Análisis de los sistemas actuales en oftalmología para el estudio de enfermedades relacionadas con la modificación geométrica de la arquitectura corneal

[ES] El análisis de la morfología corneal es un procedimiento muy útil en el diagnóstico clínico de determinadas patologías oculares, especialmente las relacionadas con alteraciones ectásicas corneales. Desde la aparición de los sistemas basados en Discos de Plácido a los sistemas que incorporan la fotografía Scheimpflug, existe una variedad de instrumentos que ofrecen la posibilidad de analizar con gran precisión parámetros de la morfología corneal. En esta comunicación se revisan los diversos instrumentos que han sido utilizados para caracterizar la morfología corneal, estando todos influenciados, en mayor o menor medida, por factores como la rapidez de adquisición de datos y la estabilidad de la película lagrimal. [ENG] The analysis of the corneal shape is a very useful process that permits the clinical diagnosis of determined ocular pathologies, especially those related with corneal ectatic disorders. From the appearance of the systems based on the Placido-disc technology to the new systems that combine the accurate Scheimpflug photography, there are a variety of ophthalmic instruments that permit to analyze with high accuracy some parameters of the corneal shape. This communication reviews the different systems that have been used to characterize the corneal morphology, being all of them influenced, to a greater or lesser extent, by factors such as the speed for data acquisition and the stability of the tear film.Centro Universitario de la Defensa. Escuela de Turismo de Cartagena. Escuela Técnica Superior de Ingeniería Industrial UPCT. Escuela Técnica Superior de Ingeniería de Telecomunicación (ETSIT). Escuela de Ingeniería de Caminos y Minas (EICM). Escuela de Arquitectura e Ingeniería de Edificación (ARQ&IDE). Parque Tecnológico de Fuente Álamo. Navantia. Campus Mare Nostrum. Estación Experimental Agroalimentaria Tomás Ferr

Presentación de producto. Realidad aumentada aplicada a la docencia

La docencia en expresión gráfica ha experimentado grandes avances en las últimas décadas. Desde el lápiz, la escuadra, cartabón, y los estilógrafos, el software CAD, desarrollado primero para representaciones 2D y evolucionado más tarde para entornos 3D, programas de gestión de producto más avanzados, como CATIA o SOLIDWORKS, que incluyen módulos CAM / CAE, y permiten ejecutar un proyecto en su conjunto, hasta motores gráficos de Realidad Virtual y REALIDAD AUMENTADA. Siempre será importante que el alumno adquiera habilidades y destrezas para transmitir los ingenios que desarrolle. Las nuevas herramientas de Realidad Aumentada (RA) facilitan el aprendizaje a alumnos que aún no son capaces de imaginar en el espacio los elementos diseñados o de transmitir la información a aquellos que podrían ser clientes o promotores de un determinado proyecto de ingeniería gráfica. Durante la pasada década se empezó a emplear la realidad virtual, fruto del desarrollo de la industria del videojuego, gracias a programas como VIZARD o UNITY. Hoy en día se presentan proyectos de realidad inmersiva, realidad mixta y realidad aumentada para múltiples aplicaciones. El vídeojuego de Pokemon GO, es un ejemplo de realidad aumentada indirecta. En este trabajo se presenta una unidad formativa que permite el aprendizaje de SOLIDWORKS apoyada en el módulo VUFORIA de UNITY para crear contenidos formativos de realidad aumentada. A la herramienta en RA que conforma la unidad didáctica presentada, se le ha denominado DemoRA (incluye tres ideas: Demostración de utilidad de la realidad aumentada, RA, evitando la demora o retraso que se produce si se tiene dificultad con la visión espacial). El conjunto de planos CAD creados en SolidWorks y archivos de realidad aumentada para la Unidad didáctica, ha sido subido al aula virtual de la UPCT, para que los alumnos puedan acceder libremente a ellos.Este trabajo ha sido posible gracias al Servicio de Diseño Industrial y Cálculo Científico (SEDIC) del Servicio de Apoyo a la Investigación Tecnológica (SAIT) de la Universidad Politécnica de Cartagena

Geometric modelling of the human cornea: A new approach for the study of corneal ectatic disease. A pilot investigation

