Rasch validation of the Keratoconus End-Points Assessment Questionnaire in a Spanish population with keratoconus.

OBJECTIVE: To carry out a methodologically complete validation of the Spanish version of the Keratoconus End-Points Assessment Questionnaire (KEPAQ) in a Spanish population with keratoconus. METHODS: Analytical, prospective study, including patients with keratoconus without previous surgical history, in which a measurement of quality of life was performed using the KEPAQ questionnaire, a complete exploration of the anterior pole and a corneal elevation topography with the Galilei G6 topographer. The evaluation of the psychometric characteristics of the scale in the studied population was carried out using Rasch modeling. RESULTS: A total of 140 patients with keratoconus were included, with a median age of 26.0 years, the majority (57.6%) being men. For the KEPAQ-E subscale, the median score was 69.3, with a reliability of 0.85 and an eigenvalue of the first contrast of 2.34. For the KEPAQ-F, the median score was 56.4, with a reliability of 0.88 and an eigenvalue of 2.00. All infit and outfit parameters were within normal limits for both subscales. A significant evaluation was found between the evaluations of both subscales (rho = 0.696; p < 0.001). The evaluations of the subscales and various clinical and tomographic characteristics showed a significant classification between them (p value between 0.048 y 0.001). CONCLUSION: The KEPAQ is a psychometrically robust and valid scale to evaluate quality of life in the Spanish population with keratoconus. This questionnaire can be easily used for both clinical and research aims.

Phonological fluency norms for Spanish middle-aged and older adults provided by the SCAND initiative (P, M, & R).

OBJECTIVE: Verbal fluency tests are quick and easy to administer neuropsychological measures and are regularly used in neuropsychological assessment. Additionally, phonological fluency is a widely used paradigm that is sensitive to cognitive impairment. This paper offers normative data of phonological verbal fluency (letters P, M, R) for Spanish middle- and older-aged adults, considering sociodemographic factors, and different measures such as the total number of words, errors (perseveration and intrusions), and 15 sec-segmented scores. METHOD: A total of 1165 cognitively unimpaired participants aged between 50 and 89 years old, participated in the study. Data for P were obtained for all participants. Letters M and R were also administered to a subsample of participants (852) aged 60 to 89 years. In addition, errors and words produced every 15 seconds were collected in the subsample. To verify the effect of sociodemographic variables, linear regression was used. Adjustments were calculated for variables that explained at least 5% of the variance (R2 ≥ .05). RESULTS: Means and standard deviations by age, scaled scores, and percentiles for all tests across different measures are shown. No determination coefficients equal to or greater than .05 were found for sex or age. The need to establish adjustments for the educational level was only found in some of the measures. CONCLUSIONS: The current norms provide clinically useful data to evaluate Spanish-speaking natives from Spain aged from 50 to 89 years. Specific patterns of cognitive impairment can be analyzed using these normative data and may be important in neuropsychological assessment.

Cribado neonatal de drepanocitosis en Castilla y León: Estudio descriptivo / Neonatal screening of drepanocytosis in Castilla y Leon (Spain): a descriptive study

Introducción. La anemia falciforme es una enfermedad de herencia autosómica recesiva que constituye una de las alteraciones genéticas más frecuentes del noroeste de Europa. Las complicaciones secundarias en los pacientes homocigotos son frecuentes durante los primeros 3 años de vida, y debido a ello, desde el 12 de julio de 2017, se ha incluido dicha patología dentro de las enfermedades objetivo de cribado neonatal de Castilla y León (CyL). Con tal fin, se pretende detectar aquellos pacientes que se beneficiarán de un diagnóstico y tratamiento precoz. Objetivos. Calcular la incidencia de hemoglobinopatía S, C, D, E u otra cadena de hemoglobina anómala en todo recién nacido vivo en CyL desde el inicio del programa de cribado hasta el 12 deoctubre de 2018 (15 meses), determinando en los distintos pacientes el sexo, lugar de origen del padre y la madre, hospital de nacimiento y fenotipo encontrado. Material y métodos. Estudio retrospectivo y descriptivo de los pacientes con cribado neonatal de hemoglobinopatías patológico nacidos en la Comunidad Autónoma de Castilla y León, del 12 de julio de 2017 al 12 de octubre de 2018. La muestra de sangre se obtuvo de la prueba del talón realizada en las maternidades de forma sistemática, a partir de las 48 horas de vida del niño. Se analizó por cromatografía líquida de alta resolución (Bio-Rad VARIANTnbs System) en Laboratorio de Referencia de Valladolid, detectándose fenotipos S, C, D, E o asociados a cualquier otra cadena de hemoglobina anómala sin tipificar. Resultados. Se incluyeron en el estudio 18.998 recién nacidos durante ese periodo, con un total de 18.975 muestras analizadas (99,8%). Se detectaron un total de 94 muestras positivas, con 1 resultado coincidente con fenotipo FS (1/18.975), 61 para fenotipo FAS (1/311), 14 FAC (1/1.355), 2 FAD (1/9.487), 1 FC (1/18.975), 11 FAX (1/1.725), y 4 FAXX (1/4.743) (AU)

