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1.
O.F.I.L ; 32(3): 295-297, julio 2022. graf
Article in Spanish | IBECS | ID: ibc-208786

ABSTRACT

La leucemia mieloblástica aguda (LMA) es una enfermedad heterogénea caracterizada por el crecimiento descontrolado de precursores mieloides indiferenciados que provoca un fallo medular. Según datos del programa de Vigilancia, Epidemiología y Resultados Finales (SEER) se estima una incidencia anual de 4,2 por cada 100.000 habitantes. El porcentaje de incidencia en menores de 20 años es 5,1% y en personas entre 65-84 años, es 46,5%. La tasa de supervivencia a 5 años varía en función de la edad de los pacientes, siendo en menores de 20 del 67% y en mayores a dicha edad disminuye al 25%. La leucemia mieloide aguda representa el 40% del total de leucemias y la mediana de edad de los pacientes es 65 años. Las alteraciones citogenéticas más frecuentes son: traslocación (8;21), inversión cromosoma 16, traslocación (16;16), trisomía del cromosoma 8, deleciones en los cromosomas 5 y 7, y mutación en el gen FLT3 (13q12), la cual está presente en el 30% de los nuevos diagnósticos. El tratamiento estándar de quimioterapia sigue basándose en el esquema intensivo 3+7 que consiste en citarabina con antraciclinas. El objetivo de las nuevas terapias en LMA es el tratamiento dirigido debido a los avances en el diagnóstico y la tipificación. (AU)


Acute myeloblastic leukemia (AML) is a heterogeneous disease characterized by uncontrolled growth of undifferentiated myeloid precursors leading to bone marrow failure. According to data from the Surveillance, Epidemiology and End Results (SEER) program, the annual incidence is estimated at 4.2 per 100,000 population. The incidence rate in children under 20 years of age is 5.1% and in people between 65-84 years of age, it is 46.5%. The 5-year survival rate varies according to the age of the patients, being 67% in those under 20 years of age and 25% in those older than 20 years of age. Acute myeloid leukemia represents 40% of all leukemias and the median age of the patients is 65 years. The most frequent cytogenetic alterations are: translocation (8;21), inversion of chromosome 16, translocation (16;16), trisomy of chromosome 8 and deletions in chromosomes 5 and 7, mutation in the FLT3 gene (13q12), which is present in 30% of new diagnoses. Standard chemotherapy treatment is still based on the intensive 3+7 scheme consisting of cytarabine with anthracyclines. The focus of new therapies in AML is targeted therapy due to advances in diagnosis and typing. (AU)


Subject(s)
Humans , Male , Middle Aged , Leukemia, Myeloid, Acute , Therapeutics , Patients
3.
Farm. comunitarios (Internet) ; 14(2): 5-8, abril 2022.
Article in Spanish | IBECS | ID: ibc-207126

ABSTRACT

Las nuevas tecnologías de la información y comunicación (TIC) están desarrollándose desde hace bastantes años, pero la pandemia de COVID-19 ha acelerado la transformación digital de la sociedad. En el campo de la salud han surgido nuevas actividades y de esta forma términos como telemedicina, teleasistencia o teleconsulta empiezan a ser habituales. Indudablemente suponen un avance, pero tienen el riesgo de deshumanizar el contacto de sanitarios y pacientes.En el campo de la farmacia ha surgido la telefarma cia con unas innegables connotaciones logísticas y comerciales. Desde la Sociedad Española de Farmacia Clínica, Familiar y Comunitaria se prefiere utilizar el término teleatención farmacéutica (TAF), definiéndolo como la práctica farmacéutica asistencial a distancia que utiliza las TIC para complementar la atención farmacéutica presencial que precise el paciente. La TAF incluye la prestación a distancia de algunos servicios profesionales farmacéuticos asistenciales (SPFA). La TAF debe ayudar al farmacéutico comunitario a prestar algunos SPFA, mejorando así la practica farmacéutica clínica sin caer en la deshumanización que la aplicación indiscriminada de las TIC puede producir. (AU)


Subject(s)
Humans , Telemedicine , Pharmaceutical Services , Public Health , SARS Virus , Pandemics
4.
Nat Commun ; 13(1): 4374, 2022 07 28.
Article in English | MEDLINE | ID: mdl-35902577

