The effect of prolonged and nocturnal use of contact lenses on the cornea: about a case of corneal decompensation and decreased endothelial count.

Corneal edema and decreased endothelial cell count are complications related to chronic low-grade hypoxia experienced by contact lens wearers, primarily due to prolonged and overnight wear. This case shows the example of a patient who has blurred vision problems in both eyes and who underwent a complete ophthalmologic examination that included photographs, corneal topography and endothelial cell count. Subsequently, the corneal metabolism, the etiopathogenesis and the complications derived from the use of contact lenses are reviewed.

Comparability of the Retinomax K-plus 3 handheld autorefractometer in quick mode versus on-table autorefractometer in standard mode.

INTRODUCTION: This study analyzes the comparability of measurements taken by a Retinomax K-plus 3 handheld autorefractometer in Quick mode and a Topcon KR-800 on-table autorefractometer in standard mode on the pediatric population, and establishes their correlation. METHODS: It is a retrospective comparative study. Spherical diopter power (SPH), cylindrical diopter power (CYL), angle of cylindrical axis (AX), and spherical equivalent (SE) were measured with the Retinomax in Quick mode and with the Topcon in standard mode. Each patient was evaluated in cycloplegic and non-cycloplegic conditions by both autorefractometers. Student's t-test was performed between the two instruments for SPH, CYL, and SE. The Pearson correlation coefficient was calculated and the dispersion was represented using Bland-Altman graphs, also evaluating the subgroup of patients under 4 years of age. A descriptive analysis of the percentages of measures that differed was performed. RESULTS: It included 98 eyes of 49 subjects (age range: 3-16 years). The data for HPS without cycloplegia are virtually identical, whereas with cycloplegia there is a hyperopic bias of +0.5 diopters measured with Retinomax. CYL results are very similar with and without cycloplegia. There is a high Pearson correlation for both instruments (>0.91) and a low degree of dispersion in the Bland-Altman plots under cycloplegia. CONCLUSION: The Retinomax data were consistent with those obtained by Topcon. The Retinomax is a useful instrument for detecting refractive errors in children between 3 and 16 years of age.

Brain Injury in Fetuses with Vein of Galen Malformation and Nongalenic Arteriovenous Fistulas: Static Snapshot or a Portent of More?

BACKGROUND AND PURPOSE: Brain injury in fetuses with vein of Galen malformations and nongalenic AVFs is a rare complication whose appearance, course, and prognosis are poorly studied. We sought to characterize the MR imaging features and examine associations with postnatal outcome. MATERIALS AND METHODS: This was a retrospective analysis of fetal MRIs of subjects with vein of Galen malformation and nongalenic arteriovenous fistulas. Two pediatric neuroradiologists independently reviewed examinations to determine the presence of abnormalities on structural imaging (T1 volumetric interpolated breath-hold examination and T2-HASTE), DWI, and T2*-weighted images; discrepancies were adjudicated by a third reviewer. Radiologic progression of injury was determined by additional fetal or neonatal MRIs. A simple composite score evaluating poor neonatal clinical outcome as either intubation or death by postnatal day 2 was also queried. A body fetal imager evaluated the presence of systemic findings of right heart strain. RESULTS: Forty-nine fetal MR imaging examinations corresponding to 31 subjects (27 vein of Galen malformations and 4 nongalenic AVF cases) were analyzed. Injury was observed in 8 subjects (26%) with 14 fetal examinations; the mean gestational age at identification of injury was 32.2 (SD 4.9) weeks. Structural abnormalities were present in all subjects with injury; restricted diffusion, in 5/7 subjects with available data; and T2* abnormalities, in all subjects with available data (n = 7). Radiologic progression was documented in all cases with follow-up imaging (n = 7). All subjects with fetal brain injury had a poor neonatal clinical outcome. CONCLUSIONS: Brain injury in fetuses with vein of Galen malformation and nongalenic AVFs shows a combination of structural abnormalities, restricted diffusion, and blooming on T2* images. Injury appears to portend a poor prognosis, with relentless progression and a likely association with adverse neonatal outcomes.

