Utilidad de la diferencia venoarterial de PCO2 como predictor de complicaciones en el postoperatorio inmediato del trasplante hepático / Utility of the central venous-to-arterial CO2 difference to predict adverse outcomes after liver transplantation

Objetivo: Evaluar la relación de la diferencia venoarterial de PCO2 (ΔPCO2) con la aparición de complicaciones en el manejo postoperatorio precoz del trasplante hepático. Materiales y métodos: Estudio observacional y prospectivo realizado en una unidad de cuidados intensivos médico-quirúrgica de un hospital universitario. Se incluyó a 150 pacientes adultos que recibieron un trasplante de hígado ortotópico entre enero de 2015 y noviembre de 2018. Los pacientes fueron clasificados en 4grupos predefinidos de acuerdo con la evolución de la ΔPCO2 durante las primeras 6 h del postoperatorio en la unidad de cuidados intensivos, al considerar ese periodo como el de mayor riesgo de alteraciones hemodinámicas: 1) ΔPCO2 persistentemente normal (normal en T0 y T6); 2) ΔPCO2 descendente (alta en T0, normal en T6); 3) ΔPCO2 ascendente (normal en T0, alta en T6) y 4) ΔPCO2 persistentemente alta (alta en T0 y T6). Se comparó la relación de dichos grupos con la aparición de disfunción multiorgánica a las 72 h y las probabilidades de supervivencia globales y en el día 30 se describieron mediante curvas de Kaplan-Meier; las diferencias se calcularon mediante un test log-rank. Para el estudio de la correlación entre índice cardiaco y ΔPCO2 se utilizó el coeficiente de correlación de Spearman. Resultados: La disfunción multiorgánica representada mediante el SOFA a las 72 h (p=0,86) y el Δ-SOFA (p=0,088) no presentó diferencias significativas entre los 4grupos a estudio, de la misma forma que ocurrió con la mortalidad hospitalaria (χ2=5,72; p=0,126) y a los 30 días (χ2=2,23; p=0,5252). Con respecto a la relación entre índice cardiaco y ΔPCO2, se demostró una correlación inversa estadísticamente significativa de valor bajo (rho de Spearman: −0,17; p=0,002). Conclusiones: En pacientes críticos admitidos tras un trasplante hepático, la diferencia venoarterial de PCO2 no predice la mortalidad ni la incidencia de complicaciones en el periodo postoperatorio inmediato.(AU)

Objective: Test whether the development of abnormal venous-to arterial CO2 difference (ΔPCO2) during the early phases of postoperative care after a liver transplantation is related to multi-organ dysfunction and outcomes. Materials and methods: Prospective cohort study accomplished in a mixed intensive care unit at a university hospital. We included 150 eligible patients after a liver transplantation between 2015 and 2018. Patients were classified in 4predefined groups according to the ΔPCO2 evolution during the first 6h of resuscitation: 1) persistently normal ΔPCO2 (normal at T0 and T6); 2) decreasing ΔPCO2 (high at T0, normal at T6); 3) increasing ΔPCO2 (normal at T0, high at T6); and 4) persistently high ΔPCO2 (high at T0 and T6). Multiorgan dysfunction at day-3 was compared for predefined groups and a Kaplan Meier curve was constructed to show the survival probabilities using a log-rank test to evaluate differences between groups. A Spearman-rho was used to test the agreement between cardiac output and ΔPCO2. Results: There were no significant differences between the study groups regarding higher SOFA scores at day-3 (P=0.86), Δ-SOFA (P=0.088), as well as global mortality rates (χ2=5.72; P=0.126) and mortality rates at day-30 (χ2=2.23; P=0.5252). A significantly poor inverse agreement between cardiac output and ΔPCO2 was observed (rho de Spearman −0,17; P=0,002) at different points of resuscitation. Conclusions: After a liver transplantation, central venous-to-arterial CO2 difference was not associated with survival or postoperative adverse outcomes in a critical care patients population.(AU)

Utility of the central venous-to-arterial CO2 difference to predict adverse outcomes after liver transplantation.