ABSTRACT

Exposure to traumatic stress can lead to fear dysregulation, which has been associated with posttraumatic stress disorder (PTSD). Previous work showed that a polymorphism in the PACAP-PAC1R (pituitary adenylate cyclase-activating polypeptide) system is associated with PTSD risk in women, and PACAP (ADCYAP1)-PAC1R (ADCYAP1R1) are highly expressed in the hypothalamus. Here, we show that female mice subjected to acute stress immobilization (IMO) have fear extinction impairments related to Adcyap1 and Adcyap1r1 mRNA upregulation in the hypothalamus, PACAP-c-Fos downregulation in the Medial Amygdala (MeA), and PACAP-FosB/ΔFosB upregulation in the Ventromedial Hypothalamus dorsomedial part (VMHdm). DREADD-mediated inhibition of MeA neurons projecting to the VMHdm during IMO rescues both PACAP upregulation in VMHdm and the fear extinction impairment. We also found that women with the risk genotype of ADCYAP1R1 rs2267735 polymorphism have impaired fear extinction.


Subject(s)
Pituitary Adenylate Cyclase-Activating Polypeptide/metabolism , Receptors, Pituitary Adenylate Cyclase-Activating Polypeptide , Animals , Extinction, Psychological , Fear/physiology , Female , Humans , Hypothalamus/metabolism , Mice , Receptors, Pituitary Adenylate Cyclase-Activating Polypeptide/genetics , Receptors, Pituitary Adenylate Cyclase-Activating Polypeptide/metabolism
5.
Geophys Res Lett ; 49(3): e2021GL096069, 2022 Feb 16.
Article in English | MEDLINE | ID: mdl-35859568

ABSTRACT

Water storage plays an important role in mitigating heat and flooding in urban areas. Assessment of the water storage capacity of cities remains challenging due to the inherent heterogeneity of the urban surface. Traditionally, effective storage has been estimated from runoff. Here, we present a novel approach to estimate effective water storage capacity from recession rates of observed evaporation during precipitation-free periods. We test this approach for cities at neighborhood scale with eddy-covariance based latent heat flux observations from 14 contrasting sites with different local climate zones, vegetation cover and characteristics, and climates. Based on analysis of 583 drydowns, we find storage capacities to vary between 1.3 and 28.4 mm, corresponding to e-folding timescales of 1.8-20.1 days. This makes the urban storage capacity at least five times smaller than all the observed values for natural ecosystems, reflecting an evaporation regime characterized by extreme water limitation.

6.
Orbit ; : 1-7, 2022 Jun 01.
Article in English | MEDLINE | ID: mdl-35642653

ABSTRACT

We describe two cases of extensive indolent calvarial osteomyelitis after rhino-orbital-mucormycosis in diabetic patients previously diagnosed with COVID-19. Both patients presented with acute rhino-orbital symptoms about one month after being diagnosed with COVID-19. Treatment with intravenous liposomal Amphotericin B and prompt radical surgical debridement was instituted, but calvarial osteomyelitis ensued and persisted chronically despite maintenance of antifungal therapy and partial debridement of necrotic calvarial bone. The patients were discharged to continue antifungal therapy on a day-hospital regime. After more than 8 months of treatment, they remain with radiological signs of osteomyelitis but with no symptoms or intracranial extension of the infection. Calvarial indolent osteomyelitis secondary to mucormycosis is extremely rare, and little is known regarding its treatment. We believe it can be controlled with medical treatment and partial bony debridement although more studies are necessary to better define therapy.

