[Central trochlear nerve palsy treated with inferior oblique muscle weakening]. / Parálisis central del nervio troclear tratada con debilitamiento del músculo oblicuo inferior.

TITLE: Parálisis central del nervio troclear tratada con debilitamiento del músculo oblicuo inferior.

Peripapillary and optic nerve head vessel density of glaucoma and healthy subjects from Afro-Caribbean and European descent: A pilot study.

PURPOSE: To compare the peripapillary and optic nerve head vessel density (PP-ONH VD) between glaucoma patients (all, early, moderated, and advanced) and healthy subjects of Afro-Caribbean descent (AD) and European descent (ED). METHODS: This was a cross-sectional study. One eye was evaluated in 90 subjects, including 66 glaucoma patients and 24 healthy subjects, who underwent PP-ONH VD imaging using SPECTRALIS® Optical Coherence Tomography Angiography (OCT-A). We analysed the superficial vascular complex using the AngioTool version 0.6a software. The correlation between the PP-ONH VD and visual field mean deviation (MD) was evaluated using a scatter plot and Spearman's rho correlation coefficient. RESULTS: Among the healthy subjects, the AD group had a lower superficial PP-ONH VD [43.29±3.25% (mean±standard deviation)] than the ED group (46.06±1.75%) (P=0.016). Overall, superficial PP-ONH VD did not show any significant differences between the total AD and ED glaucoma patients or in the subgroup analyses (early/moderate/advanced) (AD: 32.73±6.70%, 37.11±5.72%, 32.48±5.73%, 27.76±4.74%, respectively; ED: 33.94±6.89%, 38.52±3.82%, 35.56±4.18%; 27.65±6.31%, respectively) (P>0.05 for all). A strong, statistically significant correlation was established between vessel density and mean deviation among AD and ED glaucoma patients (r=0.709 and r=0.704, respectively) (P<0.001 for both). CONCLUSION: This pilot study shows that healthy subjects of AD had lower peripapillary and optic nerve head superficial vessel density than healthy subjects of ED, but no significant differences were found between AD and ED glaucoma groups (all, early, moderate, or advanced).

Afectación oftalmológica en el contexto de un síndrome de Sweet: comunicación de un caso y revisión de la literatura / Ocular involvement in a patient with Sweet syndrome: report of a case and review of the literatura

Presentamos el caso clínico de una mujer de 66 años que acudió a urgencias por lesiones cutáneas en miembros tanto superiores como inferiores, edema facial y enrojecimiento ocular, acompañados de conjuntivitis hemorrágica. Tras pautar corticoides sistémicos el cuadro se resolvió en una semana. La biopsia cutánea confirmó que se trataba de un síndrome de Sweet. El síndrome de Sweet es una enfermedad infrecuente y desconocida para la mayor parte de los oftalmólogos a pesar de cursar con manifestaciones oftalmológicas. La afectación ocular está presente en un tercio de los pacientes, siendo los más usuales la epiescleritis y la conjuntivitis. El diagnóstico de confirmación es histopatológico y se caracteriza por una rápida respuesta a los corticoides sistémicos

The case presented is a 66-year-old woman who attended the emergency department due to skin lesions on the limbs, facial oedema, and eye redness accompanied by haemorrhagic conjunctivitis. The symptoms resolved after one week of systemic steroid treatment. Skin biopsy confirmed Sweet syndrome. Sweet syndrome is rare disorder and unknown by most ophthalmologists despite its frequent ophthalmological manifestations. Ocular involvement is present in one third of patients, with episcleritis and conjunctivitis being the most repeated. Pathology findings confirm the diagnosis which is also characterised by a rapid response to systemic corticosteroids

Ocular involvement in a patient with Sweet syndrome: report of a case and review of the literature. / Afectación oftalmológica en el contexto de un síndrome de Sweet: comunicación de un caso y revisión de la literatura.

