Asunto(s)
Humanos , Masculino , Femenino , Enfermedades de la Piel , Heparina/efectos adversos , Vesícula , Piel/lesiones , Dermatología , ArgentinaAsunto(s)
Humanos , Masculino , Femenino , Enfermedades de la Piel , Heparina/efectos adversos , Vesícula , Piel/lesiones , Dermatología , ArgentinaRESUMEN
AIM: To describe the efficacy of a modification of the superior inverted flap technique, with maculorrhexis, in vitrectomy for full-thickness macular hole (MH) surgery compared to internal limiting membrane peeling (ILM). METHODS: Retrospective and comparative study of patients with MH. In group A, a superior ILM flap is created to cover the macular hole, and in group B conventional ILM peeling was performed. RESULTS: A total of 80 eyes were included (44 group A and 36 group B). MH closure occurred in 100% in group A and 91.67% in group B (p = 0.0869). There were more U-type closures in group A(90.91%) than in group B(58.33%), p = 0.0017. Both groups showed Best corrected visual acuity (BCVA) improvement at 3 and 6 months. At 3 months BCVA in group A was significantly better but at 6 months results were similar. Ellipsoid layer (EZ) recovery at 6 months was achieved in 81.82% patients in group A and 52.78% in B (p = 0.005), and external limiting membrane in 81.82% in group A and 69.44% in B (p = 0.1957). CONCLUSIONS: The superior inverted flap maculorrhexis technique is suitable for idiopathic MH treatment, with better anatomical and non-inferior functional results than the classic ILM peeling. It achieves functional recoveries earlier, better BCVA and greater gains at 3 months compared to the classic ILM peeling. It also obtains a higher number of U-shaped closures and higher EZ restorations.
RESUMEN
Objetivo Evaluar la eficacia de la técnica del flap invertido superior de membrana limitante interna (MLI) modificada para el tratamiento del desprendimiento de retina (DR) por agujero macular (AM), comparada con el pelado clásico de la MLI. Materiales y métodos Análisis retrospectivo de 10 pacientes que requirieron vitrectomía pars plana por DR con AM. Se dividieron en dos grupos, según la técnica quirúrgica realizada: grupo del flap (5 pacientes) y de pelado de MLI (5 pacientes). Se comparó la agudeza visual mejor corregida (AVMC) pre y posquirúrgica, la resolución del DR, la tasa de cierre del AM y la restauración de las capas externas de la retina entre los grupos. Resultado La AVMC poscirugía mejoró en ambos grupos, sin diferencias significativas (p=0,9). La tasa de cierre del AM fue del 100% en el grupo del flap y del 80% del grupo de pelado de la MLI, sin diferencias significativas entre los grupos. La retina se reaplicó en el 100% de los casos en ambos grupos. Solo se restauraron las capas externas de la retina en 2 pacientes del grupo del flap invertido (40%) y en ninguno del grupo de pelado de la MLI (p=0,62). Conclusiones Las técnicas de pelado de MLI y del flap invertido superior modificada son útiles para el tratamiento del DR con agujero macular en ojos miopes (AU)
Purpose To evaluate the efficacy of the modified superior inverted internal limiting (ILM) membrane flap technique in retinal reattachment, macular hole closure and external retinal layers restoration in macular hole associated retinal detachment compared to ILM peeling. Methods Retrospective case series of 10 patients that required pars plana vitrectomy for retinal detachment with macular hole followed for more than 12months. Data from medical records were retrospectively collected and patients were divided into the superior inverted flap (5 patients) and ILM peeling group (5 patients). We compared best corrected visual acuity (BCVA) before and after surgery, retinal attachment, macular hole closure rate and external retinal layer restoration between groups. Results There were significant improvements in BCVA in both groups before and after surgery, with no differences between the two groups at 12months after surgery (P=.9). The macular hole closed in 100% of cases in the inverted flap group and 80% of the ILM peeling group with no significant differences between groups. The retina was reattached in 100% of cases in both groups. Only 2 patients in the inverted flap group (40%) had external retinal layer restoration and none in ILM peeling group (P=.62). Conclusions ILM peeling and superior inverted flap techniques are useful for treating retinal detachment with macular hole in myopic eyes (AU)
Asunto(s)