7.
Eur J Pain ; 26(5): 1039-1055, 2022 05.
Article in English | MEDLINE | ID: mdl-35191131

ABSTRACT

BACKGROUND: Electrical stimulation of skin afferents can induce somatosensory plasticity in humans. Nevertheless, it is unknown if this is possible to do through percutaneous stimulation of a peripheral nerve, which will allow for regional anaesthesia interventions. Furthermore, potentiation protocols applied over mainly non-nociceptive fibres inhibit nociception in rodents, but this has not been tested in humans. OBJECTIVE: To determine whether a protocol aiming to depress the nociceptive circuit and another aiming to potentiate non-nociceptive circuits produce regional hypoalgesia and changes in motor function, applied through percutaneous peripheral nerve stimulation (pPNS), and to assess which of them is more promising for pain relief, immediately and 24 h after the intervention. METHODS: PT-cLF protocol aims to depress the nociceptive pathway through Pain Threshold, continuous Low Frequency stimulation and ST-bHF aims to produce potentiation of the non-nociceptive pathway, through Sensory Threshold burst stimulation at High Frequency. All subjects (n = 29) went through both protocols and a control condition in a randomized and blinded crossover design. RESULTS: Compared to control, ST-bHF induced distal hypoalgesia, towards electrical (p = 0.04) and mechanical stimuli (p = 0.02) and produced mechanical hypoesthesia (p = 0.02). Contrarily, hypoalgesia was not observed after PT-cLF (p > 0.05) but increased electrical motor threshold (p = 0.04), reduced motor recruitment (p = 0.03), and the subjects reported feeling reduced strength (p < 0.01). CONCLUSION: This works provides evidence that is possible to induce antinociceptive plasticity in a wide territory using pPNS. Moreover, it demonstrates for the first time in humans that a protocol aiming to produce long-term potentiation applied predominantly over non-nociceptive afferents induces hypoesthesia and hypoalgesia.


Subject(s)
Hypesthesia , Transcutaneous Electric Nerve Stimulation , Electric Stimulation/methods , Humans , Pain Threshold/physiology , Peripheral Nerves , Randomized Controlled Trials as Topic
8.
Orbit ; : 1-4, 2022 Jan 03.
Article in English | MEDLINE | ID: mdl-34974797

ABSTRACT

We report the case of a 64-year-old male patient with a 5 month history of proptosis, motility limitation and vision loss in OD. Visual acuity (VA) was 20/200 in OD and 20/20 in OS. CT showed a large, round, intraconal lesion, with bony density and no apparent connection to adjacent orbital walls. MRI showed a T1-weighted hypointense lesion surrounded by a contrast enhancing capsule. The orbital tumor was excised through a lateral orbitotomy revealing a nodular, round, osseous structure. Histological examination disclosed well-formed lamellar bone trabeculae, with no necrosis or mitosis figures. Immunohistochemical staining was negative for MDM2 and CDK4. After 3 years, there was no evidence of tumor recurrence and VA had improved to 20/30. Intraconal osteomas with no clear attachment to orbital walls are extremely rare. We are aware of a few reported cases in the lid, hand, thigh, tongue, pterygopalatine fossa and brain. To the authors' knowledge, this is the first report in English literature of an orbital intraconal osteoma without any visible relation to the orbital walls.

9.
Psychiatry Res ; 306: 114240, 2021 12.
Article in English | MEDLINE | ID: mdl-34673311

ABSTRACT

Sexual assault is one of the most traumatic events a person can experience. Despite this, information regarding the risk factors associated with the development of Acute Stress Disorder (ASD) in sexual assault victims is scarce. A follow-up prospective cohort study was designed to examine the prevalence and risk factors of ASD in women exposed to a recent sexual assault. A total of 156 women were treated at the Emergency Department of a university general hospital shortly after sexual assault. Sociodemographic, clinical and sexual assault-related variables were collected. The Acute Stress Disorder Interview was used to estimate the prevalence of ASD at three weeks post-SA. From the 156 victims, 66.6% (N = 104) met ASD diagnosis using DSM-5 criteria, whereas 59.6% (N = 93) met ASD diagnosis using DSM-IV criteria. The risk factors associated with the development of ASD were nationality, psychiatric history, peritraumatic dissociation and type of assault. In conclusion, the prevalence of ASD in female victims of recent sexual assault was high, affecting approximately two thirds of them. The recognition of the risk factors associated with ASD development, like peritraumatic dissociation or type of assault, may aid in the prompt detection of vulnerable women that require early and specific interventions shortly after trauma.


