Nuevas técnicas y avances en el tratamiento de la ambliopía en niños

La ambliopía se define como la disminución de la agudeza visual (AV) que aparece cuando la corteza visual recibe una información mal coordinada procedente del sistema binocular. Si las causas que afectan a esta mala recepción de la información no se corrigen en una fase temprana del desarrollo visual, se producirán modificaciones en la red neuronal. Un paciente ambliope no solo presenta una disminución de la AV, sino que también tiene afectadas la estereopsis y sensibilidad al contraste. El tratamiento clásico de la ambliopía es la oclusión mediante un parche del ojo no ambliope. El cumplimiento del tratamiento clásico es complicado ya que no todos los niños quieren llevar el parche, pues al ocluirles el ojo de mejor visión presentan una AV muy pobre, o incluso son los propios padres los que no quieren. Por este motivo, surgen nuevas formas de tratamiento para la ambliopía. El objetivo de este trabajo de carácter bibliográfico será conocer los nuevos métodos o técnicas más novedosas que se manejan en la actualidad para el tratamiento de la ambliopía, determinando cual es el más adecuado para cada tipo de ambliopía, así como la efectividad que estos presentan. Por ello, se realizó una búsqueda bibliográfica de artículos que incluyeran la combinación de las siguientes palabras claves: “Amblyopia”, “Therapy” y “New treatment”. Gracias a los resultados obtenidos en la búsqueda, se llegó a la conclusión de que el tratamiento más utilizado y efectivo para la ambliopía estrábica y refractiva es la combinación del tratamiento clásico junto al uso de videojuegos de forma monocular y binocular. En segundo lugar, para la ambliopía por deprivación debido a una catarata congénita la única forma de tratamiento es la cirugía intraocular. Después, con el tratamiento farmacológico se consiguen beneficios, pero se necesitan más ensayos clínicos en los que se determine su eficacia y las dosis adecuadas y, por último, son precisos más estudios que comparen los efectos beneficiosos de la fototerapia sintónica frente a otros tratamientos de la ambliopía.Amblyopia is defined as the decrease in visual acuity (AV) that appears when the visual cortex receives poorly coordinated information from the binocular system. If the causes that affect this poor reception of the information are not corrected at an early stage of visual development, changes will occur in the neural network. A patient amblyopic not only has a decrease in the AV, but also has affected the stereopsis and sensitivity to contrast. The classic treatment of amblyopia is occlusion by a patch of the non-amblyopic eye. The compliance of the classic treatment is complicated since not all the children want to carry the patch, because by occluding them the eye of better vision presents a very poor AV, or even the parents themselves who do not want. For this reason, new forms of treatment for amblyopia arise. The objective of this work of bibliographic character will be to know the new methods or newer techniques that are managed at present for the treatment of amblyopia, determining which is the most suitable for each type of amblyopia, as well as the effectiveness that these present. Therefore, a bibliographical search of articles was carried out that included the combination of the following keywords: "Amblyopia", "Therapy" and "New treatment". Thanks to the results obtained in the search, it was concluded that the most used and effective treatment for strabismic and refractive amblyopia is the combination of classic treatment together with the use of video games in Monocular and binocular form. Second, for deprivation amblyopia due to a congenital cataract the only form of treatment is intraocular surgery. Then, with pharmacological treatment, benefits are achieved, but more clinical trials are needed to determine their efficacy and appropriate doses and, finally, more studies are needed to compare the beneficial effects of Syntonic phototherapy Compared to other treatments of amblyopia.Universidad de Sevilla. Grado en Óptica y Optometrí

Eyelid Exfoliation Treatment Efficacy and Safety in Dry Eye Disease, Blepharitis, and Contact Lens Discomfort Patients: A Systematic Review

