Increase in microbial contamination risk with compression of the lid margin in eyes having cataract surgery

Purpose: To assess the bacterial contamination risk in cataract surgery associated with mechanical compression of the lid margin immediately after sterilization of the ocular surface.

Setting: Department of Cataract, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.

Design: Prospective randomized controlled double-masked trial.

Methods: Patients with age-related cataract were randomly assigned to 1 of 2 groups. In Group A (153 eyes), the lid margin was compressed and scrubbed for 360 degrees 5 times with a dry sterile cotton-tipped applicator immediately after ocular sterilization and before povidone-iodine irrigation of the conjunctival sac. Group B (153 eyes) had identical sterilization but no lid scrubbing. Samples from the lid margin, liquid in the collecting bag, and aqueous humor were collected for bacterial culture. Primary outcome measures included the rate of positive bacterial culture for the above samples. The species of bacteria isolated were recorded.

Results: Group A and Group B each comprised 153 eyes. The positive rate of lid margin cultures was 54.24%. The positive rate of cultures for liquid in the collecting bag was significantly higher in Group A (23.53%) than in Group B (9.80%) (P=.001).The bacterial species cultured from the collecting bag in Group B were the same as those from the lid margin in Group A. The positive culture rate of aqueous humor in both groups was 0%.

Conclusion: Mechanical compression of the lid margin immediately before and during cataract surgery increased the risk for bacterial contamination of the surgical field, perhaps due to secretions from the lid margin glands.

Financial Disclosure: No author has a financial or proprietary interest in any material or method mentioned.

Oración al rey N. Señor Soberano en su Suprema Sala de Justicia de su Real Consejo de las Indias, por el insigne Colegio Mayor de Santa Maria de Todos-Santos de México. Para la confirmación... de la sentencia de vista, que en la lid que sigue con aquella

UANL

Revisión sistemática de la literatura: efecto de los rellenos inyectables en la región periorbitaria

Introducción: El conocimiento actual de la fisiopatología del envejecimiento periorbitario justifica la aplicación de materiales de relleno inyectables, dado que se enfocan en la restauración del volumen perdido en esta zona, convirtiéndose en una excelente alternativa a procedimientos quirúrgicos que remueven el tejido excedente. Sin embargo los efectos y la seguridad de esta naciente tendencia terapéutica aún no se sustentan en una sólida base científica. El objetivo de esta revisión es identificar el material de relleno inyectable más adecuado para el manejo de los defectos volumétricos estéticos de la región periorbitaria. Metodología: Se realizó una búsqueda exhaustiva de los artículos indexados publicados del 1º de enero de 2.000 al 30 de septiembre de 2.013, en diversas bases de datos electrónicas, se seleccionaron catorce publicaciones, se extrajo la información referente a datos demográficos, la intervención, el seguimiento y los desenlaces y se realizó un análisis de 14 estudios que cumplieron los criterios. Resultados: Todos los artículos incluidos poseían un bajo nivel de evidencia y del grado de recomendación. Todos los materiales de relleno se asociaron a altos niveles de satisfacción para el paciente, adecuada mejoría de la apariencia estética y similares efectos colaterales, el ácido hialurónico fue el material de relleno inyectable más utilizado en la región periorbitaria. Discusión: Los materiales de relleno inyectable mejoran los defectos volumétricos estéticos de la región periorbitaria pero es necesaria mayor evidencia para determinar el tipo relleno más apropiado para esta condición.

Com raonen els nens i nenes de sis?? de prim??ria amb la llibreta de ci??ncies? Un model v??lid per ensenyar a aprendre i per aprendre a ensenyar

Resumen basado en el de la publicaci??n

El model de seq????ncia did??ctica vint anys despr??s : un model v??lid per ensenyar a aprendre i per aprendre a ensenyar

Resumen basado en el de la publicaci??n

Velocity profiles and frictional pressure drop for shear thinning materials in lid-driven cavities with fully developed axial flow

A finite element numerical study has been carried out on the isothermal flow of power law fluids in lid-driven cavities with axial throughflow. The effects of the tangential flow Reynolds number (Re-U), axial flow Reynolds number (Re-W), cavity aspect ratio and shear thinning property of the fluids on tangential and axial velocity distributions and the frictional pressure drop are studied. Where comparison is possible, very good agreement is found between current numerical results and published asymptotic and numerical results. For shear thinning materials in long thin cavities in the tangential flow dominated flow regime, the numerical results show that the frictional pressure drop lies between two extreme conditions, namely the results for duct flow and analytical results from lubrication theory. For shear thinning materials in a lid-driven cavity, the interaction between the tangential flow and axial flow is very complex because the flow is dependent on the flow Reynolds numbers and the ratio of the average axial velocity and the lid velocity. For both Newtonian and shear thinning fluids, the axial velocity peak is shifted and the frictional pressure drop is increased with increasing tangential flow Reynolds number. The results are highly relevant to industrial devices such as screw extruders and scraped surface heat exchangers. (c) 2006 Elsevier Ltd. All rights reserved.

