22 research outputs found
Comparison of dynamic contour tonometry (Pascal®) with pneumotonometry and Goldmann tonometry
To compare the intraocular pressure measurements as defined by the
Pascal tonometer, the Goldmann tonometer and the pneumotonometer. METHODS: This
was an observational clinical study, which included two hundred and five randomly
selected subjects recruited from the Ophthalmology Department. The intraocular
pressure measurements were performed with each tonometry technique in a
randomized order. RESULTS: The Pascal's intraocular pressure measurement was
significantly higher than that measured by the other two tonometers (p<0.05). The
quality data of Pascal was: optimum in 27.3% (56 of 205 patients), acceptable in
42% (86 of 205 patients) and unacceptable in 23.4% (48 of 205 patients). In 7.3%
(15 of 205 patients) it was impossible to obtain any measurement using Pascal. A
weak correlation coefficient between the Pascal and the Goldmann, and between
Pascal and the pneumotonometer was found. The Bland-Altman method of measurement
using these tonometers showed a high degree of discordance. CONCLUSION: As
reported by others authors, the Pascal's intraocular pressure measurement is
higher than that of the Goldmann tonometer. The measurement differs from 0.7 to
4.4 mmHg. In corneas with pathology, it is very difficult or even unacceptable to
measure the intraocular pressure using the Pascal tonometer
Reproducibility and clinical relevance of the ocular response analyzer in nonoperated eyes: corneal biomechanical and tonometric implications
To assess the reproducibility of the ocular response analyzer (ORA) in
nonoperated eyes and the impact of corneal biomechanical properties on
intraocular pressure (IOP) measurements in normal and glaucomatous eyes. METHODS:
In the reliability study, two independent examiners obtained repeated ORA
measurements in 30 eyes. In the clinical study, the examiners analyzed ORA and
IOP-Goldmann values from 220 normal and 42 glaucomatous eyes. In both studies,
Goldmann-correlated IOP measurement (IOP-ORAg), corneal-compensated IOP
(IOP-ORAc), corneal hysteresis (CH), and corneal resistance factor (CRF) were
evaluated. IOP differences of 3 mm Hg or greater between the IOP-ORAc and
IOP-ORAg were considered outcome significant. RESULTS: Intraexaminer intraclass
correlation coefficients and interexaminer concordance correlation coefficients
ranged from 0.78 to 0.93 and from 0.81 to 0.93, respectively, for all parameters.
CH reproducibility was highest, and the IOP-ORAg readings were lowest. The median
IOP was 16 mm Hg with the Goldmann tonometer, 14.5 mm Hg with IOP-ORAg (P <
0.001), and 15.7 mm Hg with IOP-ORAc (P < 0.001). Outcome-significant results
were found in 77 eyes (29.38%). The IOP-ORAc, CH, and CRF were correlated with
age (r = 0.22, P = 0.001; r = -0.23, P = 0.001; r = -0.14, P = 0.02,
respectively), but not the IOP-ORAg or IOP-Goldmann. CONCLUSIONS: The ORA
provides reproducible corneal biomechanical and IOP measurements in nonoperated
eyes. Considering the effect of ORA, corneal biomechanical metrics produces an
outcome-significant IOP adjustment in at least one quarter of glaucomatous and
normal eyes undergoing noncontact tonometry. Corneal viscoelasticity (CH) and
resistance (CRF) appear to decrease minimally with increasing age in healthy
adults
A Phase I/II Clinical Trial to evaluate the efficacy of baricitinib to prevent respiratory insufficiency progression in onco-hematological patients affected with COVID19: a structured summary of a study protocol for a randomised controlled trial
Objectives: Baricitinib is supposed to have a double effect on SARS-CoV2 infection. Firstly, it reduces the inflammatory response through the inhibition of the Januse-Kinase signalling transducer and activator of transcription (JAK-STAT) pathway. Moreover, it reduces the receptor mediated viral endocytosis by AP2-associated protein kinase 1 (AAK1) inhibition. We propose the use of baricinitib to prevent the progression of the respiratory insufficiency in SARS-CoV2 pneumonia in onco-haematological patients. In this phase Ib/II study, the primary objective in the safety cohort is to describe the incidence of severe adverse events associated with baricitinib administration. The primary objective of the randomized phase (baricitinib cohort versus standard of care cohort) is to evaluate the number of patients who did not require mechanical oxygen support since start of therapy until day +14 or discharge (whichever it comes first). The secondary objectives of the study (only randomized phase of the study) are represented by the comparison between the two arms of the study in terms of mortality and toxicity at day+30. Moreover, a description of the immunological related changes between the two arms of the study will be reported. Trial design: The trial is a phase I/II study with a safety run-in cohort (phase 1) followed by an open label phase II randomized controlled trial with an experimental arm compared to a standard of care arm