The case presented is a 66-year-old woman who attended the emergency department due to skin lesions on the limbs, facial oedema, and eye redness accompanied by haemorrhagic conjunctivitis. The symptoms resolved after one week of systemic steroid treatment. Skin biopsy confirmed Sweet syndrome. Sweet syndrome is rare disorder and unknown by most ophthalmologists despite its frequent ophthalmological manifestations. Ocular involvement is present in one third of patients, with episcleritis and conjunctivitis being the most repeated. Pathology findings confirm the diagnosis which is also characterised by a rapid response to systemic corticosteroids.

Importancia del radio-223 en la práctica hospitalaria. Visión del oncólogo médico / Relevance of radium-223 in hospital clinical practice from a medical oncologist point of view

Actualmente las opciones de tratamiento disponibles para el cáncer de próstata resistente a la castración metastásico (CPRCm) son diversas, pero carecemos de datos prospectivos sobre la mejor estrategia de secuenciación en estos pacientes. El dicloruro de 223Ra es el primer radiofármaco emisor de partículas alfa que ha demostrado aumento de supervivencia en pacientes con CPRCm. Este fármaco actúa selectivamente sobre el hueso, por lo que existe una ventana de oportunidad para su administración previa al desarrollo de metástasis viscerales, que debe ser tenida en cuenta a la hora de diseñar la estrategia terapéutica de estos pacientes. Es necesario, por tanto, definir los diferentes escenarios disponibles en la práctica clínica con el fin de llevar a cabo una mejor selección de pacientes y su correcta monitorización

Currently, there are several options available for the treatment of metastatic castration resistant prostate cancer (mCRPC), however evidence on the optimal treatment sequence is lacking. 223Ra is the first targeted alpha therapy that has shown an improvement in overall survival in mCRPC patients. This drug specifically targets bone lesions, so there is a window of opportunity for the administration of 223Ra previous to the development of visceral metastases. This should be taken into account to design the therapeutic strategy for mCRPC patients. It is necessary, therefore, to review the different approaches in routine clinical practice, to define best practices for patient selection and on-treatment monitoring

Relevance of radium-223 in hospital clinical practice from a medical oncologist point of view. / Importancia del radio-223 en la práctica hospitalaria. Visión del oncólogo médico.

Currently, there are several options available for the treatment of metastatic castration resistant prostate cancer (mCRPC), however evidence on the optimal treatment sequence is lacking. 223Ra is the first targeted alpha therapy that has shown an improvement in overall survival in mCRPC patients. This drug specifically targets bone lesions, so there is a window of opportunity for the administration of 223Ra previous to the development of visceral metastases. This should be taken into account to design the therapeutic strategy for mCRPC patients. It is necessary, therefore, to review the different approaches in routine clinical practice, to define best practices for patient selection and on-treatment monitoring.

Use of a tyrosine kinase inhibitor as neoadjuvant therapy for non-small cell lung cancer: A case report.

We report here a 66-year-old woman diagnosed with bronchioloalveolar carcinoma of the right lung cT4N2M0. The patient was from the Philippines, had never smoked, and tested positive for an EGFR mutation. She received gefitinib as neoadjuvant therapy for two months and displayed a partial response. The tumour was resected by performing a right pneumonectomy. The residual viable tumour accounted for less than 10%. Adjuvant chemotherapy with carboplatin-taxol was administered for four cycles. Fifteen months post-surgery, two brain metastases were found. Gefitinib was prescribed, and one month later complete radiological response was assessed. The patient remains asymptomatic and without visible disease four months later. Controlled randomised trials are needed to clarify the role of these target therapies in the neoadjuvant setting.

An hydroalcoholic extract of curcuma longa lowers the apo B/apo A ratio. Implications for atherogenesis prevention.

It is generally accepted that free-radical induced blood lipid peroxidation and especially peroxidized LDL play a central role in the pathogenesis of atherosclerosis and related cardiovascular disease. Moreover, recent research highlights the key contribution of apolipoprotein B (apo B) to atherogenesis as the main inductor of one of its earlier steps, i.e. macrophage proliferation. This has led us to investigate the apo B response to a very effective phenolic lipid-antioxidant, namely an hydroalcoholic extract of Curcuma longa, which according to our previous work does not show any toxic effects and decreases the levels of blood lipid peroxides, oxidized lipoproteins and fibrinogen. The present study shows that a daily oral administration of the extract decreases significantly the LDL and apo B and increases the HDL and apo A of healthy subjects. This and recent data on the increased anti-atherogenic action of the physiological antioxidant tocopherol in the presence of phenolic co-antioxidants (which eliminate the tocopheroxyl radical), justifies planned clinical research to test the usefulness of the curcuma extract as a co-antioxidant complement to standard treatments to prevent or retard atherosclerosis.

