Reproducibilidad de la densidad vascular peripapilar, cabeza del nervio óptico y área macular por OCT-A de acuerdo con la severidad del glaucoma / Reproducibility of peripapillary, optic nerve head and macular vessel density by OCT-A according to glaucoma severity staging

Objetivo Evaluar la reproducibilidad de la densidad vascular (DV) peripapilar, cabeza del nervio óptico (ONH-PP) y área macular mediante angiografía por tomografía de coherencia óptica de dominio espectral (SD OCT-A) en pacientes con glaucoma y en sujetos sanos. Métodos Estudio transversal que evaluó 63 ojos de 63 sujetos, incluyendo 33 pacientes con glaucoma y 30 sujetos sanos. El glaucoma se clasificó en leve, moderado o avanzado. Dos exploraciones consecutivas fueron adquiridas por Spectralis Module OCT-A (Heidelberg, Alemania) y proporcionaron imágenes del complejo vascular superficial (SVC), del plexo vascular de la capa de fibra nerviosa (NFLVP) y del plexo vascular superficial (SVP); del complejo vascular profundo (DVC), del plexo capilar intermedio (ICP) y del plexo capilar profundo (DCP). La DV (%) fue calculada mediante AngioTool. Se calcularon los coeficientes de correlación intraclase (ICC) y los coeficientes de variación (CV). Resultados Respecto a la DV de ONH-PP, el mejor ICC lo presentó el glaucoma avanzado (0,86-0,96) y moderado (0,83-0,97) en comparación con el glaucoma leve (0,64-0,86). Para la DV macular, los resultados de ICC para las capas retinianas superficiales fueron mejores para el glaucoma leve (0,94-0,96), seguido por el glaucoma moderado (0,88-0,93) y por el avanzado (0,85-0,91), y para las capas retinianas más profundas el ICC fue más alto para el glaucoma moderado (0,95-0,96), seguido por el glaucoma avanzado (0,80-0,86) y por el leve (0,74-0,91). Los CV oscilaron entre el 2,2% y el 10,94%. Entre los sujetos sanos, los ICC para las mediciones de DV ONH-PP (0,91-0,99) y para las mediciones de la DV macular (0,93-0,97) fueron excelentes en todas las capas, con CV del 1,65% al 10,33% (AU)

Objective To assess the reproducibility of peripapillary, optic nerve head (ONH-PP) and macular vessel density (VD) by spectral domain optical coherence tomography angiography (SD OCT-A) in glaucoma patients and healthy subjects. Methods Cross-sectional study assessing 63 eyes of 63 subjects, including 33 glaucoma patients and 30 healthy subjects. Glaucoma was classified in mild, moderate, or advanced. Two consecutive scans were acquired by spectralis module OCT-A (Heidelberg, Germany), and provided images of the superficial vascular complex (SVC), nerve fiber layer vascular plexus (NFLVP), superficial vascular plexus (SVP), deep vascular complex (DVC), intermediate capillary plexus (ICP) and deep capillary plexus (DCP). VD (%) was calculated by AngioTool. Intraclass correlation coefficients (ICCs) and coefficients of variation (CV) were calculated. Results Among ONH-PP VD, better ICC presented advanced (0.86-0.96) and moderate glaucoma (0.83-0.97) compared with mild glaucoma (0.64-0.86). For the macular VD reproducibility, ICC results for superficial retinal layers were better for mild glaucoma (0.94-0.96) followed by moderated (0.88-0.93) and advanced glaucoma (0.85-0.91), and for deeper retinal layers ICC was better for moderate glaucoma (0,95-0,96) followed by advanced (0.80-0.86) and mild glaucoma (0.74-0.91). CVs ranged from 2.2%% to 10.94%. Among healthy subjects, ICCs for the ONH-PP VD measurements (0.91-0.99) and for the macular VD measurements (0.93-0.97) were excellent in all layers, with CVs from 1.65% to 10.33%. Conclusions SD OCT-A used to quantify macular and ONH-PP VD showed excellent and good reproducibility in most layers of the retina, both in healthy subjects and in glaucoma patients regardless of the severity of the disease (AU)

Reproducibility of peripapillary, optic nerve head and macular vessel density by OCT-A according to glaucoma severity staging.

