Pediatric Rhegmatogenous Retinal Detachments: Etiologies, Clinical Course, and Surgical Outcomes.

Purpose: To describe the predisposing factors, clinical course, and surgical methods of pediatric rhegmatogenous retinal detachment (RRD) and determine which factors affect anatomic success. Methods: Data of patients 18 years or younger who had surgical repair for RRD from January 1, 2004, to June 31, 2020, with a minimum of 6 months of follow-up were retrospectively analyzed. Results: The study evaluated 101 eyes of 94 patients. Of the eyes, 90% had at least 1 predisposing factor to pediatric RRD, including trauma (46%), myopia (41%), prior intraocular surgery (26%), and congenital anomaly (23%); 81% had macula-off detachments and 34% had proliferative vitreoretinopathy (PVR) grade C or worse at presentation. The presence of PVR grade C or worse (P = .0002), total RRD (P = .014), and vitrectomy alone at first surgery (P = .0093) were associated with worse outcomes. Patients who had scleral buckle (SB) alone at the first surgery had statistically higher rates of anatomic success than those who had vitrectomy alone or combined with SB (P = .0002). After the final surgery, 74% of patients achieved anatomic success. Discussion: The majority of cases in this study were associated with 1 of the 4 risk factors predisposing to pediatric RRD. These patients often present late with macula-off detachments and PVR grade C or worse. The majority of patients achieved anatomic success after surgical repair using SB, vitrectomy, or a combination.

Structural and electronic properties for Be-doped Ptn (n = 1-12) clusters obtained by DFT calculations.

In this work, we have performed a computational study on the structure and electronic properties for Be-doped Ptn (n = 1-12) clusters in the framework of density functional theory (DFT). The most stable structures of the clusters are obtained by a structure search procedure based in simulated annealing. The results show that the PtnBe clusters adopt compact structure motifs with Be situated at the edge sites while only in Pt11Be the Be atom occupies the center site. The energetic parameters showed that Pt5Be, Pt7Be and Pt10Be are the most stable ones. The PtnBe clusters with (n = 5-7) have similar vertical ionization potential (vIP) and vertical electron affinity (vEA) parameters compared to the unary Pt clusters, while Pt9Be and Pt11Be have the higher vEA values. In particular, the d-band center is slightly higher for the doped clusters, suggesting an enhanced reactivity. The σ-holes are found more remarkable for the doped clusters, which are situated in the Be dopant and low coordinated Pt sites. The data on the infrared spectra of the clusters is also provided and showed a significant blue shift due to the vibrational modes of the Be atom. These results are useful for understanding the fundamental properties of Be-doped Ptn clusters in the subnanometer region.

Short-term oral albendazole therapy for diffuse unilateral subacute neuroretinitis: A case report.

PURPOSE: To report on a case of diffuse unilateral subacute neuroretinitis (DUSN) that was successfully treated with a short course of oral albendazole. OBSERVATIONS: A 51-year-old male presented with severe visual loss secondary to DUSN associated with a positive Toxocara serology. Because the parasite could not be detected on fundoscopy, first-line treatment with photocoagulation could not be administered. Treatment with a 6-day course of oral albendazole resulted in the resolution of DUSN as well as the restoration of visual acuity. CONCLUSION AND IMPORTANCE: Although DUSN is characterized by the presence of a parasitic organism in the retina, there are cases in which the parasite is not visible. Albendazole has been used to treat such cases, but a standard treatment regimen has not been determined yet. Our case suggests that the resolution of DUSN can be achieved with short-term albendazole therapy.

CKD Care and Research in Guatemala: Overview and Meeting Report.

On October 14-15, 2019, the 1st Symposium to Promote Chronic Kidney Disease (CKD) Research in Guatemala was held in Guatemala City, Guatemala. The Symposium hosted more than 50 attendees, including health care professionals, policy makers, researchers, and leaders of nongovernmental organizations. The meeting's objectives were to (1) share clinical and health delivery experiences, (2) disseminate local research, and (3) establish consensus priorities for future research. In this report, we review the state of CKD nephrology in Guatemala, summarize experiences shared during the meeting from representatives of the clinical settings in Guatemala where CKD care is provided, and describe consensus priorities for future research.