OBJECTIVE: Test whether the development of abnormal venous-to arterial CO2 difference (ΔPCO2) during the early phases of postoperative care after a liver transplantation (LT) is related to multi-organ dysfunction and outcomes. MATERIALS AND METHODS: Prospective cohort study accomplished in a mixed intensive care unit (ICU) at a university hospital. We included 150 eligible patients after a LT between 2015 and 2018. Patients were classified in four predefined groups according to the ΔPCO2 evolution during the first 6 h of resuscitation: (1) persistently normal ΔPCO2 (normal at T0 and T6); (2) decreasing ΔPCO2 (high at T0, normal at T6); (3) increasing ΔPCO2 (normal at T0, high at T6); and (4) persistently high ΔPCO2 (high at T0 and T6). Multiorgan dysfunction at day-3 was compared for predefined groups and a Kaplan Meier curve was constructed to show the survival probabilities using a log-rank test to evaluate differences between groups. A Spearman-Rho was used to test the agreement between cardiac output and ΔPCO2. RESULTS: There were no significant differences between the study groups regarding higher SOFA scores at day-3 (P = .86), Δ-SOFA (P = .088), as well as global mortality rates (χ²â€¯= 5.72; P = .126) and mortality rates at day-30 (χ²â€¯= 2.23; P = .5252). A significantly poor inverse agreement between cardiac output and ΔPCO2 was observed (r2 -0,17; P = ,002) at different points of resuscitation. CONCLUSIONS: After a LT, central venous-to-arterial CO2 difference was not associated with survival or postoperative adverse outcomes in a critical care patients population.

Fanconi-like anemia related to a FANCM mutation.

Fanconi anemia is primarily inherited as an autosomal recessive genetic disorder with common delays in diagnosis and challenging treatments. Fanconi anemia patients have a high risk of developing solid tumors, particularly in the head and neck or anogenital regions. The diagnosis of Fanconi anemia is primarily based on the chromosomal breakage but FA gene sequencing is recommended in all patients with a positive chromosome fragility test. Here, we present a 32-year-old man with advanced tonsil squamous cell carcinoma and fatal toxicity after the first cycle of chemotherapy. No anemia was present. A recent variant mutation if the FANCM gene was detected (c1511_1515delGAGTA (pArg504AsnfsTer29)). Homozygous or double heterozygous pathogenic variants have been reported in FANCM and linked to azoospermia and primary ovarian failure without anemia. Alterations in this gene have also been associated with a genetic predisposition for solid tumors (breast and ovarian cancer) and hematological malignancies (B-cell acute lymphoblastic leukemia). Due to the hypersensitivity of these patients to DNA-damaging agents such as chemotherapy and radiotherapy, surgery is the best treatment option for malignant solid tumors. Dose reductions or alternative regimens of chemotherapy and/or radiotherapy are recommended in FA patients who develop a malignant tumor.

Estudio de riesgo de recurrencia de trastorno del espectro autista (TEA) en hermanos de niños con diagnóstico TEA / Study on recurrence risk of autism spectrum disorders (ASD) in siblings of children diagnosed with ASD