Repeatability and comparability of a new swept-source optical coherence tomographer in optical biometry.

PURPOSE: To evaluate the reproducibility in the measurement of ocular biometric parameters using a new swept-source optical coherence tomographer and its comparability with an optical low coherence reflectometry biometer. DESIGN: An observational, descriptive, cross-sectional study. METHODS: 45 right eyes of 45 patients diagnosed with cataract were included. Three successive biometric measurements with Anterion and one with Lenstar LS900 were performed on each patient. The following variables were collected: axial length (AXL), anterior chamber depth (ACD), flat K (K1), steep K (K2), central corneal thickness (CCT), lens thickness (LT) and white-to-white distance (WTW). The intrasubject standard deviation (Sw) and the coefficient of Pearson "R" were calculated in order to assess the repeatability. The intraclass correlation coefficient (ICC) and the concordance correlation coefficient (CCC) were obtained to evaluate the comparability between devices. A Bland-Altman plot was performed for each variable. RESULTS: The coefficient of Pearson was excellent and statistically significant in the evaluation of the repeatability in all the variables. The highest values were 0.987 (AXL), 0.983 (CCT) and 0.942 (ACD). There were no statically significant differences between repeated measurements with Anterion in all the parameters. The ICC and CCC were excellent in the evaluation of AXL, CCT and ACD, and were also good in regard to K1, K2, LT and WTW. CONCLUSIONS: Performing biometry with the SS-OCT Anterion is a reliable and reproducible procedure, and it is comparable with the Lenstar LS900.

Tractography of the Cerebellar Peduncles in Second- and Third-Trimester Fetuses.

BACKGROUND AND PURPOSE: Little is known about microstructural development of cerebellar white matter in vivo. This study aimed to investigate developmental changes of the cerebellar peduncles in second- and third-trimester healthy fetuses using motion-corrected DTI and tractography. MATERIALS AND METHODS: 3T data of 81 healthy fetuses were reviewed. Structural imaging consisted of multiplanar T2-single-shot sequences; DTI consisted of a series of 12-direction diffusion. A robust motion-tracked section-to-volume registration algorithm reconstructed images. ROI-based deterministic tractography was performed using anatomic landmarks described in postnatal tractography. Asymmetry was evaluated qualitatively with a perceived difference of >25% between sides. Linear regression evaluated gestational age as a predictor of tract volume, ADC, and fractional anisotropy. RESULTS: Twenty-four cases were excluded due to low-quality reconstructions. Fifty-eight fetuses with a median gestational age of 30.6 weeks (interquartile range, 7 weeks) were analyzed. The superior cerebellar peduncle was identified in 39 subjects (69%), and it was symmetric in 15 (38%). The middle cerebellar peduncle was identified in all subjects and appeared symmetric; in 13 subjects (22%), two distinct subcomponents were identified. The inferior cerebellar peduncle was not found in any subject. There was a significant increase in volume for the superior cerebellar peduncle and middle cerebellar peduncle (both, P < .05), an increase in fractional anisotropy (both, P < .001), and a decrease in ADC (both, P < .001) with gestational age. The middle cerebellar peduncle had higher volume (P < .001) and fractional anisotropy (P = .002) and lower ADC (P < .001) than the superior cerebellar peduncle after controlling for gestational age. CONCLUSIONS: A robust motion-tracked section-to-volume registration algorithm enabled deterministic tractography of the superior cerebellar peduncle and middle cerebellar peduncle in vivo and allowed characterization of developmental changes.

Association of Isolated Congenital Heart Disease with Fetal Brain Maturation.

