Efectividad de la facoemulsificación para el control de la presión intraocular en pacientes vitrectomizados con aceite de silicona / Effectiveness of phacoemulsification to control intraocular pressure in patients undergoing vitrectomy with silicone oil injection

RESUMEN Objetivo: Evaluar la efectividad de la cirugía de catarata para el control de la presión intraocular en pacientes vitrectomizados con aceite de silicona remitidos de la consulta de Retina al Servicio de Catarata del Instituto Cubano de Oftalmología Ramón Pando Ferrer, en el período comprendido de enero de 2016 a enero de 2017. Métodos: Se realizó un estudio descriptivo prospectivo de series de casos en 20 pacientes. El universo quedó conformado por todos los pacientes vitrectomizados, a quienes se les colocó aceite de silicona como sustituto del vítreo con diagnóstico de catarata e hipertensión ocular. Resultados: Los pacientes vitrectomizados con aceite de silicona, a quienes se les realizó cirugía de catarata, se caracterizaron por un predominio del sexo masculino y la edad menor de 60 años, asociado a enfermedad vitreorretiniana de base. La cirugía de catarata se relacionó con una importante disminución de la presión intraocular en el posoperatorio. Todos los pacientes alcanzaron un ángulo camerular abierto posterior a la cirugía, que favoreció la disminución del uso de tratamiento tópico. No fue necesaria la cirugía filtrante posterior a esta. Conclusiones: En los pacientes vitrectomizados, la cirugía de catarata muestra una mejoría sostenida de las presiones intraoculares hasta el sexto mes del posoperatorio(AU)

ABSTRACT Objective: Evaluate the effectiveness of cataract surgery to control intraocular pressure in patients undergoing vitrectomy with silicone injection referred by retina specialists to the Cataract Service of Ramón Pando Ferrer Cuban Institute of Ophthalmology from January 2016 to January 2017. Methods: A descriptive prospective case-series study was conducted of 20 patients. The universe was all the patients undergoing vitrectomy with administration of silicone oil as a vitreal substitute who were diagnosed with cataract and ocular hypertension. Results: Patients undergoing vitrectomy with silicone oil injection and cataract surgery were mostly male, mean age was under 60 years, and a relationship was found to underlying vitreoretinal disease. Cataract surgery was associated to a considerable reduction in intraocular pressure in the postoperative period. All patients achieved an open chamber angle after surgery, leading to a reduction in the use of topical medication. Eventual filtration surgery was not required. Conclusions: In patients undergoing vitrectomy, cataract surgery leads to sustained intraocular pressure improvement until the sixth month of the postoperative period(AU)

Filifactor alocis Promotes Neutrophil Degranulation and Chemotactic Activity.

Filifactor alocis is a recently recognized periodontal pathogen; however, little is known regarding its interactions with the immune system. As the first-responder phagocytic cells, neutrophils are recruited in large numbers to the periodontal pocket, where they play a crucial role in the innate defense of the periodontium. Thus, in order to colonize, successful periodontal pathogens must devise means to interfere with neutrophil chemotaxis and activation. In this study, we assessed major neutrophil functions, including degranulation and cell migration, associated with the p38 mitogen-activated protein kinase (MAPK) signaling pathway upon challenge with F. alocis. Under conditions lacking a chemotactic gradient, F. alocis-challenged neutrophils had increased migration compared to uninfected cells, indicating that F. alocis increases chemokinesis in human neutrophils. In addition, neutrophil chemotaxis induced by interleukin-8 was significantly enhanced when cells were challenged with F. alocis, compared to noninfected cells. Similar to live bacteria, heat-killed F. alocis induced both random and directed migration of human neutrophils. The interaction of F. alocis with Toll-like receptor 2 induced granule exocytosis along with a transient ERK1/2 and sustained p38 MAPK activation. Moreover, F. alocis-induced secretory vesicle and specific granule exocytosis were p38 MAPK dependent. Blocking neutrophil degranulation with TAT-SNAP23 fusion protein significantly reduced the chemotactic and random migration induced by F. alocis Therefore, we propose that induction of random migration by F. alocis will prolong neutrophil traffic time in the gingival tissue, and subsequent degranulation will contribute to tissue damage.

