Knowledge and compliance with contact lens care: A population-based study at a referral center in Northeast Mexico.

OBJECTIVE: Despite the increasing prevalence of contact lens (CL) wear, knowledge and compliance with proper care remain suboptimal. This study aims to assess the level of knowledge and compliance with lens care practices in patients attending a third-level institution in Northeast Mexico. METHODS: A cross-sectional study using a self-administered online survey was conducted. Patients at the Instituto Tecnolgico de Monterrey were invited to participate. The questionnaire consisted of three sections: demographic data and CL information, CL practices, and CL care knowledge. Participants responding correctly to 6/7 questions from the second and third sections were classified as having good compliance and good knowledge, respectively. Predictive factors for good compliance and knowledge were calculated using a logistic regression model. RESULTS: A total of 287 users participated in the study. The median age was 25 (14-78) years with a female (n = 221, 77 %) predominance. Good knowledge was observed in 215 (74.9 %), whereas only 42 (14.6 %) presented good compliance. Failing to replace CL as prescribed (n = 199, 69.3 %) and sleeping with the devices (n = 198, 69 %) were the most frequent practices causing non-compliance. Whereas prohibition of swimming with CL was the least known practice (n = 74, 25 %). Users with recent (≤5 years) wearing experience were more likely to present good knowledge (OR 2.19, p = 0.014) and compliance (OR 3.15, p < 00.01). No statistical correlation was established between knowledge and compliance. CONCLUSION: Non-compliance and lack of knowledge of proper CL care were prevalent among in this population. Long-term CL users were at higher risk of non-compliance and lack of knowledge. Moreover, knowledge was not related to compliance; therefore, different strategies must be implemented to reduce CL misconduct.

Peru and its new challenge in higher education: Towards a research university.

The paradigm of research universities linked to the emergence of university rankings has unified and universalized the criteria relating to the quality of higher education. This situation has led to multiple responses across global society, which has started rating the quality of higher education systems through these rankings, supported by a series of indicators aligned to the characteristics of research universities. Given that the quality of a country's higher education is one of the fundamental pillars of its development, many countries have started to take government action in this respect. In the case of Peru this has not taken long, with the approval of Law 30220 in 2014. This aims to regulate the quality of higher education through a series of specific conditions governed by a newly created body known as SUNEDU. This article uses a Delphi panel to analyze the existing relationship between the conditions imposed by SUNEDU and the research universities' intrinsic characteristics. During the Delphi panel a consensus was reached through an acceptable and stable level of responses, resulting in confirmation that there is alignment between the conditions imposed by SUNEDU and the intrinsic characteristics of research universities.

Matrix metalloproteases from chondrocytes generate an antiangiogenic 16 kDa prolactin.

The 16 kDa N-terminal fragment of prolactin (16K-prolactin) is a potent antiangiogenic factor. Here, we demonstrate that matrix metalloproteases (MMPs) produced and secreted by chondrocytes generate biologically functional 16K-prolactin from full-length prolactin. When incubated with human prolactin at neutral pH, chondrocyte extracts and conditioned medium, as well as chondrocytes in culture, cleaved the Ser155-Leu156 peptide bond in prolactin, yielding - upon reduction of intramolecular disulfide bonds - a 16 kDa N-terminal fragment. This 16K-prolactin inhibited basic fibroblast growth factor (FGF)-induced endothelial cell proliferation in vitro. The Ser155-Leu156 site is highly conserved, and both human and rat prolactin were cleaved at this site by chondrocytes from either species. Conversion of prolactin to 16K-prolactin by chondrocyte lysates was completely abolished by the MMP inhibitors EDTA, GM6001 or 1,10-phenanthroline. Purified MMP-1, MMP-2, MMP-3, MMP-8, MMP-9 and MMP-13 cleaved human prolactin at Gln157, one residue downstream from the chondrocyte protease cleavage site, with the following relative potency: MMP-8 > MMP-13 > MMP-3 > MMP-1= MMP-2 > MMP-9. Finally, chondrocytes expressed prolactin mRNA (as revealed by RT-PCR) and they contained and released antiangiogenic N-terminal 16 kDa prolactin (detected by western blot and endothelial cell proliferation). These results suggest that several matrix metalloproteases in cartilage generate antiangiogenic 16K-prolactin from systemically derived or locally produced prolactin.

Trends of anticardiolipin antibodies after low-dose methylprednisolone and cyclophosphamide treatment of systemic lupus erythematosus.

