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Background/Objectives: Glucocorticoids are drugs that are increasingly used in oral surgery to reduce trismus, inflammation, and postoperative pain, three frequent complications after the surgical extraction of impacted lower third molars. The aim of this study was to compare the effect of 8 mg dexamethasone versus 40 mg methylprednisolone in the prevention of postoperative complications after third molar surgery. Methods: A randomized double-blind clinical trial was conducted following CONSORT guidelines. In detail, 84 patients were included in the study, who randomly received a single preoperative submucosal dose of dexamethasone (8 mg) or methylprednisolone (40 mg). The variables analyzed, as primary outcomes, were trismus, inflammation, and postoperative pain. The measurements were performed at baseline (0 h), 3 h, 7 h, 24 h, 48 h, and 7 th day using a Visual Analog Scale (VAS), Verbal Rating Scale (VRS), and the Gabka–Matsumara method. Results: Dexamethasone reduced trismus, inflammation, and postoperative pain significantly better than methylprednisolone. Conclusions: Preoperative submucosal administration of 8 mg dexamethasone is effective and safe in reducing the severity of postoperative complications following surgical extraction of impacted lower third molars. [ABSTRACT FROM AUTHOR]

Background: 'Periodontitis' refers to periodontal destruction of connective tissue attachment and bone, in response to microorganisms forming subgingival biofilms on the root surface, while 'apical periodontitis' refers to periapical inflammatory processes occurring in response to microorganisms within the root canal system. The treatment of both diseases is based on the elimination of the bacterial challenge, though its predictability depends on the ability of disrupting these biofilms, what may need adjunctive antibacterial strategies, such as the next‐generation antibacterial strategies (NGAS). From all the newly developed NGAS, the use of polymeric nanotechnology may pose a potential effective approach. Although some of these strategies have only been tested in vitro and in preclinical in vivo models, their use holds a great potential, and therefore, it is relevant to understand their mechanism of action and evaluate their scientific evidence of efficacy. Objectives: To explore NGAS based on polymeric nanotechnology used for the potential treatment of periodontitis and apical periodontitis. Method: A systemic search of scientific publications of adjunctive antimicrobial strategies using nanopolymers to treat periodontal and periapical diseases was conducted using The National Library of Medicine (MEDLINE by PubMed), The Cochrane Oral Health Group Trials Register, EMBASE and Web of Science. Results: Different polymeric nanoparticles, nanofibres and nanostructured hydrogels combined with antimicrobial substances have been identified in the periodontal literature, being the most commonly used nanopolymers of polycaprolactone, poly(lactic‐co‐glycolic acid) and chitosan. As antimicrobials, the most frequently used have been antibiotics, though other antimicrobial substances, such as metallic ions, peptides and naturally derived products, have also been added to the nanopolymers. Conclusion: Polymeric nanomaterials containing antimicrobial compounds may be considered as a potential NGAS. Its relative efficacy, however, is not well understood since most of the existing evidence is derived from in vitro or preclinical in vivo studies. [ABSTRACT FROM AUTHOR]

Context. The bright heads of penumbral filaments, penumbral grains (PGs), show apparent horizontal motions inward, toward the umbra, or outward, away from the umbra. Aims. We aim to ascertain statistically whether the direction of PGs' apparent motion is related to the inclination of the surrounding magnetic field. Methods. We used spectropolarimetric observations of five sunspot penumbrae to compare magnetic inclinations inside PGs with those in their surroundings. The data were taken by three observatories: the Hinode satellite, the Swedish Solar Telescope, and the GREGOR solar telescope. The direction of PGs' motion was determined by feature tracking. The atmospheric conditions in PGs and their surroundings, including magnetic field information, were retrieved by means of height-stratified spectropolarimetric inversions. Results. Out of a sample of 444 inward-moving PGs and 269 outward-moving ones, we show that 43% of the inward-moving PGs have a magnetic inclination larger by 8° ±4° than the inclination in their surroundings and 51% of the outward-moving PGs have an inclination smaller by 13° ±7° than the surrounding one. The opposite relation of inclinations is observed in only one fifth of the inward- and outward-moving PGs. Conclusions. Rising hot plasma in PGs surrounded by a less inclined magnetic field may adapt its trajectory to be more vertical, causing an inward apparent motion of PGs. Conversely, it may be dragged by a more horizontal surrounding magnetic field such that an outward apparent motion is observed. [ABSTRACT FROM AUTHOR]

