Childhood-Onset Non-Infectious Uveitis in the "Biologic Era". Results From Spanish Multicenter Multidisciplinary Real-World Clinical Settings.

OBJECTIVE: To characterize and describe clinical experience with childhood-onset non-infectious uveitis. STUDY DESIGN: A multicenter retrospective multidisciplinary national web-based registry of 507 patients from 21 hospitals was analyzed. Cases were grouped as immune disease-associated (IMDu), idiopathic (IDIu) or ophthalmologically distinct. Characteristics of juvenile idiopathic arthritis-associated (non-HLA-B27-related) uveitis (JIAu), IDIu, and pars planitis (PP) were compared. RESULTS: IMDu (62.3%) and JIAu (51.9%) predominated in young females; and IDIu (22.7%) and PP (13.6%) in older children, without sex imbalance. Ocular complications occurred in 45.3% of cases (posterior synechiae [28%], cataracts [16%], band keratopathy [14%], ocular hypertension [11%] and cystoid macular edema [10%]) and were associated with synthetic (86%) and biologic (65%) disease-modifying antirheumatic drug (DMARD) use. Subgroups were significantly associated (p < 0.05) with different characteristics. JIAu was typically anterior (98%), insidious (75%), in ANA-positive (69%), young females (82%) with fewer complications (31%), better visual outcomes, and later use of uveitis-effective biologics. In contrast, IDIu was characteristically anterior (87%) or panuveitic (12.1%), with acute onset (60%) and more complications at onset (59%: synechiae [31%] and cataracts [9.6%]) and less DMARD use, while PP is intermediate, and was mostly bilateral (72.5%), persistent (86.5%) and chronic (86.8%), with more complications (70%; mainly posterior segment and cataracts at last visit), impaired visual acuity at onset, and greater systemic (81.2%), subtenon (29.1%) and intravitreal (10.1%) steroid use. CONCLUSION: Prognosis of childhood uveitis has improved in the "biologic era," particularly in JIAu. Early referral and DMARD therapy may reduce steroid use and improve outcomes, especially in PP and IDIu.

A Robust Method for the Elaboration of SiO2-Based Colloidal Crystals as a Template for Inverse Opal Structures.

Photonic crystals (PCs) are nanomaterials with photonic properties made up of periodically modulated dielectric materials that reflect light between a wavelength range located in the photonic band gap. Colloidal PCs (C-PC) have been proposed for several applications such as optical platforms for the formation of physical, chemical, and biological sensors based on a chromatic response to an external stimulus. In this work, a robust protocol for the elaboration of photonic crystals based on SiO2 particle (SP) deposition using the vertical lifting method was studied. A wide range of lifting speeds and particle suspension concentrations were investigated by evaluating the C-PC reflectance spectrum. Thinner and higher reflectance peaks were obtained with a decrease in the lifting speed and an increase in the SP concentrations up to certain values. Seven batches of twelve C-PCs employing a SP 3% suspension and a lifting speed of 0.28 µm/s were prepared to test the reproducibility of this method. Every C-PC fabricated in this assay has a wavelength peak in a range of 10 nm and a peak width lower than 90 nm. Inverse-opal polymeric films with a highly porous and interconnected morphology were obtained using the developed C-PC as a template. Overall, these results showed that reproducible colloidal crystals could be elaborated on a large scale with a simple apparatus in a short period, providing a step forward in the scale-up of the fabrication of photonic colloidal crystal and IO structures as those employed for the elaboration of photonic polymeric sensors.

Detection of Atrazine and Its Metabolites in Natural Water Samples Using Photonic Molecularly Imprinted Sensors.

