Estudio de la morfología retiniana en sujetos miopes y emétropes

La retina es la capa más interna del globo ocular, tiene capacidad fotosensible y su misión es transformar la luz que recibe en un impulso nervioso que se transforma en las imágenes que percibimos.Cuando no existe un equilibrio entre la longitud axial del globo ocular y su potencia dióptrica, las imágenes que percibimos no focalizan en el plano retiniano y se producen las ametropías (miopía, hipermetropía o astigmatismo). Además, a lo largo de los años, ha sido objeto de estudio la miopía que se produce cuando el ojo se encuentra en condiciones de baja iluminación, denominada miopía nocturna.El objetivo principal del estudio es comprobar si la forma de la retina humana depende del estado refractivo ocular, y si además estos factores dependen de la iluminación. Para ello se han seleccionado 85 sujetos, lo que suponen 170 ojos a estudio, a los cuales se les ha evaluado el estado refractivo con un autorefractómetro y la retina con un OCT, obteniendo los valores de excentricidad y factor de forma tras la aplicación de un nuevo programa de segmentación de imagen basado en ajustes cónicos. Se han tomado las medidas en 3 posiciones lumínicas diferentes.Las conclusiones recabadas tras la evaluación de los resultados fueron que existe una dependencia entre la forma retiniana y el estado refractivo ocular, teniendo estas mayor excentricidad y menor factor de forma cuando mayor es el grado de miopía, tratándose así de retinas más prolatas. No se han obtenido pruebas estadísticamente significativas de que, con los cambios de iluminación, varíe la refracción ocular o la forma retiniana.<br /

Herramientas de comunicación en el aprendizaje de la Bioquímica

Sección Deptal. de Bioquímica y Biología Molecular (Biológicas)Depto. de Bioquímica y Biología MolecularFac. de Ciencias BiológicasFac. de Ciencias QuímicasFALSEsubmitte

Cardiac and vascular effects of diltiazem, dobutamine and amrinone, drugs used after myocardial revascularization

Hemodynamic care during postoperative management of myocardial revascularization should include vasorelaxing drugs to insure adequate graft and coronary flow, and stimulation of stroke volume to maintain vascular perfusion pressure. We tested the cardiac (inotropic and lusitropic) and vascular (relaxant) effects of diltiazem (0.1 nM to 0.1 mM), dobutamine (10 μM to 10 mM) and amrinone (10 μM to 1 mM) on isolated rat atria and thoracic aorta, and also on isolated human saphenous vein (HSV) and human mammary artery (HMA). Dobutamine produced a maximal positive inotropic effect (+dF/dtmax = 29 ± 7%) at its ED50 for aortic relaxation (88 ± 7 μM). Conversely, at their ED50 for aortic relaxation diltiazem depressed myocardial contractility and amrinone did not exhibit myocardial effects. In HSV and HMA contracted with 80 mM potassium, diltiazem and dobutamine (but not amrinone) had a vasorelaxant activity similar to that in rat aorta. Norepinephrine-contracted human vessels were significantly more sensitive than potassium-contracted vessels to the relaxant effect of amrinone (ED50 HMA = 15 ± 5 μM, ED50 HSV = 72 ± 31 μM, P < 0.05). We conclude that at concentrations still devoid of myocardial effects dobutamine and amrinone are effective dilators in graft segment vessels and rat aorta contracted by membrane depolarization. If the difference between aortic and myocardial tissue still holds in human tissues, at the appropriate concentrations these drugs should be expected to improve cardiac performance while still contributing to the maintenance of graft patency.Facultad de Ciencias Exacta

Sistemas de Información Geográfica en Salud Pública: su aplicación al programa de vigilancia y control de la legionelosis

