Hyperosmolarity of the Tear Film in the Dry Eye

The dry eye is a complex multifactor illness of the tear film and of the ocular surface characterized by symptoms of discomfort, vision alterations, and instability of the pre-corneal tear film which may bring about potential damage on the ocular surface. Instability of the film will produce increasing osmolarity of the tear film which will trigger epithelium osmotic lesions and inflammation. As these changes take place on the ocular surface, neurophysiologic mechanisms of homeostasis will be altered which will complicate the process even further with the cropping of vicious physiopathologic circuits

Impacto da poluição ambiental na superfície ocular de pacientes com síndrome de Sjögren

Purpose: To evaluate the effect of air pollution on the ocular surface of patients with Sjögren's syndrome. Methods: We investigated the ocular surfaces of thirty patients with Sjögren's syndrome and thirty healthy volunteers (control group) living in the Metropolitan Area of Buenos Aires. We used nitrogen dioxide as an indicator of exposure to air pollution. An ocular symptoms questionnaire was answered by all subjects, who also underwent a complete ocular surface ophthalmic examination-including an Ocular Surface Disease Index questionnaire, biomicroscopy, tear breakup time, Schirmer 1 test, corneal and conjunctival vital staining with fluorescein and lissamine green, tear lysozyme concentration, and impression cytology. Results: In almost all ocular surface test findings, we found a positive and significant correlation between higher levels of exposure to air pollution and higher levels of ocular surface damage in both the control group and Sjögren's syndrome patients. In Sjögren's syndrome patients, the Ocular Surface Disease Index questionnaire, tear breakup time, vital staining and impression cytology showed a significant correlation between high levels of air pollution and ocular surface disease. In the control group, the Ocular Surface Disease Index questionnaire, tear breakup time, and impression cytology showed a significant correlation between high levels of air pollution and ocular surface disease. Conclusions: Here we demonstrated that in patients with dry eye syndrome associated with Sjögren, abnormalities of the ocular surface and eye irritation related to air pollution are more severe than those in the control group. We believe that measuring air quality should be not only an integral part of the evaluation of ocular surface disease but also a therapeutic consideration.Objetivo: Avaliar o efeito da poluição do ar na superfície ocular de pacientes com síndrome de Sjögren. Métodos: Foram investigadas as superfícies oculares de trinta pacientes com síndrome de Sjögren e trinta voluntários saudáveis (grupo controle) residentes na Região Metropolitana de Buenos Aires. Usamos o dióxido de nitrogênio como um indicador de exposição à poluição do ar. Um questionário de sintomas oculares foi respondido por todos os indivíduos, que também foram submetidos a um exame oftalmológico completo da superfície ocular - incluindo um questionário do Índice da Doença da Superfície Ocular, biomicroscopia, tempo de ruptura do filme lacrimal, teste de Schirmer 1, coloração da córnea e conjuntiva com fluoresceína e lissamina verde, concentração de lisozima lacrimal e citologia de impressão. Resultados: Em quase todos os achados do teste de superfície ocular, encontramos uma correlação positiva e significativa entre níveis mais altos de exposição à poluição do ar e níveis mais elevados de danos na superfície ocular tanto no grupo controle quanto nos pacientes com síndrome de Sjögren. Em pacientes com síndrome de Sjögren, o questionário do Índice da Doença da Superfície Ocular, tempo de ruptura do filme lacrimal, coloração vital e citologia de impressão mostraram uma correlação significativa entre altos níveis de poluição do ar e doença da superfície ocular. No grupo controle, o questionário do Índice de Doenças da Superfície Ocular, tempo de ruptura do filme lacrimal e citologia de impressão mostraram uma correlação significativa entre altos níveis de poluição do ar e doença da superfície ocular. Conclusões: Aqui demonstramos que, pacientes com síndrome de olho seco associada a Sjögren, as anormalidades da superfície ocular e airritação ocular relacionadas à poluição do ar são mais graves do que aquelas no grupo controle. Acreditamos que a medição da qualidade do ar não deve ser apenas uma parte integral da avaliação da doença da superfície ocular, mas também uma consideração terapêutica.Fil: Galperín, Gustavo Javier. Hospital Oftalmológico Pedro Lagleyze; ArgentinaFil: Berra, Fabio Martín. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Hospital Oftalmológico Pedro Lagleyze; ArgentinaFil: Marquez, Maria Isabel. Bioquímica Ocular; ArgentinaFil: Mandaradoni, Mariana. Hospital Nacional Professor Dr. Alejandro Posadas; ArgentinaFil: Tau, Julia. Laboratorio de Investigaciones Oculares; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Berra, Alejandro. Laboratorio de Investigaciones Oculares; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentin

