Estudio del perfil de citoquinas en la lágrima y el humor acuoso de pacientes con glaucoma

El glaucoma es la pérdida adquirida de células ganglionares y axones del nervio óptico, que resulta en alteraciones características de la cabeza del nervio óptico y del campo visual. El glaucoma es la segunda causa de ceguera irreversible en países desarrollados. El glaucoma primario de ángulo abierto (GPAA) constituye el tipo más frecuente de glaucoma en Europa, mientras que el glaucoma pseudoexfoliativo (GPX) es la primera causa de glaucoma secundario de ángulo abierto. Aunque el principal factor de riesgo es la presión intraocular (PIO), es probable que la inflamación de bajo grado participe en la patogenia. Los modelos animales demuestran una inflamación en la retina y el nervio óptico. También, mecanismos inflamatorios similares en la cámara anterior podrían explicar la disfunción de la malla trabecular. El tratamiento se basa en el uso de fármacos hipotensores tópicos, indicándose una cirugía cuando la terapia médica no es eficaz o hay riesgo de progresión de la enfermedad. La trabeculectomía es la técnica quirúrgica principal y la cicatrización de la esclera y la conjuntiva es un factor crucial en su éxito dado que determina la filtración de la ampolla. Además, es posible que las características del humor acuoso puedan afectar a la cicatrización tras la cirugía. En los últimos años, se ha detectado que niveles intraoculares aumentados de múltiples citoquinas proinflamatorias podrían contribuir a la patogénesis de algunas enfermedades oftalmológicas y aportar información relevante sobre la fisiopatología de la enfermedad, su tratamiento, su gravedad y el pronóstico de la cirugía..

Implementación de la metodología Lean Manufacturing en un taller de mecanizados y calderería

Este trabajo fin de grado es fruto de la realización de unas prácticas en una pequeña empresa de fabricación de estructuras metálicas y mecanizados. El trabajo propone la búsqueda de soluciones que permitan optimizar la producción reduciendo despilfarros y actividades que no añadan valor al producto. Para la búsqueda de soluciones nos apoyaremos en la metodología Lean Manufacturing para la mejora de tiempos y costes en sus procesos. Esta filosofía demuestra que, con técnicas sencillas, se pueden obtener resultados muy satisfactorios. A pesar de que esta metodología va aplicada a grandes empresas, en este estudio comprenderemos que también se puede aplicar a pequeñas empresas. ABSTRACT The aim of this project, wich started during an internship in a small manufacturer of metal structures and machining, is the pursuit of possible solutions to the industry problems, such as reducting waste and deleting activities which did not add value to the product. In order to look for possible solutions, this project will support itself in the Lean Manufacturing technique, improving the timing and reducting costs. This philosophy proves that, with some simple techniques, it is possible to reach satisfying results. Despite this technique is is normally applied in big manufacturers, in this project we will prove that exists the possibility of applying it in small companies.Departamento de Ciencias de los Materiales e Ingeniería Metalúrgica, Expresión Gráfica en la Ingeniería, Ingeniería Cartográfica, Geodesia y Fotogrametría, Ingeniería Mecánica e Ingeniería de los Procesos de FabricaciónGrado en Ingeniería Mecánic

A case of atypical disseminated herpes simplex virus 1 with hepatitis in a liver transplant recipient: the need for dermatologic evaluation

Disseminated herpes simplex virus (HSV) is mainly seen in immunocompromised individuals. Atypical lesions can be present in both primary infection and reactivation disease. Compared with the general population, inmunocompromised hosts are at greater risk of increased persistency and severity of clinical manifestations, including severe systemic involvement such as esophagitis, meningitis, and hepatitis. Herein, we report the case of a liver transplant recipient with atypical disseminated herpes simplex virus-1 complicated by HSV-related hepatitis. Dermatological consultation and histological assessment were crucial for a correct diagnosis and treatment

Purpureocillium lilacinum fungal keratitis: Confocal microscopy diagnosis and histopathology correlation

Disponible online el 1 de Diciembre de 2020. In Press, Corrected Proof.Unidad Docente de Inmunología, Oftalmología y ORLFac. de Óptica y OptometríaTRUEinpres

Effects of COVID-19 pandemic on glaucoma appointment scheduling in a tertiary hospital in London, UK

