Senile Cataract Formation Does Not Affect Crystalline Lens Thickness.

INTRODUCTION: Characterizing lens thickness (LT) in patients with cataracts is important for better understanding the lens aging process and for designing new intraocular lens power formulas. This study aimed to analyze the influence of common senile cataract formation on the LT, anterior (ACS) and posterior (PCS) cortex space, and nuclear thickness (NT), controlling for sex, age, and axial length. METHODS: A cross-sectional study was performed. A consecutive sample of 603 volunteers (403 women, 200 men) aged 59.1 ± 18.8 years was recruited. The standardized Lens Opacification Classification System (LOCS)-III was used to classify eyes (randomly selected) into cataractous and non-cataractous groups. Also, they were classified according to the cataract location (presence or absence of cortical, nuclear, or posterior subcapsular cataract). Optical biometry was performed to measure LT, ACS, NT, and PCS. Propensity score was used to match participants one-to-one for sex, age, and axial length. Groups were compared using the Student's t test or Yuen's test. RESULTS: The four classifications divided unmatched eyes into: 361 cataractous lenses and 242 non-cataractous, 226 cortical and 377 non-cortical cataractous, 313 nuclear and 290 non-nuclear cataractous and 242 subcapsular and 361 non-subcapsular cataractous. Before matching, cataractous eyes showed significantly higher LT (4.52 ± 0.39 vs. 3.94 ± 0.46 mm, p < 0.001), ACS (0.75 ± 0.20 vs. 0.58 ± 0.23 mm, p < 0.001), NT (3.34 ± 0.23 vs. 3.18 ± 0.25 mm, p < 0.001) and PCS (0.42 ± 0.19 vs. 0.37 ± 0.19 mm, p = 0.003). Matched lens, cortical, nuclear, and subcapsular cataract samples comprised 146, 258, 182, and 226 eyes, respectively. After matching, no significant differences were observed in LT (4.34 ± 0.37 vs. 4.33 ± 0.36 mm, p = 0.94), ACS (0.72 ± 0.20 vs. 0.76 ± 0.19 mm, p = 0.08), NT (3.31 ± 0.22 vs. 3.30 ± 0.23 mm, p = 0.24) and PCS (0.42 ± 0.19 vs. 0.43 ± 0.16 mm, p = 0.79). CONCLUSIONS: The presence of senile cortical, nuclear, and posterior subcapsular cataract have no effect on LT, ACS, NT, and PCS. Confounding factors should be controlled for when measuring LT and its main components.

Relationship between the main components of the crystalline lens and the anterior chamber depth after cataract formation.

PURPOSE: To assess the relationship between anterior chamber depth (ACD) and lens thickness (LT), as well as its three main components (anterior and posterior cortex and nucleus thickness), in cataractous and non-cataractous eyes, depending on the axial length (AxL). METHODS: Anterior and posterior cortex and nucleus thickness of the crystalline lens, ACD, and AxL were measured using optical low-coherence reflectometry in cataractous and non-cataractous eyes. They were also classified into hyperopia, emmetropia, myopia, and high myopia, depending on AxL; thus, eight subgroups were created. A minimum sample size of 44 eyes (of 44 patients) for each group was recruited. Linear models were fitted for the whole sample and each AxL subgroup to assess if there were differences in the relationships between the crystalline lens variables and ACD, including age as a covariate. RESULTS: Three hundred seventy cataract patients (237 females, 133 males) and 250 non-cataract controls (180 females, 70 males), aged 70.5 ± 9.4 and 41.9 ± 15.5 years, respectively, were recruited. The mean AxL, ACD, and LT for the cataractous and non-cataractous eyes were 23.90 ± 2.05, 24.11 ± 2.11, 2.64 ± 0.45, and 2.91 ± 0.49, 4.51 ± 0.38, 3.93 ± 0.44 mm, respectively. The inverse relationship of LT, anterior and posterior cortex, and nucleus thickness with ACD was not significantly (p ≥ 0.26) different between cataractous and non-cataractous eyes. Further subclassification of the sample depending on AxL showed that the inverse relationship between the posterior cortex and ACD was no longer significant (p > 0.05) for any non-cataractous AxL group. LT, anterior and posterior cortex, and nucleus thickness was not significantly (p ≥ 0.43) different between cataractous and non-cataractous eyes for the whole sample, and all AxL groups after adjusting for age. CONCLUSIONS: The presence of cataracts does not modify the inverse relationship of the LT, anterior and posterior cortex, and nucleus with ACD. And this relationship does not seem to depend importantly on AxL. Besides, the possible differences in LT, anterior and posterior cortex, and nucleus between cataractous and non-cataractous eyes may not be caused by lens opacification, but possibly by the progressive lens growth due to aging.

