ABSTRACT
PURPOSE: To determine the effectiveness of intravitreal plasmin injection in the treatment of macular epiretinal membranes (MEM) and vitreomacular traction syndrome (VMTS) without associated pars plana vitrectomy. DESIGN: Interventional, prospective, case series pilot study. PATIENTS: Seven patients were enrolled in the study, 4 with MEM and 3 with VMTS. TREATMENT: 0.2 ml of autologous plasmin intravitreally injected under topical anesthesia was administered to all patients. The plasmin was obtained by a simplified method with urokinase. MAIN OUTCOME MEASURES: Degree of detachment of the MEM and the VMTS measured by optical coherence tomography (OCT), and the best corrected visual acuity (Snellen scale) before and one month after the plasmin injection. RESULTS: The follow-up period was completed by all the patients. The MEM remained attached to the retina in all cases, as measured either by biomicroscopy or OCT. The VMTS was completely detached from the foveal area in all cases, with the disappearance of secondary tractional retinal folds and recovery of the normal macular anatomic architecture as measured by OCT. Visual acuity was not modified in any of the MEM patients, and improved in all VMTS patients. No adverse effects were observed. CONCLUSION: In our case series, intravitreally injected autologous plasmin was not effective in the treatment of MEM, but resolved VMTS successfully, improving the visual acuity and releasing the retinal traction without the need for associated pars plana vitrectomy. Larger studies to confirm the efficacy of this technique and the possibility of success after repeated injections are warranted.
Subject(s)
Epiretinal Membrane/surgery , Fibrinolysin/therapeutic use , Retinal Diseases/therapy , Vitrectomy/methods , Vitreous Body/drug effects , Adult , Aged , Aged, 80 and over , Female , Fibrinolysin/administration & dosage , Fibrinolysin/isolation & purification , Humans , Injections , Male , Middle Aged , Pilot Projects , Prospective Studies , Tomography, Optical Coherence , Visual AcuityABSTRACT
Objetivo: Determinar si la inyección intravítrea de plasmina es efectiva en el tratamiento de las membranas epirretinianas maculares (MEM) y el síndrome de tracción vitreomacular (STVM), sin necesidad de asociar vitrectomía quirúrgica.Material y método: Diseño: Estudio piloto prospectivo, de intervención, serie de casos.Pacientes: Siete pacientes, cuatro con membranaepirretiniana macular y tres con síndrome de tracciónvitreomacular.Tratamiento: Inyección intravítrea de 0,2 ml de plasmina autóloga bajo anestesia tópica. La plasminafue obtenida por un método simplificado modificado por adicción de uroquinasa.Principales medidas: Grado de separación de la membrana epirretiniana de la retina medido portomografía de coherencia óptica (OCT) y la mejor agudeza visual corregida (escala Snellen), antes y almes de la inyección de plasmina.Resultados: Todos los pacientes completaron el seguimiento de 1 mes. La membrana epirretiniana(MEM) permaneció oftalmoscópicamente adherida, sin cambios ni separación del plano de la retina. Sin embargo, en los casos con síndrome de tracciónvitreomacular (STVM), la membrana se despegó del área foveal, desapareciendo los pliegues retinianostraccionales secundarios, y normalizando la mácula la estructura anatómica. La agudeza visualno se modificó en ninguno de los casos de membrana epirretiniana y mejoró en los casos de síndromede tracción vitreomacular. No se observaron efectos secundarios.Conclusión: La inyección intravítrea de plasmina autóloga como tratamiento inicial previo a la vitrectomíaquirúrgica, en la serie de casos estudiada, parece ineficaz en las membranas epirretinianasmaculares, y más eficaz en el síndrome de tracción vitreomacular, mejorando en este último la agudeza visual y consiguiendo el despegamiento al menosparcial de la membrana. Estudios más amplios son necesarios para confirmar su eficacia y la posibilidad de incrementar la misma con reinyeccionesperiódicas de plasmina(AU)
