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Neovascularización Coroidal , Drusas del Disco Óptico , Neovascularización Coroidal/diagnóstico , Neovascularización Coroidal/tratamiento farmacológico , Neovascularización Coroidal/etiología , Angiografía con Fluoresceína , Humanos , Drusas del Disco Óptico/complicaciones , Drusas del Disco Óptico/diagnóstico , Drusas del Disco Óptico/tratamiento farmacológico , Ranibizumab , Tomografía de Coherencia Óptica , Agudeza VisualAsunto(s)
Creación de Capacidad , Infecciones por Coronavirus/epidemiología , Médicos Graduados Extranjeros/provisión & distribución , Fuerza Laboral en Salud , Neumonía Viral/epidemiología , Betacoronavirus/aislamiento & purificación , COVID-19 , Creación de Capacidad/métodos , Creación de Capacidad/tendencias , Necesidades y Demandas de Servicios de Salud , Fuerza Laboral en Salud/normas , Fuerza Laboral en Salud/tendencias , Humanos , Pandemias , SARS-CoV-2 , Sudáfrica/epidemiologíaAsunto(s)
Coloboma/diagnóstico , Anomalías del Ojo/diagnóstico , Mácula Lútea/anomalías , Disco Óptico/anomalías , Células Ganglionares de la Retina/patología , Trastornos de la Visión/diagnóstico , Coloboma/complicaciones , Anomalías del Ojo/complicaciones , Humanos , Masculino , Disco Óptico/diagnóstico por imagen , Disco Óptico/patología , Tomografía de Coherencia Óptica , Trastornos de la Visión/etiología , Adulto JovenRESUMEN
The MiniBooNE experiment at Fermilab reports results from an analysis of ν_{e} appearance data from 12.84×10^{20} protons on target in neutrino mode, an increase of approximately a factor of 2 over previously reported results. A ν_{e} charged-current quasielastic event excess of 381.2±85.2 events (4.5σ) is observed in the energy range 200
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We report the first measurement of monoenergetic muon neutrino charged current interactions. MiniBooNE has isolated 236 MeV muon neutrino events originating from charged kaon decay at rest (K^{+}âµ^{+}ν_{µ}) at the NuMI beamline absorber. These signal ν_{µ}-carbon events are distinguished from primarily pion decay in flight ν_{µ} and ν[over ¯]_{µ} backgrounds produced at the target station and decay pipe using their arrival time and reconstructed muon energy. The significance of the signal observation is at the 3.9σ level. The muon kinetic energy, neutrino-nucleus energy transfer (ω=E_{ν}-E_{µ}), and total cross section for these events are extracted. This result is the first known-energy, weak-interaction-only probe of the nucleus to yield a measurement of ω using neutrinos, a quantity thus far only accessible through electron scattering.
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PURPOSE: To evaluate the results of an adjuvant contact irradiation using 50kV photons after resection of conjunctival malignancies. MATERIALS AND METHOD: From 2012 to 2014, 14 patients (male: nine; female: five) have been treated by contact irradiation after resection of a malignant tumor of the conjunctiva (melanoma: five patients; malignant fibrous histiocytoma: one patient; carcinoma: eight patients) The treatment was performed using the Papillon 50 machine (Ariane). Three to four sessions were delivered, each giving a dose of 10Gy. The median follow-up in survivors was 33 months. RESULTS: The tolerance was good. A cataract was seen in one patient, and a moderate eye dryness in one. There was no corneal ulcer. One patient died of intercurrent disease. One patient with carcinoma recurred locally. CONCLUSION: Adjuvant contact radiotherapy provides a good local control after resection of conjunctival malignancies (melanoma, malignant histiocytofibroma, carcinoma). Thanks to its precision, this technique is well tolerated with a low rate of complications. Furthermore, it is delivered on an ambulatory basis.