Effect of Plasma Argon Pretreatment on the Surface Properties of AZ31 Magnesium Alloy.

Climate change has evidenced the need to reduce carbon dioxide emissions into the atmosphere, and so for transport applications, lighter weight alloys have been studied, such as magnesium alloys. However, they are susceptible to corrosion; therefore, surface treatments have been extensively studied. In this work, the influence of argon plasma pretreatment on the surface properties of an AZ31 magnesium alloy focus on the enhancement of the reactivity of the surface, which was examined by surface analysis techniques, electrochemical techniques, and gravimetric measurements. The samples were polished and exposed to argon plasma for two minutes in order to activate the surface. Contact angle measurements revealed higher surface energy after applying the pretreatment, and atomic force microscopy showed a roughness increase, while X-Ray photoelectron spectroscopy showed a chemical change on the surface, where after pretreatment the oxygen species increased. Electrochemical measurements showed that surface pretreatment does not affect the corrosion mechanism of the alloy, while electrochemical impedance spectroscopy reveals an increase in the original thickness of the surface film. This increase is likely associated with the high reactivity that the plasma pretreatment confers to the surface of the AZ31 alloy, affecting the extent of oxide formation and, consequently, the increase in its protection capacity. The weight loss measurements support the effect of the plasma pretreatment on the oxide thickness since the corrosion rate of the pretreated AZ31 specimens was lower than that of those that did not receive the surface pretreatment.

Primary periocular squamous cell carcinoma in central Spain: Factors related to recurrence.

PURPOSE: To describe the characteristics and recurrence rates of primary periocular squamous cell carcinoma (SCC) in Spain. METHODS: This retrospective study investigates the characteristics of primary periocular SCC at two tertiary centers in Spain from 2000 to 2020. Data were collected on demographics, skin phenotype, location, clinical and histological diagnosis, the commitment of surgical margins, recurrence, and risk factors. Multivariate analysis and risk factors were used to investigate recurrence rates, considering p < 0.05 as statistically significant. RESULTS: Over the 20-year studied period, 107 patients with primary periocular SCC were assessed. The mean age of SCC was 76.8 ± 12.8 years, 55 (50.9%) were females, and 105 (98.1%) had Fitzpatrick skin phenotype type II or III. SCC lesions affected less than 1/3 of the eyelid (56/52.3% cases), mainly the lower lid (42/39.3% lesions). Sixty (56.1%) cases were SCC differentiated, 76 (71%) had clear margins. Clinical diagnosis of SCC corroborated with histological in 84 (78.5%) cases and orbital involvement occurred in 18 (16.8%) cases. Recurrence was observed in 13 (12.1%) cases, occurring more in large tumors and undifferentiated subtype (53.8%), with committed margins (69.2%) (p = 0.001), being the commitment of margins a significant predictor for recurrence, although thickness was an independent predictor. CONCLUSION: Periocular SCC in Spain showed a similar pattern as in the world. The risk of recurrence is increased in undifferentiated and large periocular SCC, partially removed with committed margins.