Purpose: To determine the efficacy and safety of eyelid exfoliation treatment in dry eye disease (DED), blepharitis, and contact lens (CL) discomfort patients. Methods: A systematic review that included only full-length randomized controlled studies, reporting the effects of eyelid exfoliation treatment in 2 databases, PubMed and Web of Science, was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. The search period was between October 29, 2022 and December 6, 2022. The Cochrane risk of bias tool was used to analyze the quality of the studies selected. Results: A total of 7 studies were included in this systematic review. Eyelid exfoliation treatment influence on DED, blepharitis, and CL discomfort were analyzed in 6, 4, and 2 studies, respectively. Eyelid exfoliation treatment achieved a better improvement than control group interventions in all reported variables. The mean differences between both groups were as follows: Ocular Surface Disease Index score of-5.0 ± 0.9 points, tear breakup time of 0.43 ± 0.2 seconds, ocular surface staining of-1.4 ± 1.5 points, meibomian glands secretions of 1.2 ± 1.1 points, meibomian glands yielding liquid secretion of 0.6 ± 0.3 points, microorganism load of-3.2 ± 4.7 points, and Contact Lens Dry Eye Questionnaire-8 of-2.15 ± 0.1 points. Minimal discomfort (n = 13) and eyelid irritation (n = 2) were the main complications after an eyelid exfoliation treatment. Conclusions: Eyelid exfoliation is a safe and effective treatment that should be indicated for DED, blepharitis, and CL discomfort

How children and adults keep track of real information when thinking counterfactually

This research was funded by grants from the Spanish Government, Ministry of Economy and Competitiveness (PSI2015-63505-P; PGC2018095868-B-I00) to SM and the Education, Culture and Sport Ministry (FPU15/05899) to JG. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.We are very grateful to the schools for their assistance with data collection and to the directors, teachers and children for their cooperation. Finally, we wish to thank Ruth Byrne and Cristina Vargas for their helpful comments.Thinking about counterfactual conditionals such as “if she had not painted the sheet of paper, it would have been blank” requires us to consider what is conjectured (She did not paint and the sheet was blank) and what actually happened (She painted and the sheet was not blank). In two experiments with adults (Study 1) and schoolchildren from 7 to 13 years (Study 2), we tested three potential sources of difficulty with counterfactuals: inferring, distinguishing what is real vs conjectured (epistemic status) and comprehending linguistic conditional expressions (“if” vs “even if”). The results showed that neither adults nor schoolchildren had difficulty in the comprehension of counterfactual expressions such as “even if” with respect to “if then”. The ability to infer with both of these develops during school years, with adults showing great ability. However, the third source factor is critical: we found that the key to young children’s difficulty with counterfactual thinking was their inability to differentiate real and conjectured information, while adults showed little difficulty with this.Spanish Government, Ministry of Economy and Competitiveness PSI2015-63505-P PGC2018095868-B-I00Education, Culture and Sport Ministry FPU15/0589

Worldwide Research Trends on Solar-Driven Water Disinfection

“Ensure access to water for all”, states Goal 6 of the UN’s Sustainable Development Goals. This worldwide challenge requires identifying the best water disinfection method for each scenario. Traditional methods have limitations, which include low effectiveness towards certain pathogens and the formation of disinfection byproducts. Solar-driven methods, such as solar water disinfection (SODIS) or solar photocatalysis, are novel, effective, and financially and environmentally sustainable alternatives. We have conducted a critical study of publications in the field of water disinfection using solar energy and, hereby, present the first bibliometric analysis of scientific literature from Elsevier’s Scopus database within the last 20 years. Results show that in this area of growing interest USA, Spain, and China are the most productive countries in terms of publishing, yet Europe hosts the most highly recognized research groups, i.e., Spain, Switzerland, Ireland, and UK. We have also reviewed the journals in which researchers mostly publish and, using a systematic approach to determine the actual research trends and gaps, we have analyzed the capacity of these publications to answer key research questions, pinpointing six clusters of keywords in relation to the main research challenges, open areas, and new applications that lie ahead. Most publications focused on SODIS and photocatalytic nanomaterials, while a limited number focused on ensuring adequate water disinfection levels, testing regulated microbial indicators and emerging pathogens, and real-world applications, which include complex matrices, large scale processes, and exhaustive cost evaluation

Updating the Master Management Plan for El Cachucho MPA (Cantabrian Sea) using a spatial planning approach

