SARS-CoV-2 monitoring at three sewersheds of different scales and complexity demonstrates distinctive relationships between wastewater measurements and COVID-19 case data.

Wastewater monitoring of SARS-CoV-2 presents a means of tracking COVID-19 community infection dynamics on a broader geographic scale. However, accounting for environmental and sample-processing losses may be necessary for wastewater measurements to readily inform our understanding of infection prevalence. Here, we present measurements of the SARS-CoV-2 N1 and N2 gene targets from weekly wastewater samples at three sites in Hamilton County, Ohio, during an increase and subsequent decline of COVID-19 infections. The concentration of N1 or N2 RNA in wastewater, measured over the course of six months, ranged from below the detection limit to over 104 gene copies/l, and correlated with case data at two wastewater treatment plants, but not at a sub-sewershed-level sampling site. We also evaluated the utility of a broader range of variables than has been reported consistently in previous work, in improving correlations of SARS-CoV-2 concentrations with case data. These include a spiked matrix recovery control (OC43), flow-normalization, and assessment of fecal loading using endogenous fecal markers (HF183, PMMoV, crAssphage). We found that adjusting for recovery, flow, and fecal indicators increased these correlations for samples from a larger sewershed (serving ~488,000 people) with greater industrial and stormwater inputs, but raw N1/N2 concentrations corresponded better with case data at a smaller, residential-oriented sewershed. Our results indicate that the optimal adjustment factors for correlating wastewater and clinical case data moving forward may not be generalizable to all sewersheds.

Twenty-first century molecular methods for analyzing antimicrobial resistance in surface waters to support One Health assessments.

Antimicrobial resistance (AMR) in the environment is a growing global health concern, especially the dissemination of AMR into surface waters due to human and agricultural inputs. Within recent years, research has focused on trying to understand the impact of AMR in surface waters on human, agricultural and ecological health (One Health). While surface water quality assessments and surveillance of AMR have historically utilized culture-based methods, culturing bacteria has limitations due to difficulty in isolating environmental bacteria and the need for a priori information about the bacteria for selective isolation. The use of molecular techniques to analyze AMR at the genetic level has helped to overcome the difficulties with culture-based techniques since they do not require advance knowledge of the bacterial population and can analyze uncultivable environmental bacteria. The aim of this review is to provide an overview of common contemporary molecular methods available for analyzing AMR in surface waters, which include high throughput real-time polymerase chain reaction (HT-qPCR), metagenomics, and whole genome sequencing. This review will also feature how these methods may provide information on human and animal health risks. HT-qPCR works at the nanoliter scale, requires only a small amount of DNA, and can analyze numerous gene targets simultaneously, but may lack in analytical sensitivity and the ability to optimize individual assays compared to conventional qPCR. Metagenomics offers more detailed genomic information and taxonomic resolution than PCR by sequencing all the microbial genomes within a sample. Its open format allows for the discovery of new antibiotic resistance genes; however, the quantity of DNA necessary for this technique can be a limiting factor for surface water samples that typically have low numbers of bacteria per sample volume. Whole genome sequencing provides the complete genomic profile of a single environmental isolate and can identify all genetic elements that may confer AMR. However, a main disadvantage of this technique is that it only provides information about one bacterial isolate and is challenging to utilize for community analysis. While these contemporary techniques can quickly provide a vast array of information about AMR in surface waters, one technique does not fully characterize AMR nor its potential risks to human, animal, or ecological health. Rather, a combination of techniques (including both molecular- and culture-based) are necessary to fully understand AMR in surface waters from a One Health perspective.

[International relationships in ophthalmology in the German Democratic Republic (GDR)]. / Internationale Beziehungen der Augenheilkunde in der DDR.

International relationships in ophthalmology in the former German Democratic Republic (GDR) were directed by the government and predominantly promoted relationships to socialist countries in Eastern Europe. The lack of freedom of travel, restrictions of import for scientific journals and general prevention of contacts by the State security service led to a stagnation in daily practice and in research, mainly from 1961 until 1989.

[Molteno/von Denffer drainage implants in therapy-refractory glaucomas]. / Drainageimplantat nach Molteno/von Denffer bei therapierefraktären Glaukomen.