Purpose: To determine the effectiveness of intravitrealplasmin injection in the treatment of macular epiretinalmembranes (MEM) and vitreomacular traction syndrome(VMTS) without associated pars plana vitrectomy.Methods:Design: Interventional, prospective, case seriespilot study.Patients: Seven patients were enrolled in the study,4 with MEM and 3 with VMTS.Treatment: 0.2 ml of autologous plasmin intravitreallyinjected under topical anesthesia was administered to all patients. The plasmin was obtained by a simplifiedmethod with urokinase.Main outcome measures: Degree of detachment ofthe MEM and the VMTS measured by optical coherencetomography (OCT), and the best correctedvisual acuity (Snellen scale) before and one monthafter the plasmin injection.Results: The follow-up period was completed byall the patients. The MEM remained attached to theretina in all cases, as measured either by biomicroscopyor OCT. The VMTS was completely detachedfrom the foveal area in all cases, with the disappearanceof secondary tractional retinal folds and recoveryof the normal macular anatomic architecture asmeasured by OCT. Visual acuity was not modifiedin any of the MEM patients, and improved in allVMTS patients. No adverse effects were observed.Conclusion: In our case series, intravitreally injectedautologous plasmin was not effective in the treatmentof MEM, but resolved VMTS successfully, improvingthe visual acuity and releasing the retinal tractionwithout the need for associated pars planavitrectomy. Larger studies to confirm the efficacy ofthis technique and the possibility of success afterrepeated injections are warranted(AU)
Subject(s)
Humans , Male , Female , Middle Aged , Adult , Vitrectomy/methods , Fibrinolysin/therapeutic use , Epiretinal Membrane/diagnosis , Epiretinal Membrane/therapy , Visual Acuity , Eye Diseases/enzymology , Eye Diseases/therapy , Vitrectomy/trends , Fibrinolysin/administration & dosage , Fibrinolysin , Prospective Studies , Visual Acuity/physiology , Vitreous Detachment/enzymologyABSTRACT
PURPOSE: To determine whether intravitreal injection of plasmin is effective in treating diffuse diabetic macular edema (DDME). DESIGN: A prospective, comparative, interventional case study. PATIENTS: Eighteen patients with bilateral DDME received, as their primary therapeutic treatment, an intravitreal injection of plasmin in one eye, with their contralateral untreated eye serving as a control. INTERVENTION: Intravitreal 0.2 ml of autologous plasmin injected under topical anesthesia. The plasmin was obtained by a simplified method. MAIN OUTCOME MEASURES: Central macular thickness (CMT), determined by optical coherence tomography (OCT), and Best Corrected Visual Acuity (LogMAR), assessed at one and three months of follow-up. RESULTS: All patients completed the 3-month follow-up assessments. Before the injection, the CMT was 525.22 SD 80.12 microm [mean +/- standard deviation (SD)] in the eyes to be injected, compared to 525.44 SD 78.13 microm in the control eyes. One month after the injection, the CMT was 323.72 SD 44.87 microm in the injected eyes and 518.44 SD 78.54 microm in the control eyes (P < 0.001, bilateral Wilcoxon test for paired samples). Three months after the injection, the CMT was 310.55 SD 35.38 microm in the injected eyes and 517.66 SD 80 microm in the control eyes (P < 0.001). Macular edema improved in all injected eyes (100%), with a reduction of at least 50% in every treated eye, but no changes occurred in the control group. Nine of the 18 treated eyes (50%) improved their BCVA by at least two vision lines. No adverse effects were observed in any of the patients. CONCLUSION: Intravitreal plasmin injection, as primary treatment, effectively reduces macular thickening due to DDME and improves visual acuity. Further studies are warranted to assess long-term efficacy and safety.
