Reporte de un caso. Queratocono con vascularización y con grosor corneal tan delgado como un lente de contacto

Se presenta el caso clínico de un varón de 24 años de edad, con diagnóstico de queratocono Grado IV y vascularización superficial en ambos ojos, con antecedente de queratitis herpética. A la exploración oftalmológica la agudeza visual en ojo derecho fue de 20/800 y ojo izquierdo 20/800. Se observó en el segmento anterior del ojo derecho papilas en conjuntiva tarsal, vascularización subepitelial periférica, discreta fibrosis estromal anterior y central, resto de córnea clara, con importante adelgazamiento paracentral inferior, cámara anterior amplia. En el segmento anterior del ojo izquierdo se observó papilas en conjuntiva tarsal, vascularización subepitelial periférica, fibrosis estromal anterior central, resto de córnea clara, con adelgazamiento paracentral inferior, cámara anterior muy amplia. Se realizó una topografía con cámara Scheimpflug (Pentacam, HR Oculos, GmbH, Wet Zlar, Alemania) encontrando una diferencial mayor a 10 entre la zona central y la más delgada en ambos ojos. En el mapa paquimétrico de ojo derecho se aprecia una diferencia de 451 entre el valor central y el periférico. La zona más delgada fue de 76 micras. En ojo izquierdo fue de 438 y la zona más delgada de 72 micras. En ambos ojos se observa una distribución paquimétrica anormal, con una marcada disminución del grosor corneal en sector inferior. Abstract A clinical case of a 24 year old male with a diagnosis of grade IV Keratoconus and superficial vascularization in both eyes, with a history of herpetic keratitis at age 13. The ophthalmologic examination the visual acuity in the right eye was 20/800 and the left eye 20/800. Papillae were observed in the anterior segment of the right eye in tarsal conjunctiva, peripheral subepithelial vascularization, discrete anterior and central stromal fibrosis, clear cornea, with significant lower paracentral thinning, anterior wide chamber. In the anterior segment of the left eye papillae were observed in tarsal conjunctiva, peripheral subepithelial vascularization, central anterior stromal fibrosis, clear cornea, with inferior paracentral thinning, anterior chamber very wide. Topography was performed with a Scheimpflug camera (Pentacam, HR Oculos, GmbH, Wet Zlar, Germany), finding a differential greater than 10 between the central area and the thinnest in both eyes. In the Pachymetric map of the right eye there is a difference of 451 between the central value and the peripheral value. The thinnest area was 76 microns. In the left eye was 438 and the thinnest area, 72 microns. In both eyes an abnormal pachymmetric distribution is observed, with a marked reduction of the corneal thickness in the lower sector

Gene Regulation in the Pi Calculus: Simulating Cooperativity at the Lambda Switch

Part of the Lecture Notes in Computer Science book series (LNCS, volume 4230).Also part of the Lecture Notes in Bioinformatics book sub series (volume 4230).International audienceWe propose to model the dynamics of gene regulatory networks as concurrent processes in the stochastic pi calculus. As a first case study, we show how to express the control of transcription initiation at the lambda switch, a prototypical example where cooperative enhancement is crucial. This requires concurrent programming techniques that are new to systems biology, and necessitates stochastic parameters that we derive from the literature. We test all components of our model by exhaustive stochastic simulations. A comparison with previous results reported in the literature, experimental and simulation based, confirms the appropriateness of our modeling approach

Variation in paranasal pneumatisation between Mid-Late Pleistocene hominins

There is considerable variation in mid-late Pleistocene hominin paranasal sinuses, and in some taxa distinctive craniofacial shape has been linked to sinus size. Extreme frontal sinus size has been reported in mid-Pleistocene specimens often classified as Homo heidelbergensis, and Neanderthal sinuses are said to be distinctively large, explaining diagnostic Neanderthal facial shape. Here, the sinuses of fossil hominins attributed to several mid-late Pleistocene taxa were compared to those of recent H. sapiens. The sinuses were investigated to clarify differences in the extent of pneumatisation within this group and the relationship between sinus size and craniofacial variation in hominins from this time period. Frontal and maxillary sinus volumes were measured from CT data, and geometric morphometric methods were used to identify and analyse shape variables associated with sinus volume. Some mid

The Cholecystectomy As A Day Case (CAAD) Score: A Validated Score of Preoperative Predictors of Successful Day-Case Cholecystectomy Using the CholeS Data Set

