Reliable monitoring system for arteriovenous ratio computation.

The degree of narrowing or widening in retinal vessels related to several cardiovascular diseases such as hypertension or diabetes may be measured by the arteriovenous ratio (AVR), that is, the relation between the artery and vein retinal vessel widths. Nevertheless, its lack of reproducibility, due mainly to a laborious manual calculation and the dependence of the vessels selected for its estimation, hinders its use in daily medical practice. This variation makes difficult to monitor the patient's condition over time. This paper describes a reliable AVR monitoring system which computes automatically the AVR from several images of the same patient acquired at different times using the same vessels measured at the same points. The system has been evaluated in a large data set of 158 pairs of images and good correlation results between medical experts and the system have been achieved.

Desensitization to allopurinol after allopurinol hypersensitivity syndrome with renal involvement in gout.

This is a case report of a 36-year-old male with tophaceous gout for 16 years. He started therapy with 300 mg/day of allopurinol. He had received variable dexamethasone doses by self-prescription for 16 years. When allopurinol was initiated, he had hyperuricemia and normal renal function. Twenty days after starting allopurinol, he presented diffuse maculopapular rash, conjunctivitis, increase in serum creatinine values, leukocytosis and eosinophilia and the diagnosis of allopurinol hypersensitivity (AH) syndrome was made. He completely recovered from the AH and renal function normalized. However, the gout worsened over the following years in spite of treatment with benzobromarone, low doses of prednisone, and colchicine. Allopurinol desensitization was successful beginning with an oral low dose scheme (6.5 mug/day) until we reached 300mg/day. Today the patient receives allopurinol with no side effects. We believe that this is the first reported example of successful desensitization in full-blown AH with renal involvement. Our cautious regimen might be tried in other such patients.