Located in the Cantabrian Sea (NE Atlantic), 30 nm off the Asturian coast, “El Cachucho” was the first off-shore Marine Protected Area (MPA) to be declared in Spain. The area includes Le Danois Bank and its intraslope basin. It joined the OSPAR Network of MPAs in 2009 and, thereafter, was included in the Natura 2000 Network in 2011. The main reason for its declaration as MPA was the presence of the 1170 Reefs habitat included in Annex I of the EU Habitats Directive. In 2018, the MPAs Master Management Plan was under revision and its design criteria were subjected to evaluation. We used Marxan decision support tool to evaluate the MPA's management design criteria. This tool selects the most important conservation features, while minimizing the socioeconomic cost. First, the 1170 Reefs habitat was defined as the main environmental value. Specifically, we took into account the six large sized target species that are more representative of this habitat in the area: the sponges Asconema setubalense, Geodia cf. barretti and Phakellia robusta, the anthipatarian Leiopathes glaberrima, and the gorgonians Placogorgia sp. and Callogorgia verticillata. A spatial distribution map was produced for each species using Generalized Additive Models (GAM). We also considered the presence of spawning stocks of fish species which are present in the area as an important conservation value. Their spatial distribution was modeled through Maxent software. Additionally, for the socioeconomic cost, fishing effort of the different fisheries operating in the area was estimated linking VMS/Logbook data before and after the MPA was declared. The first results obtained with the Marxan tool were presented in public consultation, in the context of the LIFE + INTEMARES Project, to help in decision making within the new Management Plan. Thus, to improve the management measures aimed at the conservation of the environmental values of the MPA, an enlargement of the protected area to the West was proposed, and a more reasonable use of the buffer area to fishermen than that defined in the former Management Plan was suggested. Involving all stakeholders in the development of the management plan for this MPA is a decisive step for the creation and consolidation of an important network of MPAs in Spain.En prensa2,08

Efectos de #quédateencasa: una primera aproximación a partir de datos de uso del tiempo

La crisis sanitaria global, que fue originada por el coronavirus SARS-Cov-2 a finales de 2019 en China deja, por ahora, muchas incertidumbres y pocas certezas. Entre estas últimas están la transversalidad y la enorme magnitud del impacto que este episodio tendrá sobre nuestras costumbres, presentes y futuras. Una perspectiva comparada nos permite identificar el principal instrumento que se viene aplicando en la totalidad de los países afectados, una vez los contagios –locales- se hacen más evidentes: el confinamiento total/parcial de la población y su aislamiento social con el objetivo de ralentizar, en la medida de lo posible, la transmisión del virus; esto es, hacer descender el número reproductivo básico de la epidemia. El confinamiento total vigente a la fecha de elaboración de este documento en España (7 de abril de 2020) habría conseguido, de acuerdo a Flaxman et al. (2020), hacer descender este número a la mitad, según se puede observar en el siguiente gráfico, mientras que medidas parciales tales como la distancia social o el cierre de colegios no parecen haber sido tan efectivas

El laboratorio de inmunología en el diagnóstico y control de las enfermedades autoinmunitarias sistémicas (I): protocolo de estudio ante la sospecha clínica

Inclou referències bibliogràfique

Schizophrenia risk conferred by rare protein-truncating variants is conserved across diverse human populations

Schizophrenia (SCZ) is a chronic mental illness and among the most debilitating conditions encountered in medical practice. A recent landmark SCZ study of the protein-coding regions of the genome identified a causal role for ten genes and a concentration of rare variant signals in evolutionarily constrained genes1. This recent study—and most other large-scale human genetics studies—was mainly composed of individuals of European (EUR) ancestry, and the generalizability of the findings in non-EUR populations remains unclear. To address this gap, we designed a custom sequencing panel of 161 genes selected based on the current knowledge of SCZ genetics and sequenced a new cohort of 11,580 SCZ cases and 10,555 controls of diverse ancestries. Replicating earlier work, we found that cases carried a significantly higher burden of rare protein-truncating variants (PTVs) among evolutionarily constrained genes (odds ratio = 1.48; P = 5.4 × 10−6). In meta-analyses with existing datasets totaling up to 35,828 cases and 107,877 controls, this excess burden was largely consistent across five ancestral populations. Two genes (SRRM2 and AKAP11) were newly implicated as SCZ risk genes, and one gene (PCLO) was identified as shared by individuals with SCZ and those with autism. Overall, our results lend robust support to the rare allelic spectrum of the genetic architecture of SCZ being conserved across diverse human populations.United States Department of Health & Human Services National Institutes of Health (NIH) - USA NIH National Institute of Mental Health (NIMH) R01MH109536 R01MH118278 R01MH124839 U01MH109536UK Research & Innovation (UKRI) Medical Research Council UK (MRC)Janette Mary O'Neil Research FellowshipNational Health and Medical Research Council (NHMRC) of AustraliaInstituto de Salud Carlos III Spanish GovernmentEuropean Regional Development Fund/European Social Fund A Way to Make Europe/Investing in Your FutureInstituto de Salud Carlos III Spanish GovernmentEuropean Regional Development Fund Funds from the European Commission, A Way of Making EuropeCentro de Investigacion Biomedica en Red de Salud Mental, Madrid Regional GovernmentFundacion Familia Alonso MR/L010305/1 MR/P005748/1Fundacion Alicia Koplowitz 1R01MH124851European Regional Development Fund Funds from the European Commission R01MH100125 1I01CX000995Ministry of Health, Italy P50MH066392Takeda Pharmaceutical Company LtdHoffmann-La RocheHoffmann-La RocheUnited States Department of Health & Human Services National Institutes of Health (NIH) - USA 1037196 1176716United States Department of Health & Human Services National Institutes of Health (NIH) - USA NIH National Institute of Mental Health (NIMH) 513861Australian Schizophrenia Research Bank PI18/00238 PI18/00467 B2017/BMD-3740 AGES-CM-2 115916 777394Neuroscience Research Australia PI18/00213 CPII21/00008 MS16/00153 PI19/024 R01MH085542 R01MH093725 P50MH080405 R01MH097276 RO1MH-075916 P50M096891 P50MH084053S1 R37MH057881 AG02219 AG05138 MH06692 R01MH110921 R01MH109677 R01MH109897 U01MH103392 U01MH116442 ZIC MH002903 HHSN271201300031C R01AG067025 R01AG065582 R01AG050986 R01MH125246 R01MH10605