Glomerulopatía por invaginación podocítica; reporte del primer caso en Latinoamérica y revisión de la literatura / Podocyte infolding glomerulopathy; report of the first case in Latin America and review of the literatura

ANTECEDENTES: La glomerulopatía por invaginación podocítica (GIP) es una enfermedad de origen incierto, frecuentemente asociada a enfermedades autoinmunes, de la que se desconoce el tratamiento específico y su evolución. Caracterizada por engrosamiento de paredes capilares por la presencia de burbujas no argirofílicas intramembanosas similares a las encontradas en la glomerulopatía membranosa, pero sin depósitos de inmunocomplejos electrodensos en la ultraestructura, donde se observan microesferas traslúcidas generadas por invaginación del citoplasma podocítico dentro de las membranas basales. OBJETIVOS: Generalmente descrito en pacientes jóvenes de sexo femenino. Hasta la fecha, han sido reportados escasos casos en pacientes de origen asiático. Nuestro caso constituiría el primer reporte en paciente latinoamericano de raza blanca. MÉTODOS: Mujer de 38 años con LES. En el año 2014 presentó síndrome nefrótico tratado empíricamente con corticoides (CO) y ciclofosfamida intravenosa (CF) con buena respuesta. Presenta recaída en abril del 2015 con función renal normal y sin actividad lúpica extrarrenal, por lo que es derivada a nuestro hospital para ser biopsiada. RESULTADOS: La biopsia informó esclerosis glomerular focal y segmentaria sin depósitos de inmunocomplejos en la inmunofluorescencia, pero con técnica de metenamina plata se detectaron en las paredes capilares, espacios claros acompañados de marcadas alteraciones podocíticas. Al microscopio electrónico, se observaron agregados de ultraestructuras microvesiculares y cilíndricas unidas a las membranas sin evidencia de depósitos densos y borramiento difuso de pies pedicelares, confirmando el diagnóstico sospechado. CONCLUSIONES: Reportamos el primer caso de lo que puede ser considerada, una nueva entidad patológica glomerular, en una paciente de raza blanca latinoamericana, cuya evolución y terapéutica aún se desconocen

BACKGROUND: Podocyte infolding glomerulopathy (PIG) is a condition of uncertain origin, frequently associated with autoimmune diseases. Its specific treatment and clinical course are unknown. It is characterised by thickening of the capillary walls due to the presence of non-argyrophilic intramembranous bubbles similar to those found in membranous glomerulopathy, but without electron-dense deposits of immune complexes in the ultrastructure, where translucent microspheres generated by invagination of the podocyte cytoplasm into the basement membranes are observed. OBJECTIVES: Generally reported in young females patients. To date, few cases in Asian patients have been reported. Our case is the first to be reported in a Latin American Caucasian patient. METHODS: A 38-year-old woman with SLE. In 2014 she presented with nephrotic syndrome empirically treated with corticosteroids (CO) and intravenous cyclophosphamide with good response. She had a relapse in April 2015 with normal renal function and no extrarenal lupus activity, so she was referred to our hospital to be biopsied. RESULTS: The biopsy reported focal segmental glomerular sclerosis without deposits of immune complexes in the immunofluorescence. However, methenamine silver staining revealed clear spaces in the capillary walls accompanied by marked podocyte alterations. On electron microscope study, numerous aggregates of microvesicular and cylindrical ultrastructures bound to the membranes were observed, without evidence of dense deposits, and diffuse effacement of pedicel foot processes, confirming the suspected diagnosis. CONCLUSIONS: This is the first reported case of what can be considered a new pathological glomerular entity in a Latin American Caucasian patient, whose clinical course and therapy are still unknown

Podocyte infolding glomerulopathy; report of the first case in Latin America and review of the literature. / Glomerulopatía por invaginación podocítica; reporte del primer caso en Latinoamérica y revisión de la literatura.