El trastorno del espectro autista (TEA) es un trastorno del desarrollo, común de la niñez, con una fuerte predisposición genética y alta heredabilidad. El riesgo de recurrencia en hermanos oscila entre 10-20% y en caso de familias con dos o más niños afectados el riesgo de recurrencia aumenta hasta un 35%. Dentro de las pruebas complementarias para el diagnóstico, el gold standard es la escala ADOS, existe además una prueba de pesquisa, el M-CHAT. Objetivo: evaluar riesgo de recurrencia de TEA en hermanos menores de niños con diagnóstico de TEA. Materiales y Métodos: se realizó un estudio de tipo transversal, observacional y descriptivo. Fueron estudiados niños entre 18-36 meses, hermanos de pacientes con diagnóstico de TEA. La evaluación del desarrollo se realizó utilizando: Escalas CAT/CLAMS, M-CHAT y ADOS 2. Resultados: se estudiaron 39 hermanos. 25 fueron varones y 14 fueron mujeres. Se identificaron 5 niños con diagnóstico de TEA, por lo que el riesgo de recurrencia en la población estudiada fue de 13%, con una relación varón/mujer de 4/1. Del resto de la población estudiada, 13% reunieron criterios para fenotipo ampliado del autismo (Broader Autism Phenotype ­BAP­ en su sigla en inglés), 31% presentaron retraso del lenguaje(RL) y 7%retraso global del desarrollo (RGD). Solo el 36% presentó desarrollo típico. Conclusión: Los hermanos de niños afectados representan un grupo de riesgo para problemas del desarrollo, que debe ser tenido en cuenta por los profesionales de la salud que siguen longitudinalmente a niños con diagnóstico confirmado de TEA (AU)

Autism spectrum disorder (ASD) is a developmental disorder that is common in childhood with a strong genetic predisposition and high heritability. The risk of recurrence in siblings is found to be between 10-20% and in families with two or more affected children recurrence risk is as high as 35%. Among the complementary diagnostic tests, the gold standard is the ADOS scale, and additionally the M-CHAT screening test. Objective: To evaluate the recurrence risk of ASD in younger siblings of children diagnosed with ASD. Material and Methods: A cross-sectional, observational, descriptive study was conducted. Children between 18- 36 months of age, siblings of children diagnosed with ASD were studied. Development was assessed using the CAT/CLAMS, MCHAT, and ADOS 2 scales. Results: 39 siblings were studied; 25 were male and 14 female. Five children with ASD were identified, accounting for a recurrence risk of 13% in the study population and a male/female ratio of 4/1. Of the remaining children, 13% met the criteria for the broader autism phenotype (BAP), 31% had language delay (LD), and 7% global developmental delay (GDD). Only 36% had normal development. Conclusion: Siblings of affected children are at risk for developmental disorders that should be taken into account by health professionals that ongitudinally follow children with a confirmed diagnosis of ASD (AU)

Predicción de hemorragia masiva. Índice de shock e índice de shock modificado / Prediction of massive bleeding. Shock index and modified shock index

Objetivo: Determinar la capacidad de predicción del índice de shock y del índice de shock modificado para hemorragia masiva tras sufrir un trauma grave. Diseño: Cohorte retrospectiva. Ámbito: Atención inicial hospitalaria al paciente con enfermedad traumática grave en una unidad de cuidados intensivos de trauma de un hospital terciario. Sujetos: Pacientes mayores de 14 años con trauma grave (injury severity score [ISS] >15), admitidos de forma consecutiva desde enero de 2014 hasta diciembre de 2015. Variables: Se estudiaron sensibilidad (Se), especificidad (Sp), valores predictivos positivo y negativo (VP+ y VP-), razones de verosimilitud positiva y negativa (RV+ y RV-), curvas ROC (receiver operating characteristics) y el área bajo las mismas (AUROC) para predicción de hemorragia masiva. Resultados: Se incluyeron 287 pacientes, el 76,31% (219) fueron varones, con una edad media de 43,36 (±17,71) e ISS de 26 (rango intercuartil [RIC]: 21-34). La frecuencia global de hemorragia masiva fue de 8,71% (25). Para el índice de shock se obtuvo: AUROC de 0,89 (intervalo de confianza [IC] 95%: 0,84-0,94), con un punto de corte óptimo en 1,11, Se del 91,3% (IC 95%: 73,2-97,58) y Sp del 79,69% (IC 95%: 74,34-84,16). Para el índice de shock modificado se obtuvo: AUROC de 0,90 (IC 95%: 0,86-0,95), con un punto de corte óptimo en 1,46, Se del 95,65% (IC 95%: 79,01-99,23) y Sp del 75,78% (IC 95%: 70,18-80,62). Conclusiones: El índice de shock y el índice de shock modificado son buenos predictores de hemorragia masiva y de fácil aplicación durante la atención inicial del trauma grave (AU)

