Efficacy of estimations of Hartmann-Shack sensors in small pupil sizes.

PURPOSE: The purpose of this study was to evaluate the in vivo efficacy of the estimations of wavefront analyzers using Hartmann-Shack technology to measure optical aberrations when the pupil size is smaller than the evaluated pupil area. METHODS: Patients implanted with the monofocal ZCB00 intraocular lens (Johnson and Johnson) were examined with the KR-1W Wavefront Analyzer (Topcon) without pharmacological mydriasis and with it afterward. Optical aberrations were analyzed considering a 4-mm pupil and a 6-mm pupil for both examinations. RESULTS: Sixty-six eyes of 33 patients with a mean axial length of 23.35 ± 0.91 mm were assessed. The mean pupil diameter at the baseline examination was 5.05 ± 0.88 mm and under pharmacological mydriasis, it was 6.29 ± 0.84 mm. Outcomes were similar with and without dilation in the 4-mm comparison. However, there was a great disparity in the 6-mm comparison. Most of the values obtained under mydriasis were statistically lower than at baseline (P < 0.05). CONCLUSION: The iris interferes with measurements of wavefront aberrations, and therefore, real pupil size should always be checked before evaluating optical aberrations with Hartman-Shack sensors. When pupil size is smaller than the analyzed diameter, ocular, and internal, and sometimes, corneal aberrations are estimated far more positive than real values.

[Primary stromal cyst of the iris: case report].

Primary stromal cysts of the iris are rare, often asymptomatic, and incidentally found entities. Treatment is usually indicated in cases of enlargement or complications. However, imaging tests are required to determine their cystic nature and make an accurate differential diagnosis with malignant tumors, as well as for long-term follow-up. Ultrasound biomicroscopy is the technique of choice, although in most centers anterior segment optical coherence tomography is a more accessible and available imaging modality. We present a case of primary stromal cyst of the iris with an atypical presentation to illustrate the diagnosis and initial follow-up using anterior segment optical coherence tomography and photographs, and the management of complications. Anterior segment optical coherence tomography may be useful in the initial study and follow-up of anterior non-pigmented lesions where the cyst can be fully seen.

Vision-Related Quality of Life in Patients with Systemic Lupus Erythematosus.

PURPOSE: To assess vision-related quality of life (VRQoL) in patients with systemic lupus erythematosus (SLE) under treatment with hydroxychloroquine (HCQ), and to find the influencing factors. METHODS: Cross-sectional study enrolling SLE patients for less than ten years (Group 1), SLE patients for more than ten years (Group 2), and healthy controls (Group 3). SLE patients should be under treatment with HCQ but without ophthalmological affection. Schirmer test, best-corrected visual acuity (BCVA), axial length (AL) with optical biometry, and swept-source optical coherence tomography-angiography (OCTA) Triton (Topcon) were performed. All participants fulfilled the Impact of Visual Impairment questionnaire, and SLE patients answered the Lupus Impact Tracker (LIT) questionnaire. Additional data were obtained from clinical records. RESULTS: A totals of 41 eyes (41 patients), 31 eyes (31 patients) and 45 eyes (45 volunteers) were enrolled in the study groups. The mean ages were 41.09 ± 9.56, 45.06 ± 8.47 and 40.25 ± 10.83 years, respectively (p = 0.10). The LIT outcomes were 33.49 ± 20.74 and 35.98 ± 22.66 (p = 0.63), respectively. Group 3 referred to a better VRQoL than Group 2 in all categories and than Group 1 in some of them. A linear regression analysis showed that serum ferritin, SLE activity scales, body-mass index (BMI), age, and BCVA influenced VRQoL. The LIT questionnaire was correlated to two categories of the Impact of Visual Impairment questionnaire (IVI). CONCLUSIONS: Despite no ophthalmological affection, SLE patients refer to poorer VRQoL because of disease activity and a low health-related quality of life, which has a negative influence on VRQoL. This masks the effect of other ophthalmological conditions such as dry eyes. Other variables influencing VRQoL are age and BMI, and BCVA, to a lesser extent.

