Short-term response of macroalgal communities to ocean warming in the Southern Bay of Biscay.

Climate change is causing significant shifts in biological communities worldwide, including the degradation of marine communities. Previous research has predicted that southern Bay of Biscay canopy-forming subtidal macroalgal communities will shift into turf-forming Mediterranean-like communities by the end of the century. These predictions were based on a community-environment relationship model that used macroalgal abundance data and IPCC environmental projections. We have tested the short-term accuracy of that model by resampling the same communities and locations four years later and found the short-term predictions to be consistent with the observed communities. Changes in sea surface temperature were positively correlated with changes in the Community Temperature Index, suggesting that macroalgal communities had responded quickly to global warming. The changes over four years were significant, but canopy-forming macroalgae were more resilient in local sites with favourable temperature conditions. Our study demonstrated that updating predictive models with new data has the potential to yield reliable predictions and inform effective conservation strategies.

Biocompatibility and drug release behavior of scaffolds prepared by coaxial electrospinning of poly(butylene succinate) and polyethylene glycol.

Scaffolds constituted by electrospun microfibers of poly(ethylene glycol) (PEG) and poly(butylene succinate) (PBS) were studied. Specifically, coaxial microfibers having different core-shell distributions and compositions were considered as well as uniaxial micro/nanofibers prepared from mixtures of both polymers. Processing conditions were optimized for all geometries and compositions and resulting morphologies (i.e. diameter and surface texture) characterized by scanning electron microscopy. Chemical composition, molecular interactions and thermal properties were evaluated by FTIR, NMR, XPS and differential scanning calorimetry. The PEG component of electrospun fibers could be solubilized by immersion of scaffolds in aqueous medium, giving rise to high porosity and hydrophobic samples. Nevertheless, a small amount of PEG was retained in the PBS matrix, suggesting some degree of mixing. Solubilization was slightly dependent on fiber structure; specifically, the distribution of PEG in the core or shell of coaxial fibers led to higher or lower retention levels, respectively. Scaffolds could be effectively loaded with hydrophobic drugs having antibacterial and anticarcinogenic activities like triclosan and curcumin, respectively. Their release was highly dependent on their chemical structure and medium composition. Thus, low and high release rates were observed in phosphate buffer saline (SS) and SS/ethanol (30:70 v/v), respectively. Slight differences in the release of triclosan were found depending on fiber distribution and composition. Antibacterial activity and biocompatibility were evaluated for both loaded and unloaded scaffolds.

Autopsias psicológicas de treinta suicidios en la IV región de Chile / Psychological autopsies of thirty suicides of the IV region of Chile

Background: Suicide is a relevant public health problem in Chile. This is the first Chilean study with the psychological autopsy method (PA). Aims: a) to identify risk factors for suicide in Chilean victims; b) to identify risk indicators for early intervention; c) to assess acceptability of the PA method by informants. Method: Sample consisted of 30 subjects (24 males, six females) who commited suicide in the IV Region of Chile (December 2008-September 2010). Data was collected from informant interviews. Main instrument was the Psychological Autopsy Interview Protocol. Results: Mean age at suicide was 35.8 years. Most victims communicated suicidal intent before consummation. Almost all experienced negative life events, in many cases shortly before suicide. One half had attempted suicide previously, some during the preceding month. Thirty-six percent were in mental health treatments at time of death. A quarter had recently visited mental health professionals. Psychiatric disorders (ICD-10) were identified in 90 percent, mainly depressive and substance use disorders. Personality disorders were evident in eight victims (33 percent): dissocial (4), emotionally unstable (2), paranoid (1), and anxious (avoidant) (1). Conclusions: A high rate of psychiatric disorders was confirmed. Previous suicide attempts are sensitive predictors of completed suicide. Communication of suicide intent is frequent, and may be an opportunity for intervention. Suicide is often preceded by negative life events. Prevention of suicide may be improved by effective treatment of psychiatric disorders, and focused psychosocial interventions. Intensive follow-up of attempters seems highly relevant. PA is an acceptable method for informants.

