catheters were inserted in 1546 patients for 18,570 catheter-days, and 279 long-term catheters were inserted in 243 patients for 40,440 catheter-days. The annual incidence density was 5.98 (first semester 6.40, second semester 5.64) CRBSI per 1000 catheter-days for short-term catheters, and 0.57 (first semester 0.66, second semester 0.43) CRBSI per 1000 catheter-days for long-term catheters. One hundred and forty insertion procedures were observed, with an average insertion time of 13 (standard deviation 7) min. Compliance with recommendations was as follows: hand hygiene, 86.8%; use of alcoholic chlorhexidine solution for skin disinfection, 35.5%; use of mask, 93.4%; use of gloves, 98.7%; use of gown, 75.0%; use of sterile cloth, 93.8%; use of cap, 92.2%; bandage application, 62.7%; and use of aseptic technique, 89.5%. Forty-five maintenance procedures were observed, and compliance rates were as follows: hand hygiene, 42.1%; use of gloves, 78.1%; and port disinfection with alcoholic chlorhexidine solution, 32.5%. Conclusion: The CRBSI control and prevention programme implemented at the study hospital has decreased the rate of CRBSI, provided important information about the total burden of disease, and revealed possible ways to improve interventions in the future.

Dificultades en la traducción de al-Farāfīr de Yūsuf Idrīs

En este artículo hablamos en primer lugar de la obra teatral al-Farāfīr de Yūsuf Idrīs. Abordamos las dificultades de la traducción del árabe dialectal egipcio al castellano. Nos hemos acercado al término al-Farāfīr desde un punto de vista lingüístico y pragmático. Exponemos la dificultad de la traducción literaria entre dos lenguas pertenecientes a ámbitos socio-culturales muy diferentes.

Applications for CO2-Activated Carbon Monoliths: I. Gas Storage

Carbon monoliths with high densities are studied as adsorbents for the storage of H2, CH4, and CO2 at ambient temperature and high pressures. The starting monolith A3 (produced by ATMI Co.) was activated under a CO2 flow at 1073 K, applying different activation times up to 48 h. Micropore volumes and apparent surface areas were deduced from N2 and CO2 adsorption isotherms at 77 K and 273 K, respectively. CO2 and CH4 isotherms were measured up to 3 MPa and H2 up to 20 MPa. The BET surface area of the starting monolith (941 m2/g) could be significantly increased up to 1586 m2/g, and the developed porosity is almost exclusively comprised of micropores <1 nm. Total storage amounts take into account the compressed gas in the void space of the material, in addition to the adsorbed gas. Remarkably, high total storage amounts are reached for CO2 (482 g/L), CH4 (123 g/L), and H2 (18 g/L). These values are much higher than for other sorbents with similar surface areas, due to the high density of the starting monolith and of the activated ones, for which the density decreases only slightly (from 1.0 g/cm3 to 0.8 g /cm3 upon CO2 activation). The findings reveal the suitability of high density activated carbon monoliths for gas storage application. Thus, the amounts of stored gas can be increased by more than a 70 % in the case of H2 at 20 MPa, almost 5.5 times in the case of CH4 at 3 MPa, and more than 7.5 times in the case of CO2 at 3 MPa when adsorbents are used for gas storage under the investigated conditions rather than simple compression. Furthermore, the obtained results have been recently confirmed by a scale-up study in which 2.64 kg of high density monolith adsorbent was filled a tank cylinder of 2.5 L (Carbon, 76, 2014, 123).