[Evaluation of a clinical orientation Call Center during the first months of the COVID-19 pandemic]. / Evaluación de un call center de orientación clínica durante los primeros meses de pandemia COVID-19: capacidad de resolución de los llamados.

BACKGROUND: During sanitary emergencies such as the recent pandemic, health services can collapse. In these cases, remote orientation services such as call centers may help to debottleneck these services. AIM: To assess the demand and problem resolution of a clinical guidance telephone service during the COVID-19 pandemic. MATERIAL AND METHODS: The call registry between May and August 2020 of an orientation call center for COVID-19 was analyzed. The number of calls, sociodemographic features of callers, type of enquiry and given indications were described. RESULTS: We analyzed 1,278 telephone calls, corresponding to 655 people. Sixty nine percent of queries were resolved during the call and in 31% of calls, users were referred to face-to-face evaluation. Two percent of these referrals were to an emergency service. CONCLUSIONS: The call center had a high level of resolution, favoring remote consultation and reducing face-to-face care, improving users'accessibility.

A New Surgical Approach for the Treatment of Conjunctivochalasis: Reduction of the Conjunctival Fold with Bipolar Electrocautery Forceps.

Aim. To report a new surgical technique for the treatment of conjunctivochalasis. Methods. A new surgical technique in which specially designed bipolar electrocautery forceps facilitate the complete reduction of the conjunctival folds without creating lesions near the corneoscleral limbus was designed. A retrospective revision of the medical records of patients treated with this technique between the years 2011 and 2013 was made, and eighteen eyes of sixteen patients with conjunctivochalasis treated with this new technique were included. Results. All the eyes treated showed a significant improvement with no evidence of scar lesions after a mean follow-up time of 10 months. Conclusions. The surgical technique presented here could be a good alternative for the management of conjunctivochalasis.

Nasopupillary asymmetry.

PURPOSE: To establish the prevalence of nasopupillary asymmetry (difference in nasopupillary distances) in the population and its relation with the interpupillary distance. METHODS: A retrospective descriptive study was conducted by reviewing of 1262 medical records. The values of nasopupillary asymmetry and the interpupillary distance were obtained. A statistical analysis was made and the correlation between these variables was established. RESULTS: Seventy-nine percent of the population presented some degree of nasopupillary asymmetry. The interpupillary distance had a very low correlation with the nasopupillary asymmetry (r = 0.074, P = 0.0). CONCLUSION: It is advisable to use the nasopupillary distance of each eye as a standard measurement.

Fungal keratitis: Mechanisms of infection and management strategies.

Fungal corneal ulcers are an uncommon, yet challenging, cause of vision loss. In the United States, geographic location appears to dictate not only the incidence of fungal ulcers, but also the fungal genera most encountered. These patterns of infection can be linked to environmental factors and individual characteristics of fungal organisms. Successful management of fungal ulcers is dependent on an early diagnosis. New diagnostic modalities like confocal microscopy and polymerase chain reaction are being increasingly used to detect and identify infectious organisms. Several novel therapies, including crosslinking and light therapy, are currently being tested as alternatives to conventional antifungal medications. We explore the biology of Candida, Fusarium, and Aspergillus, the three most common genera of fungi causing corneal ulcers in the United States and discuss current treatment regimens for the management of fungal keratitis.

Lamellar sclerokeratoplasty: Review of the literature and description of a special technique using fibrin glue and a giant hydrophilic contact lens.