Objective: To determine the predictive value of the Shock Index and Modified Shock Index in patients with massive bleeding due to severe trauma. Design: Retrospective cohort. Setting: Severe trauma patient's initial attention at the intensive care unit of a tertiary hospital. Subjects: Patients older than 14 years that were admitted to the hospital with severe trauma (Injury Severity Score >15) form January 2014 to December 2015. Variables: We studied the sensitivity (Se), specificity (Sp), positive and negative predictive value (PV+ and PV-), positive and negative likelihood ratio (LR+ and LR-), ROC curves (Receiver Operating Characteristics) and the area under the same (AUROC) for prediction of massive hemorrhage. Results: 287 patients were included, 76.31% (219) were male, mean age was 43,36 (±17.71) years and ISS was 26 (interquartile range [IQR]: 21-34). The overall frequency of massive bleeding was 8.71% (25). For Shock Index: AUROC was 0.89 (95% confidence intervals [CI] 0.84 to 0.94), with an optimal cutoff at 1.11, Se was 91.3% (95% CI: 73.2 to 97.58) and Sp was 79.69% (95% CI: 74.34 to 84.16). For the Modified Shock Index: AUROC was 0.90 (95% CI: 0.86 to 0.95), with an optimal cutoff at 1.46, Se was 95.65% (95% CI: 79.01 to 99.23) and Sp was 75.78% (95% CI: 70.18 to 80.62). Conclusion: Shock Index and Modified Shock Index are good predictors of massive bleeding and could be easily incorporated to the initial workup of patients with severe trauma (AU)

La hidroxicloroquina, un fármaco potencialmente letal / Hydroxychloroquine, a potentially lethal drug

No disponible

Prediction of massive bleeding. Shock index and modified shock index. / Predicción de hemorragia masiva. Índice de shock e índice de shock modificado.

OBJECTIVE: To determine the predictive value of the Shock Index and Modified Shock Index in patients with massive bleeding due to severe trauma. DESIGN: Retrospective cohort. SETTING: Severe trauma patient's initial attention at the intensive care unit of a tertiary hospital. SUBJECTS: Patients older than 14 years that were admitted to the hospital with severe trauma (Injury Severity Score >15) form January 2014 to December 2015. VARIABLES: We studied the sensitivity (Se), specificity (Sp), positive and negative predictive value (PV+ and PV-), positive and negative likelihood ratio (LR+ and LR-), ROC curves (Receiver Operating Characteristics) and the area under the same (AUROC) for prediction of massive hemorrhage. RESULTS: 287 patients were included, 76.31% (219) were male, mean age was 43,36 (±17.71) years and ISS was 26 (interquartile range [IQR]: 21-34). The overall frequency of massive bleeding was 8.71% (25). For Shock Index: AUROC was 0.89 (95% confidence intervals [CI] 0.84 to 0.94), with an optimal cutoff at 1.11, Se was 91.3% (95% CI: 73.2 to 97.58) and Sp was 79.69% (95% CI: 74.34 to 84.16). For the Modified Shock Index: AUROC was 0.90 (95% CI: 0.86 to 0.95), with an optimal cutoff at 1.46, Se was 95.65% (95% CI: 79.01 to 99.23) and Sp was 75.78% (95% CI: 70.18 to 80.62). CONCLUSION: Shock Index and Modified Shock Index are good predictors of massive bleeding and could be easily incorporated to the initial workup of patients with severe trauma.

Mutation status and immunoglobulin gene rearrangements in patients from northwest and central region of Spain with chronic lymphocytic leukemia.