Involvement of Src kinases and PLCgamma2 in clot retraction.

The integrin alpha(IIb)beta(3) plays a critical role in mediating clot retraction by platelets which is important in vivo in consolidating thrombus formation. Actin-myosin interaction is essential for clot retraction. In the present study, we demonstrate that the structurally distinct Src kinase inhibitors, PP2 and PD173952, significantly reduced the rate of clot retraction, but did not prevent it reaching completion. This effect was accompanied by abolition of alpha(IIb)beta(3)-dependent protein tyrosine phosphorylation, including PLCgamma2. A role for PLCgamma2 in mediating clot retraction was demonstrated using PLCgamma2-deficient murine platelets. Furthermore, platelet adhesion to fibrinogen leads to MLC phosphorylation through a pathway that is inhibited by PP2 and by the PLC inhibitor, U73122. These results demonstrate a partial role for Src kinase-dependent activation of PLCgamma2 and MLC phosphorylation in mediating clot retraction downstream of integrin alpha(IIb)beta(3).

Spontaneous Blinking in Patients With Graves' Upper Eyelid Retraction

Purpose: To describe spontaneous blink kinematics in Graves' upper eyelid retraction (UER).Methods: The magnetic search coil technique was used to record spontaneous blinks of 15 healthy subjects (aged 23-56 years, 15 eyelids) and 15 patients with Graves' UER (aged 22-62 years, 15 eyelids) during a 5-min period of video observation, and the signals were digitized at 200 Hz (12 bits). Overall, a total of 2,798 blinks were recorded for the controls and 1,860 for the patients. The distance between pupil center and upper eyelid margin in the primary position of gaze (MRD) was measured with the Image J software.Results: The blinking rate of patients was lower than that of control subjects, with a mean (+/-SEM) blinking rate (blinks/min) of 13.0 +/- 1.7 for patients and of 20.0 +/- 2.1 for the controls (t = 2.58, P = 0.016). There were no statistically significant differences in blink amplitude between controls (22.7 +/- 3.1 degrees) and Graves' patients (24.7 +/- 3.3 degrees). However, while only 22% of the blinks performed by controls were smaller than MRD, this rate was 78% for patients. In addition, in blinks larger than 25, patients showed lower down-phase velocity than controls.Conclusions: Patients with Graves' UER show reduced blinks rates and abnormal blink kinematics, which might be related to the development of exposure keratitis in this disease.

Periacinar Retraction Clefting in Nonneoplastic and Neoplastic Prostatic Glands: Artifact or Molecular Involvement

A space between neoplastic acini and prostatic stroma is not rare and studies have interpreted this as an artifact, considering the absence of endothelial cells indicating vascular invasion. Thus, the aims of this work were to characterize and correlate the occurrence and extent of retraction clefting with the reactivities of alpha and beta dystroglycan (alpha DG, beta DG), laminin, matrix metalloproteinase 2 (MMP-2), p63, insulin-like growth factor 1(IGF-1), vimentin, and fibroblast growth factor 2 (FGF-2). The study was based on nonneoplastic and neoplastic prostatic tissues obtained from necropsies and retropubic radical prostatectomies. The results showed that periacinar retraction clefting was significantly more frequent in prostatic carcinoma samples than in normal prostatic acini. Most of the neoplastic acini (72.0%) showed retraction clefting of more than 50% of circumference, which were significantly more frequent in Gleason score 7 and 6. Decreased collagen and reticular and elastic fibers were verified in the stroma around neoplastic acini. Weak and discontinuous alpha DG, beta DG, and laminin immunoreactivities and intensified MMP-2, vimentin, IGF-1 and FGF-2 immunoreactivities were verified in the neoplastic acini; p63 immunoreactivity was negative in all carcinomas. Thus, these findings showed that the lack of epithelial basal cells, DGs, and laminin and increased MMP-2, IGF-1, and FGF-7 could be considered important pathways in periacinar retraction occurrence. This study demonstrated the origin of and the biological mechanisms responsible for periacinar retraction clefting in prostatic carcinoma.