Associations of serum sclerostin levels with body composition, pulmonary function, and exacerbations in COPD patients.

BACKGROUND: In COPD, the bronchial epithelium shows a pathologically activated Wnt pathway. Sclerostin (SOST) is a secreted glycoprotein that is associated with bone metabolism and blocks the Wnt pathway. We hypothesized that low sclerostin levels might be associated with lung function and COPD exacerbations in patients. METHODS: We studied 139 outpatients with stable COPD and normal kidney function. We assessed the serum levels of SOST and bone metabolism parameters, body composition, clinical characteristics and lung function at baseline. We followed the patients prospectively for 12 months after enrolment. Moderate exacerbations and hospital admissions were recorded during follow-up. RESULTS: The serum SOST levels were 23.98±7.6 pmol/l (men: 25.5±7.7 pmol/l, women: 20.3±5.9 pmol/l (p < 0.001)). SOST showed correlations with age (r = 0.36), FFMI (r = 0.38), FEV1 (r = 0.27), DLCO (r = 0.39), 6MWD (r = 0.19) and CAT (r = -0.24). In multivariate linear regression analysis, only age (beta=0.264) and FFMI (beta=1.241) remained significant. SOST showed a significant negative correlation with serum phosphorus (r = -0.29). Cox proportional risk analysis indicated that patients in the lower tertile of SOST levels were at higher risk of moderate COPD exacerbation (HR 2.015, CI95% 1.136-3.577, p = 0.017) and hospital admission due to COPD (HR 5.142, CI95% 1.380-19.158, p = 0.015) than the rest of the patients. CONCLUSIONS: SOST levels are associated with body composition and lung function in patients with COPD. Furthermore, lower SOST levels predict a higher risk of exacerbations and hospitalization.

About spirals and pores: Xylariaceae with remarkable germ loci.

Based on phylogenetic analyses of a multi-gene matrix of nuITS-LSU rDNA, RPB2 and TUB2 sequences and morphology, xylariaceous species with uni- to pauciperitheciate stromata and ascospores having a spirally coiling (helicoid) germ slit are revised and reclassified, including detailed descriptions and illustrations. The genus Helicogermslita is redefined and restricted to seven species with massive, erumpent, clypeus-like carbonaceous stromata, and Rosellinia somala is combined in Helicogermslita. Within the core Xylariaceae, the poorly known Leptomassaria simplex is shown to be closely related to Anthostoma insidiosum, for which the new genus Oligostoma is established, and Anthostoma rhenanum is demonstrated to be synonymous with O. insidiosum. The new genus Albicollum, characterised by immersed ascomata and a collar of white pseudostromatic tissues surrounding the ostioles, is established for Amphisphaeria canicollis, Anthostoma chionostomum, Sordaria (= Helicogermslita) fleischhakii and Anthostoma vincensii. Anthostoma ostropoides is synomymised with Albicollum canicolle, and Al. berberidicola, Al. longisporum and Al. novomexicanum are described as new species. Rosellinia (= Helicogermslita) gaudefroyi is transferred to the new genus Spiririma. Anthostoma amoenum and Euepixylon udum, both with a poroid germ locus, are shown to be only distantly related, and An. amoenum is reclassified within the asexual genus Digitodochium. Based on phylogeny, the genus Euepixylon is treated as a synonym of Nemania. A new species, Nemania ethancrensonii, which is closely related to the two formerly accepted Euepixylon species (E. sphaeriostomum, E. udum) but strongly deviates from the morphological concept of Euepixylon and Nemania, is described from the eastern USA. The genera Anthostomelloides, Clypeosphaeria, Digitodochium, Emarcaea, Induratia, Linosporopsis, Magnostiolata, Occultitheca and Spiririma are revealed to form a morphologically heterogeneous lineage in a basal position of Xylariaceae. Anthostoma vincensii, Quaternaria simplex and Rosellinia gaudefroyi are lectotypified, and Amphisphaeria canicollis, Anthostoma amoenum, An. rhenanum, An. vincensii, Quaternaria simplex, Rosellinia gaudefroyi and Valsa insidiosa are epitypified. Keys to uni- to pauciperitheciate xylariaceous genera with sigmoid to helicoid germ slits and to species of Albicollum are provided. Citation: Voglmayr H, Tello S, Jaklitsch WM, et al. 2022. About spirals and pores: Xylariaceae with remarkable germ loci. Persoonia 49: 58-98. https://doi.org/10.3767/persoonia.2022.49.02.