The aim of this study was to investigate the frequency and mutation status of the immunoglobulin heavy variable chain (IGHV) in a cohort of 224 patients from northwest and central region of Spain diagnosed with chronic lymphocytic leukemia (CLL), and to correlate it with cytogenetic abnormalities, overall survival (OS) and time to first treatment (TTFT). 125 patients had mutated IGHV, while 99 had unmutated IGHV. The most frequently used IGHV family was IGHV3, followed by IGHV1 and IGHV4. The regions IGHV3-30, IGHV1-69, IGHV3-23, and IGHV4-34 were the most commonly used. Only 3.1% of the patients belonged to the subfamily IGHV3-21 and we failed to demonstrate a worse clinical outcome in this subgroup. The IGHV4 family appeared more frequently with mutated pattern, similar to IGHV3-23 and IGHV3-74. By contrast, IGHV1-69 was expressed at a higher frequency in unmutated CLL patients. All the cases from IGHV3-11 and almost all from IGHV5-51 subfamily belonged to the group of unmutated CLL.

Parálisis del nervio ciático poplíteo externo como consecuencia de fractura de tobillo. Revisión de un caso / Case report. Common peroneal nerve palsy after an infrasindesmotic ankle fracture

Objetivo: La lesión del nervio ciático poplíteo externo se presenta de forma infrecuente asociada a fracturas de tobillo con mecanismo de inversión forzada y su relación no parece claramente establecida. Material y método: Paciente de 52 años con una fractura infrasindesmal de tobillo derecho y parálisis del nervio ciático poplíteo externo. Conclusión: El conocimiento y sospecha de esta lesión tan poco reconocida nos permitirá un precoz tratamiento de la misma, vital para el buen resultado funcional (AU)

Objective: The common peroneal nerve palsy after an infrasindesmotic ankle fracture is an uncommon pathology and the association between them remains unclear. Material and method: 52 year old patient with an infrasindesmotic ankle fracture and a common peroneal nerve palsy. Conclusion: The knowlegde of this unrecognized pathology will allow us to detect it early, which is very important for having a good outcome (AU)

Encuesta rápida de ceguera evitable en Argentina en 2013 / Rapid assessment of avoidable blindness in Argentina in 2013

INTRODUCCIÓN Según datos de 2010, hay 32,4 millones de personas ciegas en el mundo (3,2 millones en América). La población mayor de 50 años concentra el 82%. Según el Censo Nacional 2010, el 24% de la población de Argentina son adultos mayores de 50 años, lo que lo convierte en el país más envejecido de Latinoamérica, con una expectativa de vida de 77,6 años. Es fundamental contar con información específica para evaluar el avance de las estrategias implementadas y diseñar otras nuevas, adecuadas a las necesidades presentes de la población. OBJETIVOS Describir la prevalencia de ceguera, deficiencia visual y sus causas en adultos de más de 50 años en Argentina. MÉTODOS Se realizó un estudio poblacional transversal con muestreo aleatorio, con 82 conglomerados de 50 personas de 50 años o más en todo el país y metodología de Encuesta Rápida de Ceguera Evitable (ERCE). Incluyó medición de agudeza visual (AV) con examen del cristalino y evaluación del polo posterior por oftalmoscopia directa. RESULTADOS De 4100 individuos elegidos, 92% fueron examinados. Hubo una prevalencia de ceguera total de 0,7%. Las principales causas de ceguera fueron catarata (44%), retinopatía diabética (16%), enfermedades de polo posterior (16%), glaucoma (8%), defecto refractivo no corregido (8%) y DMRE (Degeneración Macular Relacionada a la Edad, 4%). La cobertura de cirugía de catarata en la población estudiada fue del 97,3%. Un 82% de los ojos operados de catarata mostraron buenos resultados visuales (AV ≥20/60) y un 9,2%, resultados pobres (AV ≤20/200). DISCUSIÓN La prevalencia de ceguera en la población argentina de adultos de 50 años o más es baja. Esto refleja los resultados de las estrategias implementadas. La catarata sigue siendo la principal causa de ceguera y deficiencia visual severa; en igual proporción contribuyen la suma de patologías del segmento posterior. Debido a la alta cobertura de la cirugía de catarata, la transición epidemiológica y la tendencia poblacional, enfermedades como retinopatía diabética y alteraciones de polo posterior tendrán un impacto mayor en el futuro.