In a previous study, photonic-based molecularly imprinted polymers (MIPs) were fabricated using atrazine (ATZ) and its metabolites, desethylatrazine (DEA) and desisopropylatrazine (DIA), as templates in separate matrices. For the purposes of monitoring the abovementioned molecules in natural waters, the effect of natural waters-featuring ionic strength and natural organic matter (NOM) on atrazine MIP-were studied in this work, and the photonic MIP was implemented for monitoring the target molecules in natural water samples collected from land in nearby farms in northeast of Columbia MO. Non-imprinted polymers (NIP) were also fabricated and applied in the experiments as a control test. In presence of NaCl, CaCl2, and NOM, MIPs presented lower responses by 26%, higher responses by 23%, and higher responses by 35%, respectively. NIPs response in terms of an increase or decrease was consistent with those of MIPs, but only for a lower percentage. MIPs response in natural waters-which were characterized for their physicochemical characteristics such as conductivity, total organic carbon content, etc.-provided a good approximation of the real concentrations obtained from the LCMS instrument; in general, they showed a good concordance, although large discrepancies occurred for some samples, which can be related to reproducibility issues in the manufacturing process or the presence of unknown interfering compounds in the real samples.

Urinary Protein/Creatinine Ratio in Feline Medicine: Reasons to Perform It and Its Role in Clinical Practice-A Retrospective Study.

This study aimed at understanding the reasons veterinarians conduct a urinary protein/creatinine ratio (UPCR) in cats, correlating it with signalment, dipstick proteinuria tests, and urine specific gravity (USG) and assessing its role in chronic kidney disease (CKD) diagnosis and monitoring. A retrospective study was conducted, including medical data from cats consulted between 2016 and 2018 in a veterinary teaching hospital and submitted to at least one UPCR measurement. A total of 140 cats were included: 35% non-proteinuric (UPCR < 0.2), 25% borderline proteinuric (0.2 < UPCR < 0.4), and 40% overtly proteinuric (UPCR > 0.4). In contrast to other studies, there was no association between UPCR and male reproductive status. UPCR was mainly requested for CKD diagnosis and monitoring. Correlation between UPCR and combined results from dipstick tests and USG was low and inconsistent. Proteinuric CKD cats had a worse outcome at both 6 (odds ratio (OR 4.04) and 12 months (OR 4.36)), and this finding was more pronounced for severely proteinuric cases in which the OR for death was 4.36 and 6.00 at 6 and at 12 months, respectively. In addition to reinforcing the negative prognostic value of proteinuria, this study stresses the low and the inconsistent agreement between UPCR and the combined results of dipstick tests and USG in cats.

Detection of progesterone in aqueous samples by molecularly imprinted photonic polymers.

A label-free molecular imprinted polymer (MIP) sensor was fabricated for the detection of progesterone in aqueous solutions, by polymerization inside the void spaces of colloidal crystals, which gave them photonic properties. The prepolymerization mixture was prepared from acrylic acid as the functional monomer, ethylene glycol as the cross-linker agent, ethanol as solvent, and progesterone as the imprinted template. After polymerization, the colloidal crystal was removed by acid etching and the target eluted with a solvent. Material characterization included as follows: attenuated total reflectance-Fourier-transform infrared spectroscopy, dynamic light scattering, swelling experiments, and environmental scanning electron microscopy. MIPs were investigated by equilibrium binding, kinetics experiments, and UV-visible spectra to investigate Bragg diffraction peak shift that occurs with the rebinding at different progesterone concentrations in deionized water and 150-mM NaCl solutions. The MIP response was investigated with progesterone concentration in the 1-100 µg L-1 range, with LOD of 0.5 µg L-1, reaching the detected range of hormone in natural waters. Furthermore, hydrogel MIP films were successfully tested in various real water matrices with satisfactory results. Moreover, the MIP film exhibited good selectivity toward the progesterone hormone evidenced by a larger response than when exposed to structurally similar molecules. Computational studies suggested that size along with surface potential influenced the binding of analog compounds. Due to their ease of use and low cost, the sensors are promising as screening tools for the presence of progesterone in aqueous samples.

