Classroom ventilation and indoor air quality-results from the FRESH intervention study.

Inadequate ventilation of classrooms may lead to increased concentrations of pollutants generated indoors in schools. The FRESH study, on the effects of increased classroom ventilation on indoor air quality, was performed in 18 naturally ventilated classrooms of 17 primary schools in the Netherlands during the heating seasons of 2010-2012. In 12 classrooms, ventilation was increased to targeted CO2 concentrations of 800 or 1200 ppm, using a temporary CO2 controlled mechanical ventilation system. Six classrooms were included as controls. In each classroom, data on endotoxin, ß(1,3)-glucans, and particles with diameters of <10 µm (PM10 ) and <2.5 µm (PM2.5 ) and nitrogen dioxide (NO2 ) were collected during three consecutive weeks. Associations between the intervention and these measured indoor air pollution levels were assessed using mixed models, with random classroom effects. The intervention lowered endotoxin and ß(1,3)-glucan levels and PM10 concentrations significantly. PM10 for instance was reduced by 25 µg/m³ (95% confidence interval 13-38 µg/m³) from 54 µg/m³ at maximum ventilation rate. No significant differences were found between the two ventilation settings. Concentrations of PM2.5 and NO2 were not affected by the intervention. Our results provide evidence that increasing classroom ventilation is effective in decreasing the concentrations of some indoor-generated pollutants.

[Patient satisfaction after transverse blepharotomy (Wies procedure) in the management of senile entropion - a postoperative analysis]. / Die horizontale Lidspaltung bei Involutionsentropium - eine Befragung zur postoperativen Zufriedenheit.

BACKGROUND: Senile entropion is a common pathology of the aging lid. Chronic irritation of the conjunctiva and/or cornea is bothersome to the patients and may cause severe complications. Surgical intervention is typically required. We present data from a postoperative telephone interview of 38 patients undergoing 43 entropion repairs, which were performed as transverse blepharotomy according to Wies in the modification of Collin. PATIENTS AND METHODS: In a retrospective study 43 surgeries were evaluated. Mean follow-up time was 34 (6-96) months. 8 entropions were recurrencies, one surgery was performed after ectropion. Patient satisfaction, complications and symptoms after surgery and frequency of repeated surgery were evaluated by sending a questionnaire with subsequent telephone survey. RESULTS: The transverse blepharotomy was successful in 31 cases (91.2 %) as a primary surgical intervention. In recurrencies, a successful result was obtained in 8 lids (88.9 %). 4 lids underwent further surgical procedures: 2/43 eyes developed another entropion (4.7 %), one exhibited overcorrection/ectropion and one developed a lid malposition which could not be exactly specified during telephone interview. 2 patients complained of newly appearing dry eye symptoms/foreign body sensation (4.7 %) and one each suffered from granuloma due to incompletely removed suture material and fistulation. CONCLUSION: Although being a historically "old" surgical technique to treat involutional entropion, horizontal blepharotomy according to Wies proved successful in the vast majority of our patients. The overall success rate in our series was 90.7 % and rose to 91.2 % in cases of primary surgery. Even in recurrent disease, 88.9 % of surgeries resulted in sustained correction of the lid malposition.

[Clinical results of encapsulated bleb removal after Ahmed glaucoma valve implants]. / Klinische Ergebnisse von Kapselausschneidungen nach Ahmed-Implantaten.

In refractory glaucoma, surgical intervention is required which in most cases aims at artificially increasing the drainage of aqueous humor from the eye. One surgical option used with increasing frequency is the implantation of episcleral glaucoma drainage devices (GDD). The clinical success of such devices is often limited by excessive wound healing and scar formation around the base plate of the implant. In severe cases, which seem to occur most frequently in pediatric patients, the rapid formation of a thick, water-impervious fibrotic capsule within months after initial implantation leads to diminished aqueous resorption and an increase in intraocular pressure to presurgical values. Often additional surgical interventions become necessary. Excision of the fibrotic tissue around the implant may help to salvage function and might be an alternative to the more commonly practiced implantation of an additional GDD. In the case series presented here the surgical method of capsular revision is described and the clinical outcome in 11 eyes from 10 patients is reported.

[Osteogenesis imperfecta and glaucoma. A case report]. / Osteogenesis imperfecta und Glaukom. Eine Fallbeschreibung.

Osteogenesis imperfecta (OI) is a connective tissue metabolic disorder with autosomal inheritance. Ocular involvement includes blue sclera, myopia, glaucoma and keratoconus in addition to bone synthesis defects. We report the case of a male patient with OI who suffered from progressive visual field defects and advanced glaucomatous optic atrophy and underwent trabeculectomy on both eyes. Intraocular pressures (IOP) of 7-11 mmHg were measured 1 year postoperatively. This report illustrates peculiarities in the surgical therapy of open angle glaucoma in patients with OI as well as the options for complication management.