Humanos , Masculino , Femenino , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Membrana Epirretinal/cirugía , Miopía/cirugía , Desprendimiento de Retina/cirugía , Perforaciones de la Retina/cirugía , Resultado del Tratamiento , Estudios Retrospectivos , Agudeza Visual , VitrectomíaRESUMEN
Antecedentes La eritrodermia es un cuadro caracterizado por un eritema y descamación que compromete al menos el 90% de la superficie corporal. Su etiología puede ser variable. La mayor parte de sus características clínicas y alteraciones del laboratorio son inespecíficas, lo que hace que el diagnóstico sea un desafío. Materiales y métodos Se realizó un estudio retrospectivo en el periodo comprendido entre el 1 de enero de 2010 y el 1 de junio de 2020. Se revisaron los antecedentes, las características clínicas, los hallazgos de laboratorio e histopatológicos, así como la evolución de todos los pacientes con una eritrodermia hospitalizados en el Hospital Italiano de Buenos Aires, con un seguimiento mínimo de 6 meses. Resultados Se incluyeron 70 pacientes. La edad media de aparición fue de 63 años con una relación hombre:mujer de 1,2:1. La principal causa de eritrodermia fueron las reacciones adversas a fármacos (48%), siendo la vancomicina el principal medicamento involucrado (30%), mientras que la segunda causa fueron las dermatosis preexistentes, dentro de las cuales la psoriasis fue la más común (42%). En el 40% de los pacientes se observó una adecuada correlación clínico-patológica con la primera biopsia, mientras que el rédito diagnóstico aumentó a un 76% con la segunda. El número máximo de biopsias requerido para efectuar el diagnóstico etiológico fue de 8 (2 pacientes). La evolución fue favorable en el 92% de los casos. Conclusión Las reacciones adversas a fármacos fueron la primera causa de eritrodermia y la vancomicina el fármaco responsable más frecuente. No se encontraron asociaciones estadísticamente significativas entre las variables estudiadas, ni se identificaron predictores de una determinada etiología, marcadores de mala evolución o factores de riesgo asociados a mortalidad (AU)
Background Erythroderma, characterized by erythema and scaling that affects at least 90% of the body, has diverse causes. Most of the clinical manifestations and laboratory findings are nonspecific, making diagnosis challenging. Material and methods Retrospective study of patients treated between January 1, 2010, and June 1, 2020. We reviewed the records to identify all patients with erythroderma who were hospitalized in Hospital Italiano de Buenos Aires and followed for at least 6 months. We extracted information on clinical histories, the characteristics of the episodes, laboratory and histopathologic findings, and clinical course. Results Seventy patients were studied. The mean age at onset was 63 years, and the ratio of men to women was 1.2:1. Adverse drug reactions caused the largest proportion of the rashes (48%), and vancomycin was the most common culprit (involved in 30% of the cases). The next most frequent cause was a preexisting skin disease, psoriasis being the most common (in 42%). The clinicopathologic correlation was adequate for diagnosis after the first biopsy in 40% of patients, but the diagnostic yield increased to 76% with the second biopsy. The largest number of biopsies required was 8, in 2 patients. The outcome was favorable in 92% of the cases. Conclusion Adverse reactions to medications accounted for the largest proportion of erythroderma cases in this series, and vancomycin was the main culprit. We found no statistically significant associations among the variables studied. Nor did we identify potential predictors of causes, poor outcomes, or mortality (AU)
Asunto(s)
Humanos , Masculino , Femenino , Persona de Mediana Edad , Anciano , Dermatitis Exfoliativa/etiología , Erupciones por Medicamentos , Estudios Retrospectivos , Hospitales Universitarios , Factores de Riesgo , ArgentinaRESUMEN