BACKGROUND AND PURPOSE: Brain MRI of newborns with congenital heart disease show signs of immaturity relative to healthy controls. Our aim was to determine whether the semiquantitative fetal total maturation score can detect abnormalities in brain maturation in fetuses with congenital heart disease in the second and third trimesters. MATERIALS AND METHODS: We analyzed data from a prospective study of fetuses with and without congenital heart disease who underwent fetal MR imaging at 25-35 weeks' gestation. Two independent neuroradiologists blinded to the clinical data reviewed and scored all images using the fetal total maturation score. Interrater reliability was evaluated by the intraclass correlation coefficient using the individual reader scores, which were also used to calculate an average score for each subject. Comparisons of the average and individual reader scores between affected and control fetuses and relationships with clinical variables were evaluated using multivariable linear regression. RESULTS: Data from 69 subjects (48 cardiac, 21 controls) were included. High concordance was observed between readers with an intraclass correlation coefficient of 0.98 (95% CI, 0.97-0.99). The affected group had significantly lower fetal total maturation scores than the control group (ß-estimate, -0.9 [95% CI, -1.5 to -0.4], P = .002), adjusting for gestational age and sex. Averaged fetal total maturation, germinal matrix, myelination, and superior temporal sulcus scores were significantly delayed in fetuses with congenital heart disease versus controls (P < .05 for each). The fetal total maturation score was not significantly associated with any cardiac, anatomic, or physiologic variables. CONCLUSIONS: The fetal total maturation score is sensitive to differences in brain maturation between fetuses with isolated congenital heart disease and healthy controls.

MR Imaging Correlates for Molecular and Mutational Analyses in Children with Diffuse Intrinsic Pontine Glioma.

BACKGROUND AND PURPOSE: Recent advances in molecular techniques have characterized distinct subtypes of diffuse intrinsic pontine gliomas. Our aim was the identification of MR imaging correlates of these subtypes. MATERIALS AND METHODS: Initial MRIs from subjects with diffuse intrinsic pontine gliomas recruited for a prospective clinical trial before treatment were analyzed. Retrospective imaging analyses included FLAIR/T2 tumor volume, tumor volume enhancing, the presence of cyst and/or necrosis, median, mean, mode, skewness, kurtosis of ADC tumor volume based on FLAIR, and enhancement at baseline. Molecular subgroups based on EGFR and MGMT mutations were established. Histone mutations were also determined (H3F3A, HIST1H3B, HIST1H3C). Univariate Cox proportional hazards regression was used to test the association of imaging predictors with overall and progression-free survival. Wilcoxon rank sum, Kruskal-Wallis, and Fisher exact tests were used to compare imaging measures among groups. RESULTS: Fifty patients had biopsy and MR imaging. The median age at trial registration was 6 years (range, 3.3-17.5 years); 52% were female. On the basis of immunohistochemical results, 48 patients were assigned to 1 of 4 subgroups: 28 in MGMT-/epidermal growth factor receptor (EGFR)-, 14 in MGMT-/EGFR+, 3 in MGMT+/EGFR-, and 3 in MGMT+/EGFR+. Twenty-three patients had histone mutations in H3F3A, 8 in HIST1H3B, and 3 in HIST1H3C. Enhancing tumor volume was near-significantly different across molecular subgroups (P = .04), after accounting for the false discovery rate. Tumor volume enhancing, median, mode, skewness, and kurtosis ADC T2-FLAIR/T2 were significantly different (P ≤ .048) between patients with H3F3A and HIST1H3B/C mutations. CONCLUSIONS: MR imaging features including enhancement and ADC histogram parameters are correlated with molecular subgroups and mutations in children with diffuse intrinsic pontine gliomas.

Local chromatin interactions contribute to expression of the fibrinogen gene cluster.

