[Validity and usefulness of the RAE-CMBD studying patients hospitalised with influenza]. / Validez y utilidad del RAE-CMBD en el estudio de los pacientes hospitalizados con gripe.

OBJECTIVE: Understanding the hospital impact of influenza requires enriching epidemiological surveillance registries with other sources of information. The aim of this study was to determine the validity of the Hospital Care Activity Record - Minimum Basic Data Set (RAE-CMBD) in the analysis of the outcomes of patients hospitalised with this infection. METHODS: Observational and retrospective study of adults admitted with influenza in a tertiary hospital during the 2017/2018 and 2018/2019 seasons. We calculated the concordance of the RAE-CMBD with the influenza epidemiological surveillance registry (gold standard), as well as the main parameters of internal and external validity. Logistic regression models were used for risk adjustment of in-hospital mortality and length of stay. RESULTS: A total of 907 (97.74%) unique matches were achieved, with high inter-observer agreement (ƙ=0.828). The RAE-CMBD showed a 79.87% sensitivity, 99.72% specificity, 86.71% positive predictive value and 99.54% negative predictive value. The risk-adjusted mortality ratio of patients with influenza was lower than that of patients without influenza: 0.667 (0.53-0.82) vs. 1.008 (0.98-1.04) and the risk-adjusted length of stay ratio was higher: 1.15 (1.12-1.18) vs. 1.00 (0.996-1.001). CONCLUSIONS: The RAE-CMBD is a valid source of information for the study of the impact of influenza on hospital care. The lower risk-adjusted mortality of patients admitted with influenza compared to other inpatients seems to point to the effectiveness of the main clinical and organisational measures adopted.

Difficult intravenous access in a paediatric intensive care unit.

INTRODUCTION: Multiple attempts during peripheral cannulation can have major consequences for patients, relatives, and healthcare professionals, therefore we set out to determine the extent of this problem in a paediatric intensive care unit (PICU). OBJECTIVES: The main aim was to describe peripheral venous catheter (PVC) and peripherally inserted central catheter (PICC) cannulation in children in the PICU. Secondary objectives were to determine the success rate of the first cannulation attempt, to quantify patients with difficult venous access (DVA), and to explore the association between DVA and sociodemographic, technique and nursing-related characteristics. METHOD: A cross-sectional descriptive study. Consecutive sampling was used to recruit patients aged 0-18 years admitted to the PICU who required peripheral venous cannulation. An ad hoc questionnaire was used for this purpose, including the presence of DVA as an independent variable. RESULTS: A total of 163 venous cannulations were reported. A total of 55.8% (91) were performed in patients under 1 year of age. Of these, 38.7% (63) were successful on the first attempt and 36.8% (60) had DVA. When there was DVA, 85% (51) of patients had complications, median time to cannulation by short CVP was 30 minutes [15-53] and 2 or more nurses were required on 80% (48) of occasions. CONCLUSIONS: We found a low success rate at first attempt and a high proportion of DVA. More nurses and time were employed during cannulation and complications increased if the patient had DVA. A statistically significant association was found between DVA and age, weight, poor perfusion, veins that were neither visible nor palpable, DIVA score ≥ 4, history of difficult intravenous access, complications, number of nurses and time spent.

Vía venosa difícil en una unidad de cuidados intensivos pediátricos / Difficult intravenous access in a paediatric intensive care unit

