Possible relation between borderline ovarian cancer and endocervical adenocarcinoma: case report.

Case: The patient, a 74-year-old women was diagnosed with intestinal-type endocervical adenocarcinoma that developed after 11 years from borderline ovarian cancer. The diagnosis was based on biopsy and magnetic resonance imaging; hysterectomy with pelvic lymphadenectomy was then performed.

Birdlife, a tourist attraction for the southern portion of Bacalar Lagoon, Quintana Roo, Mexico.

The Bacalar Lagoon (BL) in Quintana Roo, Mexico; is an area of high interest due to its tourist potential. However, the changes in landuse patterns, urbanization, extensive cattle ranching and rapidly expanding agriculture, have generated negative impacts on areas of adjacent plan communities and wildlife habitats. The objective of this study has to evaluate the level of vegetation conservation in the southern portion of the BL through the avifauna present in sites with contrasting degrees of conservation. Additionally, change "and their habitat preference(s) in the different communities" to and their habitat use preferences in the different communities. To evaluate the level of conservation of the BL, field visits and botanical collections were carried out to identify species. For the counting and identification of birds, monthly surveys were made through coastal tours along the cenote Xul-ha in 2.5 km transects. Four transects were established: two for sites characterized as semi-conserved and two with disturbed sites. A total richness of 40 taxa was observed, which corresponds to 8.1% of the Quintana Roo avifauna and 32% to wetland birds (125 species). The species accumulation curves indicated that semi-conserved and disturbed sites tend to reach asymptotes and with a coverage percentage greater than 90%. In terms of diversity and community structure, no significant differences were observed. However, the semi-conserved and disturbed sites each have 11 unique species and share 18 species. The LB has an intermediate diversity of bird species compared to studies at the Mexican level, the habitat is important for the conservation of birdlife; as it functions as a reservoir of diversity. Strategies has been suggested that promote sustainable tourism, support the restoration of natural vegetation; and facilitate the economic development of the region.

Choroidal macrovessel and persistent metamorphopsia after epiretinal membrane surgery.

We report the case of a 59-year-old man with decreased visual acuity and metamorphopsia in both eyes in the context of bilateral epiretinal membrane (ERM) who underwent retinovitreal surgery (chromovitrectomy plus peeling of internal limiting membrane). He recovered visual acuity in his left eye. However, the visual results of his right eye were not satisfactory, with persistence of metamorphopsia in that eye. The multimodal imaging study that included color and red filter retinographies, enhanced depth imaging optical coherence tomography (EDI-OCT), fluorescein angiography (FA), indocyanine green angiography (ICGA), OCT angiography (OCTA) and OCT en face, were useful to diagnose a choroidal macrovessel. This ran from the fovea to the temporal macula. EDI-OCT revealed that the choroidal macrovessel generated a foveal deformation of both the ellipsoid zone (EZ) and the retinal pigment epithelium (RPE). This paper discusses whether structural changes in the fovea generated by the choroidal macrovessel are related to persistent metamorfopsia in the affected eye.

[CeliacScore 2.0: Up to date of the Score System for the Diagnosis of Celiac Disease: association with DQß1*02 and DQß1*0302 alleles]. / CeliacScore 2.0: Actualización del Sistema de Puntaje para el Diagnóstico de la Enfermedad Celíaca: asociación con los alelos DQ?1*02 y DQ?1*0302.

INTRODUCTION: Celiac disease (CD) diagnosis can be improved if a scoring system comprising clinical, nutritional, serological and histopathological elements is applied. DQß1*02 and/ or DQß1*0302 alleles can be expected to be more frequent among subjects with the highest scores. OBJECTIVES: To assess the relationship between score assigned to the patient by means of the system developed and alleles associated with CD. METHODS: Scores were assigned to 69 patients (Women: 68.1%; Ages ≤ 60 years: 95.7%) assisted by a multidisciplinary group for management of CD, using an updated version of a previously described score system (CeliacScore 2.0) were correlated with the occurrence of DQß1*02 and/or DQß1*0302 alleles. CD was diagnosed if the assigned score was ≥ 10. RESULTS: 17.4% of studied patients were diagnosed as CD. DQß1*02 and/or DQß1*0302 alleles were present in 56.5% of our cases. Scores assigned to patient's were independent of the presence of alleles of interest (c² = 2.3; p > 0.319). 75.0% of subjects with a score higher than 10 had the alleles of interest. The probability for the presence of DQß1*02 and/or DQß1*0302 alleles was 2.7 in patients with scores ≥ 10. CONCLUSIONS: The described system can be useful in the CD diagnosis. Alleles associated with CD concentrated among those with the highest scores. Scoring system's operating characteristics should be explored in further studies.