A method for obtaining Schwann cell cultures from adult rabbit nerve based on "in vitro" pre-degeneration and neuregulin treatment.

Schwann cells (SCs) are basic elements for cell therapy and tissue engineering in the central and peripheral nervous system. Therefore, the development of a reliable method to obtain SC cultures is required. For possible therapeutic applications the cultures need to produce a sufficiently large number of SCs with a high level of purity in a relatively short period of time. To increase SC yield and purity we pre-degenerated pieces of 1-2 mm of adult rabbit sciatic nerves by incubating them for seven days in Dulbecco's Modified Eagle's Medium supplemented with 10% fetal bovine serum, penicillin/streptomycin and NRG1-ß1. Following pre-degeneration the nerve pieces were dissociated and then cultured for 6 or 15 days in the same culture medium. After 6 days of culture we obtained around 9.5x10³ cells/mg with approximately 94% SCs (S-100 positive) purity. After 15 days of culture the yield was about 80x10³ cells/mg and the purity was approximately 75%. Pre-degeneration and subsequent culture of small pieces of adult nerve with NRG1-ß1 supplemented medium increased the number of SCs and restricted the overgrowth of fibroblast-like cells.

Cavernomas in children with brain tumors: a late complication of radiotherapy.

BACKGROUND: Delayed complications of radiation therapy comprise cerebral atrophy, radionecrosis and induction of tumors. Recent reports indicate the possibility of the "de-novo" formation of intracranial cavernomas in patients submitted to radiation therapy to the brain. OBJECTIVES: To report three children, two with medulloblastomas and one with a pineal germinoma, treated with radiotherapy that developed intracerebral cavernous hemangiomas some years after treatment. With this work, we aim to draw attention to this occurrence in the neurosurgical community. RESULTS: The patients were two girls and one boy with ages comprised between 2.5 and 7 years (mean 5.2 years). The average interval from irradiation to the appearance of cavernoma was of 5.3 years (range 5-6 years). The lesions were found during the routine neuroimaging studies performed for the follow-up of their primary neoplasms. No patient showed signs or symptoms related to the cavernomas. However, the three children will need both clinical and neuroimaging surveillance to monitor the evolution of these incidentally discovered lesions. CONCLUSIONS: Intracranial cavernomas can occur years after cerebral radiation therapy. In spite of previous reports that show a high incidence of bleeding lesions, cavernomas may be found incidentally during the neuroimaging surveillance studies that are performed to children with brain tumors previously treated with radiotherapy. In these cases, a conservative attitude seems to be advisable, reserving surgery only for those lesions that grow or bleed.

Absence of relevant effects of 5 mT static magnetic field on morphology, orientation and growth of a rat Schwann cell line in culture.

The aim of this study is to observe possible changes in the morphology, orientation or cell growth of an in vitro cultured Schwann cell line by 24 h exposure to 5 mT static magnetic fields. The magnetic field generator basically consists of a pair of circular coils in a Helmholtz arrangement and enables temperature to be controlled (37+/-0.1 degrees C). We did not find any statistically significant differences in the cell growth rate between control and exposed cells, nor did we observe any differences in cell morphology or orientation.

Long-range correlations in rabbit brain neural activity.

