Severe epithelial ingrowth after pars plana vitrectomy ten years after LASIK relifting.

Epithelial ingrowth is one of the most significant complications of Laser in Situ Keratomileusis (LASIK) refractive surgery. We present the case of a 72-year-old male with a history of myopic LASIK (1999), who underwent cataract surgery and a second thin LASIK sub-Bowman flap to correct refractive error. Then, three months after pars plana vitrectomy for an epiretinal membrane, the patient complained of progressive vision loss. A diffuse haze of the corneal stroma that did not exist before surgery was observed. As the main suspicion was epithelial ingrowth, the flap was lifted and meticulous de-epithelialization of the stromal bed was performed. Mitomycin C 0.02% was applied, the flap was sutured with 10-0 Nylon, and a bandage contact lens was placed. The epithelialization of the interface after vitrectomy in a patient with LASIK could occur even when it is a rare complication and without obvious flap traumatism.

A two-component model of hair cortisol concentration in fibromyalgia: Independent effects of pain chronicity and severity.

BACKGROUND: Fibromyalgia (FM) is a chronic pain disorder of unknown aetiopathogenesis, in which the role of activity of the hypothalamic-pituitary-adrenal (HPA) axis is not clearly established. METHODS: This study analysed the modulatory effects of disease chronicity and severity on cortisol levels. Hair cortisol concentrations (HCC) and clinical evaluation data (pain severity, impact of FM on daily activities, depression, anxiety, fatigue and insomnia) were collected from 47 female patients with FM and 36 healthy women (HW). RESULTS: The results showed that disease chronicity, with a negative effect, and symptom severity, with a positive effect, were independent predictors of HCC. Patients with a shorter disease duration had higher HCC than patients with a longer disease duration and healthy participants. Furthermore, patients with greater symptom severity had higher HCC than those patients with lower clinical severity and healthy participants. While disease chronicity in FM was associated with a decrease in HCC, clinical severity increased HCC. CONCLUSIONS: These results support the existence of a dysfunction in the regulation of the HPA axis in FM and its possible contribution to chronic pain development. SIGNIFICANCE: This is the first study to assess hair cortisol concentrations in a specific sample of patients with fibromyalgia (FM). This method is especially useful for the assessment of long-term regular cortisol excretion. Results showed a two-component model for explaining cortisol levels: disease chronicity, with a negative effect, and symptom severity, with a positive effect. This suggests that severe pain/stress evokes higher cortisol levels at earlier stages of FM, while in the longer term a decrease in cortisol levels was observed.

Assessment of the biometric modifications of the eye in LASIK during suction.

PURPOSE: To study the biometric modifications of the eyeball during suction in Laser assisted in Situ Keratomileusis (LASIK). METHODS: Observational and cross-sectional study. We studied 43 patients who underwent surgery for myopia and myopic astigmatism. Mean age was 38.3 ±â€¯11.5 years, and 19 were female (44.2%). Conventional LASIK surgery with a manual microkeratome was performed. Before and during the suction maneuvre the following parameters were measured using an 11 Mhz biometric probe: aqueous depth (AQD), lens thickness (LT), vitreous cavity length (VCL) and axial length (AXL). Paired t-test was used to compare the biometric measurements before and during suction. RESULTS: The mean spherical equivalent refractive error was -4.5 ±â€¯2.3 diopters. During suction, the AQD did not change significantly (p = 0.231). However, AXL and VCL increased by 0.12 mm and 0.22 mm respectively (p = 0.039 and <0.01) and LT decreased by 0.20 mm (p < 0.01). AXL increased in 42% of the eyes and decreased in 16%, VCL increased in 70% of the eyes and decreased in 9%, and the LT was reduced in 67% of the eyes. CONCLUSIONS: Suction maneuvres during LASIK surgery produce changes of little magnitude in the eye globe, mainly a decrease in LT and an increase in VCL and AXL. Therefore, these modifications are expected to produce minimal anatomic alterations.

Glistening on intraocular lenses: A review.

The glistening in intraocular lenses (IOLs) is a phenomenon in which tiny water-filled microvacuoles (MVs) form within the IOL material, causing light to scatter and create a sparkling or shimmering effect. The presence of glistening is common in many types of IOL materials and models and has been extensively studied in recent years to determine its incidence, risk factors, evolution, and possible clinical relevance. Classically, it has been studied in vitro in the laboratory or by means of photography obtained with a slit lamp, but these were techniques that required either specific technology or an expert explorer, complex image processing, and required a lot of time. In recent years, proposals based on the Scheimpflug camera and optical coherence tomography have emerged to try to simplify the analysis of glistening in IOLs. It has been described that the manufacturing process, the hydrophobic acrylic material, or the time since surgery are risk factors for the appearance of glistening. In addition, many issues related to this phenomenon are still unknown, such as not knowing from what number of points or their size they may have relevance to visual function since different optical phenomena related to glistening have been described on the IOLs.