This article presents three cases of Descemet's membrane detachment (DMD) occurring during 'ab externo' phacocanaloplasty procedures in three patients with uncontrolled primary open-angle glaucoma (OAG) and discusses the management of this condition by reviewing the available literature. Following a successful 360° cannulation of Schlemm's canal (SC), the microcatheter was withdrawn while an ophthalmic viscosurgical device (OVD) was injected into the canal. During passage through the inferonasal quadrant, a spontaneous separation of the posterior layer of the cornea was observed. Each case was managed differently after diagnosis, with the third case being drained intraoperatively based on experience gained from the previous cases. On the first postoperative day, slit-lamp biomicroscopy (BMC) revealed multiple DMDs in case one and a hyphema in the lower third of a deep anterior chamber. In the other two cases, a single DMD was observed. The second case developed hemorrhagic Descemet membrane detachment (HDMD), while the other two were non-hemorrhagic. In all three cases, anterior segment optical coherence tomography (AS-OCT) revealed the presence of retrocorneal hyperreflective membranes indicative of DMDs. These membranes were located in the periphery of the cornea and did not impact the visual axis. After evaluation, a small incision was made in the inferotemporal DMD of the first case. However, for the two remaining cases, a strategy of watchful waiting was deemed appropriate due to the location and size of the DMDs, as they did not affect the best-corrected visual acuity (BCVA). Over time, the patients demonstrated progressive improvement with a gradual reduction in the size of the DMDs. [ABSTRACT FROM AUTHOR]

Neurofibromatosis type 1 (NF1) is one of the central nervous system's most common autosomal dominant conditions. The diagnosis is based on the clinical diagnostic criteria and/or a molecularly confirmed mutation in the NF1 gene. This study investigated the possibility of substantiating choroidal nodules as a diagnostic criterion for the disease, including patients affected with and without high myopia. A cross-sectional study was carried out in 60 eyes of 30 adult patients diagnosed with NF1. A total of 30 healthy individuals of equivalent age and sex served as control. The Spectralis HRA+OCT MultiColor (Heidelberg Engineering GmbH, Heidelberg, Germany) evaluated the presence of choroidal abnormalities with near-infrared reflectance imaging. Secondly, the presence of iridian Lisch nodules was evaluated by slit lamp examination. Near-infrared reflectance imaging showed the presence of choroidal hyperreflective nodules in 83% of the patients diagnosed with NF1, while these choroidal abnormalities were not observed in any control subject. The patients diagnosed with NF1 associated with high myopia were the only ones who did not present the characteristic choroidal disorders. Therefore, when excluding patients diagnosed with high myopia, choroidal nodules were more frequent than Lisch nodules in a statistically significant proportion. Hyperreflective nodules detected by near-infrared reflectance imaging are as regular as Lisch nodules or even significantly more frequent when excluding high myope patients. Our observation of the mutual exclusion of choroidal hyperreflective nodules and high myopia in the NF1 patients seems a novel and interesting remark. [ABSTRACT FROM AUTHOR]

The main target of bone tissue engineering is to design biomaterials that support bone regeneration and vascularization. Nanostructured membranes of (MMA)1-co-(HEMA)1/(MA)3-co-(HEA)2 loaded with 5% wt of SiO2-nanoparticles (Si-M) were doped with zinc (Zn-Si-M) or doxycycline (Dox-Si-M). Critical bone defects were effectuated on six New Zealand-bred rabbit skulls and then they were covered with the membranes. After six weeks, a histological analysis (toluidine blue technique) was employed to determine bone cell population as osteoblasts, osteoclasts, osteocytes, M1 and M2 macrophages and vasculature. Membranes covering the bone defect determined a higher count of bone cells and blood vessels than in the sham group at the top regions of the defect. Pro-inflammatory M1 appeared in a higher number in the top regions than in the bottom regions, when Si-M and Dox-Si-M were used. Samples treated with Dox-Si-M showed a higher amount of anti-inflammatory and pro-regenerative M2 macrophages. The M1/M2 ratio obtained its lowest value in the absence of membranes. On the top regions, osteoblasts were more abundant when using Si-M and Zn-Si-M. Osteoclasts were equally distributed at the central and lateral regions. The sham group and samples treated with Zn-Si-M attained a higher number of osteocytes at the top regions. A preferential osteoconductive, osteoinductive and angiogenic clinical environment was created in the vicinity of the membrane placed on critical bone defects. [ABSTRACT FROM AUTHOR]

Background: Passive immunotherapy has been evaluated as a therapeutic alternative for patients with COVID-19 disease. Equine polyclonal immunotherapy for COVID-19 (EPIC) showed adequate safety and potential efficacy in a clinical trial setting and obtained emergency use authorization in Argentina. We studied its utility in a real world setting with a larger population. Methods: We conducted a retrospective cohort study at "Hospital de Campaña Escuela-Hogar" (HCEH) in Corrientes, Argentina, to assess safety and effectiveness of EPIC in hospitalized adults with severe COVID-19 pneumonia. Primary endpoints were 28-days all-cause mortality and safety. Mortality and improvement in modified WHO clinical scale at 14 and 21 days were secondary endpoints. Potential confounder adjustment was made by logistic regression weighted by the inverse of the probability of receiving the treatment (IPTW) and doubly robust approach. Findings: Subsequent clinical records of 446 non-exposed (Controls) and 395 exposed (EPIC) patients admitted between November 2020 and April 2021 were analyzed. Median age was 58 years and 56.8% were males. Mortality at 28 days was 15.7% (EPIC) vs. 21.5% (Control). After IPTW adjustment the OR was 0.66 (95% CI: 0.46–0.96) P = 0.03. The effect was more evident in the subgroup who received two EPIC doses (complete treatment, n = 379), OR 0.58 (95% CI 0.39 to 0.85) P = 0.005. Overall and serious adverse events were not significantly different between groups. Conclusions: In this retrospective cohort study, EPIC showed adequate safety and effectiveness in the treatment of hospitalized patients with severe SARS-CoV-2 disease. [ABSTRACT FROM AUTHOR]