PURPOSE: To investigate the impact of the delay in patient appointments caused by the COVID-19 pandemic and the triage system on the glaucomatous disease of patients in a London tertiary hospita METHODS: Observational retrospective study that randomly selected 200 glaucoma patients with more than 3 months of unintended delay for their post-COVID visit and other inclusion and exclusion criteria. Demographic information, clinical data, number of drugs, best-corrected visual acuity (BCVA), intraocular pressure (IOP), visual field (VF) mean deviation (MD), and global peripapillary retinal nerve fibre layer (pRNFL) thickness were obtained from the pre- and post-COVID visit. At the post-COVID visit, the clinical outcomes subjective clinical concern and change of treatment or need for surgery were also annotated. The variables were stratified by glaucoma severity (according to the MD into early, moderate and advanced) and by delay time (more and less than 12 months) and analysed using SPSS. RESULTS: We included 121 eyes (from 71 patients). The median patient age was 74 years (interquartile range -IQR- 15), 54% were males and 52% Caucasians. Different glaucoma types and all glaucoma severities were included. When data was stratified for glaucoma severity, at the pre-COVID visit, significant differences in BCVA, CCT and IOP were observed and there were significantly higher values in the early glaucoma group. The median follow-up delay was 11 months (IQR 8), did not differ between the glaucoma severity groups and did not correlate to the glaucoma severity. At the post-COVID visit, significant differences in BCVA, IOP, and Global pRNFL thickness were observed between the glaucoma severity groups, as lower BCVA and higher IOP and pRNFL thickness were observed in the early glaucoma group. At the post-COVID visit there was cause for concern in 40 eyes: 5 were followed more closely, 22 had a change of treatment and 13 were booked for surgery (3 for cataract and 10 for glaucoma surgery). However, the number of eyes with causes for concern were similar between the glaucoma severity groups and there was no correlation between these clinical outcomes and the delay of the post-COVID visit. The number of topical hypotensive medications increased significantly after the post-COVID visit, higher number of medications were observed in the advanced glaucoma group. When differences of IOP, MD and pRNFL thickness between the pre and post-COVID visit, only the MD difference was significantly different between the glaucoma severity groups because it was higher in the severe group. When data was stratified for delay longer or shorter than 12 months, no differences were observed between the groups except at the pre-COVID visit, when the numbers of patients with MD deviation >−6 dB had longer delay time. When differences in IOP, MD and RNFL thickness were calculated, only the pRNFL thickness showed significant differences between the delay groups, because it was higher in the longer delay group. Finally, when paired analysis of the variables at the pre- and post-COVID visits, stratified by glaucoma severity and delay were conducted, although there were no significant differences in IOP in any group, the BCVA decreased significantly in the overall group and in the longer delay groups, the number of hypotensive drugs increased significantly overall and in the moderate and advanced glaucoma, the MD of the VF worsened significantly in the overall group and in the early glaucoma and longer delay groups and the pRNFL thickness decreased significantly in all groups. CONCLUSIONS: We document that delayed care impacts negatively on the glaucomatous disease of our patients because at the post-COVID visit there were reasons for clinical concern in a third of eyes that resulted in change of treatment or surgery. However, these clinical consequences were not related to IOP, glaucoma severity or delay time and reflect that the triage methods implemented worked adequately. The most sensitive parameter to indicate progression in our sample was the pRNFL thickness

Novel Insights into the Transmission of SARS-CoV-2 Through the Ocular Surface and its Detection in Tears and Conjunctival Secretions: A Review

SARS-CoV-2 is a highly transmissible virus that spreads mainly via person-to-person contact through respiratory droplets, or through contact with contaminated objects or surfaces from an infected person. At present we are passing through a phase of slow and painful understanding of the origin, epidemiological profile, clinical spectrum, and risk profile of the virus. To the best of our knowledge there is only limited and contradictory evidence concerning SARS-CoV-2 transmission through other routes. Importantly, the eye may constitute not only a potential site of virus replication but also an alternative transmission route of the virus from the ocular surface to the respiratory and gastrointestinal tract. It is therefore imperative to gain a better insight into the potential ophthalmological transmission route of the virus and establish directions on best practice and future models of care for ophthalmological patients. This review article critically evaluates available evidence on the ophthalmological mode of viral transmission and the value of earlier identification of the virus on the eye. More evidence is urgently needed to better evaluate the need for protective measures and reliable ocular diagnostic tests to diminish further pandemic spread

