[Optical coherence tomography and macular phototoxicity]. / OCT y fototoxicidad macular.

CASE REPORT: Ocular examinations and optical coherence tomography (OCT) were performed in three patients with retinal phototoxicity lesions. Fluorescein angiography depicted a window defect. OCT exhibited hyporeflectivity at the outer foveal retina and fragmentation of the inner reflective layers, corresponding to the junction between the inner and outer photoreceptor segments. DISCUSSION: Retinal damage after light exposure has a rapid onset and shows different patterns in OCT examination. OCT findings suggest that decreased visual acuity may be associated with full-thickness photoreceptors and retinal pigment epithelium (RPE) involvement. OCT is a useful tool for objective assessment of retinal pathology in phototoxicity cases where fundus changes may be minimal or absent.

OCT y fototoxicidad macular / Optical coherence tomography and macular phototoxicity

Caso clínico: Se realiza una exploración ocular y tomografía de coherencia óptica (OCT) en tres pacientes con lesiones fototóxicas retinianas. Las angiografías fluoresceínicas muestran un defecto ventana. La OCT muestra hiporreflectividad en la porción externa de la fóvea y fragmentación de las capas más internas entre la porción interna de los fotorreceptores y los segmentos externos. Discusión: Las lesiones retinianas tras exposición a la luz aparecen precozmente mostrando diferentes patrones en la OCT. La OCT sugiere que la disminución de visión asocia una lesión de fotorreceptores y epitelio pigmentario retiniano (EPR). La OCT es útil para objetivar la retinopatía fototóxica donde los cambios oftalmoscópicos pueden estar ausentes o ser mínimos

Case report: Ocular examinations and optical coherence tomography (OCT) were performed in three patients with retinal phototoxicity lesions. Fluorescein angiography depicted a window defect. OCT exhibited hyporeflectivity at the outer foveal retina and fragmentation of the inner reflective layers, corresponding to the junction between the inner and outer photoreceptor segments. Discussion: Retinal damage after light exposure has a rapid onset and shows different patterns in OCT examination. OCT findings suggest that decreased visual acuity may be associated with full-thickness photoreceptors and retinal pigment epithelium (RPE) involvement. OCT is a useful tool for objective assessment of retinal pathology in phototoxicity cases where fundus changes may be minimal or absent (Arch Soc Esp Oftalmol 2008; 83: 267-272)

[Asymptomatic vasoproliferative retinal tumor]. / Tumor vasoproliferativo de la retina asintomático.

PURPOSE/METHOD: A case of vasoproliferative retinal tumor is described. The main differential diagnoses must be excluded and the therapeutic possibilities defined. RESULTS/CONCLUSIONS: Vasoproliferative retinal tumors are infrequent benign retinal lesions of gliovascular composition. The differential diagnoses needing consideration are a retinal hemangioma associated with von Hippel-Lindau disease, an amelanotic choroidal melanoma and an ocular metastasis from a tumor elsewhere. Treatment must be performed in those cases where the sight is threatened.

Tumor vasoproliferativo de la retina asintomático / Asimptomatic vasoproliferative retianla tumor

Objetivo/Método: Se describe un caso de tumor vasoproliferativo de la retina. Se analizan las principales entidades con las que se debe establecer el diagnóstico diferencial y la actitud terapéutica.Resultados/Conclusiones: Los tumores vasoproliferativos de la retina son lesiones retinianas benignas poco frecuentes de composición gliovascular. El diagnóstico diferencial se debe realizar con los hemangiomas retinianos de la enfermedad de von Hippel-Lindau, con el melanoma coroideo amelanótico y con las metástasis oculares. El tratamiento se debe efectuar en aquellos casos que presenten alteraciones que puedan comprometer la visión

Purpose/method: A case of vasoproliferative retinal tumor is described. The main differential diagnoses must be excluded and the therapeutic possibilities defined. Results/conclusions: Vasoproliferative retinal tumors are infrequent benign retinal lesions of gliovascular composition. The differential diagnoses needing consideration are a retinal hemangioma associated with von Hippel-Lindau disease, an amelanotic choroidal melanoma and an ocular metastasis from a tumor elsewhere. Treatment must be performed in those cases where the sight is threatened

The role of cultural norms in the self-esteem and drug use relationship.

It is widely believed that low self-esteem (SE) is associated with greater substance use, although previous research has been unable to support such a relationship consistently. The present study used the "social deviance model" to investigate whether SE was differentially related to substance use for respondents in varying cultural norms. Responses to intensity of tobacco, marijuana, alcohol, and drug use, SE, and cultural norm items from over 2,000 high school and college students failed to support this model.

Implications for the alcohol/drug education specialist working with children of alcoholics: a review of the literature from 1988 to 1992.