Gingival recessions are a prevalent oral mucosa alteration. To solve this pathology, palatal mucosa or polymeric soft tissue substitutes are used when performing coronal advanced flap (CAF) or tunnel (TUN) surgical techniques. To evaluate which is the most successful approach, a literature review and meta-analysis were conducted. For the electronic search the National Library of Medicine, the Cochrane Oral Health Group Trials Register, EMBASE and WOS were used. Pooled data for the percentage of root coverage was collected and weighted means were calculated. Heterogeneity was determined using the Higgins (I2) statistic and a random-effects model was applied. Thirteen studies were included in the systematic review (12 randomized and 1 controlled clinical trials) in which both techniques (394 patients) were compared with a follow-up of 4 to 12 months. Galbraith and Baujat plots were used to control for the presence of potential outliers. After performing the meta-analysis (11 studies), the mean root coverage was similar when using the TUN or CAF techniques (p = 0.49). The only differences between the two were found for single recessions, where CAF offered a higher percentage of root coverage (mean difference = 4.98%; p = 0.006). There were no differences when applying an autograft or a polymeric substitute with either of the two tested surgical techniques (p = 0.445). [ABSTRACT FROM AUTHOR]

We evaluated risk factors for sporadic Shiga toxin-producing Escherichia coil (STEC) infection among children in Argentina. We conducted a prospective case-control study in 2 sites and enrolled 150 case-patients and [...]

Shiga toxin-producing Escherichia coli (STEC) is known as a pathogen associated with food-borne diseases. The STEC O145 serogroup has been related with acute watery diarrhea, bloody diarrhea, hemorrhagic colitis, and hemolytic uremic syndrome (HUS). Argentina has the highest rate of HUS worldwide with 70% of the cases associated with STEC infections. We aimed to describe the epidemiology and genetic diversity of STEC O145 strains isolated across Argentina between 1998–2020. The strains isolated from 543 cases of human disease and four cattle, were pheno-genotipically characterized. Sequencing of five strains was performed. The strains were serotyped as O145:NM[H28]/H28, O145:H25, and O145:HNT, and mainly characterized as O145:NM[H28]/stx2a/eae/ehxA (98.1%). The results obtained by sequencing were consistent with those obtained by traditional methods and additional genes involved in different mechanisms of the pathogen were observed. In this study, we confirmed that STEC O145 strains are the second serogroup after O157 and represent 20.3% of HUS cases in Argentina. The frequency of STEC O145 and other significant serogroups is of utmost importance for public health in the country. This study encourages the improvement of the surveillance system to prevent severe cases of human disease. [ABSTRACT FROM AUTHOR]

Aims/Purpose: To present a case report of a 64‐year‐old man with dislocation of a dexamethasone anterior chamber (AC) implant, who underwent secondary implantation with the Canabrava technique. Methods: A male patient underwent surgery for a secondary implant in the left eye using the Canabrava technique. Post‐operatively, cystic macular oedema was observed on optical coherence tomography (OCT). After 15 days, with no anatomical improvement despite treatment with Nevanac eye drops, a dose of intravitreal injection with Ozurdex® was prescribed. A few days later, the patient came to the emergency department and reported seeing a foreign body in the treated eye. On biomicroscopic examination, an Ozurdex® insert was found in the AC. When the patient was questioned again, he stated that he had been in the praying position the previous days. A new macular OCT was performed, showing resolution of the foveal oedema. Dilation of the LAA with phenylephrine was performed with cephalic manoeuvres in the supine decubitus position, achieving the repositioning of the dexamethasone implant in the vitreous chamber. Finally, an OCT of the anterior pole shows that the secondary implant is normally positioned without complications. Results: After initial treatment with Ozurdex® intravitreal implant, total resolution of the post‐operative cystic macular oedema is achieved, even with dislocation to the anterior chamber. After outpatient management of the dislocation of the implant, we were able to relocate it to the vitreous chamber without the need for surgical management of the patient. Conclusions: In the clinical case, it is demonstrated that the anti‐inflammatory effect of Ozurdex® remains active despite dislocation of the implant to the anterior chamber. Likewise, a good ambulatory technique in the supine position with directed cephalic manoeuvres may be sufficient to reposition the implant without the need for surgery. [ABSTRACT FROM AUTHOR]