Evaluation of a Novel Αb Εxterno MicroShunt for the Treatment of Glaucoma

The surgical management of glaucoma has been revolutionized by the introduction of minimally invasive glaucoma surgery (MIGS). The various MIGS options aim to meaningfully lower intraocular pressure with a better safety profile than traditional glaucoma surgery. The key clinical attributes and the emerging potential of an ab externo MicroShunt (PreserFlo™) are reviewed in the context of published evidence and clinical experience. This novel MicroShunt consists of an 8.5-mm-long tube that is implanted in the eye via an ab externo approach enabling aqueous humor drainage into the sub-Tenon's space through the formation of a bleb, similar in appearance to that created by trabeculectomy. The efficacy and safety of this procedure, the concomitant use of antimetabolites, the impact of tube positioning, and its future value in clinical practice are critically reviewed. Recent evidence has demonstrated the MicroShunt to be less effective than traditional filtration surgery, but with a significant improvement in safety. Cumulative data suggest that the new implant provides tangible clinical benefits to selected patients with glaucoma in need of further intraocular pressure (IOP) lowering. Future research should delineate the precise role of this and other MIGS options in the rapidly evolving glaucoma treatment algorithm.Unidad Docente de Inmunología, Oftalmología y ORLDepto. de Inmunología, Oftalmología y ORLFac. de Óptica y OptometríaFac. de MedicinaTRUEpu

Robust Crop and Weed Segmentation under Uncontrolled Outdoor Illumination

An image processing algorithm for detecting individual weeds was developed and evaluated. Weed detection processes included were normalized excessive green conversion, statistical threshold value estimation, adaptive image segmentation, median filter, morphological feature calculation and Artificial Neural Network (ANN). The developed algorithm was validated for its ability to identify and detect weeds and crop plants under uncontrolled outdoor illuminations. A machine vision implementing field robot captured field images under outdoor illuminations and the image processing algorithm automatically processed them without manual adjustment. The errors of the algorithm, when processing 666 field images, ranged from 2.1 to 2.9%. The ANN correctly detected 72.6% of crop plants from the identified plants, and considered the rest as weeds. However, the ANN identification rates for crop plants were improved up to 95.1% by addressing the error sources in the algorithm. The developed weed detection and image processing algorithm provides a novel method to identify plants against soil background under the uncontrolled outdoor illuminations, and to differentiate weeds from crop plants. Thus, the proposed new machine vision and processing algorithm may be useful for outdoor applications including plant specific direct applications (PSDA)