Removal of Congo red dyes from aqueous solutions by porous γ-alumina nanoshells.

Porous alumina has been shown to be an excellent adsorbent for Congo Red (CR) dye. In this work, highly porous g-Al2O3 nanoshells were synthesized from alumina coated carbon black (CB) obtained from a new deposition technique and used for removal of CR dye from aqueous solutions. Adsorption experiments were conducted in a batch mode and a series of parameters were investigated, including contact time, initial dye concentrations, ionic strength and pH of the solutions. It was found that equilibrium for CR adsorption can be reached within 30 min, much faster than reported by other studies in the literature on similar adsorbents. It was also found that the adsorption capacity of Al2O3 nanoshells is 44.8 % higher than that of alumina/CB. The adsorption capacity of Al2O3 nanoshells was more favorable at lower pH, and the optimal adsorption ability was achieved at pH 4.0 with a removal efficiency at 98.6 %. The Al2O3 nanoshells have a maximum adsorption capacity of 370.4 mg g-1 (25 °C; pH 7; no salt added), better than or comparable to those reported in the literature. A pseudo-second-order kinetics model can best fit the kinetics of CR adsorption, which follows the Langmuir isotherm. The high adsorption capacity is attributed to the strong hydrogen-bonding interactions between the anionic dye and Al2O3 nanoshells surface as well as to the electrostatic interactions between CR dye and the Al2O3 nanoshells.

Multi-laboratory experiment PME11 for the standardization of phosphoproteome analysis.

Global analysis of protein phosphorylation by mass spectrometry proteomic techniques has emerged in the last decades as a powerful tool in biological and biomedical research. However, there are several factors that make the global study of the phosphoproteome more challenging than measuring non-modified proteins. The low stoichiometry of the phosphorylated species and the need to retrieve residue specific information require particular attention on sample preparation, data acquisition and processing to ensure reproducibility, qualitative and quantitative robustness and ample phosphoproteome coverage in phosphoproteomic workflows. Aiming to investigate the effect of different variables in the performance of proteome wide phosphoprotein analysis protocols, ProteoRed-ISCIII and EuPA launched the Proteomics Multicentric Experiment 11 (PME11). A reference sample consisting of a yeast protein extract spiked in with different amounts of a phosphomix standard (Sigma/Merck) was distributed to 31 laboratories around the globe. Thirty-six datasets from 23 laboratories were analyzed. Our results indicate the suitability of the PME11 reference sample to benchmark and optimize phosphoproteomics strategies, weighing the influence of different factors, as well as to rank intra and inter laboratory performance.

Detection of chlorantraniliprole residues in tomato using field-deployable MIP photonic sensors.

A photonic sensor based on inversed opal molecular imprinted polymer (MIP) film to detect the presence of chlorantraniliprole (CHL) residue in tomatoes was developed. Acrylic acid was polymerized in the presence of CHL inside the structure of a colloidal crystal, followed by etching of the colloids and CHL elution. Colloidal crystals and MIP films were characterized by scanning electron microscopy and FT-IR, confirming the inner structure and chemical structure of the material. MIP films supported on polymethylmethacrylate (PMMA) slides were incubated in aqueous solutions of the pesticide and in blended tomato samples. The MIP sensor displayed shifts of the peak wavelength of the reflection spectra in the visible range when incubated in CHL concentrations between 0.5 and 10 µg L-1, while almost no peak displacement was observed for non-imprinted (NIP) films. Whole tomatoes were blended into a liquid and spiked with CHL; the sensor was able to detect CHL residues down to 0.5 µg kg-1, significantly below the tolerance level established by the US Environmental Protection Agency of 1.4 mg kg-1. Stable values were reached after about 30-min incubation in test samples. Control samples (unspiked processed tomatoes) produced peak shifts both in MIP and NIP films; however, this matrix effect did not affect the detection of CHL in the spiked samples. These promising results support the application of photonic MIP sensors as an economical and field-deployable screening tool for the detection of CHL in crops.