Neosaxitoxin, a Paralytic Shellfish Poison phycotoxin, blocks pain and inflammation in equine osteoarthritis.

The Osteoarthritis is a chronic disease characterized by a progressive deterioration of the articular cartilage producing a strong inflammatory activity and chronic pain in patients. Horses also show osteoarthritis. Since the activation and progression of the disease are similar to that of human we developed a study model in horses. In this study, we test the effect of Neosaxitoxin, a phycotoxin from Paralytic Shellfish Poison, in the remediation of osteoarthritis equine clinical symptoms such as pain (showed in lameness) and inflammation quantifying the amounts of pro-inflammatory markers like cellular infiltration, TNF-alpha and nitric oxide in the synovial fluid obtained from the horse damaged joint. The outcomes show that Neosaxitoxin blocks pain for long lasting period (average 24.7 days). Furthermore, the amounts of pro-inflammatory markers were reduced and consequently an enhanced horse's well-being was obtained. Neosaxitoxin showed to be a candidate for establishing treatment protocols for OA, being safe and effective as a pain blocker in equine osteoarthritis.

One Triangle-Blepharoplasty Flap for Anterior Lamellae Pretarsal Defects on the Upper Eyelid.

PURPOSE: The aim of this study is to present the outcomes of one triangle blepharoplasty flap upper eyelid (UE) reconstruction. It is a hardly recognized technique used to repair anterior lamella pretarsal defects resulting from the removal of lesions on the UE. METHODS: Retrospective review of three excised lesions reconstructed with one triangle-blepharoplasty flap technique between 2017 and 2020 at Río Hortega University Hospital in Valladolid, Spain. It is a technique to reconstruct wide-based anterior lamella UE lesions, 25% to 50% UE length. Demographic characteristics, histology results and complications are presented. RESULTS: Medical records of three patients have been reviewed with a minimum follow-up of 6 months (mean follow up of 16 months). The patient's average age was 67 years. Histology results were three seborrheic keratosis. There were no intra or post-surgical complications and all had good functional and aesthetic upper lid results. CONCLUSIONS: The reconstruction of pretarsal lesions limited to the anterior lamella of the UE using one triangle-blepharoplasty flap is a technique with good functional and aesthetic results.

A Tribological and Ion Released Research of Ti-Materials for Medical Devices.

The increase in longevity worldwide has intensified the use of different types of prostheses for the human body, such as those used in dental work as well as in hip and knee replacements. Currently, Ti-6Al-4V is widely used as a joint implant due to its good mechanical properties and durability. However, studies have revealed that this alloy can release metal ions or particles harmful to human health. The mechanisms are not well understood yet and may involve wear and/or corrosion. Therefore, in this work, commercial pure titanium and a Ti-6Al-4V alloy were investigated before and after being exposed to a simulated biological fluid through tribological tests, surface analysis, and ionic dissolution characterization by ICP-AES. Before exposure, X-ray diffraction and optical microscopy revealed equiaxed α-Ti in both materials and ß-Ti in Ti-6Al-4V. Scratch tests exhibited a lower coefficient of friction for Ti-6Al-4V alloy than commercially pure titanium. After exposure, X-ray photoelectron spectroscopy and surface-enhanced Raman spectroscopy results showed an oxide film formed by TiO2, both in commercially pure titanium and in Ti-6Al-4V, and by TiO and Al2O3 associated with the presence of the alloys. Furthermore, inductively coupled plasma atomic emission spectroscopy revealed that aluminum was the main ion released for Ti-6Al-4V, giving negligible values for the other metal ions.

Ocular emergencies presenting to an emergency department in Central Spain from 2013 to 2018.

