The relation between intraocular pressure peak in the water drinking test and visual field progression in glaucoma.

AIM: To compare the results of the water drinking test between glaucomatous eyes with and without visual field progression. METHODS: Retrospective analysis of 76 eyes of 76 open angle glaucoma patients followed for a mean period of 26.0 (SD 13.8) months. Patients were submitted to the water drinking test at the beginning of the follow up period. Reliable achromatic automated perimetry tests performed during the studied period were used to characterise visual field progression. All subjects were under clinical therapy and had an intraocular pressure (IOP) lower than 17 mm Hg monitored by isolated measurements during the follow up period. The results of the water drinking test were compared between glaucomatous eyes with and without visual field progression. RESULTS: Twenty eight eyes reached definite visual field progression. There were no significant differences in the mean age, sex, race, basal IOP, number of antiglaucomatous drugs, initial mean deviation (MD), and corrected pattern standard deviation (CPSD) between eyes that showed visual field progression and the ones who did not progress. A significant difference of 1.9 (SD 0.6) mm Hg (p = 0.001, analysis of covariance; 95% CI 0.8 to 3.0) was observed between glaucomatous eyes that showed visual field deterioration and glaucomatous eyes that did not progress. A significant difference of 16.8% (SD 4.6%) in the mean percentage of IOP variation was also observed between the two groups (p<0.001, analysis of covariance; 95% CI 7.7 to 26.0). CONCLUSIONS: Mean IOP peak and percentage of IOP variation during water drinking test were significantly higher in patients with visual field progression compared with patients who did not progress.

Resolución quirúrgica de estenosis bronquial: informe de un caso / Bronchial stenosis. surgical correction: case report

Introducción. La estenosis bronquial es una patología poco común, de etiología congénita o adquirida. La estenosis en las vías aéreas se localiza en la gran mayoría de los casos a nivel subglótico, es rara en tráquea y extaordinariamente rara en bronquios. Caso clínico. Femenino de 6 años de edad con antecedente de intubación endotraqueal en el período neonatal. Evolución asintomática. Padecimiento de 5 meses de evolución con tos progresiva, posteriormente fiebre. Hipoventilación basal derecha, vibraciones vocales disminuidas y estertores bronquioalveolares ipsilaterales. En telerradiografía de tórax opacidad basal derecha que borra el ángulo cardiofrénico y sobredistensión pulmonar derecha. Broncoscopia con estenosis de 75 por ciento de la luz bronquial del lado derecho. Tratamiento quirúrgico con toma y colocación de injerto de cartílago costal. Evolución a 2 años favorable. Conclusiones. La estenosis bronquial fue de origen probablemente adquirido y secundario a la intubación endotraqueal en el período neonatal. El tratamiento con aplicación de parche de cartílago es una técnica útil, con resultados satisfactorios y accesible en nuestro medio

A clinical study of norethisterone enanthate in rural Mexico.

Clinical trials of norethisterone enanthate (NET-EN), a long-acting, injectable progestogen, have demonstrated its short-term safety and effectiveness as a method of contraception in a controlled trial setting. Family planning programs interested in providing NET-EN need information on its efficacy and acceptability under usual field conditions. This first field study of NET-EN was conducted in family planning clinics in rural areas of Mexico. Women admitted to the study were followed up at two-month intervals to receive an injection of 200 milligrams of NET-EN, and to be asked about possible side effects of the drug. Among the 5,792 women recruited, the overall life-table discontinuation rate was 57.0 per 100 women at 12 months and 69.0 at 18 months. The single most common reason for discontinuation was amenorrhea, followed by bleeding problems. Women who were older and who already had several children were most likely to continue using NET-EN. Nine pregnancies were reported during the study, with a cumulative pregnancy rate of 0.3 per 100 women at 18 months. NET-EN appears to be an effective method of contraception that is acceptable to a substantial proportion of women from rural areas in Mexico who choose to use it, when it is provided through a national family planning program.

Uso de un antitrombotico a largo plazo en pacientes con insuficiencia arterial de miembros inferiores. / A long term use of an antithrombotic agent in patients with arterial insufficiency

Se exponen las experiencias de mas de 10 anos con el empleo de un antitrombotico, dipiridamol, administrado a largo plazo (promedio 72 meses), en pacientes sujetos a cirugia por arteriopatia oclusiva arteriosclerotica o tromboembolica. Un grupo testigo, sin medicacion antitrombotica, sirve de control. El grupo A muestra una incidencia muy baja de fenomenos tromboembolicos, durante los periodos en que se administra el dipiridamol y alta incidencia cuando se suspende este medicamento.El grupo B, sin medicacion antitrombolica, presenta el segundo episodio oclusivo en mas del 50% de los pacientes