Lepra histioide, una variante rara: primer reporte en Ecuador / Histioid Leprosy a Rare Variant: First Report in Ecuador

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Lichens or endophytes? The enigmatic genus Leptosillia in the Leptosilliaceae fam. nov. (Xylariales), and Furfurella gen. nov. (Delonicicolaceae).

Based on DNA sequence data, the genus Leptosillia is shown to belong to the Xylariales. Molecular phylogenetic analyses of ITS-LSU rDNA sequence data and of a combined matrix of SSU-ITS-LSU rDNA, rpb1, rpb2, tef1 and tub2 reveal that the genera Cresporhaphis and Liberomyces are congeneric with Leptosillia. Coelosphaeria fusariospora, Leptorhaphis acerina, Leptorhaphis quercus f. macrospora, Leptorhaphis pinicola, Leptorhaphis wienkampii, Liberomyces pistaciae, Sphaeria muelleri and Zignoëlla slaptonensis are combined in Leptosillia, and all of these taxa except for C. fusariospora, L. pinicola and L. pistaciae are epitypified. Coelosphaeria fusariospora and Cresporhaphis rhoina are lectotypified. Liberomyces macrosporus and L. saliciphilus, which were isolated as phloem and sapwood endophytes, are shown to be synonyms of Leptosillia macrospora and L. wienkampii, respectively. All species formerly placed in Cresporhaphis that are now transferred to Leptosillia are revealed to be non-lichenized. Based on morphology and ecology, Cresporhaphis chibaensis is synonymised with Rhaphidicyrtis trichosporella, and C. rhoina is considered to be unrelated to the genus Leptosillia, but its generic affinities cannot be resolved in lack of DNA sequence data. Phylogenetic analyses place Leptosillia as sister taxon to Delonicicolaceae, and based on morphological and ecological differences, the new family Leptosilliaceae is established. Furfurella, a new genus with the three new species, F. luteostiolata, F. nigrescens and F. stromatica, growing on dead branches of mediterranean fabaceous shrubs from tribe Genisteae, is revealed to be the closest relative of Delonicicola in the family Delonicicolaceae, which is emended. ITS rDNA sequence data retrieved from GenBank demonstrate that the Leptosilliaceae were frequently isolated or sequenced as endophytes from temperate to tropical regions, and show that the genus Leptosillia represents a widely distributed component of endophyte communities of woody plants.

[Chronic fibrosing lung diseases : Idiopathic pulmonary fibrosis from the perspective of its differential diagnosis]. / Chronisch-fibrosierende Lungenerkrankungen : Die idiopathische pulmonale Fibrose im Spiegel ihrer Differenzialdiagnosen.

Fibrosing lung diseases describe a heterogeneous group of interstitial lung diseases (ILD) of highly variable etiology, but with a unifying terminal process of irreversible, fibroproliterative destruction of the alveolar surface, loss of compliance and progressive impairment of gas exchange. In view of the heterogeneity, the disastrous prognoses in some cases and the treatment consequences, a thorough differential diagnosis is essential in all patients. Antifibrotic therapies are currently only indicated in idiopathic pulmonary fibrosis (IPF). The only curative therapeutic option is lung transplantation. Therefore, suitable patients should be promptly evaluated.

A preliminary account of the Cucurbitariaceae.

Fresh collections, type studies and molecular phylogenetic analyses of a multigene matrix of partial nuSSU-ITS-LSU rDNA, rpb2, tef1 and tub2 sequences were used to evaluate the boundaries of Cucurbitaria in a strict sense and of several related genera of the Cucurbitariaceae. Two species are recognised in Cucurbitaria and 19 in Neocucurbitaria. The monotypic genera Astragalicola, Cucitella, Parafenestella, Protofenestella, and Seltsamia are described as new. Fenestella is here included as its generic type F. fenestrata (= F. princeps), which is lecto- and epitypified. Fenestella mackenzei and F. ostryae are combined in Parafenestella. Asexual morphs of Cucurbitariaceae, where known, are all pyrenochaeta- or phoma-like. Comparison of the phylogenetic analyses of the ITS-LSU and combined matrices demonstrate that at least rpb2 sequences should be added whenever possible to improve phylogenetic resolution of the tree backbone; in addition, the tef1 introns should be added as well to improve delimitation of closely related species.