Nepafenac for cystoid macular oedema secondary to paclitaxel.

Paclitaxel is used to treat a wide range of malignant tumours. This type of drug is known to cause ocular adverse effects, with cystoid macular oedema being a known, but rare complication, of this therapy. Although most cases resolve after discontinuation of the drug, several authors have attempted various treatments to accelerate resolution, or when paclitaxel therapy cannot be discontinued. A case is presented of a 62 year-old man who presented with decreased visual acuity due to bilateral cystoid macular oedema after administration of paclitaxel for oesophageal cancer. As part of the study, optical coherence tomography angiography (OCTA) was performed at the time of diagnosis, and later when the symptoms subsided. Nepafenac eye drops were prescribed as treatment.

High prevalence of asthma and allergic diseases in children aged 6 to [corrected] 7 years from the Canary Islands. [corrected].

OBJECTIVE: To investigate the prevalence of bronchial asthma and allergic diseases in schoolchildren from the Canary Islands, Spain. METHODS: Cross-sectional study following the methodology of ISAAC (International Study of Asthma and Allergies in Childhood), which uses standardized and validated questionnaires. The study participants were children aged between 6 and 7 years attending schools in Las Palmas de Gran Canaria, Canary Islands, Spain. RESULTS: Of the 3108 questionnaires distributed, 1883 were answered, and 1871 were evaluable (60.6%). Gender distribution was similar (51.8% boys vs 48.2% girls). Current prevalence of asthma was 18.4% (95% confidence interval [CI], 16.7-20.2), rhinitis 40.3% (95% CI, 38-42.3), and atopic dermatitis 35.8% (95% CI, 33.6-37.9). The highest prevalence of rhinitis was recorded during the autumn months (P<.005). Asthma was more frequent in boys than in girls (P<.05), but there were no statistical differences for the other allergic diseases. CONCLUSIONS: The prevalence of asthma and allergic diseases in children aged 6-7 years in the Canary Islands is higher than in other areas of Spain where the ISAAC study has been performed. Male gender is an important risk factor in children, especially for asthma symptoms.

Role of purines on hepatic ischemia-reperfusion lesions in rabbit.

In this work, we evaluate the effects of adenosine 5' triphosphate (ATP) on hepatic lesions caused by ischemia/reperfusion (I/R) in liver rabbit. Rabbits were pretreated with ATP (15 mg/kg IV) or saline solution 0.9% (SS), before the hepatic I/R procedure. We evaluated the effects of ATP on hepatic injury before and after I/R. The warm hepatic I/R procedure caused profound acute liver injury, as indicated by elevated serum aspartate aminotransferase, alanine aminotransferase, and lactic dehydrogenase levels, as well as a high apoptotic cell count. All these changes were attenuate by ATP treatment before the hepatic I/R procedure. These results suggested that ATP exerted protective effects on hepatic I/R lesions in the rabbit. This ATP effect may be related to improved energy metabolism during reperfusion in ischemic livers protecting against functional damage of cellular and subcellular membranes during lipid peroxidation.

[Photodynamic therapy with verteporfin in choroidal neovascularization after refractive surgery]. / Terapia fotodinámica con verteporfina en neovascularización coroidea después de cirugía refractiva.

