Contact topical anesthesia versus general anaesthesia in strabismus surgery.

OBJECTIVE: To evaluate the anesthetic block provided by contact topical anesthesia (CTA) in strabismus surgery in adult patients. To analyze postoperative pain and surgical outcome obtained by CTA compared with general anesthesia (GA). METHODOLOGY: Prospective longitudinal cohort study of adult patients undergoing strabismus surgery by CTA or GA. The intensity of pain perceived by patients during the course of surgery and in the postoperative period was measured using Numerical Pain Scale. The success of the surgical outcome, considered as a residual ocular deviation<10 prism diopters, was evaluated. RESULTS: Twenty-three patients were operated using CTA and 26 using AG. During the course of surgery, pain intensity experienced by patients in ATC group was 3.17±2.44. There were no differences between CTA group and AG group in the intensity of pain in the immediate postoperative period (2.13±2.39 vs. 2.77±2.18, respectively; P=.510) and during the first postoperative day (3.22±2.84 vs. 3.17±2.73; P=.923). Surgical success was significantly higher in the CTA group than in the GA group (78.3 vs. 73.1%; P=.019). CONCLUSIONS: CTA provides adequate sensory block to perform strabismus surgery. The control of postoperative pain is similar to that obtained with AG. Conservation of ocular motility providing CTA enables better surgical outcome.

Contact topical anesthesia for strabismus surgery in adult patients.

OBJECTIVE: To analyze the effectiveness and usefulness of contact topical anesthesia in strabismus surgery in adult patients. MATERIAL AND METHODS: A prospective study was conducted on 20 patients undergoing strabismus surgery using contact topical anesthesia and sedation with remifentanil. The intensity of pain was recorded using a numeric pain rating scale at the time of anesthesia implementation, during the surgical procedure, 30 min afterwards, and during the first postoperative day. The incidence of oculocardiac reflex, postoperative nausea and vomiting, corneal ulcers, patient satisfaction (numerically from 0 to 10) and the degree of residual ocular deviation were also assessed. RESULTS: The operation was performed successfully in all patients. Average pain intensity was 1.40 ± 1.73 during anesthesia implementation, 4.20 ± 2.57 during the surgical procedure, 2.50 ± 2.54 30 min after surgery, and 3.55 ± 2.89 during the first postoperative day. Oculocardiac reflex was observed in 7 patients (35%), postoperative nausea and vomiting in 4 (20%), and corneal ulcer in 4 (20%). The patient satisfaction was 9.53 ± 2.51. More than two-thirds (70%) of patients had a residual ocular deviation less than 10 prism diopters. CONCLUSIONS: Contact topical anesthesia is a safe and effective alternative for strabismus surgery in adult patients. Contact topical anesthesia provides adequate pain control, lower incidence of postoperative nausea and vomiting and oculocardiac reflex, and optimal setting of ocular alignment.

bioNMF: a web-based tool for nonnegative matrix factorization in biology.

In the last few years, advances in high-throughput technologies are generating large amounts of biological data that require analysis and interpretation. Nonnegative matrix factorization (NMF) has been established as a very effective method to reveal information about the complex latent relationships in experimental data sets. Using this method as part of the exploratory data analysis, workflow would certainly help in the process of interpreting and understanding the complex biology mechanisms that are underlying experimental data. We have developed bioNMF, a web-based tool that implements the NMF methodology in different analysis contexts to support some of the most important reported applications in biology. This online tool provides a user-friendly interface, combined with a computational efficient parallel implementation of the NMF methods to explore the data in different analysis scenarios. In addition to the online access, bioNMF also provides the same functionality included in the website as a public web services interface, enabling users with more computer expertise to launch jobs into bioNMF server from their own scripts and workflows. bioNMF application is freely available at http://bionmf.dacya.ucm.es.

Fístula nefrobronquial secundaria a pielonefritis crónica xantogranulomatosa como causa de absceso pulmonar y hemoptisis persistente / Nephrobronchial fistula secondary to chronic xanthogranulomatouspyelonephritis as a cause of pulmonary abscess and persistenthemoptysis

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Biclustering of gene expression data by Non-smooth Non-negative Matrix Factorization.

BACKGROUND: The extended use of microarray technologies has enabled the generation and accumulation of gene expression datasets that contain expression levels of thousands of genes across tens or hundreds of different experimental conditions. One of the major challenges in the analysis of such datasets is to discover local structures composed by sets of genes that show coherent expression patterns across subsets of experimental conditions. These patterns may provide clues about the main biological processes associated to different physiological states. RESULTS: In this work we present a methodology able to cluster genes and conditions highly related in sub-portions of the data. Our approach is based on a new data mining technique, Non-smooth Non-Negative Matrix Factorization (nsNMF), able to identify localized patterns in large datasets. We assessed the potential of this methodology analyzing several synthetic datasets as well as two large and heterogeneous sets of gene expression profiles. In all cases the method was able to identify localized features related to sets of genes that show consistent expression patterns across subsets of experimental conditions. The uncovered structures showed a clear biological meaning in terms of relationships among functional annotations of genes and the phenotypes or physiological states of the associated conditions. CONCLUSION: The proposed approach can be a useful tool to analyze large and heterogeneous gene expression datasets. The method is able to identify complex relationships among genes and conditions that are difficult to identify by standard clustering algorithms.