Panniculitis caused by Mycobacterium monacense mimicking erythema induratum: a case in Ecuador.

We report the first case of recently characterized species M. monacense associated with chronic nodular vasculitis, infecting a young woman. This case represents the first isolation of M. monacense from Ecuador. The isolate was identified by conventional and molecular techniques.

[Management of time used to treat the chronic patient: a new approach to improve quality of health care]. / Gestión del tiempo de asistencia al paciente crónico: un nuevo enfoque para mejorar la calidad asistencial.

OBJECTIVE: Chronic disease is the main epidemic of the 21st century. It takes up a large part of the social-health budgets that are dedicated to its care. The aim of this study is to analyze if the welfare quality in the management of the chronic patients improves by implementing non-contact care time. MATERIAL AND METHODS: Intervention study conducted in the health care center of Orcasitas (January 2012 - September 2013) in patients with hypertension (357), diabetes (180) and/or ischemic heart disease (60). Health care quality was analyzed through the effectiveness in the program, Tracking Objectives in Primary Care. The intervention group had four physical 10minute consultations/year and three non-physical 10minute consultations/year. The patients in the control group were seen as usual. The data were compared using the McNemar test, chi-square and Cochran's Q test. RESULTS: In the intervention group, the effectiveness increased in the analyzed period by 46%, 54% and 55.9%, respectively, for processes of hypertension, diabetes and dyslipidemia control in ischemic heart disease, whereas in the control group (community of Madrid) it was 2.54%, 1.78%, and 5.44%, respectively, for these processes (statistically significant differences [χ(2)=24.78; χ(2)=39.9 y χ(2)=67.3, P<.0001]). CONCLUSIONS: Thirty minutes/year of non-presential care represents a significant change in the level of control of chronic patients. These results should be considered in the approach strategies to chronic diseases.

Gestión del tiempo de asistencia al paciente crónico: un nuevo enfoque para mejorar la calidad asistencial / Management of time used to treat the chronic patient: A new approach to improve quality of health care

Objetivo. La cronicidad es la principal epidemia del siglo XXI y condiciona que gran parte de los presupuestos sociosanitarios se dediquen a su atención. El objetivo de este estudio es analizar si la calidad de la atención al paciente crónico mejora implantando tiempos asistenciales no presenciales. Material y métodos. Estudio de intervención realizado en el centro de salud de Orcasitas (enero de 2012-septiembre de 2013) en pacientes con hipertensión (357), diabetes (180) y/o cardiopatía isquémica (60). La calidad asistencial se analizó mediante la efectividad reflejada en el programa de seguimiento de objetivos en atención primaria (eSOAP). Para el grupo de intervención se establecieron 4 consultas presenciales y 3 no presenciales por año, de 10 min cada una, manteniendo el grupo control su dinámica habitual. Los datos se contrastaron mediante las pruebas de McNemar, Chi-cuadrado y Q de Cochran. Resultados. En el grupo de intervención la efectividad se incrementó en el periodo analizado un 46%, un 54% y un 55,9% respectivamente para los procesos hipertensión, diabetes y control de la dislipidemia en cardiopatía isquémica, mientras que en el grupo control (Comunidad de Madrid) fue, respectivamente, del 2,54%, 1,78% y 5,44% (diferencias estadísticamente significativas [χ2 = 24,78; χ2 = 39,9 y χ2 = 67,3, p < 0,0001]). Conclusiones. Treinta minutos/año de atención no presencial suponen un cambio relevante en el grado de control del paciente crónico. Este resultado debería ser tenido en cuenta en las estrategias de abordaje de la cronicidad (AU)