Introducción: El suicidio es un problema de salud pública relevante en Chile. Este es el primer estudio chileno con el método de la autopsia psicológica (AP). Objetivos: a) identificar factores de riesgo de suicidio en víctimas chilenas; b) identificar indicadores de riesgo para la intervención temprana; c) evaluar la aceptabilidad del método de la AP por los informantes. Método: La muestra consistió en 30 sujetos (24 hombres y 6 mujeres) que cometieron suicidio en la IV Región de Chile (diciembre de 2008-septiembre de 2010). La información fue recogida de entrevistas a informantes. El instrumento principal fue el Protocolo de Entrevista para Autopsia Psicológica. Resultados: La edad promedio fue 35,8 años. La mayoría comunicó intención suicida antes de consumarlo. Casi todos experimentaron eventos negativos, frecuentemente poco antes del suicidio. La mitad había intentado suicidarse previamente, algunos durante el mes precedente. El 36 por ciento estaba en tratamientos de salud mental al fallecer y un cuarto había visitado recientemente a profesionales de salud mental. Se identificó trastornos psiquiátricos (CIE-10) en el 90 por ciento, principalmente trastorno depresivo y por uso de sustancias. Los trastornos de personalidad fueron evidentes en ocho víctimas (33 por ciento): disocial (4), emocionalmente inestable (2), paranoide (1) y ansioso (evitativo) (1). Conclusiones: Se confirmó una elevada tasa de trastornos psiquiátricos. El antecedente de intentos previos es un predictor sensible de suicidio. La comunicación de intención suicida es frecuente y puede ser una oportunidad de intervención. El suicidio es frecuentemente precedido por eventos vitales negativos. La prevención del suicidio puede mejorar mediante el tratamiento efectivo de trastornos psiquiátricos e intervenciones psicosociales focalizadas. El seguimiento intensivo de intentadores parece altamente relevante. La AP es aceptable para los informantes.

Trastornos de ansiedad en pacientes hospitalizados en Medicina Interna / Anxiety disorders among patients hospitalized in a medical ward

Background: Anxiety symptoms and anxiety disorders are common among medical patients, however few studies differentiate both and consider the psychiatric comorbidity of anxiety disorders among such patients. Aim: To evaluate the presence of anxiety disorders among patients admitted to a medical ward. Patients and methods: Random selection of 406 patients (mean age 56 years, 203 female), hospitalized in a medical ward of a public hospital, mainly for cardiovascular, genitourinary and digestive diseases. All were assessed using an structured interview for DSM-III-R. Results: Twenty six percent of women and 13% of men had anxiety disorders. Fifteen percent of women and 6% of men had specific phobias, 7% of women and 4% of men had generalized anxiety, 5% of women and 0.5% of men had agoraphobia, 3% of women and 0.5% of men had social phobia, 1% of men and 0.5% of women had panic disorders and 0.5% of women had a post traumatic stress. Specific phobias and social phobias started during childhood. Anxiety and agoraphobia started during adulthood. Among patients with anxiety disorders, 43% of women and 34% of men did not have other psychiatric ailment, 34% of women and 19% of men had an associated depression and 34% of men had disorders due to use of alcohol. Conclusions: A high proportion of patients hospitalized in medical wards have anxiety disorders, that once identified it may help to treat the medical ailments.

Prevalencia de trastornos psiquiátricos por uso de alcohol y otras sustancias en hombres y mujeres hospitalizados en medicina interna de un hospital de Santiago de Chile / Prevalence of substance abuse among patients hospitalized in an internal medicine service from Santiago de Chile

Background: Studies done in Chile and abroad report a high frequency of substance abuse among patients hospitalized in general medical services. Aim: To report the frequency of substance abuse in a sample of patients hospitalized in a public hospital of Santiago. Material and methods: A structured psychiatric interview for the Third Revised Version of The Diagnostic and Statistical Manual (DSM-III-R) was applied to 203 males, aged 58.5 years and 203 females, aged 52,9 years, hospitalized in an internal medicine Service of a public hospital. All subjects had a low educational and income level. Results: The discharge diagnoses of studied patients were digestive diseases in 32 percent, circulatory diseases in 19 percent, cancer, diabetes mellitus and genitourinary diseases in 11 percent respectively and mental or behavioral diseases in 5 percent. Thirty eight percent of males and 6 percent of females qualified for alcohol dependency or abuse in some moment of their lives. The figures for benzodiazepine dependency were 1 percent among males and 6 percent among females. The figures for cannabis, cocaine or stimulant abuse were 1.5 percent for males and 1 percent for females. Other conditions of the axis 1 of DSM-IIIR were diagnosed in 47 percent of males and 65 percent of females with substance abuse. Conclusions: Substance abuse underlies medical conditions in a high proportion of patients admitted to medical services in general hospitals

