Quantitative changes in the corneal endothelium and central corneal thickness during anterior chamber inflammation: A systematic review and meta-analysis.

PURPOSE: To establish the effects of anterior chamber inflammation (ACI) on the corneal endothelium parameters and central corneal thickness (CCT). METHODS: We conducted a comprehensive literature review using medical databases (PubMed, EMBASE, VHL, and medRxiv) on March 8, 2023, for studies that included patients with ACI who had undergone specular microscopy or pachymetry. Case series with >10 patients, cross-sectional, case-control, and cohort studies were included. The risk of bias was assessed using CLARITY tools and validated scales such as those by Hassan Murad et al. and Hoy et al. A narrative synthesis and a quantitative standardized mean difference meta-analysis, I2 heterogeneity assessment, and publication bias tests were conducted. The study was registered in PROSPERO (CRD42023420148) and approved by the Universidad del Rosario ethical committee (DVO005 2277- CV1712). RESULTS: Thirty-four studies, encompassing 1,388 eyes with ACI, were included. Compared with healthy controls, overall, ACI eyes show significant mean differences in endothelial parameters (endothelial cell density (ECD), coefficient of variation (CV), and hexagonality (HEX)) (P < 0.05). In the subgroup analysis compared with healthy controls, both active and chronic-recurrent ACI demonstrated a reduced ECD. An increased CV was observed in active, inactive, and chronic-recurrent ACI. Lower HEX was evident in inactive, acute, and chronic-recurrent ACI, while both active and acute ACI exhibited high CCT. CONCLUSION: ACI leads to significant alterations in endothelial parameters and CCT. The primary contributors to these changes are increased IOP, uveitis duration, and intraocular surgeries. Further studies are needed to explore the impact of ACI etiology on the endothelium, potential biases in IOP measurements during acute ACI episodes, and the potential necessity for monitoring the endothelial parameters and CCT in patients with chronic ACI.

Occupational accidents by biological risk in clinical laboratory workers. Yopal, Colombia. / Accidentes laborales por riesgo biológico en trabajadores de laboratorio clínico. Yopal, Colombia.

BACKGROUND: Clinical laboratory workers are at permanent risk of suffering an occupational accident due to exposure to biohazard. These accidents may cause severe diseases, such as HIV, HBV or HCV. OBJECTIVE: To describe the behavior of accidents due to occupational exposure to biohazard agents, and the characteristics of reports of occupational accidents in clinical laboratories in Yopal, Colombia. MATERIAL AND METHODS: Observational descriptive study with exploratory component and retrospective analysis of incident report forms of presumed occupational accidents. RESULTS: For the period between January 1, 2016, to December 31, 2018, an occupational accident percentage of 24.6 (95% confidence interval [95% CI], 16.7-32.5) was estimated, and an underreporting percentage of 39.3 (95% CI, 21.3-57.3). The main reasons for not reporting were a perceived lack of time (45.4%), and a diminished perception of risk exposure (36.4%). In contrast, factors associated with the probability of having less occupational accidents included being hired for service time (prevalence ratio [PR] = 0.19; 95% CI, 0.04-0.89; p = 0.034), and the permanent use of personal protective equipment (PR = 0.14; 95% IC, 0.02-0.88; p =0.036). CONCLUSION: Accident statistics in clinical laboratories prove the necessity to systematically reorganize risk management strategies that take into account human factor, organizational culture and control mechanisms.

INTRODUCCIÓN: las personas que trabajan en laboratorios clínicos están en permanente riesgo de sufrir accidentes laborales por la exposición a material biológico. Estos accidentes pueden causar enfermedades graves, como hepatitis B, hepatitis C o infección por VIH. OBJETIVO: describir el comportamiento de la accidentalidad por exposición ocupacional a agentes de riesgo biológico y las características del reporte de accidentes de trabajo en laboratorios clínicos de Yopal, Colombia. MÉTODOS: estudio observacional descriptivo con componente exploratorio y análisis retrospectivo de formatos de reporte de presuntos accidentes de trabajo. RESULTADOS: para el periodo comprendido entre el 1 de enero de 2016 y el 31 de diciembre de 2018, se estimó una accidentalidad laboral de 24.6% (intervalo de confianza al 95% [IC 95%] 16.7-32.5) y un subregistro de 39.3% (IC 95% 21.3-57.3). Las principales razones del subregistro incluyeron percibir limitaciones de tiempo (45.4%) y considerar irrelevante la exposición (36.4%). Por otro lado, estar contratado por prestación de servicio (razón de prevalencias [RP] = 0.19, IC 95% 0.04-0.89, p = 0.034) y usar siempre el equipo de protección personal (RP = 0.14, IC 95% 0.02-0.88, p = 0.036) se asociaron con la probabilidad de sufrir menor accidentalidad laboral. CONCLUSIÓN: las estadísticas de accidentalidad en laboratorios clínicos reflejan la necesidad de reorganizar de manera sistemática las estrategias de gestión del riesgo en función del factor humano, la cultura organizacional y los mecanismos de control.