Objective. Chronic disease is the main epidemic of the 21st century. It takes up a large part of the social-health budgets that are dedicated to its care. The aim of this study is to analyze if the welfare quality in the management of the chronic patients improves by implementing non-contact care time. Material and methods. Intervention study conducted in the health care center of Orcasitas (January 2012 - September 2013) in patients with hypertension (357), diabetes (180) and/or ischemic heart disease (60). Health care quality was analyzed through the effectiveness in the program, Tracking Objectives in Primary Care. The intervention group had four physical 10 minute consultations/year and three non-physical 10 minute consultations/year. The patients in the control group were seen as usual. The data were compared using the McNemar test, chi-square and Cochran's Q test. Results. In the intervention group, the effectiveness increased in the analyzed period by 46%, 54% and 55.9%, respectively, for processes of hypertension, diabetes and dyslipidemia control in ischemic heart disease, whereas in the control group (community of Madrid) it was 2.54%, 1.78%, and 5.44%, respectively, for these processes (statistically significant differences [χ2 = 24.78; χ2 = 39.9 y χ2 = 67.3, P < .0001]). Conclusions. Thirty minutes/year of non-presential care represents a significant change in the level of control of chronic patients. These results should be considered in the approach strategies to chronic diseases (AU)

Histological development of the digestive system of the Amazonian pimelodid catfish Pseudoplatystoma punctifer.

The organogenesis of the digestive system was described in the Amazonian pimelodid catfish species Pseudoplatystoma punctifer from hatching (3.5 mm total length, TL) to 41 days post-fertilization (dpf) (58.1 mm TL) reared at 28°C. Newly hatched larvae showed a simple digestive tract, which appeared as a straight undifferentiated and unfolded tube lined by a single layer of columnar epithelial cells (future enterocytes). During the endogenous feeding period, comprised between 20 and 96 h post-fertilization (3.5 to 6.1 mm TL), the larval digestive system experienced a fast transformation with the almost complete development and differentiation of most of digestive organs (buccopahrynx, oesophagus, intestine, liver and exocrine pancreas). Yolk reserves were not completely depleted at the onset of exogenous feeding (4 dpf, 6.1 mm TL), and a period of mixed nutrition was observed up to 6 to 7 dpf (6.8 to 7.3 mm TL) when yolk was definitively exhausted. The stomach was the organ that latest achieved its complete differentiation, characterized by the development of abundant gastric glands in the fundic stomach between 10 and 15 dpf (10.9 to 15.8 mm TL) and the formation of the pyloric sphincter at the junction of the pyloric stomach and the anterior intestine at 15 dpf (15.8 mm TL). The above-mentioned morphological and histological features observed suggested the achievement of a digestive system characteristic of P. punctifer juveniles and adults. The ontogeny of the digestive system in P. punctifer followed the same general pattern as in most Siluriform species so far, although some species-specific differences in the timing of differentiation of several digestive structures were noted, which might be related to different reproductive guilds, egg and larval size or even different larval rearing practices. According to present findings on the histological development of the digestive system in P. punctifer, some recommendations regarding the rearing practices of this species are also provided in order to improve the actual larval rearing techniques of this fast-growing Neotropical catfish species.

Host preference of the arbovirus vector Culex erraticus (Diptera: Culicidae) at Sonso Lake, Cauca Valley Department, Colombia.

Culex erraticus (Dyar & Knab) is a competent vector of Eastern equine encephalitis virus and subtype IC Venezuelan equine encephalitis virus, and both St. Louis encephalitis virus and West Nile virus have been isolated from field-collected specimens. Previous bloodmeal analysis studies have shown this species to be a generalist, feeding on a variety of mammals, birds, reptiles, and amphibians. This behavior can bridge arboviral transmission across different vertebrate groups. Our study examined the host preference of Cx. erraticus at Sonso Lake in Colombia. From July to August 2008, blood-engorged mosquitoes were collected from resting boxes, while vertebrate abundance was determined to calculate host preference. Based on mitochondrial DNA analysis of bloodmeals, birds were the predominant hosts (57.6%), followed by mammals (30.8%), and reptiles (6.7%); 9.5% of the bloodmeals were mixed. The most commonly fed upon species were: limpkin, black-crowned night-heron, striated heron, human, and capybara. Forage ratios showed the least bittern, limpkin, Cocoi heron, striated heron, capybara, and black-crowned night heron were preferred hosts across all vertebrates. Of the available avifauna, the least bittern, limpkin, striated heron, Cocoi heron, and black-crowned night heron were preferred, whereas the bare faced ibis, great egret, snowy egret, and cattle egret were under-used. This study shows that while Cx. erraticus is an opportunistic feeder, using diverse vertebrate hosts in the environment, certain avian species are targeted preferentially for bloodmeals.