Automated analysis of choroidal thickness in patients with systemic lupus erithematosus treated with hydroxychloroquine.

PURPOSE: To evaluate the influence of hydroxychloroquine (HCQ) in choroidal thickness (CT) in patients with systemic lupus erythematous (SLE), considering the possible impact of disease activity on the choroid. METHODS: Cross-sectional study comparing three groups: two groups of SLE patients treated with HCQ without HCQ-retinopathy (32 eyes/32 patients with < 5 years of HCQ (group 1) and 44 eyes/44 patients with > 5 years of HCQ (group 2)), and an age-matched healthy control group of 46 eyes/46 patients (group 3). A complete ophthalmic examination was performed, including swept-source optical coherence tomography (SS-OCT) Triton (Topcon). Data were correlated to systemic disease activity parameters. RESULTS: CT was thicker in group 1 compared to group 3 in central, nasal, and superior sectors, and to group 2 in inner superior and outer inferior sectors (p < 0.05). In the correlation analysis, disease activity and CT were inversely correlated in most sectors (p < 0.05). In the regression analysis, HCQ was related to thinner CT in temporal and inferior sectors and disease activity with variations in nasal sectors (p < 0.05). CONCLUSIONS: In SLE patients, HCQ is correlated to decreased CT, especially in the inferior and temporal areas. The choroid shows different responses to SLE activity and HCQ, and some sectors may be more sensitive than others.

Dominios culturales de Salud Sexual y Virus del Papiloma Humano en adolescentes mexicanos / Cultural Domains of Sexual Health and Human Papillomavirus in Mexican Adolescents

Resumen El objetivo del presente artículo es explorar la percepción de la salud sexual y del Virus del Papiloma Humano (VPH) en adolescentes del municipio de Santa María del Río, en San Luis Potosí, México. Se aplicaron las técnicas de listados libres y sorteo por montones. Las palabras higieney protección reportaron mayor frecuencia en el concepto de salud sexual, mientras que enfermedad y mortal en el concepto de VPH. La higiene como elemento dentro de los dominios de salud sexual y VPH muestra la visión acerca de quienes gozan de una buena salud sexual y de quienes padecen de una mala salud sexual. Se recomienda generar intervenciones basadas en una visión promocional de la salud sexual para el riesgo del VPH en los adolescentes.

Abstract This study was conducted to explore the perception of adolescents about sexual health and HPV in the municipality of Santa Maria del Rio, San Luis Potosi, Mexico. Two phases were undertaken using free lists and pile sorts. The words hygiene and protection were more frequently associated to the concept of sexual health, while deadly and diseases were more frequently associated to the concept of HPV. Hygiene as an element in sexual health conception and HPV shows the vision of those who enjoy a good sexual health and of those who present poor sexual health. It is important to develop interventions based on a promotional perspective of health to prevent HPV in adolescents.

Promoción de la salud sexual ante el riesgo del virus del papiloma humano en adolescentes / Promoção da saúde sexual para o risco de papilomavírus humano na adolescência / Promotion of sexual health at the risk of human papilloma virus in adolescents

Objetivo: implementar un proyecto dirigido a la promoción de la salud sexual como alternativa ante el riesgo del virus del papiloma humano (VPH) en adolescentes. Materiales y métodos: se realizó un estudio de investigación acción participativa en tres fases. En la primera se delimitaron temas y estrategias para la promoción de la salud sexual y evitar el riesgo de VPH, con la participación de adolescentes en grupos de discusión. Durante la segunda fase se realizó un programa de intervención en dos etapas: la primera consistió en sesiones informativas a cargo de instituciones, organizaciones no gubernamentales y profesionales de la salud sexual; en la segunda etapa se realizaron actividades dirigidas a promocionar la salud sexual para evitar el riesgo del VPH con el apoyo de los adolescentes. Como última fase se evaluaron las limitaciones y los alcances durante el desarrollo del proyecto. Resultados: la participación de los miembros de la comunidad permitió la definición de temas prioritarios en salud sexual y posibilitó abordarlos desde una perspectiva integral y multidisciplinaria. Conclusión: es urgente la delimitación del concepto de promoción de la salud sexual para comprender claramente cuál es el papel de los adolescentes y de qué manera se puede apostar por una participación genuina.