Background Erythroderma, characterized by erythema and scaling that affects at least 90% of the body, has diverse causes. Most of the clinical manifestations and laboratory findings are nonspecific, making diagnosis challenging. Material and methods Retrospective study of patients treated between January 1, 2010, and June 1, 2020. We reviewed the records to identify all patients with erythroderma who were hospitalized in Hospital Italiano de Buenos Aires and followed for at least 6 months. We extracted information on clinical histories, the characteristics of the episodes, laboratory and histopathologic findings, and clinical course. Results Seventy patients were studied. The mean age at onset was 63 years, and the ratio of men to women was 1.2:1. Adverse drug reactions caused the largest proportion of the rashes (48%), and vancomycin was the most common culprit (involved in 30% of the cases). The next most frequent cause was a preexisting skin disease, psoriasis being the most common (in 42%). The clinicopathologic correlation was adequate for diagnosis after the first biopsy in 40% of patients, but the diagnostic yield increased to 76% with the second biopsy. The largest number of biopsies required was 8, in 2 patients. The outcome was favorable in 92% of the cases. Conclusion Adverse reactions to medications accounted for the largest proportion of erythroderma cases in this series, and vancomycin was the main culprit. We found no statistically significant associations among the variables studied. Nor did we identify potential predictors of causes, poor outcomes, or mortality (AU)
Antecedentes La eritrodermia es un cuadro caracterizado por un eritema y descamación que compromete al menos el 90% de la superficie corporal. Su etiología puede ser variable. La mayor parte de sus características clínicas y alteraciones del laboratorio son inespecíficas, lo que hace que el diagnóstico sea un desafío. Materiales y métodos Se realizó un estudio retrospectivo en el periodo comprendido entre el 1 de enero de 2010 y el 1 de junio de 2020. Se revisaron los antecedentes, las características clínicas, los hallazgos de laboratorio e histopatológicos, así como la evolución de todos los pacientes con una eritrodermia hospitalizados en el Hospital Italiano de Buenos Aires, con un seguimiento mínimo de 6 meses. Resultados Se incluyeron 70 pacientes. La edad media de aparición fue de 63 años con una relación hombre:mujer de 1,2:1. La principal causa de eritrodermia fueron las reacciones adversas a fármacos (48%), siendo la vancomicina el principal medicamento involucrado (30%), mientras que la segunda causa fueron las dermatosis preexistentes, dentro de las cuales la psoriasis fue la más común (42%). En el 40% de los pacientes se observó una adecuada correlación clínico-patológica con la primera biopsia, mientras que el rédito diagnóstico aumentó a un 76% con la segunda. El número máximo de biopsias requerido para efectuar el diagnóstico etiológico fue de 8 (2 pacientes). La evolución fue favorable en el 92% de los casos. Conclusión Las reacciones adversas a fármacos fueron la primera causa de eritrodermia y la vancomicina el fármaco responsable más frecuente. No se encontraron asociaciones estadísticamente significativas entre las variables estudiadas, ni se identificaron predictores de una determinada etiología, marcadores de mala evolución o factores de riesgo asociados a mortalidad (AU)
Asunto(s)
Humanos , Masculino , Femenino , Persona de Mediana Edad , Anciano , Dermatitis Exfoliativa/etiología , Erupciones por Medicamentos , Estudios Retrospectivos , Hospitales Universitarios , Factores de Riesgo , ArgentinaRESUMEN
PURPOSE: To evaluate the efficacy of the modified superior inverted internal limiting (ILM) membrane flap technique in retinal reattachment, macular hole closure and external retinal layers restoration in macular hole associated retinal detachment compared to ILM peeling. METHODS: Retrospective case series of 10 patients that required pars plana vitrectomy for retinal detachment with macular hole followed for more than 12 months. Data from medical records were retrospectively collected and patients were divided into the superior inverted flap (5 patients) and ILM peeling group (5 patients). We compared best corrected visual acuity (BCVA) before and after surgery, retinal attachment, macular hole closure rate and external retinal layer restoration between groups. RESULTS: There were significant improvements in BCVA in both groups before and after surgery, with no differences between the two groups at 12 months after surgery (p=0.9). The macular hole closed in 100% of cases in the inverted flap group and 80% of the ILM peeling group with no significant differences between groups. The retina was reattached in 100% of cases in both groups. Only 2 patients in the inverted flap group (40%) had external retinal layer restoration and none in ILM peeling group (p=0.62). CONCLUSIONS: ILM peeling and superior inverted flap techniques are useful for treating retinal detachment with macular hole in myopic eyes.