Lyophilized amniotic membrane patch (LAMPatch) as a replacement of tamponades in the treatment of primary rhegmatogenous retinal detachment

Background: The basis of retinal detachment repair is sealing the retinal breaks. In order to seal the retinal breaks, chorioretinal adhesion around these lesions has to be achieved. Laser retinopexy is not immediate thus necessitates the use of a temporal endotamponade to maintain both tissues in apposition. We propose the use of a patch of lyophilized human amniotic membrane (LAMPatch) in order to occlude the retinal tear effectively until the chorioretinal adhesion is settled, overcoming the risks and limitations of the current tamponades. Methods: 23-gauge vitrectomy was performed on eyes with primary retinal detachment with single retinal breaks of less than one-hour extension. A LAMPatch was deployed over the retinal breaks after retina was repositioned with perfluorocarbon. Neither gas nor silicon oil were injected. Results: Six eyes of six patients with total or partial retinal detachment were included. Retinas remained reattached in all cases until the end on follow-up (3, 5 months). Best-corrected visual acuity at 1-week postop was between 20/30 and 20/100. Neither elevations of intraocular pressure, cataracts nor signs of inflammation were registered during follow-up. No second surgeries were needed. Conclusion: This technique has proven to be safe and effective in this small case series. No intraocular pressure rise, inflammation or cataracts were registered until last follow-up visit.Fil: Saravia, Mario. No especifíca;Fil: Zeman Bardeci, Luis Alberto. Universidad de Buenos Aires. Facultad de Medicina. Hospital de Clínicas General San Martín; ArgentinaFil: Berra, Alejandro. Universidad de Buenos Aires. Facultad de Medicina; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay; Argentin

RECYCLING OF WASTE ELECTRICAL AND ELECTRONIC EQUIPMENT AS A STRATEGIC LINE TANGENTIAL OF CIRCULAR ECONOMY

Strategic planning allows the analysis and design of probable decisions in the environment of Organizations. Technological change has generated a large amount of electronic waste (E-Waste). In the health not only affects people but the entire World. The methodological application of the circular economy in Waste Electrical and Electronic Equipment (R2AE2) is done by defining efficiency indicators through linearization. A recursive decision feedback scheduling strategy for a system of efficient power generation. The competitive advantage of the circular economy through R2AE2 allows to obtain high revenues while providing adequate management in the Reduce, Reuse and Recycle (3R) of waste to avoid contaminating the environment. The proposed methodology aims to obtain similar results when applying EC strategy in South- Southeast of Mexico

RECYCLING OF WASTE ELECTRICAL AND ELECTRONIC EQUIPMENT AS A STRATEGIC LINE TANGENTIAL OF CIRCULAR ECONOMY

Strategic planning allows the analysis and design of probable decisions in the environment of Organizations. Technological change has generated a large amount of electronic waste (E-Waste). In the health not only affects people but the entire World. The methodological application of the circular economy in Waste Electrical and Electronic Equipment (R2AE2) is done by defining efficiency indicators through linearization. A recursive decision feedback scheduling strategy for a system of efficient power generation. The competitive advantage of the circular economy through R2AE2 allows to obtain high revenues while providing adequate management in the Reduce, Reuse and Recycle (3R) of waste to avoid contaminating the environment. The proposed methodology aims to obtain similar results when applying EC strategy in South- Southeast of Mexico