Introduction. Sickle cell disease is an autosomal recessive hereditary disease that constitutes one of the most frequent genetic alterations in the Northeast of Europe. The second ary complications in the homozygous patients are frequent during the first three years of life, and due to it, this condition has been included within the diseases targeted for neonatal screening of Castilla y Leon (CyL) since 12 July 2017. With that in mind, it is aimed to detect those patients who would benefit from and early diagnosis and treatment. Objectives. To calculate the incidence of hemoglobin diseases S, C, D, E or other abnormal hemoglobin chain, in all live newborn in CyL from the onset of the screening program until 12 October 2018 (15 months), determining gender, place of origin of the father and mother, hospital where born and phenotype found in the different patients. Material and methods. A retrospective and descriptive study of the patients with neonatal screening for pathological hemoglobin disease in the Regional Community of Castilla y León, from 17 July 2017 to 12 October 2018. The blood sample was obtained from the heel test conducted in the maternity wards systematically, beginning at 48 hours of life of the child. It was analyzed during rapid resolution liquid chromatography (Bio-Rad VARIANTnbs System) in the Reference laboratory of Valladolid, detecting the S, C, D, E or phenotypes or those associated to any other non-typified abnormal hemoglobin chain. Results. A total of 18,998 newborns were enrolled in the study during this period, with a total of 18,975 samples analyzed (99.8%). A total of 94 positive samples were detected, with 1 result coinciding with FS phenotype (1/18,975), 61 for FAS phenotype (1/311), 14 FAC (1/1,355), 2 FAD (1/9,487), 1 FC (1/18,975), 11 FAX (1/1,725), and 4 FAXX (1/4,743). No screening was conducted in 23 newborns out of all the children, due to death in the first hours or transfer prior to 48 hours of life (AU)

Análisis de superficie ocular en pacientes diagnosticados de ictiosis X / Ocular surface analysis in patients diagnosed with X-linked ichthyosis

Se estudió a 7 pacientes (14 ojos) diagnosticados de ictiosis X mediante test de Schirmer, biomicroscopia, tonometría, recuento endotelial, tomografía de coherencia óptica, Pentacam, analizador de superficie ocular y microscopia confocal. La edad media fue 33,83 ± 20,17 años (rango: 7-64 años). Los hallazgos más frecuentes en biomicrocoscopia fueron disfunción de glándulas de Meibomio (83,3%) y opacidades corneales estromales (33%). El tiempo de rotura de la película lagrimal se encontró acortado en el 25% de los ojos. La microscopia confocal (2 ojos) reveló queratocitos activados con partículas hiperreflectivas en su interior en estroma anterior y fuera de ellos en estroma posterior. Creemos que la extensión del uso de la microscopia confocal permitirá conocer mejor la enfermedad corneal asociada a ictiosis X y nuevas características de estos pacientes

Seven patients (14 eyes) diagnosed with X-linked ichthyosis were studied using the Schirmer test, biomicroscopy, tonometry, endothelial count, optical coherence tomography, Pentacam®, ocular surface analyser, and confocal microscopy. The mean age was 33.83 ± 20.17 years (range: 7-64 years). The most frequent findings in biomicroscopy were Meibomian glands dysfunction (83.3%) and stromal corneal opacities (33%). The tear break-up time was found shortened in 25% of the eyes. Confocal microscopy (both eyes) revealed activated keratocytes with hyper-reflective particles inside them in the anterior stroma and outside them in the posterior stroma. It is believed that the inclusion of the use of confocal microscopy will help in a better understanding of the corneal pathology associated with ichthyosis X, as well as new characteristics of these patients

Neoadjuvant chemotherapy in locally advanced colon cancer: a systematic review.

