A Combined Procedure of Intrastromal Corneal Rings Explantation and Penetrating Keratoplasty in a Patient With Keratoconus: A Case Report

Keratoconus is a non-inflammatory and degenerative corneal ectasia that determinate progressive steepening of paracentral cornea with development of irregular astigmatism and visual function deterioration. According to the stage of the pathology, different methods of correction can be used: rigid contact lenses may be used to alter corneal shape and partially correct astigmatism, corneal collagen cross-linking (CXL) and intrastromal corneal ring segment (ICRS) implantation can reinforce corneal stroma to slow disease progression. Late-stage treatment comprehend anterior lamellar keratoplasty or penetrating keratoplasty. We evaluated a 31-year-old patient who was subjected to bilateral ICRS implantation combined with CXL due to keratoconus. This led, after 9 months, to ring extrusion in his left eye, corneal thinning and microperforation into the aqueous chamber with residual irregular astigmatism of 4.50 D. cyl. 10°. The patient underwent ICRS explantation and PKP during the same surgical session. After 15 months of follow-up, the BCVA was 0.2 LogMAR with a residual astigmatism of 6.3 dpt

Calidad microbiológica de la miel en la Región Pampeana (Argentina) a lo largo del proceso de extracción

Este estudio evaluó la calidad microbiológica de la miel dentro de varias plantas de extracción de miel y la calidad del medio ambiente de las mismas en la Región Pampeana (Argentina). Se trabajó con 163 muestras de miel provenientes de 8 plantas de extracción. Se cuantificaron hongos y levaduras, bacterias aeróbicas mesófilas, bacterias esporuladas y esporas de clostridios. Asimismo, se determinó la presencia de Salmonella spp., Shigella spp. y coliformes fecales. Los resultados mostraron que por g de miel, 89 muestras tuvieron menos de 10 UFC de hongos y levaduras, 69 tuvieron entre 10 y 50 UFC y 2 alcanzaron 65,5 UFC. Ochenta y uno por ciento de las muestras presentaron menos de 30 UFC de bacterias aeróbicas mesófilas por g de miel mientras que solo 7 tuvieron entre 50 y 54,25 UFC. Se obtuvieron 36 muestras de miel directamente de tambor: los conteos de bacterias aeróbicas mesófilas fueron ≤ 30 UFC/g de miel en 25 muestras (69,4%); los valores de hongos y levaduras estuvieron entre 10 y 50 UFC en 20 muestras (55,5%) y solo se detectaron coliformes totales. No se observaron coliformes fecales, esporas de clostridios así como tampoco Salmonella spp. y Shigella spp. y se obtuvieron menos de 50 esporas de Bacillus spp./g en miel de los tambores. Se concluye que la calidad microbiológica de la miel en las plantas de extracción no presentó riesgo sanitario. Los resultados fueron entregados a los dueños de las mismas como aporte para que valoren la importancia de reforzar la aplicación de buenas prácticas de manejo y saneamiento.In this work we determined the microbiological quality of honey at different processing points and the environmental quality within honey houses, in order to enlarge and complete a research we started in 2009. Mould and yeast (MY), aerobic mesophilic heterotrophic bacteria (CHMB), spore forming bacteria and spores of clostridia number as well as the presence of Shigella spp., Salmonella spp. and fecal coliforms were determined in 163 samples of honey from eight honey houses of the Pampas Region (Argentina). Results showed that 89 samples had ≤10 cfu of MY g-1 while 69 ranged from 10 to 50 cfu g-1, except two that reached 65.5 cfu g-1. Eighty one percentage of the samples showed ≤30 cfu of CHMB g-1 while only seven samples had between 50 and 54.25 cfu g-1. Thirty six samples of honey were obtained from drums: in 25 samples (69.4%) counts of CHMB were less than ≤30 cfu g-1 of honey; in 20 samples (55.5%) values of MY were between 10 and 50 cfu g-1 of honey and total coliforms were only detected in 20 samples from 2014. Fecal coliforms, spores of clostridia as well as Salmonella spp. and Shigella spp were not detected in honey from drums and less than 50 spores of Bacillus spp. g-1 of honey were observed. We can conclude that the microbiological honey quality at honey houses did not show sanitary risks. The information given to the honey house owners would help them to understand the need of applying proper honey handling and sanitation practices.Fil: Fernandez, Leticia Andrea. Universidad Nacional del Sur. Departamento de Agronomía; ArgentinaFil: Ghilardi, Carolina. Universidad Nacional del Sur. Departamento de Agronomía; ArgentinaFil: Hoffmann, Betiana. Universidad Nacional del Sur. Departamento de Agronomía; ArgentinaFil: Busso, Carlos Alberto. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Bahía Blanca. Centro de Recursos Naturales Renovables de la Zona Semiarida. Universidad Nacional del Sur. Centro de Recursos Naturales Renovables de la Zona Semiarida; Argentina. Universidad Nacional del Sur. Departamento de Agronomía; ArgentinaFil: Gallez, Liliana María. Universidad Nacional del Sur. Departamento de Agronomía; Argentin