Incidence and prevalence of multiple sclerosis in Spain: a systematic review.

INTRODUCTION: Greater understanding of the prevalence and incidence of multiple sclerosis in Spain and their temporal trends is necessary to improve the allocation of healthcare resources and to study aetiological factors. METHODS: We performed a systematic search of the MedLine database and reviewed the reference lists of the articles gathered. We collected studies reporting prevalence or incidence rates of multiple sclerosis in any geographical location in Spain, with no time limits. In 70% of cases, data were extracted by 2 researchers (FGL and EAC); any discrepancies were resolved by consensus. RESULTS: We identified 51 prevalence and 33 incidence studies published between 1968 and 2018. In the adjusted analysis, the number of prevalent cases per 100 000 population increased by 26.6 (95% confidence interval [CI], 21.5-31.8) every 10 years. After adjusting for year and latitude, the number of incident cases per 100 000 population increased by 1.34 (95% CI, 0.98-1.69) every 10 years. We observed a trend toward higher prevalence and incidence rates at higher latitudes. CONCLUSIONS: The prevalence of multiple sclerosis in Spain has increased in recent decades, although case ascertainment appears to be incomplete in many studies. Incidence rates have also increased, but this may be due to recent improvements in the detection of new cases.

Creating a kidney organoid-vasculature interaction model using a novel organ-on-chip system.

Kidney organoids derived from human induced pluripotent stem cells (iPSCs) have proven to be a valuable tool to study kidney development and disease. However, the lack of vascularization of these organoids often leads to insufficient oxygen and nutrient supply. Vascularization has previously been achieved by implantation into animal models, however, the vasculature arises largely from animal host tissue. Our aim is to transition from an in vivo implantation model towards an in vitro model that fulfils the advantages of vascularization whilst being fully human-cell derived. Our chip system supported culturing of kidney organoids, which presented nephron structures. We also showed that organoids cultured on chip showed increased maturation of endothelial populations based on a colocalization analysis of endothelial markers. Moreover, we observed migration and proliferation of human umbilical vein endothelial cells (HUVECs) cultured in the channels of the chip inside the organoid tissue, where these HUVECs interconnected with endogenous endothelial cells and formed structures presenting an open lumen resembling vessels. Our results establish for the first-time vascularization of kidney organoids in HUVEC co-culture conditions using a microfluidic organ-on-chip. Our model therefore provides a useful insight into kidney organoid vascularization in vitro and presents a tool for further studies of kidney development and drug testing, both for research purposes and pre-clinical applications.

Consensus statement on the use of alemtuzumab in daily clinical practice in Spain.

INTRODUCTION: Alemtuzumab is a highly effective drug approved by the European Medicines Agency as a disease-modifying drug for the treatment of relapsing-remitting multiple sclerosis. OBJECTIVE: A consensus document was drafted on the management of alemtuzumab in routine clinical practice in Spain. DEVELOPMENT: A group of multiple sclerosis specialists reviewed articles addressing treatment with alemtuzumab in patients with multiple sclerosis and published before December 2017. The included studies assessed the drug's efficacy, effectiveness, and safety; screening for infections and vaccination; and administration and monitoring aspects. The initial proposed recommendations were developed by a coordinating group and based on the available evidence and their clinical experience. The consensus process was carried out in 2 stages, with the initial threshold percentage for group agreement established at 80%. The final document with all the recommendations agreed by the working group was submitted for external review and the comments received were considered by the coordinating group. CONCLUSION: The present document is intended to be used as a tool for optimising the management of alemtuzumab in routine clinical practice.

Bio-distribution and longevity of mesenchymal stromal cell derived membrane particles.