OBJECTIVE: To assess the reproducibility of peripapillary, optic nerve head (PP-ONH) and macular vessel density (VD) by Spectral Domain optical coherence tomography angiography (SD OCT-A) in glaucoma patients and healthy subjects. METHODS: Cross-sectional study assessing 63 eyes of 63 subjects, including 33 glaucoma patients and 30 healthy subjects. Glaucoma was classified in mild, moderate, or advanced. Two consecutive scans were acquired by Spectralis Module OCT-A (Heidelberg, Germany), and provided images of the superficial vascular complex (SVC), nerve fiber layer vascular plexus (NFLVP), superficial vascular plexus (SVP); deep vascular complex (DVC), intermediate capillary plexus (ICP) and deep capillary plexus (DCP). VD (%) was calculated by AngioTool. Intraclass correlation coefficients (ICCs) and coefficients of variation (CV) were calculated. RESULTS: Among PP-ONH VD, better ICC presented advanced (ICC 0.86-0.96) and moderate glaucoma (ICC 0.83-0.97) compared with mild glaucoma (0.64-0.86). For the macular VD reproducibility, ICC results for superficial retinal layers were better for mild glaucoma (0.94-0.96) followed by moderated (0.88-0.93) and advanced glaucoma (0.85-0.91), and for deeper retinal layers ICC was better for moderate glaucoma (0.95-0.96) followed by advanced (0.80-0.86) and mild glaucoma (0.74-0.91). CVs ranged from 2.2% to 10.94%. Among healthy subjects, ICCs for the PP-ONH VD measurements (0.91-0.99) and for the macular VD measurements (0.93-0.97) were excellent in all layers, with CVs from 1.65% to 10.33%. CONCLUSIONS: SD OCT-A used to quantify macular and PP-ONH VD showed excellent and good reproducibility in most layers of the retina, both in healthy subjects and in glaucoma patients regardless of the severity of the disease.

Peripapillary and optic nerve head vessel density of glaucoma and healthy subjects from Afro-Caribbean and European descent: A pilot study.

PURPOSE: To compare the peripapillary and optic nerve head vessel density (PP-ONH VD) between glaucoma patients (all, early, moderated, and advanced) and healthy subjects of Afro-Caribbean descent (AD) and European descent (ED). METHODS: This was a cross-sectional study. One eye was evaluated in 90 subjects, including 66 glaucoma patients and 24 healthy subjects, who underwent PP-ONH VD imaging using SPECTRALIS® Optical Coherence Tomography Angiography (OCT-A). We analysed the superficial vascular complex using the AngioTool version 0.6a software. The correlation between the PP-ONH VD and visual field mean deviation (MD) was evaluated using a scatter plot and Spearman's rho correlation coefficient. RESULTS: Among the healthy subjects, the AD group had a lower superficial PP-ONH VD [43.29±3.25% (mean±standard deviation)] than the ED group (46.06±1.75%) (P=0.016). Overall, superficial PP-ONH VD did not show any significant differences between the total AD and ED glaucoma patients or in the subgroup analyses (early/moderate/advanced) (AD: 32.73±6.70%, 37.11±5.72%, 32.48±5.73%, 27.76±4.74%, respectively; ED: 33.94±6.89%, 38.52±3.82%, 35.56±4.18%; 27.65±6.31%, respectively) (P>0.05 for all). A strong, statistically significant correlation was established between vessel density and mean deviation among AD and ED glaucoma patients (r=0.709 and r=0.704, respectively) (P<0.001 for both). CONCLUSION: This pilot study shows that healthy subjects of AD had lower peripapillary and optic nerve head superficial vessel density than healthy subjects of ED, but no significant differences were found between AD and ED glaucoma groups (all, early, moderate, or advanced).

