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Systemic effects of repeated intraocular dexamethasone Intravitreal implant in diabetic patients: a retrospective study

Introduction: The objective of this study is to evaluate the influence of repeated intraocular dexamethasone implant (Ozurdex) injections on metabolic control in type 2 diabetic patients. Methods: Retrospective study of 165 type 2 diabetic patients starting Ozurdex treatment who received no less than three consecutive injections. Glycated hemoglobin (HbA1c), serum creatinine, total cholesterol, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, and triglycerides (TGs) were evaluated during 15 months of follow-up after Ozurdex treatment onset. Results: Fifty-seven patients met inclusion criteria. Mean baseline values for HbA1c, creatinine, total cholesterol, HDL cholesterol, and TGs before treatment (7.1%, 1.3, 176.7, 51.1, and 125.6 mg/ dl, respectively) were similar to mean values after Ozurdex onset (Wilcoxon test p values were 0.68, 0.41, 0.06, 0.87, and 0.33, respectively) and remained stable during the follow-up period. Mean LDL cholesterol levels increased slightly after Ozurdex treatment onset (90.1 vs 88.2 mg/ dl, p = 0.04) but after 15 months of follow-up they had returned to baseline values. Transient increase in LDL cholesterol was remarkable in the group of 24 bilaterally treated patients (96.8 vs 88.4 mg/dl, p = 0.03). A third of these patients increased their baseline LDL values by more than 20%. Even with continuous injections of Ozurdex, LDL cholesterol levels also declined back to baseline by month 15. Conclusion: Ozurdex injections had no influence on HbA1c or renal function. Lipid profile changes were mild and transient. However, a significant temporary increase has been found in LDL cholesterol levels in patients receiving simultaneous bilateral injections. Lipid levels should be monitored in patients starting with bilateral Ozurdex injections especially in those with recent history of acute myocardial infarction

Novedades florísticas para la provincia de Albacete I

Se presenta un listado de 29 especies de flora novedosas para la provincia de Albacete, algunas de ellas, de elevado interés biogeo- gráfico

Novedades florísticas para la provincia de Albacete III

Se presenta un listado de 10 especies de flora novedosas para la provincia de Albacete procedentes de la Sierra del Relumbrar y zo- nas adyacentes, algunas de ellas, de elevado interés biogeográfi- co

Novedades florísticas para las provincias de Albacete, Almería y Granada (España)

14 new or interesting records for the flora of Albacete, Almeria and Granada are listed in this paper. For each species, chorological, taxonomic and ecology data are included. Furthermore, data belonging to their Conservation status are added, in order to take into account them in further revisions of Catalogues of threatened flora.Se presenta un listado de 14 especies de flora, novedosas para las provincias de Albacete, Almería y Granada (España). Se incluyen datos sobre la corología y ecología de todas las especies, además de otros comentarios relativos a la conservación o de carácter taxonómico

Challenges in Diabetic Macular Edema Management: An Expert Consensus Report

Purpose: This paper aimed to present daily-practice recommendations for the management of diabetic macular edema (DME) patients based on available scientific evidence and the clinical experience of the consensus panel. Methods: A group of Spanish retina experts agreed to discuss different aspects related with the clinical management of DME patients. Results: Panel was mainly focused on therapeutic objectives in DME management; defini-tion terms; and role of biomarkers as prognostic and predictive factors to intravitreal treatment response. The panel recommends to start DME treatment as soon as possible in those eyes with a visual acuity less than 20/25 (always according to the retina unit capacity). Naive patient was defined, in a strict manner, as a patient who, up to that moment, had never received any treatment. A refractory DME patient may be defined as the one who did not achieve a complete resolution of the disease, regardless of the treatment administered. Different optical coherence tomography biomarkers, such as disorganization of the retinal inner layers, hyperreflective dots, and cysts, have been identified as prognostic factors. Conclusion: This document has sought to lay down a set of recommendations and to identify key issues that may be useful for the daily management of DME patients

Role of Klotho and AGE/RAGE-Wnt/β-catenin signalling pathway on the development of cardiac and renal fibrosis in diabetes

Fibrosis plays an important role in the pathogenesis of long-term diabetic complications and contributes to the development of cardiac and renal dysfunction. The aim of this experimental study, performed in a long-term rat model, which resembles type 1 diabetes mellitus, was to investigate the role of soluble Klotho (sKlotho), advanced glycation end products (AGEs)/receptor for AGEs (RAGE), fibrotic Wnt/β-catenin pathway, and pro-fibrotic pathways in kidney and heart. Diabetes was induced by streptozotocin. Glycaemia was maintained by insulin administration for 24 weeks. Serum and urine sKlotho, AGEs, soluble RAGE (sRAGE) and biochemical markers were studied. The levels of Klotho, RAGEs, ADAM10, markers of fibrosis (collagen deposition, fibronectin, TGF-β1, and Wnt/β-catenin pathway), hypertrophy of the kidney and/or heart were analysed. At the end of study, diabetic rats showed higher levels of urinary sKlotho, AGEs and sRAGE and lower serum sKlotho compared with controls without differences in the renal Klotho expression. A significant positive correlation was found between urinary sKlotho and AGEs and urinary albumin/creatinine ratio (uACR). Fibrosis and RAGE levels were significantly higher in the heart without differences in the kidney of diabetic rats compared to controls. The results also suggest the increase in sKlotho and sRAGE excretion may be due to polyuria in the diabetic rats