BACKGROUND: The aim of the study is to analyze retrospectively the effect of low-dose methylprednisolone (MP) and cyclophosphamide (CYC) pulse therapy on anticardiolipin antibodies (aCL) serum levels in patients with systemic lupus erythematosus (SLE). METHODS: For aCL determinations, a beta2-glycoprotein I-dependent enzyme-linked immunosorbent test (ELISA) was performed. Lupus anticoagulant was investigated by Russell venom time with platelet neutralization. Antinuclear antibodies were performed by standardized methods. All SLE patients (from a total of 137) with aCL determinations who were assayed before and after MP and CYC pulse therapy were included in the study. RESULTS: Nine patients had aCL determinations before and after MP-CYC pulse therapy. All active patients with SLE improved clinically without severe MP-CYC side effects; 21 had IgG-aCL determinations, and 19 IgM-aCL determinations (40 assays) were performed in all nine patients during the observation period (zero time to 21 months). Three patients had secondary antiphospholipid syndrome (APLS)-related clinical manifestations. In all patients, IgG aCL antibodies decreased significantly (p <0.05). CONCLUSIONS: Decrease of IgG aCL serum levels as a consequence of the MP-CYC therapy herein reported might help to redefine previous concepts with regard to modulation of antiphospholipid antibody (aPL) immune response by immunosuppressive therapy. These findings might also have prognostic and therapeutic implications in SLE, on pregnancy in SLE, and in antiphospholipid syndrome (APL) as well, although prospective studies are required.

Medium-sized arterial vasculitis associated with vascular deposits of immunoglobin E. Favorable response to intravenous methylprednisolone and cyclophosphamide.

Herein we describe the case of a female patient with medium-sized arterial vasculitis associated with high serum immunoglobin E (lgE) levels in the absence of eosinophilia. During occlusive vascular events, IgE deposits in the arterial muscle layer were demonstrated by immunohistochemistry, suggesting a pathogenic role of this antibody in blood vessel inflammation. Combined treatment with methylprednisolone and cyclophosphamide was successful in reducing serum IgE levels and IgE tissue deposits and in inducing the clinical manifestations of vasculitis into remission. This primary medium-sized IgE-associated vasculitis may constitute a new syndrome not previously reported.

Endomyocardial fibrosis (Davies Disease) coincidental with systemic lupus erythematosus

Los autores presentan el caso de una mujer de 27 años, con signos y síntomas de insuficiencia cardiaca congestiva rebelde al tratamiento, anemia, úlceras en la mucosa gingival, fotosensibilidad y alopecia. Los datos electrocardiográficos, ecocardiográficos, angiográ-ficos y hemodinámicos orientaron el diagnóstico de cardiomiopatía restrictiva, insuficiencia mitral secundaria a prolapso mitral y dilatación biauricular. El examen histológico de la biopsia endomiocárdica, tomada durante el cateterismo cardiaco, mostró signos de fibrosis endomiocárdica y el examen inmunológico resultó compatible con lupus eritematoso sistémico. Hasta donde sabemos, este es el primer caso de fibrosis endomiocárdica (enfermedad de Davies) asociado con lupus eritematoso sistémico publicado en la literatura médica. Permanece incierta la etiología de la fibrosis endomiocárdica y su asociación con lupus eritematoso sistémico sugiere el probable origen autoinmune de este padecimiento.

El corazón y la artritis reumatoide: estudio prospectivo de 100 casos / The heart and rheumatoid arthritis: prospective study of 100 cases

Se estudiaron 100 pacientes consecutivos con Artritis Reumatoide del adulto desde el punto de vista cardiológico a través de métodos no invasivos para detectar la frecuencia de complicaciones cardiovasculares. Setenta y tres casos (73%) fueron del sexo femenino y veintisiete (27%) del masculino. Edad spromedio, 48.6 años. Edad promedio de inicio del padecimiento reumático, 34.2 años. Promedio de duración del mismo, 21.8 años. El 57% presentaron algún tipo de complicación cardiopulmonar. Clínicamente, 52 por ciento refirieron algún tipo de sintomatología cardiopulmonar. El examen físico fue anormal en el 27 por ciento. El factor reumatoide (Waaler-Rose) fue positivo en el 82%. La serie cardiaca mostró alguna alteración en el 33 por ciento, el electrocardiograma de reposo en el 48 por ciento y el ecocardiograma Modo M en el 52 por ciento de los casos. Las alteraciones más frecuentemente detectadas fueron: derrame pericárdico (21%); derrame pleural (9%); fibrosis pulmonar (6%) que corresponde a cifras más elevadas que lo publicado en la litratura; insuficiencia cardiaca (10%); lesión valvular (9%) dentro de las que se incluyen a seis pacientes con valvulopatía de etiología no precisable; cardiopatía isquémica (8%); miocarditis (6%); trastornos del ritmo (22%) y de la conducción (20%) incluyendo a una pacientes de 46 años de edad, quien durante una exacerbación de su padecimiento desarrolló bloqueo AV completo, requiriendo colocación de marcapaso definitivo. Nuestros resultados muestran que algunas de las lesiones encontradas son en parte más frecuentes y graves que la informadas en la literatura, probablemente debido a que su búsqueda fue por un lado intencionada y por otro a que nuestra muestra está formada por pacientes con enfermedad seria