Manejo de las úlceras corneales neurotróficas con Cacicol®- ReGeneraTing Agent: serie de casos / Management of corneal neurotrophic ulcers with Cacicol®-RGTA (ReGeneraTing Agent): a case series

OBJETIVO: Las úlceras corneales neurotróficas son difíciles de tratar y las terapias convencionales fracasan con frecuencia. Un nuevo agente regenerativo de la matriz extracelular («ReGeneraTing Agents»), Cacicol® (Laboratoires Théa), ha demostrado buenos resultados en los últimos años. El objetivo de este estudio fue evaluar la respuesta a Cacicol® en una serie de casos con úlceras corneales neurotróficas. MÉTODOS: Serie de casos retrospectiva. Once pacientes con úlceras corneales neurotróficas que no respondieron a una terapia convencional fueron tratados con Cacicol®. Un ciclo incluyó una gota cada 2 días durante 5 días. RESULTADOS: El rango de duración de la terapia convencional, previa al comienzo del tratamiento con Cacicol® fue 0 a 91 días. Tras introducir Cacicol® el 82% (9/11) de los casos se curaron y el 18% (2/11) no lo hicieron, llegando a requerir un trasplante de membrana amniótica o una queratoplastia penetrante, respectivamente. El 67% (6/9) de los pacientes curados requirieron solo un ciclo de Cacicol® y el 45% (5/11) pacientes necesitaron más de un ciclo. Un caso de úlcera corneal bacteriana respondió favorablemente pero un caso infectado por Acanthamoeba fracasó. En la mayoría de los pacientes, la agudeza visual mejoró o se mantuvo. CONCLUSIÓN: Cacicol® resultó una terapia exitosa en una alta proporción de úlceras neurotróficas, incluidas las infecciosas. Algunos casos requieren más de un ciclo de Cacicol® o su uso como primer línea de tratamiento

PURPOSE: Neurotrophic corneal ulcers are difficult to treat, and the conventional treatment often results in failure. A new matrix regenerating agent ("ReGeneraTing Agents"), Cacicol® (Laboratoires Théa), has demonstrated good results over the last few years. Therefore, the aim of this study was to evaluate the response to Cacicol® in a series of cases with neurotrophic corneal ulcers. METHODS: Retrospective case series looking at 11 patients with corneal ulcers unresponsive to conventional therapy that underwent treatment with Cacicol®. One cycle included 1 drop every two days for 5 days. RESULTS: The range of conventional therapy prior to Cacicol® was 0-91 days. On introducing Cacicol® 82% (9/11) of the cases were cured, and 18% (2/11) failed, requiring an amniotic membrane transplant or penetrating keratoplasty. The healing only required one cycle of Cacicol® in 67% (6/9) of the patients. More than one cycle of Cacicol® was needed in 45% (5/11) patients. One corneal bacterial ulcer responded favourably and one case related to Acanthamoeba did not respond. Most of the patients improved or maintained their visual acuity. CONCLUSION: Cacicol® was a useful therapy in a high number of difficult neurotrophic corneal ulcers, including corneal infections. Some cases may require more than one cycle of Cacicol® or used as first-line treatment in order to achieve the desired result

Management of corneal neurotrophic ulcers with Cacicol®-RGTA (ReGeneraTing Agent): a case series. / Manejo de las úlceras corneales neurotróficas con Cacicol®- ReGeneraTing Agent: serie de casos.

PURPOSE: Neurotrophic corneal ulcers are difficult to treat, and the conventional treatment often results in failure. A new matrix regenerating agent ("ReGeneraTing Agents"), Cacicol® (Laboratoires Théa), has demonstrated good results over the last few years. Therefore, the aim of this study was to evaluate the response to Cacicol® in a series of cases with neurotrophic corneal ulcers. METHODS: Retrospective case series looking at 11 patients with corneal ulcers unresponsive to conventional therapy that underwent treatment with Cacicol®. One cycle included 1 drop every two days for 5 days. RESULTS: The range of conventional therapy prior to Cacicol® was 0-91 days. On introducing Cacicol® 82% (9/11) of the cases were cured, and 18% (2/11) failed, requiring an amniotic membrane transplant or penetrating keratoplasty. The healing only required one cycle of Cacicol® in 67% (6/9) of the patients. More than one cycle of Cacicol® was needed in 45% (5/11) patients. One corneal bacterial ulcer responded favourably and one case related to Acanthamoeba did not respond. Most of the patients improved or maintained their visual acuity. CONCLUSION: Cacicol® was a useful therapy in a high number of difficult neurotrophic corneal ulcers, including corneal infections. Some cases may require more than one cycle of Cacicol® or used as first-line treatment in order to achieve the desired result.

Association analysis in a Latin American population revealed ethnic differences in rheumatoid arthritis-associated SNPs in Caucasian and Asian populations.