Abstract Background Shiga toxin-producing Escherichia coli (STEC) is an important cause of bloody diarrhoea (BD), non-bloody diarrhoea (NBD) and the haemolytic uraemic syndrome (HUS). In Argentina and New Zealand, the most prevalent STEC serotype is O157:H7, which is responsible for the majority of HUS cases. In Australia, on the other hand, STEC O157:H7 is associated with a minority of HUS cases. The main aims of this study were to compare the phenotypic and genotypic characteristics of STEC O157 strains isolated between 1993 and 1996 from humans in Argentina, Australia and New Zealand, and to establish their clonal relatedness. Results Seventy-three O157 STEC strains, isolated from HUS (n = 36), BD (n = 20), NBD (n = 10), or unspecified conditions (n = 7) in Argentina, Australia and New Zealand, were analysed. The strains were confirmed to be E. coli O157 by biochemical tests and serotyping. A multiplex polymerase chain reaction (PCR) was used to amplify the stx1, stx2 and rfbO157 genes and a genotyping method based on PCR-RFLP was used to determine stx1 and stx2 variants. This analysis revealed that the most frequent stx genotypes were stx2/stx2c (vh-a) (91%) in Argentina, stx2 (89%) in New Zealand, and stx1/stx2 (30%) in Australia. No stx1-postive strains were identified in Argentina or New Zealand. All strains harboured the eae gene and 72 strains produced enterohaemolysin (EHEC-Hly). The clonal relatedness of strains was investigated by phage typing and pulsed-field gel electrophoresis (PFGE). The most frequent phage types (PT) identified in Argentinian, Australian, and New Zealand strains were PT49 (n = 12), PT14 (n = 9), and PT2 (n = 15), respectively. Forty-six different patterns were obtained by XbaI-PFGE; 37 strains were grouped in 10 clusters and 36 strains showed unique patterns. Most clusters could be further subdivided by BlnI-PFGE. Conclusion STEC O157 strains isolated in Argentina, Australia, and New Zealand differed from each other in terms of stx-genotype and phage type. Additionally, no common PFGE patterns were found in strains isolated in the three countries. International collaborative studies of the type reported here are needed to detect and monitor potentially hypervirulent STEC clones.

To the Editor: Argentina has the highest incidence of hemolytic uremic syndrome (HUS) in the world, and 10.4 cases per 100,000 children A 2-year-old girl was brought to the emergency [...]

St Alban's English College in Valladolid, established at the height of the Catholic Reformation for the training of English secular clergy under the rule of Spanish Jesuits, underwent an alteration in its management after the expulsion of the religious order from Spain in 1767. As part of this process, numerous valuable archival records were produced which have not, thus far, been studied. This article analyses a portion of these documents: the surviving manuscript inventories of the library. It also considers the series of governmental orders issued by the Spanish authorities as part of the process of expulsion and examines how these orders shaped the production of the library inventories. It offers an overview of the contents of the catalogues, with descriptions of some of those specific book entries that make these inventories unique. The study of these archival documents provides insight into, and understanding of, a key moment in the College history: its shift from Spanish Jesuit control to an English secular one and the difficulties that the Spanish authorities faced because of this change in the College's national identity. [ABSTRACT FROM AUTHOR]

Background Shiga toxin–producing Escherchia coli (STEC) O157:H7 is a zoonotic pathogen that causes numerous food and waterborne disease outbreaks. It is globally distributed, but its origin and the temporal sequence of its geographical spread are unknown. Methods We analyzed whole-genome sequencing data of 757 isolates from 4 continents, and performed a pan-genome analysis to identify the core genome and, from this, extracted single-nucleotide polymorphisms. A timed phylogeographic analysis was performed on a subset of the isolates to investigate its worldwide spread. Results The common ancestor of this set of isolates occurred around 1890 (1845–1925) and originated from the Netherlands. Phylogeographic analysis identified 34 major transmission events. The earliest were predominantly intercontinental, moving from Europe to Australia around 1937 (1909–1958), to the United States in 1941 (1921–1962), to Canada in 1960 (1943–1979), and from Australia to New Zealand in 1966 (1943–1982). This pre-dates the first reported human case of E. coli O157:H7, which was in 1975 from the United States. Conclusions Inter- and intra-continental transmission events have resulted in the current international distribution of E. coli O157:H7, and it is likely that these events were facilitated by animal movements (eg, Holstein Friesian cattle). These findings will inform policy on action that is crucial to reduce the further spread of E. coli O157:H7 and other (emerging) STEC strains globally. [ABSTRACT FROM AUTHOR]

Purpose: To describe the clinical characteristics, the surgical management and the evolution after cataract surgery in a patient with nanophthalmos. Methods: We present the case of a 57‐year‐old woman with a progressive decrease in visual acuity referred for evaluation of a cataract intervention. As history, he presented high hyperopia [Right Eye (OD): +15.50; Left Eye (OS): +16.25], not corrected with glasses in childhood; episode of pupillary block 3 years ago treated with iridotomies in OD and chronic treatment with topical prostaglandin in both eyes. The best corrected visual acuity (BCVA) is 20/50 in both eyes. Slit‐lamp examination revealed very narrow anterior chambers, patent iridotomies, iridocrystalline synechiae, and advanced nuclear cataracts. Intraocular pressure is 21 mmHg in both eyes with latanoprost. Biometry reveals an axial length of 16.59 mm in OD and 16.60 mm in OS. A cataract was diagnosed in patient with bilateral nanophthalmos and it was decided to intervene in the OD. In surgery, 2 lamellar scleral incisions were made followed by suturing of the overlying conjunctiva and phacoemulsification with a 40D intraocular lens implant in the posterior chamber. Systemic corticosteroids were administered postoperatively. Results: Postoperative complications observed were: posterior synechiae and anterior capsule phimosis that required Nd‐YAG laser capsulotomy. Despite the good evolution, no improvement was obtained in visual acuity with respect to pre‐surgical values, and the patient currently has a BCVA of 20/50. Conclusions: Eyes with nanophthalmos require the recognition of cardinal signs of paramount importance for their diagnosis, as well as follow‐up and search for possible complications over time, and the use of extensive preoperative precautionary measures when surgical approach is necessary. [ABSTRACT FROM AUTHOR]