Tear Film Stabilization and Symptom Improvement in Dry Eye Disease: The Role of Hyaluronic Acid and Trehalose Eyedrops versus Carmellose Sodium

This study evaluated the effectiveness of hyaluronic acid and trehalose (HA/trehalose) eyedrops in managing dry eye disease (DED) symptoms by measuring tear stability and administering a DED questionnaire. Sixty patients were treated with either HA/trehalose eyedrops (Tear A) or carmellose sodium eyedrops (Tear B) as controls. The tear breakup time (TBUT) and non-invasive breakup time (NIBUT) were monitored, and patients completed the standard patient evaluation of eye dryness (SPEED) questionnaire. After two months of twice-daily applications, patients treated with the HA/trehalose eyedrops demonstrated significant improvements in the NIBUT (12.98 ± 3.22 s) and TBUT (12.95 ± 2.98 s), indicating increased tear stability. Moreover, they reported lower dry eye sensation (6.70 ± 4.94 SPEED score points), suggesting a reduction in DED symptoms. These findings underscore the efficacy of HA/trehalose eyedrops in improving both the objective and subjective signs of DED, with twice-daily application enhancing ocular surface conditions and reducing patient-reported symptoms. © 2023 by the authors

Choroidal thickness assessment in keratoconus patients treated with cross-linking compared to healthy population.

Purpose: To analyze the choroidal thickness between patients with keratoconus undergoing cross-linking treatment and a healthy population, as well as to determine the factors that influence choroidal thickness. Methods: This was an observational, analytical, case–control study that was conducted from February 2021 to June 2021. Choroidal thickness was measured at different locations, including the subfoveal, nasal (1000 μm), temporal (1000 μm), superior (1000 μm) and inferior (1000 μm) locations using a Spectral-domain optical coherence tomography with enhanced depth imaging, which allowed us to obtain horizontal and vertical B-scans centered on the fovea. Results: This study included 21 patients with keratoconus (mean age, 21.86 ± 5.28 years) and 28 healthy patients (mean age, 24.21 ± 4.71 years). Choroidal thickness was significantly greater in patients with keratoconus than in healthy patients in each of the following measured locations: subfoveal (P < 0.001); nasal (1000 μm) (P < 0.001), temporal (1000 μm) (P < 0.001), superior (1000 μm) (P < 0.001) and inferior (1000 μm) (P < 0.001) locations. Variables such as age (ρ = − 0.09; P = 0.50) and refraction (ρ = 0.14; P = 0.34) were not found to be associated with choroidal thickness. In a stepwise multiple linear regression, the group was the single variable correlated with choroidal thickness (β = 0.88; P < 0.001). Conclusion: Choroidal thickness is thicker in keratoconus patients treated with cross-linking than in the healthy population. This finding could be associated with inflammatory choroidal mechanisms in keratoconus patients, but more studies are needed. Age and refractive error do not seem to influence choroidal thickness. © 2022, The Author(s), under exclusive licence to Springer Nature B.V