Introducción: Los múltiples intentos durante la canalización periférica pueden producir importantes consecuencias que afectan a pacientes, familiares y profesionales, por ello se planteó la necesidad de conocer la dimensión de este problema en una unidad de cuidados intensivos pediátricos (UCIP).Objetivos: El objetivo principal fue describir la canalización de catéter venoso periférico y catéter central de inserción periférica en niños de UCIP. Como objetivos secundarios se propuso determinar la proporción de éxito en el primer intento de canalización, cuantificar los pacientes que presentan vía venosa difícil (VVD), así como explorar la asociación entre la aparición de la VVD y las características sociodemográficas, las relativas a la técnica y a las enfermeras.Método: Estudio descriptivo transversal. Mediante muestreo consecutivo se reclutaron pacientes entre 0 y 18 años ingresados en UCIP que precisaron canalización de acceso venoso periférico. Para ello se utilizó un cuestionario ad hoc incluyendo la presencia de VVD como variable independiente.Resultados: Se recogieron 163 canalizaciones venosas. El 55,8% (91) se realizaron en pacientes menores de 1 año. El 38,7% (63) acertó en el primer intento y el 36,8% (60) presentaron VVD. Cuando aparecía VVD el 85% (51) de los pacientes tuvieron complicaciones, la mediana de tiempo para la canalización mediante catéter venoso periférico corto fue de 30minutos [15-53] y se precisaron 2 o más enfermeras en el 80% (48) de las ocasiones.Conclusiones: Se encontró un bajo porcentaje de acierto al primer intento y una proporción elevada de VVD. Aparecía un mayor número de enfermeras y de tiempo empleado durante la canalización y un aumento de las complicaciones si el paciente presentaba VVD. Se encontró asociación estadísticamente significativa entre VVD y edad, peso, mala perfusión, vena no visible ni palpable, puntuación en la escala DIVA≥4, historia de VVD, complicaciones, número de enfermeras y tiempo empleado.

Introduction: Multiple attempts during peripheral cannulation can have major consequences for patients, relatives, and healthcare professionals, therefore we set out to determine the extent of this problem in a paediatric intensive care unit (PICU).Objectives: The main aim was to describe peripheral venous catheter (PVC) and peripherally inserted central catheter (PICC) cannulation in children in the PICU. Secondary objectives were to determine the success rate of the first cannulation attempt, to quantify patients with difficult venous access (DVA), and to explore the association between DVA and sociodemographic, technique and nursing-related characteristics.Method: A cross-sectional descriptive study. Consecutive sampling was used to recruit patients aged 0-18 years admitted to the PICU who required peripheral venous cannulation. An ad hoc questionnaire was used for this purpose, including the presence of DVA as an independent variable.Results: A total of 163 venous cannulations were reported. A total of 55.8% (91) were performed in patients under 1 year of age. Of these, 38.7% (63) were successful on the first attempt and 36.8% (60) had DVA. When there was DVA, 85% (51) of patients had complications, median time to cannulation by short CVP was 30minutes [15-53] and 2 or more nurses were required on 80% (48) of occasions.Conclusions: We found a low success rate at first attempt and a high proportion of DVA. More nurses and time were employed during cannulation and complications increased if the patient had DVA. A statistically significant association was found between DVA and age, weight, poor perfusion, veins that were neither visible nor palpable, DIVA score≥4, history of difficult intravenous access, complications, number of nurses and time spent.

Difficult intravenous access in a paediatric intensive care unit. / Vía venosa difícil en una unidad de cuidados intensivos pediátricos.

INTRODUCTION: Multiple attempts during peripheral cannulation can have major consequences for patients, relatives, and healthcare professionals, therefore we set out to determine the extent of this problem in a paediatric intensive care unit (PICU). OBJECTIVES: The main aim was to describe peripheral venous catheter (PVC) and peripherally inserted central catheter (PICC) cannulation in children in the PICU. Secondary objectives were to determine the success rate of the first cannulation attempt, to quantify patients with difficult venous access (DVA), and to explore the association between DVA and sociodemographic, technique and nursing-related characteristics. METHOD: A cross-sectional descriptive study. Consecutive sampling was used to recruit patients aged 0-18 years admitted to the PICU who required peripheral venous cannulation. An ad hoc questionnaire was used for this purpose, including the presence of DVA as an independent variable. RESULTS: A total of 163 venous cannulations were reported. A total of 55.8% (91) were performed in patients under 1 year of age. Of these, 38.7% (63) were successful on the first attempt and 36.8% (60) had DVA. When there was DVA, 85% (51) of patients had complications, median time to cannulation by short CVP was 30minutes [15-53] and 2 or more nurses were required on 80% (48) of occasions. CONCLUSIONS: We found a low success rate at first attempt and a high proportion of DVA. More nurses and time were employed during cannulation and complications increased if the patient had DVA. A statistically significant association was found between DVA and age, weight, poor perfusion, veins that were neither visible nor palpable, DIVA score≥4, history of difficult intravenous access, complications, number of nurses and time spent.