Background Day-case surgery is associated with significant patient and cost benefits. However, only 43% of cholecystectomy patients are discharged home the same day. One hypothesis is day-case cholecystectomy rates, defined as patients discharged the same day as their operation, may be improved by better assessment of patients using standard preoperative variables. Methods Data were extracted from a prospectively collected data set of cholecystectomy patients from 166 UK and Irish hospitals (CholeS). Cholecystectomies performed as elective procedures were divided into main (75%) and validation (25%) data sets. Preoperative predictors were identified, and a risk score of failed day case was devised using multivariate logistic regression. Receiver operating curve analysis was used to validate the score in the validation data set. Results Of the 7426 elective cholecystectomies performed, 49% of these were discharged home the same day. Same-day discharge following cholecystectomy was less likely with older patients (OR 0.18, 95% CI 0.15–0.23), higher ASA scores (OR 0.19, 95% CI 0.15–0.23), complicated cholelithiasis (OR 0.38, 95% CI 0.31 to 0.48), male gender (OR 0.66, 95% CI 0.58–0.74), previous acute gallstone-related admissions (OR 0.54, 95% CI 0.48–0.60) and preoperative endoscopic intervention (OR 0.40, 95% CI 0.34–0.47). The CAAD score was developed using these variables. When applied to the validation subgroup, a CAAD score of ≤5 was associated with 80.8% successful day-case cholecystectomy compared with 19.2% associated with a CAAD score >5 (p < 0.001). Conclusions The CAAD score which utilises data readily available from clinic letters and electronic sources can predict same-day discharges following cholecystectomy

Factors Associated with Revision Surgery after Internal Fixation of Hip Fractures

Background: Femoral neck fractures are associated with high rates of revision surgery after management with internal fixation. Using data from the Fixation using Alternative Implants for the Treatment of Hip fractures (FAITH) trial evaluating methods of internal fixation in patients with femoral neck fractures, we investigated associations between baseline and surgical factors and the need for revision surgery to promote healing, relieve pain, treat infection or improve function over 24 months postsurgery. Additionally, we investigated factors associated with (1) hardware removal and (2) implant exchange from cancellous screws (CS) or sliding hip screw (SHS) to total hip arthroplasty, hemiarthroplasty, or another internal fixation device. Methods: We identified 15 potential factors a priori that may be associated with revision surgery, 7 with hardware removal, and 14 with implant exchange. We used multivariable Cox proportional hazards analyses in our investigation. Results: Factors associated with increased risk of revision surgery included: female sex, [hazard ratio (HR) 1.79, 95% confidence interval (CI) 1.25-2.50; P = 0.001], higher body mass index (fo

Reporte de un caso. Queratocono con vascularización y con grosor corneal tan delgado como un lente de contacto

Se presenta el caso clínico de un varón de 24 años de edad, con diagnóstico de queratocono Grado IV y vascularización superficial en ambos ojos, con antecedente de queratitis herpética. A la exploración oftalmológica la agudeza visual en ojo derecho fue de 20/800 y ojo izquierdo 20/800. Se observó en el segmento anterior del ojo derecho papilas en conjuntiva tarsal, vascularización subepitelial periférica, discreta fibrosis estromal anterior y central, resto de córnea clara, con importante adelgazamiento paracentral inferior, cámara anterior amplia. En el segmento anterior del ojo izquierdo se observó papilas en conjuntiva tarsal, vascularización subepitelial periférica, fibrosis estromal anterior central, resto de córnea clara, con adelgazamiento paracentral inferior, cámara anterior muy amplia. Se realizó una topografía con cámara Scheimpflug (Pentacam, HR Oculos, GmbH, Wet Zlar, Alemania) encontrando una diferencial mayor a 10 entre la zona central y la más delgada en ambos ojos. En el mapa paquimétrico de ojo derecho se aprecia una diferencia de 451 entre el valor central y el periférico. La zona más delgada fue de 76 micras. En ojo izquierdo fue de 438 y la zona más delgada de 72 micras. En ambos ojos se observa una distribución paquimétrica anormal, con una marcada disminución del grosor corneal en sector inferior. Abstract A clinical case of a 24 year old male with a diagnosis of grade IV Keratoconus and superficial vascularization in both eyes, with a history of herpetic keratitis at age 13. The ophthalmologic examination the visual acuity in the right eye was 20/800 and the left eye 20/800. Papillae were observed in the anterior segment of the right eye in tarsal conjunctiva, peripheral subepithelial vascularization, discrete anterior and central stromal fibrosis, clear cornea, with significant lower paracentral thinning, anterior wide chamber. In the anterior segment of the left eye papillae were observed in tarsal conjunctiva, peripheral subepithelial vascularization, central anterior stromal fibrosis, clear cornea, with inferior paracentral thinning, anterior chamber very wide. Topography was performed with a Scheimpflug camera (Pentacam, HR Oculos, GmbH, Wet Zlar, Germany), finding a differential greater than 10 between the central area and the thinnest in both eyes. In the Pachymetric map of the right eye there is a difference of 451 between the central value and the peripheral value. The thinnest area was 76 microns. In the left eye was 438 and the thinnest area, 72 microns. In both eyes an abnormal pachymmetric distribution is observed, with a marked reduction of the corneal thickness in the lower sector