Essentials The fibrinogen gene cluster is flanked by CCCTC-binding factor (CTCF) interaction sites. Chromatin looping of the fibrinogen cluster was demonstrated by chromosome conformation capture. Deleting a CTCF interaction site alters chromatin looping and halves fibrinogen expression. Looping of the human fibrinogen locus is functionally linked to fibrinogen gene expression. SUMMARY: Background The coordinately regulated genes encoding human fibrinogen are clustered. This evolutionarily conserved configuration provides a possible mechanism for co-regulation whereby regulatory elements influence gene expression locally. The cluster is flanked by CCCTC-binding factor (CTCF) interaction sites that are candidate insulator regions mediating chromatin looping. Objectives To further our understanding of fibrinogen gene regulation, we aimed to investigate whether interactions exist between parts of the fibrinogen locus and how these contacts contribute to fibrinogen expression. Methods We used chromosome conformation capture in cultured cell lines to detect chromatin interactions at the fibrinogen gene cluster. We generated clonal cell lines where two CTCF interaction sites at one end of the locus were deleted using CRISPR-Cas9-mediated genome editing. Fibrinogen expression and protein production were measured using qRT-PCR and ELISA, respectively. Results We detected proximity between the ends of the fibrinogen locus, regardless of whether cells express fibrinogen. An interaction between the FGA promoter and the edge of the locus was more frequent in fibrinogen-expressing cells. Deletion of a CTCF site at one edge of the cluster altered chromatin interactions, reduced steady-state expression of FGB and FGG mRNA, and led to a halving of secreted fibrinogen. These phenotypes were completely restored by reintroduction of the CTCF interaction motif in previously motif-deleted clones. Conclusions Chromatin interactions are important for the coordinated regulation of the human fibrinogen genes. This finding furthers our comprehension of how fibrinogen is produced and identifies a possible source of variability in plasma fibrinogen levels seen in populations.

Criminal characteristics of a group of primary criminals diagnosed with aspd: approach to criminal recidivis.

INTRODUCTION: Antisocial personality disorder (ASPD) is commonly associated with the risk of criminal recidivism. Knowing more about the factors associated with this pattern of behaviour can help with the design of effective prevention strategies. The purpose of this article is to establish if there are differences in socio-criminogenic variables of a group of criminals sentenced for the first time and with APSD compared to another group of first-time offenders who do not present this disorder. MATERIALS AND METHODS: Analytical observation study of 70 men classified into 2 groups according to the presence of ASPD TPA (n=47; age: 29.98±7.8 years) or absence of ASPD (n=23; age: 32.35±8.7 years). RESULTS: The inmates with ASPD showed higher frequencies of current consumption of psychoactive substances (31.9%), criminal associations and simultaneous use of psychoactive substances (70.2%), having committed the crime under the effects of a psychoactive substance (55.3%), not having the possibility of distancing themselves from criminal associations (83%) and a lack of legal resources for proceedings for defence and release (76.6%). DISCUSSION: This sample contains a group of variables called dynamic that are more commonly present amongst first time offenders with ASPD; said variables have been associated as major predictors of recidivism. Given that they are regarded as dynamic, they may well be modifiable.

Effects of CaCO3 treatment on the morphology, crystallinity, rheology and hydrolysis of gelatinized maize starch dispersions.

Using calcium salts instead of lime allows for an ecological nixtamalization of maize grains, where the negative contamination impact of the traditional lime nixtamalization is reduced. This work assessed the effects of calcium carbonate (0.0-2.0%w/w CaCO3) on the morphology, crystallinity, rheology and hydrolysis of gelatinized maize starch dispersions (GMSD). Microscopy analysis showed that CaCO3 changed the morphology of insoluble remnants (ghosts) and decreased the degree of syneresis. Analysis of particle size distribution showed a slight shift to smaller sizes as the CaCO3 was increased. Also, X-ray patterns indicated that crystallinity achieved a minimum value at CaCO3 concentration in the range of 1%w/w. GMSD with higher CaCO3 concentrations exhibited higher thixotropy area and complex viscoelastic behavior that was frequency dependent. A possible mechanism involved in the starch chain modification by CaCO3 is that starch may act as a weak acid ion exchanger capable of exchanging alcoholic group protons for cations (Ca(+2)).

Effect of lime concentration on gelatinized maize starch dispersions properties.

