Primeras experiencias españolas con el uso de los ANTIVEGF intravítreos en la retinopatía del prematuro. Estudio multicéntrico

Objetivo: Evaluar el pronóstico anatómico de los niños con retinopatía del prematuro (ROP) tratados con inyecciones intraoculares de antiVEGF y laser. Metodo: Estudio multicéntrico, intervencional y retrospectivo. En el estudio se incluyeron 15 ojos de 12 prematuros con ROP de alto riesgo de 6 hospitales diferentes. De ellos, 17 recibieron fotocoagulación e inyección intraocular de dos formas diferentes: Grupo 1.Tratamiento combinado. Siete ojos. Ambas técnicas se aplicaron en un intervalo menor de 10 días. Grupo 2. Tratamiento postlaser. Siete ojos. Pacientes en los que seguía progresando la retinopatía después de la fotocoagulación (la inyección se efectuó, de media, 37,4 días después). El pronóstico se estableció por la necesidad de vitrectomía y por el resultado anatómica retiniano final. Se efectuó un estudio estadístico comparativo entre ambos grupos con test no paramétricos (U Mann-Withney y Chi2). Resultados: Grupo 1. Se dio laser y se puso la inyección intraocular a los 83,2 y 84,7 días de media, respectivamente. (37,8 y 38,7 semanas postmenstruales-PM-). Grupo 2. Se fotocoaguló a los 70,1 días (36,4 semanas PM) y la inyección intraocular se inyectó a los 107,5 días (41,8 semanas PM). Sólo 4 ojos necesitaron vitrectomía, todos pertenecientes al grupo 1 (57,1 %) y por tanto ninguno del grupo 2 (p=0,07). Evolucionaron a pliegue macular o desprendimiento de retina el 14,3 % del grupo 1 y el 71,4 % del grupo 2 (p=0,1). Conclusiones: La inyección intravítrea de antiVEGF con fotocoagulación fue más efectiva que cuando se administra en casos de ojos no respondedores a la fotocoagulaciónObjective: To assess the anatomical outcome of babies with retinopathy of prematurity (ROP) treated with laser and intravitreal injection of antiVEGF. Methods: Retrospective, interventional, multicenter trial. The study included 15 eyes of twelve preterm infants with high risk ROP (from 6 hospitals). Fourteen eyes received intravitreal injections of antiVEGF (bevacizumab or pegaptanib sodium) and laser photocoagulation in two different regimes: Group 1 - combined treatment - (7 eyes). Laser and antiVEGF injections were performed in less than 10 days. Group 2 - postlaser treatment - (7 eyes). Patients with progressive ROP despite peripheral laser ablation (injection antiVEGF, -mean- 37.4 days after). The results were evaluated for the need of more surgery and the final retinal anatomical status. Outcomes for the 2 treatment groups were compared using parametric tests (U Mann-Whitney and Chi2). Results: Group 1. Retinal photocoagulation and intraocular injection were performed at 83.2 and 84.7 days (mean values) or 37.8 and 38.7 weeks (mean values) (postmenstrual age -PMA-). Group 2. Babies underwent photocoagulation at 70.1 days (mean) [36.4 weeks PMA] and injection at 107.5 days [41.8 w. PMA]. Four eyes of group 2 needed vitrectomy (57.1 %) but none in group1 (p=0,07). Macular fold or retinal detachment developed in 14.3 % of group 1 and 71.4 % of group 2 (p=0,1). Conclusion: Intravitreal injection of antiVEGF with photocoagulation was more effective than intravitreal injection in eyes unresponsive to photocoagulatio

Comparison Between Two Warm Ischemic Models in Experimental Liver Transplantation in Pigs

Experimental models of warm ischemia in liver transplantation have been employed to study the mechanisms and treatment of ischemia reperfusion injury. METHODS: We compared a control group without (group A, n = 10) versus two models of warm ischemia of liver transplants in pigs: namely, occlusion of the hepatic artery and portal vein for 30 minutes (group B, n = 23) and extraction of the liver 60 minutes after cardiac arrest (group C, n = 5). Liver function tests, coagulation studies, and liver biopsies were performed during the first 24 hours post-liver transplant. RESULTS: Clamping of the hepatic vasculature in group B produced a significant liver injury compared with the control group: elevation of the ALT and an abnormal 1-hour post-revascularization biopsy similar to that observed in the cardiac arrest group C. The transaminase levels were lower among group A animals (P <.05). But the hepatic synthetic functions as reflected in the protrombin time (PT) were not affected in group B versus group A. The alteration in PT with respect to the initial value was similar among group A and group B animals, which were significantly less than that in group C (P <.05). CONCLUSIONS: Occlusion of the hepatic artery and portal vein, a simple surgical maneuver, causes moderate damage to a liver graft but less alteration of hepatic synthetic function. Clamping of the hepatic vasculture obtains more long-term survivors after OLT than cardiac arrest