The aim of this study was to describe the application of a new bioengineering graphical technique based on geometric custom modelling capable to detect and to discriminate small variations in the morphology of the corneal surface. A virtual 3D solid custom model of the cornea was obtained employing Computer Aided Geometric Design tools, using raw data from a discrete and finite set of spatial points representative of both sides of the corneal surface provided by a corneal topographer. Geometric reconstruction was performed using B-Spline functions, defining and calculating the representative geometric variables of the corneal morphology of patients under clinical diagnosis of keratoconus

Automatic image processing applied to corneal endothelium cell count and shape characterization

Corneal endothelium cell count, as well as cell hexagonality percent characterization, are of great importance nowadays to detect anomalies and pathologies of human eye, such as glaucoma. Prevalent technologies used are mainly based in both microscopy and a later image analysis. However, automatic cell count made by microscopes’ built-in software is rather inconsistent, therefore many laboratories opt for using manual count as the most reliable alternative. This count is a tedious and time-consuming task, that can lead to human error, for this reason, several proposals to automate the process have been made. Present communication shows a procedure for the automatic pre-processing, segmentation and analysis of the images obtained by a confocal microscope, using watershed transform, and the graphics user interface (GUI) created with Matlab® to apply this procedure. In order to quantify the procedure’s quality, 30 corneal endothelium images with a number of cells between 90 and 170 were analysed, resulting in a mean error in cell count of 4.3%, which can be considered a reasonably good result. However, results achieved for hexagonality percent using this method, and with the available image quality, are not as good as expected, which invites to improving image quality, focusing in areas with better cell homogeneity or even considering the application of other algorithms, such as neural networks, for future works.This work was supported by the Thematic Network for Co-Operative Research in Health (RETICS-RD16/0008/0012), financed by the Carlos III Health Institute and the European Regional Development Fund (FEDER)

Procedimiento y sistema para detectar queratocono subclínico

Número de publicación: 2 564 397 Número de solicitud: 201431361Procedimiento y sistema para detectar queratocono subclínico, donde el sistema comprende: - un topógrafo corneal configurado para proporcionar un primer (1) y un segundo conjunto (2) de datos espaciales normalizados asociados a la superficie anterior y posterior de la córnea, y un valor de distancia (8) representativo de la separación entre ambas superficies y; - unos medios de procesamiento configurados para generar una primera (3) y una segunda superficie (4) a partir del primer (1) y segundo conjunto de datos (2), y generar un modelo (7) tridimensional que proporciona al menos un primer parámetro (p1) con información de una primera medida de desviación (16) correspondiente a la distancia existente entre el punto de mayor altura (14) de la segunda superficie (4) respecto de un eje axial (12), y donde los medios de procesamiento están además configurados para detectar un posible queratocono subclínico a partir de la medida proporcionada.Universidad Politécnica de CartagenaUniversidad de Murci

Variación estacional de la condición nutricional larvaria del boquerón (Engraulis encrasicolus) en el estuario del Guadalquivir

European anchovy recruitment to the Guadalquivir estuary mainly occurs when the environmental conditions show more stability. Unusual changes in the environmental conditions of this estuary negatively impacted on key preys of anchovy and therefore on its nursery function. In this way, nutritional condition should determine strongly the physiological state of this species in estuaries and thus its survival and recruitment. RNA:DNA ratio has been applied with success as indicator of nutritional condition and growth in marine organisms. We study RNA:DNA ratio in anchovies of the coupled system Guadalquivir estuary-coastal influenced area in the Gulf of Cádiz in order to evaluate the condition seasonal variability of this species along this spatial gradient. Spatial differences in the size distribution of anchovy and high values of RNA:DNA in the Guadalquivir estuary compared to its influence coastal area suggest that anchovies migrate to the estuary and they acquire a very good condition. We conclude that RNA:DNA is an useful tool to understand the ecological mechanisms by which the coupled system Guadalquivir estuary-coastal influenced area in the Gulf of Cádiz control the success or failure of the recruitment of this important fishery resource in the region

Effectiveness of an intervention for improving drug prescription in primary care patients with multimorbidity and polypharmacy:Study protocol of a cluster randomized clinical trial (Multi-PAP project)