Maize starch was lime-cooked at 92 °C with 0.0-0.40% w/w Ca(OH)2. Optical micrographs showed that lime disrupted the integrity of insoluble remnants (ghosts) and increased the degree of syneresis of the gelatinized starch dispersions (GSD). The particle size distribution was monomodal, shifting to smaller sizes and narrower distributions with increasing lime concentration. X-ray patterns and FTIR spectra showed that crystallinity decreased to a minimum at lime concentration of 0.20% w/w. Lime-treated GSD exhibited thixotropic and viscoelastic behaviour. In the linear viscoelastic region the storage modulus was higher than the loss modulus, but a crossover between these moduli occurred in the non-linear viscoelastic region. The viscoelastic properties decreased with increased lime concentration. The electrochemical properties suggested that the amylopectin-rich remnants and the released amylose contained in the continuous matrix was firstly attacked by calcium ions at low lime levels (<0.20% w/w), disrupting the starch gel microstructure.

Electrochemical characterization of gelatinized starch dispersions: voltammetry and electrochemical impedance spectroscopy on platinum surface.

The electrochemical properties of gelatinized starch dispersions (GSD; 5% w/w) from different botanical sources were studied using cyclic voltammetry (CV) and electrochemical impedance spectroscopy (EIS) tests over a platinum surface. The phenomenological modelling of EIS data using equivalent circuits indicated that after gelatinization the electrical resistance was determined mainly by the resistance of insoluble material (i.e., ghosts). Sonication of the GSD disrupted the ghost microstructure, and produced an increase in electrical conductivity by reducing the resistance of the insoluble material. The CV data showed three oxidation peaks at potentials where glucose solutions displayed oxidation waves. It is postulated that hydrolysis at the bulk and electrocatalyzed oxidation on the Pt-surface are reactions involved in the starch transformation. Starches peak intensity increased with the amylose content, suggesting that the amylose-rich matrix played an important role in the charge transfer in the electrolytic system.

In vitro digestibility, physicochemical, thermal and rheological properties of banana starches.

Banana starches (BS) were isolated from Enano, Morado, Valery and Macho cultivars. The BS possessed B-type crystallinity and an amylose content varying from 19.32 to 26.35%. Granules had an oval morphology with different major-to-minor axis ratios, exhibiting both mono- and bi-modal distributions and mean particle sizes varying from 32.5 to 45 µm. BS displayed zeta-potential values ranging between -32.25 and -17.32 mV, and formed gels of incipient to moderate stability. The enthalpy of gelatinization of BS affected the crystalline order stability within the granules. In-vitro digestibility tests showed fractions as high as 68% of resistant starch. Rheological oscillatory tests at 1 Hz showed that BS dispersions (7.0%, w/w) exhibited Type III behaviour, attributed to the formation of a continuous phase complex three-dimensional amylose gel reinforced by swollen starch granules acting as fillers. Amylose content and granules morphology were the main factors influencing the BS properties.

Acid hydrolysis of native corn starch: morphology, crystallinity, rheological and thermal properties.

The acid hydrolysis of native corn starch at 35 °C was monitored during 15 days. After this time, the residual solids were about 37.0 ± 3.0%. First-order kinetics described the hydrolysis data, giving a constant rate of kH = 0.18 ± 0.012 days(-1). Amylose content presented a sharp decrement of about 85% and X-ray diffraction results indicated a gradual increase in crystallinity during the first 3 days. SEM micrographs showed that hydrolysis disrupted granule morphology from an initial regular shape to increasingly irregular shapes. Fractal analysis of SEM images revealed an increase in surface roughness. Fast changes in the thermal effects were caused by molecular rearrangements after fast hydrolysis of amylose in the amorphous regions in the first day. Steady shear rate and oscillatory tests showed a sharp decrease of the apparent viscosity and an increase of the damping factor (tan(δ)) caused by amylose degradation.