Evaluación de vacuna terapéutica en pacientes con cáncer de pulmón avanzado tratados en la Atención Primaria de Salud / Evaluation of therapeutic vaccine in patients with advanced lung cancer treated in Primary Health Care

Se realiza un estudio con el objetivo de evaluar la seguridad y efectividad de la vacuna terapéutica CIMAvax EGF en pacientes con cáncer de pulmón de células no pequeñas en estadio IIIB ó IV tratados en la Atención Primaria de Salud, en la provincia Guantánamo durante el año 2011. Se incluyen pacientes con confirmación citohistológica de carcinoma de células no pequeñas de pulmón en estadios avanzados que no fueran candidatos a las terapias oncoespecíficas o porque las lesiones progresaron con posterioridad a recibir las mismas y solo estuvieran recibiendo los cuidados de soporte o paliativos. Se evaluaron 35 pacientes, de estos, 11, cumplieron con los criterios de inclusión y exclusión. Los eventos adversos que con mayor frecuencia se registraron fueron: fiebre, dolor en sitio de inyección y vómitos. La tasa de fallecimiento en el estudio fue del 54,5 por ciento. El tiempo global de supervivencia fue de 3,1 meses y la supervivencia a la inclusión, 1,8 meses. La calidad de vida de vida de los pacientes mejoró notablemente, con disminución de la disnea e incorporación de los pacientes a su medio familiar(AU)

A study to evaluate the safety and effectiveness of CIMAvax EGF therapeutic vaccine in patients with lung cancer non-small cell stage IIIB or IV treated in primary health care in the province is done during the year Guantánamo, 2011. It was important the insertion of patients with cytohistological confirmation of non-small cell carcinoma of lung in advanced stages who were not candidates for oncospecific therapies because lesions were progressing after receiving supportive care or palliative. 35 patients were evaluated, only 11 of these completed the inclusion and exclusion criteria. Adverse events were registered such as: fever, injection site pain and vomiting. The death rate in the study was 54, 5 percent. The survival time was 3, 1 month and survival at inclusion, 1,8 months. The quality of life the patients improved significantly, with low dyspnea and incorporation of patients to their families

Relation between serum vitamin D level and asthma.

UNLABELLED: Asthma is a chronic multifactorial condition racterized by inflammation, bronchial hyperresponsiveness, narrowing of airway associated with wheezing and shortness of breath, where trials have evidenced that approximately 50% despite being on adequate treatment don't achieve optimal control. Asthma has been related to vitamin D deficiency, where lower levels have been correlated to an increased hyperreactiveness and lower measures in pulmonary function test. Up to our knowledge, no studies have been conducted in Hispanic patients for this association. METHODS: Cross-Sectional pilot study in the setting of a pneumology office practice. Population consisted of asthmatic patients with no past medical history or risk factors for lower vitamin D levels. Variables studied included Peak-Flow s a measurement of the maximal velocity of air expelled in a forced exhalation adjusted for height and age; Serum vitamin D levels where optimal was > 30, and deficient < 30. Data coIlection period occurred between January 2010 and May 2011. RESULTS: A direct proportion relation between vitamin D levels and asthma control test (ACT) questionnaire was noted. An inversely direct proportion between vitamin D and peak flow was evidenced, while no relation noted between peak flow and asthma. DISCUSSION: An 80% prevalence of vitamin D deficiency was noted in our population. Higher levels of vitamin D were associated with higher punctuation on ACT questionnaire, evidencing that most patients felt better during the last month. Peak flow measurements resulted to be lower when vitamin D was higher, though this measure could be influenced by a variety of external conditions.

Aspectos clínico-espirométricos en pacientes con hábito de fumar / Spirometric clinical aspects in patients with smoking habit

Se realiza un estudio con los 120 pacientes fumadores del Policlínico Universitario Omar Ranedo Pubillones de Guantánamo, en el período enero-diciembre de 2010, con el propósito de describir las principales alteraciones clínicas-espirométricas de dichos pacientes. Las variables a utilizar fueron: edad, sexo, cantidad de cigarrillos, años de fumador, patrón espirométrico, resultados del volumen espiratorio forzado en un segundo (VEF1) y síntomas asociados. Se realizan encuestas y se selecciona una muestra probabilística a conveniencia de la autora. Predominaron los pacientes del grupo de edades de 45-54 años, el sexo masculino fumadores moderados entre 10-20 años con hábito de fumar y con patrón obstructivo. La alteración del VEF1 más frecuente encontrada fue la de moderada intensidad y con síntoma predominante la disnea de esfuerzo (AU)

A study with 120 smokers is done at the Polyclinic Omar Ranedo Pubillones, Guantanamo, from January to December 2010, with the purpose of describing the major characteristics of spirometry in these patients. The variables were used: age, sex, number of cigarettes, years of smoking, spirometric pattern, results in forced expiratory volume in one second (FEV1) and associated symptoms. Surveys are conducted and a sample is selected at the convenience of the author. Were prevailing age of group ,45-54 years, males and 10-20 years moderated smokers with smoking habits and obstructive pattern. The most frequent alteration in FEV1 was found, moderated intensity and symptoms such as: acute dyspnea (AU)

Outcomes associated with conventional management of severe sepsis at Damas Hospital.