PURPOSE: To determine the frequency of ocular conditions among patients presenting to an emergency department at a tertiary hospital in Spain. METHODS: A retrospective, longitudinal analysis of all patients who presented to the ocular emergency department of Rio Hortega University Hospital, Valladolid, Spain, from 2013 to 2018 was performed. Data on demographics, ophthalmic examination, and diagnosis were collected. Diseases were classified according the International Classification of Diseases, Ninth Revision, Clinical Modification codes. RESULTS: We had 20,822 patients, of which 10,878 (52.2%) were women. The main age categories were 45-65 years (7391 patients; 35.5%) and 15-45 years (5979 patients; 28.2%). Most of the patients (17,793; 85.5%) were discharged on the same day. Conjunctival pathology was the most common cause of presentation (4110; 19.7%), followed by corneal disorders (4025; 19.3%). Acute conjunctivitis was diagnosed in 2920 (14%) and ocular trauma in 2125 (10.2%) patients. Non-emergency ophthalmic conditions were diagnosed in 1581 (7.6%) patients. Retinal detachments and peripheral holes occurred more commonly in patients aged 45-65 years (p <0.001). Corneal or conjunctival disorders and lid inflammation (p <0.001) were more frequent in women, whereas men had higher incidences of trauma (p <0.001). CONCLUSION: Most of our patients presented ocular surface diseases. Men were more vulnerable to trauma, mainly superficial foreign body. The majority of the patients presented with uncomplicated ocular conditions that would be managed more cost-effectively by primary health care providers. We advocate greater education of primary care physicians and patients in managing simple ocular emergencies to reduce the cases presenting to an emergency department of a tertiary hospital.

Solitary fibrofolliculoma: a retrospective case series review over 18 years / Fibrofoliculoma solitário: revisão de série retrospectiva de casos de 18 anos

ABSTRACT Purpose: The purpose of this study was to report a series of cases of solitary fibrofolliculoma, a lesion seldom observed in the lids. Demographics, as well as clinical and histological aspects of the lesion were evaluated. Methods: This was a retrospective case series spanning a period of 18 years. All the included patients were diagnosed with solitary fibrofolliculoma confirmed by histological examination. Data regarding patient demographics, signs, and symptoms, course of the disease, location of the lesion, clinical and histological diagnosis, and outcome were collected. Results: Eleven cases of solitary fibrofolliculoma were diagnosed in the study period. The median age of patients was 51 ± 16.3 years (range: 27-78 years). Most patients were females (7/11; 64%). Five of the patients (45%) were asymptomatic; four (36%) reported bleeding, one (9%) had referred itching, and one (9%) rubbing of the lesion. The lesion occurred in a wide range of locations; one of them was located in the lids. The diagnosis for all lesions was histological based on characteristic findings of a hair follicle occasionally dilated and containing keratin material surrounded by a moderately well-circumscribed thick mantle of fibrous tissue. The infundibular follicular epithelium extended out into this fibrous mantle forming epithelial strands or cords. There were no relapses after exeresis. Conclusion: Solitary fibrofolliculoma is a rare lesion, seldom affecting the eyelids. We reported 11 cases, and the third case reported thus far in the literature affecting the lids. Diagnosis may be easily missed due to the nonspecific symptoms and clinical appearance. Therefore, it is necessary to perform excisional biopsy and histological examination for the recognition of this lesion.