PURPOSE: To analyze the results obtained with Photodynamic Therapy (PDT) to treat subfoveal and juxtafoveal Choroidal Neovascularization (CNV) in patients with high myopia corrected by Laser-Assisted in situ Keratomileusis (LASIK) or by implanting a Phakic Intraocular Lens (PIOL). METHODS: We analyzed the results from 14 highly myopic eyes corrected by LASIK (seven cases) or by PIOL implantation (seven cases), which later developed CNV and were treated by PDT with verteporfin. RESULTS: Mean Best Corrected Visual Acuity (BCVA) after refractive surgery was 0.45 SD 0.17 (range, 0.2 to 0.8), with residual spherical equivalent (RSE) -0.5 SD 1.8 D (range, 1 to 5.5 D). After CNV appearance, BCVA was 0.10 SD 0.19 (range, 0.025 to 0.7). CNV was treated in all cases by PDT (mean, 2.0 SD 0.8 treatments). After CNV closure, the mean BCVA improved up to 0.22 SD 0.18 (range, 0.1 to 0.63) (RSE -1.4 SD 1.4 D, range, 0.5 to -4 D). Differences in RSE after refractive surgery and after PDT, and differences between BCVA after CNV appearance and final were not statistically significant (p=0.82 and p=0.06, respectively, Student's t test paired data). CONCLUSION: We consider that PDT is effective in achieving closure of CNV in myopic patients after refractive surgery without inducing changes in spherical equivalent.

X-linked mental retardation with marfanoid habitus: first report of four Italian patients.

We report on 4 new cases of mildly retarded patients with marfanoid habitus and a characteristic constellation of minor anomalies. These patients, although sporadic, are likely to be affected by the same X-linked type of mental retardation described by Lujan et al. (American Journal of Medical Genetics 17:311-322, 1984) and more recently by Fryns and Buttiens (American Journal of Medical Genetics 28:267-274, 1987). The similar psychiatric history in 2 of our patients suggests that psychotic behaviour could be an additional manifestation, previously unrecognized in this condition. Late diagnosis of this relatively new syndrome in all our patients confirms the difficulty of the nosologic definition of mentally retarded individuals on clinical grounds alone. On the other hand, the Lujan-Fryns syndrome appears to be more common than one would have thought.

A single blind comparison of amisulpride, fluoxetine and clomipramine in the treatment of restricting anorectics.

1. The study evaluated the efficacy of amisulpride, fluoxetine and clomipramine at the beginning of the re-feeding phase of the treatment of restricting anorexia nervosa according to DSM-IV criteria. 2. 13 patients, mean weight 37.61 kg +/- 9.80 SD, were treated with clomipramine at a mean dosage of 57.69 mg +/- 25.79 SD; 10 patients, mean weight 40.90 kg +/- 6.98 SD, were treated with fluoxetine at a mean dosage of 28.00 mg +/- 10.32 SD; 12 patients, mean weight 38.41 kg +/- 8.33 SD, were treated with amisulpride at a mean dosage of 50.00 mg +/- 0.00 SD. 3. Clinical evaluation was carried out under single-blind condition at basal time and after three months by a structured clinical interview, the Eating Disorder Interview based on Long Interval Follow-up Evaluation (LIFE II BEI). 4. Patients treated with amisulpride showed a more significant increase (p=0.016) of mean weight. Concerning weight phobia, body image disturbance and amenorrhoea, no significant difference resulted.

Symptom prevalence in the last week of life.

Palliative care is the management of patients with progressive, far-advanced disease for whom the prognosis is limited and the focus of care is quality of life. During the last days of life, it is important to redefine the goals, as previously present symptoms may increase and new symptoms may appear. To assess these symptoms, 176 patients were evaluated. A questionnaire evaluated symptoms during the last week of life and compared these prevalences with those at the first evaluation. The patients comprised 121 men and 55 women. The mean age was 67.7 years. Metastases were present in 66.5% and were multiple in 52%. The most frequent symptoms at the end of life (> 50%) were anorexia, asthenia, dry mouth, confusion, and constipation. The majority of patients died at home (64.2%). We observed good control of "reversible" symptoms, but many symptoms were difficult to control at the end of life. Symptom assessment is important in this population.

Prevalence of thyroid autoimmunity in insulin dependent diabetes mellitus in the Bayamon region.

The purpose of this study was to describe our experience in the Bayamon region with respect to the prevalence of thyroid autoimmunity in our pediatric diabetic population. We identified a total of 78 patients with IDDM and all were examined to ascertain the presence of goiter. Thyroid profile, free thyroxine, thyrotropin, and thyroid microsomal autoantibodies were measured by radioimmunoassay in 65 of these patients. The data was analyzed using the Chi square test in order to correlate thyroid dysfunction with respect to sex and thyroid autoimmunity. Our results revealed a prevalence of thyroid autoimmunity in our IDDM patients of 15%, 40% of them had a goiter (p less than 001) and most of them were female (9 of 12). This is the lowest prevalence of thyroid autoimmunity in diabetic children reported in Hispanic groups in the United States thus far.