Large genome-wide association studies (GWAS) have increased our knowledge of the genetic risk factors of rheumatoid arthritis (RA). However, little is known about genetic susceptibility in populations with a large admixture of Amerindian ancestry. The aim of the present study was to test the generalizability of previously reported RA loci in a Latin American (LA) population with admixed ancestry. We selected 128 single nucleotide polymorphisms (SNPs) in linkage equilibrium, with high association to RA in multiple populations of non-Amerindian origin. Genotyping of 118 SNPs was performed in 313 RA patients/487 healthy control subjects by mid-density arrays of polymerase chain reaction (PCR). Some of the identified associations were validated in an additional cohort (250 cases/290 controls). One marker, the SNP rs2451258, located upstream of T Cell Activation RhoGTPase Activating Protein (TAGAP) gene, showed significant association with RA (p = 5 × 10-3), whereas 18 markers exhibited suggestive associations (p < 0.05). Haplotype testing showed association of some groups of adjacent SNPs around the signal transducer and activator of transcription 4 (STAT4) gene (p = 9.82 × 10-3 to 2.04 × 10-3) with RA. Our major finding was little replication of previously reported genetic associations with RA. These results suggest that performing GWAS and admixture mapping in LA populations has the potential to reveal novel loci associated with RA. This in turn might help to gain insight into the 'pathogenomics' of this disease and to explore trans-population differences for RA in general.

High prevalence of clarithromycin resistance and effect on Helicobacter pylori eradication in a population from Santiago, Chile: cohort study and meta-analysis.

Helicobacter pylori (H. pylori) eradication using standard triple therapy (STT) with proton pump inhibitors (PPI), amoxicillin and clarithromycin (CLA) has been the standard in Latin America. However, CLA resistance is a rising problem affecting eradication rates. Genetic polymorphisms of CYP2C19, a PPI metabolizer may also affect eradication. The primary aims of this study were to evaluate the effect of clarithromycin resistance on H. pylori eradication in a population from Santiago, and to establish the pooled clarithromycin resistance in Santiago, Chile. Symptomatic adult patients attending a tertiary hospital in Santiago were recruited for this study. CLA resistance and the polymorphisms of CYP2C19 were determined on DNA extracted from gastric biopsies, using PCR. The STT was indicated for 14 days and eradication was determined by a urea breath test 4-6 weeks after therapy. A meta-analysis of CLA resistance studies among adult residents in Santiago was performed. Seventy-three out of 121 consecutive patients had positive rapid urease test (RUT) and received STT. Sixty-nine patients (95%) completed the study. The H. pylori eradication rate was 63% and the prevalence of CLA resistance was 26%. According to the CYP2C19 polymorphisms, 79.5% of the RUT-positive patients were extensive metabolizers. Multivariable analyses showed that only CLA resistance was significantly and inversely associated with failure of eradication (OR: 0.13; 95% confidence interval [95% CI], 0.04-0.49). A meta-analysis of two previous studies and our sample set (combined n = 194) yielded to a pooled prevalence of CLA resistance of 31.3% (95% CI 23.9-38.7). Our study shows that CLA resistance is associated with failure of H. pylori eradication. Given the high pooled prevalence of CLA resistance, consideration of CLA free therapies in Santiago is warranted. We could recommend bismuth quadruple therapy or high-dose dual therapy, according to bismuth availability. Further studies need to evaluate the best therapy.

Hemorragia vítrea una rara manifestación del hamartoma astrocítico retiniano: a propósito de un caso pediátrico / Vitreous haemorrhage a rare manifestation of retinal astrocytic hamartoma: a paediatric case report

Introducción: El hamartoma astrocítico retiniano es un tumor benigno generalmente asintomático, asociado o no al complejo de esclerosis tuberosa. La hemorragia vítrea es una rara presentación. Caso clínico: Paciente de 12 años acude por visión de "una mancha negra" en el hemicampo temporal superior del ojo derecho. Refiere un episodio similar hace 2 años. En lámpara de hendidura el polo anterior es normal. En la funduscopia se evidencia una masa de aspecto translúcido blanco-amarillenta peripapilar y hemorragia vítrea peripapilar. Las características de la autofluorescencia, angiografía fluoresceínica y la tomografía de coherencia óptica son compatibles con un hamartoma astrocítico retiniano. Los estudios complementarios (serología y radiografías) y examen clínico completo descartan afectación sistémica asociada. Se procedió a un seguimiento estrecho del paciente hasta reabsorción de la hemorragía vítrea. Conclusión: La hemorragia vítrea es una rara complicación de hamartoma astrocítico retiniano y dificulta la exploración fundoscópica. Debería descartarse afectación sistémica