RESUMO Objetivo: o objetivo deste estudo foi relatar uma série de casos de fibrofoliculoma solitário, uma lesão raramente observada nas pálpebras. Demografia, bem como aspectos clínicos e histológicos da lesão foram avaliados. Métodos: Trata-se de uma série de casos retrospectivos, com um período de 18 anos. Todos os pacientes incluídos foram diagnosticados com fibrofoliculoma solitário confirmado por exame histológico. Foram coletados dados referentes à demografia, sinais e sintomas dos pacientes, evolução da doença, localização da lesão, diagnóstico clínico e histológico e desfecho. Resultados: Onze casos de fibrofoliculoma solitário foram diagnosticados no período do estudo. A média de idade dos pacientes de 51 ± 16,3 anos (variação: 27-78 anos). A maioria dos pacientes era do sexo feminino (7/11, 64%). Cinco dos pacientes (45%) eram assintomáticos; quatro (36%) relataram sangramento, um (9%) referiu coceira e um (9%) fricção da lesão. A lesão ocorreu em luma ampla variedade de locais; um deles sendo nas pálpebras. O diagnóstico de todas as lesões foi histológico com base nos achados característicos de um folículo piloso ocasionalmente dilatado e contendo material de queratina, cercado por um manto espesso de tecido fibroso moderadamente bem circunscrito. O epitélio infundibular folicular se estendeu até esse manto fibroso, formando cordões ou cordões epiteliais. Não houve recaídas após exérese. Conclusão: Fibrofoliculoma solitário é uma lesão rara, mais ainda quando afeta as pálpebras. Relatamos 11 casos, e o terceiro relatado até o momento na literatura que afeta as pálpebras. O diagnóstico pode ser facilmente esquecido devido a sintomas inespecíficos e aparência clínica. Portanto, é necessário realizar biópsia excisional e exame histológico para o reconhecimento dessa lesão.

Changes in Lower Lid Position after Standard Phacoemulsification Cataract Surgery.

PURPOSE: To evaluate the changes on the position of the lower lid after phacoemulsification surgery using objective methods. METHODS: This prospective study evaluated the lower lid position of cataract carriers who underwent to phacoemulsification surgery from January to May 2017. Data were collected on demographics, type of anesthesia, duration of the surgical procedure, and duration of the speculum remained in place. Standardized digital photographs of the patient's face in primary gaze position were obtained preoperatively and 1, 30, 90, and 180 days, postoperatively. The data were analyzed on the distraction test, distance of the lower lacrimal punctum from the inner canthus, and margin reflex distance 2 (MRD2). Comparative and correlation statistical analyses involving preoperative and postoperative measurements were performed. RESULTS: One hundred twelve cataract patients comprised the study sample. There were 68 (60.7%) females with a median age of 74 (interquartile range, 70-81) years old. The mean distraction test value before surgery was 7 ± 2 mm and 6.8 ± 1.8 mm 180 days postoperatively (P = 0.02). The mean lacrimal lower punctum distance changed from 5 ± 1.1 mm preoperatively to 5.4 ± 1 mm at 180 days postoperatively (P = 0.06). The mean MRD2 preoperatively was 5 ± 1 mm and increased to 5.4 ± 0.9 mm 180 days after surgery (P = 0.02). The duration of surgery and the duration that speculum remained in place were not correlated to MRD2 (P = 0.7; P = 0.98). CONCLUSIONS: There is a mild lower lid laxity after phacoemulsification reflected by slight increased lacrimal lower punctum distance to the inner canthus and MRD2. Lacrimal lower punctum distance and MRD2 vary along the study and remained altered at 180 days after surgery, while distraction test tends to recover to similar preoperative levels. Although lid laxity is common in elderly cataract carriers, even a short procedure as phacoemulsification can mildly increase flaccidity.

Characteristics and Recurrence of Primary Eyelid Basal Cell Carcinoma in Central Spain.