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Carcinoma/terapia , Neoplasias de la Conjuntiva/terapia , Histiocitoma Fibroso Maligno/terapia , Melanoma/terapia , Radioterapia Adyuvante , Adulto , Anciano , Anciano de 80 o más Años , Carcinoma/patología , Catarata/etiología , Neoplasias de la Conjuntiva/patología , Femenino , Histiocitoma Fibroso Maligno/patología , Humanos , Masculino , Melanoma/patología , Persona de Mediana Edad , Recurrencia Local de Neoplasia , Dosificación Radioterapéutica , Xeroftalmia/etiologíaRESUMEN
OBJECTIVE: To compare the efficacy of a double-balloon catheter versus vaginal prostaglandin E2 (dinoprostone) for cervical ripening in obese patients with unfavorable cervix at term. METHODS: The study had an open-label, prospective combined with retrospective, observational design. From January 2013 until May 2016, a prospective cohort study of 46 women with pre-pregnancy BMI>30kg/m2, live singleton term fetuses (>37 weeks) in vertex presentation and unfavorable cervix (Bishop score<6), who underwent labor induction for conventional indications using a double-balloon catheter. In the same period, 46 obese women who had undergone cervical ripening using vaginal dinoprostone (3mg) were retrospectively included. Women in groups were paired according to Bishop score before the insertion, pre-pregnancy BMI and parity. The primary outcome was a favorable cervix (Bishop score ≥6) 24h after cervical ripening. RESULTS: After 24h, there was a significantly higher rate of women with favorable cervix (Bishop score ≥6) in the double-balloon group than in dinoprostone group (80.4% vs 47.8%; P=0.001). After adjustment, a double-balloon catheter was significantly associated with an efficient cervical ripening compared to vaginal dinoprostone (aOR 7.81, 95% CI 2.58-23.60). No difference was observed in cesarean section rate (39.1% in each group; P=0.96) and in mean induction time to vaginal delivery (34.5h in the balloon group vs 36.5h in the dinoprostone group; P=0.53). Maternal and neonatal outcomes were similar. CONCLUSION: For obese patients at term, cervical ripening using a double-balloon catheter is more efficient on Bishop score after 24h compared to vaginal dinoprostone.
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Cateterismo/métodos , Maduración Cervical/fisiología , Dinoprostona/administración & dosificación , Obesidad/complicaciones , Complicaciones del Embarazo/terapia , Administración Intravaginal , Adulto , Maduración Cervical/efectos de los fármacos , Femenino , Humanos , Trabajo de Parto Inducido/métodos , Oxitócicos/administración & dosificación , Embarazo , Estudios Prospectivos , Estudios Retrospectivos , Enfermedades del Cuello del Útero/complicaciones , Enfermedades del Cuello del Útero/terapiaRESUMEN
The MiniBooNE-DM Collaboration searched for vector-boson mediated production of dark matter using the Fermilab 8-GeV Booster proton beam in a dedicated run with 1.86×10^{20} protons delivered to a steel beam dump. The MiniBooNE detector, 490 m downstream, is sensitive to dark matter via elastic scattering with nucleons in the detector mineral oil. Analysis methods developed for previous MiniBooNE scattering results were employed, and several constraining data sets were simultaneously analyzed to minimize systematic errors from neutrino flux and interaction rates. No excess of events over background was observed, leading to a 90% confidence limit on the dark matter cross section parameter, Y=ε^{2}α_{D}(m_{χ}/m_{V})^{4}â²10^{-8}, for α_{D}=0.5 and for dark matter masses of 0.01
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Radiation-induced damage of ocular, orbital and eyelid structures are mainly reported for the optic nerve, retina, lens and lacrimal gland. Dose-volume relationships are, however, inaccurate due to the small volume of most of the organs at risk involved and limited ability of irradiation techniques to spare these structures in the pre-IMRT (intensity-modulated radiation therapy) era. The ability of newest radiation techniques including IMRT and proton therapy to generate steep dose gradients may yield more accurate models in the future. Some toxicities are severe and irreversible, leading to vision loss, as in the case of radiation-induced optic neuropathy for which curative treatments are suboptimal. Other toxicities can lead to reversible vision loss but can be surgically corrected, as is the case for radiation-induced cataract. In this paper, we will review the dose effects for the ocular; orbital and eyelid structures.
