Diabetes mellitus. Manifestaciones oftalmológicas

Diabetes mellitus is caused by an alteration of the carbohydrate metabolism which leads to the appearance of excessive amounts of glucose in blood and sometime in the urine. This produces alterations in all the structures of the eyeball, being diabetic retinopathy the most frequent and precocious complication. It is caused as a result of a prolonged hyperglycemia; with cell, capillary and neurosensory alterations in the retina. It represents the first cause of blindness in the adult population of the industrialized countries, and its development is associated to the duration of the illness and poor glycemic control.La diabetes mellitus es una enfermedad producida por una alteración del metabolismo de los carbohidratos en la que aparece una cantidad excesiva de glucosa en la sangre y a veces en la orina que produce una alteración a nivel de todas las estructuras del globo ocular. Es la retinopatía diabética la complicación más frecuente y precoz de la diabetes, se produce como consecuencia de la hiperglucemia prolongada y muestra alteraciones celulares, capilares y neurosensoriales de la retina; es la primera causa de ceguera del adulto en los países industrializados y su desarrollo se asocia a la duración de la enfermedad y al pobre control glucémico

Presentación de un paciente con enfermedad de Coats

Coats’ disease is the third most common cause of infant leukocoria. It is more common at the end of the first decade of life and in males, usually unilateral and with no family history. The case of a nine-year-old patient with an advanced stage of the disease is reported. A treatment with peripheral cryotherapy was applied in two sectors. Sector 1: temporal from H3 to H11, and sector 2: inferonasal. A second treatment used laser therapy, applied at the level of the telangiectatic vessels. After two year of follow-up, the patient kept the same visual acuity, there was no retinal detachment, retinal exudates were with no progression and no inherent complications of Coats’ disease have appeared.La enfermedad de Coats es la tercera causa más frecuente de leucocoria infantil, es más usual al final del primer decenio de vida y en varones, normalmente es unilateral y habitualmente no hay antecedentes familiares. Se presenta un paciente de nueve años de edad con la enfermedad en un estadio avanzado, se aplicó como tratamiento crioterapia periférica en dos sectores: sector 1: temporal desde H3 a H11 y sector 2: inferonasal; en un segundo tratamiento se aplicó laserterapia a nivel de los vasos telangiectásicos; a los dos años de seguimiento conservaba igual agudeza visual, no hubo desprendimiento de retina, las exudaciones retinianas eran sin progresión y no han aparecido complicaciones inherentes a la enfermedad de Coats

Chagasic Thymic Atrophy Does Not Affect Negative Selection but Results in the Export of Activated CD4+CD8+ T Cells in Severe Forms of Human Disease

Extrathymic CD4+CD8+ double-positive (DP) T cells are increased in some pathophysiological conditions, including infectious diseases. In the murine model of Chagas disease, it has been shown that the protozoan parasite Trypanosoma cruzi is able to target the thymus and induce alterations of the thymic microenvironment and the lymphoid compartment. In the acute phase, this results in a severe atrophy of the organ and early release of DP cells into the periphery. To date, the effect of the changes promoted by the parasite infection on thymic central tolerance has remained elusive. Herein we show that the intrathymic key elements that are necessary to promote the negative selection of thymocytes undergoing maturation during the thymopoiesis remains functional during the acute chagasic thymic atrophy. Intrathymic expression of the autoimmune regulator factor (Aire) and tissue-restricted antigen (TRA) genes is normal. In addition, the expression of the proapoptotic Bim protein in thymocytes was not changed, revealing that the parasite infection-induced thymus atrophy has no effect on these marker genes necessary to promote clonal deletion of T cells. In a chicken egg ovalbumin (OVA)-specific T-cell receptor (TCR) transgenic system, the administration of OVA peptide into infected mice with thymic atrophy promoted OVA-specific thymocyte apoptosis, further indicating normal negative selection process during the infection. Yet, although the intrathymic checkpoints necessary for thymic negative selection are present in the acute phase of Chagas disease, we found that the DP cells released into the periphery acquire an activated phenotype similar to what is described for activated effector or memory single-positive T cells. Most interestingly, we also demonstrate that increased percentages of peripheral blood subset of DP cells exhibiting an activated HLA-DR+ phenotype are associated with severe cardiac forms of human chronic Chagas disease. These cells may contribute to the immunopathological events seen in the Chagas disease