Vesicle-based medicines hold great promise for therapy development but essential knowledge on the bio-distribution and longevity of vesicles after administration is lacking. We generated vesicles from the membranes of human mesenchymal stromal cells (MSC) and we demonstrated earlier that these so-called membrane particles (MP) mediate immunomodulatory and regenerative responses in target cells. In the present study we examined the bio-distribution and longevity of MP after intravenous administration in mice. While most vesicle tracking methods are based on imaging techniques, which require labeling of vesicles and can only detect dense accumulations of vesicles, we used proteomics analysis to detect the presence of MP-derived proteins in multiple organs and tissues. MP proteins were mainly present in plasma and leukocytes at 1 h after injection, indicating that MP - in contrast to whole MSC - do not accumulate in the lungs upon first passage but remain in circulation. After 24 h, MP proteins were still present in plasma but were most abundant in the liver. RNA sequencing of livers demonstrated that MP impact liver function and in particular induce metabolic pathways. These data provide a clear view of the bio-distribution and longevity of MP, which is likely extrapolatable to other types of vesicles, and demonstrate that MP circulate for up to 24 h and may be a tool for targeting the liver.

A Review of the EUSO-Balloon Pathfinder for the JEM-EUSO Program.

EUSO-Balloon is a pathfinder for JEM-EUSO, the mission concept of a spaceborne observatory which is designed to observe Ultra-High Energy Cosmic Ray (UHECR)-induced Extensive Air Showers (EAS) by detecting their UltraViolet (UV) light tracks "from above." On August 25, 2014, EUSO-Balloon was launched from Timmins Stratospheric Balloon Base (Ontario, Canada) by the balloon division of the French Space Agency CNES. After reaching a floating altitude of 38 km, EUSO-Balloon imaged the UV light in the wavelength range ∼290-500 nm for more than 5 hours using the key technologies of JEM-EUSO. The flight allowed a good understanding of the performance of the detector to be developed, giving insights into possible improvements to be applied to future missions. A detailed measurement of the photoelectron counts in different atmospheric and ground conditions was achieved. By means of the simulation of the instrument response and by assuming atmospheric models, the absolute intensity of diffuse light was estimated. The instrument detected hundreds of laser tracks with similar characteristics to EASs shot by a helicopter flying underneath. These are the first recorded laser tracks measured from a fluorescence detector looking down on the atmosphere. The reconstruction of the direction of the laser tracks was performed. In this work, a review of the main results obtained by EUSO-Balloon is presented as well as implications for future space-based observations of UHECRs.

Consensus statement on the use of alemtuzumab in daily clinical practice in Spain. / Consenso de expertos sobre el uso de alemtuzumab en la práctica clínica diaria en España.

INTRODUCTION: Alemtuzumab is a highly effective drug approved by the European Medicines Agency as a disease-modifying drug for the treatment of relapsing-remitting multiple sclerosis. OBJECTIVE: A consensus document was drafted on the management of alemtuzumab in routine clinical practice in Spain. DEVELOPMENT: A group of multiple sclerosis specialists reviewed articles addressing treatment with alemtuzumab in patients with multiple sclerosis and published before December 2017. The included studies assessed the drug's efficacy, effectiveness, and safety; screening for infections and vaccination; and administration and monitoring aspects. The initial proposed recommendations were developed by a coordinating group and based on the available evidence and their clinical experience. The consensus process was carried out in 2 stages, with the initial threshold percentage for group agreement established at 80%. The final document with all the recommendations agreed by the working group was submitted for external review and the comments received were considered by the coordinating group. CONCLUSION: The present document is intended to be used as a tool for optimising the management of alemtuzumab in routine clinical practice.

Agreement between optical coherence and Scheimpflug tomography: Vault measurements and reproducibility after implantable collamer lens implantation.

PURPOSE: To evaluate the agreement between Scheimpflug tomography (Pentacam, Oculus) and anterior segment optical coherence tomography (AS-OCT, RTVue 100, Optovue) as well as the reproducibility of each technique in assessing the lens-ICL distance (vault) after implantable collamer lens (ICL) implantation. METHODS: The vault was measured manually with Scheimpflug tomography and AS-OCT. Intraclass correlation coefficients (ICC) and Bland-Altman plots were used to determine the reproducibility of measurements and the agreement between them. Multivariate regression analysis was performed to identify predictors of differences in vault measurements between devices. RESULTS: 80 eyes of 46 ICL patients were analyzed. Mean patient age was 33.8±7.4 years (range, 21 to 51), and 27 (59%) were women. The preoperative spherical equivalent refraction ranged from -26 to 8.5 diopters (D). The mean vault measured by AS-OCT was 558.8±240.2µm (range, 162 - 1220) vs. 430.1±215.3µm (range, 0 to 1070) by Pentacam. AS-OCT yielded vault values, on average, 128.1±64.6µm higher than the Pentacam (range, -22 to 293µm). The ICC values for consistency and absolute agreement were 0.960 and 0.928, respectively. Reproducibility of vault measurements was excellent for both devices (ICC≥0.946). Four parameters-vault, pupil diameter (PD), PD differences between devices, and preoperative spherical equivalent refraction-were significant predictors of differences in vault measurements (adjusted-R2=0.412; P<0.001). CONCLUSIONS: Agreement between AS-OCT and Pentacam for vault measurement was good. Vaults were higher when measured by AS-OCT. These differences are clinically relevant, and therefore these devices cannot be used interchangeably to measure vault.

