Aflibercept intravítreo en dosis fijas en pacientes naïve con degeneración macular asociada a la edad neovascular: resultados a un año en práctica clínica real / Outcomes in patients receiving fixed-dosed aflibercept for treatment-naïve neovascular age-related macular degeneration during one year of routine clinical practice

Objetivo: Evaluar los resultados visuales y anatómicos de aflibercept en pacientes naïve con degeneración macular asociada a la edad neovascular (DMAEnv) no seleccionados tras un año de tratamiento en régimen bimestral fijo en un entorno de práctica clínica real. Métodos: Estudio retrospectivo, serie de casos consecutivos no aleatorizados que incluye 35 pacientes naïve, 38 ojos con DMAEnv, tratados con aflibercept intravítreo (Eylea(R)). Los pacientes recibieron una dosis de carga de 3 inyecciones mensuales (2 mg/0,05 ml) seguida de inyecciones cada 2 meses. Resultados: Tras la dosis de carga y a los 12 meses de tratamiento, el cambio en la mejor agudeza visual corregida (MAVC) mejoró significativamente respecto a la MAVC basal (ETDRS 50,5 ± 14,5 y 53,1 ± 14,5 vs. 39,6 ± 14,7, respectivamente, p < 0,05). Al mes 3 y al mes 12, la proporción de pacientes que mejoró la agudeza visual en ≥ 15 letras fue de 37,1% y de 45,7%, respectivamente. La disminución media del espesor central de la retina fue también significativa tras la dosis de carga (239,6 ± 52,0 μm) y al mes 12 (227 ± 53,2μm) comparada con los valores pretratamiento (370,3 ± 117,6; p < 0,001). También se observó la resolución del desprendimiento del epitelio pigmentario en 14 de los 20 ojos (70%) con ese desprendimiento previo al tratamiento. Conclusión: Mejorías funcionales y anatómicas significativas fueron observadas tras el tratamiento con aflibercept intravítreo en pacientes naïve con DMAEnv en práctica clínica real

Objective: To investigate the visual and anatomical outcomes of aflibercept as therapy in patients with treatment-naïve neovascular age-related macular degeneration during one year in routine clinical practice. Methods: The study was a retrospective, case series, including 35 patients, 38 eyes, with neovascular age-related macular degeneration that received aflibercept injections (Eylea(R)). Patients received a loading dose of 3 monthly injections (2 mg / 0.05 ml) followed by intravitreal injections every 2 months. Results: At 3 and 12 months, the mean best-corrected visual acuity improved significantly as compared with baseline (ETDRS 50.5 ± 14.5 and 53.1 ± 14.5 vs. 39.6 ± 14.7, respectively, P < .05). At 3 and 12 months, the proportion of patients who improved visual acuity by ≥ 15 letters was 37.1% and 45.7%, respectively. The mean decrease in central macular thickness was also significant after loading dose (239.6 ± 52.0μm) and at 12 month (227 ± 53.2 μm) compared with pre-treatment values (370.3 ± 117, 6) (P < .001). Resolution of pigment epithelial detachment (PED) was also observed in 14 out of 20 (70%) eyes with PED at baseline. Conclusion: Aflibercept administered by fixed dosing over one year improved visual acuity and macular morphology in treatment-naïve eyes in routine daily practice

Outcomes in patients receiving fixed-dosed aflibercept for treatment-naïve neovascular age-related macular degeneration during one year of routine clinical practice. / Aflibercept intravítreo en dosis fijas en pacientes naïve con degeneración macular asociada a la edad neovascular: resultados a un año en práctica clínica real.

OBJECTIVE: To investigate the visual and anatomical outcomes of aflibercept as therapy in patients with treatment-naïve neovascular age-related macular degeneration during one year in routine clinical practice. METHODS: The study was a retrospective, case series, including 35 patients, 38 eyes, with neovascular age-related macular degeneration that received aflibercept injections (Eylea®). Patients received a loading dose of 3monthly injections (2mg / 0.05ml) followed by intravitreal injections every 2 months. RESULTS: At 3 and 12 months, the mean best-corrected visual acuity improved significantly as compared with baseline (ETDRS 50.5±14.5 and 53.1±14.5 vs. 39.6±14.7, respectively, P<.05). At 3 and 12 months, the proportion of patients who improved visual acuity by ≥15 letters was 37.1% and 45.7%, respectively. The mean decrease in central macular thickness was also significant after loading dose (239.6±52.0µm) and at 12 month (227±53.2µm) compared with pre-treatment values (370.3±117, 6) (P<.001). Resolution of pigment epithelial detachment (PED) was also observed in 14 out of 20 (70%) eyes with PED at baseline. CONCLUSION: Aflibercept administered by fixed dosing over one year improved visual acuity and macular morphology in treatment-naïve eyes in routine daily practice.

