Scleral fixation of posterior chamber intraocular lenses using fascia lata to cover the knots

BACKGROUND AND OBJECTIVE: To describe the use of fascia lata to cover the polypropylene knots of scleral fixated posterior chamber intraocular lenses (PCIOL). PATIENTS AND METHODS: Fascia lata was used to cover the knots of scleral fixated PCIOL in 5 eyes with significant scleral thinning. Four of the 5 eyes had the PCIOL insertion and the fascia lata patching in the same setting. The fifth eye previously had scleral fixated PCIOL with late suture erosion through a partial thickness scleral flap. RESULTS: There was no suture exposure or graft thinning throughout a follow-up period of 8 to 16 months. The eyes tolerated the fascia lata well with no early or late postoperative complications. CONCLUSION: Fascia lata provides an effective means to cover the knots of scleral fixated PCIOL, especially in aphakic patients with significant scleral thinning.     

Douleur, stratégies d’ajustement et détresse psychologique. Analyse complémentaire sur la validité française du coping strategies questionnaire

Coping strategies implemented by chronic pain patients play an important part in their biopsychosocial experience of life. This research aimed to confirm the validity of a coping scale and evaluate the role of different coping strategies in patient adjustment to intensity of pain and psychological distress. One hundred and thirty patients from the Pain Center of the University Hospital of ‘La Timone’ (Marseille) completed a questionnaire including the Coping Strategies Questionnaire (CSQ), the Hospital Anxiety and Depression Scale and some questions concerning the intensity of their pain. Results confirm the psychometric values of the French version of the CSQ. Several dimensions of the CSQ predict the general level of pain, anxiety and depression. Taking into account these strategies is a fruitful approach to describing the complexity of the pain experience and to thinking about how to deal with pain.     

Analyse des représentations sociales du cancer et de la souffrance

Social psychology makes it possible to link individual and social interpretations of the suffering associated with the experience of cancer. The aim of this field of psychology is to offer a branch of research that focuses on studying the potential impact of the meanings associated with cancer and societal models of coping. The psychosocial analysis of the links between suffering and cancer underlines the role of the collective experience in creating meaning with respect to suffering as well as the role of social imagery in the development of individual behaviour. This kind of analysis makes it possible to understand a significant number of the issues associated with therapeutic interaction.     

Severe hyponatremia associated with transcervical resection of a uterine myoma

Purpose

Sever hyponatremia is associated with a high mortality rate. It can occur during procedures requiring irrigation with a glycine solution.

Clinical features

A 31-year old female patient underwent transcervical resection of a uterine myoma under general anesthesia. 35 minutes into surgery, a 41 min^?1 bradycardia with hypertension (150/86 mmHg) was observed, followed by a 50 cmH₂O increase in airway pressure and an expired CO₂ of 49 mmHg, a sodium of 100 mmoles L^?1 and a negative irrigation fluid water balance of 3000 mL. After administering 600 mL of 3% hypertonic saline, 60 mg of furosemide, performing a transvaginal puncture to release the extravased fluid in the peritoneal cavity, and artificial ventilation for 6 h, positive outcome was finally achieved.

Conclusions

The resorption syndrome during transcervical resection of a uterine myoma is linked to the passage into the blood of the irrigation fluid that contains glycine. The symptoms are hidden during general anesthesia and severe hyponatremia can occur before the syndrome is detected.     

Cocaine induces the expression of homer 1b/c, homer 3a/b, and hsp 27 proteins in rat cerebellum

The long homer proteins 1b/c, 2a/b, and 3a/b play an important role in postsynaptic neurons by clustering glutamate receptors and by coupling the receptors with various intracellular effectors. Using immunohistochemistry and Western-blot analysis, this study shows that the expression of the long homer isoforms 1b/c and 3a/b was induced in rat cerebellum in response to cocaine administration. Acute treatment produced a very robust induction of both constitutive isoforms, whereas repeated treatment for 10 days induced a large expression of homer 1b/c and a more modest increase in the expression of the 3a/b isoform. The heat shock protein hsp 27 was also considerably induced in the cerebellum of cocaine-treated rats, suggesting that it participates in assisting the correct folding of proteins, and by counteracting oxidative stress mechanisms triggered by the psychostimulant. In addition of being expressed in Purkinje neurons, homer 3a/b and hsp 27, but not homer 1b/c, were localized within Bergmann glial cells and in their extensions, which surround Purkinje cells, as assessed by coimmunoreactivity with glial fibrillary acidic protein. Cocaine was also found to induce both proteins in the Bergmann glial cells. Since we found that homer 3a/b colocalized with the mGluR1 receptor in Purkinje cells, the data suggest that the long homer isoforms are involved in the cocaine-induced neuroplasticity that takes place in the cerebellum, by reshaping postsynaptic densities in Purkinje cell dendrites.