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Membrana Epirretinal , Miopía , Desprendimiento de Retina , Perforaciones de la Retina , Membrana Epirretinal/cirugía , Humanos , Miopía/cirugía , Retina , Desprendimiento de Retina/cirugía , Perforaciones de la Retina/cirugía , Estudios Retrospectivos , Agudeza Visual , Vitrectomía/métodosRESUMEN
BACKGROUND: Erythroderma, characterized by erythema and scaling that affects at least 90% of the body, has diverse causes. Most of the clinical manifestations and laboratory findings are nonspecific, making diagnosis challenging. MATERIAL AND METHODS: Retrospective study of patients treated between January 1, 2010, and June 1, 2020. We reviewed the records to identify all patients with erythroderma who were hospitalized in Hospital Italiano de Buenos Aires and followed for at least 6 months. We extracted information on clinical histories, the characteristics of the episodes, laboratory and histopathologic findings, and clinical course. RESULTS: Seventy patients were studied. The mean age at onset was 63 years, and the ratio of men to women was 1.2:1. Adverse drug reactions caused the largest proportion of the rashes (48%), and vancomycin was the most common culprit (involved in 30% of the cases). The next most frequent cause was a preexisting skin disease, psoriasis being the most common (in 42%). The clinicopathologic correlation was adequate for diagnosis after the first biopsy in 40% of patients, but the diagnostic yield increased to 76% with the second biopsy. The largest number of biopsies required was 8, in 2 patients. The outcome was favorable in 92% of the cases. CONCLUSION: Adverse reactions to medications accounted for the largest proportion of erythroderma cases in this series, and vancomycin was the main culprit. We found no statistically significant associations among the variables studied. Nor did we identify potential predictors of causes, poor outcomes, or mortality.
Asunto(s)
Dermatitis Exfoliativa , Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos , Femenino , Hospitales de Enseñanza , Humanos , Masculino , Estudios Retrospectivos , VancomicinaRESUMEN
PURPOSE: To report predictive factors for therapeutic response to anti-VEGF in patients with neovascular age-related macular degeneration (nAMD) in daily clinical practice in our patient population. METHODS: Retrospective cohort study including 56 patients (69 eyes) with nAMD treated with anti-VEGF, followed for at least two years between February 2012 and April 2018. Patients received three intravitreal anti-VEGF (bevacizumab) injections (loading dose) and were monitored and treated according to a PRN regimen. We analysed whether a gain in visual acuity of 15 or more ETDRS letters at the final visit was associated with demographic characteristics, presence of systemic comorbidities, fundus lesions or measurable improvement on Cirrus optical coherence tomography (OCT) between the first and last visit. RESULTS: After a mean follow-up of 15.5 months (4.7-27.8 interquartile range), central retinal thickness (CRT) (RR: 1.004; IC 95%: 1.001-1.007; P=0.011) and macular hemorrhage (RR: 0.30; IC 95%: 0.10-0.90, P=0.032) at baseline were found to be useful predictive factors for visual acuity improvement (≥15 letters) in patients treated for nAMD by anti-VEGF in a real world clinical setting. CONCLUSION: In the present series of patients with nAMD receiving a loading dose of bevacizumab and followed according to a PRN regimen for 24 months, the only predictable factors for a ≥15 letter gain in visual acuity were anatomical response as measured by OCT and macular hemorrhage at baseline.
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Inhibidores de la Angiogénesis/administración & dosificación , Bevacizumab/administración & dosificación , Degeneración Macular/tratamiento farmacológico , Agudeza Visual , Anciano , Anciano de 80 o más Años , Inhibidores de la Angiogénesis/efectos adversos , Bevacizumab/efectos adversos , Biomarcadores Farmacológicos/análisis , Femenino , Humanos , Inyecciones Intravítreas , Degeneración Macular/diagnóstico , Degeneración Macular/epidemiología , Masculino , Neovascularización Patológica/diagnóstico , Neovascularización Patológica/tratamiento farmacológico , Neovascularización Patológica/epidemiología , Pautas de la Práctica en Medicina/estadística & datos numéricos , Pronóstico , Estudios Retrospectivos , Resultado del Tratamiento , Factor A de Crecimiento Endotelial Vascular/antagonistas & inhibidores , Factor A de Crecimiento Endotelial Vascular/inmunologíaAsunto(s)