Prevalencia de trastornos psiquiátricos en hombres y mujeres hospitalizados en un servicio de medicina interna de un hospital de Santiago de Chile / Prevalence of psychiatric disorders among subjects hospitalized in a medicine ward of a general hospital

Background: Mental disorders may interfere, aggravate or mimic medical conditions. Aim: To study the prevalence of psychiatric disorders among patients hospitalized in a medical ward of a general hospital. Patients and methods: A structured interview for DSM-III, devised for "non patients", was applied to 203 men and 203 women, aged 11 to 90 years old, hospitalized in an internal medicine service of a public hospital. Thirty four psychiatric conditions that can be discriminated with the instrument and others that complied with DSM-III criteria, were investigated. Results: There was a 60 percent prevalence of mental disorders among men (alcohol dependency in 26 percent, delirium or dementia in 10.8 percent, anxiety disorders in 10.4 percent, major depression in 7.8 percent and adaptation disorders in 3 percent). Among women, the prevalence of mental disorders was 65 percent (major depression in 23.2 percent, anxiety disorders in 14.3 percent, adaptation disorders in 8.4 percent, dementia in 5.6 percent, delirium in 3 percent and alcohol dependency in 2.5 percent). Most conditions were of moderate or mild intensity. Two or more conditions coexisted in 40 percent of cases. Only in 8 percent of these subjects, a psychiatric consultation was requested. Conclusions: There is a high frequency of psychiatric disorders among medical patients. These must be adequately diagnosed and treated

Hongos filamentosos contaminantes de superficie de diferentes frutas deshidratadas de venta libre en Santiago de Chile / Surface contaminant filamentous fungi of different dehydrated fruits sold in markets in Santiago, Chile

Sesenta y una muestra de frutas deshidratadas de diferentes marcas de venta libre en Santiago de Chile, fueron analizadas para determinar los hongos filamentosos contaminantes de superficie, con el objeto de tener una primera aproximación sobre el riesgo derivado de su consumo. De éstas 36 corresponden a muestras envasadas y 25 a granel. Las técnicas de estudio se desarrollaron bajo procedimientos estándar. 45 (73,8 porciento) muestras presentaron desarrollo fúngico. Se identificó en total 11 géneros, siendo los más encontrados: Aspergillus, Rhizopus, Penicillium y Mucor. Géneros como Aureobasidium, Chrysosporium, Paecilomyces, Epicoccum, Ulocladium, Scopulariopsis y Alternaria también fueron descritos. Se discute el potencial riesgo de infección de pacientes inmunodeprimidos que consumen frutas deshidratadas

Persistent endophthalmitis after intravitreal antimicrobial therapy.

PURPOSE: To assess the frequency of persistent infection after injection of intravitreal antimicrobials as therapy for endophthalmitis and to determine if persistent infection influences the final visual outcome after treatment. METHODS: In a series of 42 eyes with culture-positive endophthalmitis of various types, the authors performed a second vitreous culture and injection of antimicrobial agents in 22 eyes. Repeat cultures were obtained 3 to 8 days after initial therapy in 20 of the 22 eyes. RESULTS: Twelve of the 22 eyes were persistently culture-positive. Organisms identified in the persistently culture-positive eyes included staphylococcal species (n = 4), Streptococcus (n = 4), Serratia (n = 1), Propionibacterium acnes (n = 1), and fungi (n = 2). Eyes in which the initial antimicrobial therapy failed to eradicate a bacterial infection had a worse outcome than those that were culture-negative on repeat sampling. Final visual acuity of 20/200 or better after repeat injection was attained in 4 of the 12 culture-positive eyes. CONCLUSION: A single injection of intravitreal antimicrobial agents may be insufficient to cure some cases of endophthalmitis, and a second injection should be considered in some circumstances.