[Abnormalities of sexual development in Puerto Rico: status report]. / Anomalías de desarrollo sexual en Puerto Rico: estado de situación.

Puerto Rico presents the highest incidence in the world of anomalous sexual development. The authors have collected over 3100 cases in the past 19 years. Clinical and laboratory studies suggest possible estrogenic contamination of meats and poultry products. Variation in diet provides protection to a significant number of patients. The possibility of mycotic contamination of food employed in animal husbandry by Fusarium sp., and mycotoxins capable of estrogenic effects have been suggested in a preliminary study. Private and government investigators are active in the study of the condition, but more fiscalizing action is needed. A detailed study of food components for possible contaminants determination is considered mandatory.

Macrovaso coroideo y metamorfopsia persistente después de cirugía de membrana epirretiniana / Choroidal macrovessel and persistent metamorphopsia after epiretinal membrane surgery

Presentamos el caso de un hombre de 59 años con disminución de agudeza visual y metamorfopsia en ambos ojos en el contexto de membrana epirretiniana bilateral (MER) que fue intervenido con cirugía retinovítrea (cromovitrectomía más pelado de membrana limitante interna). Presentó recuperación de agudeza visual en su ojo izquierdo. Sin embargo, los resultados visuales de su ojo derecho no fueron satisfactorios, con persistencia de metamorfopsia en dicho ojo. El estudio con imagen multimodal que incluyó retinografía en color y filtro rojo, tomografía de coherencia óptica con imagen de profundidad mejorada (OCT-EDI), angiografía fluoresceínica (AF), angiografía verde de indocianina (ICGA), OCT-angiografía (OCTA) y OCT en-face fue útil para diagnosticar un macrovaso coroideo. Este recorría desde la fóvea hasta la mácula temporal. La OCT-EDI reveló que el macrovaso coroideo generaba una deformación foveal tanto de la zona elipsoide (ZE) como del epitelio pigmentario de retina (EPR). En este trabajo se discute si los cambios estructurales en la fóvea generados por el macrovaso coroideo están relacionados con la metamorfopsia persistente en el ojo afectado (AU)

We report the case of a 59-year-old man with decreased visual acuity and metamorphopsia in both eyes in the context of bilateral epiretinal membrane (ERM) who underwent retinovitreal surgery (chromovitrectomy plus peeling of internal limiting membrane). He recovered visual acuity in his left eye. However, the visual results of his right eye were not satisfactory, with persistence of metamorphopsia in that eye. The multimodal imaging study that included colour and red filter retinographies, enhanced depth imaging optical coherence tomography (EDI-OCT), fluorescein angiography (FA), indocyanine green angiography (ICGA), OCT angiography (OCTA) and OCT en face, were useful to diagnose a choroidal macrovessel. This ran from the fovea to the temporal macula. EDI-OCT revealed that the choroidal macrovessel generated a foveal deformation of both the ellipsoid zone (EZ) and the retinal pigment epithelium (RPE). This paper discusses whether structural changes in the fovea generated by the choroidal macrovessel are related to persistent metamorfopsia in the affected eye (AU)

Nepafenaco para edema macular cistoideo secundario a paclitaxel / Nepafenac for cystoid macular oedema secondary to paclitaxel

El paclitaxel es utilizado para tratar una amplia gama de tumores malignos. Se sabe que estos fármacos causan efectos adversos oculares, siendo el edema macular cistoide una complicación conocida pero rara de esta terapia. Aunque la mayoría de los casos se resuelven después de la interrupción del fármaco, varios autores han intentado diversos tratamientos para acelerar la resolución o cuando la terapia con paclitaxel no puede suspenderse. Presentamos un caso de un varón de 62 años que presentó disminución de la agudeza visual debido a edema macular cistoideo bilateral después de la administración de paclitaxel para cáncer de esófago; como parte del estudio se realizó angiografía por tomografía de coherencia óptica en el momento del diagnóstico y posteriormente cuando el cuadro remitió. Como tratamiento se prescribió colirio de nepafenaco (AU)