Subject(s)
Diabetic Retinopathy/drug therapy , Fibrinolysin/administration & dosage , Macular Edema/drug therapy , Vitrectomy/methods , Aged , Aged, 80 and over , Female , Humans , Injections , Male , Middle Aged , Pilot Projects , Prospective Studies , Vitreous BodyABSTRACT
Objetivo: Determinar si la inyección intravítrea de plasmina es efectiva en el tratamiento del edema macular diabético difuso (EMDD). Diseño: Estudio piloto prospectivo, comparativo, de intervención, serie de casos. Pacientes: Dieciocho pacientes con edema macular diabético bilateral, recibieron como primera actuación terapéutica una inyección intravítrea de plasmina en un ojo, sirviendo el ojo contralateral como control. Tratamiento: Inyección intravítrea de 0,2 ml de plasmina autóloga bajo anestesia tópica. La plasmina fue obtenida por un metodo simplificado. Principales medidas: Engrosamiento macular central (EMC) medido por tomografía de coherencia óptica (OCT) y agudeza visual (escala LogMAR), al mes y los 3 meses. Resultados: Todos los pacientes completaron el seguimiento de 3 meses. Antes de la inyección el EMC 525,22 DE 80,12 μm [media ± desviación estandard (DE)] en los ojos inyectados, versus 515,44 DE 78,13 μm en los ojos control. Un mes tras la inyección el EMC era 323,72 DE 44,87 μm en los ojos inyectados y 518,44 DE 78,54 μm en los ojos control (P < 0,001, test bilateral de Wilcoxon para muestras pareadas). A los tres meses tras la inyección el EMC era 310,55 DE 35,38 μm en los ojos inyectados y 517,66 DE 80 μm en los ojos control (P < 0,001). El edema macular mejoró en todos los ojos inyectados (100%), con una reducción al menos del 50%, mientras permaneció sin cambios en el grupo control. Nueve de los 18 ojos tratados (50%) ganaron al menos 2 líneas de visión, manteniéndose dicha mejoría durante los tres meses de seguimiento. No se observó en ningún paciente efectos secundarios. Conclusión: La inyección intravítrea de plasmina autóloga, como tratamiento de primera elección, mejora el edema macular diabético difuso y la agudeza visual. Estudios futuros son necesarios para confirmar su eficacia y seguridad a largo plazo
Purpose: To determine whether intravitreal injection of plasmin is effective in treating diffuse diabetic macular edema (DDME). Design: A prospective, comparative, interventional case study. Patients: Eighteen patients with bilateral DDME received, as their primary therapeutic treatment, an intravitreal injection of plasmin in one eye, with their contralateral untreated eye serving as a control. Intervention: Intravitreal 0.2 ml of autologous plasmin injected under topical anesthesia. The plasmin was obtained by a simplified method. Main Outcome Measures: Central macular thickness (CMT), determined by optical coherence tomography (OCT), and Best Corrected Visual Acuity (LogMAR), assessed at one and three months of follow-up. Results: All patients completed the 3-month follow-up assessments. Before the injection, the CMT was 525.22 SD 80.12 μm [mean ± standard deviation (SD)] in the eyes to be injected, compared to 525.44 SD 78.13 μm in the control eyes. One month after the injection, the CMT was 323.72 SD 44.87 μm in the injected eyes and 518.44 SD 78.54 μm in the control eyes (P < 0.001, bilateral Wilcoxon test for paired samples). Three months after the injection, the CMT was 310.55 SD 35.38 μm in the injected eyes and 517.66 SD 80 μm in the control eyes (P < 0.001). Macular edema improved in all injected eyes (100%), with a reduction of at least 50% in every treated eye, but no changes occurred in the control group. Nine of the 18 treated eyes (50%) improved their BCVA by at least two vision lines. No adverse effects were observed in any of the patients. Conclusion: Intravitreal plasmin injection, as primary treatment, effectively reduces macular thickening due to DDME and improves visual acuity. Further studies are warranted to assess long-term efficacy and safety
Subject(s)
Male , Female , Middle Aged , Aged , Humans , Vitrectomy/methods , Macular Edema/surgery , Fibrinolysin/administration & dosage , Diabetes Mellitus/complications , Fibrinolysin/therapeutic use , Drug Administration Routes , Prospective Studies , Treatment Outcome , Pseudophakia , Diabetic Retinopathy , Visual AcuitySubject(s)