Surgical management of submacular hemorrhage. A series of 47 consecutive cases.

BACKGROUND: The development of a thick submacular hemorrhage usually carries a poor visual prognosis. The surgical removal of submacular blood may improve the otherwise poor outlook in these cases. SUBJECTS AND METHODS: Forty-seven consecutive patients underwent vitrectomy with surgical removal of submacular hemorrhage. The patient population consisted of two consecutive groups. Group 1 (1989 to 1991) included 23 patients (20 with age-related macular degeneration [ARMD], one with idiopathic submacular hemorrhage, one with presumed ocular histoplasmosis syndrome [POHS], and one with angioid streaks) who underwent mechanical clot extraction. Group 2 (1991 to 1993) included 24 patients (19 with ARMD, two with POHS, two with arterial macroaneurysm, and one with angioid streaks) who underwent tissue plasminogen activator-assisted drainage of thick submacular hemorrhage. The dose of tissue plasminogen activator ranged from 10 to 40 micrograms. All patients had surgery within 72 hours of diagnosis. RESULTS: In group 1, the mean size of the submacular hemorrhage was 11 disc areas (range, 1 to 16 disc areas). Mean follow-up was 40 weeks. Mean postoperative visual acuity for eyes with ARMD was 20/200. (Visual acuity improved in six eyes, was stable in seven eyes, and deteriorated in seven eyes.) All three of the eyes without ARMD had visual improvement with a mean postoperative visual acuity of 20/70. Overall, visual acuity stabilized or improved in 13 (57%) of 23 patients and decreased in 10 (43%) patients. In group 2, the mean size of the submacular hemorrhage was 11 disc areas (range, 3 to 16 disc areas). Mean follow-up was 24 weeks. Mean postoperative visual acuity for eyes with ARMD was 20/480 (visual acuity was stable in 15 eyes, improved in two eyes, and deteriorated in two eyes). Four of five eyes without ARMD had visual improvement and one was stable, with a mean postoperative visual acuity of 20/60. Visual acuity stabilized or improved in 22 (92%) of 24 patients and decreased in two (8%). The degree of clot lysis was variable. CONCLUSIONS: Submacular hemorrhage secondary to ARMD has a poor visual prognosis, with or without surgical drainage. The addition of tissue plasminogen activator-assisted clot lysis does not appear to significantly improve the visual outcome following surgery. The determination of whether surgical intervention is appropriate in these cases requires a prospective, randomized clinical trial.

Clinicopathologic studies of an eye after submacular membranectomy for choroidal neovascularization.

BACKGROUND: Submacular membranectomy has been suggested as an alternative treatment for subfoveal choroidal neovascularization (CNV). Clinicopathologic features of the right eye of a 59-year-old man with recurrent subfoveal CNV who underwent submacular membranectomy after two unsuccessful laser photocoagulation treatments are reported. METHODS: The surgically excised subfoveal membrane was sectioned serially and evaluated by light microscopy. The globes were obtained postmortem and serial sectioned through the macula and optic nerve head for light microscopy. Ultrastructural study of a tissue section in the center of the lesion was performed. RESULTS: Histopathologic study of the surgically excised membrane disclosed a thin two-component fibrovascular membrane with the larger component internal to residual retinal pigment epithelium and basal laminar deposit. Photoreceptor outer segments were present on the internal surface of the membrane near one margin. Light and electron microscopic study of the postmortem globe revealed a very thin subfoveal subretinal pigment epithelial fibrovascular membrane with loss of photoreceptor cell layer in a central 0.5 mm area, loss of outer segments, reduction of inner segments, and thinning of the outer nuclear layer in the remainder of the lesion. There was moderate retinal pigment epithelial attenuation and mild basal laminar and basal linear deposits. CONCLUSION: Submacular membranectomy for recurrent subfoveal CNV secondary to age-related macular degeneration after two unsuccessful laser photocoagulation treatments appeared to be effective with repopulation of two thirds of the area of membranectomy by extension of attenuated retinal pigment epithelium from adjacent areas. There was, however, persistence or recurrence of CNV, moderate atrophy of the overlying retina with total loss of the photoreceptor cells over the central 0.5 mm of the membrane, and moderate loss of the photoreceptor cells over the remaining area.