Multidisciplinary Management of the Adverse Effects of Apremilast. / Manejo de los efectos adversos de apremilast desde un abordaje multidisciplinar.

We present a series of general and specific recommendations based on pathophysiologic considerations for managing the most common adverse effects of apremilast that lead to treatment discontinuation: diarrhea, nausea, and headache. The recommendations are based on a review of the literature and the experience of a multidisciplinary team of 14 experts including dermatologists, rheumatologists, neurologists, gastroenterologists, pharmacists, and nurses. We propose a series of simple algorithms that include clinical actions and suggestions for pharmacologic treatment. The adverse effects of apremilast can be managed from a multidisciplinary approach. The purpose of optimizing management is to bring clinical benefits to patients.

Can straw-biochar mulching mitigate erosion of wildfire-degraded soils under extreme rainfall?

High severity wildfires cause a drastic alteration of soil carbon cycling - both oxidising and thermally altering soil organic matter (SOM) - and usually are followed by strong runoff and erosion events. To restore wildfire-degraded soils, SOM needs to be rebuilt while soil erosion is prevented. Post-fire straw mulching has been shown to mitigate soil erosion by providing a protective cover against rainsplash. However, SOM takes many decades or centuries to rebuilt naturally. Biochar, co-applied with straw to the soil surface can replace the SOM of the O-horizon, while the stabilised soil - by straw mulching - may gain in SOM naturally and by downward movement of biochar. We conducted a field study to test if straw-only and straw-biochar co-application could restore soils degraded by wildfire in one high burn severity (HBS) and one moderate burn severity (MBS) study area in southern Portugal and Spain, respectively, by monitoring erosion and SOM for the most intense rainfall period of the first post-fire year. Burned sites were characterized for soil and sediment physical properties, TOC content, SOM quality by thermogravimetry (DTG) and nuclear magnetic resonance (NMR 13C) spectroscopy. Straw-biochar mulching significantly reduced soil erosion by 76% and 65% in the HBS and MBS sites, respectively, in both cases similar to the erosion reduction by straw-only mulching. DTG and NMR 13C indicated that a relatively small proportion of the biochar eroded, i.e. 0.7%, indicating that co-application of straw with biochar may help restore the SOC lost in the wildfire in the medium term. The amount of SOM eroded was lower with straw-biochar mulching than in the untreated plots for both study areas. Straw-biochar mulching mitigates erosion of wildfire-degraded soils under extreme rainfall, while a relatively small proportion of the biochar is lost by erosion. Future studies need to monitor medium term effects.

Knowledge based recursive non-linear partial least squares (RNPLS).

Soft sensors driven by data are very common in industrial plants to perform indirect measurements of difficult to measure critical variables by using other variables that are relatively easier to obtain. The use of soft sensors implies some challenges, such as the colinearity of the predictor variables, the time-varying and possible non-linear nature of the industrial process. To deal with the first challenge, the partial least square (PLS) regression has been employed in many applications to model the linear relations between process variables, with noisy and highly correlated data. However, the PLS model needs to deal with the other two issues: the non-linear and time-varying characteristics of the processes. In this work, a new knowledge-based methodology for a recursive non-linear PLS algorithm (RNPLS) is systematized to deal with these issues. Here, the non-linear PLS algorithm is set up by carrying out the PLS regression over the augmented input matrix, which includes knowledge based non-linear transformations of some of the variables. This transformation depends on the system's nature, and takes into account the available knowledge about the process, which is provided by expert knowledge or emulated using software tools. Then, the recursive exponential weighted PLS is used to modify and adapt the model according to the process changes. This RNPLS algorithm has been tested using two case studies according to the available knowledge, a real industrial evaporation station of the sugar industry, where the expert knowledge about the process permits the formulation of the relationships, and a simulated wastewater treatment plant, where the necessary knowledge about the process is obtained by a software tool. The results show that the methodology involving knowledge regarding the process is able to adjust the process changes, providing highly accurate predictions.