Introduction: Retinal astrocytic hamartoma is generally an asymptomatic benign tumour that may or may not be associated with the tuberous sclerosis complex. Haemorrhage is a rare presentation. Case report: The case concerns a 12-year-old patient with "a black spot" vision in the upper temporal hemifield of the right eye, who referred a similar episode 2 years ago. The anterior pole was normal in the slit lamp. A mass of translucent white-yellow peri-papillary appearance and vitreous peri-papillary haemorrhage was observed in funduscopy. The autofluorescence, fluorescence angiography, and optical coherence tomography characteristics were all compatible with retinal astrocytic hamartoma. Complementary studies (serology and X-rays) and the complete clinical examination rule out associated systemic involvement. The patient was followed-up closely until the vitreous haemorrhage was reabsorbed. Conclusion: Vitreous haemorrhage is a rare complication of Retinal astrocytic hamartoma and funduscopic exploration is difficult. Systemic involvement should be ruled out

Vitreous haemorrhage a rare manifestation of retinal astrocytic hamartoma: a paediatric case report. / Hemorragia vítrea una rara manifestación del hamartoma astrocítico retiniano: a propósito de un caso pediátrico.

INTRODUCTION: Retinal astrocytic hamartoma is generally an asymptomatic benign tumour that may or may not be associated with the tuberous sclerosis complex. Haemorrhage is a rare presentation. CASE REPORT: The case concerns a 12-year-old patient with "a black spot" vision in the upper temporal hemifield of the right eye, who referred a similar episode 2 years ago. The anterior pole was normal in the slit lamp. A mass of translucent white-yellow peri-papillary appearance and vitreous peri-papillary haemorrhage was observed in funduscopy. The autofluorescence, fluorescence angiography, and optical coherence tomography characteristics were all compatible with retinal astrocytic hamartoma. Complementary studies (serology and X-rays) and the complete clinical examination rule out associated systemic involvement. The patient was followed-up closely until the vitreous haemorrhage was reabsorbed. CONCLUSION: Vitreous haemorrhage is a rare complication of Retinal astrocytic hamartoma and funduscopic exploration is difficult. Systemic involvement should be ruled out.

Historia del tracoma / History of tracoma

No disponible

A Non-inferiority Pilot Study Comparing the Clinical Efficacy and Safety of Generic Wide-spectrum Antibiotic Use in Septic Oncology Patients.

The present study is a non-inferiority study based on a descriptive and comparative case series for comparison of generic vs. original intravenous antimicrobials in septic oncology patients at an oncology private ICU. 1906 cancer patients admitted to Arturo Lopez Perez Foundation, Chile, were included in this study. After recruitment, a first retrospective group of 206 septic cancer patients recorded from 1st January, 2008 until July 14th, 2010, treated with original antibiotics (cefoperazone-sulbactam, imipenem-cilastatin, piperacillin-tazobactam) were included for analyses and a second prospective group of 143 septic cancer patients recorded from July 15th, 2010 until January 02, 2013, treated with the same but generic antibiotics were also included for comparisons. The trial protocol was developed in accordance with Helsinki and Good Clinical Practices recommendations. The results of this study showed no significant differences between the 2 groups in days of treatment, rate of success and lab test determinations (white cell count, PCR and procalcitonin), with lower, but not significant, total bed days and CPU bed days for generic antibiotics. Therefore, we conclude that the safety and efficacy of the generic antibiotics cefactam®, imipen® and Piperazam® are not inferior to original antibiotics for the treatment of severe sepsis in hospitalised patients at the Arturo Lopez Perez Foundation.

Delphinol® standardized maqui berry extract reduces postprandial blood glucose increase in individuals with impaired glucose regulation by novel mechanism of sodium glucose cotransporter inhibition.

