Estimation and interrater reliability of pupillography by digital mobile app: Digital movil pupillography app validity.

OBJECTIVE: The examination of pupillary light reflexes is widely employed to evaluate the autonomic system's balance, ocular, and neurological conditions, typically evaluated by qualitative observation. To describe and evaluate the inter-rater reliability and agreement of pupillometric values obtained with a novel semi-automatic mobile pupillography app. METHODS: Two examiners and two graders perform the measurements with an android app which corrects the device-face distance, measure the maximum contraction of the pupil, and calculates its slope, in a hospital room setting with three levels of environmental light intensity: <100, 101 to 200, and 201 to 300 lux, at 200, 400, 600, 900, 1200, and 1500 milliseconds. RESULTS: Sixty healthy individuals, aged 18 to 45, were included; 85% had brown eyes. The reliability of the pupil/iris ratio had Ri = 70% to 88%, and bland Altman graphics show a uniform agreement. The pupillography curves show a similar slope at different light intensities, during the contraction phase. CONCLUSION: There were very good repeatability and inter-rater reproducibility of the measurements at average levels of illumination in examination rooms, even in dark-eyed people. This app provides a highly promising approach to pupillary measurements in clinical practice.

In silico pace-mapping: prediction of left vs. right outflow tract origin in idiopathic ventricular arrhythmias with patient-specific electrophysiological simulations.

AIMS: A pre-operative non-invasive identification of the site of origin (SOO) of outflow tract ventricular arrhythmias (OTVAs) is important to properly plan radiofrequency ablation procedures. Although some algorithms based on electrocardiograms (ECGs) have been developed to predict left vs. right ventricular origins, their accuracy is still limited, especially in complex anatomies. The aim of this work is to use patient-specific electrophysiological simulations of the heart to predict the SOO in OTVA patients. METHODS AND RESULTS: An in silico pace-mapping procedure was designed and used on 11 heart geometries, generating for each case simulated ECGs from 12 clinically plausible SOO. Subsequently, the simulated ECGs were compared with patient ECG data obtained during the clinical tachycardia using the 12-lead correlation coefficient (12-lead ρ). Left ventricle (LV) vs. right ventricle (RV) SOO was estimated by computing the LV/RV ratio for each patient, obtained by dividing the average 12-lead ρ value of the LV- and RV-SOO simulated ECGs, respectively. Simulated ECGs that had virtual sites close to the ablation points that stopped the arrhythmia presented higher correlation coefficients. The LV/RV ratio correctly predicted LV vs. RV SOO in 10/11 cases; 1.07 vs. 0.93 P < 0.05 for 12-lead ρ. CONCLUSION: The obtained results demonstrate the potential of the developed in silico pace-mapping technique to complement standard ECG for the pre-operative planning of complex ventricular arrhythmias.

Usefulness of Ilae 2010 classification in Mexican epilepsy patients.

OBJECTIVE: Advances in neuroimaging, genomics, and molecular biology have improved the understanding of the pathogenesis of epilepsy. That is why the International League Against Epilepsy (ILAE) has created a new classification system. The present study aims to evaluate the association between epilepsy cases classified by the ILAE 2010 classification proposal, electroencephalography (EEG), and magnetic resonance imaging brain findings (MRI). METHODS: Prospective cross-sectional design of 277 cases of epilepsy seen at the Epilepsy Clinic, Hospital Central "Dr. Ignacio Morones Prieto", were compared with the ILAE classification based on the etiology and clinical manifestations and their MRI and EEG findings. STATISTICAL ANALYSIS: Cochran, Mantell, Haenzel test with significance p<0.05. RESULTS: MRI findings were associated with the etiology of the ILAE classification. According to EEG findings, the structural-metabolic etiology patients had more dysfunctional reports than genetic or unknown etiology patients (p<0.05). SIGNIFICANCE: The adoption of the ILAE classification is recommended, as it can provide useful guidance towards the etiology of cases of epilepsy even when brain MRIs and EEGs are not available.

Complicaciones por dispositivos intrauterinos. Servicio de planificación familiar; centro de medicina integral "La Sabanita": trienio 1979-1980 / Complication by intrauterino devices family planing service, integral medicine center \"La Sabanita\": three years 1979-1980-1981

Se revisaron 288 historias de usuarias que utilizaran dispositivos intrauterinos de las cuales 154 utilizaran lippes C, 96 lippes D, 28 T de cobre y 10 multiload, encontrando que el mayor grupo etario de usuarias estaba comprendido entre 15 y 24 años; con un total de 158 usuarias de las cuales 189 eran solteras y 99 casadas. En relación con las complicaciones por el uso de dispositivos intrauterinos el más alto porcentaje estuvo representado por hemorragias con un 30,9%; una tasa de embazado de 1,73% la cual coincide con la estimada por otros autores el porcentaje mayor de embarazo se presentó en las usuarias de dispositivo lippes D; en cuanto a las infecciones correspondió a un 13,19%; no hubo perforación uterina en ningún caso de las mujeres observadas