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Ojo/efectos de la radiación , Neoplasias de Cabeza y Cuello/radioterapia , Órganos en Riesgo , Dosificación Radioterapéutica , Radioterapia de Intensidad Modulada , Ceguera/etiología , Ceguera/prevención & control , Catarata/etiología , Catarata/prevención & control , Relación Dosis-Respuesta en la Radiación , Humanos , Enfermedades del Nervio Óptico/etiología , Enfermedades del Nervio Óptico/prevención & controlRESUMEN
During recent decades, mechanical devices have been substituted by pharmacological methods. Their place in the therapeutic arsenal remains important with a renewed obstetrical interest for these devices. Due to a lack of data they are still not recommended as first-line. This review thus attempted to examine the use of expansion dilatation balloons (Foley catheter and double-balloons) to analyze their effectiveness in case of native uterus and previous cesarean section. Twenty-seven clinical trials had compared balloons catheter and prostaglandins in patients without a history of uterine scar. The risk of cesarean section did not differ. Mechanical methods seemed to be more effective in achieving delivery within 24hours, with fewer episodes of excessive uterine contractions, but they necessitated more oxytocin during labor. Ten clinical trials analyzed dilatation balloons in patients with previous cesarean section. More than 70% women had favorable cervical ripening (Bishop score>6), and vaginal delivery was reported between 35 and 70% of patients. The risk of uterine rupture was low between 0.64 and 0.72%, with neither increased risk of severe neonatal and maternal morbidity nor increased risk of infectious morbidity. Mechanical methods are effective and safe for third trimester cervical ripening, mainly in women with previous cesarean section. Potential advantages may include wide availability and reduction of some of the side effects.
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Maduración Cervical/fisiología , Dilatación/métodos , Trabajo de Parto Inducido/métodos , Cateterismo/efectos adversos , Cateterismo/instrumentación , Cateterismo/métodos , Contraindicaciones , Parto Obstétrico/efectos adversos , Parto Obstétrico/instrumentación , Parto Obstétrico/métodos , Dilatación/efectos adversos , Dilatación/instrumentación , Femenino , Humanos , Primer Periodo del Trabajo de Parto/fisiología , Trabajo de Parto Inducido/efectos adversos , Trabajo de Parto Inducido/instrumentación , Embarazo , Rotura Uterina/etiología , Rotura Uterina/prevención & control , Parto Vaginal Después de Cesárea/instrumentación , Parto Vaginal Después de Cesárea/métodosRESUMEN
Biogenic dissolution of carbonates by microborers is one of the main destructive forces in coral reefs and is predicted to be enhanced by eutrophication and ocean acidification by 2100. The chlorophyte Ostreobium sp., the main agent of this process, has been reported to be one of the most responsive of all microboring species to those environmental factors. However, very little is known about its recruitment, how it develops over successions of microboring communities, and how that influences rates of biogenic dissolution. Thus, an experiment with dead coral blocks exposed to colonization by microborers was carried out on a reef in New Caledonia over a year period. Each month, a few blocks were collected to study microboring communities and the associated rates of biogenic dissolution. Our results showed a drastic shift in community species composition between the 4th and 5th months of exposure, i.e., pioneer communities dominated by large chlorophytes such as Phaeophila sp. were replaced by mature communities dominated by Ostreobium sp. Prior the 4th month of exposure, large chlorophytes were responsible for low rates of biogenic dissolution while during the community shift, rates increased exponentially (×10). After 6 months of exposure, rates slowed down and reached a "plateau" with a mean of 0.93 kg of CaCO3 dissolved per m(2) of reef after 12 months of exposure. Here, we show that (a) Ostreobium sp. settled down in new dead substrates as soon as the 3rd month of exposure but dominated communities only after 5 months of exposure and (b) microbioerosion dynamics comprise three distinct steps which fully depend on community development stage and grazing pressure.