Bioactive properties of honey with propolis.

Nowadays, propolis is used as an innovative preservative and as a bioactive food supplement. Due to its bitter and astringent flavour, propolis is hardly accepted by consumers. The aim of this study was to obtain a likeable food product made with honey and propolis, whose antimicrobial, antioxidant and anti-inflammatory properties were enhanced in comparison with those of the base honeys used. 0.1%, 0.3% and 0.5% soft propolis extracts were added to honeys and the products that most appealed to the users were subjected to further research. Total phenolics, flavonoids, ABTS free radical and hydroxyl radicals scavenging and anti-inflammatory activities increased in all mixtures. Antimicrobial activity of the combined products showed synergic effects, resulting in higher results than those of the base honeys and propolis extracts. Therefore, honeys enriched with small amounts of propolis extracts are promising functional foods.

Control of Escherichia coli and Listeria monocytogenes in suckling-lamb meat evaluated using microbial challenge tests.

Escherichia coli and Listeria monocytogenes microbial challenge tests were performed on fresh suckling-lamb meat. Hind leg slices were chilly stored under two modified atmosphere packaging (MAP) environments (A: 15%O2/60%CO2/25%N2, B: 15%O2/30%CO2/55%N2) and vacuum packaging (V). Only E. coli was reduced between 0.72-1.25 log cfu/g from day 1 to day 4 by the combined use of MAP/V, chilling storage and the growth of native lactic acid bacteria. However, L. monocytogenes was not inhibited by the application of V or MAP. Even do, in inoculated samples, this pathogen increased between 1.2-2.7 log cfu/g throughout the study. Consequently, a second experiment that combined the effects of MAP/V and a protective culture (Leuconostoc pseudomesenteroides PCK 18) against L. monocytogenes was designed. Two different levels of protective cultures were assayed (4 and 6 log cfu/g). Lc. pseudomesenteroides PCK 18 was able to control the growth of L. monocytogenes when the differences between them are higher than 2 log cfu/g. Moreover, when high level of protective culture was used a significant reduction of L. monocytogenes counts were noticed in samples packaged in 60% of CO2 along the storage period, although sensory properties were also affected.

Microbial performance of food safety management systems implemented in the lamb production chain.

The actual microbial status of the lamb production chain at three slaughterhouses, one processing plant, and five butcher shops selling whole or cut lamb carcasses to consumers was assessed with a previously developed microbial assessment scheme. All studied establishments had a food safety management system (FSMS) that was implemented according to legislative requirements. Microbial safety level profiles were constructed for each establishment and provided clear indications of which pathogens, hygiene indicators, or utility parameters required attention to improve the performance of the microbiological control protocols of the implemented FSMS. The highest contamination was found in the slaughterhouses in samples taken from the meat products (aerobic mesophilic plate counts [AMPs] of 3.40 to 6.63 log CFU/cm(2) and Enterobacteriaceae counts of 1.00 to 4.62 log CFU/cm(2)), contact surfaces (AMPs of 2.44 to 8.92 log CFU/cm(2)), and operators' hands and/or gloves (AMPs of 2.84 to 8.09 log CFU/cm(2)), especially after hide removal and evisceration. The microbial assessment scheme is a useful tool for providing insight into the actual microbiological results achieved with an FSMS implemented in establishments at various stages along the lamb production chain.

Prevalence and quantification of Shiga-toxin producing Escherichia coli along the lamb food chain by quantitative PCR.

Shiga-toxin producing Escherichia coli (STEC), which is responsible for numerous food-borne disease outbreaks, is the most important human pathogen found in ruminants. In this study, conventional microbiology and quantitative PCR (qPCR) were used to detect and quantify STEC along the lamb food chain, from slaughterhouses to butcheries, in both meat and environmental samples. Microbial Assessment Scheme (MAS) was used to select Critical Sampling Locations (CSLs) in each establishment. The rpoB gene was used to enumerate total E. coli by qPCR, whereas the genes stx(1), stx(2) and eae were directly amplified for quantification of E. coli virulent populations. The results obtained show that E. coli carrying all three virulence genes were the most prevalent in slaughterhouses (69%), whereas E. coli with the eae gene alone were found more frequently in the processing plant (32%), and stx(1)- and stx(2)-positive E. coli were predominant in butcheries (9-10%). E. coli virulent populations were not common in butcheries. Samples determined to be positive for E. coli virulent populations after enrichment were quantified by qPCR and compared with conventional microbiology counts using validated methods. The results showed a higher number of positive CSLs for E. coli virulent populations, and higher counts were obtained when qPCR was used than when using conventional methods.