BACKGROUND: Podocyte infolding glomerulopathy (PIG) is a condition of uncertain origin, frequently associated with autoimmune diseases. Its specific treatment and clinical course are unknown. It is characterised by thickening of the capillary walls due to the presence of non-argyrophilic intramembranous bubbles similar to those found in membranous glomerulopathy, but without electron-dense deposits of immune complexes in the ultrastructure, where translucent microspheres generated by invagination of the podocyte cytoplasm into the basement membranes are observed. OBJECTIVES: Generally reported in young females patients. To date, few cases in Asian patients have been reported. Our case is the first to be reported in a Latin American Caucasian patient. METHODS: A 38-year-old woman with SLE. In 2014 she presented with nephrotic syndrome empirically treated with corticosteroids (CO) and intravenous cyclophosphamide with good response. She had a relapse in April 2015 with normal renal function and no extrarenal lupus activity, so she was referred to our hospital to be biopsied. RESULTS: The biopsy reported focal segmental glomerular sclerosis without deposits of immune complexes in the immunofluorescence. However, methenamine silver staining revealed clear spaces in the capillary walls accompanied by marked podocyte alterations. On electron microscope study, numerous aggregates of microvesicular and cylindrical ultrastructures bound to the membranes were observed, without evidence of dense deposits, and diffuse effacement of pedicel foot processes, confirming the suspected diagnosis. CONCLUSIONS: This is the first reported case of what can be considered a new pathological glomerular entity in a Latin American Caucasian patient, whose clinical course and therapy are still unknown.

UNILATERAL NEURORETINITIS AS A LATE-ONSET MANIFESTATION OF THE CHIKUNGUNYA FEVER: A CASE SERIES.

PURPOSE: To report 3 cases of unilateral neuroretinitis associated with the chikungunya fever (CHIKV). METHODS: Retrospective noncomparative case series. RESULTS: Three female patients with similar complains of blurry vision and decreased visual acuity that started several weeks after experiencing symptoms of the CHIKV. All patients had decreased best-corrected visual acuity and distortion on the Amsler grid in the affected eye. Evidence of unilateral optic nerve swelling and macular exudates was noted in all patients. No pharmacologic therapy was given. At 2-month follow-up evaluation, all patients had regained at least 3 lines in the Snellen chart, and subretinal fluid and optic nerve swelling had resolved. CONCLUSION: Unilateral neuroretinitis can present as a late-onset manifestation of CHIKV. Three patients with diagnosis of CHIKV developed unilateral neuroretinitis weeks after the acute viral syndrome, suggesting a possible immunological etiology for this manifestation. To our knowledge, this is the first case series of CHIKV leading to neuroretinitis in the Western World.

Primary hepatic carcinoid tumor metastasizing to eyelid: A case report.

PURPOSE: We report a rare case of a metastatic carcinoid tumor to the right lower lid masquerading as a chalazion. OBSERVATIONS: A 78-year-old Hispanic woman who presented with a 3-month history of a non-resolving chalazion on the right lower lid despite aggressive medical treatment. The patient had a history of noninfectious anterior uveitis and primary hepatic carcinoid tumor that was incidentally diagnosed during the initial uveitis work-up. The right lower eyelid lesion was biopsied and histological and immunopathological analysis revealed a well differentiated neuroendocrine tumor consistent with a carcinoid tumor. CONCLUSIONAND IMPORTANCE: Neuroendocrine tumors should be considered as part of the differential diagnosis of focal, vascularized eyelid masses. To the authors best knowledge this is the first reported case of primary hepatic carcinoid tumor with metastasis to the eyelids. We also highlight the importance of pursuing a histopathologic diagnosis, in the setting of a non-resolving or recurrent chalazion.

Ocular Symptoms and Signs of Chikungunya Fever in Puerto Rico.

OBJECTIVE: To determine what ocular symptoms and signs are most common and if there are any associations with comorbid conditions in patients with Chikungunya fever. METHODS: A retrospective data review and analysis of the ocular symptomatology of 139 patients with Chikungunya fever who visited a local emergency room from August through September 2014. Frequencies were calculated, and Pearson's chisquare test employed. All the patients were confirmed as having Chikungunya with IgM (ELISA) before admittance into the study. RESULTS: Of the 139 patients, 42 (30.2%) had red eyes, 27 (19.4%) had conjunctivitis, and 13 (9.4%) had symptoms related to anterior uveitis, such as unilateral red eye, ciliary flush, or irregular pupil(s). Patients with a history of diabetes, hypertension, or cancer were more likely to have both red eyes (p = 0.033) and the symptomatology of anterior uveitis (p = 0.006), while patients with nausea or vomiting were more likely to have red eyes only (p = 0.001). CONCLUSIONS AND RELEVANCE: Red eyes, conjunctivitis, and anterior uveitis occur frequently in patients with Chikungunya fever. Systemic diseases, such as diabetes, hypertension, and cancer, may increase the risk of such ocular manifestations. Routine ophthalmic evaluation is warranted in patients with these medical conditions. The relevance of this study lies in the fact that this disease remains an important public health issue, since such ocular sequelae as may be present can range from mild to severe, either as an acute or a delayed manifestation.