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Antozoos/microbiología , Arrecifes de Coral , Animales , Carbonato de Calcio/química , Chlorophyta/fisiología , Cianobacterias/aislamiento & purificación , Hongos/aislamiento & purificación , Hongos/fisiología , Nueva Caledonia , Solubilidad , SolucionesRESUMEN
Since the discovery of the structure of DNA in 1953 by Watson and Crick, our understanding of the genetic causes and the regulations involved in tumor development have hugely increased. The important amount of research developed since then has led to the development of gene therapy, which specifically targets and treats cancer cells by interacting with, and correcting their genetic material. This study is a review of the most accomplished research using gene therapy aimed at treating malignant ophthalmologic diseases, and focuses more specifically on uveal melanoma and retinoblastoma. Such approaches are remarkable regarding the efficiency and the cellular targeting specificity. However, gene therapy-based treatments are so recent that many long-term interrogations subsist. The majority of the reviewed studies are conducted in vitro or in murine models, thereby requiring several years before the resulting therapies become part of the daily ophthalmologists' arsenal. However, the recent spectacular developments based on advanced scientific knowledge justify an up-to-date review that would benefit the ophthalmologist community.
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Neoplasias del Ojo/terapia , Terapia Genética/métodos , Procedimientos Quirúrgicos Oftalmológicos/métodos , Procedimientos Quirúrgicos Oftalmológicos/tendencias , Animales , Neoplasias del Ojo/genética , Técnicas de Transferencia de Gen , Vectores Genéticos/administración & dosificación , Humanos , Inmunoterapia/métodos , Inmunoterapia/tendencias , Liposomas , Melanoma/terapia , Neoplasias de la Retina/terapia , Retinoblastoma/terapia , Neoplasias de la Úvea/terapiaRESUMEN
The MiniBooNE experiment at Fermilab reports results from an analysis of ν[over ¯](e) appearance data from 11.27×10(20) protons on target in the antineutrino mode, an increase of approximately a factor of 2 over the previously reported results. An event excess of 78.4±28.5 events (2.8σ) is observed in the energy range 200
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PURPOSE: To present data pointing out that small tumour size might not be a sufficient predictor of good prognosis of choroidal melanoma and present a new promising therapy of hepatic metastasis. METHODS: Retrospective, noncomparative case report of two patients with small choroidal melanoma. RESULTS: Two cases of small choroidal melanoma which developed metastases are described. Both patients underwent radiotherapy of the primary tumour. Metastases were treated by combined therapy in patient 1 while in patient 2 a new therapeutic modality of stereotactic radiotherapy, Cyberknife, was applied. Patient 1 died from metastatic spread 7,6 years after primary therapy despite a very good local tumour control. Patient 2 died 11,3 years after primary therapy due to intercurrent disease with a very good local eye findings and hepatic metastasis in regression. CONCLUSION: Choroidal melanoma of a small size can develop into metastatic disease even long time after satisfactory primary treatment. Further studies are required to assess the risk factors of metastatic spread in small uveal melanomas. Cyberknife stereotactic radiotherapy seems to be a promising therapeutic method of a solitary hepatic metastasis. Key words: choroidal melanoma, metastasis, prognostic factors, stereotactic radiotherapy.
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Neoplasias de la Coroides/secundario , Melanoma/secundario , Radiocirugia/métodos , Neoplasias de la Úvea/secundario , Adulto , Neoplasias de la Coroides/diagnóstico , Neoplasias de la Coroides/cirugía , Diagnóstico Diferencial , Resultado Fatal , Estudios de Seguimiento , Humanos , Masculino , Melanoma/diagnóstico , Melanoma/cirugía , Metástasis de la Neoplasia , Neoplasias de la Úvea/diagnóstico , Neoplasias de la Úvea/cirugíaRESUMEN
PURPOSE: The purpose of this study was to evaluate the efficacy and safety of bevacizumab in the first-line treatment of myopic choroidal neovascularization. PATIENTS: We report a retrospective study of patients with subfoveal or juxtafoveal choroidal neovascularization associated with pathologic myopia treated with intravitreal injection of bevacizumab in Lyon, France, from January 2009 to June 2010. Best-corrected visual acuity, ocular pressure, fundus examination, optical coherence tomography, and fluorescein angiography were performed for each patient at baseline and monthly. Indications for retreatment were persistent or recurrence of exsudative activity. RESULTS: The study included eight eyes of eight patients. The mean follow-up time was 19 months. The mean number of intravitreal injections was three at the end of the first year. Six patients maintained or improved their vision. No injection complications or drug-related side effects were noted during the follow-up period. CONCLUSIONS: In this study, intravitreal injection of bevacizumab seems to be a safe and effective treatment for myopic choroidal neovascularization.