Results of a Diagnostic Procedure Based on Multiplex Technology on Dried Blood Spots and Buccal Swabs for Subjects With Suspected Alpha1 Antitrypsin Deficiency / Resultados de un procedimiento diagnóstico basado en tecnología multiplex que usa manchas de sangre seca y frotis bucales en sujetos con sospecha de deficiencia de alfa-1 antitripsina

INTRODUCTION: The objective of this analysis was the evaluation of a new national circuit used for diagnosing alpha1 antitrypsin deficiency (AATD) based on multiplex technology using online registration and mail posted samples from dried blood spots (DBS) and buccal swabs. METHODS: This is an observational, ongoing study conducted in Spain since March 2018. Samples are coded on a web platform and sent by postal mail to the central laboratory. Allele-specific genotyping for the 14 most common mutations was done with the Luminex 200 Instrument System. Gene sequencing was done if none of the mutations were found and the AAT serum level was < 60 mg/dl, or by request from the clinician in charge. RESULTS: At the time of the present report, 5803 (92.9%) samples were processed, 4984 (85.9%) from buccal swab and 819 (14.1%) from DBS. The prevalence of the frequent allele combinations were: MS 19.0%, MZ 14.4%, SS 2.9%, SZ 3.7%, and ZZ: 1.4%. Globally, Z carriers represented 20.0% and S carriers 26.6% of this population, with differences seen between regions. 209 (3.6%) were identified carrying rare alleles, 12 (0.2%) carrying null alleles and 14 (0.3%) new mutations were described. Respiratory diseases other than COPD, including poorly controlled asthma or bronchiectasis, also presented AATD mutations. CONCLUSIONS: The availability of a diagnostic system based on the simultaneous testing of 14 genetic variants from buccal swabs or DBS sent by postal mail and with web registration has proven to be useful, and the system can improve the timely diagnosis of AATD

INTRODUCCIÓN: El objetivo de este análisis fue la evaluación de un nuevo circuito nacional utilizado para diagnosticar la deficiencia de alfa-1 antitripsina (DAAT) basado en tecnología multiplex con muestras de manchas de sangre seca (DBS, por sus siglas en inglés) y frotis bucales enviados por correo postal tras un registro previo en línea. MÉTODOS: Este es un estudio observacional en curso que se está llevando a cabo en España desde marzo de 2018. Las muestras se codifican en una plataforma web y se envían por correo postal al laboratorio central. El genotipado de un alelo específico buscando las 14 mutaciones más comunes se realizó con el sistema Luminex(R) 200. Se realizó secuenciación génica si no se encontraba ninguna de las mutaciones y el nivel sérico de AAT era < 60mg/dl, o por solicitud del médico responsable. RESULTADOS: En el momento del presente informe se habían procesado 5.803 (92,9%) muestras, 4.984 (85,9%) de frotis bucal y 819 (14,1%) de DBS. La prevalencia de las combinaciones frecuentes de alelos fue: MS 19,0%, MZ 14,4%, SS 2,9%, SZ 3,7% y ZZ 1,4%. Globalmente, los portadores de Z representaron el 20,0% y los portadores de S el 26,6% de esta población, observándose diferencias entre las regiones. Se identificaron 209 (3,6%) portadores de alelos raros, 12 (0,2%) portadores de alelos nulos y se describieron 14 (0,3%) nuevas mutaciones. Otras enfermedades respiratorias que no eran EPOC, incluyendo el asma mal controlado o las bronquiectasias, también presentaron mutaciones DAAT. CONCLUSIONES: La disponibilidad de un sistema de diagnóstico con registro web basado en el análisis simultáneo de 14 variantes genéticas de frotis bucales o DBS enviados por correo postal ha demostrado ser útil, y el sistema puede mejorar el diagnóstico temprano de DAAT

Results of a Diagnostic Procedure Based on Multiplex Technology on Dried Blood Spots and Buccal Swabs for Subjects With Suspected Alpha1 Antitrypsin Deficiency.