El efecto del uso prolongado y nocturno de las lentes de contacto en la córnea. A propósito de un caso de descompensación corneal y descenso del recuento endotelial / The effect of prolonged and nocturnal use of contact lenses on the cornea: About a case of corneal decompensation and decreased endothelial count

El edema corneal y la disminución del recuento de células endoteliales son complicaciones relacionadas con la hipoxia crónica de bajo grado, que experimentan los usuarios de lentes de contacto, principalmente debido al uso prolongado y nocturno. Este caso muestra el ejemplo de un paciente que presenta problemas de visión borrosa en ambos ojos, y a quien se le realizó un examen oftalmológico completo que incluyó fotografías, topografía corneal y conteo de células endoteliales. Posteriormente se revisa el metabolismo corneal, la etiopatogenia y las complicaciones derivadas del uso de lentes de contacto (AU)

Corneal edema and decreased endothelial cell count are complications related to chronic low-grade hypoxia experienced by contact lens wearers, primarily due to prolonged and overnight wear. This case shows the example of a patient who has blurred vision problems in both eyes and who underwent a complete ophthalmologic examination that included photographs, corneal topography and endothelial cell count. Subsequently, the corneal metabolism, the etiopathogenesis and the complications derived from the use of contact lenses are reviewed (AU)

Plantain starch granules morphology, crystallinity, structure transition, and size evolution upon acid hydrolysis.

Plantain native starch was hydrolysed with sulphuric acid for twenty days. Hydrolysis kinetics was described by a logistic function, with a zero-order rate during the first seven days, followed by a slower kinetics dynamics at longer times. X-ray diffraction results revealed a that gradual increase in crystallinity occurred during the first seven days, followed by a decrease to values similar to those found in the native starch. Differential scanning calorimetry analysis suggested a sharp structure transition by the seventh day probably due to a molecular rearrangement of the starch blocklets and inhomogeneous erosion of the amorphous regions and semi crystalline lamellae. Scanning electron micrographs showed that starch granules morphology was continually degraded from an initial oval-like shape to irregular shapes due to aggregation effects. Granule size distribution broadened as hydrolysis time proceeded probably due to fragmentation and agglomeration phenomena of the hydrolysed starch granules.

Comparabilidad del autorrefractómetro portátil Retinomax K-plus 3 en modo rápido versus autorrefractómetro de sobremesa en modo estándar / Comparability of the Retinomax K-plus 3 handheld autorefractometer in quick mode versus on-table autorefractometer in standard mode

I ntroducción Este estudio analiza la comparabilidad de las medidas tomadas por un autorefractómetro portátil Retinomax K-plus 3 en modo Quick (rápido) y un autorrefractómetro de sobremesa Topcon KR-800 en modo estándar sobre la población pediátrica, y establece su correlación. Método Es un estudio comparativo retrospectivo. Se midieron las variables potencia dióptrica esférica (SPH), potencia dióptrica cilíndrica (CYL), ángulo del eje cilíndrico (AX) y equivalente esférico (SE) con el Retinomax en modo Quick y con el Topcon en modo estándar. Cada paciente fue evaluado en condiciones ciclopléjicas y no ciclopléjicas por ambos autorefractómetros. Se realizó la prueba t de Student entre ambos instrumentos para SPH, CYL y SE. Se calculó el coeficiente de correlación de Pearson y se representó la dispersión mediante gráficas de Bland-Altman, evaluándose también el subgrupo de pacientes menores de 4 años. Se realizó un análisis descriptivo de los porcentajes de medidas que diferían. Resultados Incluyó 98 ojos de 49 sujetos (rango de edad: 3-16 años). Los datos de SPH sin cicloplejia son prácticamente idénticos, mientras que con cicloplejia hay un sesgo hipermetrópico de +0,5 dioptrías medidas con Retinomax. Los resultados de CYL son muy similares con y sin cicloplejia. Existe una gran correlación de Pearson para ambos instrumentos (>0,91) y un bajo grado de dispersión en los gráficos de Bland-Altman bajo cicloplejia. Conclusión Los datos del Retinomax fueron consistentes con los obtenidos por el Topcon. El Retinomax es un instrumento útil para detectar errores de refracción en niños de entre 3 y 16 años (AU)