Actitud del Personal de Salud , COVID-19/epidemiología , Dermatología , Terapia de Inmunosupresión , Inmunosupresores/uso terapéutico , SARS-CoV-2 , Acceso a la Información , Adolescente , Adulto , Argentina/epidemiología , COVID-19/prevención & control , Estudios Transversales , Dermatitis Atópica/tratamiento farmacológico , Dermatitis Atópica/epidemiología , Dermatología/estadística & datos numéricos , Encuestas de Atención de la Salud/estadística & datos numéricos , Hidradenitis Supurativa/tratamiento farmacológico , Hidradenitis Supurativa/epidemiología , Humanos , Persona de Mediana Edad , Distanciamiento Físico , Psoriasis/tratamiento farmacológico , Psoriasis/epidemiología , Sociedades Médicas/estadística & datos numéricos , Adulto JovenRESUMEN
BACKGROUND: Pemphigus vulgaris (PV) is an uncommon, serious disease that is treated with systemic corticosteroids and corticosteroid-sparing agents. OBJECTIVES: To describe and analyze the demographic and clinical characteristics of patients with PV. MATERIAL AND METHODS: Retrospective cohort study of adults diagnosed with PV over a period of 12years. RESULTS: PV presented with mucosal lesions in 20 of the 32 patients studied (63%); the most common site was the oral mucosa followed by the vulva. Mucosal involvement was more common in women (P=.03). Lesions were found at more than 1 mucosal site in patients whose disease began in the mucosa, independently of age or sex (P=.003). Disease onset before the age of 40years was associated with generalized skin lesions (P=.003), a need for corticosteroid-sparing therapy (P=.05), and refractory PV (P=.02). Azathioprine was the most widely prescribed corticosteroid-sparing agent (in 22 patients). Eight patients (25%) were dependent on corticosteroids and disease recurred in 26 (81%). Complete remission, with or without treatment, was achieved in 15 patients (47%). Patients remained disease-free for a median of 14months, and 2 patients died (6%). CONCLUSION: Onset before the age of 40 years could be a sign of poor prognosis in patients with PV, as it was significantly associated with a higher risk of generalized skin involvement, a need for corticosteroid-sparing therapy, and refractory disease.
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Pénfigo , Enfermedades de la Piel , Corticoesteroides/uso terapéutico , Adulto , Azatioprina/uso terapéutico , Femenino , Humanos , Pénfigo/tratamiento farmacológico , Estudios RetrospectivosAsunto(s)
Enfermedades Hereditarias del Ojo/diagnóstico , Mácula Lútea/patología , Degeneración Retiniana/diagnóstico , Enfermedades de la Retina/diagnóstico , Anciano , Enfermedades Hereditarias del Ojo/patología , Femenino , Angiografía con Fluoresceína , Fondo de Ojo , Humanos , Mácula Lútea/diagnóstico por imagen , Degeneración Retiniana/patología , Enfermedades de la Retina/etiología , Enfermedades de la Retina/patología , Baja Visión/diagnóstico , Baja Visión/etiologíaAsunto(s)
Astrocitoma/patología , Neoplasias de la Retina/patología , Inhibidores de la Angiogénesis/uso terapéutico , Astrocitoma/irrigación sanguínea , Astrocitoma/diagnóstico por imagen , Astrocitoma/terapia , Bevacizumab/uso terapéutico , Terapia Combinada , Crioterapia , Membrana Epirretinal/etiología , Exudados y Transudados , Angiografía con Fluoresceína , Humanos , Fotocoagulación , Edema Macular/diagnóstico por imagen , Edema Macular/tratamiento farmacológico , Edema Macular/etiología , Masculino , Neoplasias de la Retina/irrigación sanguínea , Neoplasias de la Retina/diagnóstico por imagen , Neoplasias de la Retina/terapia , Telangiectasia Retiniana/complicaciones , Telangiectasia Retiniana/diagnóstico , Telangiectasia Retiniana/terapia , Vitrectomía , Adulto JovenRESUMEN
Objetivo: Determinar la relación entre el tonómetro de contorno dinámico (TCD), Goldmann (TG) y neumotonómetro (NT) en pacientes con hipertensión ocular (HTO) y su relación con el grosor central de la córnea (GCC) y amplitud del pulso ocular (APO). Método: Se han incluido 60 pacientes (101 ojos) con presión intraocular (PIO)mayor o igual 21mmHg con TG y sin alteraciones glaucomatosas en disco óptico y campo visual. Se ha medido la PIO con TG, TCD y NT, la APO con el TCD y el GCC con paquímetro de ultrasonido. Se ha estudiado la diferencia de PIO entre los tres tonómetros mediante el test no paramétrico de Wilconxon y la relación de la APO con el GCC y la PIO con el coeficiente de correlación de Spearman. Resultados: La mediana de PIO con NT fue de 24mmHg (RIC: 22-26), con TG de 22mmHg (RIC: 22-24) y con TCD de 28,2mmHg (rango intercunatílico [RIC]:24,1-30,7). En comparación con el TG la PIO fue mayor con el NT y con el TCD, siendo la diferencia de medianas de 2,0 y de 6,2mmHg respectivamente. La media del