«Doctor mi hija tuerce un ojo» / Doctor, my daughter crosses an eye

El estrabismo divergente o exotropía consiste en una al/teración del aparato oculomotor que se caracteriza por la desviación hacia fuera de uno de los ejes oculares. Es intermitente en la mayoría de los casos (85%). En la prueba del cover test, cuando se ocluye el ojo fijador, el descubierto gira hacia adentro para fijar. En nuestro medio, es menos frecuente que la endotropía. La exotropía intermitente cursa en su mayoría con buena visión binocular y ausencia de ambliopía. La desviación suele precipitarse por luz brillante, sueño, fatiga, salud deteriorada o distracción visual, alineándose los ojos al llamar la atención del niño. El cierre de un ojo ante la luz intensa es un signo característico. Otros síntomas son la astenopía ante esfuerzos visuales y la diplopía ocasional. Una anamnesis detallada, así como una exploración minuciosa con la realización de la prueba del cover test de lejos son piezas fundamentales del diagnóstico (AU)

Extropia or divergent strabismus consists in an alteration of the oculomotor apparatus that is characterized by the exodeviation of one of the ocular axis either constantly (15%) or intermittently (85%). On the cover-uncover test, when the fixating eye is covered, the uncovered eye turns inward to take up fixation. Exotropia is less common than exotropia. Intermittent exotropia usually has a good binocular vision and amblyopia is rare. Deviation is generally precipitated by bright light, tiredness, fatigue, deteriorated health or visual distraction, and the eyes become aligned when the child's attention is required. Closing one eye when there is intense light is a characteristic sign. Other symptoms are astenopia when there is visual efforts and occasional diplopia. A detailed clinical history and ophthalmic examination that includes the cover test at distance are essential for the diagnosis (AU)

Life-history characteristics of the large Amazonian migratory catfish Brachyplatystoma rousseauxii in the Iquitos region, Peru.

The main life-history traits of the dorado Brachyplatystoma rousseauxii, a large Amazonian catfish undertaking the largest migration known for a freshwater fish species (from the nursery area in the estuary of the Amazon to the breeding zones in the head waters of the western Amazon basin close to the Andes), were determined from a 5 year sampling of >15,000 specimens in the Peruvian Amazon. The breeding season occurred during the falling and low-water periods, which is hypothesized to be an adaptation to maximize the chances of young stages to reach the estuary. The size at first sexual maturity was slightly larger for females than males, c. 91 and 83 cm standard length (L(S)), respectively. Both males and females reproduce for the first time at >3 years old. The fecundity per spawning event ranged from 481,734 to 1,045,284 oocytes for females weighing 25 and 34 kg, respectively. Seasonal variations of body condition were similar among sexes, but differed between immature specimens that had a higher condition during the low-water period and lower condition during rising waters, and mature individuals that showed the opposite pattern. The growth characteristics were estimated by L(S) frequency analysis. For females, the best fitting models gave a mean birth date in August, during the height of the breeding cycle, with the following von Bertalanffy growth function parameters: L(Sinfinity) = 153.3, K = 0.29 and t(0) =- 0.37 years. For males, the best fitting model gave a mean birth date in July, also during the height of the breeding period, with L(Sinfinity) = 142, K = 0.30 and t(0) =- 0.36 years. At a given age, females were systematically larger than males and the size difference increased with age. The largest females sampled (148 cm L(S)) was 11 years old and the largest male (134 cm L(S)) was 9 years old. The mortality estimates were higher for males total (Z) = 1.34, natural (M) = 0.52 and fishing (F) = 0.82 than for females (Z = 0.98, M = 0.50, F = 0.48). The life-history patterns of B. rousseauxii are discussed in light of the available knowledge about this species and the understanding of its complex life cycle.