Phacoemulsification and intraocular lens implantation in patients with oculocutaneous albinism.

PURPOSE: To evaluate the benefits of phacoemulsification and intraocular lens implantation in patients with oculocutaneous albinism (OCA). METHOD: The charts of 195 patients with OCA who visited a local eye clinic were reviewed. All of these patients had genetic linkage analysis to establish OCA type. Frequencies and Paired t-test analysis were determined. RESULTS: Of the 195 patients, nine (4.6%) underwent clear cornea phacoemulsification with intraocular lens implantation. Seven of the nine patients with OCA had the Hermansky-Pudlak (HPS) type 1; two had OCA type 1. Pre-operative BCVA of all eyes ranged from 1.0 to 2.3 logMAR with a mean of 1.42 logMAR and a standard deviation of 0.41 logMAR. Post-operative BCVA of all eyes ranged from 1.0 to 1.30 logMAR with a mean of 1.04 logMAR and a standard deviation of 0.10 logMAR. BCVA improved after phacoemulsification surgery and intraocular lens implantation (p = 0.002). Pre-operative astigmatism of all eyes ranged from +0.50 to +5.75 with a mean of +2.25 and a standard deviation of +2.40. Post-operative astigmatism of all eyes ranged from +0.50 to +2.00 with a mean of +1.23 and a standard deviation of +0.42. Astigmatism improved after phacoemulsification surgery and intraocular lens implantation (p = 0.05). CONCLUSION: Nine patients with OCA who underwent phacoemulsification and intraocular lens implant experienced improved visual acuity and reduced astigmatism post-operatively. These results suggest cataract surgery may improve vision and refractive errors, and thus quality of life, in patients with albinism.

Klinefelter Syndrome (49, XXXXY/48, XXXY) associated with narrow angle glaucoma: A case report.

INTRODUCTION: Previous studies have described Klinefelter syndrome as a genetic disorder characterized by at least one extra X chromosome and at least 47 chromosomes. It is the most common sex chromosome aneuploidy among men. Patients may present with large height, gynecomastia, low testosterone levels, infertility, hypogonadism and diseases usually more common in females such as osteoporosis, breast cancer and auto-immune disorders. Other rare ophthalmic associations have been described, such as diffuse choroidal atrophy, microphtalmia, cataracts, juvenile glaucoma, choroid colobomas and goniodysgenesis. OBJECTIVES: To report on the ocular findings in a Puerto Rican patient with Klinefelter syndrome (XXXXY/XXXY). PATIENTS AND METHODS: A patient with Klinefelter syndrome with revious history of elevated intraocular pressure underwent a comprehensive ocular examination, Humphrey visual fields and Stratus optical coherence tomography (OCT) tests. Patient had inreased intraocular pressure, visual field loss and OCT findings compatible with glaucoma. After laser YAG laser iridotomies, high IOP persisted. Brimonidine 0.2 % drops three times a day drops were prescribed to lower IOP. CONCLUSIONS: A patient with Klinefelter syndrome had poor visual acuity, high intraocular pressure, visual fields and OCT results, all compatible with angle closure glaucoma as part of the syndrome.

Nanomanipulation-coupled nanospray mass spectrometry applied to the extraction and analysis of trace analytes found on fibers.

This article presents the novel instrumentation of nanomanipulation coupled to nanospray ionization-mass spectrometry, which is used to directly probe trace analytes found on individual fibers. The low detection limits and sample volumes associated with nanospray ionization-mass spectrometry make it the ideal instrument to implement for trace analysis. Nanospray ionization-mass spectrometry, coupled with the nanomanipulator, allows for the direct probing of trace particulates on fibers. The technique is demonstrated by dissolving an electrostatic particle of cocaine from a fiber, collecting the analyte solution in a nanospray tip, and transferring the tip directly to the mass spectrometer to complete analysis. The utility of this technique is evident through the minimal sample preparation and short analysis time. The use of nanomanipulation coupled to nanospray ionization-mass spectrometry could improve on current trace particulate analysis by reducing both detection limits and sample size required to complete analysis.

