Allogeneic mesenchymal stem cells improve the wound healing process of sheep skin.

BACKGROUND: Skin wound healing includes a system of biological processes, collectively restoring the integrity of the skin after injury. Healing by second intention refers to repair of large and deep wounds where the tissue edges cannot be approximated and substantial scarring is often observed. The objective of this study was to evaluate the effects of mesenchymal stem cells (MSCs) in second intention healing using a surgical wound model in sheep. MSCs are known to contribute to the inflammatory, proliferative, and remodeling phases of the skin regeneration process in rodent models, but data are lacking for large animal models. This study used three different approaches (clinical, histopathological, and molecular analysis) to assess the putative action of allogeneic MSCs at 15 and 42 days after lesion creation. RESULTS: At 15 days post-lesion, the wounds treated with MSCs showed a higher degree of wound closure, a higher percentage of re-epithelialization, proliferation, neovascularization and increased contraction in comparison to a control group. At 42 days, the wounds treated with MSCs had more mature and denser cutaneous adnexa compared to the control group. The MSCs-treated group showed an absence of inflammation and expression of CD3+ and CD20+. Moreover, the mRNA expression of hair-keratine (hKER) was observed in the MSCs-treated group 15 days after wound creation and had increased significantly by 42 days post-wound creation. Collagen1 gene (Col1α1) expression was also greater in the MSCs-treated group compared to the control group at both days 15 and 42. CONCLUSION: Peripheral blood-derived MSCs may improve the quality of wound healing both for superficial injuries and deep lesions. MSCs did not induce an inflammatory response and accelerated the appearance of granulation tissue, neovascularization, structural proteins, and skin adnexa.

Principales factores de riesgo cardiovasculares y adherencia al tratamiento en pacientes del centro de salud familiar Yanequén, Negrete, Chile 2015 / Main cardiovascular risk factors and treatment continuity of patients from the Yanequén family health center, Negrete, Chile 2015

Introducción: Los factores de Riesgo Cardiovasculares (FRCVs) son condiciones de cada individuo que pueden aumentar el riesgo de desarrollar una enfermedad cardiovascular (ECV). El objetivo del presente trabajo es identificar los principales Factores de Riesgo Cardiovasculares presentes en una población de pacientes ingresados al Programa de Salud Cardiovascular el Centro de Salud Familiar Yanequén en el año 2015 y su adherencia al tratamiento, con la finalidad de conocer la realidad local y poder trabajar en estrategias para la promoción de estilos de vida saludables. Materiales y métodos: Se realizó un estudio Descriptivo, retrospectivo y Transversal mediante la entrevista médico paciente y los datos del tarjetón del Programa de Salud Cardiovascular (PSCV). Se seleccionó una muestra de 109 pacientes adultos de ambos sexos ingresados al PSCV en el año 2015 hasta el mes de diciembre. Se seleccionaron personas de ambos sexos, mayores de 15 años que tengan las siguientes enfermedades: Hipertensión arterial, Diabetes Mellitus, Dislipidemia. Se excluyeron a aquellos Pacientes con datos incompletos. Resultados: EL 50% DE LOS FRCV correspondieron a: sedentarismo, Dieta no Saludable, Dislipidemia, Obesidad e hipertensión arterial. La adherencia al tratamiento es positiva con más del 50% de pacientes que cumplen con éste. Discusión: Los principales FRCV son el sedentarismo, Dieta no Saludable, Dislipidemia y, Obesidad, por lo tanto es necesario implementar medidas de promoción de la Salud con base en estilos de vida saludable para disminuir el riesgo de padecer ECV

Introduction: The Cardiovascular Risk Factors (CVRFs) are conditions from every individual that can increase the cardiovascular disease risk (CVD). The objective of this paper is to identify the main CVRFs present in a population of admitted patients in the Cardiovascular Health Program (CVHP) from the Family Health Center (FHC) Yanequén in the 2015 and their continuity in the treatment, with the purpose of knowing the local reality and to be able to work on strategies for promoting healthier life styles. Materials and methods: A Descriptive, retrospective and transversal study has been realized through the doctor-patient interview and the CVHP information. The Sample was about 109 adult patients from both sex admitted in the CVHP in the year 2015 until december. The Inclusion Criteria was people from both sex above 15 years old, with the following diseases: high blood pressure, Diabetes Mellitus, Dyslipidemia, and above 55 years old smokers. Patients with incomplete information were excluded. Results: 50% of the CVRFs were: sedentary lifestyle, unhealthy diet, dyslipidemia, obesity and high blood pressure. The treatment continuity was positive with more than 50% of patients that attended the CVHP. Discussion: The main CVRFs are the sedentary life style, unhealthy diet, dyslipidemia and obesity, so it is necessary to implement Health promotion based on healthy lifestyles to decrease the risk of CVDs

Risk factors for otitis media with effusion: case-control study in Sicilian schoolchildren.