PURPOSE: To define the incidence, characteristics, and management of eyelid basal cell carcinoma (BCC) in Central Spain. METHODS: This retrospective study investigates the characteristics and the outcome of eyelid BCC from 2000 to 2016 in a central region of Spain. Data were collected on demographics, skin phenotype, location of the eyelid lesion, clinical and histological diagnosis, surgery, commitment of surgical margins, and recurrence rate. RESULTS: Primary eyelid BCC occurred in a mean of 20.6 lesions a year or 9.4/100,000 inhabitants/year. The mean age of BCC carriers was 69.4 ± 16.2 years, with no gender difference (P = 0.479), predominantly affecting Fitzpatrick II-III skin (81.3%) (P < 0.001). The most common location was the inner canthus (154/45.7%) (P < 0.001) and type nodular (215 cases/63.8%) (P < 0.001). The surgical margins were affected in 69 (20.5%) individuals, and the recurrence rate was 5.6 (95% confidence interval, 3.2-8.3) significantly higher in affected margins (P < 0.001). The most common location for recurrence was the inner canthus (P = 0.003), and the most common histological type for recurrence was sclerosing (16.7%), then multinodular (12.5%), and infiltrating (10.4%) with no significant difference (P = 0.27). CONCLUSIONS: The frequency of occurrence of eyelid BCC is much less than the estimated crude incidence for skin tumors involving all areas of the body in the Spanish population. Eyelid BCC is more common in the seventh decade of life, with no predilection for gender. Nodular histological type is the most common. The recurrence rate is 5.6%, depending on site and affected margins, even though clear free margins also can present with recurrence.

Solitary fibrofolliculoma: a retrospective case series review over 18 years.

PURPOSE: The purpose of this study was to report a series of cases of solitary fibrofolliculoma, a lesion seldom observed in the lids. Demographics, as well as clinical and histological aspects of the lesion were evaluated. METHODS: This was a retrospective case series spanning a period of 18 years. All the included patients were diagnosed with solitary fibrofolliculoma confirmed by histological examination. Data regarding patient demographics, signs, and symptoms, course of the disease, location of the lesion, clinical and histological diagnosis, and outcome were collected. RESULTS: Eleven cases of solitary fibrofolliculoma were diagnosed in the study period. The median age of patients was 51 ± 16.3 years (range: 27-78 years). Most patients were females (7/11; 64%). Five of the patients (45%) were asymptomatic; four (36%) reported bleeding, one (9%) had referred itching, and one (9%) rubbing of the lesion. The lesion occurred in a wide range of locations; one of them was located in the lids. The diagnosis for all lesions was histological based on characteristic findings of a hair follicle occasionally dilated and containing keratin material surrounded by a moderately well-circumscribed thick mantle of fibrous tissue. The infundibular follicular epithelium extended out into this fibrous mantle forming epithelial strands or cords. There were no relapses after exeresis. CONCLUSION: Solitary fibrofolliculoma is a rare lesion, seldom affecting the eyelids. We reported 11 cases, and the third case reported thus far in the literature affecting the lids. Diagnosis may be easily missed due to the nonspecific symptoms and clinical appearance. Therefore, it is necessary to perform excisional biopsy and histological examination for the recognition of this lesion.

An Objective Evaluation of the Upper Eyelid Position after Phacoemulsification Cataract Surgery.

Purpose: To objectively measure the upper eyelid position following phacoemulsification cataract surgery and to identify the determinants of postoperative transient ptosis. Methods: This is a single arm prospective study of patients who underwent cataract surgery from January to May 2017 at a tertiary Eye Hospital in Spain. Data comprised of: the type of anesthesia, the duration that the speculum remained in place and the total surgical time (duration of the procedure). The total surgical time was defined as, the time from the beginning of the paracentesis to the closure of the wounds (incision time). Digital photographs were obtained of: the face with the eye in primary gaze, looking inferiorly and superiorly, preoperatively, and 1, 30, 90 and 180 days postoperatively. Measurements for eyelid crease, levator function, and marginal reflex distance 1 (MRD1) were performed using ImageJ. Statistical analysis was performed of the difference between the preoperative and postoperative measurements. Results: The study consisted of 112 patients. The median lid crease was 9.0 mm [IQR (interquartile range) 7.5; 10.0] both preoperatively and at 180 days postoperatively (IQR 8.0; 10.8). No statistical difference was determined in the lid crease measurements between these two times (P = .17). The median levator function differed significantly preoperatively, at day 1 and 30, 60 and 180 days postoperatively (P < .01). MRD1 decreased significantly from a median of 3.01 mm preoperatively to 2.7 mm at 30 days postoperatively (P = .05) but was similar at preoperative and after 180 days (P = .7). The correlation of MRD1 to the duration of the speculum in place (P = .2) and the incision time (P = .57) was not significant. Conclusions: Ptosis, following phacoemulsification cataract surgery, is mild and transient, occurring only in the early postoperative period.

