Diagnosis of bone cement implantation syndrome using point of care ultrasound examination.

Once regarded as a rare complication, the potentially fatal bone cement implantation syndrome (BCIS) has been increasingly reported. BCIS can present as transient desaturation, hypotension, cardiac dysrhythmias, and cardiovascular collapse. Diagnosis of BCIS is often clinical and confirmed with computed tomography (CT) imaging postoperatively. However, point of care ultrasound (POCUS) examination could be a helpful and timely tool to clinch the diagnosis in a sudden cardiovascular collapse. We present a case of Grade 3 BCIS where POCUS examination revealed a massive clot in the right atrium, which supports the diagnosis.

Myopization factors affecting urban elementary school students in Taiwan.

PURPOSE: To investigate factors that may contribute to the myopization of urban elementary school students in Taiwan. METHODS: Grades 1 to 6 students of the same racial background (n = 1894; mean age, 6.3-11.3 years) in three schools, located in Tamsui, Taichung, and Tainan, were refracted to obtain the best corrected visual acuity. The refractive power needed for best corrected visual acuity was used for subsequent statistical analysis. On behalf of their children, parents also completed a questionnaire on six categories of potential myopization variables. Correlation between these variables and the increase or decrease in the refractive error was assessed. The predictive value of each variable was also calculated based on linear regression analysis. RESULTS: The overall mean refractive error in grades 1 to 6 was -0.37, -0.68, -1.33, -1.60, -1.90, and -2.51 D, respectively. The prevalence of myopia (-1.00 D or more minus) showed a significant difference between grades 2 and 3 and, again, between grades 5 and 6. In addition, 20 potential modulating factors were evaluated; 65.9% of the change in the refractive error could be explained by four: (1) lag in optimal correction, defined as a -1.00-D deficit between new refractive error and current optical correction; (2) outdoor spectacle wear; (3) spectacles for different working distances; and (4) hours spent on reading and writing on weekdays. In contrast, outdoor time and the intake frequency of 36 food items both held very low predictive values of 0.2% and 2.5%, respectively. CONCLUSIONS: Each variable associated with the refractive error has a different predictive value, either positive or negative. Ultimately, the interplay of these variables decides the outcome of the pattern and the degree of school myopia.

Change in corneal shape and corneal wave-front aberrations with accommodation.

This study investigated the change in corneal curvature and corneal wave-front aberrations with accommodation. The corneal curvature of the right eyes of 12 young adults was measured using a corneal topography system, while subjects fixated far (4.0 m) and near (0.2 m) targets with their left eyes. Convergence was controlled. Both the mean corneal radius at the vertex and the shape parameter significantly increased from the far to the near viewing condition. No significant change in root mean square of wave-front aberrations with accommodation was observed for the group, but there was individual variation in the change of wave-front aberration. A significant mean change for the group in both x-axis coma and spherical aberration was found. The change in corneal surface with accommodation suggests an increase in peripheral curvature with flattening at the vertex.