Polimorfismo rs4998 del gen ADRB3 y su relación con el índicede masa corpora / Polymorphism rs4998 of the ADRB3 gene and its relationship with the bodymass index

Introducción: Para el 2007 en Colombia se estimó que el 56% de la población adulta era obesa, condición que se considera un problema de salud pública con implicaciones en el desarrollo de enfermedad coronaria. Objetivo: Determinar la distribución de las frecuencias alélicas y genotípicas y la relación del polimorfismo rs4998 del gen ADRB3 con el índice de masa corporal en una población de docentes y administrativos. Materiales y Métodos: La extracción de ADN se llevó a cabo mediante un método comercial, para la amplificación de ADN se emplearon cebadores específicos no marcado con fluorocromos, los fragmentos obtenidos fueron purificados mediante las enzimas SAP y EXOSAP, finalmente se realizó minisecuenciación en el ABI PRISM 310 y posterior lectura de electroferogramas. El análisis de las variables sociode mográficas se realizó mediante métodos univariados y métodos bivariados empleando pruebas de significancia como: test Chi2 de Pearson y test exacto de Fisher. Modelos logísticos fueron empleados para evaluar asociación. Resultados: Las frecuencias genotípicas encontradas fueron 0.96 GG, 0.014 CG y 0,020 CC. Las frecuencias alélicas fueron 0,027 C y 0,973 G. La muestra se encontró en equilibrio de Hardy-Weinberg con Chi2 = 81.153(1) (p = 0.000) y se calculó la estructura poblacional mediante la prueba Fst = 0,743. Discusión: Encontrar la población en equilibrio de Hardy-Weinberg indica que los individuos se están mezclando al azar. El coeficiente de endogamia o estadístico Fst, indica que la población presenta una alta estructura o diferenciación genética y existe fijación del alelo mutado G; esto podría obtener falsas asociaciones con la patología de interés. Conclusión: Las frecuencias obtenidas en este estudio no se ajustan a los modelos génicos propuestos para estudios de asociación; por lo tanto, se recomienda aumentar el tamaño de la muestra para futuras investigaciones o plantear estudios de casos y controles

Introduction: At 2007 in Colombia it was estimated that a portion 56 % from the adult population was obese, a condition that is considered a public health problem with implications in the development of coronary heart disease.Objective: Determine the distribution of allelic and genotypic frequencies and the relation of the polymorphism rs4998 of the ADRB3 gene with the Body Mass Index in a population of teachers and administrators of an university institution in Colombia. Methods: DNA extraction was carried out by a commercial method, for specific DNA amplification, specific primers not labeled with fluorochromes were used, fragments obtained were purified by SAP and EXOSAP enzymes, and finally minisequencing was performed in the ABI PRISM 310 and later electropherogram reading. The analysis of the sociodemographic variables was performed using univariate methods and bivariate methods using significance tests such as: Pearson's Chi2 test and Fisher's exact test. Logistic models were used to evaluate association. Results: The genotype frequencies found were 0.96 GG, 0.014 CG and 0.020 CC. The allele frequencies were 0.027 C and 0.973 G. The sample was found in Hardy-Weinberg equilibrium with Chi2 = 81.153 (1) (p = 0.000) and the population structure was calculated by means of the Fst test = 0.743. Discussion: Finding the population in Hardy-Weinberg equilibrium, indicates that individuals were mixed randomly. The coefficient of inbreeding or statistical Fst, is very close to one, which indicates that the population has a high structure or genetic differentiation and there is fixation of the mutated allele G. This could obtain false associations with the pathology of interest. Conclusion: The frequencies obtained in this study do not fit the proposed gene models for association studies, therefore, it is recommended to increase the sample size for future researches or to propose case-control studies

Scanning Electron Microscope Analysis of Stromal Surface Regularity in DSAEK Using Manual or Automated Microkeratomes or DMEK.