Subject(s)
Crime Victims , Sex Offenses , Stress Disorders, Post-Traumatic , Stress Disorders, Traumatic, Acute , Crime Victims/psychology , Female , Humans , Prevalence , Prospective Studies , Risk Factors , Sex Offenses/psychology , Stress Disorders, Post-Traumatic/psychology , Stress Disorders, Traumatic, Acute/diagnosis , Stress Disorders, Traumatic, Acute/epidemiology
10.
Ophthalmic Plast Reconstr Surg ; 37(6): e206-e208, 2021.
Article in English | MEDLINE | ID: mdl-34366384

ABSTRACT

The association of C-antineutrophil cytoplasmic antibody (ANCA) vasculitis and IgG4 positivity is a new condition not well described in clinical terms. The authors examined a 28-year-old man with a previous diagnosis of eosinophilic granulomatosis with polyangiitis, formerly known as Churg-Strauss disease, who presented with bilateral orbital inflammation. Magnetic resonance imaging revealed diffuse orbital infiltration and enlargement of the major divisions of the trigeminal nerve. Biopsy of the orbital contents showed necrotizing granulomatous vasculitis and a high number of IgG4-positive plasma cells (IgG4/IgG = 60%).


Subject(s)
Churg-Strauss Syndrome , Granulomatosis with Polyangiitis , Adult , Antibodies, Antineutrophil Cytoplasmic , Churg-Strauss Syndrome/complications , Churg-Strauss Syndrome/diagnosis , Granulomatosis with Polyangiitis/complications , Granulomatosis with Polyangiitis/diagnosis , Humans , Immunoglobulin G , Male , Plasma Cells
11.
Nat Commun ; 12(1): 2496, 2021 05 03.
Article in English | MEDLINE | ID: mdl-33941789

ABSTRACT

Memory formation is key for brain functioning. Uncovering the memory mechanisms is helping us to better understand neural processes in health and disease. Moreover, more specific treatments for fear-related disorders such as posttraumatic stress disorder and phobias may help to decrease their negative impact on mental health. In this line, the Tachykinin 2 (Tac2) pathway in the central amygdala (CeA) has been shown to be sufficient and necessary for the modulation of fear memory consolidation. CeA-Tac2 antagonism and its pharmacogenetic temporal inhibition impair fear memory in male mice. Surprisingly, we demonstrate here the opposite effect of Tac2 blockade on enhancing fear memory consolidation in females. Furthermore, we show that CeA-testosterone in males, CeA-estradiol in females and Akt/GSK3ß/ß-Catenin signaling both mediate the opposite-sex differential Tac2 pathway regulation of fear memory.


Subject(s)
Central Amygdaloid Nucleus/physiology , Conditioning, Classical/physiology , Fear/physiology , Memory Consolidation/physiology , Protein Precursors/antagonists & inhibitors , Tachykinins/antagonists & inhibitors , Animals , Antipsychotic Agents/pharmacology , Estradiol/metabolism , Female , Male , Mice , Mice, Inbred C57BL , Piperidines/pharmacology , Protein Precursors/metabolism , Sex Factors , Signal Transduction , Tachykinins/metabolism , Testosterone/metabolism
12.
J Thromb Thrombolysis ; 51(1): 40-46, 2021 Jan.
Article in English | MEDLINE | ID: mdl-32613385

ABSTRACT

Recent studies suggest that thrombotic complications are a common phenomenon in the novel SARS-CoV-2 infection. The main objective of our study is to assess cumulative incidence of pulmonary embolism (PE) in non critically ill COVID-19 patients and to identify its predicting factors associated to the diagnosis of pulmonary embolism. We retrospectevely reviewed 452 electronic medical records of patients admitted to Internal Medicine Department of a secondary hospital in Madrid during Covid 19 pandemic outbreak. We included 91 patients who underwent a multidetector Computed Tomography pulmonary angiography(CTPA) during conventional hospitalization. The cumulative incidence of PE was assessed ant the clinical, analytical and radiological characteristics were compared between patients with and without PE. PE incidence was 6.4% (29/452 patients). Most patients with a confirmed diagnosed with PE recieved low molecular weight heparin (LMWH): 79.3% (23/29). D-dimer peak was significatly elevated in PE vs non PE patients (14,480 vs 7230 mcg/dL, p = 0.03). In multivariate analysis of patients who underwent a CTPA we found that plasma D-dimer peak was an independen predictor of PE with a best cut off point of > 5000 µg/dl (OR 3.77; IC95% (1.18-12.16), p = 0.03). We found ninefold increased risk of PE patients not suffering from dyslipidemia (OR 9.06; IC95% (1.88-43.60). Predictive value of AUC for ROC is 75.5%. We found a high incidence of PE in non critically ill hospitalized COVID 19 patients despite standard thromboprophylaxis. An increase in D-dimer levels is an independent predictor for PE, with a best cut-off point of > 5000 µg/ dl.