Olho seco e depressão em um consultório de superfície ocular

Objetivo: Evaluar los síntomas de depresión y los síntomas del ojo seco en un entorno clínico de pacientes ambulatorios que consultan por ojo seco.Métodos: Este estudio involucró a pacientes consecutivos que visitaron a uno de nuestros autores(AA), oftalmólogo clínico especializado en patologías de la superficie ocular. Los sujetos eran pacientes de segunda vez con diagnóstico definido en consultas previas. El oftalmólogo efectuó el examen habitual de ojo seco y los sujetos realizaron voluntariamente una encuesta de autoevaluación de síntomas oculares, factores ambientales y una escala de depresión. El investigador estuvo enmascarado respecto de las respuestas del cuestionario.Resultados: La edad media de la muestra de 105 sujetos fue de 60,1 ± 13,4 años y 86 fueron mujeres (81,9%). El 6,7% de la muestra presentó diagnóstico de depresión y un 18,1% tuvo sospecha de depresión. El 62,9% de la muestra evaluada referíasíntomas de ojo seco. No hubo asociación entre los síntomas y el menisco disminuido. La regresión logística mostró asociación estadística entre el menisco disminuido y la tinción con verde de lisamina (p<0.001). Se encontró que las personas con menisco normal tenían un mayor puntaje de depresión (p=0.033) y su porcentaje de sospecha de depresión llegó al 29,2%.Conclusión: La sintomatología no se relaciona con la gravedad de los signos objetivos de ojo seco.Entre los pacientes que consultan por ojo seco el hallazgo de un menisco normal se asoció con depresión.Purpose: To assess symptoms of depression and dry eye symptoms in a clinical setting of dry eye outpatients. Methods: This study involved consecutive patients who visited one of our authors (AA), a clinical ophthalmologist specializing in ocular surface pathology. All were second time patients with defined diagnosis which had been obtained in previous visits. They had an ocular surface exam and voluntarily completed a self-assessment survey of ocular symptoms, environmental factors and a depression scale. The ophthalmologist was masked for the results of the questionnaire. Results: The mean age of the sample of 105 patients was 60.1±13.4 years. And 86 were females (81.9%). In all, 6.7% of the sample had a diagnosis of depression, and 18.1% had suspicion of depression. Dry eye symptoms were reported by 62.9% of the tested sample. There was no association between symptoms and decreased meniscus. Logistic regression showed statistical association between decreased meniscus and lisamine green staining (p<0.001). Individuals with normal meniscus were found to have a higher depression score (p=0.033) with their percentage of suspected depression reaching 29.2%. Conclusions: Symptomatology is not related to the severity of objective signs of dry eye. Depression should be taken into account in the dry eye consultation as a normal meniscus may be associated with depression in the dry eye consultation.Objetivo: Avaliar sintomas de depressão e sintomas de olho seco em um ambiente clínico de pacientes ambulatoriais com olho seco. Métodos: Este estudo envolveu pacientes consecutivos que visitaram um dos autores (AA), um oftalmologista clínico especializado em patologias da superfície ocular. Os sujeitos eram pacientes de segunda vez com diagnóstico definido em consultas anteriores. O oftalmologista realizou o exame de olho seco usual e os sujeitos preencheram voluntariamente uma pesquisa de autoavaliação de sintomas oculares, fatores ambientais e uma escala de depressão. O pesquisador esteve mascarado respeito das respostas do questionário. Resultados: A média de idade da amostra de 105 sujeitos foi de 60,1 ± 13,4 anos e 86 eram mulheres (81,9%). 6,7% da amostra apresentou diagnóstico de depressão e 18,1% tinha suspeita de depressão. 62,9% da amostra avaliada relataram sintomas de olho seco. Não houve associação entre sintomas e menisco lacrimal diminuído. A regressão logística mostrou associação estatística entre menisco diminuído e coloração verde de lissamina (p<0,001). Verificou-se que pessoas com menisco normal apresentaram maior pontuação de depressão (p=0,033) e seu percentual de suspeita de depressão chegou a 29,2%. Conclusão: A sintomatologia não está relacionada com a gravidade dos sinais objetivos de olho seco. Entre os pacientes consultados por olho seco, o achado de menisco normal foi associado à depressão.Fil: Aguilar, Alejandro. Consultorio de Superficie Ocular Dr. Aguilar; ArgentinaFil: Girado, Fernanda. Consultorio de Superficie Ocular Dr. Aguilar; ArgentinaFil: Tau, Julia. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata. Instituto de Investigaciones Bioquímicas de La Plata "Prof. Dr. Rodolfo R. Brenner". Universidad Nacional de la Plata. Facultad de Ciencias Médicas. Instituto de Investigaciones Bioquímicas de La Plata "Prof. Dr. Rodolfo R. Brenner"; Argentina. Universidad de Buenos Aires. Facultad de Medicina. Departamento de Patología; ArgentinaFil: Berra, Alejandro. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad de Buenos Aires. Facultad de Medicina. Departamento de Patología; ArgentinaFil: Iribarren, Rafael. Consultorios Dres. Iribarren; Argentin