Terapéutica en Atención Primaria. Uso de los opioides en pacientes con dolor oncológico / Therapy in Primary Health Care. Use of opioids in cancer patients with pain

Los opioides representan la mejor arma terapéutica para el control del dolor en el paciente oncológico. Más de la mitad de los pacientes con dolor oncológico precisarán, a lo largo de su seguimiento, tratamiento con opioides del 3.er escalón de la Organización Mundial de la Salud (OMS) para ser controlados. El tipo de interacción con los receptores opioides determina las distintas acciones farmacológicas y sus efectos adversos. Pero además las sustancias opioides pueden interaccionar sobre otros sistemas de neurotransmisores y otros receptores. La codeína y el tramadol constituyen el segundo nivel de la escala de la OMS, eficaces en dolor moderado. Se caracterizan por tener techo analgésico. Dentro de este grupo se incluye a la buprenorfina. La morfina, la oxicodona, el fentanilo y la metadona son igual de eficaces para el control del dolor. La selección de uno u otro depende de la vía de administración, el coste del fármaco y los efectos secundarios. La morfina es el opioide mayor de elección aunque no existen estudios concluyentes. El tratamiento del dolor oncológico debe incluir siempre dosis de opioides de rescate para control del dolor irruptivo. Debemos de tener siempre en cuenta los efectos secundarios de los opioides y prevenirlos. La rotación o el cambio de opiáceos es una alternativa terapéutica para mejorar la relación entre la eficacia analgésica y la aparición de efectos secundarios de tratamiento opi

Opioids are the best therapeutic armamentarium for the control of pain in the oncology patient. More than half of the cancer patients with pain will need treatment with opioid treatment (WHO step 3) during their follow-up to be controlled. The type of interaction with the opioid receptors determines the different drug actions and their adverse effects. However, opioid substances can also interact on other neurotransmitter systems and other receptors. Codeine and tramadol make up the second level on the WHO scale, and are effective in moderate pain. They are characterized by having an analgesic ceiling effect. Buprenorphine are included within this group. Morphine, oxycodone, phentanyl and methadone are as effective to control pain. Choosing one or the other depends on the administration route, drug cost, side effects. Morphine is the opioid of choice, although there are no conclusive studies. Treatment of cancer pain should always include rescue opioid dose to control irruptive pain. We should always keep the side effects of opioids in mind and prevent them. Rotation or change of opiates is a therapeutic alternative to improve the relationship between analgesic efficacy and appearance of side effects of opiate treatment

A propósito de un caso de fiebre por picadura de garrapata africana / A case report of African tick bite fever

Durante muchos años, la única rickettsiosis conocida en España del grupo de las fiebres manchadas ha sido la fiebre botonosa mediterránea. Sin embargo, la existencia de viajes a países cada vez más lejanos por turismo y el continuo incremento de la inmigración ha dado lugar a un aumento de los casos de las rickettsiosis adquiridas de otros países. Presentamos el caso clínico de un paciente con fiebre por picadura de la garrapata africana (Rickettsia africae)

For many years, the only rickettsiosis known in Spain from the spotted fever group was Mediterranean boutonneuse fever. However, the existence of tourist trips to increasingly far away countries and the continuous increase of immigration have given rise to an increase in the cases of rickettsiosis acquired from other countries. We present the clinical case of a patient with African tick bite fever (Rickettsia africae)

[Comparative study of pneumotonometer and Goldmann tonometer for screening high intraocular pressure in primary care]. / Estudio comparativo del neumotonómetro respecto al tonómetro de Goldmann para el cribado de presión intraocular (PIO) elevada en atención primaria.

OBJECTIVE: Evaluation of reliability of measurements of IOP obtained with air-puff noncontact tonometer respect the obtained with the conventional Goldmann tonometer. As well, analysis of the possibility of a higher difference between the measurements by both methods respect the fact of being myope or hypermetrope. DESIGN: Comparative study of two measurement methods. SETTING: General ophthalmology clinic and primary care clinic of our sanitary area. PATIENTS: Aleatory sample among the patients who went to the general ophthalmology clinic for any cause from the first of May to the thirtieth of June of 1996. The patients with predisposing processes for glaucoma were excluded, as well as those who suffered ocular surgery or those who took drugs which influenced the IOP. INTERVENTIONS: The ophthalmologist made three measurements of IOP in each eye and the sight of all the patients were tested. The arithmetic average was made among every three measurements. The physician of primary care made three measurements of IOP in each eye with the air-puff noncontact tonometer, and the arithmetic average was made. RESULTS: 81 patients were included, from whom 7 presented high IOP. The sensibility of the air-puff noncontact tonometer, compared with Goldmann tonometer, was 86% (95% CI, 18.20-99.63%), and the specificity 84% (95% CI, 89.66-78.08%). The air-puff noncontact tonometer obtained measurements between 1.116 and 2.008 mmHg higher than the Goldman tonometer. This difference, worthless from the clinic point of view, didn't find a relationship with the fact of being myope or hypermetrope. It was found a positive lineal association between the measurements made by both methods, with a correlation coefficient of 0.8086 (p < 0.001, 95% CI, 0.7476-0.8560). CONCLUSIONS: The results obtained are similar to the ones of other published series. A tendency of higher measurements with the air-puff noncontact tonometer is observed. It hasn't been observed a higher difference between both methods in myopes. The air-puff tonometer is a valid reliable technique to be used in primary care, it is easy to use, it doesn't transmit infectious illnesses, and it isn't necessary to use anaesthetic or staining eyedrops.