Ventajas de la cirugía combinada de catarata y vitrectomía con la lente "Bag-in-the-lens" / Advantages of combined cataract and vitrectomy surgery with the "Bag-In-the-Lens"

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Maniobra del tapón especular para implante express / Bubble mirror technique for express shunt surgery

TÉCNICA QUIRÚRGICA: La maniobra del tapón especular o «bubble mirror technique» consiste en la estabilización de la cámara anterior con una combinación de aire y viscoelástico colocados estratégicamente. En la interfase aire-viscoelástico de este taponamiento surge una línea donde se refleja, como en un espejo, el ángulo camerular. DISCUSIÓN: El tapón especular aporta 3 beneficios a la cirugía del glaucoma con implante Ex-PRESS: 1) efecto tapón del viscoelástico, que proporciona estabilidad a la cámara anterior, impidiendo su colapso; 2) efecto tono de la burbuja de aire; y 3) efecto especular de la interfase, que permite al cirujano el control visual del ángulo camerular durante la implantación del Ex-PRESS

SURGICAL TECHNIQUE: The bubble mirror technique consists of the stabilization of the anterior chamber by means of a plug made with a combination of conveniently placed air and viscoelastic material. A line arises at interface between the air and viscoelastic where the anterior chamber angle reflected can be seen as in a mirror (bubble mirror). DISCUSSION: The viscoelastic-air plug offers three advantages in glaucoma surgery with the Ex-PRESS implant: 1) plug effect of viscoelastic, giving stability to the anterior chamber and preventing it from collapsing; 2) toning effect of the air bubble; and 3) specular effect at the interface, which allows the surgeon to visually control the chamber angle during the Ex-PRESS implantation

[Bubble mirror technique for express shunt surgery]. / Maniobra del tapón especular para implante express.

SURGICAL TECHNIQUE: The bubble mirror technique consists of the stabilization of the anterior chamber by means of a plug made with a combination of conveniently placed air and viscoelastic material. A line arises at interface between the air and viscoelastic where the anterior chamber angle reflected can be seen as in a mirror (bubble mirror). DISCUSSION: The viscoelastic-air plug offers three advantages in glaucoma surgery with the Ex-PRESS implant: 1) plug effect of viscoelastic, giving stability to the anterior chamber and preventing it from collapsing; 2) toning effect of the air bubble; and 3) specular effect at the interface, which allows the surgeon to visually control the chamber angle during the Ex-PRESS implantation.

[Hemorrhagic Descemet's membrane detachment after viscocanalostomy]. / Desprendimiento hemorrágico de la membrana de Descemet tras viscocanalostomía.

INTRODUCTION: Viscocanalostomy is an option in the surgical treatment of glaucoma. This non-penetrating technique favours aqueous drainage through the Schlemm channel while avoiding filtering blebs and their related pathologies. Complications associated to this surgery are unusual, one of which is Decemet's membrane detachment (DMD) CLINICAL CASE: A 64 year-old female diagnosed with open-angle chronic glaucoma, whose had undergone a viscocanalostomy of the left eye. In the immediate postoperative period we noticed a hemorrhagic DMD in the lower temporal quadrant. After adopting a wait and see attitude, we did not find improvement 15 days after surgery and corneal edema was established with vision decrease. We proceeded to a surgical reapplication by means of Descemet's membrane micropuncture and SF6 injection into the anterior chamber and achieving an anatomical and functional improvement DISCUSSION: We believe that the intrusion of viscoelastic material into the supradescemetic was a consequence of the high-pressure during the high-density hyaluronate injection. Hemorrhagic DMD management is mainly determined by its location, size and evolution. In our case, the posterior endothelial micropuncture and descematopexy by means of 20% SF6 injection into the anterior chamber was useful in resolving this complication.

