Evaluation of the central vault after phakic collamer lens (ICL) implantation

Curso 2019-2020Objetivo: Comparar cómo varía el vault de las lentes fáquicas tipo ICL a lo largo del tiempo. Material y métodos: Se incluyeron 626 ojos de 343 pacientes operados en la Clínica Miranza IOA Madrid entre febrero de 2004 y diciembre de 2016. Se estudió la evolución del vault central en función de los 3 modelos de ICL implantados de potencia miópica: el modelo ICM y los modelos VICMO y VICM5 que presentan un agujero central (aquaPORT) que ayuda al correcto flujo del humor acuoso. La evaluación del modelo ICM se hizo mediante lámpara de hendidura y OCT, mientras que para los modelos VICMO y VICM5 la evaluación se realizó únicamente con OCT. Todos los valores se incluyeron en micras en la base de datos creada en SPSS para su análisis. Resultados: Las lentes tipo ICM presentaron una disminución estadísticamente significativa en el vault central dos años después de la implantación de la lente (26,70±117,76μm; p=0,018). En las lentes con AquaPORT (VICMO y VICM5) se observó una disminución estadísticamente significativa desde el primer año tras la inserción de la lente (98,79±143,23μm; p=0,000 y 190,74±155,59μm; p=0,000 respectivamente), siendo está disminución mayor durante los primeros 12 meses. Se observaron diferencias estadísticamente significativas entre las lentes ICM y VICMO (p=0,000) tanto en la medida postquirúrgica y durante los dos años siguientes (p=0,011), y entre la lente ICM y VICM5 en la medida postquirúrgica (p=0,000). No se observaron diferencias estadísticamente significativas entre los modelos VICMO y VICM5. Conclusiones: Existe una disminución estadísticamente significativa en el vault central de todos los modelos de ICL evaluados a lo largo del tiempo.Purpose: To compare how the vault of phakic collamer lens (ICL) changes over the time. Material and methods: 626 eyes of 343 patients operated on in Clinic Miranza IOA Madrid between February 2004 and December 2016 were included. Central vault evolution was studied according to the 3 ICL models implanted with myopic power: the ICM model and the VICMO and VICM5 models that have a central hole (aquaPORT) which helps the correct flow of aqueous humor. The evaluation of the ICM model was performed with a slit lamp and OCT while for the VICMO and VICM5 models the evaluation was carried out only with OCT. All values were included in microns in the database created in SPSS for analysis. Result: ICM lenses presented a statistically significant decrease in the annual vault 2 years later from the lens insertion (26,70±117,76μm; p=0,018). In the case of the lens with AquaPORT it was observed a statistically significant decrease from the first year after the lens insertion (98,79±143,23μm; p=0,000 y 190,74±155,59μm; p=0,000 respectively), being this decrease higher during the first 12 months. Statistically significant differences were observed between the ICM and VICMO (p=0,000) lenses both in the post-surgical measurement and during the following two years (p=0,011), and between the ICM and VICM5 lens in the post-surgical visit (p=0,000). Non statistically significant differences were observed between the VICMO and VICM5 models. Conclusions: There is a statistically significant decrease in the central vault of the lens with and without AquaPORT over the time.Depto. de Optometría y VisiónFac. de Óptica y OptometríaTRUEsubmitte

Los familiares que habitan con enfermos cardiacos de Huesca, ¿están preparados para hacer frente a una parada cardiorrespiratoria?