AIM: The impetus of our study was to investigate the effects of a nutritional supplement Delphinol®, an extract of maqui berries (Aristotelia chilensis) standardised to ≥25% delphinidins and ≥35% total anthocyanins, on postprandial blood glucose and insulin levels and identify the physiologic mechanism involved. METHODS: Postprandial blood glucose and insulin were investigated in double-blind, placebo-controlled, cross-over fashion in ten volunteers with moderate glucose intolerance. Longer term effects on blood sugar levels were investigated in streptozotocin-diabetic rats over a four months period. Effects of maqui berry delphinidins on sodium-glucose symport were examined in rodent jejenum of the small intestine. RESULTS: Delphinol® intake prior to rice consumption statistical significantly lowered post prandial blood glucose and insulin as compared to placebo. We identified an inhibition of Na+-dependant glucose transport by delphinidin, the principal polyphenol to which Delphinol® is standardised. In a diabetic rat model the daily oral application of Delphinol® over a period of four months significantly lowered fasting blood glucose levels and reached values indistinguishable from healthy non-diabetic rats. CONCLUSION: Our results suggest a potential use of Delphinol® for naturally controlling post-prandial blood glucose owed to inhibition of sodium glucose co-transporter in small intestine.

Polimorfismo de citocromo P-450(CYP1A1*2A) como factor de riesgo y pronóstico del cáncer de próstata / Polymorphism of cytochrome P450 (CYP1A1 * 2A) as a risk factor andprognosis of prostate cancer

INTRODUCCIÓN: Polimorfismos en enzimas de biotransformación hansido asociados como factores de riesgo de cáncer prostático (CaP), aunque su papel como marcadores de pronóstico no está totalmente validado. El objetivo de este trabajofue estudiar en un grupo de pacientes sometidos a tamizaje, la utilidad del polimorfismo de CYP1A1 en el diagnóstico y sobrevida de pacientes chilenos con CaP.MATERIALES Y MÉTODOS: 255 controles y 234 casos con CaP fueron incluidos en programa de tamizaje en CONAC entre1995 y 2004. De muestras de sangre periférica se obtuvo DNA genómico y determinó polimorfi smo de CYP1A1*2A. Paraanálisis de susceptibilidad se usaron modelos de regresión logística uni y multivariado. Los pacientes con CaP fueron seguidos por 8,76 años en promedio, determinando sobrevida global y cáncer – específica a través de curvas de Kapplan-Meier y test de Log-rank. Se obtuvieron riesgos (Hazard Ratio) ajustados con modelo proporcional de Cox, con IC del 95%...

INTRODUCTION: Polymorphisms in biotransformation enzymes have been associated as risk factors for prostate cancer(CaP), although their role as prognostic markers is not fully validated. The aim of this work was to study in a group ofpatients undergoing screening, utility CYP1A1 polymorphism in the diagnosis and survival of Chilean patients with PCa.MATERIALS AND METHODS: 255 cases and 234 controls with CaP that were included in CONAC screening program between1995 and 2004. Genomic DNA was obtained from samples of peripheral blood and polymorphism of CYP1A1 * 2ª determined.For sensitivity analysis uni and multivariate logistic regression models were used. PCa patients were followed for8.76 years on average, determining overall and cancer–specifi c survival through Kapplan- Meier curves and log-rank test.Risks (Hazard Ratio) adjusted Cox proportional model, with 95% was obtained...

Bioequivalence of acenocoumarol in chilean volunteers: an open, randomized, double-blind, single-dose, 2-period, and 2-sequence crossover study for 2 oral formulations.

