Melanoma maligno de coroides: a propósito de un caso / Choroidal malignant melanoma: a case report

El melanoma maligno de coroides es el tumor intraocular primario más frecuente en la edad adulta. Su evolución clínica es muy variable y constituye un peligro potencial para la vida de las personas afectadas. Se presenta el caso de un paciente de 42 años, caucásico, de procedencia urbana que acudió al Centro Oftalmológico de Holguín por disminución lenta y progresiva de la visión de aproximadamente hacía dos años de evolución que inicialmente comenzó como un defecto del campo visual periférico hasta afectar la visión central. La oftalmoscopía mostró lesión tumoral yuxtapapilar de coloración pardo-grisácea, elevada en forma de hongo, que produjo desprendimiento de retina secundario en tienda de campaña. Fue diagnosticado como portador de un melanoma maligno de coroides y remitido al Instituto Nacional de Oncología y Radiobiología donde se le realizó la enucleación del ojo derecho y se confirmó el diagnóstico por anatomía patológica. Se discutieron los principales factores de riesgo, la forma clínica de presentación, los hallazgos en las investigaciones clínicas realizadas para el diagnóstico, la modalidad de tratamiento aplicada, la evolución y el pronóstico, a partir de la información recogida de la revisión del expediente clínico del paciente.

Choroidal malignant melanoma is the most frequent intraocular tumor in adults. Its clinical evolution is very variable and it is a potential hazard for the life of the affected people. The case of a 42-year-old Caucasian urban male patient is reported. The patient presented to the Ophthalmological Center of Holguín complaining of slow and progressive loss of vision of about 2-years´ evolution that initially began as a peripheral visual field defect up to affect central vision. The ophthalmoscopy showed an elevated grayish-brown-colored mushroom-shaped tumoral lesion next to the papilla that produced a secondary tent-like retinal detachment. He was diagnosed as carrier of choroidal malignant melanoma and was referred to The National Institute of Oncology and Radiobiology where the enucleation of his righ eye ball was performed and the diagnosis was confirmed through pathological study. The main risk factors, clinical presentation, clinical research findings for diagnosis, treatment, evolution and prognosis were discussed from the information obtained from his clinical record.

Factores de riesgo ocular y experiencia del cirujano en las complicaciones de la cirugía de catarata / Ocular risk factors and the surgeon's experience to manage complications in the cataract surgery

OBJETIVO: determinar influencia de factores de riesgo ocular y experiencia del cirujano en las complicaciones de 158 pacientes operados de catarata en el Centro Oftalmológico de Holguín entre abril y octubre de 2010. MÉTODOS: se realizó un estudio descriptivo de corte transversal donde se analizaron variables como edad, sexo, factores de riesgo ocular, complicaciones transoperatorias y posoperatorias inmediatas relacionadas con factores de riesgo y experiencia del cirujano. RESULTADOS: el grupo de edad que predominó fue el de 70-79 años con 38,6 % y el sexo femenino en 58,8 %. El factor de riesgo más frecuente fue la madurez e hipermadurez del cristalino en 51,2 %. La complicación transoperatoria que más incidió fue la ruptura de cápsula posterior con pérdida de vítreo en 8,2 % relacionada con madurez del cristalino y pupila pequeña. El edema corneal constituyó la complicación posoperatoria inmediata que predominó en 6,3 % relacionada fundamentalmente con pupila insuficiente y catarata madura. En la cirugía realizada por residentes predominaron las complicaciones en 15,8 %. CONCLUSIONES: la intervención de cataratas en etapas de madurez e hipermadurez asociada a pupilas insuficientes expuso a estos ojos a un riesgo mayor de ruptura de cápsula posterior con o sin pérdida de vítreo y al edema corneal. La cirugía de catarata en pacientes con factores de riesgo oculares fue más propensa a complicaciones cuando la realizaron residentes y oftalmólogos con menos entrenamiento y experiencia.

OBJECTIVE: to determine the influence of ocular risk factors and the surgeon's experience on complications affecting 158 patients operated on for cataract at the Ophthalmologic Center in Holguin from April to October, 2010. METHODS: cross-sectional descriptive study in which variables such as age, sex, ocular risk factors, immediate transoperative and postoperative complications related to risk factors and the surgeon's experience were analyzed.RESULTS: the 70-79 years-old group prevailed with 38,6 %, and the females accounted for 58,8 % in the group. The most frequent risk factors were the maturity and hypermaturity of the crystalline lens in 51,2 % of cases. The transoperative complication that mostly affected the patients was the rupture of the posterior capsule with vitreous loss in 8,2 % of cases, associated with maturity of the crystalline lens and the small pupil. The corneal edema represented the predominant immediate postoperative complication in 6,3 % of cases, due to insufficient pupil and mature cataract. The complications were more frequent in surgeries performed by residents in 15,8 % of patients. CONCLUSIONS: operating cataracts at maturity and hypermaturity stages due to insufficient pupils meant higher risk of the posterior capsule rupture with or without vitreous loss and of corneal edema. Cataract surgery in patients with ocular risk factors was proner to complications when they are performed by residents or by ophthalmologists with less training and experience in this field.