How to increase technology transfers to developing countries: a synthesis of the evidence
The existing United Nations Framework Convention on Climate Change (UNFCCC) has failed to deliver the rate of low-carbon technology transfer (TT) required to curb GHG emissions in developing countries. This failure has exposed the limitations of universalism and renewed interest in bilateral approaches to TT. Gaps are identified in the UNFCCC approach to climate change TT: missing links between international institutions and the national enabling environments that encourage private investment; a non-differentiated approach for (developing) country and technology characteristics; and a lack of clear measurements of the volume and effectiveness of TTs. Evidence from econometric literature and business experience on climate change TT is reviewed, so as to address the identified pitfalls of the UNFCCC process. Strengths and weaknesses of different methodological approaches are highlighted. International policy recommendations are offered aimed at improving the level of emission reductions achieved through TT
The evolution of the ventilatory ratio is a prognostic factor in mechanically ventilated COVID-19 ARDS patients
Background: Mortality due to COVID-19 is high, especially in patients requiring mechanical ventilation. The purpose of the study is to investigate associations between mortality and variables measured during the first three days of mechanical ventilation in patients with COVID-19 intubated at ICU admission. Methods: Multicenter, observational, cohort study includes consecutive patients with COVID-19 admitted to 44 Spanish ICUs between February 25 and July 31, 2020, who required intubation at ICU admission and mechanical ventilation for more than three days. We collected demographic and clinical data prior to admission; information about clinical evolution at days 1 and 3 of mechanical ventilation; and outcomes. Results: Of the 2,095 patients with COVID-19 admitted to the ICU, 1,118 (53.3%) were intubated at day 1 and remained under mechanical ventilation at day three. From days 1 to 3, PaO2/FiO2 increased from 115.6 [80.0-171.2] to 180.0 [135.4-227.9] mmHg and the ventilatory ratio from 1.73 [1.33-2.25] to 1.96 [1.61-2.40]. In-hospital mortality was 38.7%. A higher increase between ICU admission and day 3 in the ventilatory ratio (OR 1.04 [CI 1.01-1.07], p = 0.030) and creatinine levels (OR 1.05 [CI 1.01-1.09], p = 0.005) and a lower increase in platelet counts (OR 0.96 [CI 0.93-1.00], p = 0.037) were independently associated with a higher risk of death. No association between mortality and the PaO2/FiO2 variation was observed (OR 0.99 [CI 0.95 to 1.02], p = 0.47). Conclusions: Higher ventilatory ratio and its increase at day 3 is associated with mortality in patients with COVID-19 receiving mechanical ventilation at ICU admission. No association was found in the PaO2/FiO2 variation
LMDI decomposition analysis of energy consumption in Andalusia (Spain) during 2003–2012: the energy efficiency policy implications
Bioavailability of once-daily tacrolimus formulations used in clinical practice in the management of De Novo kidney transplant recipients: the better study.
Multicenter, prospective, observational study to compare the relative bioavailability of once-daily tacrolimus formulations in de novo kidney transplant recipients. De novo kidney transplant recipients who started a tacrolimus-based regimen were included 14 days post-transplant and followed up for 6 months. Data from 218 participants were evaluated: 129 in the LCPT group (Envarsus) and 89 in the PR-Tac (Advagraf) group. Patients in the LCPT group exhibited higher relative bioavailability (Cmin /total daily dose [TDD]) vs. PR-Tac (61% increase; P