Use of Alkylarsonium Directing Agents for the Synthesis and Study of Zeolites

This is the peer reviewed version of the following article: Chem. Eur. J. 2019, 25, 16390 16396 , which has been published in final form at https://doi.org/10.1002/chem.201904043. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.[EN] Expanding the previously known family of -onium (ammonium, phosphonium, and sulfonium) organic structure-directing agents (OSDAs) for the synthesis of zeolite MFI, a new member, the arsonium cation, is used for the first time. The new group of tetraalkylarsonium cations has allowed the synthesis of the zeolite ZSM-5 with several different chemical compositions, opening a route for the synthesis of zeolites with a new series of OSDA. Moreover, the use of As replacing N in the OSDA allows the introduction of probe atoms that facilitate the study of these molecules by powder X-ray diffraction (PXRD), solid-state nuclear magnetic resonance (MAS NMR), and X-ray absorption spectroscopy (XAS). Finally, the influence of trivalent elements such as B, Al, or Ga isomorphically replacing Si atoms in the framework structure and its interaction with the As species has been studied. The suitability of the tetraalkylarsonium cation for carrying out the crystallization of zeolites is demonstrated along with the benefit of the presence of As atoms in the occluded OSDA, which allows its advanced characterization as well as the study of its evolution during OSDA removal by thermal treatments.Program Severo Ochoa SEV-2016-0683 and Maria de Maeztu MDM-2015-0538 are gratefully acknowledged. S.S-F. thanks MEC for his Severo Ochoa Grant SPV-2013-067884, P.O.-B. and G.M.E. thank MEC for his Ramon y Cajal contracts (RYC-2014-16620 and RYC-2013-14386). The authors thank the financial support by the Spanish Government (RTI2018-096399-A-I00, RTI2018-101784-B-I00 and CTQ2017-89528-P) and the Generalitat Valeciana (PROMETEO/2017/066). The Electron Microscopy Service of the UPV is acknowledged for their help in sample characterization. We gratefully acknowledge ESRF synchrotron for allocating beamtime (proposal CH-5193), the Italian CRG beam-line at ESRF (LISA-BM08), and Alessandro Puri for the help and technical support during our experiment. C.W.L. (Science without Frontiers-Process no. 13191/13-6) thanks CAPES for a predoctoral fellowship.Saez-Ferre, S.; Lopes, CW.; Simancas-Coloma, J.; Vidal Moya, JA.; Blasco Lanzuela, T.; Agostini, G.; Mínguez Espallargas, G.... (2019). Use of Alkylarsonium Directing Agents for the Synthesis and Study of Zeolites. Chemistry - A European Journal. 25(71):16390-16396. https://doi.org/10.1002/chem.201904043S16390163962571Sun, J., Bonneau, C., Cantín, Á., Corma, A., Díaz-Cabañas, M. J., Moliner, M., … Zou, X. (2009). The ITQ-37 mesoporous chiral zeolite. Nature, 458(7242), 1154-1157. doi:10.1038/nature07957Jiang, J., Yu, J., & Corma, A. (2010). Extra-Large-Pore Zeolites: Bridging the Gap between Micro and Mesoporous Structures. Angewandte Chemie International Edition, 49(18), 3120-3145. doi:10.1002/anie.200904016Jiang, J., Yu, J., & Corma, A. (2010). Zeolithe mit sehr großen Poren als Bindeglied zwischen mikro- und mesoporösen Strukturen. Angewandte Chemie, 122(18), 3186-3212. doi:10.1002/ange.200904016Shayib, R. M., George, N. C., Seshadri, R., Burton, A. W., Zones, S. I., & Chmelka, B. F. (2011). Structure-Directing Roles and Interactions of Fluoride and Organocations with Siliceous Zeolite Frameworks. Journal of the American Chemical Society, 133(46), 18728-18741. doi:10.1021/ja205164uInternational Zeolite Association Website http://www.iza-online.org/(accessed October 4 2018).Pinar, A. B., McCusker, L. B., Baerlocher, C., Hwang, S.-J., Xie, D., Benin, A. I., & Zones, S. I. (2016). Synthesis and structural characterization of Zn-containing DAF-1. New Journal of Chemistry, 40(5), 4160-4166. doi:10.1039/c5nj02897cDorset, D. L., Kennedy, G. J., Strohmaier, K. G., Diaz-Cabañas, M. J., Rey, F., & Corma, A. (2006). P-Derived Organic Cations as Structure-Directing Agents:  Synthesis of a High-Silica Zeolite (ITQ-27) with a Two-Dimensional 12-Ring Channel System. Journal of the American Chemical Society, 128(27), 8862-8867. doi:10.1021/ja061206oCorma, A., Diaz-Cabanas, M. J., Jorda, J. L., Rey, F., Sastre, G., & Strohmaier, K. G. (2008). A Zeolitic Structure (ITQ-34) with Connected 9- and 10-Ring Channels Obtained with Phosphonium Cations as Structure Directing Agents. Journal of the American Chemical Society, 130(49), 16482-16483. doi:10.1021/ja806903cCorma, A., Diaz-Cabanas, M. J., Jiang, J., Afeworki, M., Dorset, D. L., Soled, S. L., & Strohmaier, K. G. (2010). Extra-large pore zeolite (ITQ-40) with the lowest framework density containing double four- and double three-rings. Proceedings of the National