Strategies to Reduce Oxidative Stress in Glaucoma Patients.

BACKGROUND: Primary open-angle glaucoma (POAG) is a multifactorial pathology involving a variety of pathogenic mechanisms, including oxidative/nitrosative stress. This latter is the consequence of the imbalance between excessive formation and insufficient protection against reactive oxygen/nitrogen species. OBJECTIVE: Our main goal is to gather molecular information to better managing pathologic variants that may determine the individual susceptibility to oxidative/nitrosative stress (OS/NS) and POAG. METHOD: An extensive search of the scientific literature was conducted using PUBMED, the Web of Science, the Cochrane Library, and other references on the topic of POAG and OS/NS from human and animal model studies published between 2010 and 2017. Finally, 152 works containing relevant information that may help understanding the role of antioxidants, essential fatty acids, natural compounds and other similar strategies for counteracting OS/NS in POAG were considered. RESULTS: A wide variety of studies have proven that antioxidants, among them vitamins B3, C and E, Coenzyme Q10 or melatonin, ω-3/ω-6 fatty acids and other natural compounds (such as coffee, green tea, bear bile, gingko biloba, coleus, tropical fruits, etc.,) may help regulating the intraocular pressure as well as protecting the retinal neurons against OS/NS in POAG. CONCLUSION: Based on the impact of antioxidants and ω-3/ω-6 fatty acids at the molecular level in the glaucomatous anterior and posterior eye segments, further studies are needed by integrating all issues involved in glaucoma pathogenesis, endogenous and exogenous risk factors and their interactions that will allow us to reach newer effective biotherapies for preventing glaucomatous irreversible blindness.

Impacto del tipo de hospital en la supervivencia de pacientes con mieloma múltiple: estudio MICORE / The impact of the type of hospital on survival of multiple myeloma patients: the MICORE study

Objetivo. Analizar el impacto del tipo de hospital en la supervivencia global de los pacientes con mieloma múltiple. Pacientes y método. Análisis de supervivencia de todos los pacientes (n=431) diagnosticados en 5 hospitales públicos (4 comarcales y uno universitario), durante el periodo 1993-2006. Resultados. Los pacientes atendidos en los hospitales comarcales difieren significativamente de los atendidos en el hospital de referencia en las siguientes variables: edad media (70 años [rango 31-92] versus 67,9 [rango 35-91]; p=0,038), porcentaje de pacientes en estadio iii (62,6 versus 69,1%; p=0,033), y porcentaje de pacientes sometidos a trasplante autólogo de médula ósea (8,2 versus 18,2%; p=0,026). En el análisis multivariante, las variables asociadas de forma significativa con la mortalidad fueron la edad (p<0,001), el estadio (iii respecto a i; p=0,03) y la insuficiencia renal (p=0,04). El tipo de hospital no alcanzó significación estadística (hazard ratio de 0,72 [intervalo de confianza al 95% 0,48-1,07], p=0,1). Conclusiones. El tipo de hospital no se asocia de forma significativa con la mortalidad en pacientes con mieloma múltiple. Estos datos apoyan el actual modelo de atención a estos pacientes, en el que los hospitales comarcales son responsables de su manejo primario, de forma coordinada con el hospital universitario (AU)

Objective. To analyze the impact of the type of hospital in overall survival of multiple myeloma patients. Patients and method. A survival analysis was performed of all patients (n=431) diagnosed in 5 public hospitals (4 community hospitals and one university hospital) during the period 1993-2006. Results. Patients attended to in community hospitals differ significantly from those seen in the university hospital in the following variables: mean age (70 years [31-92] versus 67.9 (35-91), P=.038); percentage of stage iii patients (62.6% versus 69.1%, P=.033), and percentage of patients who had autologous stem cell transplant (8.2% versus 18.2%, P=.026). The variables associated with mortality in the multivariate analysis were age (P<.001), stage (iii versus i; P=.03) and renal failure (P=.04). The type of hospital did not reach statistical significance (hazard ratio of 0.72 (95% confidence interval 0.48-1.07), P=.1]. Conclusions. The type of hospital is not significantly associated with mortality in multiple myeloma patients. These data support our current model of health care, in which the community hospitals are responsible for the primary care of these patients, in a coordinated work with the university hospital (AU)

The impact of the type of hospital on survival of multiple myeloma patients: the MICORE study.

OBJECTIVE: To analyze the impact of the type of hospital in overall survival of multiple myeloma patients. PATIENTS AND METHOD: A survival analysis was performed of all patients (n=431) diagnosed in 5 public hospitals (4 community hospitals and one university hospital) during the period 1993-2006. RESULTS: Patients attended to in community hospitals differ significantly from those seen in the university hospital in the following variables: mean age (70 years [31-92] versus 67.9 (35-91), P=.038); percentage of stage iii patients (62.6% versus 69.1%, P=.033), and percentage of patients who had autologous stem cell transplant (8.2% versus 18.2%, P=.026). The variables associated with mortality in the multivariate analysis were age (P<.001), stage (iii versus i; P=.03) and renal failure (P=.04). The type of hospital did not reach statistical significance (hazard ratio of 0.72 (95% confidence interval 0.48-1.07), P=.1]. CONCLUSIONS: The type of hospital is not significantly associated with mortality in multiple myeloma patients. These data support our current model of health care, in which the community hospitals are responsible for the primary care of these patients, in a coordinated work with the university hospital.

[Hematologic values and iron levels in a rural student population]. / Valores hematológicos y niveles férricos en una población escolar rural.

PURPOSE: To assess the haematological values of a rural population of school children in the province of Cádiz and to estimate the incidence of iron deficiency amongst them. METHODS: The study was performed on 250 children of both sexes aged between 5 and 16 years. Informed consent was obtained from their parents in every case. White cell count, red cell count, haemoglobin, MCV, MCH, MCHC and RDW were assessed with a Coulter S Plus Jr automatic cell counter; serum iron was measured with a Ferrochem II analyser; turbidimetric measure of transferrin was performed with turbitimer, and ferritin was measured by microparticle enzymoimmunoassay. The normality criteria for children given by WHO were used as a reference. RESULTS: Of the 250 samples, 245 were evaluable, corresponding to 138 boys (56.3%) and 107 girls (43.7%) and the findings were stratified according to age. The mean values attained in each group were similar to those reported in other Mediterranean countries, and their age distribution was parallel in both sexes until age 11, when haemoglobin and haematocrit increase in boys due to the erythropoietic stimulus exerted by androgens. Iron deficiency was found in 35 children (14.2%); of them, 17 (6.9%) had hypo-ferritinaemia, 13 (5.3%) had hyposideraemia and 5 (2%) had a combination of the two. Iron-lack anaemia was present in 2 cases (0.8%). CONCLUSIONS: The group under study is a sample of the normal school-age population of the area. The detection of iron deficiency in children is important due to the influence of this precursor in the physical and intellectual development.

[Second neoplasm in a patient diagnosed with IgD myeloma. Presentation of a case and review of the literature]. / Segunda neoplasia en un paciente diagnosticado de mieloma Ig D. Presentación de un caso y revisión de la literatura.

A case of IgD myeloma who developed a glioblastoma multiforme in the left temporal lobe after a partial remission is reported. The clinical and laboratory particular features of IgD myeloma are pointed out and the association of the multiple myeloma and secondary neoplasms is discussed.