Desprendimiento hemorrágico de la membrana de Descemet tras viscocanalostomía / Hemorrhagic Descemet’s membrane detachment after viscocanalostomy

Introducción: La viscocanalostomía constituye una alternativa en el tratamiento quirúrgicodel glaucoma. Esta técnica no penetrante favorece el drenaje del acuoso a través del canalde Schlemm evitando la aparición de ampollas de filtración y de las patologías relacionadascon éstas. Las complicaciones asociadas a esta cirugía son escasas; una de ellas es eldesprendimiento de la membrana de Descemet (DMD).Caso clínico: Mujer de 64 años diagnosticada de glaucoma crónico de ángulo abierto cuyoojo izquierdo fue intervenido mediante viscocanalostomía. En el posoperatorio inmediatoapareció un DMD hemorrágico en el cuadrante temporal inferior. Tras adoptar inicialmenteuna actitud expectante, a los 15 días de la cirugía no se objetivó mejoría del DMD y seinstauró un edema corneal que produjo disminución de la visión. Se procedió a la reaplicaciónquirúrgica del defecto mediante micropunción de la membrana de Descemet e inyecciónde SF6 en cámara anterior. Se consiguió una mejoría anatómica y funcional delcuadro.Discusión: Pensamos que la salida del material viscoelástico al espacio supradesceméticofue consecuencia de la alta presión en el proceso de inyección del hialuronato de alta densidad.El manejo de un DMD hemorrágico está condicionado fundamentalmente por sulocalización, tamaño y evolución. La actuación diferida mediante micropunción endotelialy posterior descematopexia por medio de inyección en cámara anterior de SF6 al 20% resultóde utilidad para solucionar esta complicación(AU)

Introduction: Viscocanalostomy is an option in the surgical treatment of glaucoma. Thisnon-penetrating technique favours aqueous drainage through the Schlemm channel whileavoiding filtering blebs and their related pathologies. Complications associated to thissurgery are unusual, one of which is Decemet’s membrane detachment (DMD)Clinical case: A 64 year-old female diagnosed with open-angle chronic glaucoma, whose hadundergone a viscocanalostomy of the left eye. In the immediate postoperative period wenoticed a hemorrhagic DMD in the lower temporal quadrant. After adopting a wait and seeattitude, we did not find improvement 15 days after surgery and corneal edema wasestablished with vision decrease. We proceeded to a surgical reapplication by means ofDescemet’s membrane micropuncture and SF6 injection into the anterior chamber andachieving an anatomical and functional improvementDiscussion: We believe that the intrusion of viscoelastic material into the supradescemeticwas a consequence of the high-pressure during the high-density hyaluronate injection.Hemorrhagic DMD management is mainly determined by its location, size and evolution.In our case, the posterior endothelial micropuncture and descematopexy by means of 20%SF6 injection into the anterior chamber was useful in resolving this complication(AU)

Functional analysis of CYP1B1 mutations and association of heterozygous hypomorphic alleles with primary open-angle glaucoma.

Glaucoma is an inherited complex and heterogeneous disease, and one of the most prevalent causes of definitive blindness in the world. Recent reports have indicated that heterozygous mutations of the CYTOCHOROME P4501B1 (CYP1B1) gene are present in 4-10% of patients with primary open-angle glaucoma (POAG). To further evaluate the role of CYP1B1 mutations in POAG we extended our previous association study and carried out a functional analysis of the mutations identified by polymerase chain reaction (PCR) DNA sequencing of the three exons of the gene in a total of 245 unrelated Spanish patients and 326 control subjects. Eight of nine different mutations identified in these patients were cloned and functionally assessed by measuring ethoxyresorufin O-deethylation activity and CYP1B1 stability in transiently transfected HEK-293T cells. All these mutants showed reduced catalytic activity, ranging from 20% to 60% of wild-type and/or decreased protein stability and, therefore, they were classified as hypomorphic alleles. No null alleles were identified in these patients. We found heterozygous hypomorphic CYP1B1 mutations in 17 (6.7%) patients and in seven controls (2.1%) showing that these mutations are associated with an increased risk of POAG (p = 0.005; odds ratio = 3.2; 95% confidence interval = 1.30-9.19). Our data suggest that hypomorphic CYP1B1 mutations are, to date, the main known genetic risk factor in POAG.