OBJECTIVE: To identify the prevalence and demographic, maternal and child risk factors for otitis media with effusion (OME) in Sicilian schoolchildren and analyse the results with reference to the review of the literature. METHODS: Associations of possible risk factors with prevalence of otitis media with effusion (OME) were studied in a cohort of 2097 children, aged 5-14 years. In order to determine OME, otoscopy and tympanometry were performed at 3-monthly intervals beginning at term date. Sixteen epidemiologically relevant features were inventoried by means of standardized questionnaires and skin tests were performed. Univariate analysis was performed to examine the association between determinants and occurrence of OME; multivariate logistic regression analysis was made to investigate the joint effect of atopy and other determinants on OME. RESULTS: Prevalence of OME resulted 6.8% (143/2097) and it was most strongly associated with atopy (P<0.0001; or=12.67; 95% CI=8.78-18.27). Other factors significantly associated with the prevalence of OME were snoring (P<0.0001), previous history of acute otitis media (P<0.001) and of recurrent URTIs (P<0.0001), mother's no schooling (P=0.01) and no breastfeed (P=0.05). No significance was found for school type, economic status of the family, family size, family history of presence of allergy and of ear disease, mother's work status, smoking parents and birth history. Moreover on multivariate logistic regression analysis it resulted that age, positive URTI's history and smoking exposure were found to be significant (P<0.0001). CONCLUSIONS: OME during infancy is a common and multifactorial disease; as most of the risk factors associated with its etiology and pathogenesis, are modifiable, their modification should represent the reasonable primary care intervention leading to a decrease in OME prevalence.

The role of atopy in otitis media with effusion among primary school children: audiological investigation.

The objective of this study was to evaluate the role of atopy in otitis media with effusion (OME) in children attending primary school in western Sicily focusing on the audiological characteristics among atopic and non-atopic subjects suffering from OME. A total of 310 children (5-6 years old) were screened by skin tests and divided into atopics (G1) and non-atopics (G2). The samples were evaluated for OME by pneumatic otoscopy, tympanogram and acoustic reflex tests. The parameters considered were: documented persistent middle ear effusion by otoscopic examination for a minimum of 3 months; presence of B or C tympanogram; absence of ipsilateral acoustic reflex and a conductive hearing loss greater than 25 dB at any one of the frequencies from 250 Hz through 4 kHz. A total of 56 children (18.06%) resulted to be atopics while 254 were non-atopics. OME was identified in 24 atopic children and in 16 non-atopic children for a total number of 40 children; the overall prevalence rate was 12.9% (42.85% for G1 and 6.30% for G2). OME was bilateral in 28 children (70%), with a significative difference between G1 (79.17%) and G2 (56.25%). The prevalence of B tympanogram was 70.59%, corresponding to 79.07% for G1 and 56% for G2. The mean air conduction pure tone was, respectively, 31.97 dB for G1 and 29.8 dB for G2. The prevalence value of OME in atopic children, also supported by the higher predominance of bilaterality, B tympanogram and hearing loss among this group, could suggest the important role of allergy in the pathogenesis of OME.

Morphological restoration of gonadotrope population by thymulin gene therapy in nude mice.

The integrity of the thymus during the first week of life is necessary for a proper maturation of the pituitary-gonadal axis as revealed by the significantly reduced levels of circulating gonadotropins in congenitally athymic (nude) mice. In the present work we studied the impact of athymia and the effect of neonatal thymulin gene therapy on the pituitaries of adult nude mice. Also circulating thymulin and gonadotropin levels were evaluated. We used an adenoviral vector expressing a synthetic gene for the thymic peptide thymulin (metFTS) termed RAd-FTS. On postnatal day 1, each experimental heterozygous (nu/+) and homozygous (nu/nu) pup of both sexes received a single bilateral i.m. injection of RAd-FTS or RAd-GFP/TK, a control vector expressing green fluorescent protein. On postnatal days 51-52, mice were bled and sacrificed, their pituitaries were immediately dissected, fixed and immunostained. Morphometry was performed by means of an image analysis system. The following parameters were calculated: volume density (VD: cell area/reference area), cell density (CD: number of cells/reference area), and cell size (expressed in microm(2)). Serum thymulin levels were measured by a bioassay and gonadotropin levels were assayed by RIA. It was observed that neonatal thymulin gene therapy in the athymic mice restored their serum thymulin levels and prevented the reduction in circulating gonadotropin levels. The histometrical analysis revealed that the treatment prevented the reduction in gonadotrope CD and the VD in athymic mice. Our data suggest that thymulin gene therapy may be an effective strategy to approach reproductive deficits associated with endocrine thymus dysfunction.

Inflammatory myofibroblastic tumor of the larynx. Case report.