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Anticuerpos Monoclonales Humanizados/administración & dosificación , Neovascularización Coroidal/tratamiento farmacológico , Miopía Degenerativa/tratamiento farmacológico , Adulto , Anciano , Inhibidores de la Angiogénesis/administración & dosificación , Bevacizumab , Neovascularización Coroidal/complicaciones , Neovascularización Coroidal/diagnóstico , Femenino , Angiografía con Fluoresceína , Estudios de Seguimiento , Humanos , Inyecciones Intravítreas , Masculino , Persona de Mediana Edad , Miopía Degenerativa/diagnóstico , Miopía Degenerativa/etiología , Estudios Retrospectivos , Resultado del TratamientoRESUMEN
AIM: To compare the efficacy and safety of bevacizumab versus ranibizumab in the treatment of patients with neovascular age-related macular degeneration (AMD). PATIENTS AND METHODS: Retrospective case-controlled series of 30 patients treated with intravitreal bevacizumab and 28 patients treated with intravitreal ranibizumab for exudative AMD. Main outcomes measured included best-corrected visual acuity (BCVA), central macular thickness (CMT) and foveal thickness, quantity of subretinal fluid, neovessel size and total number of injections over the first year treatment period. A secondary outcome was the report of any adverse events in both groups. RESULTS: BCVA stabilized and increased from LogMAR 0.70 to 0.47 in the bevacizumab group and from 0.55 to 0.54 in the ranibizumab group (P>0.05). CMT decreased in the bevacizumab group from 369 to 284 µm and in the ranibizumab group from 340 to 271 µm (P>0.05). The number of injection was significantly lower (4.8) in the bevacizumab group than in the ranibizumab group (5.8) (P<0.05). No serious ocular adverse events were noted in both groups. CONCLUSION: This retrospective study failed to show a difference in visual and anatomic outcomes between bevacizumab and ranibizumab. The number of re-treatment was lower in the bevacizumab group (P=0.03).
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Inhibidores de la Angiogénesis/uso terapéutico , Anticuerpos Monoclonales Humanizados/uso terapéutico , Anciano , Bevacizumab , Estudios de Casos y Controles , Femenino , Humanos , Degeneración Macular/tratamiento farmacológico , Masculino , Ranibizumab , Estudios RetrospectivosRESUMEN
OBJECTIVE: To compare efficacy of sterilization reversals by laparotomy versus laparoscopy. DESIGN: Meta-analysis. SEARCH STRATEGY: Electronic searches were carried out for randomized controlled trials and retrospective and prospective clinical studies. Search engines such as PubMed, Science Direct, Medline and the Cochrane database were made use of. Our restrictions were English human studies published from 1989 to January 2010. INTERVENTIONS: Microsurgical tubal reanastomosis performed comparing laparoscopy with laparotomy using a microsurgical technique. OUTCOME MEASURES: Primary: overall pregnancy rates, including positive clinical pregnancy, intrauterine and ectopic pregnancy rates. Secondary: surgery time. RESULTS: Three retrospective comparative studies were retrieved from international data that investigated laparotomy versus laparoscopy. A total number of 184 patients were included, 88 and 96 respectively undergoing laparoscopy and laparotomy. Pregnancy rates achieved by laparoscopy ranged from 65 to 80.5% (mean 74.43%) and by laparotomy from 70 to 80% (mean 71.33%). A subanalysis of two of the three comparative studies show that laparoscopy reversal surgery requires a statistically significant longer operative time than does laparotomy (p < 0.00001). CONCLUSIONS: There is no difference between the laparoscopy and laparotomy approach to tubal reanastomosis when regarding overall pregnancy rates, intrauterine and ectopic pregnancy rates.
