Intravitreal bevacizumab and cataract surgery after wet age-related macular degeneration / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To report the use of intravitreal bevacizumab associated with cataract surgery to prevent the re-activation of choroidal neovascularization (CNV) secondary to age-related macular degeneration (AMD).METHODS: Twelve eyes from 12 patients who had been previously treated for wet AMD and presented cataracts were operated on by clear cornea phacoemulsification with intraocular lens implantation, and an intravitreal injection of 1.25mg (0.05mL) bevacizumab was performed by the end of the procedure. The results were evaluated in terms of visual acuity improvement and reactivation of CNV, as determined by the appearance of fluid in optical coherence tomography (OCT). RESULTS: Best-corrected visual acuity(BCVA) significantly improved after surgery (P<0.01 and P=0.049 for BCVA after CNV closure and BCVA after cataract development respectively, Student's t test for paired data). Mean follow-up after cataract surgery was 11.8 months (SD 6.1, range 3 to 22 months). CNV reactivation or appearance of new CNV lesions was not observed in any case during follow-up. CONCLUSION: Intravitreal bevacizumab immediately after cataract surgery may prevent CNV reactivation in patients previously treated from CNV secondary to AMD.

Macular atrophy after combined intravitreal triamcinolone and photodynamic therapy to treat choroidal neovascularization / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To report the appearance of choriocapillaris atrophy after combined high dose intravitreal triamcinolone acetonide (TA) and photodynamic therapy (PDT) to treat choroidal neovascularization (CNV) associated with age related macular degeneration (AMD).METHODS: The present study was retrospective about non-randomized interventional case series. Fifty-one consecutive eyes with subfoveal (all types) CNV associated with AMD were treated by PDT and intravitreal (19.4±2.1)mg per 0.1mL TA at the Alicante Institute of Ophthalmology. The appearance of macular choriocapillaris and retinal pigment epithelium (RPE) atrophy was considered at two years follow-up. Thirty consecutive eyes treated by PDT alone, matched for age, sex, and type and size of CNV were considered as control group. RESULTS: Twenty-one of 47 eyes in the study group (45%) and 7 of 30 eyes in the control group (23%) developed macular RPE and choriocapillaris atrophy in the treated area at month 24 (P =0.04, Chi-square test). The greatest diameter of the atrophic areas averaged (5 044±1 666)μm in the study groupvs(4 345±1 550)μm in the control group. Mean final best corrected visual acuity (logarithm of minimal angle of resolution) was (0.87±033) in the cases with RPE atrophyvs(0.66±0.26) in the cases with no RPE atrophy in the study group (P=011, Mann-Whitney U test). CONCLUSION: The association of high doses of intravitreal TA and PDT may increase the risk for RPE and choriocapillaris atrophy.

Diabetes, obesity and non-optimum blood pressure levels in a group of employees of the University of Puerto Rico, Medical Sciences Campus, 2003

OBJECTIVE: To estimate the proportion of diabetes, obesity and non-optimum blood pressure levels in a group of employees of the University of Puerto Rico Medical Sciences Campus that participated in a diabetes health fair at the [quot ]Centro de Diabetes para Puerto Rico[quot ]. METHODS: A total of 113 participants of the diabetes health fair completed a questionnaire to obtain demographic characteristics and the frequency of self-reported diabetes. The nursing staff examined the participants in order to obtain the following clinical characteristics: body mass index, blood pressure and blood glucose levels. RESULTS: The proportion of self-reported diabetes, obesity (> or = 30 kg/m2) and non-optimum blood pressure levels (systolic > or = 20 mm/Hg or diastolic > or = 80 mm/Hg) were 15.4(95CI: 8.5- 25.7), 80.0(95CI: 70.8-86.9) and 70.5(95CI: 61.1-78.6), respectively. Although it was not statistically significant, diabetes was higher among females (15.4) compared to males (12.0). All participants with self-reported diabetes were overweight or obese, and 91.7showed non-optimum blood pressure levels. A significant positive correlation (p < 0.001) was observed between blood pressure levels and body mass index (r = 0.3). CONCLUSIONS: The percentage of persons with diabetes, obesity, and non-optimum blood pressure levels in this sample of Medical Sciences Campus employees underscores the need for confirming these results in a larger study and developing strategies focused on reducing health risks in this population.

