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Les Cabinotiers Temporis Duo Grand Complication Openface is a lyrical celebration of time
Les Cabinotiers Temporis Duo Grand Complication Openface is a lyrical celebration of time

Khaleej Times

time6 days ago

  • Business
  • Khaleej Times

Les Cabinotiers Temporis Duo Grand Complication Openface is a lyrical celebration of time

In the world of watchmaking, few names carry the weight of history quite like Vacheron Constantin. The Swiss maison's 270-year legacy of being the world's oldest watchmaker in continuous production perfectly embodies humankind's quest to capture time and distil its mysteries within the confines of a metal case. Across that remarkable journey, the brand has tackled the grandest of complications and pushed the boundaries of horological expression. Yet, even for this fabled watchmaker, bringing together a split-seconds chronograph, a minute repeater, and a tourbillon in a wristwatch remains an extraordinary feat. These three complications, each formidable on its own, have tested generations of craftsmen. While they have shared space in the occasional grand pocket watch, uniting them in a single wristwatch remains a rare achievement. Vacheron Constantin first explored this daring combination in 2022 with a one-of-a-kind Les Cabinotiers timepiece powered by calibre 2757. Now, with the singular Les Cabinotiers Temporis Duo Grand Complication Openface — another one-off creation — the maison reveals the intricate beauty of the movement through a sapphire dial and caseback. Seen up close, the Temporis Duo Grand Complication Openface is a breathtaking spectacle. Its open worked sapphire dial, scarcely half a millimetre thick, offers an intimate view of the mechanical ballet beneath. Driving this marvel is the calibre 2757 S, a masterpiece of modern watchmaking composed of 696 meticulously finished components. From the split-seconds chronograph that captures parallel moments with elegant precision, to the minute repeater that strikes the hours, quarters, and minutes with remarkable clarity, every function reflects Vacheron Constantin's relentless pursuit of perfection. Anchoring it all is the tourbillon regulator, fitted with a spherical hairspring, quietly resisting the pull of gravity to keep time steady and true. And yet, the watch wears its technical brilliance lightly. Thoughtful choices such as titanium, silicon, and aluminium within the movement help reduce weight and friction, enhancing performance and preserving energy. Together, they sustain a generous 50-hour power reserve, even with the chronograph engaged. Frosted and polished surfaces, warm 5N pink gold accents, and a rich olive-green strap lend contemporary flair to this vessel of timeless craft. The 45mm pink gold case frames it all, substantial yet harmonious on the wrist. But beyond the complexity and beauty, there is a deeply human story. Much like the cabinotiers — the master watchmakers of Geneva who, centuries ago, crafted bespoke marvels for discerning patrons — a single artisan at Vacheron Constantin saw this creation through from start to finish. From the first bevel to the final adjustment, every polished edge, every satin-brushed surface, every hidden screw speaks of patience, skill, and a craft reverently passed down through generations. With the Les Cabinotiers Temporis Duo Grand Complication Openface, Vacheron Constantin invites us to witness the passage of time, to feel it, and to hear it. This is not merely a technical triumph, but a lyrical celebration of time's fleeting beauty, captured forever in metal, sapphire, and sound.

RSV Raises Risk for Diverse Complications Across Adulthood
RSV Raises Risk for Diverse Complications Across Adulthood