Subject(s)
Anticoagulants/therapeutic use , COVID-19 , Chemoprevention , Lung , Pulmonary Embolism , COVID-19/complications , COVID-19/diagnosis , COVID-19/physiopathology , Causality , Chemoprevention/methods , Chemoprevention/statistics & numerical data , Computed Tomography Angiography/methods , Electronic Health Records/statistics & numerical data , Female , Fibrin Fibrinogen Degradation Products/analysis , Hospitalization/statistics & numerical data , Humans , Incidence , Lung/blood supply , Lung/diagnostic imaging , Male , Middle Aged , Pulmonary Embolism/blood , Pulmonary Embolism/diagnostic imaging , Pulmonary Embolism/epidemiology , Pulmonary Embolism/etiology , SARS-CoV-2/isolation & purification , Spain/epidemiology , Thrombophilia/diagnosis , Thrombophilia/etiology
13.
Arq. bras. oftalmol ; 83(1): 28-32, Jan.-Feb. 2020. tab, graf
Article in English | LILACS (Americas) | ID: biblio-1088952

ABSTRACT

ABSTRACT Purpose: The purpose of the present work is to measure the interocular upper lid contour symmetry using a new method of lid contour quantification. Methods: The Bézier curve tool of the Image J software was used to extract the right and left upper eyelid contours of 75 normal subjects. Inter-observer variability of 29 right lid contours obtained by two independent observers was estimated using the coefficient of overlap of two curves and an analysis of the differences of the contour peak location. A two-way analysis of variance was used to test the mean value of the coefficient of overlap of the right and left contours in males and females and lid segments. The same analysis was performed to compare the location of the contour peak of the right and left contours. Results: The coefficient of contour overlap obtained by independent observers ranged from 93.5% to 98.8%, with a mean of 96.1% ± 1.6 SD. There was a mean difference of 0.02 mm in the location of the contour peak. Right and left contour symmetry did not differ between females and males and was within the range of the method variability for contour overlap and location of the contour peak. Conclusions: The upper eyelid contour is highly symmetrical. Bézier lines allow a quick and fast quantification of the lid contour, with a mean inter-observer variability of 3.9%.


RESUMO Objetivo: O objetivo do presente estudo é mensurar a simetria interocular do contorno da pálpebra superior por meio de um novo método de quantificação de contorno palpebral com curvas de Bézier. Métodos: A ferramenta de curva de Bézier do software ImageJ foi utilizada para extrair os contornos palpebrais direito e esquerdo de 75 sujeitos normais. A variabilidade interobservador de 29 contornos palpebrais do olho direito obtidos por dois observadores diferentes foi estimada pelo coeficiente de superposição de duas curvas e pela análise das diferenças das posições do pico do contorno. Análise de variância de dois fatores foi empregada para testar a média do coeficiente de superposição entre os contornos direito e esquerdo quanto ao sexo e segmento palpebral. A mesma análise foi utilizada para comparar a localização do pico do contorno dos olhos direito e esquerdo. Resultados: O coeficiente de superposição obtidos por observadores independentes variou ente 93,5% e 98,8% com média de 96,1% ± 1,6 DP. A diferença das médias da localização do pico do contorno palpebral foi de 0,02 mm. A simetria entre os contornos dos olhos direito e esquerdo não diferiu entre o sexo feminino e masculino e esteve na faixa de variabilidade do método para o coeficiente de superposição e localização do pico do contorno. Conclusões: O contorno da pálpebra superior é altamente simétrico. As linhas Bézier permitem uma rápida e prática quantificação do contorno palpebral com uma média de variabilidade interobservador de 3,9%.