Purpose: We describe a case of Fish‐Eye Disease (FED) in which the clinical features and visual function were investigated using anterior‐segment optical coherence tomography (AS‐OCT). Methods: A 38‐year‐old Spanish man with a known history of dyslipidemia came to our Hospital referring mild blurred vision and whitening of both eyes. Visual acuity was 1.00 (decimal). Slit‐lamp examination showed bilateral, peripheral yellowish‐white corneal opacities, causing corneal clouding. An AS‐OCT was then performed, showing homogeneously hyper‐reflective corneal stroma. On systemic examination, the patient had low plasma high‐density lipoprotein cholesterol levels. Results: Both slit‐lamp examination and AS‐OCT imaging revealed a corneal opacification compatible with FED, a clinical feature secondary to a lecithin‐cholesterol acyltransferase (LCAT) deficiency. The patient was sent to genetic counselling to study the mutation, which was later found to be positive for LCAT gene. Conclusions: Although it is not a common genetic disorder, FED should be included in the differential diagnosis of corneal clouding. The findings from this case suggest that a complete eye examination, both with slit‐lamp and AS‐OCT, can be useful for an early FED diagnosis despite good visual acuity. [ABSTRACT FROM AUTHOR]

Purpose: To describe a case of pupillary block in a pseudophakic patient secondary to synechiae between the iris and the intraocular lens implanted in the capsular bag. Methods: 60‐year‐old woman presented severe diabetic retinopathy and cataract in her right eye. Phacoemulsification + hydrophobic monofocal intraocular lens in capsular bag was decided. The next day, we found a hemovitreous in right eye, observation was decided after performing ultrasound. As the condition did not resolve, a pars plana vitrectomy was performed. Seventeen days after the second surgery, the patient presented intense pain in her right eye, visual acuity of hand motion, IOP of 70 mm Hg, intense corneal edema, iris bombe, wide chamber and narrow in the periphery. Correct pseudophakia. Irregular pupil with mild non‐reactive miosis. Closed angle. Topical hypotensive drugs, oral acetazolamide, and IV mannitol were prescribed without response. Peripheral iridotomies were performed with good response. Mydriatics are added to force pupillary dilation. Results: The next day she presented an IOP 10. One month after the iridotomies she presented an IOP 12 and visual acuity of 0.6. Conclusions: Pseudophakic pupillary blocks rarely occur with current phacoemulsification techniques and capsular bag intraocular lens implantation. Complications inherent to surgery and patients (glaucoma, diabetes, children, previous early surgery) that predispose to a greater inflammatory context may be associated with the potential development of synechiae between the iris and the anterior intraocular lens / capsule, preventing the correct flow of the aqueous humour due to the pupillary block. In a study of the type of intraocular lens in a uveitic context, a greater association was found with hydrophobic intraocular lens than with other types. The ocation where the intraocular lens is implanted is also related, being greater in the intraocular lens in the anterior chamber or sulcus. Peripheral YAG laser iriditomies are a good therapeutic option but are not recommended intraoperatively because they can cause more complications than benefits. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the effectiveness (lowering medication) of a single trabecular microbypass stent (iStent Inject® W, Glaukos) implantation in combination with phacoemulsification in open‐angle glaucoma eyes over a 12‐month period. Methods: Non‐randomized, single‐centre, retrospective case series of glaucoma eyes undergoing iStent implantation with phacoemulsification. Patients with no prior glaucoma surgery and intolerant or non‐compliant with medications were eligible for inclusion. Primary outcome effectiveness measures include reduction number of glaucoma medications and stabilization of intraocular pressure (IOP). Results: 30 eyes of 24 patients (mean age 74.9 ± 8.4) were included in this study. Mean baseline IOP was 17.7 ± 3.5 mmHg and was reduced to 16.1 ± 2.6 and 15.7 ± 2.5 at 6‐ and 12 months respectively (p = 0.002). Mean number of medications was 2.3 ± 1 at baseline and was significantly reduced to 0.7 ± 0.9 at 12 months (p < 0.001; −68%). No eye was medication free at baseline versus 50% (n = 15) at 12 months. In controlled glaucoma eyes (≤18 mmHG), mean IOP was stable (15.5 ± 2.1 at baseline; 15.3 ± 2.4 at 12‐month) while medications were reduced from 1.9 ± 0.7 at baseline to 0.5 ± 0.6, whereas in uncontrolled glaucoma eyes (>18mmHG at baseline) both IOP and medications were reduced from 20.7 ± 2.5 and 2.7 ± 1.2 at baseline to 16.2 ± 2.6 and 1.1 ± 1.1 at 12‐month respectively. There was no statistically significant change in retinal nerve fibre layer (RNFL) thickness at 12 months (p = 0.32). No eyes have experienced adverse events such as postoperatively IOP spikes or hyphema. Conclusions: iStent Inject W implantation with phacoemulsification results in a significant reduction in mean glaucoma medications in glaucoma eyes. IOP was also reduced and there was no loss of visual acuity or RNFL. In uncontrolled IOP eyes, the stent implantation has brought IOP under control and reduced the number of medications, while in controlled IOP eyes, it has lowered the number of medications. [ABSTRACT FROM AUTHOR]