Lamellar sclerokeratoplasty is a surgical procedure described since 1979 by Lim in China and reported by different surgeons in the world. Our purpose is to report a modified technique in which not only the whole cornea with a scleral rim is utilized, but the importance of including the whole Schlemm's canal area is also insisted; therefore, a new aqueous humor drainage pathway can be restored. The technique is designed for cases in which not only the whole cornea is decompensated, but also have untreatable glaucoma. This procedure replaces the entire anterior segment with a clear donor cornea including the limbus and part of the trabecular meshwork. We present the results of visual acuity by the logMAR scale of 55 cases from 110 patients receiving this surgical technique. The results describe 39 cases that had visual improvement after more than 1 year of follow-up and 16 cases that did not improve in their visual acuity. Large-diameter sclerokeratoplasty is an alternative and therapeutic option to eliminate the entire corneal pathology, while obtaining structural and even optical results with a lower immunological reaction. It can be considered an option in cases that are not suitable for standard grafting procedures.

Evaluación de un call center de orientación clínica durante los primeros meses de pandemia COVID-19: capacidad de resolución de los llamados / Evaluation of a clinical orientation Call Center during the first months of the COVID-19 pandemic

BACKGROUND: During sanitary emergencies such as the recent pandemic, health services can collapse. In these cases, remote orientation services such as call centers may help to debottleneck these services. AIM: To assess the demand and problem resolution of a clinical guidance telephone service during the COVID-19 pandemic. Material and Methods: The call registry between May and August 2020 of an orientation call center for COVID-19 was analyzed. The number of calls, sociodemographic features of callers, type of enquiry and given indications were described. RESULTS: We analyzed 1,278 telephone calls, corresponding to 655 people. Sixty nine percent of queries were resolved during the call and in 31% of calls, users were referred to face-to-face evaluation. Two percent of these referrals were to an emergency service. Conclusions: The call center had a high level of resolution, favoring remote consultation and reducing face-to-face care, improving users'accessibility.

Lamellar corneal transplantation.

Penetrating keratoplasty (PK) has been the gold standard for the surgical treatment of most corneal pathologies; lamellar keratoplasty that only replaces the diseased corneal layers has recently evolved as an alternative, however. Innovations in surgical technique and instrumentation provide visual outcomes comparable to PK. We review the indications and outcomes of various techniques of anterior lamellar surgery developed to treat stromal disorders. Similarly, we discuss posterior lamellar keratoplasty techniques such as Descemet stripping automated endothelial keratoplasty and Descemet membrane endothelial keratoplasty. Posterior lamellar keratoplasty provides faster visual rehabilitation than PK in cases of Fuchs endothelial dystrophy and pseudophakic bullous keratopathy. In addition, for medically unresponsive infectious keratitis, therapeutic anterior lamellar keratoplasty yields similar graft survival to PK without an increased risk of disease recurrence.

A scleral soft contact lens designed for the postoperative management of pterygium surgery.

PURPOSE: To introduce a new hydrophilic contact lens design to be used as a corneoscleral bandage for different types of conjunctival surgery and pterygium surgery. METHODS: The soft lenses are fabricated in large diameters from 17.5 to 19 mm and have custom peripheral curvatures to guarantee a normal tear film circulation to allow for extended wear for 2 or 3 consecutive weeks. CONCLUSIONS: This novel design facilitates postoperative recovery and reduces the chance of recurrence after pterygium surgery. The authors have been using this type of lens in their clinical practice for more than 4 years.

Caracterización morfométrica de los órganos linfoides en pollos de engorde de la línea ross criados bajo condiciones de campo en el estado Zulia Venezuela / Morphometric characterization of ross line broiler chickens lymphoid organs reared under field conditions in Zulia state Venezuela