Visual results after surgical removal of subfoveal choroidal neovascular membranes.

PURPOSE: The authors report their experience with the surgical removal of subfoveal choroidal neovascularization. Correlations between preoperative characteristics and final postoperative visual acuity are explored. METHODS: A retrospective study of 159 consecutive patients was performed between February 1990 and August 1993. Follow-up of 2 or more months was available for 147 eyes: presumed ocular histoplasmosis syndrome, 67 eyes; age-related macular degeneration, 41 eyes; myopia, 10 eyes; multifocal choroiditis, 9 eyes; idiopathic, 8 eyes; angioid streaks, 4 eyes; and miscellaneous, 8 eyes. RESULTS: Sixty-seven eyes had presumed ocular histoplasmosis syndrome: mean follow-up was 10.5 months. Visual acuity was stable or improved in 56 (83%) eyes and 20/40 or greater in 21 (31%) eyes. Mean interval to best visual acuity was 3 months. A recurrence rate of 37% had no significant effect on final visual outcome (P = 0.952). Forty-one eyes had age-related macular degeneration: mean follow-up was 15 months. Visual acuity was improved in only five (12%) eyes and was 20/40 or greater in only two (5%) eyes. The interval to best visual acuity was 5 months. A recurrence rate of 27% had not significant effect on final visual outcome (P = 0.31). The visual results and recurrence rates for eyes with less common disorders are presented. CONCLUSION: The surgical excision of subfoveal choroidal neovascularization may stabilize or improve visual acuity in selected cases. Patients with focal disorders of the retinal pigment epithelium-Bruch's membrane complex appear to have a better surgical outcome than those with diffuse disease.

External argon laser choroidotomy versus needle drainage technique in primary scleral buckle procedures. A prospective randomized study.

PURPOSE: To compare the rates of intraoperative and postoperative complications of external argon laser choroidotomy and needle drainage techniques during scleral buckle procedures for primary retinal detachment. METHODS: A group of 175 patients undergoing scleral buckling for primary retinal detachment was randomly assigned to undergo either external argon laser choroidotomy or needle drainage. Complications associated with drainage of subretinal fluid were categorized as retinal break, retinal incarceration, or hemorrhage (dot, < or = 1 disc diameter [DD], or > 1 DD), and recorded during surgery and 24 hours after surgery. RESULTS: In the group that underwent laser choroidotomy, 12 (13%) of 92 patients had complications, including 4 dot hemorrhages, 3 hemorrhages 1 DD or smaller, 3 hemorrhages larger than 1 DD, 1 retinal incarceration, and 1 suprachoroidal hemorrhage. In the group that underwent needle drainage, 13 (16%) of 81 patients had complications, including 3 dot hemorrhages, 4 hemorrhages 1 DD or smaller, 5 hemorrhages larger than 1 DD, and 1 suprachoroidal hemorrhage. No significant difference was noted between the two groups in the incidence of complications (P = 0.657). CONCLUSION: External argon laser choroidotomy and needle choroidotomy are comparable, safe, and effective ways to drain subretinal fluid during scleral buckle surgery.

Magnetic resonance imaging findings in Vogt-Koyanagi-Harada syndrome.

BACKGROUND: Vogt-Koyanagi-Harada Syndrome (VKHS) is a systemic disorder consisting of bilateral panuveitis with associated cutaneous and neurologic findings. In the absence of extraocular manifestations, diagnosis of VKHS may be difficult. METHODS: The results of magnetic resonance imaging (MRI) in two patients with VKHS and of computed tomography (CT) in a third patient with VKHS are described. RESULTS: Bilateral, diffuse choroidal thickening with scleral sparing was the norm. Choroidal thickening was demonstrable, despite the normal fundus appearance and fluorescein angiogram, in one eye. Intense enhancement after administration of gadopentetate was seen in the acute stages, but not after corticosteroid treatment. High-intensity periventricular lesions were seen in one patient. CONCLUSION: MRI superbly discriminates the fibrous sclera from the choroid and allows for the detection of subclinical ocular and central nervous system disease. It is therefore a useful adjunct in the diagnosis and follow-up of VKHS.