[Postoperative outcomes after combined glaucoma surgery. Comparison of ex-press miniature implant with standard trabeculectomy]. / Resultados postquirúrgicos en la cirugía combinada de glaucoma. Comparación del implante express con la trabeculectomía estándar.

PURPOSE: To evaluate postoperative outcomes and success after combined phacoemulsification and glaucoma surgery with Ex-PRESS miniature implant compared with combined surgery with standard trabeculectomy. METHODS: In this prospective series of 40 consecutive eyes we compared 20 eyes in 17 patients treated with combined phacoemulsification and glaucoma filtering surgery with the Ex-PRESS miniature glaucoma implant under a scleral flap with 20 matched control eyes in 20 patients who underwent combined cataract and glaucoma surgery with trabeculectomy. RESULTS: The average follow-up was 9.7 months (range 4.5 to 15) for the Ex-PRESS group and 10.3 months (range 3.5 to 14.5) for the trabeculectomy group. The mean IOP was significantly higher in the early postoperative period in the Ex-PRESS group compared with the trabeculectomy group. Complications rate in the early postoperative period was significantly higher in the trabeculectomy group. No significant differences were objectified in success between both groups after the first week. DISCUSSION: The Ex-PRESS implant is an effective and safe alternative to standard trabeculectomy in selected cases which makes possible to reduce remarkably the classic early postoperative complications associated with trabeculectomy.

Resultados postquirúrgicos en la cirugía combinada de glaucoma. Comparación del implante express con la trabeculectomía estándar / Postoperative outcomes after combined glaucoma surgery. Comparison of ex-press miniature implant with standard trabeculectomy

el éxito tras cirugía combinada mediante facoemulsificacióne implante Ex-PRESS comparado concirugía combinada con trabeculectomía estándar.Métodos: En esta serie prospectiva de 40 ojos consecutivoscomparamos 20 ojos de 17 pacientes tratadosmediante facoemulsificación combinada concirugía filtrante de glaucoma con implante de válvulaEx-PRESS bajo un colgajo escleral con 20ojos controles en 20 enfermos que fueron sometidosa facoemulsificación combinada con trabeculectomíaestándar.Resultados: El tiempo de seguimiento medio fuede 9,7 meses (rango: 4,5-15) en el grupo Ex-PRESSy 10,3 meses (rango 3,5-14,5) en el grupo trabeculectomía.La PIO media fue significativamentesuperior en el postoperatorio precoz en el grupo Ex- PRESS comparada con el de trabeculectomía. Latasa de complicaciones en dicho período resultósuperior en el grupo sometido a trabeculectomía.No se objetivaron diferencias significativas en latasa de éxito entre ambos grupos más allá de la primera semana.Conclusiones: El implante Ex-PRESS constituyeuna alternativa eficaz y segura a la trabeculectomíaen casos seleccionados que permite disminuir notablementelas clásicas complicaciones postquirúrgicasprecoces asociadas a la trabeculectomía(AU)

Purpose: To evaluate postoperative outcomes andsuccess after combined phacoemulsification andglaucoma surgery with Ex-PRESS miniatureimplant compared with combined surgery withstandard trabeculectomy.Methods: In this prospective series of 40 consecutiveeyes we compared 20 eyes in 17 patients treatedwith combined phacoemulsification and glaucomafiltering surgery with the Ex-PRESS miniatureglaucoma implant under a scleral flap with 20 matchedcontrol eyes in 20 patients who underwentcombined cataract and glaucoma surgery with trabeculectomy.Results: The average follow-up was 9.7 months(range 4.5 to 15) for the Ex-PRESS group and 10.3months (range 3.5 to 14.5) for the trabeculectomygroup. The mean IOP was significantly higher inthe early postoperative period in the Ex-PRESSgroup compared with the trabeculectomy group.Complications rate in the early postoperative periodwas significantily higher in the trabeculectomygroup. No significant differences were objectifiedin success between both groups after the first week. Discussion: The Ex-PRESS implant is an effectiveand safe alternative to standard trabeculectomy inselected cases which makes possible to reduceremarkably the classic early postoperative complicationsassociated with trabeculectomy(AU)

Optic nerve alterations in P27(Kip1) knockout mice.