This study was funded by the Fondo de Investigaciones Sanitarias ISCIII (Grant Numbers PI15/00276, PI15/00572, PI15/00996), REDISSEC (Project Numbers RD12/0001/0012, RD16/0001/0005), and the European Regional Development Fund ("A way to build Europe").Background: Multimorbidity is associated with negative effects both on people's health and on healthcare systems. A key problem linked to multimorbidity is polypharmacy, which in turn is associated with increased risk of partly preventable adverse effects, including mortality. The Ariadne principles describe a model of care based on a thorough assessment of diseases, treatments (and potential interactions), clinical status, context and preferences of patients with multimorbidity, with the aim of prioritizing and sharing realistic treatment goals that guide an individualized management. The aim of this study is to evaluate the effectiveness of a complex intervention that implements the Ariadne principles in a population of young-old patients with multimorbidity and polypharmacy. The intervention seeks to improve the appropriateness of prescribing in primary care (PC), as measured by the medication appropriateness index (MAI) score at 6 and 12months, as compared with usual care. Methods/Design: Design:pragmatic cluster randomized clinical trial. Unit of randomization: family physician (FP). Unit of analysis: patient. Scope: PC health centres in three autonomous communities: Aragon, Madrid, and Andalusia (Spain). Population: patients aged 65-74years with multimorbidity (≥3 chronic diseases) and polypharmacy (≥5 drugs prescribed in ≥3months). Sample size: n=400 (200 per study arm). Intervention: complex intervention based on the implementation of the Ariadne principles with two components: (1) FP training and (2) FP-patient interview. Outcomes: MAI score, health services use, quality of life (Euroqol 5D-5L), pharmacotherapy and adherence to treatment (Morisky-Green, Haynes-Sackett), and clinical and socio-demographic variables. Statistical analysis: primary outcome is the difference in MAI score between T0 and T1 and corresponding 95% confidence interval. Adjustment for confounding factors will be performed by multilevel analysis. All analyses will be carried out in accordance with the intention-to-treat principle. Discussion: It is essential to provide evidence concerning interventions on PC patients with polypharmacy and multimorbidity, conducted in the context of routine clinical practice, and involving young-old patients with significant potential for preventing negative health outcomes. Trial registration: Clinicaltrials.gov, NCT02866799Publisher PDFPeer reviewe

Geometrical custom modeling of human cornea in vivo and its use for the diagnosis of corneal ectasia.

AIM: To establish a new procedure for 3D geometric reconstruction of the human cornea to obtain a solid model that represents a personalized and in vivo morphology of both the anterior and posterior corneal surfaces. This model is later analyzed to obtain geometric variables enabling the characterization of the corneal geometry and establishing a new clinical diagnostic criterion in order to distinguish between healthy corneas and corneas with keratoconus. METHOD: The method for the geometric reconstruction of the cornea consists of the following steps: capture and preprocessing of the spatial point clouds provided by the Sirius topographer that represent both anterior and posterior corneal surfaces, reconstruction of the corneal geometric surfaces and generation of the solid model. Later, geometric variables are extracted from the model obtained and statistically analyzed to detect deformations of the cornea. RESULTS: The variables that achieved the best results in the diagnosis of keratoconus were anterior corneal surface area (ROC area: 0.847, p<0.000, std. error: 0.038, 95% CI: 0.777 to 0.925), posterior corneal surface area (ROC area: 0.807, p<0.000, std. error: 0.042, 95% CI: 0,726 to 0,889), anterior apex deviation (ROC area: 0.735, p<0.000, std. error: 0.053, 95% CI: 0.630 to 0.840) and posterior apex deviation (ROC area: 0.891, p<0.000, std. error: 0.039, 95% CI: 0.8146 to 0.9672). CONCLUSION: Geometric modeling enables accurate characterization of the human cornea. Also, from a clinical point of view, the procedure described has established a new approach for the study of eye-related diseases

Sagittal plane of the cornea passing through the Z axis and minimum thickness points of both corneal surfaces.

<p>Sagittal plane of the cornea passing through the Z axis and minimum thickness points of both corneal surfaces.</p

Volume of corneal cylinder with a determined radius: a) 2D view of the cylinder and its parameters, b) 3D view of the intersection between the solid model of the cornea and the cylinder.

<p>Volume of corneal cylinder with a determined radius: a) 2D view of the cylinder and its parameters, b) 3D view of the intersection between the solid model of the cornea and the cylinder.</p