BACKGROUND: Preoperative or neoadjuvant chemotherapy (NAC) has emerged as a novel alternative to treat locally advanced colon cancer (LACC), as in other gastrointestinal malignancies. However, evidence of its efficacy and safety has not yet been gathered in the literature. The aim of the present study was to perform an extensive review of the scientific evidence for NAC in patients with LACC. METHODS: PubMed, EMBASE, MEDLINE and Cochrane Library were searched for a systematic review of the literature from 2010 to 2019. Six eligible studies were included, with a total of 27,937 patients, 1232 of them (4.4%) treated with NAC. There were only one randomized controlled trial, three phase II non-randomized single arm studies and two retrospective studies. RESULTS: The baseline computed tomography scan showed that most of patients had a T3 tumor. The completion rate of the planned neoadjuvant treatment ranged from 52.5 to 93.8%. Between 97.2 and 100% of patients had the scheduled surgery. The median tumor volume reduction after NAC ranged from 62.5 to 63.7%. The anastomotic leak rate in the NAC group ranged from 0 to 7%, with no cases of postoperative mortality. There was major pathological tumor regression in 4-34.7% of cases. Between 84 and 100% of NAC patients had R0-surgery. Survival after NAC seems to be encouraging although significant improvement has only been proven in T4b tumours. CONCLUSIONS: According to our systematic review, the NAC may be a safe and effective emerging therapeutic alternative for treating LACC. This approach, which is still being tested, increases the reliance on accurate radiological staging.

Ocular surface analysis in patients diagnosed with X-linked ichthyosis. / Análisis de superficie ocular en pacientes diagnosticados de ictiosis X.

Seven patients (14 eyes) diagnosed with X-linked ichthyosis were studied using the Schirmer test, biomicroscopy, tonometry, endothelial count, optical coherence tomography, Pentacam®, ocular surface analyser, and confocal microscopy. The mean age was 33.83±20.17 years (range: 7-64 years). The most frequent findings in biomicroscopy were Meibomian glands dysfunction (83.3%) and stromal corneal opacities (33%). The tear break-up time was found shortened in 25% of the eyes. Confocal microscopy (both eyes) revealed activated keratocytes with hyper-reflective particles inside them in the anterior stroma and outside them in the posterior stroma. It is believed that the inclusion of the use of confocal microscopy will help in a better understanding of the corneal pathology associated with ichthyosis X, as well as new characteristics of these patients.

El crowdsourcing como metodología en la lucha contrala malaria / Crowdsourcing as a methodology in the fight against malaria

No disponible

[Retinal toxicity of intravitreal doxycycline. A pilot study]. / Toxicidad retiniana de doxiciclina intravítrea. Estudio piloto.

OBJECTIVE: To assess the retinal toxicity of varying concentrations of intravitreally administered doxycycline, a member of tetracycline family. METHODS: Fourteen New Zealand albino rabbits, divided into 5 groups, were used for this study. The initial concentration of doxycycline (100 mg) was titrated using 5% dextrose solution to the following concentrations in a volume of 0.1 ml: 2000 microg, 1000 microg, 500 microg, 250 microg, 125 microg, and 62.5 microg. Each concentration was injected into 2 rabbit eyes. Two control eyes received 0.1 ml of 5% dextrose solution. All animals were examined before and after injection using indirect ophthalmoscopy and slit-lamp biomicroscopy. Electroretinography (ERG) was performed on all animals prior to the intravitreal injection and 2 weeks post-injection. The animals were re-examined at this time by indirect ophthalmoscopy and slit-lamp biomicroscopy and were then subjected to euthanasia. Their eyes were enucleated and examined using light microscopy. RESULTS: The doxycycline injected group exhibited significant decreases in ERG of the eyes injected with 2000 microg, 1000 microg, 500 microg, and 250 microg/0.1 ml. No significant changes in the ERG were observed following the injection of lesser concentration levels. There were no signs of retinal toxicity on slit-lamp examination, indirect ophthalmoscopy, or light microscopy in all the eyes injected with doxycycline concentrations of 125 microg or lower. CONCLUSIONS: Doxycycline injected intravitreally appeared safe at concentrations of 125 microg/0.1 ml or less in albino rabbits. Intravitreal doxycycline may be beneficial, and is an inexpensive alternative drug which could be used in the treatment of bacterial endophthalmitis particularly against resistant Staphylococcus aureus organisms.