Enfermedades crónicas

Adherencia al tratamiento farmacológico y relación con el control metabólico en pacientes con DM2Aluminio en pacientes con terapia de reemplazo renal crónico con hemodiálisis en Bogotá, ColombiaAmputación de extremidades inferiores: ¿están aumentando las tasas?Consumo de edulcorantes artificiales en jóvenes universitariosCómo crecen niños normales de 2 años que son sobrepeso a los 7 añosDiagnóstico con enfoque territorial de salud cardiovascular en la Región MetropolitanaEfecto a corto plazo de una intervención con ejercicio físico, en niños con sobrepesoEfectos de la cirugía bariátrica en pacientes con síndrome metabólico e IMC < 35 KG/M2Encuesta mundial de tabaquismo en estudiantes de profesiones de saludEnfermedades crónicas no transmisibles: Consecuencias sociales-sanitarias de comunidades rurales en ChileEpidemiología de las muertes hospitalarias por patologías relacionadas a muerte encefálica, Chile 2003-2007Estado nutricional y conductas alimentarias en adolescentes de 4º medio de la Región de CoquimboEstudio de calidad de vida en una muestra del plan piloto para hepatitis CEvaluación del proceso asistencial y de resultados de salud del GES de diabetes mellitus 2Factores de riesgo cardiovascular en población universitaria de la Facsal, universidad de TarapacáImplicancias psicosociales en la génesis, evolución y tratamiento de pacientes con hipertensión arterial esencialInfarto agudo al miocardio (IAM): Realidad en el Hospital de Puerto Natales, 2009-2010Introducción de nuevas TIC y mejoría de la asistencia a un programa de saludNiños obesos atendidos en el Cesfam de Puerto Natales y su entorno familiarPerfil de la mortalidad por cáncer de cuello uterino en Río de JaneiroPerfil del paciente primo-consultante del Programa de Salud Cardiovascular, Consultorio Cordillera Andina, Los AndesPrevalencia de automedicación en mujeres beneficiarias del Hospital Comunitario de Til-TiPrevalencia de caries en población preescolar y su relación con malnutrición por excesoPrevalencia de retinopatía diabética en comunas dependientes del Servicio de Salud Metropolitano Occidente (SSMOC)Problemas de adherencia farmacológica antihipertensiva en población mapuche: Un estudio cualitativoRol biológico de los antioxidantes innatos en pacientes portadores de VIH/SidaSobrepeso en empleados de un restaurante de una universidad pública del estado de São Paul

Study of forward Z + jet production in pp collisions at √s=7 TeV

A measurement of the $Z(\rightarrow\mu^+\mu^-)$+jet production cross-section in $pp$ collisions at a centre-of-mass energy $\sqrt{s} = 7$ TeV is presented. The analysis is based on an integrated luminosity of $1.0\,\text{fb}^{-1}$ recorded by the LHCb experiment. Results are shown with two jet transverse momentum thresholds, 10 and 20 GeV, for both the overall cross-section within the fiducial volume, and for six differential cross-section measurements. The fiducial volume requires that both the jet and the muons from the Z boson decay are produced in the forward direction ($2.0<\eta<4.5$). The results show good agreement with theoretical predictions at the second-order expansion in the coupling of the strong interaction.A measurement of the $Z(\rightarrow\mu^+\mu^-)$+jet production cross-section in $pp$ collisions at a centre-of-mass energy $\sqrt{s} = 7$ TeV is presented. The analysis is based on an integrated luminosity of $1.0\,\text{fb}^{-1}$ recorded by the LHCb experiment. Results are shown with two jet transverse momentum thresholds, 10 and 20 GeV, for both the overall cross-section within the fiducial volume, and for six differential cross-section measurements. The fiducial volume requires that both the jet and the muons from the Z boson decay are produced in the forward direction ($2.0<\eta<4.5$). The results show good agreement with theoretical predictions at the second-order expansion in the coupling of the strong interaction