Optic nerve and macular optical coherence tomography in recovered COVID-19 patients

Purpose: To investigate the peripapillary retinal nerve fiber layer thickness (RNFLT), macular RNFLT, ganglion cell layer (GCL), and inner plexiform layer (IPL) thickness in recovered COVID-19 patients compared to controls. Methods: Patients previously diagnosed with COVID-19 were included, while healthy patients formed the historic control group. All patients underwent an ophthalmological examination, including macular and optic nerve optical coherence tomography. In the case group, socio-demographic data, medical history, and neurological symptoms were collected. Results: One hundred sixty patients were included; 90 recovered COVID-19 patients and 70 controls. COVID-19 patients presented increases in global RNFLT (mean difference 4.3; CI95% 0.8 to 7.7), nasal superior (mean difference 6.9; CI95% 0.4 to 13.4), and nasal inferior (mean difference 10.2; CI95% 2.4 to 18.1) sectors of peripapillary RNFLT. Macular RNFL showed decreases in COVID-19 patients in volume (mean difference −0.05; CI95% −0.08 to −0.02), superior inner (mean difference −1.4; CI95% −2.5 to −0.4), nasal inner (mean difference −1.1; CI95% −1.8 to −0.3), and nasal outer (mean difference −4.7; CI95% −7.0 to −2.4) quadrants. COVID-19 patients presented increased GCL thickness in volume (mean difference 0.04; CI95% 0.01 to 0.07), superior outer (mean difference 2.1; CI95% 0.8 to 3.3), nasal outer (mean difference 2.5; CI95% 1.1 to 4.0), and inferior outer (mean difference1.2; CI95% 0.1 to 2.4) quadrants. COVID-19 patients with anosmia and ageusia presented an increase in peripapillary RNFLT and macular GCL compared to patients without these symptoms. Conclusions: SARS-CoV-2 may affect the optic nerve and cause changes in the retinal layers once the infection has resolved

La cerámica pintada tardoantigua, de tradición indígena, documentada en la villa romana de El Saucedo (Talavera la Nueva, Toledo)

Presentamos en este artículo el estudio tecno-tipológico de las cerámicas pintadas romanas de tradición indígena de época tardoantigua aparecidas en las campañas de excavación realizadas en la villa de El Saucedo (Talavera la Nueva, Toledo). A través de su análisis y caracterización arqueométrica hemos podido determinar la existencia de dos grupos diferenciables. El primero integrado por producciones que debieron de realizarse en algún taller de la submeseta sur y el segundo por aquellas otras que presentan entre sus desgrasantes abundante mica de color dorado, además de otros componentes. Dichas cerámicas quizá fueron elaboradas en un alfar ubicado en la vecina civitas de Caesarobriga (Talavera de la Reina). El análisis arqueométrico se ha realizado mediante Microscopía Óptica (MO), microanálisis SEM-EDX y análisis DRXThis research focuses on the Late Roman painted pottery of indigenous tradition founded at the roman villa of El Saucedo (Talavera la Nueva, Toledo). By means of a detailed analysis, is possibly to make a distinction of two ceramics groups: productions from a potter work-shop situated in an indeterminable place of the Southern Meseta, perhaps, and productions in which the golden isinglass is a very important component. In both cases, we must considerer Caesarobriga and the territory around the city like a nuclear area of those ceramics. The archaeometric analysis have been realized: SEM-EDX, DRX and Optical MicroscopyEste trabajo se ha desarrollado en el marco del proyecto: SIGIcedo (II) Estudio cronotipológico y arqueométrico de la vajilla fina en la villa de El Saucedo (Talavera la Nueva, Toledo). La terra sigillata procedente de los complejos termales y la cerámica pintada romana de tradición indígena bajoimperial del proyecto Corpus Vasorum Hispanorum. Análisis tipológico, cronológico y prosopográfico de los sigilla en terra sigillata hispánica a partir de los centros consumidores. Parte I: Lusitania (PGC2018-093478-A-I00 – Convocatoria Proyectos de Excelencia – Plan Estatal de Generación de Conocimiento – Ministerio de Ciencia, Innovación y Universidades – Españ