Oxidation mechanisms of amoxicillin and paracetamol in the photo-Fenton solar process.

The present study shows the results of solar photo-Fenton oxidation of paracetamol (PCT) and amoxicillin (AMX). Fe2(SO4)3 was used as the source of iron and EDDS as the iron complexing agent, employing different doses of hydrogen peroxide. Two aqueous matrices, a synthetic wastewater and real wastewater from El Ejido WWTP effluent (Almeria) were used. In all cases, the process was operated under conditions of natural sunlight. Results showed that the degradation of both drugs is favoured when the aqueous matrix presents low concentration of carbonates. Under the conditions studied here, degradation percentages above 90% were obtained in the synthetic wastewater and 80% in the actual effluent. The degradation products were determined using liquid chromatography coupled to high-resolution mass spectrometry with hybrid quadrupole time-of-flight analyser. The intermediates detected throughout the oxidative process for both micro-contaminants were mainly products of hydroxylation reactions. The toxicity of the samples was determined using the bacterium Vibrio fischeri. In the acute toxicity test, it was observed that the bacteria did not undergo inhibition in any of the cases. However, chronic toxicity studies showed that the higher the Hydraulic Retention Time (HRT) employed in the assays, the higher the bacterial inhibition.

Clinical applicability of diagnostic biomarkers in early-onset cognitive impairment.

BACKGROUND AND PURPOSE: Several diagnostic biomarkers are currently available for clinical use in early-onset cognitive impairment. The decision on which biomarker is used in each patient depends on several factors such as its predictive value or tolerability. METHODS: There were a total of 40 subjects with early-onset cognitive complaints (<65 years of age): 26 with Alzheimer's disease (AD), five with frontotemporal dementia and nine with diagnostic suspicion of non-neurodegenerative disorder. Clinical and neuropsychological evaluation, lumbar puncture for cerebrospinal fluid (CSF) AD core biochemical marker determination, medial temporal atrophy evaluation on magnetic resonance imaging, amyloid-positron emission tomography (PET) and 18 F-fluorodeoxyglucose-PET were performed. Neurologists provided pre- and post-biomarker diagnosis, together with diagnostic confidence and clinical/therapeutic management. Patients scored the tolerability of each procedure. RESULTS: Cerebrospinal fluid biomarkers and amyloid-PET increased diagnostic confidence in AD (77.4%-86.2% after CSF, 92.4% after amyloid-PET, P < 0.01) and non-neurodegenerative conditions (53.6%-75% after CSF, 95% after amyloid-PET, P < 0.05). Biomarker results led to diagnostic (32.5%) and treatment (32.5%) changes. All tests were well tolerated. CONCLUSIONS: Biomarker procedures are well tolerated and have an important diagnostic/therapeutic impact on early-onset cognitive impairment.

Comparison of the state of Lithium-Sulphur and lithium-ion batteries applied to electromobility.

The market share in electric vehicles (EV) is increasing. This trend is likely to continue due to the increased interest in reducing CO2 emissions. The electric vehicle market evolution depends principally on the evolution of batteries capacity. As a consequence, automobile manufacturers focus their efforts on launching in the market EVs capable to compete with internal combustion engine vehicles (ICEV) in both performance and economic aspects. Although EVs are suitable for the day-to-day needs of the typical urban driver, their range is still lower than ICEV, because batteries are not able to store and supply enough energy to the vehicle and provide the same autonomy as ICEV. EV use mostly Lithium-ion (Li-ion) batteries but this technology is reaching its theoretical limit (200-250 Wh/kg). Although the research to improve Li-ion batteries is very active, other researches began to investigate alternative electrochemical energy storage systems with higher energy density. At present, the most promising technology is the Lithium-Sulphur (Li-S) battery. This paper presents a review of the state of art of Li-Sulphur battery on EVs compared to Li-ion ones, considering technical, modelling, environmental and economic aspects with the aim of depicting the challenges this technology has to overcome to substitute Li-ion in the near future. This study shows how the main drawbacks for Li-S concern are durability, self-discharge and battery modelling. However, from an environmental and economic point of view, Li-S technology presents many advantages over Li-ion.