Increase with age of serum lipid peroxides: implications for the prevention of atherosclerosis.

There is considerable support for the concept that oxygen free radicals and related lipid peroxides play a key role in the pathogenesis of normal senescence and of age-related chronic degenerative diseases, including atherosclerosis. This has led to a great deal of interest regarding peroxidized LDL, which seems to be more atherogenic than LDL. In contrast, the relationship of total serum or plasma lipid peroxides (which also have a marked atherogenic action) with both aging and atherogenesis are not well understood. In view of the above, we have determined the level of serum lipid peroxide (expressed as thiobarbituric acid reactive substances) in a sample of 100 healthy men and women ranging in age from 20 to 70 years. Our data show that there is an age related increase in the concentration of lipid peroxide, with men showing higher or about equal values than women until about 60 years, after which age women show the higher values. Our data also suggest that in certain men and women, aging is linked to a decline in the competence of the oxyradical-detoxifying mechanisms, which results in increased serum lipid peroxidation. Further research is needed to find out if lowering the serum peroxide levels of aging subjects by diet supplementation with antioxidants will decrease that risk. An adequate intake of antioxidants seems especially indicated in post-menopausal women because of their apparent greater sensitivity to age related oxygen stress.

In vitro studies on the immunomodulating effects of polypodium leucotomos extract on human leukocyte fractions.

The in vitro effect of Anapsos, a water based extract of the naturally occurring fern Polypodium leucotomos (calagualine), on human leukocyte fractions was investigated. Calagualine inhibited interleukin-2 secretion and concanavalin A (Con A) stimulated proliferation of T-lymphocytes in a concentration dependent manner. In contrast, a greatly enhanced secretion of IL-1 alpha, IL-1 beta and tumor necrosis factor alpha was induced suggesting a stimulation of monocytes and dendritic cells also present in this system. Endotoxin induced stimulation was excluded. Also in the absence of Con A, calagualine stimulated cytokine production. The presented data show for the first time that calagualine exerts an immunomodulating effect on leukocyte fractions, paving the way for further detailed studies related to possible clinical efficacy.

[Multicenter drug surveillance of sublingual immunotherapy in allergic patients]. / Estudio multicéntrico de farmacovigilancia de inmunoterapia sublingual en pacientes alérgicos.

A study of pharmacovigilance has been performed in 522 patients suffering from allergic rhinitis and/or asthma. Sensitization was due to pollens and mites in ther majority of cases. The treatment consisted in biologically standardized glycerinated allergenic extracts for specific sublingual immunotherapy (SLIT) and, major allergens were also quantified, depending on the allergenic composition. The aims of the study were to assay the effect of the SLIT in a short-and-medium-term course and to know the adverse reactions most frequently appearing, as well as the unexpected side effects that are only possible to know through the study of a numerous sample of patients. We also evaluated the factors that can modify the tolerance of the treatment, such as the onset of patient's disease and its severity. All the patients had a clinical history of, at least, two years of evolution and positive skin-prick test to the allergen/s cause of their atopic disorder. Exclusion criteria were immunotherapy in the last two years, pregnancy and those situations in which the immunotherapy is contraindicated according to the EAACI requirements. In order to carry out the daily record of the SLIT as well as the possible appearance of symptoms, two diaries were given to each patient. Tolerance was evaluated by the physician at the end of the build-up phase (3 months) and when the maintenance phase finished (5 months later). Total administered doses were 44.021, the final number of patients who registered any adverse reaction in relation with SLIT was 41 (7.9%), with a number of 67 adverse reactions that means a 0.15% over the total administered doses.(ABSTRACT TRUNCATED AT 250 WORDS)