Informe de la actividad hotelera y gastronómica de la ciudad de Rosario

El presente informe, realizado por el Instituto de Investigaciones Económicas (IIE) de la Facultad de Ciencias Económicas de la UNR a pedido de la Asociación Civil Empresaria Hotelero Gastronómica y Afines Rosario (AEHGAR), analiza la actividad hotelera y gastronómica de la ciudad de Rosario y su evolución reciente. Para ello en primer lugar se presenta un análisis del indicador de facturación a partir de datos suministrados por el Centro de Información Económica (CIE) de la Municipalidad de Rosario. Luego, se expone la cantidad de locales y la facturación media del sector, también en base a datos del CIE. En tercer lugar, se analiza la importancia de Hoteles y Restaurantes en la generación de empleo del Aglomerado Gran Rosario en base a datos de la Encuesta Permanente de Hogares del INDEC (EPH). A continuación, se presenta una estimación de la carga tributaria promedio para los sectores servicios de alojamiento y servicio de comida. Por último, en el anexo I se analizan indicadores relacionados a oferta y demanda hotelera en Rosario.Instituto de Investigaciones Económicas, Facultad de Ciencias Económicas y Estadística, Universidad Nacional de Rosari

Validez de la tarea de fluidez verbal semantica en cinco categorias lexicas en ninos con desarrollo tipico del lenguaje, entre 3 anos y 4 anos 11 meses de la ciudad de Curico

64 p.Introducción: La Tarea de Fluidez Verbal Léxico-Semántica, es una tarea cognitiva compleja, no obstante, es de fácil y rápida aplicación y se mide en un minuto, las categorías evaluadas fueron: frutas, animales, ropa, transportes y partes del cuerpo. El propósito del trabajo fue validar la tarea de fluidez verbal semántica en cinco categorías léxicas al ser aplicada en niños con un desarrollo del lenguaje típico de entre 3 años y 4 años 11 meses que asisten a jardines infantiles en la ciudad de Curicó. Metodología: Estudio Correlacional. Sujetos: Selección aleatoria de los niños, en donde participaron 36 niños de nivel medio mayor y 40 niños de primer nivel de transición. Instrumentos: Se aplicó la Tarea de Fluidez Léxica, el Test de Vocabulario en Imágenes y el Test Exploratorio de Gramática Española de A. Toronto. Validez: Validez de Constructo y la Validez de Criterio Predictiva. Análisis de Datos: Correlación de Pearson (correlación entre variables), Prueba de Rachas (aleatoriedad) y Prueba Kolmogorov-Smirnov (normalidad de la muestra). Resultados: Los resultados obtenidos son aleatorios, normales y poseen validez. Discusión: Las categorías evaluadas son manejadas por niños preescolares. Los datos obtenidos de fluidez léxica se correlacionan con léxico pasivo y edad, no así con sexo

CHARACTERISTICS OF INTERNET USE AMONGST ITALIAN UNIVERSITY STUDENTS

Background: Problematic Internet use (PIU), that may be defined as the inability to control one’s use of Internet with negative consequences in daily life, is an emerging problem involving primarily, but not only young generations. Different studies have shown that students are particularly vulnerable to PIU. Given the paucity of information on PIU in our country, the aim of this paper was at investigating the characteristics of PIU amongst Italian University students. Subjects and methods: A self-assessment questionnaire, referred by the acronym QUNT (“Questionario sull’Utilizzo delle Nuove Tecnologie”), composed by 101 items grouped together to identify a series of factors, was developed and sent through e-mail invitation to several students from three Italian Universities. Results: The returned questionnaires were 3324, out of a total of 51,304 sent, with no difference between the two sexes. On the contrary, the distribution of the QUNT factors was different in the two sexes, in people living alone and in overweight subjects. Men resulted to be more involved in online recreational activities, whereas women seemed more attracted to instant messaging and generally to social networks. PIU was significantly more present in men than women. The comparisons of QUNT factor scores in the four BMI categories showed that the greater the BMI the greater the score of some factors. Conclusions: The findings of the present study indicate that the use of Internet through new technologies may exceed its real utility amongst Italian university student, with some sex-related differences. Men seem more prone to use Internet for passing time and women for social relationships. Men are also at risk of developing PIU. Again, Internet use might be a basic vulnerability factor of increasing weight gain and obesity amongst young people

An Unusual Histology for a Lung Nodule: A Case Report of Primary Pulmonary Paraganglioma