Neuronavegación En La Planificacion Prequirúrgica Y En La Cirugia De La Epilepsia Refractaria / Neuronavigation In Pre Surgical Planning And Surgery Of Refractory Epilepsy

RESUMEN Introducción: La epilepsia es una de las patologías neurológicas crónicas más frecuentes, con una incidencia de 50/100.000/año y una prevalencia entre 0,5 y 2% a nivel mundial. Un tercio de estos pacientes son resistentes al tratamiento con fármacos antiepilépticos, lo que se conoce como epilepsia refractaria. La mayoría de estos pacientes sufren de epilepsias focales secundarias a lesiones epileptogénicas evidenciadas cada vez más frecuentemente en correlación directa con las nuevas técnicas de neuroimagen cerebral. La cirugía de la epilepsia es el único tratamiento que podría curar la epilepsia de los pacientes con epilepsia refractaria. El objetivo de la cirugía de la epilepsia es remover la zona epileptogénica con preservación de las áreas elocuentes, y aquí la experiencia quirúrgica y la tecnología de neuroimagen juegan un papel capital. Objetivos: Demostrar la utilidad de la neuronavegación en la planificación prequirúrgica y en la cirugía de la epilepsia refractaria. Método: Estudio descriptivo transversal y analítico, en base a 47 cirugías realizadas (12 resectivas, 32 paliativas y 3 diagnósticas) en pacientes con epilepsia refractaria y edad media de 9,93 años (SD 4,1). En 27 pacientes (57.44%) se utilizó el neuronavegador. En el grupo de pacientes operados con neuronavegación disminuyó el tiempo quirúrgico en 47.17 minutos (p = 0,022), la cantidad de hemorragia en 111.41 mililitros (p = 0,011) y los días de hospitalización en 6.68 días (p = 0,005), en comparación con el grupo intervenido sin neuronavegación. Las complicaciones en el grupo con neuronavegación fueron del 29,63% en comparación con 65% en el grupo intervenido sin neuronavegación (p = 0,034). Conclusiones: En nuestra serie, el uso del neuronavegador en la planificación y desarrollo de la cirugía tuvo un impacto significativo al reducir la cantidad de hemorragia perdida, el tiempo quirúrgico, los días de hospitalización, y las complicaciones postquirúrgicas.

Abstract Introduction: Epilepsy is one of the more frequent neurologic disorders, with an incidence of 50/100,000/year and prevalence between 0.5 and 2% worldwide. A third of these patients suffer focal epilepsy due to epileptogenic lesions evident by Neuroimaging new techniques. Epilepsy surgery is the only treatment that can cure refractory epilepsy. Its goal is to remove the epileptogenic lesion with preservation of eloquent areas, and in this case both surgical experience and neuroimaging technology play a pivotal role. Objective: To demonstrate utility of neuronavigation in presurgical planning and surgery of refractory epilepsy. Method: Descriptive, cross sectional and analytic study of 47 performed surgeries (12 resective, 12 palliative and 3 diagnostic) in patients with refractory epilepsy with an average age of 9.93 years (SD 4.1). In 27 patients (57.44%) neuronavigation was used. In patients operated with assistance of neuronavigation, surgical time diminished in 47.17 minutes (p=0.022), hemorrhage in 111.41 ml (p=0.011) and days of hospitalization in 6.68 days (p=0.005) comparing with group without neuronavigation. Complications in the group with neuronavigation were 29.63% compared with 65% in the group without it. (P=0,034). Conclusions: In this study, using neuronavigation in planning and performing surgery in reducing the amount of blood loss, surgical time, days of hospitalization and post surgical complications.

Optimizing morphology through blood cell image analysis.

INTRODUCTION: Morphological review of the peripheral blood smear is still a crucial diagnostic aid as it provides relevant information related to the diagnosis and is important for selection of additional techniques. Nevertheless, the distinctive cytological characteristics of the blood cells are subjective and influenced by the reviewer's interpretation and, because of that, translating subjective morphological examination into objective parameters is a challenge. METHODS: The use of digital microscopy systems has been extended in the clinical laboratories. As automatic analyzers have some limitations for abnormal or neoplastic cell detection, it is interesting to identify quantitative features through digital image analysis for morphological characteristics of different cells. RESULT: Three main classes of features are used as follows: geometric, color, and texture. Geometric parameters (nucleus/cytoplasmic ratio, cellular area, nucleus perimeter, cytoplasmic profile, RBC proximity, and others) are familiar to pathologists, as they are related to the visual cell patterns. Different color spaces can be used to investigate the rich amount of information that color may offer to describe abnormal lymphoid or blast cells. Texture is related to spatial patterns of color or intensities, which can be visually detected and quantitatively represented using statistical tools. CONCLUSION: This study reviews current and new quantitative features, which can contribute to optimize morphology through blood cell digital image processing techniques.