Bioavailability of two new formulations of paracetamol, compared with three marketed formulations, in healthy volunteers.

The aim of this study was to compare the main pharmacokinetic characteristics of two new paracetamol formulations, powder sachet and tablet, with that of three commercially available paracetamol formulations: two conventional solid tablets and one effervescent tablet. Twelve healthy volunteers participated in an open, single dose (paracetamol 1,000 mg), randomized, five-way, crossover study. Formulations studied included: formulation A: 2 x 500 mg paracetamol tablets (Laboratorios Belmac S.A.); formulation B: 1 x 1,000 mg paracetamol powder sachets (Laboratorios Belmac, S.A.); formulation C: 2 x 500 mg paracetamol film-coated tablets (Panadol, SmithKline Beecham); formulation D: 2 x 500 mg paracetamol tablets (Tylenol, McNeil); and formulation E: 1 x 1,000 mg effervescent paracetamol tablets (Efferalgan, UPSA). The primary variables were area under the plasma concentration time curve extrapolated to infinity (AUC(0-infinity)), maximum plasma concentration (Cmax), and time to maximum plasma concentration (tmax). Mean AUC(0-infinity) ranged from 52.6 (B) to 56.3 microg x h/ml (D); mean Cmax varied between 17.98 (C) and 20.73 microg/ml (E); mean tmax ranged from 0.40 (E) to 0.88 h (C); and median t(1/2) varied between 2.65 (C) and 2.81 h (A). Formulations A, B and E showed significantly shorter tmax than formulation C. The tmax and Cmax values found for formulations A and B were very similar to that found for E, an effervescent tablet formulation. In conclusion, the two new formulations of paracetamol tested in this study were absorbed rapidly after a single oral dose in healthy volunteers, similar to an effervescent paracetamol formulation and significantly faster than two ordinary commercialized paracetamol tablets.

[Glaucomatous damage pattern in swap in the early stages of glaucoma]. / Patrón de daño campimétrico en la perimetría automatizada de longitud de onda corta (PALOC) en las fases iniciales del glaucoma.

PURPOSE: To determine with Short-Wavelength Automated Perimetry (SWAP) the patterns of early glaucomatous damage and to compare frequency of diffuse defects to localized defects. METHODS: One hundred and sixty eyes from 83 ocular hypertensive subjects who met the selection criteria (intraocular pressure greater than 21 mm Hg and normal standard visual fields) were studied. SWAP was performed with a modified Humphrey Field Analyser. Total (TD) and pattern deviation (PD) probability maps were calculated to evaluate the pattern of visual field loss. RESULTS: The frequency of defects was higher in TD than in PD for all levels of defects (p<0.001). There was also a relative topographical distribution of glaucomatous defects. CONCLUSIONS: We documented the existence of predominantly diffuse visual field defects for all depth levels at early glaucoma stages.

[Predictive value of the pattern-electroretinogram in glaucoma]. / Valor predictivo del pattern-electrorretinograma en el glaucoma.

PURPOSE: To determine the ability of pattern-electroretinogram (PERG) to discriminate individual evolution of glaucomatous visual field losses in glaucoma suspects. METHODS: We studied 151 eyes of 78 GS, classified depending on their risk to develop glaucomatous damage. The initial visual field was normal. Those eyes showing at least 2 reduced amplitudes in the PERG components (P50, N95 and NP) were considered pathologic. The mean follow-up was 30 months (range: 13-50 months); the VF was evaluated at the end of the study. RESULTS: At the beginning of the study the PERG was pathologic in 65 eyes (43%); in 45 of these eyes (69%) the visual field was pathologic at the end of the study. The positive predictive value of the PERG of visual field glaucomatous changes was 69% and the negative predictive value was 80%. The N95 amplitude showed the best predictive value, with 100% and 77% in the high and medium risk groups, respectively. CONCLUSIONS: The PERG study can discriminate the glaucoma suspects that will develop visual field glaucomatous losses.

Estudio de la queratitis infecciosa en el injerto corneal / Study of infectious keratitis complicating penetrating keratoplasty