The aim of this study was to compare the bioavailability of an oral formulation of the coumarin derivative-vitamine K antagonist acenocoumarol (Acebron™ 4 mg, Test) with the reference formulation (Neo-Sintrom™ 4 mg). We performed a single-dose, double-blind, fasting, 2-period, 2-sequence, crossover study design. Plasma concentrations of acenocoumarol were determined using a validated UPLC-MS/MS method. 24 healthy Chilean volunteers (11 male, 13 female) were enrolled and all of them completed the study. Adverse events were monitored throughout the study. The values of the pharmacokinetic parameters were (mean ± SD): AUC0-24 =1 364.38±499.26 ngxh/mL for the test and 1 328.39±429.20 ngxh/mL for the reference; AUC0-∞ =1 786.00±732.85 ngxh/mL for the test and 1 706.71±599.66 ngxh/mL for the reference; Cmax =180.69±35.11 ng/mL with a Tmax of 1.83±0.95 h for the test and 186.97±38.21 ng/mL with a Tmax of 2.19±0.83 h for the reference. Regarding half life measurements, the mean ± SD of t1/2 were 11.84±4.54 h for the test and 11.08±3.28 h for the reference. The 90% confidence intervals for the test/reference ratio using logarithmic transformed data were 97.89-100.87%, 98.62-101.99% and 98.64-102.38% for Cmax, AUC0-t(24) and AUC0-∞. There were no significant differences in pharmacokinetic parameters between groups.The results obtained in this study lead us to conclude, based on FDA criteria, that the test acenocoumarol formulation (Acebron™, 4 mg tablets) is bioequivalent to the reference product (Neo-Sintrom™, 4 mg tablets).

Relative bioavailability study with two oral formulations of topiramate using a validated UPLC-MS/MS method.

Changes in bioavailability of anticonvulsant drugs such as topiramate may cause loss of or worsened seizure control. Thus, the purpose of this study was to evaluate, in a double-blind crossover design, the bioavailability between two oral formulations of topiramate in healthy volunteers after a single dose. The protocol, approved by the Institutional Committee of Ethics, consisted of administration of 1 tablet of 100 mg of topiramate of each formulation (Toprel and Topamax), to 20 healthy volunteers after a 12 h overnight fast, using an open, two-period, randomized, crossover and double-blind design. Thus, the plasma concentrations (Cp) of topiramate were measured at predetermined intervals of time, from 0 to 24 h, using a validated UPLC-MS/MS method. Based on plasma concentration-time profiles we obtained the following pharmacokinetic parameters: AUC(0-inf) 63,418.31 +/- 22,141.69 and 67,094.70 +/- 22,487.2 ngh/ml; AUC0-24: 30,421.02 +/- 9,964.0 and 30,489.35 +/- 9,407.17, ng x h/ml; tmax: 2.77 +/- 1.76 and 1.95 +/- 1.89 h; C(max): 2,143.33 +/- 724.26 and 2,262.51 +/- 751.12 ng/ml, for A (Toprel) and B (Topamax), respectively. All these differences were not statically significant with 90% confidence interval. The test of bioequivalence showed that Cmax, AUC(0-24) and AUC(0-inf) parameters are found within the range of 0.8 - 1.25 recommended by the FDA with a probability of bioequivalence of 100%. In accordance with these results, we can conclude that Toprel 100 mg, A (Test), is a bioequivalent generic and interchangeable with Topamax 100 mg, B (Reference).

Un caso de vasculitis p-ANCA positivo con derrame pericárdico asociado / No disponible

No disponible

Tratamiento quirúrgico de los hemangiomas faciales en niños / Surgical treatment of facial hemangiomas in children

Los hemangiomas son los tumores de tejido blando más comunesen la infancia. Ocurren aproximadamente en el 5-10% de los niños deun año de edad. A pesar de la frecuencia de estos tumores, su patogénesisno está completamente esclarecida. Aunque el manejo conservador es usualmentepropuesto para los hemangiomas que ocurren en la infancia, la presenciade estos tumores en la cara puede resultar en complicaciones severasy proporcionar una indicación para el tratamiento. En este trabajo mostramoscuatros pacientes que recibieron tratamiento quirúrgico antes de los sietesaños por las complicaciones severas que incluían sangramientos repetidos,distorsión de las estructuras adyacentes y trastornos visuales. Las técnicasquirúrgicas dependieron de la localización y tamaño de la lesión(AU)

Hemangiomas are the most common soft-tissue tumorsin childhood. They occur in approximately 5-10% of one-year-oldchildren. Despite their frequency, the pathogenesis of these tumorsis not completely clear. Conservative management usually is proposedfor hemangiomas that occur in childhood, but the occurrence ofthese tumors on the face can result in severe complications and maybe an indication for treatment. We report four patients who receivedsurgical treatment before the age of seven years for severecomplications, including repeated bleeding, distortion of adjacentstructures, and vision disorders. The surgical techniques dependedon the location and size of the lesion(AU)