Purpose: Optic disc pit (ODP) is a rare congenital disorder that affects one in 10 000 people. Serous detachment of macula is the most common complication and the natural history of untreated ODP maculopathy is a gradual deterioration with significant visual loss. A multitude of interventions have been designed for the treatment but none has been established as the treatment of choice. Pars plana vitrectomy is one of the most commonly used procedure in recent years. We present a case report with surgical treatment and management of complications. Methods: An interventional case report of a 63‐year‐old man who attended the emergency room due to sudden visual loss and best corrected visual acuity (BCVA) of 20/200 in the right eye (RE). Upon his arrival, a visual field was performed in which complete abolition of the right field was observed, severely affecting the central area. A papillary pit was found in the eye fundus. Optical coherence tomography (OCT) revealed a serous retinal detachment (RD) with macular involvement and surgical management was decided. Results: A successful pars plana vitrectomy (PPV) with peeling of the internal limiting membrane and application of an endolaser was performed. Three months later, he came back with a higher serous RD and a worsening of BCVA. We performed a second PPV with sulfur hexafluoride (SF6) with good anatomical results. One year later, cataract and an inferior rhegmatogenous retinal detachment with proliferative vitreoretinopathy (PVR) was treated with intraocular lens implantation and PPV with silicone oil. Five months later, supero‐temporal retina was detached, so a new PPV was carried out with silicone oil again. One year later, the silicone oil was removed and a retinal detachment was noted 3 months later. Finally, the last surgery was performed practicing encircling band, PPV, application of endolaser and again using silicone oil. Conclusions: Surgical management of serous retinal detachment caused by papillary pit continues being a challenge for retinal specialists. Complications of surgery are no usually publish in literature and this case report make us take into account. Since it ranges from observation to surgical approach using different techniques and procedures without any showing clear superiority. [ABSTRACT FROM AUTHOR]

Purpose: To study retinal thickness using optical coherence tomography (OCT) (Spectralis OCT) in patients after undergone pars plana vitrectomy to repair rhegmatogenous retinal detachment (RRD) during different time points over 1 year follow up. OCT can detect retinal thickness changes in RRD. These changes can modify in the follow up time. RRD by itself or due to the surgical procedure could induces macular thickness changes. Methods: We performed a single‐center cross‐sectional descriptive study including 49 eyes of patients with macula OFF RRD after 23 PPV + SF6 as tamponade; the contralateral eye was used as the control group. All participants underwent a complete ophthalmic examination that included refraction, axial length (AL), and Spectralis spectral‐domain (SD)‐OCT. Results: Thirty‐six of the patients were male and 16 female; 40.8% of the eyes were right one. Central foveal thickness was diminished in 1 month and 3 months time points. There were not differences in the 6‐ and 12‐months examination. The parafoveal ring was similar in both groups but there were statistically significant differences in the inferior and nasal outer ring of the ETDRS grid, in the 1 month follow up. After 1 year, differences were only found in the outer temporal and nasal rings. Conclusions: The findings of this study suggest that retinal thickness remains similar 1 year after RRD was successfully treated. These may indicate that there is a progressive anatomical restoration in the macular area. References 1. Zghal I, et al. Macula analysis by spectral domain OCT in rhegmatogenous retinal detachment surgery. J Fr Ophthalmol. 2015; 38(3): 181–92. 2. Han KJ, et al. Optical coherence tomography automated layer segmentation of macula after retinal detachment repair. Plos One. 2019; 13 (5). 3. Terauchi G, et al. Recovery of photoreceptor inner and outer segment layer thickness after reattachment of rhegmatogenous retinal detachment. Br J Ophthalmol. 2015; 99(10): 1323–1327. [ABSTRACT FROM AUTHOR]