Type 2 diabetes mellitus among youth in Puerto Rico, 2003

AIMS: To describe the clinical characteristics, and estimate the prevalence of type 2 diabetes mellitus among Puerto Rican youth, 1995-2003. METHODS: All patients aged less than 20 years with a confirmed diagnosis of type 2 diabetes were identified from pediatric endocrinologists' medical practices. Medical records of each patient were reviewed to confirm the diagnosis, classify the type of diabetes, and gather sociodemographic and clinical characteristics. From 1995 to 2003 a total of 32,444 records were reviewed. A total of 2,800 children with diabetes were identified, of which 2,702 were type 1 and 93 type 2; typel/type 2 ratio was 29:1. Frequency distributions were obtained for categorical variables, and summary measures (mean +/- standard deviation) for quantitative measure were computed. RESULTS: Mean age at first visit was 14 years. The majority of cases were females (69), for a female/ male ratio of 2.2:1. 78.5had a family history of the disease, 74.2were overweight, and 48had acanthosis nigricans. 64.5of the cases were receiving some type of hypoglycemic therapy. 18.5of the cases had severe hypertension while 17.5had cholesterol levels considered at increased risk (e[quot ]200). The overall prevalence was 13.5 per 100,000 population. CONCLUSIONS: This study is the first that describes the frequency and clinical presentation of type 2 diabetes in children and adolescents in a sample of Puerto Ricans. Further investigations must be conducted to obtain a more precise estimate of the burden of type 2 diabetes in youth and to raise awareness of this condition among health care professionals.

Catheter related infections in Damas Hospital

The purpose of this study is to investigate the extent of catheter-related infections in our Institution. We examined retrospectively 89 medical records of patients in whom an intravascular catheter tip culture were obtained during January through December 1991. Forty-seven catheter related infections were identified in 43 patients. There were 33 multiple lumen infected catheters and 14 single lumen. Catheters for hemodialysis were infected in 38.3 of the patients. Twenty catheters were inserted into the subclavian vein. Fifty percent of the reinserted catheters were placed in the same site, of which 28.6 became infected. Staphylococcus epidermis was isolated in 28.1 of the patients, while in 50 of the patients with Staphylococcus aureus, bacteremia was identified. Staphylococci and Enterococci were more sensitive to Vancomycin than to any other antibiotic

Eficacia clinica de la cefoperazona: estudio multicentrico en infecciones variadas / Clinical efficacy of cefoperazone: multicenter study in different infections

Se evaluó, en infecciones mixta por microorganismos aerobios y anaerobios, la eficacia y tolerancia del tratamiento combinado de Cefoperazona(2g/dia) y tinidazol (0.8g/d), administrando por via intravenosa en 36 pacientes (rango de edad 13-65 anos, 20 mujeres y 16 hombres) durante 5-17 dias (promedio 7.8 dias) con las siguientes infecciones severas: peritonitis(n=18), sepsis(n=2) abceso de pared abdominal(n=3), enfermedades inflamatoria pelviana(n=3) neumonia (n=2) colecistitis(n=1), osteomielitis(n=1), abceso subfrenico(n=3), abceso hepatico, tubo-ovarico y gangrena de miembros inferiores(1caso c/u). Los microorganismos sensibles a cefoperazona y/o tinidazol aislados fueron: E. Coli, Acinetobacter, sp., Bacteroides, sp., P.aeruginosa, k. pneumoniae, peptoestreptococcus, Enterocoicos, P.vulgaris,