GCC fue de 594,5 micrometro (DE 30,0), encontrándose una asociación estadísticamente significativa entre esta y la PIO con TG (r:0,209; p=0,036) y de magnitud similar aunque sin ser significativa con el TCD (r:0,195; p=0,051). No se encuentra asociación entre GCC y NT (r: 0,15; p=0,12). La APO fue de 4,8mmHg (RIC: 3,6-6,1), incrementándose significativamente con la PIO tomada por el TG (r: 0,388; p<0,001) y con el GCC (r: 0,287; p=0,004). Esta relación no fue significativa con el NT y TCD (r: 0,067; p=0,50 y r: 0,17; p=0,08 respectivamente). Conclusiones: Los valores de PIO con TCD y NT son mayores que con TG en pacientes con HTO. La PIO con TG se ve influenciada por el aumento de GCC. El incremento de APO se asocia a un incremento del GCC y de PIO con los tres tonómetros (siendo esta relación solo estadísticamente significativa con el TG)(AU)
Purpose: To determine the relationship between dynamic contour tonometry (DCT), Goldmann applanation tonometry (GAT) and pneumotonometry (PNT) in ocular hypertension patients (OHT) and their relationship to central corneal thickness (CCT) and ocular pulse amplitude (OPA). Methods: Sixty patients (101 eyes) with intraocular pressure (IOP) greater than or equal 21mmHg using GAT and normal appearing optic nerve heads and normal visual fields were included. The following tests were performed simultaneously during a single visit: IOP using DCT, GAT and PNT, OPA using DCT and CCT using ultrasound pachymetry. We studied the difference IOP between these 3 tonometers using Wilcoxon non-parametric test and the effect of CCT on IOP and OPA, as well as the relationship between OPA and IOP using Spearman correlation coefficient. Results: The median PNT IOP was 24mmHg (Inter-quartile range [IQR]: 22-26), median GAT IOP was 22mmHg (IQR: 22-24), and median DCT IOP was 28.2mmHg (IQR: 24.1-30.7). PNT and DCT had higher IOP values than GAT (median 2mmHg and 6.2mmHg, respectively). Mean CCT was 594.5 micrometer (SD 30.0). GAT IOP and DCT IOP showed an increase with increased corneal thickness (r: 0.209; P=0.036 and r: 0.195; P=0.051, respectively). PNT IOP did not change with CCT (r: 0.15; P=0.12). The median OPA was 4.8mmHg (IQR: 3.6-6.1), and significantly increased with GAT IOP (r: 0,38; P<0.001) and with CCT (r:0.287; P=0.004). This association was unclear with IOP PNT and IOP DCT (r: 0.067; P=0.50 and r: 0,17, P=0.08, respectively). Conclusions: DCT and PNT IOP values were higher than GAT IOP measurements in ocular hypertension patients. GAT IOP showed a significant increase with increased corneal thickness. Increased OPA seems to correlate with increased CCT and IOP, particularly if GAT is used(AU)
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Humanos , Tonometría Ocular/instrumentación , Hipertensión Ocular/diagnóstico , Glaucoma/fisiopatología , Córnea/anatomía & histología , Presión Intraocular/fisiologíaRESUMEN
PURPOSE: To determine the relationship between dynamic contour tonometry (DCT), Goldmann applanation tonometry (GAT) and pneumotonometry (PNT) in ocular hypertension patients (OHT) and their relationship to central corneal thickness (CCT) and ocular pulse amplitude (OPA). METHODS: Sixty patients (101 eyes) with intraocular pressure (IOP) ≥21 mmHg using GAT and normal appearing optic nerve heads and normal visual fields were included. The following tests were performed simultaneously during a single visit: IOP using DCT, GAT and PNT, OPA using DCT and CCT using ultrasound pachymetry. We studied the difference IOP between these 3 tonometers using Wilcoxon non-parametric test and the effect of CCT on IOP and OPA, as well as the relationship between OPA and IOP using Spearman correlation coefficient. RESULTS: The median PNT IOP was 24 mmHg (Inter-quartile range [IQR]: 22-26), median GAT IOP was 22 mmHg (IQR: 22-24), and median DCT IOP was 28.2 mmHg (IQR: 24.1-30.7). PNT and DCT had higher IOP values than GAT (median 2 mmHg and 6.2 mmHg, respectively). Mean CCT was 594.5 µm (SD 30.0). GAT IOP and DCT IOP showed an increase with increased corneal thickness (r:0.209; P=.036 and r:0.195; P=.051, respectively). PNT IOP did not change with CCT (r:0.15; P=.12). The median OPA was 4.8 mmHg (IQR: 3.6-6.1), and significantly increased with GAT IOP (r:0,38; P<.001) and with CCT (r:0.287; P=.004). This association was unclear with IOP PNT and IOP DCT (r:0.067; P=.50 and r:0,17, P=.08, respectively). CONCLUSIONS: DCT and PNT IOP values were higher than GAT IOP measurements in ocular hypertension patients. GAT IOP showed a significant increase with increased corneal thickness. Increased OPA seems to correlate with increased CCT and IOP, particularly if GAT is used.
