Reconstrucción de la superficie ocular con membrana amniótica / Reconstruction of the ocular surface with amniotic membrane

Objetivo: Evaluar la utilización de Membrana Amniótica (MA) para la reconstrucción de diversos desórdenes de la superficie ocular. Diseño: Estudio prospectivos iniciado en junio de 2000. Realizado en servicios de Oftalmología, Obstetricia, y centro de Investigaciones Perinatales del Hospital del Sótero del Río. Autorizado por Comité de Bioética en Investigación del Servicio de Salud Metropolitano Sur Oriente (SSMSO). Materiales y Métodos: Se realizó injerto de MA o MA más limbo en 21 pacientes con las siguientes patologías: Tumores conjuntivales benignos, Úlceras neurotróficas, Queratopías bulosas, Causticación, Reconstrucción de Ampolla de Filtración Hipertrófica, Síndrome de Stevens Johnson, Déficit de células madres y Perforación corneal. Se utilizó MA criopreservada. Resultados: Se logró reconstrucción anatómica y/o funcional en 19 de los 21 pacientes tratados. Conclusiones: El injerto de MA puede ser considerado como un método alternativo para determinados defectos conjuntivales y corneales regractarios o no a tratamiento convencional...

Heparina de bajo peso molecular versus heparina no fraccionada en el tratamiento de la angina inestable / Comparison of low molecular weight heparin and unfractionated heparin in the treatment of unstable angina

Background: Low molecular weight hepartin can be administered by the subcutaneous route and has stable and prolonged antithrombotic effect. These features have prompted clinical essays about its use as an alternative to unfractional heparin in the treatmen of unstable angina. Aim: To compare the clinical effects of low molecular weight heparin and unfractionated conventional heparin in patients with unstable angina or non Q infarction. Patients and methods: Seventy patients (47 male) admitted to the hospital with the diagnosis of unstable angina or non Q acute myocardial infarction were randomly assigned to receive unfractionated intravenous heparin or subcutaneous low molecular weight heparin bid. All received aspirin po and iv nitroglycerin. The incidence of recurrent angina, acute myocardial infarction or a need for emergency surgical revascularization during hospital stay were assessed in both groups. Results: Compared to patients with low molecular weight heparin, patients receiving unfractionated heparin had a higher incidence of recurrent resting angina (23 and 47.75 percent respectively, p< 0.04) and higher need for emergency surgical revascularization (3.3 and 17.5 percent respectively, p< 0.06). Patients treated with unfractionated conventional heparin had a 3 times higher risk of having an adverse cardiovascular event than patients receiving low molecular weight heparin (O.R. 0.33, confidence intervals 0.11-0.58). Conclusions: Low molecular weight heparin is superior to unfractionated conventional heparin in the treatment of unstable angina and non Q acute myocardial infarction