Objective: implement a project aimed at the promotion of sexual health as an alternative to the risk of Human Papillomavirus (HPV) in adolescents. Materials and methods: A participatory action research study was carried out in three phases. In the first, topics and strategies were defined for the promotion of sexual health and the risk of HPV, with the participation of adolescents in discussion groups. During the second phase, a two-stage intervention program was conducted: the first consisted of information sessions by institutions, non-governmental organizations and sexual health professionals; in the second stage, activities aimed at promoting sexual health were carried out to avoid the risk of HPV with the support of adolescents. The last phase evaluated the limitations and the scope during the development of the project. Results:the participation of the members of the community allowed the definition of priority topics in sexual health and made it possible to approach them from a comprehensive and multidisciplinary perspective. Conclusion: There is an urgent need to define the concept of sexual health promotion in order to clearly understand the role of adolescents and how genuine participation can be positioned.

Objetivo: implementar um projecto que visa a promoção da saúde sexual como uma alternativa para o risco de papilomavírus humano (HPV) na adolescência. Materiais e métodos: Um estudo de pesquisa-ação participativa realizada em três fases. As primeiras questões prioritárias e estratégias de promoção da saúde sexual e HPV de risco, com a participação de adolescentes em grupos de discussão foram levantadas. Durante a segunda fase de um programa de intervenção foi realizada em duas etapas: a primeira consistiu de sessões de informação por parte das instituições, associações civis e profissionais de saúde sexual; no segundo estágio, foram feitas atividades para promover sexual HPV risco para a saúde, com o apoio de adolescentes , como as restrições de fase final e escopo para o projeto foram avaliados. Resultados: A participação de membros da comunidade permitiu a definição das questões prioritárias na área da saúde sexual e permitiu resolvê-los de uma perspectiva holística e multidisciplinar. Conclusão: Há uma delimitação urgente do conceito de promoção da saúde sexual para entender claramente o que é o papel dos adolescentes e como você pode apostar em uma participação genuína.

Mycosis fungoides-like lesions in a patient with diffuse cutaneous sporotrichosis / / Lesiones que semejan una micosis fungoide en un paciente con esporotricosis cutánea difusa

Background. Sporotrichosis is a subacute or chronic mycosis acquired by traumatic inoculation or inhalation of fungal conidia. It is caused by the dimorphic fungus Sporothrix, which causes different clinical presentations, being the cutaneous and lymphocutaneous variants being the most frequent. The disseminated cutaneous form is a rare presentation occurring in a minority of cases in Mexico. Case report. We report an atypical case of disseminated sporotrichosis in an alcoholic and iatrogenically immunosuppressed patient, whose clinical lesions resembled tumoral-stage mycosis fungoides. Histological examination and culture revealed the presence of Sporothrix schenckii. Conclusions. The patient was treated with itraconazole 200 mg per day for 4 months with clinical resolution. To the best of our knowledge, this is the first report of this type of clinical manifestation (AU)

Antecedentes. La esporotricosis es una micosis subaguda o crónica adquirida por inoculación traumática o inhalación de conidias fúngicas. Está causada por el hongo dimórfico Sporothrix, y puede presentar distintas manifestaciones clínicas, si bien las variantes linfocutánea y cutánea son las más frecuentes. La forma cutánea diseminada es una presentación infrecuente que se ha observado en una minoría de casos en México. Caso clínico. Informamos de un caso atípico de esporotricosis diseminada en un paciente alcohólico y con inmunosupresión iatrogénica, cuyas lesiones se asemejaban a una micosis fungoide en fase tumoral. La observación histológica y el cultivo demostraron la presencia de Sporothrix schenckii. Conclusiones. El paciente fue tratado con 200 mg de itraconazol diarios durante 4 meses con resolución clínica. Este es el primer informe en relación con esta manifestación clínica (AU)