Expresión y rol del slpi (secretory leukocyte protease inhibitor) en la inmunidad innata del ojo asociado a procesos inflamatorios e infecciosos oculares.

En la terapia antimicrobiana, se pretende comprender y desarrollar sinergia con los mecanismos de defensa innatos del huésped, en el área oftalmológica, los relacionados a procesos oculares infecciosos tanto específicos como no específicos. Conservando y estimulando la presencia de los péptidos antimicrobianos, se obtendría una prevención e inhibición de los microorganismos responsables de los principales procesos infecciosos e inflamatorios oculares, que permitirá un tratamiento rápido y eficaz en el control del proceso patológico.De esta forma se podrá evitar secuelas devastadoras de dichas complicaciones que en un gran porcentaje llevan a la ceguera del paciente asociadas al diagnóstico tardío, inespecífico o asociado a resistencia a los antibióticos actuales.Los péptidos antimicrobianos y anti-inflamatorios prometen ser un método terapéutico eficaz, natural, libre de efectos secundarios y adversos en la terapia antimicrobiana e inmuno moduladora futura.Basados en estudios publicados realizados en animales, estos péptidos con capacidad antibacteriana se expresarían en tejidos oculares normales actuando como agentes antimicrobianos de la inmunidad innata del ojo y así también como regulador de la actividad inflamatoria. Estos péptidos antimicrobianos – anti inflamatorios podrían utilizarse para la prevención y tratamiento de procesos infecciosos oculares, en formulaciones simples o combinadas a otras sustancias antibióticas antimicrobianas en forma sinérgica.Secretory leukocyte protease inhibitor (SLPI), terminología anglosajona que se utilizo para definir a una proteína de 12 kDa de peso molecular cuya única función conocida hasta hace unos años era la de ser secretada por leucocitos para inhibir proteasas de la matriz extracelular. El objetivo es estudiar la presencia del péptido antimicrobiano SLPI en relación con el remodelado cicatrizal de la matriz extracelular de la cornea y otras estructuras intra oculares, como así también su expresión en relación a procesos inflamatorios e infecciosos del ojo como agente antimicrobiano de la inmunidad innata del huéspe

Evaluation of oxidative stress markers in human conjunctival epithelial cells exposed to diesel exhaust particles (DEP)