Excited-state phase transition leading to symmetry-breaking steady states in the Dicke model

We study the phase diagram of the Dicke model in terms of the excitation energy and the radiation-matter coupling constant lambda. Below a certain critical value lambda(c), all the energy levels have a well-defined parity. For lambda > lambda(c) the energy spectrum exhibits two different phases separated by a critical energy E-c that proves to be independent of lambda. In the upper phase, the energy levels have also a well-defined parity, but below E-c the energy levels are doubly degenerated. We show that the long-time behavior of appropriate parity-breaking observables distinguishes between these two different phases of the energy spectrum. Steady states reached from symmetry-breaking initial conditions restore the symmetry only if their expected energies are above the critical. This fact makes it possible to experimentally explore the complete phase diagram of the excitation spectrum of the Dicke model

Quantum phase transitions and spontaneous symmetry-breaking in Dicke Model

A method to find the Excited-States Quantum Phase Transitions (ESQPT's) from parity-symmetry in the Dicke model is studied and presented. This method allows us to stablish a critical energy where ESQPT's take places, and divides the whole energy spectrum in two regions with different properties

Alteraciones más frecuentes del segmento posterior en pacientes con el virus de inmunodeficiencia humana

Introduction: human immunodeficiency virus infection has gradually increased worldwide in recent years and has become a public health problem, mainly for developing countries. Objective: to carry out a review of the most frequent alterations of the posterior segment in these patients with the aim of updating the existing knowledge on the subject. Methods: review of scientific articles in Google Academic and other mega search engines for systematic review using Trip Database and Cochrane. Results: retinopathy associated to human immunodeficiency virus (non-infectious) is the most frequent posterior segment alteration in these patients and cotton wool exudates its most representative clinical finding. Cytomegalovirus retinitis is the most common opportunistic eye infection in patients with very low CD4 T-cell counts; it is seen in up to 40% and is the most frequent cause of blindness in these patients. Conclusions: Toxoplasma chorioretinitis presents in an atypical way in these patients and has a close relationship with cerebral toxoplasmosis, so a complete neurological study should be performed. Sometimes, it is a diagnostic challenge for the Ophthalmology Specialist.Introducción: la infección por el virus de inmunodeficiencia humana se ha incrementado paulatinamente a nivel mundial en los últimos años y se ha convertido en un problema de salud pública, principalmente para los países en vías de desarrollo. Objetivo: realizar una revisión acerca de las alteraciones del segmento posterior más frecuentes en estos pacientes con el objetivo de actualizar los conocimientos existentes sobre el tema. Métodos: revisión de artículos científicos en Google Académico y otros mega buscadores de revisión sistemática mediante TripDatabase y Cochrane. Resultados: la retinopatía asociada al virus de inmunodeficiencia humana (no infecciosa) es la alteración del segmento posterior más frecuente en estos pacientes y los exudados algodonosos su hallazgo clínico más representativo. La retinitis por citomegaloviruses la infección ocular oportunista más común en pacientes con recuentos muy bajos de linfocitos TCD4; se observa hasta en el 40% y es la causa más frecuente de ceguera en estos enfermos. Conclusiones: la coriorretinitis por toxoplasma se presenta de una forma atípica en estos pacientes y tiene una estrecha relación con la toxoplasmosis cerebral, por lo que se les debe realizar un estudio neurológico completo. En ocasiones, constituye un reto diagnóstico para el Especialista en Oftalmología