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Laparoscopía/métodos , Laparotomía/métodos , Reversión de la Esterilización/métodos , Ensayos Clínicos como Asunto , Femenino , Humanos , Tempo Operativo , Embarazo , Índice de Embarazo , Embarazo Ectópico/epidemiología , Ensayos Clínicos Controlados Aleatorios como AsuntoRESUMEN
BACKGROUND: IMM-101 is a heat-killed innate and adaptive immune-activating mycobacterial product; a phase I study aimed to determine its safety and tolerability in individuals with melanoma. PATIENTS AND METHODS: An intra-patient placebo-controlled study evaluated the safety and tolerability of three doses, namely, 0.1 (1 mg/ml), 0.5 (5 mg/ml) and 1.0 mg (10 mg/ml) of IMM-101 in stage III or IV melanoma. Each dose was administered in ascending order to one of the three cohorts. RESULTS: Based on observations from patients administered the 0.1-mg dose, it was considered appropriate to proceed with dosing the patients in the 0.5-mg dose cohort and then the 1.0-mg cohort (n = 6 per cohort). Treatment-emergent adverse events that would be considered typical of a post-vaccination state (including joint pains/aches, headaches and influenza-like symptoms) occurred at all dose levels, along with injection site reactions. These were mainly mild in intensity, resolved in a matter of days and responded well to supportive care. During post-study follow-up, two clinical responses (15%) were observed in patients with stage IV disease. CONCLUSION: IMM-101 is safe and well tolerated and there is a rationale for studying IMM-101 at a nominal 1.0-mg dose to complement conventional cytotoxic therapy for patients with advanced cancer.
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Antineoplásicos/administración & dosificación , Antineoplásicos/efectos adversos , Vacunas contra el Cáncer/administración & dosificación , Vacunas contra el Cáncer/efectos adversos , Melanoma/terapia , Neoplasias Cutáneas/terapia , Adulto , Anciano , Vacunas Bacterianas/administración & dosificación , Vacunas Bacterianas/efectos adversos , Relación Dosis-Respuesta a Droga , Femenino , Estudios de Seguimiento , Humanos , Inmunoterapia/efectos adversos , Inyecciones Intradérmicas , Masculino , Melanoma/inmunología , Persona de Mediana Edad , Modelos Biológicos , Mycobacterium/inmunología , Placebos , Neoplasias Cutáneas/inmunologíaRESUMEN
AIM: To report the efficacy of external local radiotherapy in the treatment of choroidal metastases. PATIENTS AND METHODS: The study reports four cases of patients with choroidal metastases of lung neoplasm confirmed by the bronchial biopsy. Polychemotherapy was associated with external radiotherapy of the ocular metastases. DISCUSSION AND CONCLUSION: The external radiotherapy dose of 30 Gy to the posterior segment of the eye in 10 fractions was effective and seemed to be the most appropriate management of choroidal metastasis despite the use of the newest molecules in chemotherapy.
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Adenocarcinoma/tratamiento farmacológico , Adenocarcinoma/radioterapia , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Neoplasias de la Coroides/tratamiento farmacológico , Neoplasias de la Coroides/radioterapia , Neoplasias Pulmonares/tratamiento farmacológico , Neoplasias Pulmonares/radioterapia , Adenocarcinoma/patología , Adenocarcinoma del Pulmón , Anciano , Neoplasias de la Coroides/secundario , Quimioterapia Combinada , Femenino , Humanos , Neoplasias Pulmonares/patología , Masculino , Persona de Mediana Edad , RadioterapiaRESUMEN
In view of the limited protection against tuberculosis, especially the infectious forms of pulmonary tuberculosis, afforded by Bacille Calmette-Guérin (BCG) vaccination, attempts are being made to develop more effective alternatives. Many of these attempts are based on the classical strategy of selecting 'protective' epitopes of Mycobacterium tuberculosis to induce immune responses in the vaccinated host. Such strategies, which in the past have been applied very effectively for the prevention of many acute infectious diseases, may not be relevant for a chronic disease in which both pathogen and host have co-evolved so that the majority of infected individuals remain asymptomatic, albeit latently infected, and in which inappropriate, dysregulated, patterns of immune reactivity predispose to, and maintain, the long-term pathological processes in a minority of symptomatic diseased individuals. While immune responses against the causative pathogen are of doubtless importance in the mediation of protection in the asymptomatic majority, we postulate that it is equally, or more, significant for public health to induce the required protective pattern of immune reactivity by immunotherapy in the diseased minority.