Contact Lenses , Lenses, Intraocular , Medical Errors , Refraction, Ocular , Biometry/methods , Female , Humans , Middle Aged , Refractive ErrorsABSTRACT
No disponible
Subject(s)
Humans , Lenses, Intraocular , Optometry/methods , Contact Lenses , Biometry/methods , Contact LensesABSTRACT
In the genus Pinus the internal transcribed spacers (ITS1 and ITS2) and the 5.8s region of the nuclear ribosomal DNA are approximately 3000â bp in length. ITS1 is considerably longer than ITS2 and partial sequences of ITS1 indicate that this region is evolving rapidly and exhibits intraspecific variation. The ITS2 and 5.8s regions are relatively conserved. We surveyed restriction fragment length variability of PCR-amplified fragments (PCR-RFLP) of the ITS region in four populations (86 individuals) of Pinus rzedowskii, a pine endemic to western Michoacán, Mexico. Five of the restriction endonucleases assayed revealed variation, with a total of 13 variants, most of which were length mutations of 300-900â bp. A moderate degree of population differentiation was detected. The average diversity (Shannon's index) of ITS fragment size patterns was 1.19, with 34% of the variation due to differences among populations and 66% due to differences among individuals within populations. The same individuals were assayed for nine polymorphic isozymes, which gave diversity measures similar to those of each restriction endonuclease.
ABSTRACT
La investigación realizada pretendió conocer algunos factores de riesgos asociados con las ETS, siendo el propósito central, el describir creencias, opiniones y conductas, respecto a la sexualidad de los pacientes que consultan por estas enfermedades, comparados con un grupo control. El diseño correspondió a un estudio de casos y controles, incluyó 78 casos consultantes por ETS en el Hospital Regional de Concepción y 82 controles consultantes por otras patologías en el Consultorio Víctor Manuel Fernández del S.N.S.S. Se detectó que la mayoría de los casos, 79 fue contagiado por una pareja casual y declaró desconocer la patología que lo afectaba. Creencias y opiniones no se asociaron con el riesgo de contraer ETS. Por último, de las conductas consideradas, se asociaron con el hecho de ser protador de ETS: el número de parejas sexuales, la homosexualidad, el consumo de drogas y tranquilizantes
Subject(s)
Humans , Male , Female , Health Knowledge, Attitudes, Practice , Sexuality , Case-Control Studies , Condoms/statistics & numerical data , Sex Education/statistics & numerical data , Hospitals, State/statistics & numerical data , Risk Factors , Sexually Transmitted DiseasesABSTRACT
We present a case of Amelogenesis imperfecta associated with Dentinogenesis imperfecta, affecting the primary dentition which is rehabilitated under general anesthesia. Dentinogenesis imperfecta is a tooth abnormality which presents clinical, radiological and histological characteristics, they should be recognized by the dentist who will determine the treatment depending on age and grade of affection. In the primary dentition we recommend the use of stainless steel crowns do to it's resistance and easy adaptation which will remain in the mouth until it's normal exfoliation.
Subject(s)
Crowns , Dentinogenesis Imperfecta/therapy , Child, Preschool , Female , Humans , Stainless Steel , Tooth, DeciduousABSTRACT
Se describe la situación epidemiológica de las enfermedades de transmisión sexual en los servicios de salud de la VIII región, comparándolos con lo que se observa en el resto del país. Se concluye que hay una subnotificación de los casos de sífilis y gonorrea. Los factores responsables serían: a) actualmente la frecuencia de consultas por ETS ha disminuído, b) existe una menor demanda del test VDRL, c) Test de mayor sensibilidad prácticamente no son realizados. Estas limitaciones son más frecuentes en los servicios de Talcahuano y Ñuble. Las tendencias observadas coinciden con las nacionales en una reducción de la incidencia de sífilis y en un ascenso o meseta en las cifras de gonorrea. Es necesario hacer notar que ambas enfermedades aumentan en los adolescentes