Thermodynamics of Black Holes in Two (and Higher) Dimensions

A comprehensive treatment of black hole thermodynamics in two-dimensional dilaton gravity is presented. We derive an improved action for these theories and construct the Euclidean path integral. An essentially unique boundary counterterm renders the improved action finite on-shell, and its variational properties guarantee that the path integral has a well-defined semi-classical limit. We give a detailed discussion of the canonical ensemble described by the Euclidean partition function, and examine various issues related to stability. Numerous examples are provided, including black hole backgrounds that appear in two dimensional solutions of string theory. We show that the Exact String Black Hole is one of the rare cases that admits a consistent thermodynamics without the need for an external thermal reservoir. Our approach can also be applied to certain higher-dimensional black holes, such as Schwarzschild-AdS, Reissner-Nordstrom, and BTZ.Comment: 63 pages, 3 pdf figures, v2: added reference

Revista de Vertebrados de la Estación Biológica de Doñana

Materiales para una «Herpetofauna Balearica 5. Las salamanquesas y tortugas del archipiélago de CabreraEcología de una población insular mediterránea del Eslizón ibérico, Chalcides bedriagai (Sauria Scincidae).Ecología alimenticia del águila imperial ibérica (Aquila adalberti) en el Coto Doñana durante la crianza de los pollosDatos sobre la dieta invernal del colirrojo tizón (Phoenicurus ochruros) en encinares de Andalucía occidentalSobre infecciones estafilocócicas en el Aguila imperial ibérica (Aquila adalberti Brehm)Breves notas sobre el Sapo partero ibérico (Alytes cisternasii Boscá)Sobre la presencia de Hyla arborea en la provincia de BadajozAlgunas presas de Elaphe scalaris.Observaciones de Tarentola maurítanica en nido de Hirundo dauricaObservación de una culebra viperina Natrix maura en agua marinaPrimera cita de la CollaIba yebélica (Oenanthe leucopyga) en la Península ibéricaObservaciones de Phoenicopterus ruber en la Ría de Vigo (PontevedraDatos sobre el Myotis emarginatus en la Península ibérica.Peer reviewe

Papel de la cirugía en el tratamiento del linfoma gástrico primario

Primary gastric lymphoma's optimum management remains controversial. We reviewed our series of 23 patients with primary gastric lymphoma treated in our hospital between 1976 and 1998 with surgery as main therapy. Ten patients underwent surgical resection alone, whereas 13 also received postoperative adjuvant therapy, depending on the oncologist-haematologist's recommendations. No differences were found between treatments regarding mortality and morbidity. Clinical-histological features and patients, follow-up are analyzed. No patient died because of lymphoma and there wasn't either local or distant recurrence. We consider that surgery remains a valid option for the primary gastric lymphoma treatment. The introduction of combined modalities of radiation therapy and chemotherapy will depend on the final stage, the tumor histological features, and the feasibility of getting a radical resection

Comparison Between Two Warm Ischemic Models in Experimental Liver Transplantation in Pigs

Experimental models of warm ischemia in liver transplantation have been employed to study the mechanisms and treatment of ischemia reperfusion injury. METHODS: We compared a control group without (group A, n = 10) versus two models of warm ischemia of liver transplants in pigs: namely, occlusion of the hepatic artery and portal vein for 30 minutes (group B, n = 23) and extraction of the liver 60 minutes after cardiac arrest (group C, n = 5). Liver function tests, coagulation studies, and liver biopsies were performed during the first 24 hours post-liver transplant. RESULTS: Clamping of the hepatic vasculature in group B produced a significant liver injury compared with the control group: elevation of the ALT and an abnormal 1-hour post-revascularization biopsy similar to that observed in the cardiac arrest group C. The transaminase levels were lower among group A animals (P <.05). But the hepatic synthetic functions as reflected in the protrombin time (PT) were not affected in group B versus group A. The alteration in PT with respect to the initial value was similar among group A and group B animals, which were significantly less than that in group C (P <.05). CONCLUSIONS: Occlusion of the hepatic artery and portal vein, a simple surgical maneuver, causes moderate damage to a liver graft but less alteration of hepatic synthetic function. Clamping of the hepatic vasculture obtains more long-term survivors after OLT than cardiac arrest