INTRODUCTION: The objective of this analysis was the evaluation of a new national circuit used for diagnosing alpha1 antitrypsin deficiency (AATD) based on multiplex technology using online registration and mail posted samples from dried blood spots (DBS) and buccal swabs. METHODS: This is an observational, ongoing study conducted in Spain since March 2018. Samples are coded on a web platform and sent by postal mail to the central laboratory. Allele-specific genotyping for the 14 most common mutations was done with the Luminex 200 Instrument System. Gene sequencing was done if none of the mutations were found and the AAT serum level was <60mg/dl, or by request from the clinician in charge. RESULTS: At the time of the present report, 5803 (92.9%) samples were processed, 4984 (85.9%) from buccal swab and 819 (14.1%) from DBS. The prevalence of the frequent allele combinations were: MS 19.0%, MZ 14.4%, SS 2.9%, SZ 3.7%, and ZZ: 1.4%. Globally, Z carriers represented 20.0% and S carriers 26.6% of this population, with differences seen between regions. 209 (3.6%) were identified carrying rare alleles, 12 (0.2%) carrying null alleles and 14 (0.3%) new mutations were described. Respiratory diseases other than COPD, including poorly controlled asthma or bronchiectasis, also presented AATD mutations. CONCLUSIONS: The availability of a diagnostic system based on the simultaneous testing of 14 genetic variants from buccal swabs or DBS sent by postal mail and with web registration has proven to be useful, and the system can improve the timely diagnosis of AATD.

GCAP neuronal calcium sensor proteins mediate photoreceptor cell death in the rd3 mouse model of LCA12 congenital blindness by involving endoplasmic reticulum stress.

Loss-of-function mutations in the retinal degeneration 3 (RD3) gene cause inherited retinopathy with impaired rod and cone function and fast retinal degeneration in patients and in the natural strain of rd3 mice. The underlying physiopathology mechanisms are not well understood. We previously proposed that guanylate cyclase-activating proteins (GCAPs) might be key Ca2+-sensors mediating the physiopathology of this disorder, based on the demonstrated toxicity of GCAP2 when blocked in its Ca2+-free form at photoreceptor inner segments. We here show that the retinal degeneration in rd3 mice is substantially delayed by GCAPs ablation. While the number of retinal photoreceptor cells is halved in 6 weeks in rd3 mice, it takes 8 months to halve in rd3/rd3 GCAPs-/- mice. Although this substantial morphological rescue does not correlate with recovery of visual function due to very diminished guanylate cyclase activity in rd3 mice, it is very informative of the mechanisms underlying photoreceptor cell death. By showing that GCAP2 is mostly in its Ca2+-free-phosphorylated state in rd3 mice, we infer that the [Ca2+]i at rod inner segments is permanently low. GCAPs are therefore retained at the inner segment in their Ca2+-free, guanylate cyclase activator state. We show that in this conformational state GCAPs induce endoplasmic reticulum (ER) stress, mitochondrial swelling, and cell death. ER stress and mitochondrial swelling are early hallmarks of rd3 retinas preceding photoreceptor cell death, that are substantially rescued by GCAPs ablation. By revealing the involvement of GCAPs-induced ER stress in the physiopathology of Leber's congenital amaurosis 12 (LCA12), this work will aid to guide novel therapies to preserve retinal integrity in LCA12 patients to expand the window for gene therapy intervention to restore vision.

Drug Retention Rate and Causes of Discontinuation of Adalimumab in Uveitis: Real-World Data from the Biotherapies in Uveitis (BioÚvea) Study Group.