Toxicidad retiniana de doxiciclina intravitrea. Estudio piloto / Intravitreal toxicity of doxycycline. A pilot study

Objetivo: Valorar la toxicidad retiniana de la doxiciclina administrada en inyecciones intravítreas. Método: Utilizamos catorce conejos albinos neozelandeses que dividimos en 5 grupos. Inyectamos en dos ojos cada una de las siguientes concentraciones de doxiciclina: 2.000 µg/0,1 ml; 500 µg/0,1 ml; 250 µg/0,1 ml; 125 µg/0,1 ml y 67,5 µg/0,1 ml. Dos ojos, usados como control, recibieron 0,1 ml de solución de dextrosa al 5%. Examinamos a todos los animales antes y después de la inyección con oftalmoscopía indirecta y biomicroscopía. Realizamos electrorretinogramas en todos antes de la inyección intravítrea y dos semanas después; y posteriormente los animales fueron eutanizados. Se enuclearon los ojos y se prepararon para estudio histológico. Resultados: Los grupos que mostraron una disminución significativa en los electrorretinogramas fueron los inyectados con las siguientes concentraciones de doxiciclina: 2.000 µg/0,1 ml; 500 µg/0,1 ml y 250 µg/0,1 ml. No se observaron cambios significativos en los electrorretinogramas de los inyectados con 125 y 67,5 µg/0,1 ml. No hubo signos de toxicidad retiniana en los exámenes de biomicroscopía, en oftalmoscopía indirecta e histología de los inyectados con 125 µg/0,1 ml o niveles menores de doxiciclina. Conclusión: Las inyecciones intravítreas de doxiciclina parecen seguras en un rango igual o menor a 125 µg/0,1 ml en el conejo albino. La doxiciclina intravítrea podría ser una alternativa barata y beneficiosa para el tratamiento de la endoftalmitis, especialmente frente a los staphylococcus aureus resistentes

Objective: To assess the retinal toxicity of varying concentrations of intravitreally administered doxycycline, a member of tetracycline family. Methods: Fourteen New Zealand albino rabbits, divided into 5 groups, were used for this study. The initial concentration of doxycycline (100 mg) was titrated using 5% dextrose solution to the following concentrations in a volume of 0.1 ml: 2000 µg, 1000 µg, 500 µg, 250 µg, 125 µg, and 62.5 µg. Each concentration was injected into 2 rabbit eyes. Two control eyes received 0.1 ml of 5% dextrose solution. All animals were examined before and after injection using indirect ophthalmoscopy and slit–lamp biomicroscopy. Electroretinography (ERG) was performed on all animals prior to the intravitreal injection and 2 weeks post-injection. The animals were re-examined at this time by indirect ophthalmoscopy and slit–lamp biomicroscopy and were then subjected to euthanasia. Their eyes were enucleated and examined using light microscopy. Results: The doxycycline injected group exhibited significant decreases in ERG of the eyes injected with 2000 µg, 1000 µg, 500 µg, and 250 µg/0.1 ml. No significant changes in the ERG were observed following the injection of lesser concentration levels. There were no signs of retinal toxicity on slit-lamp examination, indirect ophthalmoscopy, or light microscopy in all the eyes injected with doxycycline concentrations of 125 µg or lower. Conclusions: Doxycycline injected intravitreally appeared safe at concentrations of 125 µg/0.1 ml or less in albino rabbits. Intravitreal doxycycline may be beneficial, and is an inexpensive alternative drug which could be used in the treatment of bacterial endophthalmitis particularly against resistant Staphylococcus aureus organisms

Contribution of the gasoline distribution cycle to volatile organic compound emissions in the metropolitan area of Mexico City.