Subject(s)
Humans , Male , Female , Adult , Eyelids/anatomy & histology , Facial Asymmetry/diagnosis , Reference Values , Computer Simulation , Signal Processing, Computer-Assisted , Software
14.
Phys Rev E ; 100(3-1): 032413, 2019 Sep.
Article in English | MEDLINE | ID: mdl-31639977

ABSTRACT

We formulate a simple effective model to describe molecular interactions in a lipid monolayer and calculate the line tension between coexisting domains. The model represents lipid molecules in terms of two-dimensional anisotropic particles on the plane of the monolayer. These particles interact through forces that are believed to be relevant for the understanding of fundamental properties of the monolayer: van der Waals interactions originating from lipid chains and dipolar forces between dipole groups in the molecular heads. The model stresses the liquid-crystalline nature of the ordered phase in lipid monolayers and explains coexistence properties between ordered and disordered phases in terms of molecular parameters. Thermodynamic and interfacial properties of the model are analyzed using density-functional theory. In particular, the line tension at the interface between ordered and disordered phases turns out to be highly anisotropic with respect to the angle between the nematic director and the interface separating the coexisting phases. This important feature mainly results from the tilt angle of lipid chains and, to a lesser extent, from dipolar interactions perpendicular to the monolayer. The role of the two dipolar components, parallel and perpendicular to the monolayer, is assessed by comparing with computer simulation results for lipid monolayers.


Subject(s)
Lipids/chemistry , Models, Molecular , Anisotropy , Density Functional Theory
15.
Case Rep Surg ; 2019: 6146125, 2019.
Article in English | MEDLINE | ID: mdl-31559103

ABSTRACT

The surgical procedure for orthotopic liver transplantation (OLT) is well standardized, and most groups use the retrohepatic caval preservation or piggyback technique to improve hemodynamic tolerance. However, when a discrepancy between the site in the right upper quadrant of the liver recipient and a small graft is present, this technique can provoke a rotation on the axis of the vena cava and cause an occlusion of the suprahepatic vein drainage. This problem can be detected intraoperatively, and several methods have been described to resolve it by placing different devices to correct the position. Early withdrawal may cause the development of clinical hepatic congestion with ascites unresponsive to medical treatment. We present three cases of OLT who developed obstruction of the venous drainage solved intraoperatively with the placement of a Sengstaken-Blakemore tube. As a novelty, prior to the withdrawal of the device, a transjugular hemodynamic study was performed to ensure the correct position of the liver with adequate venous drainage.

16.
Langmuir ; 35(42): 13782-13790, 2019 10 22.
Article in English | MEDLINE | ID: mdl-31553617

ABSTRACT

We report on atomistic simulations of DPPC lipid monolayers using the CHARMM36 lipid force field (and also the Slipid force field as a control case), combined with a four-point OPC water model. The entire two-phase region where domains of the "liquid-condensed" (LC) phase coexist with domains of the "liquid-expanded" (LE) phase has been explored. The simulations are long enough that the complete phase-transition stage, with two domains coexisting in the monolayer, is reached in all cases. Also, system sizes used are larger than those in previous works. As expected, domains of the minority phase are elongated, emphasizing the importance of anisotropic van der Waals and/or electrostatic dipolar interactions in the monolayer plane. The molecular structure is quantified in terms of distribution functions for the hydrocarbon chains and the PN dipoles. In contrast to previous work, where average distributions are calculated, distributions are here extracted for each of the coexisting phases by first identifying lipid molecules that belong to either LC or LE regions. In the case of the CHARMM36 force field, the three-dimensional distributions show that the average tilt angle of the chains with respect to the normal outward direction is (39.0 ± 0.1)° in the LC phase and (48.1 ± 0.5)° in the LC phase. In the case of the PN dipoles, the distributions indicate a tilt angle of (110.8 ± 0.5)° in the LC phase and (112.5 ± 0.5)° in the LE phase. These results are quantitatively different from those in previous works, which indicated a smaller normal component of the PN dipole. Also, the distributions of the monolayer-projected chains and PN dipoles have been calculated. Chain distributions peak along a particular direction in the LC domains, while they are uniform in the LE phase. Long-range ordering associated with the projected PN dipoles is absent in both phases. These results strongly suggest that LC domains do not exhibit dipolar ordering in the plane of the monolayer, the effect of these components being averaged out at short distances. Therefore, the only relevant component of the molecular dipoles, with regard to both intra- and long-range interdomain interactions, is normal to the monolayer. Also, the local orientation of chain projections is almost constant in LC domains and points in the direction along which domains are elongated, suggesting that the line tension driving the phase transition might be anisotropic with respect to the interfacial domain boundary.