Medscape

time11-07-2025

  • Health
  • Medscape

RSV Raises Risk for Diverse Complications Across Adulthood

Respiratory syncytial virus (RSV) infections were associated with significantly increased risk for complications beyond pulmonology, including poor kidney outcomes and cardiovascular conditions, according to data from a pair of new studies. In a study of nearly 45,000 individuals published online in Influenza and Other Respiratory Viruses , Wang Chun Kwok, MD, of the University of Hong Kong, Hong Kong, and colleagues compared data from 41,206 adult patients hospitalized with flu and 3565 hospitalized for RSV infections at centers in Hong Kong. Overall, patients with RSV infection had significantly higher risk not only for in-patient mortality but also severe respiratory failure, secondary bacterial pneumonia, and acute kidney injury than patients with flu ( P < .001 for all). In addition, the researchers highlighted end-stage kidney disease requiring renal replacement therapy as a significant independent risk factor for poor outcomes among the RSV patients, with an adjusted odds ratio of 4.74 for in-hospital mortality ( P < .001). The patients with RSV infection also were stratified by age based on current US recommendations for RSV vaccination (aged 60 years and older, younger than 60 years, and 50-59 years). Notably, the findings of increased risk were consistent across all adult age groups, the researchers wrote. 'The risk factors for severe RSV infections demonstrated in this study provided insights on the target patient subgroups for vaccination, especially among countries and places with limited resources that do not allow vaccination for the entire population,' they concluded. Flu vs RSV The study by Kwok and colleagues provides an essential comparison, said Seyedmohammad Pourshahid, MD, assistant professor of thoracic medicine and surgery at the Lewis Katz School of Medicine at Temple University, Philadelphia, in an interview. 'For decades, influenza has set the standard in how we talk about vaccine-preventable adult respiratory disease, but with RSV vaccines now entering clinical use, it's critical to understand whether RSV deserves similar attention,' he said. 'The findings speak to more than just respiratory illness. The added burden of renal complications and secondary infections makes it clear that RSV can be a systemic threat, especially in hospitalized adults,' said Pourshahid. What stands out is that this pattern was seen across a range of adult ages, not just in the elderly, which challenges the current boundaries we draw around vaccine eligibility,' he added. Limitations of the study include not only the retrospective design but also the impact of variables including coding accuracy, variability in care, and the effect of existing vaccine use for influenza, which all play a role in shaping outcomes, said Pourshahid. However, the consistent trends seen in the study point toward a need to reevaluate RSV prevention, he said. 'From a clinical perspective, this means not underestimating RSV, especially in patients with kidney or cardiopulmonary disease. From a public health perspective, it raises the question of whether our current vaccine recommendations are too narrow,' Pourshahid told Medscape Medical News . 'With further data, particularly post-vaccine implementation, we may find that the case for broader immunization is stronger than expected,' he said. Additional studies should follow vaccinated patients to identify any changes in the patterns of complications, Pourshahid said. 'These kinds of real-world data will be essential in helping us understand not just whether the vaccine prevents RSV infection, but whether it also reduces the broader complications that come with it,' he said. In another study, published in Clinical Infections Diseases, Paulina Sudnik, MD, of the University of Rochester, Rochester, New York, and colleagues found that approximately one-third of 471 adults hospitalized with RSV experienced a cardiovascular event (CVE) during the high-risk period of the first 28 days after hospital admission. Previous studies support an association between respiratory viral infections such as influenza and COVID-19 and acute CVEs, but data on the patients with CVEs in the context of RSV are lacking, the researchers wrote. The study population included 471 adults aged 18 years and older who were hospitalized for at least 24 hours with RSV. Overall, 174 of the patients (37%) experienced a total of 270 CVEs during the high-risk period. The most common CVE was congestive heart failure (25%), followed by atrial fibrillation or flutter (13%), and myocardial infarction (9%). Although 44% of the CVEs occurred in patients with no prior history of CVEs, preexisting conditions including hypertension, congestive heart failure, atrial fibrillation, and coronary artery disease, or evidence of at least three classic cardiac risk factors were significantly associated with increased CVE risk among patients older than 65 years. Additionally, the monthly incidence of CVE after RSV infection was significantly increased compared to the pre-infection period, with incidence rate ratios of 18.5 and 1.6 during the high-risk and low-risk periods, respectively, compared to the pre-RSV period. The study was limited by several factors, including the retrospective design and a lack of data on subclinical cardiac injury and CVEs that were mild or occurred outside the hospital setting. However, the results were strengthened by the comparison of CVE data before and after RSV hospitalization, and the data may inform clinical decision-making on RSV vaccination, the researchers concluded. Translating Data Into Practice The study by Sudnick and colleagues brings needed attention to a dimension of RSV that is often overlooked, Pourshahid said in an interview. 'While most clinical focus has been on its respiratory manifestations, this work shifts the lens to cardiovascular complications and raises important questions about who is truly at risk and how those risks unfold,' he said. 'The fact that many of the events occurred in people without known heart disease adds weight to the idea that RSV can act as a stressor, revealing latent disease or perhaps even provoking new events through inflammation and hemodynamic strain,' he added. Several limitations prevent drawing broad conclusions from the study, Pourshahid told Medscape Medical News . 'The data come from a specific region and rely on retrospective review, which limits how far we can generalize, and hospitalized patients also tend to be monitored more closely, so we may be picking up events that would otherwise go unnoticed,' he said. However, these limitations don't detract from the message that the RSV's impact is wider than clinicians might often consider, he added. Clinically, the data reinforce the importance of paying close attention to the cardiovascular profile of patients admitted with RSV, even those without known cardiac disease, and contribute to conversations among policy makers and vaccine and vaccine developers, he noted. 'Preventing RSV might mean preventing not just respiratory failure but also heart failure, arrhythmias, or ischemic events, which is an important shift in how we think about vaccine value,' he said. Prospective studies that can look more closely at how these events happen, how often they recur, and whether vaccines can interrupt that trajectory,' Pourshahid said. 'As this study took place before RSV vaccines became available, we are in a key moment to begin tracking how the clinical picture changes in vaccinated populations,' he said. Kwok and Desmond Yat Hin Yap disclosed receiving research support from GlaxoSmithKline. The study by Sudnik and colleagues received no outside funding. Sudnik disclosed having no financial conflicts.