Phenotypic high myopia in X-linked retinitis pigmentosa secondary to a novel mutation in the RPGR gene.

BACKGROUND: Retinitis pigmentosa (RP) is a clinically and genetically heterogeneous disease causing progressive degeneration of retinal photoreceptor cells. The most severe form of this disease is X-linked RP (XLRP), in which photoreceptor degeneration begins in early childhood and complete blindness often occurs by the fourth decade of life. Two genes commonly associated with XLRP have been previously identified. MATERIAL AND METHODS: One Spanish family with confirmed XLRP was studied for mutations using direct sequencing. A genotype-phenotype correlation with pathologic myopia (PM) is detailed. RESULTS: A new pathogenic mutation in the third exon of the RP GTPase regulator (RPGR) was identified: a variant c212C>G (pSER71*). This mutation appears as a hemizygous variant in the male proband with RP, and as heterozygous variant in the females of this pedigree who invariably exhibit symmetrical PM in both eyes. CONCLUSION: A complete family history allowed determination of the inheritance pattern providing genetic counseling for patients and their families. The geno-phenotypic attributes of this heterozygosity suggest a correlation between RP and PM. This novel mutation would expand the mutation spectrum of RP2 and RPGR, and help to study molecular pathogenesis of RP.

Periocular inverted follicular keratosis: a retrospective series over 17 years.

PURPOSE: To evaluate the demographic, clinical, and histopathologic characteristics of periocular inverted follicular keratosis (IFK), a very rare lesion with poorly defined characteristics. STUDY DESIGN: Retrospective case series. METHODS: We evaluated 11 patients with clinically diagnosed IFK confirmed by histologic analysis. Data were collected on the patients' demographics, clinical presentation and course of the disease, signs and symptoms, location of the lesion, and outcomes of treatment. RESULTS: The patients' mean age was 71 years (range, 32-91 years). Seven (64%) of the patients were female. Eight of the patients (72.7%) had no symptoms, two (18.2%) reported itching, and one (9.1%) had edema and bleeding of the lesion. The lesion affected the upper eyelid in 4 of the patients (36%), the lower lid in 3 of the patients (27%), and the inner canthus in 4 of the patients (36%). CONCLUSIONS: IFK has no specific clinical characteristic and thus requires histologic confirmation for its diagnosis and appropriate management.

Neosaxitoxin, a Paralytic Shellfish Poison toxin, effectively manages bucked shins pain, as a local long-acting pain blocker in an equine model.

Local anesthesia is an effective method to control pain. Neosaxitoxin is a phycotoxin whose molecular mechanism includes a reversible inhibition of voltage-gated sodium channels at the axonal level, impeding nerve impulse propagation. The present study was designed to evaluate the clinical efficacy of Neosaxitoxin as a local long-acting pain blocker in horse bucked shins, and it was found to effectively control pain. While Neosaxitoxin and Gonyautoxin, another Paralytic Shellfish Poison (PSP) toxin, have been successfully used in humans as long-lasting pain blockers, this finding marks the first time a PSP has been shown to have an established effect in veterinary medicine.

Atención médica primaria a nivel urbano / Primary medical care at urbal level

Los módulos de servicio y puestos urbanos realizan una atención médica esporádica, ya que no llevan un registro de los pacientes y el seguimiento de los mismos es ineficiente. Se realizó una revisión bibliográfica del tema deAtención Primaria de Salud, y se tomó como ejemplo algunos de los Centros Asistenciales del Distrito Maracaibo, a fin de demostrar la existencia real del problema. La información se obtuvo a través de los registros oficiales de los diferentes centros de Atención Médica y de Instituciones de caracter zonal