This experience has been developed by the Public Health Institute of the Community of Madrid in order to use the GIS tools in the Legionnaires’ disease prevention programme and specifically in three work areas: epidemiologic surveillance, cooling towers environmental control and plans of intervention in case of an outbreak of Legionnaires’ disease.After having considered different strategies with their advantages the selected model have been the use of map viewers in the intranet with a different configuration format depending on its goals: images map viewers for systematic non-outbreak cases and cooling towers surveillance, viewers that allow an easier and usual consultation and, in the other hand, layers map viewers, better adapted to more complex users’ necessities and so designed to work in emergency situations. Both models are implemented to decentralise the use of these indispensable tools and make them closer of the public health professionals.Some methodological proposals to study spatial association of Legionaires’disease outbreaks are also presented and discussed in this paper.Se presenta la experiencia desarrollada en el Instituto de Salud Pública de la Comunidad de Madrid en el manejo y aplicación de los SIG al programa de legionelosis en tres campos específicos e interrelacionados: la vigilancia de casos esporádicos, la vigilancia sanitario-ambiental de las instalaciones de riesgo y la intervención ante situaciones de alerta en salud pública.Se hace una revisión de los diferentes modelos operativos que se pueden aplicar, sus ventajas e inconvenientes, así como los modelos elegidos en este caso: el uso de visores cartográficos difundidos internamente en la organización vía web, de diferente configuración según su uso en la vigilancia sistemática (tanto de casos como de factores de riesgo medioambiental) o en la atención a situaciones de brotes comunitarios. En el primer caso se ha optado por visores cerrados, de imágenes, que facilitan la consulta sistemática de la situación y en el segundo, por visores de capas, más flexibles en su manejo. En ambos casos se persigue descentralizar el uso de las herramientas imprescindibles por parte de los técnicos de salud pública que trabajan en el territorio.Se revisa asimismo la estructura organizativa puesta en marcha para cumplir los objetivos en la forma diseñada.Por último, se formulan como propuestas metodológicas de abordaje del estudio espacial de brotes las diseñadas a lo largo de la experiencia que se presenta en este artículo

First experiences of monitoring of vancomycin in a General Hospital of Specialties

Introducción: vancomicina es un antibiótico eficaz para el tratamiento de infecciones por gérmenes grampositivos, sin embargo la toxicidad renal asociada a su uso, ha relegado su utilización a líneas secundarias de uso. Este hecho ha consolidado el tratamiento empírico con antibióticos más caros. Objetivo: analizar los datos de monitorización de vancomicina y valorar la eficiencia frente al uso de otros antibióticos. Método: estudio observacional donde se analiza la monitorización farmacocinética de vancomicina y la eficiencia de una Unidad de Farmacocinética Clínica, con una población de 137 pacientes ingresados en un hospital general de especialidades. Resultados: la utilización de vancomicina en primera intención, supuso un ahorro de 16.472,82€ respecto al uso de daptomicina y de 83.039,83€ respecto al de linezolid. No obstante, el 18% de nuestra muestra no pudo ser tratado con vancomicina, lo que hace necesario disponer de otros fármacos.Introduction: vancomycin is an effective antibiotic for the treatment of infections due to Gram-positive germs, however renal toxicity associated with its use, has relegated its use to use secondary lines. This fact has consolidated the empirical treatment with more expensive antibiotics. Objective: to analyze the data of monitoring of vancomycin and rating the efficiency facing the use of other antibiotics. Materials and methods: observational study where discusses monitoring pharmacokinetics of Vancomycin and a unit of pharmacokinetics clinical efficiency, with a population of 137 patients admitted to a general hospital specialties. Results: the use of Vancomycin in first intention meant a savings of € 16.472,82 regarding the use of € 83.039,83 the linezolid and daptomycin. However, 18% of our sample not could be treated with Vancomycin, making it necessary to have other drugs.The authors have received no payment in the preparation of this manuscript/ Los autores no han recibido financiación alguna durante la preparación de este manuscrito

Aplicación de la metodología Aprendizaje - Servicio a alumnos que cursan el Máster en Economía Internacional y Desarrollo

Depto. de Economía Aplicada, Estructura e HistoriaFac. de Ciencias Económicas y EmpresarialesFALSEsubmitte

The Myeloid-Epithelial-Reproductive Tyrosine Kinase (MERTK) rs4374383 Polymorphism Predicts Progression of Liver Fibrosis in Hepatitis C Virus-Infected Patients: A Longitudinal Study

