Clinical importance of neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio and systemic immune-inflammation index in dogs with leishmaniasis.

Leishmaniasis is a zoonotic disease caused by Leishmania spp., impacts multiple systems and organs. While hematological and biochemical profiles aren't definitive for diagnosis, recent studies have identified the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and systemic immune-inflammation index (SII) as predictors of morbidity and mortality in critically ill human and dog patients. This study examined 100 dogs diagnosed with leishmaniasis, categorized by the International Renal Interest Society (IRIS) stages 1-4. Additionally, the dogs were divided based on whether they survived less or more than one year (L1Y and G1Y). Control group consisted of 43 dogs. The NLR increased as the disease progressed (IRIS 1-4), presenting statistically significant differences (P<0.05) when compared to the control group (2,37±2,08) IRIS 3 and 4 (4,59±13,39 and 6,99±12,86, respectively), and G1Y and L1Y (3,60±4,02 and 4,87±5,82, respectively). Significant changes in SII were only evident in short-term survivors (L1Y 951,93±1402) and advanced renal disease cases (IRIS 4 stage 1073,68±1901,09). Conversely, PLR remained largely unchanged. In conclusion, these results suggest that the neutrophil-to-lymphocyte ratio (NLR) and systemic immune-inflammation index (SII) may serve as potential markers for assessing disease progression and prognosis in dogs diagnosed with leishmaniasis.

Photic maculopathy: A review of the literature (I). / Maculopatía fótica: revisión de la literatura (I).

The human retina, as transducer of light energy, is especially exposed to light toxicity. Solar maculopathy has been the only form of photic maculopathy for millennia, often secondary to the observation of an eclipse. During the last century, technological advances have led to the appearance of new forms of photic maculopathy, related to the exposure to new forms of artificial light, such as welding devices and lasers. In recent years, the general use of laser pointers has led to an upturn in interest in this pathology. The aim of this review is to offer an integrated view of the different types of photic maculopathy. Due to the extension of this topic, the review is presented divided into two parts. In this first part solar maculopathy and welding arc maculopathy are presented.

Photic maculopathy: A review of the literature (ii). / Maculopatía fótica: revisión de la literatura (ii).

The human retina, as transducer of light energy, is especially exposed to light toxicity. Solar maculopathy has been the only form of photic maculopathy for millennia, often secondary to the observation of an eclipse. During the last century, technological advances have led to the appearance of new forms of photic maculopathy, related to the exposure to new forms of artificial light, such as welding devices and lasers. In recent years the general use of laser pointers has led to an upturn in interest in this pathology. The aim of this review is to offer an integrated view of the different types of photic maculopathy. Due to the extension of the topic, the review is presented divided into 2 parts. In this second part, atomic bomb maculopathy, laser maculopathy, iatrogenic forms of photic maculopathy, and foveomacular retinitis are presented.

The visual system of diurnal raptors: updated review. / El sistema visual de las rapaces diurnas: revisión actualizada.

OBJECTIVE: Diurnal birds of prey (raptors) are considered the group of animals with highest visual acuity (VA). The purpose of this work is to review all the information recently published about the visual system of this group of animals. MATERIAL AND METHODS: A bibliographic search was performed in PubMed. The algorithm used was (raptor OR falcon OR kestrel OR hawk OR eagle) AND (vision OR «visual acuity¼ OR eye OR macula OR retina OR fovea OR «nictitating membrane¼ OR «chromatic vision¼ OR ultraviolet). The search was restricted to the «Title¼ and «Abstract¼ fields, and to non-human species, without time restriction. RESULTS: The proposed algorithm located 97 articles. CONCLUSIONS: Birds of prey are endowed with the highest VA of the animal kingdom. However most of the works study one individual or a small group of individuals, and the methodology is heterogeneous. The most studied bird is the Peregrine falcon (Falco peregrinus), with an estimated VA of 140 cycles/degree. Some eagles are endowed with similar VA. The tubular shape of the eye, the large pupil, and a high density of photoreceptors make this extraordinary VA possible. In some species, histology and optic coherence tomography demonstrate the presence of 2foveas. The nasal fovea (deep fovea) has higher VA. Nevertheless, the exact function of each fovea is unknown. The vitreous contained in the deep fovea could behave as a third lens, adding some magnification to the optic system.

Nonsurgical Procedures for Keratoconus Management.

OBJECTIVES: To describe the past 20 years' correction modalities for keratoconus and their visual outcomes and possible complications. METHODS: A review of the published literature related to the visual outcomes and possible complications in the context of keratoconus management using nonsurgical procedures for the last 20 years (glasses and contact lenses) was performed. Original articles that reported the outcome of any correction modalities of keratoconus management were reviewed. RESULTS: The most nonsurgical procedure used on keratoconus management is the contact lens fitting. Soft contact lenses and soft toric contact lenses, rigid gas-permeable contact lenses, piggyback contact lens system, hybrid contact lenses, and scleral and corneoscleral contact lenses form the contemporary range of available lens types for keratoconus management with contact lenses. All of them try to restore the vision, improve the quality of life, and delay surgical procedures in patients with this disease. Complications are derived from the intolerance of using contact lens, and the use of each depends on keratoconus severity. CONCLUSIONS: In the context of nonsurgical procedures, the use of contact lenses for the management of keratoconic patients represents a good alternative to restore vision and improve the quality of live in this population.