Introduction This study analyzes the comparability of measurements taken by a Retinomax K-plus 3 handheld autorefractometer in quick mode and a Topcon KR-800 on-table autorefractometer in standard mode on the pediatric population, and establishes their correlation. Methods It is a retrospective comparative study. Spherical diopter power (SPH), cylindrical diopter power (CYL), angle of cylindrical axis (AX), and spherical equivalent (SE) were measured with the Retinomax in quick mode and with the Topcon in standard mode. Each patient was evaluated in cycloplegic and non-cycloplegic conditions by both autorefractometers. Student's t-test was performed between the two instruments for SPH, CYL, and SE. The Pearson correlation coefficient was calculated and the dispersion was represented using Bland-Altman graphs, also evaluating the subgroup of patients under 4 years of age. A descriptive analysis of the percentages of measures that differed was performed. Results It included 98 eyes of 49 subjects (age range: 3-16 years). The data for HPS without cycloplegia are virtually identical, whereas with cycloplegia there is a hyperopic bias of +0.5 diopters measured with Retinomax. CYL results are very similar with and without cycloplegia. There is a high Pearson correlation for both instruments (>0.91) and a low degree of dispersion in the Bland-Altman plots under cycloplegia. Conclusion The Retinomax data were consistent with those obtained by Topcon. The Retinomax is a useful instrument for detecting refractive errors in children between 3 and 16 years of age (AU)

Impacto de un programa piloto de seguimiento farmacoterapéutico sobre el control de la presión arterial de pacientes ambulatorios hipertensos y con síndrome metabólico en México / Impact of a pilot program of medication review with follow-up on the blood pressure control in hypertension ambulatory patients with metabolic syndrome in Mexico

Introducción: En México el 25.5% de los adultos padecen hipertensión arterial sistémica y aproximadamente el 50% de ellos presenta descontrol de la enfermedad. El farmacéutico puede colaborar en el tratamiento de la presión arterial de pacientes hipertensos. Objetivos: Evaluar la mejoría en la presión arterial en pacientes ambulatorios hipertensos con síndrome metabólico mediante un programa piloto de seguimiento farmacoterapéutico Métodos: Se realizó un estudio controlado, aleatorizado y de intervención en pacientes hipertensos y con síndrome metabólico mediante un programa piloto de seguimiento farmacoterapéutico. Se evaluó el control de la presión arterial y el riesgo cardiovascular (RCV) de acuerdo al NCEP-ATP III. Se otorgó seguimiento farmacoterapéutico durante 6 meses, incluyendo educación sanitaria, monitoreo de adherencia, valoración de problemas relacionados con los medicamentos (PRM) y resultados negativos de la medicación (RNM). Se efectuaron mediciones clínicas y de laboratorio para compararse al final de la intervención. Resultados: El promedio de presión arterial sistólica disminuyó en el 16.1% de los participantes del grupo intervención, alcanzándose la meta control de la guía mexicana para hipertensión y del NCEP-ATP III. El RCV en el grupo de intervención y control fue de "bajo riesgo" usando la calculadora PAHO/WHO, y de un rango de 1% a 9.9% usando escala Framingham. La adherencia farmacológica mejoró en el grupo intervención (p=0.021). El promedio de PRM/paciente cambió de 2.5 (DE=1.3) a 0.4 (DE=0.6) al final del estudio (p<0.01). Conclusiones: El seguimiento farmacoterapéutico favoreció el control de la presión arterial en el 16.1% de la población intervenida por el programa piloto