Objective: To describe if people who lives with cardiac patients, possess the sufficient knowledge to confront out of hospital cardiac arrest.Methods: A descriptive crossover study. The population to study was composed by the family of the patients hospitalized in the Service of Cardiology of San Jorge Hospital in Huesca, in September and October, 2014. The variables were gathered by a structured questionnaire of own production.Results: The total of the participants was 177: 61% was women; the middle ages were 55,63 years. 26,6% had witnessed a out of hospital cardiac arrest , 20,9% had realized a course of cardiopulmonary resuscitation, 36,7 % would be able to recognize people at the risk of suffering a heart arrest, 56,5% knew  the Service of Medical Emergencies  number, 9,6% had the sufficient knowledge to initiate manoeuvres of cardiopulmonary resuscitation, 98,3% was thinking that it was important to have knowledge cardiopulmonary resuscitation and 72,9% would take part in training courses.Conclusions: The person who lives with cardiac patients, do not possess the sufficient knowledge to face out of hospital cardiac arrest and for that it is really important   increase the efforts in the creation of strategies directed to develop the two first and fundamental links of the chain of survival.Objetivo: Describir si los familiares que habitan con  enfermos cardiacos, poseen los conocimientos suficientes para hacer frente a una parada cardiaca extrahospitalaria (PCEH).Métodos: Estudio descriptivo, transversal. La población a estudio estuvo compuesta por los familiares de los pacientes ingresados en el Servicio de Cardiología del Hospital San Jorge de Huesca, en los meses de septiembre y octubre de 2014. Las variables fueron recogidas con un cuestionario estructurado de elaboración propia. Resultados: El total de los participantes fue de 177. El 61% eran mujeres, la edad media fue de 55,63 años. El 26,6% había presenciado una PCEH, el 20,9% había realizado un curso de reanimación cardiopulmonar (RCP), el 36,7% sabría reconocer personas con riesgo de sufrir una parada cardiaca, el 56,5% conocía el número del Servicio de Emergencias Médicas (SEM), el 9,6% tenía los conocimientos suficientes para iniciar maniobras de RCP, el 98,3% creía que era importante tener conocimientos sobre RCP y el 72,9% participaría en cursos de formación. Conclusiones: Los familiares que habitan con enfermos cardiacos no poseen los conocimientos suficientes para hacer frente a una PCEH y por ello es de vital importancia que se incrementen los esfuerzos en la creación de estrategias dirigidas a desarrollar los dos primeros y fundamentales eslabones de la cadena de supervivencia

Visual and optical quality of enhanced intermediate monofocal versus standard monofocal intraocular lens

Purpose: Intraocular lens designs are constantly evolving, trying to obtain more spectacle independence after cataract surgery. This advantage can be linked to some disadvantages, such as optical quality decrease. For that reason, it is important to assess, not only the amount of vision provided but also the quality of vision once they are implanted. The purpose of the present work was to compare the visual performance between two monofocal intraocular models: a standard model and a monofocal with enhanced intermediate vision lens. Methods: Prospective, randomized, comparative study. Sixty adult subjects scheduled to undergo bilateral cataract surgery and IOL implantation were randomized to receive one of the two IOLs in both eyes at Miranza IOA, Madrid, Spain (group A: monofocal with enhanced intermediate vision lens and group B: standard monofocal lens). Monocular outcomes (right eyes) determined 1 and 3 months postoperatively were photopic corrected distance visual acuity (CDVA), uncorrected distance visual acuity (UDVA), perceived halo, corrected intermediate-distance contrast sensitivity, and higher-order aberrations. The impact of the new IOL in the postoperative management with autorefraction devices was also evaluated. Results: No differences were found in CDVA between the two groups. Significant differences were detected between the two lenses evaluated in both total HOA (p = 0.028) and internal HOA (p = 0.037). Contrast sensitivity and halometry results obtained at 1 month were similar across the two IOL groups. Conclusion: In patients undergoing cataract surgery, monofocal with enhanced intermediate vision IOL offered similar distance performance and contrast sensitivity along with perceived HOA and halos compared with the standard monofocal IOLs tested