PURPOSE: To study the morphologic characteristics of the optic nerve (ON) by using an experimental model of knockout mice for the expression of the P27(Kip1) gene, mainly involved in cell cycle arrest, apoptosis control, and retinoblastoma protein phosphorylation. METHODS: Eyeballs with the retrobulbar ON attached were obtained from 26-week-old mice. By using morphologic and morphometric techniques, light and electron transmission microscopy, the ON characteristics were determined in two groups of mice: 1) wild type mice as the control group (n=15), 2) homozygous knockout mice (-/-) for the P27(Kip1) gene as the knockout group (n=15). Glial fibrillary acidic protein (GFAP) and myelin basic protein (MBP) were studied using Western blot and immunoblotting approaches. RESULTS: The ON cross-sectional area was significantly larger in the P27(Kip1) knockout mice group than in the control group (p<0.001). The axon sizes in knockout animals were much larger than in wild-type mice (p<0.001). Higher number of axons forming the ON, intra-axonal degeneration, myelin sheath, and axoplasm density alterations were found in P27(Kip1) knockout mice when compared with control group (p<0.001). Analysis of lysates of optic nerves by Western blot showed less expression of myelin basic protein and GFAP in P27(Kip1) knockout mice as compared to wild type mice (p<0.005, p<0.01, respectively). CONCLUSIONS: The morphologic and morphometric results suggest that homozygous P27(Kip1) knock-out mice had hypertrophic, hyperplastic, and dystrophic ON.

Optic nerve alterations in PTEN +/- mice.

PURPOSE: To study the morphologic characteristics of the optic nerve (ON) by using an experimental model of knockout mice for the expression of the PTEN gene, mainly involved in cell cycle arrest, apoptosis control, and cell size regulation. METHODS: The eyeballs with the retrobulbar ON attached were obtained from 26-week-old mice. By using morphologic and morphometric techniques, light and electron transmission microscopy, the ON characteristics were determined in two groups of mice: 1) 'wild type' mice as the control group (C-G; n=15), 2) heterozygous knockout mice (+/-) for the PTEN gene (PTEN-G; n=15). Glial fibrillary acidic protein (GFAP) and myelin basic protein (MBP) were studied using Western blot and immunoblotting approaches. RESULTS: The ON cross-sectional area was significantly higher in the PTEN-G than in the C-G (p<0.001). The axon sizes in mutant animals were much larger than in wild-type mice (p<0.001). No significant differences were noticed between those groups regarding the number of axons forming the ON and the presence of intra-axonal degeneration, myelin sheath alterations, or axoplasm density. No differences were detected in developmental marker protein expression. CONCLUSIONS: The morphologic and morphometric results suggest that heterozygous PTEN knockout mice had hypertrophic ON without ultrastructural alterations.

Optic nerve alterations in PTEN +/- mice.

PURPOSE: To study the morphologic characteristics of the optic nerve (ON) by using an experimental model of knockout mice for the expression of the PTEN gene, mainly involved in cell cycle arrest, apoptosis control, and cell size regulation. METHODS: The eyeballs with the retrobulbar ON attached were obtained from 26-week-old mice. By using morphologic and morphometric techniques, light and electron transmission microscopy, the ON characteristics were determined in two groups of mice: 1) 'wild type' mice as the control group (C-G; n=15), 2) heterozygous knockout mice (+/-) for the PTEN gene (PTEN-G; n=15). Glial fibrillary acidic protein (GFAP) and myelin basic protein (MBP) were studied using Western blot and immunoblotting approaches. RESULTS: The ON cross-sectional area was significantly higher in the PTEN-G than in the C-G (p<0.001). The axon sizes in mutant animals were much larger than in wild-type mice (p<0.001). No significant differences were noticed between those groups regarding the number of axons forming the ON and the presence of intra-axonal degeneration, myelin sheath alterations, or axoplasm density. No differences were detected in developmental marker protein expression. CONCLUSIONS: The morphologic and morphometric results suggest that heterozygous PTEN knockout mice had hypertrophic ON without ultrastructural alterations.