PURPOSE: To analyze differences in the stromal bed according to the method used to obtain the disc for endothelial transplant with 1) an automated microkeratome for Descemet stripping automated endothelial keratoplasty (DSAEK), 2) homogeneous dissection of Descemet membrane (Descemet membrane endothelial keratoplasty [DMEK]), or 3) a manual microkeratome used for DSAEK. METHODS: We analyzed the stromal bed of 25 consecutive corneas used for endothelial transplantation, divided into 3 groups: 1) 11 samples cut with an automated microkeratome, 2) 5 samples used for DMEK, 3) 9 samples cut with a manual microkeratome. A scanning electron microscope was used to obtain an image of the center of the stromal bed. The irregularity index of the surface complementary to the stromal surface of the disc obtained for grafting was calculated with the Canny algorithm (0: completely smooth; 1: completely irregular). RESULTS: At all thresholds studied (20, 30, 50, and 70), the mean irregularity index for group C (35.2, 24.4, 13.7, and 8.8, respectively) was higher than that of group A (26.2, 14.8, 6.7, and 4.0, respectively), which in turn was higher than that of group B (7.0, 4.2, 2.4, and 1.8, respectively). Differences were statistically significant among all groups and for all thresholds. CONCLUSIONS: Irregularity of the stromal bed after any dissection can be quantified using the Canny method. The use of an automated microkeratome for DSAEK reduces irregularity and helps obtain a surface more similar to that obtained with DMEK than with a manual microkeratome.

A case-control study of post-traumatic endophthalmitis at a Spanish hospital.

Our aim was to identify the potential risk factors for developing post-traumatic endophthalmitis (PTE) and the possible measures of prevention. Retrospective case-control study, with 15 cases of PTE and 2 matched controls. We reviewed the medical records of the cases and their respective controls during the period 1996-2008 at a Spanish Hospital. We collected demographic data and information about the type of trauma, the potential risk factors, comorbidities, microbial isolations, antimicrobial susceptibility, administered treatments, and the visual outcome. The independent predictor factors identified for PTE were intraocular foreign body (IOFB) (OR 5.48; CI 95 % 1.05-28.7), dirty wound (OR 4.91; CI 95 % 0.96-25.3), and wound closure delays of 24 h or more (OR 5.48; CI 95 % 1.05-28.7). The probability of endophthalmitis in patients without these risk factors was 5.9 %, but ascended to 65.3 % and 90.3 %, in those patients with two and three risk factors, respectively. Infected patients presented a complication rate of 80 %, with an evisceration rate of 53 %; both were significantly associated with infection. The visual outcome was poor and related to the presence of IOFB and virulent microorganisms (Bacillus sp., filamentous fungus), visual acuity at presentation, and retinal detachment. Patients who presented an IOFB, dirty wound, and delayed wound closure were 15 times more likely to develop infection, and when infected, patients fared much worse than those non-infected. We thus recommend aggressive prophylactic measures in patients with these risk factors, adding antifungal prophylaxis when the injury is contaminated with vegetable matter.

Estudio microbiológico de los casos de endoftalmitis infecciosa con cultivo positivo en un periodo de 13 años / Microbiological study of infectious endophthalmitis with positive culture within a 13 year-period

Introducción. Nuestros objetivos son describir el espectro microbiano y la susceptibilidad a los antimicrobianos de los casos de endoftalmitis con cultivo positivo. Materiales y métodos. Estudio retrospectivo de los pacientes con diagnóstico microbiológico de endoftalmitis atendidos en el Servicio de Oftalmología del Hospital General La Mancha Centro en el periodo 1996-2008. La identificación de los aislamientos se realizó mediante el sistema automatizado VITEK-2® y las galerías Api (BioMérieux, España S.A.). La susceptibilidad a los antimicrobianos se realizó por el sistema VITEK-2® (BioMérieux, España S.A.), tiras de E-test (MIC Test Strip, Liofilchem, Italy) y el sistema comercial Sensititre® YeastOne (Trek, Diagnostic Systems, Ohio, USA) para las especies de Candida. Resultados. De los 63 casos de endoftalmitis, 44 (70%) presentaron cultivo positivo. Tanto en las endoftalmitis postquirúrgicas (EPQ) como postraumáticas (EPT) las bacterias gram-positivas fueron mucho más frecuentes que las bacterias gram-negativas, predominando Staphylococcus epidermidis en las EPQ; en las EPT predominó Bacillus sp., aislándose además el 75% del total de hongos aislados. Las cepas aisladas presentaron una sensibilidad del 100% frente a vancomicina, ceftazidima y amikacina, mientras que la resistencia a ciprofloxacino fue mayor del 15%. El tratamiento antifúngico empírico falló en el 50% de los casos. El pronóstico visual fue significativamente menos favorable en las EPT. Conclusiones. En base a la sensibilidad de nuestros aislamientos, vancomicina, ceftazidima y amikacina constituyen buenas opciones para el tratamiento empírico de las endoftalmitis, al contrario que ciprofloxacino. Recomendamos la realización de profilaxis antifúngica después de un traumatismo del globo ocular en medio rural (AU)