Surprising characteristics of visual systems of invertebrates. / Curiosidades sobre el sistema visual de los invertebrados.

OBJECTIVE: To communicate relevant and striking aspects about the visual system of some close invertebrates. MATERIAL AND METHODS: Review of the related literature. RESULTS: The capacity of snails to regenerate a complete eye, the benefit of the oval shape of the compound eye of many flying insects as a way of stabilising the image during flight, the potential advantages related to the extreme refractive error that characterises the ocelli of many insects, as well as the ability to detect polarised light as a navigation system, are some of the surprising capabilities present in the small invertebrate eyes that are described in this work. CONCLUSIONS: The invertebrate eyes have capabilities and sensorial modalities that are not present in the human eye. The study of the eyes of these animals can help us to improve our understanding of our visual system, and inspire the development of optical devices.

Ocular residual astigmatism's effect on high myopic astigmatism LASIK surgery.

PURPOSE: To analyze the effect of ocular residual astigmatism (ORA) on the effectiveness of LASIK for treating high myopic astigmatism. METHODS: This is an observational, cross-sectional study. We studied 116 consecutive myopic eyes with -3 diopters (D) or more of astigmatism that underwent LASIK surgery. The magnitude of uncorrected residual refractive astigmatism 3 months postoperatively was measured. RESULTS: The mean preoperative cylinder was -4.0±0.83 D (range, -7.5 to -3 D) and the mean preoperative ORA was 0.82±0.5 D. The mean residual refractive cylinder 3 months postoperatively was -0.78±0.83 D (range, -3 to 0 D). No correlation was found between ORA and the refractive cylinder 3 months postoperatively (P=0.6). CONCLUSION: In eyes with high myopic astigmatism undergoing LASIK, ORA was not correlated with the residual postoperative cylinder.

[Risk management at an Intensive Care Department: conciliation of medication]. / Gestión de riesgos en un servicio de Medicina Intensiva: conciliación de la medicación.

OBJECTIVE: To explain the implementation process of conciliation of medication as one measure included in the risk management program at an Intensive Care department. METHOD: A multidisciplinary team was put together to work on a risk management program. Work meetings were held from January to December of 2011. The development of the risk management program was done in sequential stages; identification of potential risks; analysis and assessment, management, set-up, implementation, follow-up, and reassessment. RESULTS: In total, 17 potential risks were identified, of which those with the highest scores given by the working group were analyzed and managed. Conciliation of medication was included. For managing this particular risk, conciliation of medication was proposed as an improvement measure, for which the pharmacist was in charge of its implementation. Besides, he also was in charge of the follow-up and reassessment process to assure its efficacy by designing indicators allowing periodic monitoring. CONCLUSIONS: The implementation of a clinical risks management program aims at reducing the errors and consequently improving the patient's safety. The inclusion of the pharmacist in the Intensive Care units contributes to achieving this goal and therefore we should accept our duties in the implementation of this kind of measures, such as conciliation of medication.

Objetivo: Explicar el proceso de implantación de la conciliación de la medicación como medida dentro de un plan de gestión de riesgos en un servicio de Medicina Intensiva. Método: Para la realización del plan de gestión de riesgos se creó un equipo de trabajo multidisciplinar. Se realizaron reuniones de trabajo durante los meses de enero a diciembre de 2011. El desarrollo del plan de gestión de riesgos se realizó en fases sucesivas: identificación de los riesgos potenciales, análisis y evaluación, tratamiento, despliegue, implementación, seguimiento y revisión. Resultados: Se identificaron un total de 17 riesgos potenciales, de los cuales se analizaron y trataron aquellos con mayor puntuación otorgada por el grupo de trabajo, entre ellos los errores de conciliación. Para el tratamiento de este riesgo se propuso como medida la conciliación de la medicación donde el farmacéutico se responsabilizó de su implementación. Asimismo, se responsabilizó del proceso de seguimiento y revisión de esta medida, para asegurar su eficacia, mediante el diseño de indicadores que permitiesen una monitorización periódica. Conclusiones: La implantación de un plan de gestión de riesgos clínicos es promover la reducción de errores y, consecuentemente, apostar por una mejora en la seguridad del paciente. La integración del farmacéutico en los servicios de Medicina Intensiva contribuye a la consecución de este objetivo, y por ello debemos aceptar nuestra responsabilidad en la implantación de medidas que vayan en esta línea como puede ser la conciliación de la medicación.

PLIO: a generic tool for real-time operational predictive optimal control of water networks.