PURPOSE. The aim of this study was to evaluate oxidative stress markers in human conjunctival epithelial cells (IOBA-NHC) exposed to diesel exhaust particles (DEP). METHODS. Reactive oxygen (ROS) and nitrogen (RNS) species production; hydrogen peroxide (H2O2) levels; protein oxidation; antioxidant enzymes activities (superoxide dismutase [SOD], catalase [CAT], glutathione peroxidase [GPx], glutathione S-transferase [GST], and glutathione reductase [GR]); total reactive antioxidant potential (TRAP); reduced (GSH) and oxidized glutathione (GSSG) were evaluated. Transmission electron microscopy was performed to evaluate DEP uptake. RESULTS. Diesel exhaust particles were entrapped by membrane protrusions developed by IOBA-NHC. Cells exposed to DEP 50 and 100 μg/mL showed a significant increase in ROS, RNS, H2O2 levels, SOD, GPx, and GST compared with the control group. A significant decay in GR was observed in both groups, meanwhile CAT levels remained unchanged. The group exposed to DEP 100 μg/mL displayed a significant increase in protein oxidation. In both groups, TRAP was significantly reduced as well as the GSH/GSSG ratio. CONCLUSIONS. The decrease in nonenzymatic antioxidants and the compensatory increase of SOD, GPX, and GST activities are consequence of the increase in ROS and RNS production due to DEP exposure and its accumulation inside the cells. The decay in GR activity leads to the decrease in GSH/GSSG recycling. These results suggest that oxidative stress could play an important role in the development of DEP effects on human conjunctival epithelial cells.Fil: Lasagni Vitar, Romina Mayra. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Bioquímica y Medicina Molecular. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica. Instituto de Bioquímica y Medicina Molecular; ArgentinaFil: Tau, Julia. Universidad de Buenos Aires. Facultad de Medicina. Departamento de Patología; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Reides, Claudia Gabriela. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Bioquímica y Medicina Molecular. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica. Instituto de Bioquímica y Medicina Molecular; ArgentinaFil: Berra, Alejandro. Universidad de Buenos Aires. Facultad de Medicina. Departamento de Patología; ArgentinaFil: Ferreira, Sandra María. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Bioquímica y Medicina Molecular. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica. Instituto de Bioquímica y Medicina Molecular; ArgentinaFil: Llesuy, Susana Francisca. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Bioquímica y Medicina Molecular. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica. Instituto de Bioquímica y Medicina Molecular; Argentin

Guía de práctica clínica sobre el síndrome de fibromialgiga para profesionales de la salud

Este capítulo de libro pretende mostrar algunos de los Test para una valoración global de la condición física saludable y específica del paciente con síndrome de fibromialgia

Polluted Air Exposure Compromises Corneal Immunity and Exacerbates Inflammation in Acute Herpes Simplex Keratitis

Air pollution is a serious environmental issue worldwide in developing countries?megacities, affecting the population?s health, including the ocular surface, bypredisposing or exacerbating other ocular diseases. Herpes simplex keratitis (HSK) iscaused by the herpes simplex virus type 1 (HSV-1). The primary or recurring infection inthe ocular site causes progressive corneal scarring that may result in visual impairment.The present study was designed to study the immunopathological changes of acute HSKunder urban polluted air, using the acute HSK model combined with an experimentalurban polluted air exposure from Buenos Aires City. We evaluated the corneal clinicaloutcomes, viral DNA and pro-inflammatory cytokines by RT-PCR and ELISA assays,respectively. Then, we determined the innate and adaptive immune responses in bothcornea and local lymph nodes after HSV-1 corneal by immunofluorescence staining andflow cytometry. Our results showed that mice exposed to polluted air develop a severeform of HSK with increased corneal opacity, neovascularization, HSV-1 DNA andproduction of TNF-a, IL-1b, IFN-g, and CCL2. A high number of corneal residentimmune cells, including activated dendritic cells, was observed in mice exposed topolluted air; with a further significant influx of bone marrow-derived cells including GR1+ cells (neutrophils and inflammatory monocytes), CD11c+ cells (dendritic cells), and CD3+ (T cells) during acute corneal HSK. Moreover, mice exposed to polluted air showed apredominant Th1 type T cell response over Tregs in local lymph nodes during acute HSKwith decreased corneal Tregs. These findings provide strong evidence that urban pollutedair might trigger a local imbalance of innate and adaptive immune responses thatexacerbate HSK severity. Taking this study into account, urban air pollution should beconsidered a key factor in developing ocular inflammatory diseases.Fil: Sendra, Victor German. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad de Buenos Aires. Facultad de Medicina; ArgentinaFil: Tau, Julia. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad de Buenos Aires. Facultad de Medicina; ArgentinaFil: Zapata, Gustavo Leonardo. Universidad de Buenos Aires; ArgentinaFil: Lasagni Vitar, Romina Mayra. Universidad de Buenos Aires; ArgentinaFil: Illian, Eduardo. Dirección Nacional de Instituto de Investigación.Administración Nacional de Laboratorios e Institutos de Salud "Dr. Carlos G. Malbrán"; ArgentinaFil: Chiaradía, Pablo. Universidad de Buenos Aires; ArgentinaFil: Berra, Alejandro. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad de Buenos Aires. Facultad de Medicina; Argentin