PURPOSE: To study the drug retention rate (DRR), causes, and predictors of discontinuation of adalimumab (ADA) in a real-world uveitis setting. DESIGN: Multicentric, nationwide, registry-based, ambispective, observational study. PARTICIPANTS: Patients treated with ADA for noninfectious uveitis (NIU) in the Biotherapies for Uveitis (BioÚvea) Spanish registry from November 2016 to November 2017. METHODS: Demographics, clinical data, timing, and reasons for discontinuation, if occurred, were recorded. The DRR and drug retention time (DRT) were estimated using the Kaplan-Meier method. Median follow-up was analyzed by reverse Kaplan-Meier. Log-rank test was used for comparisons. Cox proportional-hazards model (PHM) and propensity score matching were used to identify predictors for discontinuation due to inefficacy and adverse events. MAIN OUTCOME MEASURES: Drug retention rate and DRT. RESULTS: A total of 392 patients were analyzed, including 218 women. Median age was 39 (interquartile range, 25) years. Nonanterior uveitis was recorded in 242 patients. Median follow-up was 49.07 (0.97-131.67) months, median DRT (survival) was 69.3 months, and 14 patients were lost to follow-up. The DRR at 6, 12, 24, and 60 months was 92.97%, 87.68%, 76.31%, and 54.28%, respectively. Adalimumab was discontinued in 151 patients. Discontinuation was due to lack or loss of efficacy in 74 patients, adverse event in 34 patients, and sustained quiescence in 25 patients. Recorded adverse events included infections in 10 patients and malignant neoplasms in 3 patients. Concurrent classic immunomodulatory therapy (IMT) was given to 251 patients. We did not find DRT differences regarding the use of concurrent IMT. Adalimumab was prescribed as a second or greater biotherapy line in 76 patients who showed shorter DRT (P = 0.038). Starting ADA in nonbiotherapy-naive patients was a predictor for "discontinuation due to inefficacy," whereas undifferentiated uveitis was a predictor for "discontinuation due to adverse event." Drug retention time was significantly shorter when spared or intensified, mainly due to discontinuation after sustained quiescence. CONCLUSIONS: Drug retention rate of ADA in uveitis at 60 months was 54.28%, with a good safety profile. The use of concurrent IMT did not show a significant influence on DRT. The use of ADA as a second or further biotherapy could be predictive for discontinuation due to inefficacy. Undifferentiated uveitis may be prone to premature discontinuation of ADA due to adverse events.

Perforación de colon sigmoides por espina de pescado: tratamiento combinado laparoscópico y endoscópico / Fishbone perforation of the sigmoid colon: combined laparoscopic and endoscopic treatment

La ingestión accidental de cuerpos extraños, más frecuentemente espinas de pescado, causa perforaciones intestinales en menos del 1 % de los casos; la alta morbimortalidad asociada con estas ha favorecido la búsqueda de alternativas frente a la cirugía convencional. El caso presentado muestra cómo el abordaje combinado secuencial laparoscópico y endoscópico, permite resolver con menor grado de agresión una perforación sigmoidea por cuerpo extraño

Accidental ingestion of foreign bodies, more frequently fishbones, causes intestinal perforations in less than 1% of cases. The associated high morbidity and mortality has lead to the search for alternatives to conventional surgery. The presented case shows how sequential approach, laparoscopic and endoscopic combined, allows a sigmoid perforation by a foreign body to be solved with a lower aggressive approach

A multicentric study to evaluate the use of relative retention times in targeted proteomics.