This paper presents a generic tool, named PLIO, that allows to implement the real-time operational control of water networks. Control strategies are generated using predictive optimal control techniques. This tool allows the flow management in a large water supply and distribution system including reservoirs, open-flow channels for water transport, water treatment plants, pressurized water pipe networks, tanks, flow/pressure control elements and a telemetry/telecontrol system. Predictive optimal control is used to generate flow control strategies from the sources to the consumer areas to meet future demands with appropriate pressure levels, optimizing operational goals such as network safety volumes and flow control stability. PLIO allows to build the network model graphically and then to automatically generate the model equations used by the predictive optimal controller. Additionally, PLIO can work off-line (in simulation) and on-line (in real-time mode). The case study of Santiago-Chile is presented to exemplify the control results obtained using PLIO off-line (in simulation).

[An experimental model to measure real intraocular pressure (IOP) during LASIK]. / Modelo experimental para medir la presión intraocular (PIO) durante LASIK.

PURPOSE: To design a model to measure real IOP during lasik in pig eyes. METHODS: A reusable blood pressure transducer was used. Each eye was placed on a stand with sufficient support for the surgical procedure. The globes were inflated with 5% glucosated solution through the optic nerve to attain an IOP of 10-20 mmHg. A 27-gauge catheter was then inserted from the pars plana to the anterior chamber cavity. Real IOP was transmitted via the catheter liquid column to an external sensor. A suction ring was applied and a flap was created. During the procedure, IOP was registered with the ML110 Bridge Amplifier connected to a baro transducer. RESULTS: Values of real IOP were measured in freshly enucleated pig eyes during the lasik procedure. The model was able to instantaneously register the changes in IOP induced by the application of a suction ring and the creation of a flap in the pig eyes with good reproducibility. At the end of the procedure the IOP values remained stable. CONCLUSIONS: We have developed an experimental model to observe the course of suctioning and changes in IOP simultaneously. This model seems to be accurate in obtaining IOP values from the anterior chamber cavity during LASIK.

Histerectomía laparoscópica. Revisión de 71 casos. Descripción de la técnica. Análisis de resultados y complicaciones / Laparoscopic hysterectomy: Revision of 71 cases. Description o the technique, analysis of results and complications

El objetivo de este trabajo es analizar los primeros 71 casos de Histerectomía Laparoscópica (HTL) y Anexohisterectomía Laparoscópica (AHTL) realizados en el Servicio de Ginecología de Clínica Güemes de Luján

Histerectomía laparoscópica. Revisión de 71 casos. Descripción de la técnica. Análisis de resultados y complicaciones / Laparoscopic hysterectomy: Revision of 71 cases. Description o the technique, analysis of results and complications

El objetivo de este trabajo es analizar los primeros 71 casos de Histerectomía Laparoscópica (HTL) y Anexohisterectomía Laparoscópica (AHTL) realizados en el Servicio de Ginecología de Clínica G³emes de Luján (AU)

[Impact of cataract surgery upon functional capacity of the elderly]. / Repercusión de la intervención de cataratas en la capacidad funcional del anciano.

PURPOSE: To determine the impact of cataract intervention on visual function of the elderly and on autonomy in daily activities, analyzing the influence of clinical and sociodemographic variables. METHODS: Observational and longitudinal study. 185 elderly patients having undergone cataract surgery were compared with 179 elderly patients on a surgical waiting list. The first group was evaluated prior to surgery and at 4 months post-intervention. Control group patients were evaluated at the same times, without having received surgery. For all subjects, the state of visual function was determined by the Activities of Daily Vision Scale (ADVS). Degree of dependence in carrying out basic daily activities, cognitive state and self-perception of vision were also measured. Other variables were visual acuity, other ocular diseases and sociodemographic characteristics. RESULTS: Amongst the elderly patients having undergone surgery, the proportion of subjects able to carry out basic activities 4 months post-intervention (60.7%) was very similar to the initial pre-intervention figure (62.2%). However, in the control group, the proportion (63.1%) diminished significantly at the 4-month mark (48.8%) (p= 0.0001). Of the intervened subjects, 75.7% demonstrated improved self-perception of vision after 4 months as opposed to 15.4% of the non-intervened patients (p= 0.00001). Post-intervention, the mean score on the ADVS rose from 51.0 S.D. 28.4 to 76.0 S.D. 25.4 (p < 0.001). In contrast, the control group's mean score dropped from 54.8 S.D. 24.8 to 46.5 S.D. 27.1 (p < 0.001). CONCLUSIONS: Cataract surgery in the elderly improves visual function and prevents loss of autonomy, delaying dependency in carrying out basic daily activities.

[Hyperhomocysteinemia as risk factor in a Mexican population]. / La hiperhomocisteinemia como factor de riesgo en una población mexicana.

Hyperhomocysteinemia is considered one of the emerging risk factors for the development of coronary artery disease (CAD). In order to know the prevalence of this metabolic disorder in a Mexican population with early CAD (< 50 years), we studied a group of these patients and compared the levels of homocysteine with a group of patients, paired by age and gender, without angiographic evidence of coronary atherosclerosis. Preliminary results show that the population with early CAD has more traditional risk factors, specially diabetes mellitus, and higher levels of homocysteine in plasma. Moreover there is a genetic factor with higher incidence of a TT homozygotic mutation of the MTHFR that increases homocysteine because of an altered folate metabolism.

Melanoma amelanótico subungueal / Subungueal amelanotic melanoma

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