Introduction. Our objectives are to describe the microbial spectrum and antimicrobial susceptibility of isolates from patients with culture-proven endophthalmitis. Material and methods. Retrospective study of patients with microbiological diagnosis of endophthalmitis treated at the Ophthalmology Department of the General Hospital La Mancha Centro in the period 1996-2008. The identification of isolates was performed using the automated VITEK-2® and Api galleries (bioMérieux, Spain SA). The antimicrobial susceptibility was performed by the VITEK-2® system (bioMérieux, Spain SA), E-test strips (MIC Test Strip, Liofilchem, Italy) and Sensititre® YeastOne trading system (Trek Diagnostic Systems, Ohio, USA) for Candida species. Results. Forty four (70%) of 63 cases of endophthalmitis were culture positive. Gram-positive bacteria were much more common than gram-negative bacteria in both postoperative endophthalmitis (POE) and post-traumatic endophthalmitis (PTE). Staphylococcus epidermidis was predominant in POE, while Bacillus sp. predominated in the PTE; furthermore, the 75% of total fungal isolates corresponded to postraumatic cases. The isolated strains showed 100% susceptibility to vancomycin, ceftazidime and amikacin, while resistance to ciprofloxacin was greater than 15%. The empirical antifungal therapy failed in 50% of cases. The visual prognosis was significantly less favorable in the PTE. Conclusions. Based on the susceptibility of our isolates, vancomycin, ceftazidime and amikacin are good choices for empirical treatment of endophthalmitis, unlike ciprofloxacin. We recommend conducting antifungal prophylaxis after penetrating ocular trauma in a rural environment (AU)

Impact of changes in antibiotic prophylaxis on postoperative endophthalmitis in a Spanish hospital.

OBJECTIVE: This study aims to assess whether changes in antibiotic prophylaxis used in cataract surgery in the La Mancha Centro General Hospital, Spain, were associated with a reduced incidence of postoperative endophthalmitis (POE). METHODS: The hospital employed two different antibiotic prophylaxis regimens during two clearly differentiated periods. In the first period (January 2000 to April 2003), subconjunctival injections of gentamicin were used while in the second (May 2003 to December 2008), vancomycin and gentamicin were added to the irrigating solution. During both periods, povidone iodine was used at the site of surgery and aminoglycoside eye drops were administered postoperatively. A Poisson regression model was used to evaluate the relationship between the incidence rate of endophthalmitis and variables such as time trends, seasonality, and change in antibiotic prophylaxis regimen. RESULTS: During the period between 2000 and 2008, 26 cases of POE were detected after 14,285 operations for an incidence rate (IR) of 1.8 cases per 1000 procedures (95% confidence interval 1.2-2.7 cases out of 1000 procedures). In the period prior to the change in prophylaxis, 23 cases were detected (IR 4.5 cases/1000 procedures) while only three cases were observed in the period after the change (IR 0.3 cases/1000 procedures). A total of 84% of the microorganisms isolated were gram-positive, and all were sensitive to vancomycin. CONCLUSIONS: The change in antibiotic prophylaxis regimen for cataract surgery was associated with a relevant and significant decrease in the incidence of POE.