Trainspotting (1996): el problema de las adicciones en los jóvenes

Trainspotting (1996) es una película inglesa dirigida por Danny Boyle, basada en la novela homónima escrita por el escocés Irvine Welsh. La trama gira en torno a Mark Renton, un joven adicto a la heroína con una clara conducta antisocial que se enfrenta a vida y a la toma de decisiones que ésta conlleva. Rodeado por un mundo de drogas y adicciones, el protagonista interactúa con un grupo de amigos, también adictos, donde crean una micro sociedad en la que su único objetivo es consumir. Finalmente Renton, tras formar parte de una comunidad terapéutica y lograr dejar las drogas, consigue trabajo como como agente inmobiliario en Londres, siendo finalmente el único miembro del grupo que consigue escapar del destino autodestructivo que parece esperar a sus ex compañeros.</p

COVID-19 in Older Patients: Assessment of Post-COVID-19 Sarcopenia

(1) Background: Acute COVID-19 infections produce alterations in the skeletal muscle, leading to acute sarcopenia, but the medium- and long-term consequences are still unknown. The aim of this study was to evaluate: (1) body composition; (2) muscle strength and the prevalence of sarcopenia; and (3) the relationship between muscle strength with symptomatic and functional evolution in older patients affected by/recovered from COVID-19; (2) Methods: A prospective, longitudinal study of patients aged ≥65 years who had suffered from COVID-19 infection between 1 March and 31 May 2020, as confirmed by PCR or subsequent seroconversion. Persistent symptoms, as well as anthropometric, clinical, and analytical characteristics, were analyzed at 3 and 12 months after infection. The degree of sarcopenia was determined by dynamometry and with SARC-F; (3) Results: 106 participants, aged 76.8 ± 7 years, were included. At 3 months postinfection, a high percentage of sarcopenic patients was found, especially among women and in those with hospitalization. At 12 months postinfection, this percentage had decreased, coinciding with a functional and symptomatic recovery, and the normalization of inflammatory parameters, especially interleukin-6 (4.7 ± 11.6 pg/mL vs. 1.5 ± 2.4 pg/mL, p < 0.05). The improvement in muscle strength was accompanied by significant weight gain (71.9 ± 12.1 kg vs. 74.7 ± 12.7 kg, p < 0.001), but not by an increase in lean mass (49.6 ± 10 vs. 49.9 ± 10, p 0.29); (4) Conclusions: Older COVID-19 survivors presented a functional, clinical, and muscular recovery 12 months postinfection. Even so, it is necessary to carry out comprehensive follow-ups and assessments that include aspects of nutrition and physical activity.Funding for open access charge: Universidad de Málag

De-Intensification of Antidiabetic Treatment Using Canagliflozin in Patients with Heart Failure and Type 2 Diabetes: Cana-Switch-HF Study

Canagliflozin is a sodium-glucose co-transporter 2 inhibitor that reduces glycemia as well as the risk of cardiovascular events. Our main objective was to analyze antidiabetic treatment de-intensification and the glycemic efficacy of replacing antidiabetic agents (excluding metformin) with canagliflozin in patients with heart failure and type 2 diabetes with poor glycemic control. In this observational, retrospective, real-world study, we selected patients treated with metformin in combination with ≥2 non-insulin antidiabetic agents or metformin in combination with basal insulin plus ≥1 non-insulin antidiabetic agent. Non-insulin antidiabetic agents were replaced with canagliflozin. Patients were followed-up on at three, six, and 12 months after the switch and a wide range of clinical variables were recorded. A total of 121 patients were included. From baseline to 12 months, the number of antidiabetic agents (3.1 ± 1.0 vs. 2.1 ± 0.8, p < 0.05), basal insulin dose (20.1 ± 9.8 vs. 10.1 ± 6.5 units, p < 0.01), and percentage of patients who used basal insulin (47.9% vs. 31.3%, p < 0.01) decreased. The proportion of patients who used diuretics also declined significantly. In addition, we observed improvement in glycemic control, with an increase in the proportion of patients with glycated hemoglobin <7% from 16.8% at three months to 63.5% at 12 (p < 0.001). Canagliflozin use was also beneficial in terms of body weight, blood pressure, heart failure status, functional class, and cardiovascular-renal risk. There were also reductions in the number of emergency department visits and hospitalizations for heart failure. Moreover, canagliflozin was well-tolerated, with a low rate of drug-related discontinuation. Mounting evidence from randomized controlled trials and real-world studies point to the beneficial profile of sodium-glucose co-transporter type 2 inhibitors such as canagliflozin in patients with heart failure.This work was supported by PI15/00256 from the Institute of Health “Carlos III” (ISCIII), co-funded by the Fondo Europeo de Desarrollo Regional-FEDER. Maria Isabel Queipo-Ortuño was supported by the “Miguel Servet Type II” program (CPI18/00003, ISCIII, Spain, co-funded by the Fondo Europeo de Desarrollo Regional-FEDER) and by the “Nicolas Monardes” research program of the Consejería de Salud (C-0030-2018, Junta de Andalucía, Spain. Bruno Ramos Molina was supported by the “Miguel Servet Type I” program (CP19/00098, ISCIII, Spain, co-funded by the Fondo Europeo de Desarrollo Regional-FEDER). Lidia Sanchez-Alcoholado was the recipient of a predoctoral grant (PE-0106-2019) from the Consejería de Salud y Familia (co-funded by the Fondo Europeo de Desarrollo Regional-FEDER, Andalucia, Spain). Aurora Laborda-Illanes was the recipient of a predoctoral grant, PFIS-ISCIII (FI19-00112), co-funded by the Fondo Europeo de Desarrollo Regional-FEDER, Madrid, Spain.Ye