Purpose: To present the assessment and surgical approach to late pseudophakic bullous keratopathy in a case of pseudophakia with Baikoff type anterior chamber (AC) IOL implantation with haptics synechiated to the iridian stroma. We opted for Descemet Stripping with Automated Endothelial Keratoplasty (DSAEK), which allowed us to solve the corneal decompensation. Methods: We present the case of a 72‐year‐old male with a history of traumatic cataract and superior iridodialysis, who was surgically treated with lens extraction and implantation of a three‐haptic Baikoff‐type AC IOL. During the 30 years after surgery, the patient remained stable. However, in 2021, he went for a revision with a decrease in visual acuity. During the slit‐lamp biomicroscopic examination and the images obtained, the presence of synechiae of the three haptics of the lens to the peripheral iridian stroma was evidenced, as well as the presence of generalized edema with increased thickness and loss of corneal transparency, which did not subside with medical treatment. Results: Given the need for surgical intervention, the risk–benefit of performing a lens explant was studied. It was decided to perform a DSAEK endothelial transplantation keeping the IOL in its position, given the existence of a wide iridian dialysis and a wide anterior chamber. During the operation, the implanted gas bubble allowed the graft to adhere properly, although it did not remain in the anterior chamber, due to the presence of the traumatic superior iridodialysis. However, in the immediate postoperative period, the graft of the posterior corneal layers remained adhered without the need of the gas bubble, resolving the previous bullous keratopathy. Conclusions: Late corneal decompensation is a complication to be taken into account in eyes with AC IOL. On the other hand, DSAEK offers advantages in the ease of positioning and maintenance of the graft compared to DMEK in cases with iridodialysis, obtaining a prompt recovery with good refractive results. [ABSTRACT FROM AUTHOR]

Purpose: To describe the clinical manifestations and diagnosis of choroidal haemangioma with the aid of different multimodal images, as well as its usefulness for making a differential diagnosis. Methods: A case of a patient who comes due to blurred vision is described, who underwent different complementary tests of multimodal images: optical coherence tomography (OCT), fluorescein angiography (FA), indocyanine green angiography (ICGA), autofluorescence (AF), ultrasound eye exam and retinography to achieve the accurate diagnosis. Results: We present the case of a 50‐year‐old patient who debuted with recently‐onset blurred vision in the left eye (LE). In the eye fundus of LE, a yellow‐orange temporal‐inferior lesion of 3 disc diameter (DD) with neurosensory detachment of 4 DD that affects the fovea is observed. An OCT is performed that shows a choroidal mass associated with subretinal and intraretinal fluid with hyperrefringent points, the B‐scan ultrasound shows a hyperechoic lesion in the posterior pole, and both ICGA and FA reveal a hyperfluorescent pattern in all its phases, being the choroidal vessels of better visualization in the latter phase (without double vascularization pattern). AF shows hyperautofluorescence. After the definitive diagnosis of choroidal haemangioma, he was referred for treatment with Argon laser with favourable results. Conclusions: Choroidal haemangioma is a rare benign vascular tumour that occurs in middle‐aged adults and can be circumscribed (CCH) or diffuse depending on its extension. For the diagnosis of intraocular tumours it is very important to make a good differential diagnosis with the help of multimodal images: OCT, FA, ICGA, AF, Ultrasound and retinography; in order to differentiate it from similar posterior pole lesions with worse prognosis. CCH itself is benign and asymptomatic, and its treatment consists of observation; but it can present inflammatory signs with subretinal fluid and affect the macular area and therefore a more invasive treatment is indicated. References. 1. Singh AD, Kaiser PK, Sears JE. Choroidal hemangioma. Ophthalmol Clin North Am. 2005;18(1):151–61, ix. 2. Berry M, Lucas LJH. Circumscribed choroidal hemangioma: A case report and literature review. J Optom. 2017;10(2):79–83. [ABSTRACT FROM AUTHOR]

Purpose: Corneal neovascularization (CNV) in the paediatric population has a variety of etiologies including bacterial ulcers, herpes keratitis, exposure keratopathy, blepharokeratoconjunctivitis and corneal anaesthesia. Monotherapy with antiangiogenic agents or corneal fine‐needle diathermy (FND) alone do not completely resolve CNV; however, the combined treatment of these two seems to offer better results. Methods: We present the results of FND with adjuvant injection of intrastromal and subconjunctival Bevacizumab in a child with CNV of herpetic origin. Results: A 3‐year‐old patient who has been treated in our hospital for corneal involvement in the left eye (LE) due to herpetic keratitis of weeks of evolution comes to our consultation. Examination under general anaesthesia reveals in LE an inferior paracentral corneal leukoma with partial involvement of the visual axis and CNV that enters through the limbus from 5 to 8 h and begins to involve corneal stroma; no epithelial lesions, no corneal oedema or inflammatory activity in the anterior segment. After not improvement, it was decided to perform FND of lower CNV in conjunction with an intrastromal injection and another subconjunctival injection of Bevacizumab. Subsequently, it remains stable with topical and oral antiherpetic treatment, and topical corticosteroid therapy. At 3 months, the CNV reactivated, for which FND + intrastromal and subconjunctival bevacizumab was performed again. Finally, at 2 months, the patient is asymptomatic with VA LE of 1.0, with 2 corneal leukomas without CNV or epithelial lesions, and continues to be treated with oral acyclovir at prophylactic doses. Conclusions: FND of CNV together with adjuvant treatment with intrastromal and subconjunctival Bevacizumab is a good choice in children to treat those active corneal neovascularizations that do not respond to corticosteroid. References 1. Yeung SN, Lichtinger A, Kim P, Amiran MD, Slomovic AR. Combined use of subconjunctival and intracorneal bevacizumab injection for corneal neovascularization. Cornea. 2011; 30(10): 1110–4. 2. Koenig Y, Bock F, Kruse FE, Stock K, Cursiefen C. Angioregressive pretreatment of mature corneal blood vessels before keratoplasty: Fine‐needle vessel coagulation combined with Anti‐VEGFs. Cornea. 2012; 31(8): 887–92. [ABSTRACT FROM AUTHOR]