BACKGROUND: In glaucoma eyes in which the pressure regulation was not possible with drugs and surgery or which were blind already, we treated the patients with a Molteno implant by von Denffer. MATERIALS AND METHODS: In 10 years (1995 to 2004) we treated 19 eyes with a glaucoma drainage device -- the Molteno implant developed by von Denffer. The average age of the patients was 64 (range: 15 to 77) years. On average 3,1 operations were realised before the implant. The average eye pressure was 44 mm Hg preoperatively. Our patients suffered from different glaucomatous diseases: 7 primary glaucomas (congenital, open and narrow angle glaucoma) and secondary: neovascular glaucoma (4), PEX glaucoma (2), traumatic glaucoma (3) and postoperative glaucoma (3). RESULTS: The intraocular pressure had a successful outcome of under 20 mm Hg in 13 eyes, 5 patients out of these were treated with 1 to 3 drugs. Early complications (flat anterior chamber, hyphaema, hypotonia) were reversible. Late complications were phthisis bulbi (3), explantation of the implant (2) and one evisceration bulbi. We found an improvement of the visual acuity in 4 cases in traumatic and postoperative glaucoma. The stabilisation of visual acuity was possible in primary glaucoma. CONCLUSIONS: The implantation of the Molteno implant by von Denffer is an ultimate ratio in eyes with persistent high intraocular pressure. A durable reduction of the pressure is possible in two-thirds and the conservation of the bulbus was achieved in three-fourths of the patients.

[Long-term results of penetrating keratoplasty with different trephine systems -- a clinical investigation from the university eye hospital of halle/saale and the eye clinic of the helios hospital aue]. / Langzeitergebnisse der perforierenden Keratoplastik mit verschiedenen Trepansystemen -- Eine klinische Studie aus der Universitätsaugenklinik Halle/Saale und der Augenklinik des Helios Klinikums Aue.

BACKGROUND: The results of penetrating keratoplasty in two centres for cornea transplantation were investigated with regard to the following parameters: the trephine system used, the origin of the donor cornea, the influence on the postoperative astigmatism and other aspects. PATIENTS AND METHODS: The retrospective clinical investigation reports about the results of 186 patients with penetrating keratoplasty from the University Eye Hospital of Halle and 204 patients from the Eye Clinic of the Helios hospital Aue. RESULTS: Three trephine systems have been used: the Hessburg-Barron trephine, the guided trephine system (GTS) and the Asmotom device. There were no significant differences between them concerning visual acuity after 12 months postoperatively. The results were highly significantly better (p = 0.003 Halle; p = 0.001 Aue) when using larger diameters of the trephine (7.5 mm and 8.0 mm). The origin of the donor cornea ("fresh" cornea from a deceased subject or organ cultivated cornea from a cornea bank) had no influence on visual outcome after twelve months (p > 0.8). There were less wound dehiscences using the double running suture in comparison with other techniques (p = 0.05). The removal of suturing material was not effective in reducing postoperative astigmatism (p > 0.11). There was no increase in astigmatism when leaving the sutures in situ (p > 0.25). CONCLUSIONS: Generally, each of the three trephine systems can be recommended for clinical use. The trephination should be done with trephine diameters of 7.5 mm or 8.0 mm. A timely operation guarantees better visual acuity at one year postoperatively.

[25 years Cardona keratoprosthesis after severe chemical eye burns--long-term outcome of 4 eyes]. / 25 Jahre Cardona-Keratoprothese nach schweren Augenverätzungen--Langzeitergebnisse an vier Augen.

BACKGROUND: A keratoprosthesis should be implanted only in such eyes, in which a risk-keratoplasty (HLA-typified) was unsuccessful. However, the keratoprosthesis is an ultima ratio procedure. PATIENTS AND METHODS: 25 years ago a modified keratoprosthesis according to Cardona was implanted in 2 patients in 4 eyes with very heavy alkali burns. Complications are described in a 25-years follow up in all of the 4 eyes. The loss of visual acuity was the first alarm sign for each complication. Reversible epicorneal complications are: epithelium over-running in front of the prosthesis, retraction of mucosa, lyophilized sclera including fistulation and dislocation or extrusion of the prosthesis. The opposite of the epithelium over-running was the development of a retro-prosthetic membrane as a sign for over-running inside. Severe (intraocular) complications were: macular oedema and choriodal detachment in bulbar hypotension, vitreal haemorrhage, retinal detachement and exacerbation of a secondary glaucoma. An endophthalmitis and later a phthisis bulbi were observed due to a permanent fistulation. RESULTS: Exactly after 25 years the visual acuity is in both patients: patient 1: 0.6 p and amaurosis; patient 2: 1.3 p and 0.8 p. The visual field is limited by the keratoprosthesis usually to 30 to 40 degrees, in our both eyes with secondary glaucoma the visual field was reduced to 10 and 25 degrees. CONCLUSIONS: Bad auspices bring many complications and many operations. The patients should be sent back to the surgeons very early. Besides, a psychological guidance is important for the patients.