Gasoline distribution in the metropolitan area of Mexico City (MAMC) represents an area of opportunity for the abatement of volatile organic compound (VOC) emissions. The gasoline distribution in this huge urban center encompasses several operations: (1) storage in bulk and distribution plants, (2) transportation to gasoline service stations, (3) unloading at service stations' underground tanks, and (4) gasoline dispensing. In this study, hydrocarbon (HC) emissions resulting from breathing losses in closed reservoirs, leakage, and spillage from the operations just listed were calculated using both field measurements and reported emission factors. The results show that the contribution of volatile HC emissions due to storage, distribution, and sales of gasoline is 6651 t/year, approximately 13 times higher than previously reported values. Tank truck transportation results in 53.9% of the gasoline emissions, and 31.5% of emissions are generated when loading the tank trucks. The high concentration of emissions in the gasoline transportation and loading operations by tank trucks has been ascribed to (1) highly frequent trips from distribution plant to gasoline stations, and vice versa, to cope with excessive gasoline sales per gasoline station; (2) low leakproofness of tank trucks; and (3) poor training of employees. In addition, the contribution to HC evaporative and exhaust emissions from the vehicles of the MAMC was also evaluated.

Contribution of liquefied petroleum gas to air pollution in the metropolitan area of Mexico City.

An estimation of hydrocarbon emissions caused by the consumption of liquefied petroleum gas (LPG) in the Metropolitan Area of Mexico City (MAMC) is presented. On the basis of experimental measurements at all points of handling, during the distribution process, and during the consumption of LPG in industrial devices and domestic appliances, an estimated 76,414 tons/year are released to the air. The most important contribution is found during the domestic consumption of LPG (70%); this makes the control initiatives available to the consumer. By developing a control program of LPG losses, a 77% reduction in emission is expected in a 5-yr period. The calculated amounts of LPG emissions when correlated with the consumption of LPG, combined with information from air samples from the MAMC, do not point to LPG emissions as the most important factor contributing to tropospheric ozone in the air in Mexico City.

Contribution of LPG-derived emissions to air pollution in the metropolitan area of Guadalajara City.

Measurements of hydrocarbon (HC) emissions generated by the use of liquefied petroleum gas (LPG) in the metropolitan area of Guadalajara City (MAG) are presented in this work. Based on measurements in the course of distribution, handling, and consumption, an estimated 4407 tons/yr are released into the atmosphere. The three most important contributors to LPG emissions were refilling of LPG-fueled vehicles and commercial and domestic consumption. The MAG shows a different contribution pattern of LPG emission sources compared with that of the metropolitan area of Mexico City (MAMC). These results show that each megacity has different sources of emissions, which provides more accurate strategies in the handling procedures for LPG to decrease the impact in O3 levels. This work represents the first evaluation performed in Guadalajara City, based on current measurements, of the LPG contribution to polluting emissions.

Topical vitamin E inhibition of immunosuppression and tumorigenesis induced by ultraviolet irradiation.

Ultraviolet (UV) irradiation of C3H/HeN mice induces skin cancer and an immunosuppression that prevents the host from rejecting antigenic UV-induced tumors. The capacity of topical vitamin E (dl-alpha-tocopherol) to prevent photocarcinogenesis or the immunosuppression induced by UV irradiation were assessed. Skin cancer incidence in UV-irradiated mice was 81% at 33 weeks after the first UV exposure; application to mice of 25 mg vitamin E three times per week for three weeks before UV irradiation, and throughout the experiment, reduced this incidence to 42% (p = 0.0065, log rank test). Immunoenhancement by vitamin E was assessed by comparing levels of immunosuppression by splenocytes from normal or UV-irradiated mice, with and without topical vitamin E treatment. Transfer of splenocytes from UV-irradiated mice to naive mice prevented the recipients from rejecting a UV-induced tumor challenge, whereas splenocytes from UV-irradiated mice treated with vitamin E did not prevent recipients from rejecting a similar tumor challenge. Phenotypic analysis of splenocytes used in the passive transfer assay, conducted with a biotin-avidin-immunoperoxidase technique, revealed that vitamin E treatment of mice undergoing UV irradiation prevented the UV-induced down regulation of Ia expression in splenocytes and increased the proportion of Lyt-2+ and L3T4+ splenocytes. Therefore, chronically applied vitamin E can effectively reduce cancer formation and immunosuppression induced by UV irradiation. Prevention of UV-induced down regulation of Ia expression may have contributed to this immunomodulation.