Academy of Sciences, 107(32), 13997-14002. doi:10.1073/pnas.1003009107Hernández-Rodríguez, M., Jordá, J. L., Rey, F., & Corma, A. (2012). Synthesis and Structure Determination of a New Microporous Zeolite with Large Cavities Connected by Small Pores. Journal of the American Chemical Society, 134(32), 13232-13235. doi:10.1021/ja306013kSimancas, J., Simancas, R., Bereciartua, P. J., Jorda, J. L., Rey, F., Corma, A., … Mugnaioli, E. (2016). Ultrafast Electron Diffraction Tomography for Structure Determination of the New Zeolite ITQ-58. Journal of the American Chemical Society, 138(32), 10116-10119. doi:10.1021/jacs.6b06394Jo, C., Lee, S., Cho, S. J., & Ryoo, R. (2015). Synthesis of Silicate Zeolite Analogues Using Organic Sulfonium Compounds as Structure-Directing Agents. Angewandte Chemie International Edition, 54(43), 12805-12808. doi:10.1002/anie.201506678Jo, C., Lee, S., Cho, S. J., & Ryoo, R. (2015). Synthesis of Silicate Zeolite Analogues Using Organic Sulfonium Compounds as Structure-Directing Agents. Angewandte Chemie, 127(43), 12996-12999. doi:10.1002/ange.201506678Lee, S., Jo, C., Park, H., Kim, J., & Ryoo, R. (2019). Sulfonium-based organic structure-directing agents for microporous aluminophosphate synthesis. Microporous and Mesoporous Materials, 280, 75-81. doi:10.1016/j.micromeso.2019.01.048Fattorini, D., Notti, A., & Regoli, F. (2006). Characterization of arsenic content in marine organisms from temperate, tropical, and polar environments. Chemistry and Ecology, 22(5), 405-414. doi:10.1080/02757540600917328Bonilla, G., Díaz, I., Tsapatsis, M., Jeong, H.-K., Lee, Y., & Vlachos, D. G. (2004). Zeolite (MFI) Crystal Morphology Control Using Organic Structure-Directing Agents. Chemistry of Materials, 16(26), 5697-5705. doi:10.1021/cm048854wVan Koningsveld, H., van Bekkum, H., & Jansen, J. C. (1987). On the location and disorder of the tetrapropylammonium (TPA) ion in zeolite ZSM-5 with improved framework accuracy. Acta Crystallographica Section B Structural Science, 43(2), 127-132. doi:10.1107/s0108768187098173Fyfe, C. A., Brouwer, D. H., Lewis, A. R., & Chézeau, J.-M. (2001). Location of the Fluoride Ion in Tetrapropylammonium Fluoride Silicalite-1 Determined by1H/19F/29Si Triple Resonance CP, REDOR, and TEDOR NMR Experiments. Journal of the American Chemical Society, 123(28), 6882-6891. doi:10.1021/ja010532vBalimann, G., & Pregosin, P. . (1977). Arsenic-75 nuclear magnetic resonance. A study of some arsenic salts. Journal of Magnetic Resonance (1969), 26(2), 283-289. doi:10.1016/0022-2364(77)90174-3Klinowski, J. (1991). Solid-state NMR studies of molecular sieve catalysts. Chemical Reviews, 91(7), 1459-1479. doi:10.1021/cr00007a010Canche-Tello, J., Vargas, M. C., Hérnandez-Cobos, J., Ortega-Blake, I., Leclercq, A., Solari, P. L., … Mustre de Leon, J. (2015). X-ray Accelerated Photo-Oxidation of As(III) in Solution. The Journal of Physical Chemistry A, 119(12), 2829-2833. doi:10.1021/jp510596pArai, Y., Elzinga, E. J., & Sparks, D. L. (2001). X-ray Absorption Spectroscopic Investigation of Arsenite and Arsenate Adsorption at the Aluminum Oxide–Water Interface. Journal of Colloid and Interface Science, 235(1), 80-88. doi:10.1006/jcis.2000.7249Farquhar, M. L., Charnock, J. M., Livens, F. R., & Vaughan, D. J. (2002). Mechanisms of Arsenic Uptake from Aqueous Solution by Interaction with Goethite, Lepidocrocite, Mackinawite, and Pyrite:  An X-ray Absorption Spectroscopy Study. Environmental Science & Technology, 36(8), 1757-1762. doi:10.1021/es010216gMorin, G., Ona-Nguema, G., Wang, Y., Menguy, N., Juillot, F., Proux, O., … Brown Jr., G. E. (2008). Extended X-ray Absorption Fine Structure Analysis of Arsenite and Arsenate Adsorption on Maghemite. Environmental Science & Technology, 42(7), 2361-2366. doi:10.1021/es072057sRamírez-Solís, A., Mukopadhyay, R., Rosen, B. P., & Stemmler, T. L. (2004). Experimental and Theoretical Characterization of Arsenite in Water:  Insights into the Coordination Environment of As−O. Inorganic Chemistry, 43(9), 2954-2959. doi:10.1021/ic0351592Prieto, C., Blasco, T., Camblor, M., & Pérez-Pariente, J. (2000). Characterization of Ga-substituted zeolite Beta by X-ray absorption spectroscopy. Journal of Materials Chemistry, 10(6), 1383-1387. doi:10.1039/b001643hLamberti, C., Turnes Palomino, G., Bordiga, S., Zecchina, A., Spanò, G., & Otero Areán, C. (1999). Catalysis Letters, 63(3/4), 213-216. doi:10.1023/a:1019025206662Axon, S. A., Huddersman, K., & Klinowski, J. (1990). Gallium EXAFS and solid-state NMR studies of Ga-substituted MFI-type zeolites. Chemical Physics Letters, 172(5), 398-404. doi:10.1016/s0009-2614(90)87133-

Curso evolutivo y neuritis óptica en la esclerosis múltiple

Carta científicaUnidad Docente de Inmunología, Oftalmología y ORLFac. de Óptica y OptometríaTRUEpu