No abstract

Lima, as the capital of Peru, has become its first megacity with more than 10 million people in an area that extends over 80 km in a North-South direction. As a city of this size, it faces complex mobility issues with a strong reliance on informal transport modes (buses, minibuses, and paratransit vehicles) due to the deterioration of its transit system quality during the 20th century. This paper examines the current urban situation in Lima through an analysis of the city’s structure, with an emphasis on its transport history and the resulting types of walking, transit, and car-oriented fabrics that can be identified. The mobility analysis was made through data collection, including daily trips by public and private modes, annual passenger kilometers and vehicle kilometers of travel, length of exclusive lanes for public transport and freeways, car and paratransit modes ownership, transport emissions, and safety. These data are used to position Lima in a comparative global context showing its relative strengths and weaknesses in urban form and mobility and providing suggestions for a more sustainable transport and land use system. It is asserted that Lima is an informal transit-oriented city, as distinct from recognized transit metropolises (e.g., Tokyo or German cities such as Berlin or Munich), which often involve private companies, operating under an umbrella of strong government regulation, fare setting, and high service standards. Lima is shown to have some important qualities such as a high density, comparatively low car ownership and freeway provision and still healthy levels of transit and non-motorized mode use despite non-ideal conditions for either. These qualities, if combined with effective governance structures, government commitment to higher quality formal transit systems, which better integrate the important informal transit sector, cessation of high capacity road building, greater protection and encouragement for non-motorized modes and some effective controls over growing car and motorcycle ownership, would see Lima develop a more sustainable transport system.

Neurotrophic keratopathy is a condition associated with corneal damage and impaired corneal healing. There are no specific treatments available for this disease and current treatments are not associated with improved visual function. Matrix regenerating agents (RGTA) are recent topical agents showing positive results in the treatment of several corneal conditions, including neurotrophic keratopathy. We report the case of a 73-year-old patient with a neurotrophic ulcer treated with RGTA. Treatment with RGTA allowed complete corneal healing and a dramatic recovery in visual function in our patient. RGTA solutions are an important and safe therapeutic option for the treatment of selected corneal pathology.

A 61-year old male was referred to the Ophthalmology department because of decreased bilateral visual acuity. The patient had metastatic pancreatic adenocarcinoma and was being treated with gemcitabine+nab-paclitaxel. On examination, the patient presented best corrected visual acuities of 4/20 and 2/20 in the right and left eye, respectively. The optical coherence tomography revealed bilateral severe macular edema. Macular edema was considered secondary to nab-paclitaxel and the drug was discontinued. Three months after drug discontinuation, the patient presented best corrected visual acuities of 20/20 and 16/20 in the right and left eye, respectively, and normal fundoscopy. Macular edema is a very rare side effect of taxanes, and the etiopathology is still unknown. Edema is usually reversible upon discontinuation of the offending agent. Clinicians should be aware of this adverse effect of taxanes, and a high index of clinical suspicion is essential for diagnosis.