This article reviews the scientific literature on children of alcoholics (COAs) from 1988 to 1992. First the publications were divided into two classifications: practitioner-oriented and research-oriented literature. Each practitioner-oriented article was evaluated on the following criteria: program description, theoretical model, recommendations substantiated by research, behavioral indicators of COAs, suggestions for intervening, and resource lists. For each of the research-oriented articles, the variables measured, sample source, sample size, and number of COAs in the sample are listed. Additionally, those articles are evaluated for research design, instruments, and analytical techniques. Reviews of early research in this area identified severe methodological limitations across the majority of articles. However, results of this more recent review indicate that research on COAs no longer suffers from previously common methodological weaknesses and sampling biases. The research-based literature also indicated that a larger number of COAs are resilient, which calls into question common assumptions about the inevitable negative effects of familial alcoholism. Alcohol/drug education specialists need to be cognizant of the more recent results on non-clinical samples of COAs in designing and implementing sensitive programs.

Enhancing adoption of an alcohol abuse prevention program: An application of diffusion theory.

The purpose of this study was to apply diffusion theory (Rogers, 1983) to an alcohol abuse prevention program in order to enhance program adoption. Three of the four stages of diffusion theory (dissemination, adoption, and implementation) are discussed relative to the development and implementation of a program designed to increase awareness of the destructive effects upon children who live with an addicted parent of living with that parent. The program also focused upon resiliency building strategies to use with children in order to mitigate the harmful effects of addiction in the home. Empirical data are presented concerning the dissemination, adoption and implementation phases of the program.

Use of the theory of reasoned action to predict drug and alcohol use.

The present study examines the role of self-esteem (SE) in the prediction of drug and alcohol use. Consistent with research on the theory of reasoned action, we suggest that alcohol and drug attitudes and subjective norms are more useful in the prediction of self-reported drug and alcohol consumption than SE. In the present study, measures of SE, drug attitudes, subjective norms, and drug use behaviors were collected from 2,074 high school and college students. Results indicate that drug attitudes and subjective norms do predict drug and alcohol use, but that SE does not add significantly to the prediction of the drug and alcohol behaviors.

Satisfaction with health-related educational workshops: the role of environmental and logistical factors.

The present study examined correlates of the perceived quality of four educational conferences. Specifically, the study examined the relationships of ratings of subjective overall conference quality with environmental and logistical aspects of the conferences. The results showed that ratings of room quality as well as ratings of meeting structure were significantly related to ratings of overall conference quality. Follow-up coverall conference ratings, measured up to one year after the conferences, were predicted by initial ratings of food quality.

Smokeless tobacco use among American college students.

This study sought to delineate patterns of smokeless tobacco use among college students in the United States. A national sample (N = 5,894) of approximately equal numbers of men and women from 72 colleges and universities participated in the study. Eight percent of the college students in the Northeast used smokeless tobacco, whereas 15% in the South Central United States were using it. Seventeen percent of the American Indian, 14% of Mexican-American, 12% of white, and 4% of black students reported they had dipped or chewed. Smokeless tobacco users were more likely to have family and friends who also used smokeless tobacco. Almost two thirds (63%) of current users plan to continue to dip or chew. More than half (57%) the users consumed less than two cans or pouches per week. Smokeless tobacco is a serious problem in American colleges and universities. Unless prevention and cessation efforts target this group, the problem will continue to increase and ultimately could result in an oral cancer epidemic.

Age of initiation and switching patterns between smokeless tobacco and cigarettes among college students in the United States.

A stratified, random, multi-stage, cluster sample of physical activity classes among 72 colleges and universities throughout the United States yielded 5,894 usable responses (males = 2,888); (females = 3,006). Twenty-three per cent of the students who began smoking before the age of 10 were current smokers, while 61 per cent of those who began using smokeless tobacco before the age of 10 were current smokeless tobacco users. College students were more likely to switch from smokeless tobacco to cigarettes than from smoking cigarettes to smokeless tobacco.

Environmental communication: new roles, hard choices.

PIP: Concerning the environment, conservation implies maintaining the same or previous standards, while natural resource management indicates we can somehow manage the earth's resources. A better term might be sustainable development which to some means simply food sufficiency, to others stabilizing population growth, and yet others participation in decision making and the political process. There are 3 global ecological trends: warming of the climate caused by man's activities, loss of genetic resources, and loss of productivity of a large part of the arable land. What is not known is how much corrective action is needed and when. The global population growth may be a major cause and a fundamental issue. When it comes to policy and funding, we seem to be better in cleaning up than in changing basic behavior in controlling our excesses. Developing countries' poorest people suffer the most, as arable lands decay and wood supplies dwindle. Unfortunately industrial and economic development are almost always in conflict with environmental issues. The poorest countries are most concerned about water supplies, sufficient food and fuel while the richest countries can be concerned about whales, elephants and the forests. The media has played a major role in raising the consciousness of the developed world to the environmental issues.^ieng

Anesthetic considerations in patients with gas gangrene.

Anesthesia for a patient with gas gangrene presents a challenge for the anesthesiologist, since it is an uncommon disease requiring emergency treatment. The authors, faced with such a challenge and finding little guidance in the literature, have proposed modalities of anesthetic management based on pathophysiology, symptomatology, and the reported experience of others. In addition to choice of anesthetic agents, problems reviewed include shock, hypovolemia, tachycardia, fever, anemia, renal dysfunction, pulmonary insufficiency, and contamination. Factors relating to anesthesia during hyperbaric-O2 therapy are also reviewed.