The detrimental effects of delayed intravitreal anti-VEGF therapy for treating retinal pathology: lessons from a forced test-case.

PURPOSE: Determine the anatomical consequences of delaying intravitreal injection (IVI) therapy with anti-vascular endothelial growth factor (anti-VEGF) in patients using treat-and-extend (T&E) protocol. METHODS: Retrospective medical record review of consecutive patients receiving intravitreal anti-VEGF therapy using T&E protocol prior to and during the COVID-19 pandemic. RESULTS: The study included 923 eyes of 691patients; 58.8% (543 eyes), 25% (231 eyes), and 16.2% (149 eyes) had nvAMD, DME, and RVO, respectively. Mean (± SD) patient age was 74.5 ± 11.7 years. Overall, 56.3% of cases had a delay in therapy of ≥ 7 days; specifically, 56.2%, 61.5%, and 49.0% of nvAMD, DME, and RVO cases, respectively, had a delay. The median delay in days, among cases ≥ 7 days late was 21 (IQR 7 to 42) days, with 21(IQR 7 to 45), 22.5(IQR 8 to 42), and 14(IQR 7 to 33.5) days of delay among patients with nvAMD, DME, and RVO, respectively. Delaying therapy by ≥ 7 days resulted in increased CST in 47.5%, 58.5%, and 58.9% of nvAMD, DME, and RVO cases, respectively, with a significant correlation between the length of treatment delay and the increase in CST (Spearman's rho: 0.196; p < 0.001). CONCLUSIONS: Delayed IVI treatment in eyes treated with T&E protocol was associated with increased macular thickness with potential consequences with respect to visual outcome.

Effect of supercritical carbon dioxide processing on Vibrio parahaemolyticus in nutrient broth and in oysters (Crassostrea gigas).

This study aimed to evaluate the technical feasibility of supercritical carbon dioxide (sc-CO2) treatment for Vibrio parahaemolyticus inactivation in oysters (Crassostrea gigas) and in nutrient broth. For this purpose, a variable-volume reactor was used as experimental system and a 23 factorial design was adopted considering the mass ratio between carbon dioxide and the product, pressurization and depressurization rate and pressurization cycles. Through statistical analysis of the experimental data, the mass ratio of 1:0.8 (product:carbon dioxide), depressurization rate of 10.0 MPa/min and one cycle of pressurization was determined as the best process condition to eliminate V. parahaemolyticus, and this was the condition used for the inactivation kinetic analysis. Comparison between the inactivation kinetics of V. parahaemolyticus showed that the behavior of this microorganism inactivation depends on the environment in which it operates and its initial count. The results confirm that the supercritical carbon dioxide is effective in inactivating microorganisms in oysters, including pathogenic V. parahaemolyticus, demonstrating the potential of this technology in the food industry.

Acceso y calidad del agua para el consumo humano en Santa Marta como indicador de inequidad en salud / Access and quality of water for human consumption in Santa Marta as an indicator of inequity in health

Objetivo: Determinar el acceso y la calidad del agua para el consumo humano en el área urbana de Santa Marta, por ser este un determinante del proceso salud­enfermedad que se debe transformar desde el marco de los Objetivos de Desarrollo del Milenio para el año 2015. Método: Estudio de corte transversal con 1557 viviendas seleccionadas por muestreo probabilístico por conglomerados, en las cuales se aplicó una encuesta de acceso al agua segura domiciliaria. Por cada comuna se tomó una muestra de agua para evaluar su calidad a través de la técnica de filtración de membrana y sustrato definido. Se utilizó Epi Info 7 para analizar los datos a través de asociación con Odds Ratio y para georeferenciarlos. Resultados: 94,7% de las viviendas tienen servicio de agua domiciliaria pero el 49,7% presentó cortes frecuentes del servicio. Las relaciones entre: acceso al agua domiciliaria y estrato (OR=4,27), y cortes del servicio y estrato (OR=2,61) fueron significativas (p<0,0001). Cuatro de las nueve muestras resultaron contaminadas con coliformes. Conclusión: Los tomadores de decisiones deben garantizar la calidad y acceso permanente al agua segura para el consumo humano a todas las personas para avanzar en la reducción de las brechas de inequidad en salud.

Objective: To determine the access and quality of water for human consumption in the urban area of Santa Marta as one of Social Determinants of Health that must be transformed in the framework of the Millennium Development Goals by 2015. Methods: A cross-sectional study was carried out with 1557 selected houses by cluster samplings, which were surveyed of household access to safe water. A water sample was taken from each district of Santa Marta in order to evaluate its quality of it through the membrane filtration technique and defined substrate. Epi Info 7 was used to analyze the data through association with Odds Ratio and to georeference them. Results: 94.7% of houses have home water service but 49.7% showed frequent service cuts. The relationship between household water access and socioeconomic stratum (OR = 4.27), and between service cuts and socioeconomic stratum (OR = 2.61) were significant (p < 0.0001). Four of the nine samples were contaminated with coliform. Conclusion: Decision makers must ensure quality and permanent access to safe water for human consumption to all people, so that there is an advance in reducing the health inequality gaps.