17.
Arq Bras Oftalmol ; 83(1): 28-32, 2020.
Article in English | MEDLINE | ID: mdl-31531548

ABSTRACT

PURPOSE: The purpose of the present work is to measure the interocular upper lid contour symmetry using a new method of lid contour quantification. METHODS: The Bézier curve tool of the Image J software was used to extract the right and left upper eyelid contours of 75 normal subjects. Inter-observer variability of 29 right lid contours obtained by two independent observers was estimated using the coefficient of overlap of two curves and an analysis of the differences of the contour peak location. A two-way analysis of variance was used to test the mean value of the coefficient of overlap of the right and left contours in males and females and lid segments. The same analysis was performed to compare the location of the contour peak of the right and left contours. RESULTS: The coefficient of contour overlap obtained by independent observers ranged from 93.5% to 98.8%, with a mean of 96.1% ± 1.6 SD. There was a mean difference of 0.02 mm in the location of the contour peak. Right and left contour symmetry did not differ between females and males and was within the range of the method variability for contour overlap and location of the contour peak. CONCLUSIONS: The upper eyelid contour is highly symmetrical. Bézier lines allow a quick and fast quantification of the lid contour, with a mean inter-observer variability of 3.9%.


Subject(s)
Eyelids/anatomy & histology , Facial Asymmetry/diagnosis , Adult , Computer Simulation , Female , Humans , Male , Reference Values , Signal Processing, Computer-Assisted , Software
18.
Ophthalmic Plast Reconstr Surg ; 36(1): 13-16, 2020.
Article in English | MEDLINE | ID: mdl-31373985

ABSTRACT

PURPOSE: To report a multicenter large case series of orbital decompression for non-thyroid eye disease proptosis. METHODS: Retrospective chart review of cases of orbital decompression performed by 9 experienced orbital surgeons from different countries from 2014 to 2017 for non-thyroid eye disease proptosis. Patients were divided into 3 groups: 1) negative vector (high axial length or shallow orbit), 2) inflammatory, and 3) tumor. Types of orbital decompression and Hertel exophthalmometry (preoperative and minimum 6 months postoperative) were recorded. Charts were also assessed for serious complications. The amount of exophthalmometry improvement was recorded according to the above groups. RESULTS: The analysis included 41 orbits of 29 patients (14 women and 15 men) with a mean age of 38.9 years (ranging from 9 to 74; standard deviation (SD) 15.66). There were 17 orbits of 11 patients in the negative vector group, 16 orbits of 10 patients in the inflammatory group, and 8 orbits of 8 patients in the tumor group. The mean reduction of proptosis was 2.95 mm in the negative vector group, 2.54 mm in the inflammatory group, and 5.75 mm in the tumor group. There were no serious complications. CONCLUSIONS: Orbital decompression was safe and effective in reducing proptosis for non-thyroid eye disease indications in this series. The amount of exophthalmometry improvement was less in the inflammatory orbitopathy group compared with other proptosis etiology groups.Orbital decompression may have a role in improving proptosis in non-thyroid eye disease entities.