Objetivo: Analizar es un estudio retrospectivo, la microbiología y los factores de riesgo asociados en la queratitis infecciosa (Ql) tras queratoplastia penetrante (QP).Métodos: Han sido estudiadas 246 QP (realizadas en 17 años, 1980-1997) para identificar QI en QP. Criterio de inclusión fue el cultivo o extensión positiva. Fueron estudiadas las indicaciones de QP, intervalo de tiempo entre QP y QI, factores de riesgo asociados, estudio microbiológico, complicaciones y transparencia final del injerto. Resultados: Se encontraron 12 casos de QI en 246 QP, por tanto, una incidencia del 4,8 por ciento. Entre estos casos, la causa más frecuente de QP fue la queratopatía herpética (41,6 por ciento). Los factores de riesgo asociados fueron: 1.º Oculares (descompensación del injerto, lente de contacto terapéutica y sutura); 2.º Medicaciones tópicas (antibióticos y corticoides) y 3.º Sistémicas (diabetes mellitus). El tiempo medio entre QP y QI fue de 27,1ñ25,7 meses. El 25 por ciento de casos se aparecieron en el período precoz (12 meses) asociados a la descompensación del injerto y empleo lente de contacto terapéutica. El 66,6 por ciento de casos fueron bacterianos predominando los Gram (+) (Staphyilococcus y Streptococcus) y el resto de origen fúngico (Candida). Se observó un caso de queratopatía cristalina infecciosa por Streptococcus Mitis. La incidencia de complicaciones severas como evisceración y pérdida de trasparencia del injerto es del 75 por ciento. Conclusiones: La QI en QP es una complicación poco frecuente (4,8 por ciento) y grave. Es mayor la incidencia de QI tardía asociada a descompensación del injerto y empleo de lente de contacto terapéutica. Los microorganismos más frecuentemente implicados son bacterias Gram (+) y hongos (Cándida) (AU)

[Isolation, identification, and typing of yeasts from HIV-positive patients with oral candidiasis]. / Aislamiento, identificación y tipificación de levaduras en pacientes VIH positivos con candidiasis oral.

A study of oral candidiasis was conducted among 25 HIV-positive and AIDS patients. The predominant clinical form of presentation was the pseudomembranous one, whereas the most frequently yeast species found in the isolations were: Candida albicans (54.1%), Candida tropicalis (8.1%), and Torulopsis glabrata (8.1%). It was demonstrated that patients with recurrent infections have colonization of the oral cavity by multiple strains and/or yeast species more often (30.8%) than those through their first episode of oral candiadisis (12.5%). Of the 3 culture media used for the initial isolation, the combination of the potatodextrose agar (PDA) with Sabouraud triphenytletrazolium agar (STA) allowed to obtain the maximum isolation and differentiation among strains. The Sabouraud agar (SA), the most used medium to these ends at the international level, proved to be less useful than the previous ones. The STA was very efficient in the studies of phenotypic typing of most of the isolated yeast species and specially of C. albicans, which will make possible to approach epidemiological studies.

[The minimum dosage of praziquantel in the treatment of Taenia saginata, 1986-1993]. / Dosis mínima de praziquantel en el tratamiento de Taenia saginata, 1986-1993.

Praziquantel was used in a therapeutic trial in 50 patients presenting with Taenia saginata in a dose of 5 mg/body weight as a single dose. The most frequent symptoms were: abdominal pain (72%), nervousness (42%), and body weight loss (32%). Tolerance to the drug was excellent. In 100% of patients the elimination of proglottids and/or strobilus of Taenia saginata.

Electrophysiological methods in early glaucoma detection.

Electrophysiological methods like pattern electroretinogram and pattern visual evoked potentials may be the best approach for early glaucoma detection, as they have demonstrated to be sensitive to the ganglion cells functional changes. Reported values of both P50 and N95 pattern electroretinogram components differ widely, a fact perhaps related to a heterogeneous grouping of patients suffering from ocular hypertension and glaucoma, rather than to the type of technique utilized. This study is based on a total of 42 subjects: 14 normals, 16 subjects suffering from ocular hypertension, and 12 patients with glaucoma, with 79 eyes examined. Pattern electroretinogram and pattern visual evoked potentials were used as successive techniques. Setting condition for pattern electroretinogram, such as low temporal frequency (2 Hz), 30 min check size, high contrast (99%) and luminance (93 cd/m2), identified the N95 component as the best index for early glaucoma detection. In the control group N95 mean amplitude was 1.62 muV +/- 0.59 SD and showed almost significant difference with ocular hypertension (p = 0.07) and highly significant difference with the glaucoma group (p < 0.01), with decrement of 58.6% in the glaucoma group. P50 mean amplitude, on the contrary, did not show significant differences among the groups (Newman-Keul test), its reduction in glaucoma being 28%. The mean pattern visual evoked potentials latency was alos highly significant between glaucoma and control groups, but not between ocular hypertension and control groups; the mean amplitude did not show significant differences. A proportion of 26.6% abnormal pattern electroretinogram was found in the group suspected of having glaucoma where conventional methods had proved normal.(ABSTRACT TRUNCATED AT 250 WORDS)

Lectin-binding patterns in the development of the cerebellum.

We studied the binding distribution of several lectins, Con A, DBA, UEA and WGA, in the embryonic development of the chick cerebellum between stages 18 to 45 of Hamburger and Hamilton. We observed a differential labeling (in intensity and distribution) in the migratory and cortical layers of the cerebellum anlage with these different lectins. The different distributions and modifications in the labeling pattern suggest intense variations of the glycoproteins and glycosaminoglycans in the extracellular matrix during development. These variations coincide with cellular and organizational phenomena in the migratory and cortical layers, and suggest compartmentalization of the Purkinje cell labeling.