Introduction: In Mexico, 25.5% of adults live with systemic hypertension and approximately 50% of them have poor control of the disease. The pharmacist may collaborate with the medical team in the treatment of blood pressure in hypertensive patients. Objective: To evaluate the blood pressure improvement in outpatients with hypertension and metabolic syndrome through a medication review with follow-up (MRF) pilot program. Methods: It was carried out a randomized, controlled and interventional study in patients with hypertension and metabolic syndrome through a MRF pilot program. Blood pressure control and cardiovascular risk were evaluated using the NCEP-ATP III. A pharmatherapeutical monitoring was provided during 6 months. It included health education, medication adherence monitoring and DRP and NOM assessment. Clinical and laboratory measures were collected and compared at the end of the intervention period with the control group. Results: The systolic blood pressure average diminished in 16.1% of the participants in the intervention group, reaching the control goal of the hypertension Mexican guideline and NCEP-ATP III. The CVR in both groups was "low" using the PAHO/WHO calculator and from 1% to 9.9% using Framingham score. The prevalence of medication adherence increased significantly in the intervention group (p=0.021). The average of DRP/patient changed from 2.5 (SD=1.3) to 0.4, SD=0.6 (p<0.01) at the end of the intervention

Repetibilidad y comparabilidad de un nuevo tomógrafo con tecnología SS-OCT en biometría óptica / Repeatability and comparability of a new swept-source optical coherence tomographer in optical biometry

Objetivo Evaluar la reproducibilidad en la medición de los parámetros biométricos utilizando un nuevo biómetro por tomografía de coherencia óptica con fuente de barrido y compararlo con un biómetro por reflectometría óptica de baja coherencia. Diseño Estudio observacional, descriptivo, de corte transversal. Método Se incluyeron 45 ojos derechos de 45 pacientes, a los que se realizó tres mediciones consecutivas con el biómetro Anterion y una con el biómetro Lenstar LS900. Se recogieron las siguientes variables: longitud axial (AXL), profundidad de cámara anterior (ACD), K plana (K1), K curva (K2), grosor corneal central (CCT), grosor del cristalino (LT) y distancia blanco-blanco (WTW). Para evaluar la repetibilidad se calculó el coeficiente de Pearson «R» y la desviación estándar intrasujeto (Sw). Para evaluar la comparabilidad entre los biómetros se utilizó el coeficiente de correlación de concordancia (CCC) y el coeficiente de correlación intraclase (CCI). Además, se realizaron gráficos de Bland-Altman para cada variable. Resultados El coeficiente de Pearson fue excelente y estadísticamente significativo en la evaluación de la repetibilidad para todas las variables. Los valores más altos fueron 0,987 (AXL), 0,983 (CCT) y 0,942 (ACD). No hubo diferencias estadísticamente significativas entre las repetidas mediciones con Anterion para todas las variables. Los valores de CCC y CCI fueron excelentes en la evaluación de las variables AXL, CCT y ACD, y fueron altos para las variables K1, K2, LT y WTW. Conclusiones La realización de una biometría óptica ocular con el biómetro SS-OCT Anterion es un procedimiento reproducible y comparable con el biómetro Lenstar LS900 (AU)

Purpose To evaluate the reproducibility in the measurement of ocular biometric parameters using a new swept-source optical coherence tomographer and its comparability with an optical low coherence reflectometry biometer. Design An observational, descriptive, cross-sectional study. Methods 45 right eyes of 45 patients diagnosed with cataract were included. Three successive biometric measurements with Anterion and one with Lenstar LS900 were performed on each patient. The following variables were collected: axial length (AXL), anterior chamber depth (ACD), flat K (K1), steep K (K2), central corneal thickness (CCT), lens thickness (LT) and white-to-white distance (WTW). The intrasubject standard deviation (Sw) and the coefficient of Pearson «R» were calculated in order to assess the repeatability. The intraclass correlation coefficient (ICC) and the concordance correlation coefficient (CCC) were obtained to evaluate the comparability between devices. A Bland–Altman plot was performed for each variable. Results The coefficient of Pearson was excellent and statistically significant in the evaluation of the repeatability in all the variables. The highest values were 0.987 (AXL), 0.983 (CCT) and 0.942 (ACD). There were no statically significant differences between repeated measurements with Anterion in all the parameters. The ICC and CCC were excellent in the evaluation of AXL, CCT and ACD, and were also good in regard to K1, K2, LT and WTW. Conclusions Performing biometry with the SS-OCT Anterion is a reliable and reproducible procedure, and it is comparable with the Lenstar LS900 (AU)