Subject(s)
Exophthalmos , Graves Ophthalmopathy , Adult , Decompression, Surgical , Exophthalmos/diagnosis , Exophthalmos/surgery , Female , Graves Ophthalmopathy/complications , Graves Ophthalmopathy/diagnosis , Graves Ophthalmopathy/surgery , Humans , Male , Orbit/surgery , Retrospective Studies , Treatment Outcome
19.
Rev Neurol ; 69(1): 27-31, 2019 Jul 01.
Article in Spanish | MEDLINE | ID: mdl-31236908

ABSTRACT

INTRODUCTION: Metronidazole is a widely known and used antibiotic. In exceptional cases, an encephalopathy with characteristic lesions on magnetic resonance imaging (MRI), usually located in the cerebellum and splenium of the corpus callosum, may be an adverse effect. The incidence and pathogenesis are unknown. The suspension of the treatment usually resolves the symptoms and normalizes the MRI in a few weeks. Due to the usual good prognosis, the anatomopathological findings are exceptional. We present a clinical case with the radiological findings suggestive of metronidazole-induced encephalopathy and, exceptionally, we provide the anatomopathological findings. CASE REPORT: A 72 years-old woman with severe Crohn's disease who, months after starting treatment with metronidazole, presented a slowly progressing bradypsychia and difficulty walking until she came to coma. In MRI it showed hyperintense images in T2 in the corpus callosum, red and dentate nuclei. He improved by stopping metronidazole but later developed sepsis and died. At autopsy, softening of the red nucleus was observed and, microscopically, cell necrosis and demyelination. CONCLUSION: With the publication of the clinical, radiological and anatomopathological information of our case we intend to promote the knowledge of this infrequent treatable cause of subacute encephalopathy and provide data that help to clarify its pathogenesis.


TITLE: Encefalopatia inducida por metronidazol: descripcion de un caso con hallazgos radiologicos y anatomopatologicos.Introduccion. El metronidazol es un antibiotico ampliamente conocido y utilizado. En casos excepcionales puede producir como efecto adverso un cuadro de encefalopatia con unas lesiones caracteristicas en la resonancia magnetica, localizadas generalmente en el cerebelo y el esplenio del cuerpo calloso. La incidencia y la patogenia se desconocen. La suspension del tratamiento habitualmente resuelve los sintomas y normaliza la resonancia magnetica en pocas semanas. Debido al habitual buen pronostico, los hallazgos anatomopatologicos son excepcionales. Se presenta un caso clinico con los hallazgos radiologicos sugestivos de la encefalopatia inducida por metronidazol y, de forma excepcional, se aportan los hallazgos anatomopatologicos. Caso clinico. Mujer de 72 años, con enfermedad de Crohn grave, que meses mas tarde de iniciar tratamiento con metronidazol presento de forma lentamente progresiva bradipsiquia y dificultad para caminar hasta llegar al coma. En la resonancia magnetica mostraba caracteristicas imagenes hiperintensas en T2 en el cuerpo calloso, y los nucleos rojos y dentados. Mejoro al suspender el metronidazol, pero posteriormente desarrollo una sepsis y fallecio. En la autopsia se observo reblandecimiento del nucleo rojo y, microscopicamente, necrosis celular y desmielinizacion. Conclusion. Con la publicacion de la informacion clinica, radiologica y anatomopatologica de este caso se pretende fomentar el conocimiento de esta infrecuente causa tratable de encefalopatia subaguda y aportar datos que ayuden a aclarar su patogenia.


Subject(s)
Anti-Bacterial Agents/adverse effects , Brain Diseases/chemically induced , Brain Diseases/diagnosis , Metronidazole/adverse effects , Aged , Brain Diseases/diagnostic imaging , Brain Diseases/pathology , Female , Humans , Magnetic Resonance Imaging
20.
Neurosci Biobehav Rev ; 103: 81-108, 2019 08.
Article in English | MEDLINE | ID: mdl-31129235

ABSTRACT

Despite the exponential increase in fear research during the last years, few studies have included female subjects in their design. The need to include females arises from the knowledge gap of mechanistic processes underlying the behavioral and neural differences observed in fear extinction. Moreover, the exact contribution of sex and hormones in relation to learning and behavior is still largely unknown. Insights from this field could be beneficial as fear-related disorders are twice as prevalent in women compared to men. Here, we review an up-to-date summary of animal and human studies in adulthood that report sex differences in fear extinction from a structural and functional approach. Furthermore, we describe how these factors could contribute to the observed sex differences in fear extinction during normal and pathological conditions.


Subject(s)
Brain/physiology , Extinction, Psychological/physiology , Fear/physiology , Sex Characteristics , Animals , Female , Humans , Male
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