Purpose: To present a case of persistent corneal edema after endothelial disease of unknown cause and with a severe decrease in the endothelial count and clinical improvement after DWEK (descemetorhexis without endothelial keratoplasty). Methods: A 61‐year‐old immunocompetent male patient, with no relevant ophthalmological or systemic history, who after multiple episodes of subacute endotheliitis with retrokeratic precipitates and diffuse iridian atrophy in his right eye, showed central persistent corneal edema, secondary to a marked decrease in endothelial count and severe decrease in best‐corrected visual acuity (0.2) after several months of inflammatory stability. Results: During flare‐ups of inflammation, treatment with corticosteroids, topical ganciclovir and oral acyclovir was prescribed, with a good clinical response. Aqueous humour samples were taken during the outbreaks without yielding results for herpesviruses. The endothelial count remained low at the central level several months later, although the peripheral count was good. The fellow eye showed a normal count. It was decided to perform DWEK in the endothelial zone of retrokeratic precipitates as a diagnostic measure. The analyses of the endothelial sample FOR THE HERPESVIRIDAE FAMILY do not show results, however, a progressive improvement in corneal edema and visual acuity was observed from the first month after DWEK. He is currently stable, with mild paracentral edema and a best‐corrected visual acuity of 0.7. Conclusions: DWEK is reserved for cases of slightly advanced endothelial dystrophy, in which the central endothelial denudation causes a centripetal migration of the peripheral endothelial reserve. In this case, the clinical findings suggest a viral aetiology of the endothelial loss, therefore, DWEK was considered as a diagnostic procedure, to obtain samples for PCR and as a first step prior to DMEK. The improvement after DWEK in the area of retrokeratic precipitates without the need for a subsequent transplant suggests localized endothelial involvement in cases of endothelial loss associated with localized inflammatory precipitates. [ABSTRACT FROM AUTHOR]

More than 400 serotypes of Shiga toxin-producing Escherichia coli (STEC) have been implicated in outbreaks and sporadic human diseases. In recent years STEC strains belonging to serogroup O178 have been commonly isolated from cattle and food of bovine origin in South America and Europe. In order to explore the significance of these STEC strains as potential human pathogens, 74 German and Argentinean E. coli O178 strains from animals, food and humans were characterized phenotypically and investigated for their serotypes, stx-genotypes and 43 virulence-associated markers by a real-time PCR-microarray. The majority (n = 66) of the O178 strains belonged to serotype O178:H19. The remaining strains divided into O178:H7 (n = 6), O178:H10 (n = 1), and O178:H16 (n = 1). STEC O178:H19 strains were mainly isolated from cattle and food of bovine origin, but one strain was from a patient with hemolytic uremic syndrome (HUS). Genotyping of the STEC O178:H19 strains by pulsed-field gel electrophoresis revealed two major clusters of genetically highly related strains which differ in their stx-genotypes and non-Stx putative virulence traits, including adhesins, toxins, and serine-proteases. Cluster A-strains including the HUS-strain (n = 35) carried genes associated with severe disease in humans (stx2a, stx2d, ehxA, saa, subAB1, lpfAO113, terE combined with stx1a, espP,iha). Cluster B-strains (n = 26) showed a limited repertoire of virulence genes (stx2c, pagC, lpfAO113,espP, iha). Among O178:H7 strains isolated from deer meat and patients with uncomplicated disease a new STEC variant was detected that is associated with the genotypestx1c/stx2b/ehxA/subAB2/espI/[terE]/espP/iha. None of the STEC O178 strains was positive for locus of enterocyte effacement (LEE)- and nle-genes. Results indicate that STEC O178:H19 strains belong to the growing group of LEE-negative STEC that should be considered with respect to their potential to cause diseases in humans. [ABSTRACT FROM AUTHOR]

Polymeric membranes are frequently used for bone regeneration in oral and periodontal surgery. Polymers provide adequate mechanical properties (i.e., Young's modulus) to support oral function and also pose some porosity with interconnectivity to permit for cell proliferation and migration. Bacterial contamination of the membrane is an event that may lead to infection at the bone site, hindering the clinical outcomes of the regeneration procedure. Therefore, polymeric membranes have been proposed as carriers for local antibiotic therapy. A literature search was performed for papers, including peer-reviewed publications. Among the different membranes, collagen is the most employed biomaterial. Collagen membranes and expanded polytetrafluoroethylene loaded with tetracyclines, and polycaprolactone with metronidazole are the combinations that have been assayed the most. Antibiotic liberation is produced in two phases. A first burst release is sometimes followed by a sustained liberation lasting from 7 to 28 days. All tested combinations of membranes and antibiotics provoke an antibacterial effect, but most of the time, they were measured against single bacteria cultures and usually non-specific pathogenic bacteria were employed, limiting the clinical relevance of the attained results. The majority of the studies on animal models state a beneficial effect of these antibiotic functionalized membranes, but human clinical assays are scarce and controversial. [ABSTRACT FROM AUTHOR]