En base a la relación existente entre la morfometría de los órganos linfoides y la inmunocompetencia de las aves, se estudió el desarrollo de los órganos linfoides, evaluando 24 pollos (Ross) semanales durante seis semanas, provenientes de un lote de 600 aves, criadas bajo condiciones de campo en el Centro Experimental de Producción Animal de la Universidad del Zulia. Se calculó la relación entre el peso de Bursa, Bazo, timo y el peso corporal (Ibu, Iba Iti), entre el peso y el diámetro de la Bursa, así como el coeficiente de correlación (CC) y la razón entre los órganos (Ro). Los órganos linfoides fueron evaluados histopatológicamente, determinándose además los títulos de anticuerpos contra la enfermedad de Newcastle (ENC). Fueron aplicados estadígrafos de posición y dispersión. Se utilizaron la prueba de Correlación de Pierson y Chicuadrado del Paquete Estadístico SAS. El peso vivo inicial fue de 44 gr. promedio y el final de 2.139 gr. Al día 1 el peso de la Bursa, Timo y Bazo fue de 0,06, 0,03 y 0,15 gr respectivamente; alcanzando pesos de 1,14, 2,31 y 7,47 gr al día 42. Ibu aumentó hasta la cuarta semana, descendiendo a partir de esta, Iba e Iti mostraron poca variación. La razón Bursa-bazo disminuyó a partir de la cuarta semana. El timo creció con más rapidez que la bolsa y el bazo. Se obtuvieron altos CC entre el peso corporal, el timo y el bazo, así como entre el peso y el diámetro de la Bursa. Durante la quinta y sexta semanas se observaron alteraciones histopatológicas en Bursa compatibles con enfermedad de Gumboro. La respuesta serológica a la vacunación contra ENC fue deficiente, probablemente debido a la presencia de agentes inmunosupresores. Esto concuerda con la disminución de los indicadores Ibu y Burza/bazo durante ese período. Se concluye que en condiciones de campo los índices morfométricos son una herramienta útil para determinar la inmunocompetencia de las aves

Osteossarcoma parostal: avaliaçäo clínico-histopatológica em 18 casos operados / Parosteal osteossarcoma: clinical-histopathological evaluation of 18 cases

Foram avaliados 18 casos de osteossarcoma parostal tratados no Instituto de Ortopedia e Traumatologia da Faculdade de Medicina da Universidade de Säo Paulo, com relaçäo aos aspectos clínicos, graduaçäo histológica e resultados cirúrgicos. Houve seis casos de recidiva local que foram reoperados e apenas dois amputados. O resultado funcional (MSTS) foi excelente em cinco casos, bom em seis, regular em dois e mau em dois. A maioria das recidivas ocorreu no grau hsitológico II (cinco casos)

Análise da estabilidade de três montagens do fixador externo circular / Stability analysis of three assemblies of the external circular fixator

Compararam-se a rigidez axial e a estabilidade radial do fixador externo circular na montagem "clássica" preconizada por Ilizarov, utilizando apenas fios finos tensionados e, nas variaçöes propostas pela escola de Lecco, utilizando fios finos tensionados e pinos de Schanz, e por Green (Rancho de Los Amigos - EUA), utilizando apenas pinos de Schanz, através de ensaios de flexo-compressäo (compressäo excêntrica). Todas as montagens utilizaram quatro anéis circulares de aço inoxidável de 150mm, dois em cada lado do espaço que simulava perda óssea (situaçäo de insatabilidade). Foram utilizados fios de Kirscgner de 1,8mm de diâmetro e pinos de Schanz de 4,8mm de diâmetro. No centro das extremidades confrontantes dos tubos, passando pelo eixo da montagem, foram colocados ponteiros de metal como pontos de referência. O modelo adotado simula fratura de alta energia na regiäo diafisária do terço médio da tíbia com 2 cm de perda de substância óssea. As montagens foram instaladas em máquinas universais de ensaios mecânicos, provida de célula de carga eletrônica e de registrador gráfico. A carga aplicada através de um pino excêntrico de extremidade esférica polida situado a 25mm do eixo do sistema, em posiçäo que se convencionou dorsal, a fim de gerar momentos que se assemelham aos da tíbia humana durante a fase de apoio da marcha (toque calcâneo). Conclui-se que, axialmente, a montagem "clássica" é a mais elástica das três, enquanto a montagem norte-americana (Rancho) é a mais rígida e que as três montagens têm a mesma rigidez no sentido radial do foco de fratura