Contacto piel a piel inmediato: efecto sobre el estado de ansiedad y depresión materna posparto y sobre la adaptabilidad neonatal hacia la lactancia materna precoz / Early skin to skin contac: effect on mother`s anxiety and depression levels after delivery and on early neonatal adaptation to early breastfeeding

Objetivo: Demostrar el efecto del contacto piel a piel inmediato sobre los niveles de ansiedad y depresión materna a las 2 y 48 horas posparto; así como sobre la adaptación neonatal hacia la lactancia materna inmediata y sobre los niveles de satisfacción materna sobre el parto en sí. Material y métodos: Se realizó un estudio prospectivo, randomizado, a doble ciego (ensayo clínico) comparando dos grupos formados de manera aleatoria: grupo de estudio (CPPI) n=38 y grupo de control n =41. El grupo de estudio fue beneficiado con el contacto piel a piel inmediato de 30 minutos de duración. Se aplicaron las siguientes escalas a las 2 y 48 horas posparto: Escala hospitalaria para la ansiedad y depresión (HAD) y escala de Hamilton para la ansiedad. A las dos horas de vida los recién nacidos fueron puestos sobre el pecho materno, observándose cuántos de ellos lograron éxito en la lactancia materna inmediata. Se interrogó a las madres sobre la percepción y satisfacción hacia la experiencia del parto en si. Resultados: Los niveles de ansiedad y depresión materna fueron menores en el grupo de estudio (CPPI) a las 48 horas posparto comparado con los del grupo de control (p menor 0,0001), tanto en sus puntajes absolutos como el valorarlos según los grados del trastorno estudiado; mientras que a las 2 horas posparto no se halló diferencia significativa. Los recién nacidos del grupo de estudio lograron mayor éxito en la lactancia materna inmediata versus los del grupo de control (29 de 38 versus 12 de 41, p menor 0,0001). El grado de satisfacción sobre la percepción materna del parto fue mayor en el grupo de estudio (p menor que 0,0001).

Operativización de variables en la investigación psicológica / Operationally defined variables in psychological research

El propósito perseguido en este artículo es señalar la importancia, en ocasiones olvidada, que tiene la utilización de definiciones operacionales cuando se realiza una investigación. Diversas aproximaciones han enfatizado la importancia de las definiciones operacionales centradas en dos de las variables más importantes de cualquier investigación experimental: Variable Independiente y Variable Dependiente. Pero han caído en un olvido fundamental, a nuestro parecer: las Variables Contaminadoras (o Extrañas, según algunos autores). Lo que aquí se propone es la ampliación del concepto de Definición Operacional a las Variables Contaminadoras de una investigación, con el nombre de Definición Operacional de Control, entendida como "la definición conceptual y operativa de una Variable Contaminadora concreta, así como todas las actividades que debe realizar el investigador para someterla a un control efectivo, bien experimental, bien estadístico" (AU)

The purpose of this paper is to remark the importance to use operational definitions, sometimes forgotten in psychological research. Several approaches have emphasized the importance of operational definition, centering interest in two of more important variables in any experimental research: Independent Variable and Dependent Variable, but falling into basic oblivion: Extraneous Variables. Our proposition is to extend operational definition concept to Extraneous Variables, naming it as Control Operational Definition, and meaning it as: "conceptual and operative definition of a concrete Extraneous Variable, including the activities that researcher must do in order to obtain a more effective experimental or statistic control of extraneous variables in experiment" (AU)

La enseñanza de los métodos y diseños de investigación en Psicología / Scientific methodology teaching in Psychology

En esta investigación se ha intentado averiguar si el porcentaje de aprobados obtenido por los alumnos cuando cursaban la enseñanza de Metodología de Investigación en el último curso de Primer Ciclo y como asignatura anual, variaba al cursar dicha asignatura en los dos primeros años de la Licenciatura y considerándola como dos asignaturas cuatrimestrales. Se realizaron contrastes del porcentaje de aprobados en ambas situaciones, encontrando que dicho porcentaje era significativamente superior (p<.01) cuando la asignatura se impartía en el último año del Primer Ciclo y como asignatura anual. Se comentan las implicaciones que tiene este hecho para la enseñanza de dicha asignatura, y algunas consideraciones para la realización de nuevos Planes de Estudios (AU)

In this paper the difference between the percentage of university students passed in Methodology when this subject is teached in the third year and like an annual subject, and the percentage of students passed in the same subject when it is teached in first and second years and like two four-months subjects was investigated. The results showed that the percentage was significantly higher (p< .01) when subject were teached in the third year and like annual subject. Implications for teaching of this subject and some considerations for put into effect New Curricula are discussed (AU)