Office-Based Cataract Surgery Measures Up To ASC Cases
Office-Based Cataract Surgery Measures Up To ASC Cases

Medscape

time20-05-2025

  • Health
  • Medscape

Office-Based Cataract Surgery Measures Up To ASC Cases

Cataract surgeries performed in a surgery suite in the ophthalmologist's office had significantly lower complication rates than operations performed in an ambulatory surgery center, a study of more than 1300 operations performed by the same surgeon in both settings found. Joseph Starns 'Our study shows that performing cataract surgery in an office setting does not increase the rate or risk of adverse events,' Joseph Starns, a medical student at the Louisiana State University Health Sciences Center School of Medicine in New Orleans, told Medscape Medical News . Starns presented results of a retrospective review of 1335 cataract surgeries performed in both an office-based setting and a surgery center on May 7 at Association for Research in Vision and Ophthalmology (ARVO) 2025 Annual Meeting in Salt Lake City. All the operations were performed by Brendon Sumich, MD, a cornea specialist in New Orleans. The 656 surgeries performed in the office occurred between September 2022 and June 2024; the 679 operations in the surgery center took place from January 2021 through June 2024. Adverse Event Rates Seven patients (1%) treated in the office setting experienced an adverse event. These complications included three unplanned vitrectomies (0.46%), two returns to the operating room (0.3%), one referral for retinal complications (0.15%), and one call to 911 (0.15%). Among patients seen in the surgery center, 22 patients (3%) experienced adverse events. These included one case of endophthalmitis (0.15%), six unplanned vitrectomies (0.88%), nine returns to the operating room (1.33%), five referrals for retinal complications (0.74%), and one event of persistent corneal edema (0.15%). In the past decade or so, cataract surgeons have been transitioning straightforward operations from surgery centers to the office. Market Scope Ophthalmic Perspectives, a data analytics firm, reported the proportion of office-based cataract procedures rose to 2.2% in 2023, up from 0.5% in 2020. 'We anticipate office-based surgery becoming more popular over the next 5-10 years,' Starns told Medscape Medical News . Cataract surgery does not require patients to receive an IV or to fast before the operation, and in most cases, they already know both the setting and the support staff, Starns said. But potential drawbacks can include more difficulty for the operating team to control patient anxiety and the inability to combine the cataract surgery with other procedures, such as minimally invasive glaucoma surgery, he said. The latter point can potentially skew outcomes, Starns said. 'There may be selection bias, in that anticipated complex surgery may be selectively scheduled' for a surgery center, he acknowledged. The new study did not look at the cost of having cataract surgery in one setting vs the other, but Starns said office-based procedures are likely more cost-effective because they do not require anesthesia and the fees for these services. Nor does it require preoperative testing or medical clearance examinations from the patient's primary care provider, cardiologist, or other types of providers. He added that providers do not charge a facility fee for office-based surgery, whereas surgery centers do, which further lowers costs for the office setting. Currently, Medicare does not cover facility fees for office-based procedures, but it does so for surgery centers. Strengths and Limitations Starns noted one strength of the study is that one surgeon performed all the procedures. 'That means uniform surgical techniques, patient population, and perioperative care routines,' he said. Both observation groups demonstrated 'significant surgical volume,' he added. Neal Shorstein, MD The study population size is another strength, said Neal Shorstein, MD, a retired cataract surgery with Kaiser Permanente in Northern California and an adviser to the Seva Foundation, a nonprofit group that develops eye care programs in underserved regions. 'When you get over 1000 or so, a study of this nature has a little bit more statistical power,' he said. The evidence comparing the two settings for cataract surgery is limited, he said. However, the new findings agree with results of a 2016 retrospective consecutive case series of 21,505 cataract operations performed in an office setting, Shorstein said. Clarity on the types of cases performed in the office is needed to better compare those done in a surgery center. 'That's extremely important because their conclusion that office-based surgery was better, with fewer adverse events, raises the question: Was there some sort of conscious or unconscious selection bias of healthier patients for the office-based surgery?' Shorstein said. The study was independently supported. Starns and Shorstein reported having no relevant financial conflicts of interest.

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