Inflammatory myofibroblastic tumors (IMT) of the larynx are uncommon lesions that easily may be misinterpreted as malignant epithelial or mesenchymal spindle cell neoplasms. When located in the upper airway, IMTs tend to be less aggressive, but have the potential for local invasion and recurrence. The authors describe a rare case of IMT in a 47 year old man, occurring in the vocal fold who underwent surgical treatment five times, because of its higher recurrence rate.

Photorefractive keratectomy for residual myopia after radial keratotomy.

PURPOSE: To evaluate the results of photorefractive keratectomy (PRK) to treat undercorrected radial keratotomy (RK). SETTING: Instituto de Oftalmologia Tadeu Cvintal, São Paulo, Brazil. METHODS: A consecutive series of 28 eyes that had PRK to treat residual myopia after RK were studied. Refractive visual and safety data were collected and evaluated. RESULTS: One year after PRK, 75% of eyes had an uncorrected visual acuity of 20/25 or better and 85%, 20/40 or better. All but one case maintained or improved best corrected visual acuity; one case decreased from 20/25 to 20/30. At 1 year, 75% of eyes were within 0.50 diopter (D) of emmetropia and 90% were within 1.00 D. Only one case was more than 1.00 D undercorrected (-1.125 D) at 1 year. Mean pre-RK myopia was -5.90 D (range -2.00 to 11.80 D). Mean spherical equivalent improved from the residual postoperative level of -2.71 D +/- 0.86 (SD) before PRK to -0.21 +/- 0.86 D 1 to 3 months after PRK and to -0.40 +/- 0.43 D 1 year after PRK. CONCLUSION: Photorefractive keratectomy was efficacious in correcting residual myopia after RK in a group of selected patients.

The Martines enhancement technique for correcting residual myopia following laser assisted in situ keratomileusis.

BACKGROUND AND OBJECTIVE: Laser assisted in situ keratomileusis (LASIK) is highly effective for correcting moderate to severe levels of myopia with rapid visual recovery, minimal pain and easier post-operative management compared with Photorefractive keratectomy. Nevertheless, undercorrection may occur. The purpose of this paper is to evaluate 14 undercorrected LASIK cases in which the cap was dissected and the stromal bed re-ablated using a method developed by one of the authors (EM). PATIENTS AND METHODS: Among a series of 297 LASIK procedures, visual and refractive results of 14 cases undergoing enhancement were evaluated. All cases were targeted for plano refraction. RESULTS: All 14 cases were followed at least 6 months and 7 (50%) have been followed two years. Mean pre-LASIK myopia of -14.60 +/- 4.90 D had been reduced to a mean of -4.50 +/- 2.60 D prior to enhancement. Following enhancement mean spherical equivalent was -0.22 D at 6 months. Results were stable at two years. All cases were within 1.25 D of target and 11 of 14 were within one diopter. Uncorrected vision was improved in all cases. Best corrected vision was maintained or improved in all but one case. This case had a decentered ablation. CONCLUSION: Laser enhancement of undercorrected LASIK cases using the Martines Technique was predictable and efficacious.

Small-diameter corneal inlay in presbyopic or pseudophakic patients.

We report the results of using the small-diameter corneal inlay to create a bifocal cornea. The inlay was implanted in five eyes in January 1993. At 12 months postoperatively, uncorrected near vision had improved from J4 to better than J2 in four of the five. The results indicate that the corneal inlay improves near vision and is compatible within the cornea.

Photorefractive keratectomy following penetrating keratoplasty.

We present 3 eyes that underwent photorefractive keratectomy (PRK) for residual myopia after penetrating keratoplasty, and 1 eye that was treated for recurrent granular dystrophy and myopia following penetrating keratoplasty. The 3 refractive eyes experienced improvements in visual acuity and refractive error through 3 months postoperative, but exhibited regression of effect after 6 months postoperative. One eye also exhibited substantial corneal haze at three months postoperative that was not responsive to steroid retreatment. The eye with granular dystrophy obtained symptomatic relief as well as improvement in vision. We tentatively conclude that the corneal transplant reacts to photorefractive keratectomy in much the same way as a normal cornea. Eyes with substantial degrees of post-graft myopia exhibit regression of refractive effect, much like high myopes following primary photorefractive keratectomy. Photorefractive was unable to prevent the recurrence of granular dystrophy in the transplanted tissue. The eyes reported here achieved only modest long-term visual and refractive improvements.

Excimer laser photoablation of primary familial amyloidosis of the cornea.

A 31-year old female underwent lamellar keratoplasty for the treatment of bilateral primary familial amyloidosis of the cornea in 1983 (OS), 1986 (OD), and 1989 (OS). The lesions recurred bilaterally and visual acuity in 1992 was 20/400 in each eye. After debridement of essentially all corneal epithelium, the entire cornea of the left eye was treated with excimer laser phototherapeutic keratectomy (PTK). One month postoperatively, visual acuity was 20/50 and the corneal surface appeared smooth and clear with no evidence of recurrence. Four months postoperatively, the patient continued to be free of recurrence.