Prospective evaluation of the effect of pseudophakic cystoid macula edema on contrast sensitivity.

OBJECTIVE: To evaluate the effect of pseudophakic cystoid macular edema (PCME) on contrast sensitivity. DESIGN: Best-corrected visual acuity, fluorescein angiogram, and contrast sensitivity measurements were obtained before surgery and at 8 weeks and 8.5 months after surgery. Eyes were classified as having no PCME, transient PCME, or persistent PCME. PARTICIPANTS: The study population consisted of 31 consecutive patients undergoing extracapsular cataract extraction with posterior chamber intraocular lens implantation between September 1990 and March 1991. MAIN OUTCOME MEASUREMENTS: Outcomes were best-corrected visual acuity and contrast sensitivity. RESULTS: Analysis of variance showed a significant decrease for all spatial frequencies at 8 weeks (P < .005) and for higher frequencies at 8.5 months (P < .05) in both PCME groups and for higher frequencies at 8 weeks in the transient PCME group. CONCLUSION: Decrease in contrast sensitivity associated with PCME may account for persistent visual difficulties despite good Snellen visual acuity.

Subretinal endophotocoagulation in the treatment of choroidal neovascularization.

The development of subfoveal choroidal neovascularization is a major cause of visual loss in age-related macular degeneration and other disorders of the retinal pigment epithelium-Bruch's membrane complex. We designed a new subretinal laser delivery system and used it to treat subfoveal neovascular membranes in three eyes with age-related macular degeneration. Preoperative visual acuities were 20/200, 20/80, and 20/300, respectively. With a mean follow-up of seven months, postoperative visual acuities were 20/80, 20/400, and 20/300, respectively. One eye developed recurrent neovascularization, which was adequately treated with slit lamp-delivered laser photocoagulation. Another eye continued to lose visual acuity because of progressive atrophy of the retinal pigment epithelium. Although ablation of choroidal neovascular membranes was possible with this technique, visual results were disappointing, probably because of damage of the underlying retinal pigment epithelium and choriocapillaris.

Exuberant conjunctival pseudopolyposis in a patient with dermatomyositis.

Dermatomyositis is a disease of unknown cause, characterized by a diffuse inflammatory myopathy and skin changes consisting of heliotrope eruption, Gottron's papules, periungual telangiectasia with dystrophic cuticles, skin telangiectasia, and atrophy. Ocular involvement may consist of conjunctival edema, nystagmus, extraocular muscle imbalance (when associated with myasthenia gravis), iritis, cotton-wool spots, and optic atrophy. Conjunctival avascularity and membranous conjunctivitis also have been reported. We describe an unusual conjunctival finding with secondary corneal surface disturbances in a patient with dermatomyositis.

Interferon alfa-2a in the treatment of subfoveal choroidal neovascularization.

We prospectively evaluated the effect of interferon alfa-2a on subfoveal choroidal neovascularization. Eight patients with recurrent subfoveal choroidal neovascularization after surgical excision and 12 patients with subfoveal choroidal neovascularization without previous surgical excision received interferon alfa-2a (3.0 to 6.0 million U/m2 of body surface area), every other night for an average of 12 weeks. Mean follow-up was nine months. Visual acuity improved in two of 20 (10%), remained stable in seven of 20 (35%), and worsened in 11 of 20 (55%) patients. The fluorescein angiogram improved in two of 20 (10%), remained stable in three of 20 (15%), and deteriorated in 15 of 20 (75%) patients. All patients had side effects, which led to the discontinuation of therapy in five of 20 (25%) patients. Side effects included flulike symptoms, leukopenia, thrombocytopenia, increased liver enzymes, alopecia, fever, nausea, and suicidal depression. Interferon alfa-2a failed to improve visual acuity or the fluorescein angiographic appearance of subfoveal neovascular membranes in 90% of cases and was associated with marked side effects. We discourage the widespread use of interferon alfa-2a in the treatment of choroidal neovascularization.