[Carl Gustav Carus (1789-1869) and his single ophthalmologic publication]. / Carl Gustav Carus (1789-1869) und seine einzige ophthalmologische Publikation.

Carl Gustav Carus is the most important personality in medicine in Dresden in the first half of the 19th century. He is well known for his manifold activity as a doctor, scientist and philosopher as well as a landscape painter of the romantic period. His literary output is estimated at about 25,000 printed pages. There is just one paper which touches ophthalmology and teratology: in 1842, Carus described the monstrous head of a pig with cyclopia. The discussion follows an idealistic line with comparative anatomical studies in fauna and flora.

[Carl Ferdinand von Graefe (1787-1840) and his relevance to ophthalmology]. / Carl Ferdinand von Graefe (1787-1840) und seine Relevanz für die Augenheilkunde.

This paper gives a short biography of Carl Ferdinand von Graefe, father of the most famous German oculist Albrecht von Graefe (1828-1870). On the occasion of his 200th birthday his work, in particular in the field of ophthalmology (cataract operations, prescription formulae, and therapeutic procedures, publications) is given due recognition. Although C.F. von Graefe was first and foremost a surgeon and the creator of plastic surgery of the face, he may also be considered one of the pioneers of ophthalmology, which, in the first third of the last century, had not yet achieved the status of an independent specialty.

[Primary isolated amyloidosis--a rare corneal degeneration]. / Die primäre isolierte Amyloidose--eine seltene Hornhautdegeneration.

Report on a 47-year-old woman patient in whom an eccentric tumorlike corneal change was found in the left eye. Only after penetrating keratoplasty was the exact diagnosis--a primary isolated corneal amyloidosis--established, by light microscopic examination. The graft remained clear. Familial and systemic amyloidosis were ruled out by further examinations. The prognosis is favorable.

[Histopathologic study following optic keratoprosthesis. A case report]. / Histopathologische Untersuchung nach optischer Keratoprothese. Eine kasuistische Darstellung.

The authors present the case history of a patient in whom an optical keratoprosthesis was implanted after recurrent corneal ulcers in aphakia at the age of 80. The globe was examined histologically post mortem. A solid retroprosthetic membrane, a hemorrhage in the vitreous and retinal detachment after trauma were found to be the causes of the visual disorder. Wound healing following implantation of a keratoprosthesis is discussed in the light of the histopathological findings.

[Intraarterial injection of Tolazolinhydrochlorid in retinal arterial occlusions. Our experiences with puncture of the carotid artery (author's transl)]. / Intraarterielle Injektion von Vasodilatantien bei arteriellen Netzhautgefässverschlüssen. Unsere Erfahrungen mit der Karotispunktion

In partial and total retinal arterial occlusions we have been giving intracarotideal Tolazolinhydrochlorid since 1969. In the beginning we have prepared surgically the common carotid artery, at present this puncture is done percutanously. The author describes the surgical procedure and the results. A significant improvement of the visual acuity and of the visual field was present in the cases with intraarterial injection.

[Homonymous hemianopsia and oral ovulation inhibitors. A neuro-ophthalmologic consideration]. / Homonyme Hemianopsie unter oralen Ovulationshemmern. Eine neuro-ophthalmologische Betrachtung

PIP: The case of a 41-year-old woman who developed homonymous hemianopsia after treatment with Ovosiston and Non-ovlon is reported. The patient had had migraine headaches and eye flickering for 5 years previously. Left homonymous hemianopsia was diagnosed at examination, but neurological, hematological, and cerebrovascular findings were normal ex cept that the A. cerebri posterior was not visible at angiography. Hemi anopsia was unchanged 7 months after diagnosis. The social and occupati onal repercussions of the disorder are discussed.^ieng