Estudio comparativo del neumotonómetro respecto al tonómetro de Goldmann para el cribado de presión intraocular (pio) elevada en atención primaria / Comparative study of aif-puff noncontact tonometer respect goldmann tonometer for screening of high intraocular presure (iop) in primary care

Objetivo. Evaluación de la fiabilidad de las mediciones de PIO obtenidas con el neumotonómetro respecto a las obtenidas con el tonómetro de referencia tipo Goldmann. Asimismo, análisis de la diferencia entre las mediciones obtenidas por ambos métodos respecto al hecho de ser miope o hipermétrope. Diseño. Estudio comparativo de dos métodos de medida. Emplazamiento. Consultas de oftalmología general y atención primaria de nuestra área sanitaria. Pacientes. Muestra aleatoria de entre los pacientes que acudieron por cualquier motivo a la consulta de oftalmología general entre el 1 de mayo y el 30 de junio del 1996. Se excluyeron aquellos con enfermedades predisponentes para glaucoma, intervenciones oculares o toma de fármacos influyentes en la PIO. Intervenciones. El oftalmólogo realizó 3 mediciones de PIO en cada ojo, hallándose la media aritmética y graduó a todos los pacientes. El médico de atención primaria realizó 3 mediciones de la PIO en cada ojo con el neumotonómetro, hallándose la media aritmética. Resultados. Se incluyeron 81 pacientes, de los cuales 7 presentaron una PIO elevada. El neumotonómetro, respecto al tonómetro de Goldmann presentó una sensibilidad del 86 por ciento (IC del 95 por ciento, 18,20-99,63 por ciento) y una especificidad del 84 por ciento (IC del 95 por ciento, 89,66-78,08 por ciento). El neumotonómetro obtuvo mediciones de 1,116-2,008 mmHg superiores al tonómetro de Goldmann. Esta diferencia, clínicamente despreciable, no se relacionó con el hecho de ser miope o hipermétrope. Se ha encontrado una asociación lineal positiva entre las mediciones realizadas por los 2 métodos, con un coeficiente de correlación de 0,8086 (p < 0,001; IC del 95 por ciento, 0,7476-0,8560). Conclusiones. Los resultados obtenidos coinciden con otras series publicadas. Se observa una tendencia a medidas más elevadas con el neumotonómetro. No se han objetivado mayores diferencias entre ambos métodos en miopes. El neumotonómetro es una técnica válida y fiable para su utilización en atención primaria, es de sencillo manejo, no transmite enfermedades infecciosas ni requiere colirios anestésicos ni tinciones corneales (AU)

Evaluación clínica de la analgesia dental electrónica / Clinical evaluation of the electronic dental anesthesia

Durante mucho tiempo se ha usado en odontología anestesia química local. Pero ahora, hay una nueva alternativa llamada anestesia dental electrónica. El respaldo fisiológico está basado en la teoría de control de puerta de Melzack y Wall. En el presente estudio, una unidad llamada H-Wave se ha usado para comparar la eficiencia de la anestesia electrónica en lugar de anestesia química. El estudio mostró que no hay diferencias significativas en el efecto anestésico y el 64 por ciento de los pacientes prefirieron la electrónica

Home automation in the workplace.

Environmental control units and home automation devices contribute to the independence and potential of individuals with disabilities, both at work and at home. Devices currently exist that can assist people with physical, cognitive, and sensory disabilities to control lighting, appliances, temperature, security, and telephone communications. This article highlights several possible applications for these technologies and discusses emerging technologies that will increase the benefits these devices offer people with disabilities.