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Paquimetría Corneal , Hipertensión Ocular/diagnóstico , Tonometría Ocular/métodos , Adulto , Anciano , Anciano de 80 o más Años , Córnea/ultraestructura , Femenino , Humanos , Presión Intraocular , Masculino , Persona de Mediana Edad , Hipertensión Ocular/diagnóstico por imagen , Hipertensión Ocular/fisiopatología , Reproducibilidad de los Resultados , Tonometría Ocular/instrumentación , UltrasonografíaRESUMEN
Ruidera Pools Natural Park, Spain, constitutes one of the most representative systems of carbonate precipitation in Europe. The prokaryotic community of a dry modern stromatolite recovered from the park has been analyzed by molecular techniques that included denaturing gradient gel electrophoresis (DGGE) and 16S rRNA gene clone library analysis, together with microscopic observations from the sample and cultures. Ribosomal RNA was directly extracted to study the putatively active part of the microbial community present in the sample. A total of 295 16S rRNA gene sequences were analyzed. Libraries were dominated by sequences related to Cyanobacteria, most frequently to the genus Leptolyngbya. A diverse and abundant assemblage of non-cyanobacterial sequences was also found, including members of Firmicutes, Bacteroidetes, Proteobacteria, Actinobacteria, Acidobacteria,Planctomycetes and Chloroflexi groups. No amplification was obtained when using archaeal primers. The results showed that at the time of sampling, when the pool was dry, the bacterial community of the stromatolites was dominated by groups of highly related Cyanobacteria, including new groups that had not been previously reported, although a high diversity outside this phylogenetic group was also found. The results indicated that part of the Cyanobacteria assemblage was metabolically active and could thus play a role in the mineralization processes inside the stromatolites.
Asunto(s)
Bacterias/clasificación , Bacterias/crecimiento & desarrollo , Biodiversidad , Microbiología del Suelo , Análisis por Conglomerados , ADN Bacteriano/química , ADN Bacteriano/genética , ADN Ribosómico/química , ADN Ribosómico/genética , Electroforesis en Gel de Poliacrilamida , Metagenoma , Microscopía , Datos de Secuencia Molecular , Desnaturalización de Ácido Nucleico , Filogenia , ARN Ribosómico 16S/genética , Análisis de Secuencia de ADN , EspañaRESUMEN
OBJECTIVE: To estimate the rate of complications and establish risk factors for their development in patients with uveitis. METHODS: Prospective study of a cohort of 398 patients (413 eyes) that were reviewed from January 2000 to October 2007 and monitored during a period of at least one month. Demographic data, laterality, course (acute, subacute, chronic), location, diagnosis (idiopathic, infectious, ocular origin, systemic origin, others) and development of complications (cataract, cystoid macular edema, macular complications, retinal complications and others) were evaluated. RESULTS: After a mean follow-up of 35.2 months (range 1-160), 25% of patients developed one or more of the following complications: cataract 8.5%, macular edema 6.1%, macular complications (epiretinal membranes, choroidal neovascular membranes, macular necrosis) 4.1%, retinal complications (retinal detachment, retinal neovascularization, vitreous hemorrhage, retinal tears, retinal vascular occlusions) 4.1%, glaucoma or ocular hypertension 3.6%, and others 1.5%. Risk factors for development of uveitis complications were chronic course OR 6.37 (3.25-12.47) P <0.0001, bilaterality OR 1.98 (1.03-3.08) P =0.039, subacute course OR 1.94 (0.02-4.08) P=0.08, and panuveitis OR 1,92 (0.99-4.80) P=0.161. CONCLUSIONS: In our patients, cases involving chronic and bilateral uveitis were more prone to develop complications, with cataracts being the most frequent complication (Arch Soc Esp Oftalmol 2009; 84: 523-528).