BACKGROUND: The myeloid-epithelial-reproductive tyrosine kinase (MERTK) is involved in hepatic steatosis, inflammation, and liver fibrosis. Here we evaluated the association between the MERTK rs4374383 single nucleotide polymorphism (SNP) and liver fibrosis progression in hepatitis C virus (HCV)-infected patients. METHODS: We performed a retrospective study (repeated measures design) in 208 patients who had liver stiffness measurement (LSM), which was assessed using transient elastography. No patient had cirrhosis at baseline (LSM ≥ 12.5 kPa). RESULTS: At baseline, 53.8% were male, the median age was 47.1 years, 13.5% reported a high intake of alcohol, 10.1% were prior injection drug users, 85.3% were infected with HCV genotype 1, and 22.6% had previously failed antiviral therapy (pegylated-interferon-alpha/ribavirin). During a median follow-up of 46.6 months, 26 patients developed cirrhosis. The rs4374383 G carriers had a higher risk of increasing LSM (adjusted arithmetic mean ratio (aAMR) = 1.14; p = 0.006) and a higher likelihood of having an increase in LSM greater than 5 kPa (ΔLSM ≥ 5 kPa) (adjusted odds ratio (aOR) = 2.37; p = 0.029), and greater than 7 kPa (ΔLSM ≥ 7 kPa) (aOR = 3.24; p = 0.032), after controlling for confounding. The SNP's association with cirrhosis progression was close to statistical significance (aOR = 2.18; p = 0.070). CONCLUSIONS: MERTK rs4374383 A carriers had a lower risk of liver fibrosis progression than G carriers, supporting the hypothesis that this SNP seems to have a critical role in the pathogenesis of liver disease in HCV-infected patients.This work has been supported by grants given by Instituto de Salud Carlos III (ISCIII) (grant numbers PI14CIII/00011 and PI17CIII/00003 to SR). AFR is also supported by ISCIII (grant numbers CP14CIII/00010).S

Primary cardiac fibroma in infants: A case report and review of cases of cardiac fibroma managed through orthotopic heart transplant

Cardiac fibromas (CF) are the second most common cardiac tumors in children. They can be aggressive tumors despite their benign histopathologic nature, accounting for the highest mortality rate among primary cardiac tumors. CF usually show a progressive growth and spontaneous regression is rare. Therefore, a complete surgical excision is the preferred therapeutic approach when patients become symptomatic or if mass-related life-threatening complications are anticipated, even in asymptomatic patients. However, some cases are not good candidates for surgical excision due to the impossibility of preserving a normal cardiac anatomy or function after the tumor resection. Orthotopic heart transplantation (OHT) can be an exceptional but adequate alternative for some giant unresectable CF in children. In this article, we report our experience with the case of a 7-month-old infant with a giant unresectable cardiac fibroma who was successfully managed through OHT.Ye

Cardiac and vascular effects of diltiazem, dobutamine and amrinone, drugs used after myocardial revascularization

Hemodynamic care during postoperative management of myocardial revascularization should include vasorelaxing drugs to insure adequate graft and coronary flow, and stimulation of stroke volume to maintain vascular perfusion pressure. We tested the cardiac (inotropic and lusitropic) and vascular (relaxant) effects of diltiazem (0.1 nM to 0.1 mM), dobutamine (10 μM to 10 mM) and amrinone (10 μM to 1 mM) on isolated rat atria and thoracic aorta, and also on isolated human saphenous vein (HSV) and human mammary artery (HMA). Dobutamine produced a maximal positive inotropic effect (+dF/dtmax = 29 ± 7%) at its ED50 for aortic relaxation (88 ± 7 μM). Conversely, at their ED50 for aortic relaxation diltiazem depressed myocardial contractility and amrinone did not exhibit myocardial effects. In HSV and HMA contracted with 80 mM potassium, diltiazem and dobutamine (but not amrinone) had a vasorelaxant activity similar to that in rat aorta. Norepinephrine-contracted human vessels were significantly more sensitive than potassium-contracted vessels to the relaxant effect of amrinone (ED50 HMA = 15 ± 5 μM, ED50 HSV = 72 ± 31 μM, P < 0.05). We conclude that at concentrations still devoid of myocardial effects dobutamine and amrinone are effective dilators in graft segment vessels and rat aorta contracted by membrane depolarization. If the difference between aortic and myocardial tissue still holds in human tissues, at the appropriate concentrations these drugs should be expected to improve cardiac performance while still contributing to the maintenance of graft patency.Facultad de Ciencias Exacta