ABSTRACT
Resumen El trasplante pulmonar implica una serie de desafíos, que como lo ha demostrado la historia, no sólo depende de un adecuado desarrollo de técnicas quirúrgicas, sino también de la comprensión de una serie de complejas interacciones inmunológicas celulares y humorales que serán las responsables del tipo de respuesta (innata y/o adquirida) fisiológica y que pudiesen desencadenar las complicaciones asociadas al trasplante (rechazo hiperagudo, agudo o crónico). Cada una de las cuales tiene su potencial prevención y/o tratamiento. El poder conocer esta serie de respuestas, permite al clínico anticiparse a algunos de estos eventos y evitar de mejor forma el daño y las consecuencias que pueden producir en los casos de trasplante pulmonar.
Lung transplantation involves a series of challenges, which as history has shown, depends not only on an adequate development of surgical techniques, but also on the understanding of a series of complex cellular and humoral immunological interactions that will be responsible for the type of physiological response (innate - acquired) and that could trigger the complications associated with transplantation (hyperacute, acute or chronic rejection). Each of which has its potential prevention and treatment. Being able to know this series of responses, allows the clinician to anticipate some of these events and to avoid in a better way the damage and the consequences that can occur in cases of lung transplantation.
Subject(s)
Humans , Transplantation Immunology/immunology , Lung Transplantation , Graft Rejection/immunology , T-Lymphocytes/immunology , Autoimmunity , Nuclear Factor 45 Protein , Graft Rejection/prevention & control , Immunity, Cellular , Immunity, Innate , Immunosuppressive AgentsABSTRACT
PURPOSE: Postoperative astigmatism following intracapsular cataract extraction with or without anterior chamber intraocular lens implantation is reported as an outcome from a randomised controlled trial. METHODS: Five hundred and two of 1002 eyes randomised to intracapsular cataract extraction with anterior chamber intraocular lens (ICCE/AC IOL) and 417 of 998 eyes to intracapsular cataract extraction with aphakic spectacles (ICCE/AS) were seen for objective refraction one year after surgery. The prevalence and axis of astigmatism were evaluated using univariate analysis. Logistic regression was used to compare the postoperative astigmatism between the groups. RESULTS: Acceptable astigmatism (-0.5 to 0.0 DCyl) in the AC IOL group was found in 60 (12.0%) patients (95% CI 9.1%-14.9%) and in the aphakic spectacles group (AS) in 69 (16.5%) patients (95% CI 12.9%-20.1%), moderate astigmatism (-1.0 to-1.5 DCyl) was found in 153 (30.4%) patients (95% CI 26.4-34.6%) in ACIOL group and in 288 (69.1%) patients (95% CI 64.6%-73.6%) in AS group; and large astigmatism (-2.0 to - 8.0 D Cyl) was found in 289 (57.6%) patients (95% CI 53.1%-61.6%) in ACIOL group and in 60 (14.4%) patients (95% CI 11.0% 17.8%) in AS group. Large astigmatism was approximately four times more common in the ICCE/AC IOL group compared to ICCE/AS group. In both groups, most patients had "against-the-rule" astigmatism, 446 (88.8%) (95%CI 86.0%-91.6%) in AC IOL group and 348 (83.5%) (95%CI 79.9%-87.1%) in AS group. CONCLUSION: Astigmatism is common after intracapsular cataract extraction. Insertion of an anterior chamber IOL increases the risk of astigmatism.
Subject(s)
Adolescent , Adult , Anterior Eye Segment , Astigmatism/epidemiology , Cataract Extraction/adverse effects , Child , Child, Preschool , Female , Follow-Up Studies , Humans , Lens Capsule, Crystalline/surgery , Lens Implantation, Intraocular/adverse effects , Male , Middle Aged , Nepal/epidemiology , Postoperative Complications , Prevalence , Refraction, Ocular , Visual AcuityABSTRACT
Community ophthalmology requires a comprehensive approach for primary, secondary and tertiary prevention of all eye diseases like vitamin A deficiency, trachoma, measles, diabetic retinopathy, refractive errors, etc. Community ophthalmology is based on the principles of primary health care approach. Equitable distribution, community involvement, focus on prevention, appropriate technology and multisectorial approach are to name a few in primary health care approach. In India, National Programme for Trachoma Control was launched in 1963 and National Programme for Control of Blindness was launched in 1976. Prevention of blindness was included in 20-point plan in early 1980s. Increase in blindness was reassessed in 1986-89 and the strategy was changed. World Bank came to help in planning 11 million cataract operations in 7 years in 7 States where there was the highest prevalence of cataract. Departments of community ophthalmology have recently been developed in several institutions. If the problem of blindness is to be solved, extension of community-based approach including all strata of society is the need of the hour.
Subject(s)
Blindness/prevention & control , Community Health Centers/organization & administration , Government Programs/organization & administration , Health Policy , Humans , India , OphthalmologyABSTRACT
El objetivo de este artículo es presentar cuatro casos clínicos que requerían tratamiento protésico y/o periodontal y cómo la extrusión ortodóncica contribuye a un mejor resultado final e incluso evita la necesidad de realizar procedimientos periodontales complejos. La odontología restauradora actual encuentra cada vez con mayor frecuencia el reto de preservar dientes severamente destruidos o reemplazarlos de la manera más estética y funcional posible. Esto requiere procedimientos predecibles y de corta duración, funcionales, estéticos, económicos y no dolorosos, para la rehabilitación y/o reemplazo de dichos dientes...
Subject(s)
Dental Implantation , Periodontics , Tooth Movement Techniques , Dental Prosthesis , Dentistry , OrthodonticsABSTRACT
A population-based prevalence survey of ocular disease was conducted in the Lower Shire Valley of Malawi in 1983. A total of 5;436 children less than 6 years of age and 1;664 persons greater than or equal to 6 years were examined. The prevalence of inflammatory trachoma peaked in the 1-2-year-old age group at 48.7 percent and declined rapidly with age to less than 5 percent by age 15. The prevalence of cicatricial trachoma was low in young children and climbed gradually with age to greater than 40 percent among those greater than or equal to 50 years. Risk factors for infLammatory disease in young children included low socioeconomic status of the family; long walking distance to the household's primary source of water; absence of a latrine in the family compound; and presence of trachoma among siblings. Indices of crowding practices were not associated with inflammatory disease. An apparent inverse association of facewashing and inflammatory trachoma in children did not hold up when adjusted for other risk factors