We have analyzed the presence of persistence properties in rabbit brain electrical signals by means of non-equilibrium statistical physics tools. To measure long-memory properties of these experimental signals, we have first determined whether the data are fractional Gaussian noise (fGn) or fractional Brownian motion (fBm) by calculating the slope of the power spectral density plot of the series. The results show that the series correspond to fBm. Then, the data were studied by means of the bridge detrended scaled windowed variance analysis, detecting long-term correlation. Three different types of experimental signals have been studied: neural basal activity without stimulation, the response induced by a single flash light stimulus and the average of the activity evoked by 200 flash light stimulations. Analysis of the series revealed the existence of persistent behavior in all cases. Moreover, the results also exhibited an increasing correlation in the level of long-term memory from recordings without stimulation, to one sweep recording or 200 sweeps averaged recordings. Thus, brain neural electrical activity is affected not only by its most recent states, but also by previous states much more distant in the past.

H-ras immunohistochemical expression and molecular analysis of urinary bladder lesions in grazing adult cattle exposed to bracken fern.

Chronic ingestion of bracken fern (Pteridium spp.) by cattle produces upper alimentary tract and urinary bladder tumours causing a syndrome called bovine enzootic haematuria (BEH). Previous studies demonstrated ptaquiloside-DNA adducts and mutations in the h-ras gene in ileal epithelial cells of bracken fern-fed calves. Systematic inspection of the bladder mucosa of grazing cattle (n=126) from bracken-fern areas was carried out in a slaughterhouse. Of the 126 slaughterhouse cattle, 46 showed macroscopical lesions of the bladder. These bladders, together with six others known to have BEH, were examined histopathologically and by H-ras immunohistochemistry. Thirteen affected bladders were also examined by H-ras molecular analysis to detect mutations. Macroscopical and histological study of urinary bladder lesions found at the slaughterhouse revealed chronic cystitis (34.1%) and tumours (2.4%). There was significantly increased immunohistochemical expression of H-ras (P<0.05) in chronic cystitis (H-ras=53.24%) and bladder tumours (H-ras=63.60%) as compared with normal urinary bladders (H-ras=4.32%). A silent mutation (D38D) was detected in one animal with a mixed bladder tumour. The prevalence of urinary bladder lesions (chronic cystitis and tumours) obtained at the slaughterhouse was higher than expected. This study demonstrates that close inspection of urinary bladders of adult grazing cows is necessary to prevent possible human exposure to bracken-fern carcinogens. The absence of mutations in the codons of h-ras studied did not exclude the presence of polymorphisms in other regions of the gene (promoter or regulation sequences) or in other genes (belonging or not to the ras family) that significantly affect the H-ras protein.

[Functional improvement after vision rehabilitation in low monocular vision after myopic macular degeneration and retinal detachment]. / Mejora funcional tras la rehabilitación visual en una paciente con visión monocular deficitaria debido a degeneración macular miópica y desprendimiento de retina.

PURPOSE: We present a case of a 62 year-old woman, with a single eye functional vision (VA of 0.16) who improved her vision after following a vision rehabilitation program, which included optical and non-optical devices for daily performance. CONCLUSIONS: A correct optometric evaluation and a training program are key factors to improve quality of life in low vision patients, whose ocular pathology allows no other treatment.

[First results of the IOBA low vision unit]. / Primeros resultados de la Unidad de Baja Visión del IOBA.

PURPOSE: To verify the efficacy a treatment for the rehabilitation of vision in our Unit for Clinical Low Vision in the testing of improvements in patient's efficiency for daily life activities. MATERIAL AND METHOD: 80 patients were studied. Ophthalmologic and optometric evaluation followed by a customised vision rehabilitation program were performed according to patient's immediate needs. In a second stage a telephoned questionnaire was filled in order to record efficacy of prescribed visual aids in their own environment. RESULTS: Rehabilitation training resulted in 89% of patients showing improvement in their quality of life in both fields; functional and psychological. 85% of patients showed improvement in near activities and 35% in far activities. DISCUSSION: A correct and specialised low vision refraction and a posterior vision rehabilitation training in the use of optical and non optical aids show increase in quality of life in patients with severe visual deficiencies.