Clinical rating scale for pantothenate kinase-associated neurodegeneration: A pilot study

Pantothenate kinase-associated neurodegeneration is a progressive neurological disorder occurring in both childhood and adulthood. The objective of this study was to design and pilot-test a disease-specific clinical rating scale for the assessment of patients with pantothenate kinase-associated neurodegeneration.info:eu-repo/semantics/publishedVersio

El derecho del trabajo y de la seguridad social en españa en 2018

En su quinta edición, el Informe “El Derecho del Trabajo y de la Seguridad Social en España 2018” le ofrece una síntesis, que por concreta no es menos rigurosa, de los principales hitos por los que ha transitado el iuslaboralismo a lo largo del último año. En concreto, en las páginas que siguen, los expertos integrantes de la Sección Juvenil de la Asociación Española de Derecho del Trabajo y de la Seguridad Social (AEDTSS) analizan para usted, en primer lugar, las principales resoluciones europeas y nacionales en materia de igualad y no discriminación, acoso en sus más diversas manifestaciones, liberad religiosa y libertad de expresión. Asimismo, se abordan también las cuestiones relativas al empleo y la contratación, casi monopolizadas por el impacto de las plataformas y las consecuencias del caso de Diego. En materia de vicisitudes, sin perder importancia el despido colectivo, observará un cierto auge de los casos relativos a sucesión empresarial, movilidad funcional y empleo público. En el ámbito del derecho colectivo, además de analizarse el IV AENC, encontrará un estudio pormenorizado de las principales resoluciones en materia de libertad sindical, representación unitaria y ultraactividad. La sección relativa a conciliación y corresponsabilidad incluye este año como novedad un apartado relativo a violencia de género, al hilo de los avances normativos derivados del Real Decreto-ley 9/2018. Los epígrafes concernientes a la protección social y la prevención de riesgos laborales crecen de forma significativa en esta edición, lo que ha permitido abordar la evolución jurisprudencial para buena parte de las prestaciones y riesgos previstos en la Ley. Por último, las expertas del apartado de derecho procesal se han encargado de revisar a fondo los casos más significativos en el marco de las modalidades procesales especiales, con especial hincapié en el ámbito concursal. También han abordado la jurisprudencia constitucional más reciente sobre el de recurso de reposición. En suma, tienen ante usted un trabajo científico consolidado en el tiempo y sólido en cuanto al contenido, fiel reflejo de, a pesar del difícil contexto, el buen hacer de la joven doctrina iuslaboralista española