Despite the maturity reached by targeted proteomic strategies, reliable and standardized protocols are urgently needed to enhance reproducibility among different laboratories and analytical platforms, facilitating a more widespread use in biomedical research. To achieve this goal, the use of dimensionless relative retention times (iRT), defined on the basis of peptide standard retention times (RT), has lately emerged as a powerful tool. The robustness, reproducibility and utility of this strategy were examined for the first time in a multicentric setting, involving 28 laboratories that included 24 of the Spanish network of proteomics laboratories (ProteoRed-ISCIII). According to the results obtained in this study, dimensionless retention time values (iRTs) demonstrated to be a useful tool for transferring and sharing peptide retention times across different chromatographic set-ups both intra- and inter-laboratories. iRT values also showed very low variability over long time periods. Furthermore, parallel quantitative analyses showed a high reproducibility despite the variety of experimental strategies used, either MRM (multiple reaction monitoring) or pseudoMRM, and the diversity of analytical platforms employed. BIOLOGICAL SIGNIFICANCE: From the very beginning of proteomics as an analytical science there has been a growing interest in developing standardized methods and experimental procedures in order to ensure the highest quality and reproducibility of the results. In this regard, the recent (2012) introduction of the dimensionless retention time concept has been a significant advance. In our multicentric (28 laboratories) study we explore the usefulness of this concept in the context of a targeted proteomics experiment, demonstrating that dimensionless retention time values is a useful tool for transferring and sharing peptide retention times across different chromatographic set-ups.

ECAMulticapa: Effectiveness of double-layered compression therapy for healing venous ulcers in primary care: a Study Protocol.

BACKGROUND: Chronic venous insufficiency, in its final stage can cause venous ulcers. Venous ulcers have a prevalence of 0.5 % to 0.8 % in the general population, and increases starting at 60 years of age. This condition often causes increased dependency in affected individuals, as well as a perceived reduced quality of life and family overload. Local Treating chronic venous ulcers has 2 components: topically healing the ulcer and controlling the venous insufficiency. There is evidence that compressive therapy favours the healing process of venous ulcers. The studies we have found suggest that the use of multilayer bandage systems is more effective than the use of bandages with a single component, these are mostly using in Spain. Multilayer compression bandages with 2 layers are equally effective in the healing process of chronic venous ulcers as 4-layer bandages and are better tolerated and preferenced by patients. More studies are needed to specifically compare the 2-layer bandages systems in the settings where these patients are usually treated. METHOD/DESIGN: Randomised, controlled, parallel, multicentre clinical trial, with 12 weeks of follow-up and blind evaluation of the response variable. The objective is to assess the efficacy of multilayer compression bandages (2 layers) compared with crepe bandages, based on the incidence of healed venous ulcers in individuals treated in primary care nursing consultations, at 12 weeks of follow-up. The study will include 216 individuals (108 per branch) with venous ulcers treated in primary care nursing consultations. The primary endpoint is complete healing at 12 weeks of follow-up. The secondary endpoints are the degree of healing (Resvech.2), quality of life (CCVUQ-e), adverse reactions related to the healing process. Prognosis and demographic variables are also recorder. Effectiveness analysis using Kaplan-Meier curves, a log-rank test and a Cox regression analysis. The analysis was performed by intention to treat. DISCUSSION: The study results can contribute to improving the care and quality of life of patients with venous ulcers, decreasing healing times and healthcare expenditure and contributing to the consistent treatment of these lesions. TRIAL REGISTRATION: This study has been recorded in the Clinical Trials.gov site with the code NCT02364921. 17 February 2015.

Feasibility of custom-made hydrogel contact lenses in keratoconus with previous implantation of intracorneal ring segments.