Introduction: Primary pulmonary paraganglioma is a rare tumor with few cases reported in literature and unspecific clinical presentation.Case Presentation: A 49-year-old woman presented to our department with an incidental finding of a pulmonary mass at chest X-ray and no associated clinical symptom. The CT scan and the FDG-PET showed mild uptake of contrast, but a definitive diagnosis was only possible after surgery through histopathological examination.Conclusion: Paragangliomas originating in the pulmonary tissue are generally non-functioning masses discovered incidentally in otherwise asymptomatic patients. Surgery appears to be the best treatment option, with only radiologic follow-up necessary afterwards

Interleukin 12p40 is required for dendritic cell migration and T cell priming after Mycobacterium tuberculosis infection

Migration of dendritic cells (DCs) to the draining lymph node (DLN) is required for the activation of naive T cells. We show here that migration of DCs from the lung to the DLN after Mycobacterium tuberculosis (Mtb) exposure is defective in mice lacking interleukin (IL)-12p40. This defect compromises the ability of IL-12p40–deficient DCs to activate naive T cells in vivo; however, DCs that express IL-12p40 alone can activate naive T cells. Treatment of IL-12p40–deficient DCs with IL-12p40 homodimer (IL-12(p40)2) restores Mtb-induced DC migration and the ability of IL-12p40–deficient DCs to activate naive T cells. These data define a novel and fundamental role for IL-12p40 in the pathogen-induced activation of pulmonary DCs

Beta oscillatory changes and retention of motor skills during practice in healthy subjects and in patients with Parkinson's disease

Recently we found that modulation depth of beta power during movement increases with practice over sensory-motor areas in normal subjects but not in patients with Parkinson's disease (PD). As such changes might reflect use-dependent modifications, we concluded that reduction of beta enhancement in PD represents saturation of cortical plasticity. A few questions remained open: What is the relation between these EEG changes and retention of motor skills? Would a second task exposure restore beta modulation enhancement in PD? Do practice-induced increases of beta modulation occur within each block? We thus recorded EEG in patients with PD and age-matched controls in two consecutive days during a 40-min reaching task divided in fifteen blocks of 56 movements each. The results confirmed that, with practice, beta modulation depth over the contralateral sensory-motor area significantly increased across blocks in controls but not in PD, while performance improved in both groups without significant correlations between behavioral and EEG data. The same changes were seen the following day in both groups. Also, beta modulation increased within each block with similar values in both groups and such increases were partially transferred to the successive block in controls, but not in PD. Retention of performance improvement was present in the controls but not in the patients and correlated with the increase in day 1 modulation depth. Therefore, the lack of practice-related increase beta modulation in PD is likely due to deficient potentiation mechanisms that permit between-block saving of beta power enhancement and trigger mechanisms of memory formation

Ethical Criteria for the Admission and Management of Patients in the ICU Under Conditions of Limited Medical Resources: A Shared International Proposal in View of the COVID-19 Pandemic

Introduction The present pandemic has exposed us to unprecedented challenges that need to be addressed not just for the current state, but also for possible future similar occurrences. It is worth pointing out that discussions on the allocation of medical resources may not necessarily refer to an exception, but, unfortunately, to a regular condition for a large part of humanity (1). The criteria for admission to an Intensive Care Unit (ICU) setting generally take into account multiple factors. There must be a diagnostic and prognostic basis for the decisions made, considering both biological factors and patient values and wishes. Furthermore, the decision-making process should, whenever possible, respect the patient's advance directives as well as the relationship with the patient's family or attorney. Therapeutic neglect should be avoided. Having applied standard clinical evaluation criteria for the appropriate treatment of patients with COVID-19, including consideration of prognosis, if a hospital then finds itself unable to provide optimal treatment (e.g., due to a disproportion between the number of patients and the availability of beds, healthcare providers, ventilators, and drugs in the ICU), it becomes necessary to evaluate, case by case, how to achieve justice and the best possible good for the greatest number of patients. It is therefore mandatory to explore alternative solutions; these include increasing available beds and healthcare providers, implementing alternative, though suboptimal, approaches (where appropriate), transferring patients to other clinical units, etc. Making these decisions properly also involves the recovery of the political role of medicine and science (2). If the imbalance between needs and resources reaches a critical level, an emergency triage protocol, following the operational and ethical indications of “disaster medicine,” should be activated. These have been deployed in major and serious natural (earthquakes or tsunamis for example) and technological (factory explosions, public transport accidents for example) disasters, as well as following terrorist attacks (3, 4). The question of the feasibility of developing a clinical evaluation algorithm to support the decision-making of the triage team remains open, though many such protocols have been written. According to the above, we propose the following five ethical criteria for the triage of patients in conditions of limited resources, such as the COVID pandemic. They are the result of an interdisciplinary and intercultural dialogue between specialists from different disciplines. Several of the authors are working in the main epicenters of the crisis and currently are playing a central role in the bioethical, clinical, social and legal aspects of the management of the COVID-19 pandemic