[Ocular sarcoidosis. Retrospective study of 18 cases]. / Sarcoidosis ocular. Estudio retrospectivo de 18 casos.

PURPOSE: To assess the clinical and epidemiological characteristics, diagnostic and therapeutic methods, and the final visual outcome of a group of patients with ocular sarcoidosis. METHODS: Retrospective study of 18 patients diagnosed of ocular sarcoidosis between March 1989 and May 1999. In every patient the following data were obtained: age, sex, bilaterality, initial and final visual outcome, systemic and ocular manifestations, stage of chest x-ray, serum markers, gallium scan, results of biopsy, medical and surgical treatment, and complications of treatment. RESULTS: The mean age at onset was 49.7 years (S.D. 19.9). Fourteen patients (77.8%) were female and 4 (22.2%) were male. The average follow-up time was 40.3 months (S.D. 28.7). Nine patients (50.0%) underwent a biopsy. The presence of non-caseating granulomata was observed in 7 (77.8%). Gallium scanning was positive in 16 cases (88.8%). The most frequent ocular manifestation was panuveitis (40.0%). Among the 30 eyes studied, conjunctival involvement was found in 10 (33.3%), secondary cataracts in 9 (30.0%), and secondary glaucoma in 6 (20.0%). Eleven patients (61.1%) were treated with oral corticosteroids and 10 (55,5%) with cyclosporine A. When sarcoidosis was diagnosed, 11 eyes (36.6%) had a visual acuity better than 0.6. At the end of the follow-up, the final visual outcome was better than 0.6 in 17 eyes (56.6%). CONCLUSIONS: An adequate control of ocular inflammation may improve the prognosis in patients with ocular sarcoidosis. Posterior segment involvement (posterior uveitis, macular edema or epiretinal membrane) may be associated with a worse visual prognosis.

Sarcoidosis ocular. Estudio retrospectivo de 18 casos / Ocular sarcoidosis. Retrospective study of 18 cases

Objetivos: Analizar las características clínicas y epidemiológicas, los métodos diagnósticos y terapéuticos empleados, y la agudeza visual (AV) en un grupo de pacientes con sarcoidosis ocular. Métodos: Estudio retrospectivo de 18 pacientes diagnosticados de sarcoidosis ocular entre marzo de 1989 y mayo de 1999. Se evaluó la edad, sexo, bilateralidad, AV inicial y final, manifestaciones clínicas sistémicas y oculares, estadío radiológico del tórax, marcadores serológicos, gammagrafía con galio-67, realización de biopsia y resultado de la misma, tratamiento médico y quirúrgico, y complicaciones del tratamiento. Resultados: La edad media en el momento del diagnóstico fue de 49,7 años (D.E. 19,9). Catorce (77,8 por ciento) fueron mujeres y 4 (22,2 por ciento) varones. El seguimiento medio fue de 40,38 meses (D.E. 28,7). Se realizó biopsia en 9 pacientes (50,0 por ciento). De ellos, en 7 (77,8 por ciento) se demostró la presencia de granulomas no caseificantes. La gammagrafía con galio fue positiva en 16 casos (88,8 por ciento). La manifestación ocular más frecuente fue la panuveítis (40,0 por ciento). De los 30 ojos analizados, se describió afectación conjuntival en 10 (33,3 por ciento), de cataratas secundarias en 9 (30,0 por ciento), y glaucoma secundario en 6 (20,0 por ciento). Once pacientes (61,1 por ciento) fueron tratados con corticoides orales y 10 (55,5 por ciento) con ciclosporina A. En el momento del diagnóstico, 11 ojos (36,6 por ciento) presentaban una AV mayor de 0,6. Al final del seguimiento, el número de ojos con AV mayor de 0,6 era de 17 (56,6 por ciento). Conclusiones: Un control adecuado de la inflamación ocular puede mejorar el pronóstico de los pacientes con sarcoidosis ocular. La afectación del segmento posterior (uveítis posterior, edema de mácula o membrana epirretiniana) puede relacionarse con un peor pronóstico visual (AU)