PURPOSE: To analyze the feasibility of a custom-made hydrogel silicone contact lens (CL) in keratoconus with intracorneal ring segments (ICRS) and to compare outcomes taking in consideration the geometry of the fitted lens-full periphery (FP) vs. sector management control (SMC). METHOD: A retrospective review of cases with previous KeraRings ICRS implantation and subsequently fitted with Kerasoft-IC CL was performed. The main outcome measurements were corrected spectacle distance visual acuity (CDVA), differences between flat and steep simulated keratometries (K-diff) and between steep and flat P values (CPV-diff), CL visual acuity (CLVA), wearing time (WT) and complications associated with wear. RESULTS: Thirty eyes of 22 patients and a follow-up time of 10.3±2.3 months were reviewed. Statistically significant improvement was observed between LogMAR CDVA and CLVA (0.25±0.19 vs. 0.04±0.05; P<0.0001). WT was 11.2h±1.2. Two eyes with mild corneal staining and another two with mild injection were noted. Twenty SMC designs were recorded and associated with lower levels of CDVA (0.36±0.22 vs. 0.18±0.10; P=0.006), CLVA (0.06±0.05 vs. 0.01±0.03; P=0.03), and larger amounts of CPV-diff (2.31±1.86 vs. 1.03±1.11; P=0.02) than those eyes fitted with FP designs. No statistical differences were found in the amount of K-diff and WT between both sub-groups. CONCLUSIONS: Fitting custom-made hydrogel silicone CL in keratoconus with ICRS is a feasible treatment with low rate of complications and adequate visual acuity and WT.

Advances in sperm proteomics: best-practise methodology and clinical potential.

The recent application of mass spectrometry to the study of the sperm cell has led to an unprecedented capacity for identification of sperm proteins in a variety of species. Knowledge of the proteins that make up the sperm cell represents the first step towards understanding its normal function and the molecular anomalies associated with male infertility. The present review starts with an introduction of the sperm cell biology and is followed by the consideration of the methodological key aspects to be aware of during sample sourcing and preparation, including data interpretation. It then overviews the initiatives developed so far towards the completion of the sperm proteome, with a particular focus in human but with the inclusion of some comments on different model species. Finally, all studies performing differential proteomics in infertile patients are reviewed, pointing to future potential applications.

Novedades en alteraciones del ritmo cardiaco: electrofisiología cardiaca, arritmias y estimulación cardiaca / Innovations in heart rhythm disturbances: cardiac electrophysiology, arrhythmias, and cardiac pacing

En este artículo se revisan los trabajos más relevantes en el campo de las arritmias publicados en 2012, incluyendo aritmología clínica, técnicas de ablación, estimulación cardiaca y genética de la muerte súbita (AU)

This article reviews the most relevant articles published in 2012 in the field of arrhythmias, on subjects that include clinical arrhythmology, ablation, cardiac pacing, and the genetics of sudden cardiac death (AU)

Effect of corneal morphometry on dynamic contour and Goldmann applanation tonometry.

OBJECTIVES: To determine the effects on dynamic contour tonometry (DCT) and Goldmann applanation tonometry (GAT) of the power of the flattest and steepest corneal meridians, their orientation, central corneal thickness (CCT), mean overall corneal thickness, and the mean thickness of a circular zone centered at the corneal apex of 1 mm radius (zone I) and the mean thicknesses of several concentric rings also centered at the apex of width 1 mm (zones II to VI, respectively). METHODS: A total of 136 consecutive healthy eyes were examined. Two multivariate linear regression models were constructed, 1 for each tonometry system. In both models, the predictive variables were: keratometric power of the flattest and steepest axes, flattest axis (as one of the categories 0 to 30, 30 to 60, 60 to 90, 90 to 120, 120 to 150, and 150 to 180 degrees), CCT, mean overall corneal thickness (determined using the Pentacam), and mean thicknesses of corneal zones I, II, III, IV, V, and VI (determined using the Pentacam). RESULTS: The multivariate regression analysis (adjusted R=0.11; P=0.04) revealed that GAT was influenced by CCT [B=0.042; 95% confidence interval (CI), 0.002-0.085] and the mean thicknesses of zones I (B=0.996; 95% CI, 0.105-1.729), II (B=-1.688; 95% CI, -3.171 to -0.204), and III (B=0.718; 95% CI, 0.028-1.407), whereas DCT was solely affected by the mean thickness of zone II (B=-0.372; 95% CI, -0.728 to -0.016) (adjusted R2=0.13; P=0.02). CONCLUSIONS: Although DCT is only affected by the mean thickness of zone II, GAT is influenced by CCT and the mean thickness of zones I, II, and III.