[Treatment of conjunctival intraepithelial neoplasia with topical mitomycin C 0.02%]. / Tratamiento de las neoplasias conjuntivales intraepiteliales con colirio de mitomicina C al 0,02%

PURPOSE: To evaluate the efficacy of topical mitomycin C (MMC) 0.02% in treating conjunctival intraepithelial neoplasia (CIN). METHODS: Three patients with CIN were treated with topical MMC 0.02%. Our follow-up period was twelve months (range 8-18 months). RESULTS: CIN was resolved in all three cases without modifying the normal corneal and conjunctival architecture. CONCLUSIONS: Topical MMC 0.02% four times daily during two weeks is a useful alternative tool for the surgical management of CIN.

Optic nerve alterations in apolipoprotein E deficient mice.

PURPOSE: To study the morphologic characteristics of the optic nerve (ON) by using an experimental model of knockout mice for expression of the ApoE gene. METHODS: Eyeballs with the retrobulbar ON attached were obtained from 24-week-old mice. Using morphologic and morphometric techniques and light and transmission electron microscopy, the ON characteristics were determined in three groups of mice: 1) wild type mice as the controls (CG; n = 15), 2) knockout mice for the ApoE gene (ApoE-G; n = 15), and 3) knockout mice for the ApoE gene that were fed a cholesterol-supplemented diet (ApoED-G; n = 15). RESULTS: The ON cross-sectional area was significantly higher in the ApoE-G than in the CG (p < 0.001) mice, whereas no significant changes were noticed between the ApoE-G and ApoED-G mice. Significant differences were noticed between those groups regarding the myelination index. Higher density of intra-axonal degeneration and myelin sheath alterations were found in both ApoE groups in respect to the CG. CONCLUSIONS: These results suggest that ApoE knockout mice have changes in ON morphology and myelination.

[Estimation of the efficacy of deep sclerectomy in glaucoma surgery. One-year follow-up]. / Estimación de la eficacia de la esclerectomía profunda no perforante en el tratamiento quirúrgico del glaucoma al año de la cirugía.

PURPOSE: To evaluate the efficacy of deep sclerectomy in the surgical treatment of glaucoma one year after surgery. METHODS: 53 eyes of 43 patients (26 male, 27 female) with medically uncontrolled glaucoma of various types, were treated with deep sclerectomy surgery. RESULTS: The mean postoperative intraocular pressure (IOP) was 18.19 S.D. 5.22 mmHg., and the mean preoperative IOP was 26.66 S.D. 5.93 mmHg. We observed a statistically significant reduction in the IOP (p<0.05). Our success criteria were IOP lower than 21 mmHg with or without associated hypotensive medications, no advance in glaucomatous visual field defects and no advance in optic nerve cupping. This was achieved in 88.68% of the cases at 12 months follow-up. CONCLUSIONS: Deep sclerectomy is an efficient technique to control IOP, with few early post-operative complications.

Estimación de la eficacia de la esclerectomía profunda no perforante en el tratamiento quirúrgico del glaucoma al año de la cirugía / Estimation of te efficacy of deep sclerectomy in glaucoma surgery. One-year follow-up

Objetivo: Estimar la eficacia del tratamiento quirurgico del glaucoma mediante la técnica de esclerectomia protunda no perborante (E.P.N.P.) al año de la cirugía.Material y métodos: 53 ojos de 43 pacientes (26 varones, 27 mujeres), con diferentes tipos de glaucomas mal controlados médicamente, fueron sometidos a una esclerectomia protunda no perborante.Resultados: La presión intraocular (P.I.O.) media f¦nal fue de 18,19 D.E. 5,22 mmHg., comparada con la P.I.O. media preoperatoria de 26,66 D.E. 5,93 mmHg. Se observa una reducción de la P.I.O. estadisticamente significativa (p<0,05). Consideramos éxito cuando la P.I.O. era menor de 21 mmHg. Con o sin tratamiento médico hipotensor postoperatorio, y no avanzaban los defectos glaucomatosos en el campo visual y no avanzaba la excavación papilar; consiguiéndolo en el 88,68 por ciento de los casos a los 12 meses.Conclusiones: La esclerectomia profunda no perforante es una técnica eficaz para el control de la P.l.O., con pocas complicaciones. (AU)