Paclitaxel is used to treat a wide range of malignant tumours. This type of drug is known to cause ocular adverse effects, with cystoid macular oedema being a known, but rare complication, of this therapy. Although most cases resolve after discontinuation of the drug, several authors have attempted various treatments to accelerate resolution, or when paclitaxel therapy cannot be discontinued. A case is presented of a 62 year-old man who presented with decreased visual acuity due to bilateral cystoid macular oedema after administration of paclitaxel for oesophageal cancer. As part of the study, optical coherence tomography angiography (OCTA) was performed at the time of diagnosis, and later when the symptoms subsided. Nepafenac eye drops were prescribed as treatment (AU)

[Surgical removal of peripapillary choroidal neovascularization in young patients]. / Extracción quirúrgica de la neovascularización coroidea peripapilar en pacientes jóvenes.

PURPOSE: To analyze anatomical and visual outcomes after subretinal surgery for peripapillary choroidal neovascularization (CNV) not associated with age-related macular degeneration (AMD). METHODS: Five eyes from five patients with peripapillary CNV who had been treated by subretinal surgery were retrospectively analyzed. RESULTS: The patients averaged 32 years of age (range, 11 to 49, SD 14.5 years) and mean follow-up was 31.4 months (range, 8 to 48, SD 20.8 months). Best corrected visual acuity was 0.05 (range, 0.001 to 0.16, SD 0.07) before surgery and 0.64 (range, 0.2 to 0.9, SD 0.26) after surgery (p=0.005; Student's t test for paired data). Neither intraoperative nor postoperative incidences occurred. CONCLUSIONS: Surgical removal may be considered one of the therapeutic options to treat peripapillary CNV not related to AMD.

Photodynamic therapy to treat choroidal neovascularisation in highly myopic patients: 4 years' outcome.

AIMS: To report the visual outcome in a series of eyes with myopic choroidal neovascularisation treated by photodynamic therapy (PDT) followed during 48 months. METHODS: Prospective, consecutive, non-randomised interventional case series. Thirty-nine eyes from 36 highly myopic patients treated by PDT were evaluated. Best corrected visual acuity (BCVA) and fluorescein angiography were performed every 3 months. Multiple regression analysis was used to analyse changes in BCVA in relationship with initial BCVA, spherical equivalent, age, diameter of CNV and chorioretinal atrophy. RESULTS: Mean initial BCVA was 9.0 Early Treatment Diabetic Retinopathy Study lines (SD 4.3). BCVA was 10.4 lines (3.6) at month 12, 9.7 lines (SD 3.9) at month 24, 9.6 lines (SD 3.8) at month 36 and 9.6 lines (SD 4.2) at month 48. BCVA improvement was associated with initial BCVA (p<0.002), lesion diameter (p<0.04) and age (p<0.04) (multiple regression analysis). CONCLUSIONS: Our results suggest a better visual outcome for those eyes with better initial BCVA and larger lesions in younger patients treated by PDT. The poorer results for elderly patients with lower initial BCVA might lead us to consider other therapeutic approaches.

Optical coherence tomography predictive factors for macular hole surgery outcome.

AIM: To evaluate the use of preoperative optical coherence tomography (OCT) findings as predictive factors for macular hole (MH) surgery outcomes. METHODS: 46 eyes from 46 patients with a diagnosis of MH were included in this study. In all cases, a pars plana 25-gauge vitrectomy with peeling of the internal limiting membrane was performed. Before and after surgery, a complete clinical examination and a detailed macular analysis, which included the MH minimum and base diameter, the MH height, the Macular Hole Index (MHI), Diameter Hole Index (DHI) and Tractional Hole Index (THI), were performed. Predictive factors for visual prognosis after surgery were obtained by receiver operating characteristic curve analysis. RESULTS: Minimum and base diameter as well as THI and MHI correlated significantly (p<0.01, p = 0.01, p = 0.04, p = 0.03, respectively) with postoperative best spectacle corrected visual acuity at 3 months, but DHI and MH height did not. Cut-off values of 311 microm and 1.41 were obtained for the minimum diameter and THI, respectively, from receiver operating characteristic curve analysis, providing an acceptable sensitivity and specificity. CONCLUSION: An MH minimum diameter of <311 microm or a THI >1.41 are predictive factors for a good visual prognosis after MH surgery.