UNLABELLED: Severe sepsis and septic shock have become one of the leading causes of medical intensive care unit (MICU) mortality as well as one of the greater consumers of healthcare resources. Several institutions in the United States have reported positive outcomes after following the Severe Sepsis Campaign (SSC) recommendations. Current management of severe sepsis and septic shock at Damas Hospital's MICU follows no specific protocols or recommendations. This study report data regarding outcomes associated with ongoing management of severe sepsis at our institution. METHODS: Historical controls with ICD-9 diagnosis of Severe Sepsis and/or Septic Shock hospitalized between January 2007 and August 2009 were randomly selected. Data regarding survival, length of stay (ICU/ In-hospital), and disease severity was gathered through record review. Measured outcomes as well as sociodemographic data were compared to those reported in the literature. RESULTS: Thirty patients were studied with a mean age of 62 years; 50% male and 50% female. Mean APACHE II score was 21 (40% mortality) with average MICU length of stay of 5.2 days and overall hospital stay of 12.9 days. Overall mortality was 66%. CONCLUSION: There is a high mortality rate associated with conventional management of severely septic patients in Damas Hospital ICU. Studies with similar populations had significantly lower mortality rates based on conventional management of severe sepsis/septic shock. Starting protocoled care of patients with severe sepsis as recommended by the SSC could have a positive impact in the overall mortality at Damas Hospital.

Possible active origin of replication in the double stranded extended form of the left terminus of LuIII and its implication on the replication model of the parvovirus.

BACKGROUND: The palindromic termini of parvoviruses have proven to play an essential role as origins of replication at different stages during the replication of their viral genome. Sequences from the left-end telomere of MVM form a functional origin on one side of the dimer replicative form intermediate. In contrast, the right-end origin can operate in its closed replicative form hairpin configuration or as a fully duplex linear sequence derived from either arm of a palindromic tetramer intermediate. To study the possibility that the LuIII left hairpin has a function in replication, comparable to that described for MVM, the replication of a minigenome containing two copies of the LuIII left terminus (LuIII Lt-Lt) was studied. RESULTS: The data presented demonstrates that LuIII Lt-Lt was capable of replicating when NS1 helper functions were provided in trans. This extended hairpin, capable of acting as an origin of replication, lacks the arrangement of the specific domains present in the dimer duplex intermediate of MVM, the only active form of the left hairpin described for this parvovirus. CONCLUSIONS: These findings suggest that the left hairpin of LuIII has an active NS1 driven origin of replication at this terminus in the double stranded extended form. This difference between LuIII and MVM has great implications on the replication of these viruses. The presence of origins of replication at both the left and right termini in their natural hairpin form can explain the unique encapsidation pattern observed for LuIII hinting on the mechanism used by this virus for the replication of its viral genome.

PROJETO DE INTERVENÇÃO PARA ELEVAR O CONHECIMENTO DA POPULAÇÃO SOBRE A MALÁRIA E DIMINUIR SUA INCIDÊNCIA NA COMUNIDADE DE CUJUBIM/RO

A finalidade do estudo é elevar conhecimento da população sobre a malária e diminuir sua incidência na unidade de saúde José Gomes Ferreira de Cujubim Grande / Porto Velho no período de Janeiro-Dezembro 2014. Realizou-se um projeto de intervenção onde utilizamos uma mostra de (n=50) que foi composta por pacientes de idades entre 15 e 40 anos, pessoas que trabalham na beira do rio em dragas, não usam meios de proteção para evitar a picada do mosquito, não tem condições ótimas de moradia, em comparação com restante da população que habitam em locais mais distantes do rio e tem melhores condições de moradia. As informações foram coletadas do questionário aplicado à amostra estudada. Os resultados se apresentam nas tabelas chegando às conclusões boas que possibilitaram o cumprimento dos objetivos, onde no primeiro momento demostrou-se que os pacientes estudados não tinham conhecimentos sobre o conceito, etiologia, sintomas, fatores de risco, tratamento farmacológico e medidas higiênicas a desenvolver nas casas para a prevenção da doença, ao final, com a aplicação do programa educativo, comprovou-se a efetividade da mesma com a elevação dos conhecimentos da amostra estudada.