Benefits of omega-3 fatty acid dietary supplementation on health-related quality of life in patients with meibomian gland dysfunction.

BACKGROUND: We assessed the impact of a dietary supplement based on the combination of omega-3 essential fatty acids and antioxidants on health-related quality of life in patients with meibomian gland dysfunction (MGD). METHODS: Patients of either sex (aged 18-85 years) diagnosed with MGD according to criteria identified at a 2011 International Workshop on Meibomian Gland Dysfunction participated in this randomized, double-masked, placebo-controlled study. Group A patients (controls) received an oral placebo supplement and group B patients received the oral study supplement (Brudysec(®) 1.5 g; Brudy Laboratories, Barcelona, Spain). At baseline and at 3-month follow-up, the patients completed the 36-Item Short Form Health Survey questionnaire using a Spanish validated version. The Physical (PCS) and Mental (MCS) Component Summary scores were the main outcome variables. RESULTS: A total of 61 patients completed the study (group A, n=31; group B, n=30). There were no significant differences in PCS and MCS scores at baseline between the two study groups, but after 3 months of treatment, significantly higher mean PCS and MSC scores were observed in patients treated with the active omega-3 dietary supplement as compared with controls (mean [standard deviation] PCS score 53.33±5.57 versus 47.46±7.31, P=0.008; mean MCS score 54.60±5.64 versus 47.80±8.45, P=0.0005). Moreover, mean differences between values at 3 months as compared with baseline were statistically significant for patients in group B (PCS score 7.14±5.81, 95% confidence interval 4.97-9.31, P=0.000; MCS score 5.96±7.64, 95% confidence interval 3.10-8.81, P=0.0002), whereas mean differences in patients assigned to group A were not statistically significant. CONCLUSION: Dietary supplementation with a combination of omega-3 essential fatty acids and antioxidants had a significant beneficial effect on HRQoL (health-related quality of life) in patients with MGD.

Emotional dysfunction associated with diabetes in Mexican adolescents and young adults with type-1 diabetes.

OBJECTIVE: To assess the emotional dysfunction associated with diabetes in Mexican young individuals with type-1 diabetes. MATERIAL AND METHODS: A cross-sectional survey was conducted to perform a complete clinical and psychosocial evaluation of 93 consecutive type-1 diabetes patients, and 14 to 30 years. RESULTS: Adolescents had higher scores of emotional dysfunction related to diabetes and a diminished knowledge in diabetes-related areas. A multivariate logistic regression model showed that an inadequate emotional response to diabetes (high problem areas in diabetes or PAID scores) was mainly associated with a poor glycemic control (OR = 2.9, 95% CI 0.9-9.7, p = 0.09). Apprehension about the future and the possibility of serious complications had the highest mean PAID score in all age groups. CONCLUSIONS: New strategies should be developed to improve the routine care and support of young individuals with type-1 diabetes.

Emotional dysfunction associated with diabetes in Mexican adolescents and young adults with type-1 diabetes

OBJECTIVE: To assess the emotional dysfunction associated with diabetes in Mexican young individuals with type-1 diabetes. MATERIAL AND METHODS: A cross-sectional survey was conducted to perform a complete clinical and psychosocial evaluation of 93 consecutive type-1 diabetes patients, aged 14 to 30 years. RESULTS: Adolescents had higher scores of emotional dysfunction related to diabetes and a diminished knowledge in diabetes-related areas. A multivariate logistic regression model showed that an inadequate emotional response to diabetes (high problem areas in diabetes or PAID scores) was mainly associated with a poor glycemic control (OR=2.9, 95 percent CI 0.9-9.7, p=0.09). Apprehension about the future and the possibility of serious complications had the highest mean PAID score in all age groups. CONCLUSIONS: New strategies should be developed to improve the routine care and support of young individuals with type-1 diabetes

Simultaneous expression of different variant-specific surface proteins in single Giardia lamblia trophozoites during encystation.

A novel variant-specific surface protein (VSP) from Giardia was identified using the monoclonal antibody 9B10, raised against purified cyst walls. VSP9B10B is preferentially induced during encystation and expressed simultaneously with other VSPs on the surface of encysting trophozoites. These results support the hypothesis that encystation and antigenic variation are processes that are mechanistically related.

Contusión ocular en el niño asociada con hipema: estudio de 200 pacientes / Ocular contusion in the child associated with hyphema: study of 200 patients

Se realiza un estudio de 200 historias clínicas de niños ingresados en el Servicio de Oftalmología Pediátrica del Hospital Provincial Docente "V. I Lenin", en el período de agosto de 1981 hasta agosto de 1986. Se analizan variables como edad, sexo, tiempo de evolución del trauma, cantidad de sangre en mm, tiempo de reabsorción de la misma, lesiones asociadas, complicaciones, secuelas, entre otras. Se realizan conclusiones