Laser in situ keratomileusis and surface ablation in pregnancy.

PURPOSE: Although corneal refractive surgery is contraindicated during pregnancy, some patients are unaware that they are pregnant when they undergo surgery. Our objectives were to determine the functional outcomes of corneal refractive surgery during pregnancy and to compare the results with those of nonpregnant women. METHODS: We performed a multicenter, retrospective, interventional case series review of patients who were pregnant and who underwent laser in situ keratomileusis (LASIK) or surface ablation (photorefractive keratectomy, PRK) from September 11, 2002 to December 12, 2020 (group 1, n=82 eyes). Patients were included consecutively. Findings were compared with those of nonpregnant women (group 2, n=164 eyes). Functional (visual and refractive) outcomes are described. Follow-up was at least 550 days (control group, median [IQR], 990 days [715-1496]; study group, 895 days [709-1310]). The setting was Clínica Baviera, Spain, (AIER Eye Hospital Group). RESULTS: A statistically significant difference was found between the groups in terms of efficacy index (EI). No complications of pregnancy or labor were reported. Similarly, a search of medical records revealed no adverse effects in the infants. CONCLUSIONS: To the best of our knowledge, this is the first case series on pregnancy and refractive surgery. We do not recommend performing LASIK or surface ablation on pregnant women. Our objective in the present study was to present relevant scientific data obtained from women who underwent refractive surgery while unaware that they were pregnant.

Pragmatic, open-label, single-center, randomized, phase II clinical trial to evaluate the efficacy and safety of methylprednisolone pulses and tacrolimus in patients with severe pneumonia secondary to COVID-19: The TACROVID trial protocol.

INTRODUCTION: Some COVID-19 patients evolve to severe lung injury and systemic hyperinflammatory syndrome triggered by both the coronavirus infection and the subsequent host-immune response. Accordingly, the use of immunomodulatory agents has been suggested but still remains controversial. Our working hypothesis is that methylprednisolone pulses and tacrolimus may be an effective and safety drug combination for treating severe COVID-19 patients. METHODS: and analysis: TACROVID is a randomized, open-label, single-center, phase II trial to evaluate the efficacy and safety of methylprednisolone pulses and tacrolimus plus standard of care (SoC) versus SoC alone, in patients at advanced stage of COVID-19 disease with lung injury and systemic hyperinflammatory response. Patients are randomly assigned (1:1) to one of two arms (42 patients in each group). The primary aim is to assess the time to clinical stability after initiating randomization. Clinical stability is defined as body temperature ≤37.5 °C, and PaO2/FiO2 > 400 and/or SatO2/FiO2 > 300, and respiratory rate ≤24 rpm; for 48 consecutive hours. DISCUSSION: Methylprednisolone and tacrolimus might be beneficial to treat those COVID-19 patients progressing into severe pulmonary failure and systemic hyperinflammatory syndrome. The rationale for its use is the fast effect of methylprednisolone pulses and the ability of tacrolimus to inhibit both the CoV-2 replication and the secondary cytokine storm. Interestingly, both drugs are low-cost and can be manufactured on a large scale; thus, if effective and safe, a large number of patients could be treated in developed and developing countries. TRIAL REGISTRATION NUMBER: NCT04341038 / EudraCT: 2020-001445-39.

Can We Accurately Predict Cost Effectiveness Without Access to Overall Survival Data? The Case Study of Nivolumab in Combination with Ipilimumab for the Treatment of Patients with Advanced Melanoma in England.

BACKGROUND: Nivolumab with ipilimumab (the Regimen) is the first immuno-oncology combination treatment to demonstrate long-term clinical benefit for advanced melanoma patients. We evaluated the cost effectiveness of the Regimen in this population, with and without the availability of overall survival (OS) data. METHODS: A partitioned survival model and a Markov state-transition model were developed to estimate the lifetime costs and benefits of the Regimen versus ipilimumab. These models were built with and without the availability of OS data, as only progression-free survival data were available from the head-to-head, phase III trial against ipilimumab at the time of the National Institute for Health and Care Excellence (NICE) submission. Patient utilities and resource use data were sourced from trial data or the literature. RESULTS: Incremental cost-effectiveness ratios (ICERs) and absolute costs were similar between the models with and without OS data, but the model with OS data generated more than 1 additional quality-adjusted life-year (QALY) across both treatment arms. In both models, based on list prices, the Regimen was the most cost-effective treatment. CONCLUSIONS: The analyses show that the Regimen is a cost-effective treatment for advanced melanoma patients in England, and methods to overcome the lack of OS can give reasonable estimates of QALYs gained and ICERs.

Correction to: Can We Accurately Predict Cost Effectiveness Without Access to Overall Survival Data? The Case Study of Nivolumab in Combination with Ipilimumab for the Treatment of Patients with Advanced Melanoma in England.

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Resultados visuales, independencia de gafas e insatisfacción tras implante de una lente intraocular difractiva trifocal / Visual outcomes, spectacle independence and satisfaction after diffractive trifocal intraocular lens implantation

OBJETIVO: Evaluar los resultados visuales, la independencia de gafas y la satisfacción tras el implante de una lente intraocular trifocal. MÉTODOS: Estudio retrospectivo de 5.186 sujetos intervenidos de facoemulsificación con implante de la lente trifocal difractiva FineVision Micro F12 (PhysIOL, Liège, Bélgica). RESULTADOS: La queratometría media preoperatoria fue 43,61±1,55 D y el cilindro queratométrico medio -0,86 ± 0,66 D. A los 3 meses, cambiaron a 43,59±1,56 y −0,71±0,46 D respectivamente. La esfera media pasó de 2,04±2,60 a 0,14±0,38 D y el equivalente esférico medio de 1,64±2,61 a −0,05±0,36 D. Más del 60% alcanzaron una mejor agudeza visual corregida de lejos. La mayoría presentó un defecto residual final (predictibilidad) menor de 1 D (99,1%). El 14,3% precisó un ajuste refractivo, el 2,2% capsulotomía posterior y se recolocó la lente intraocular en 5 casos. Un porcentaje elevado estaba satisfecho en términos de visión e independencia de gafas en todas las distancias. Aunque un 2% refirió un empeoramiento en la visión nocturna, únicamente un 2% estaba poco satisfecho y 20 pacientes insatisfechos. Las causas fueron: visión borrosa (7 casos), necesidad de gafas (10), disfotopsias (7) y sequedad ocular (4). CONCLUSIONES: La implantación de esta lente permite obtener buenos resultados visuales en las 3 distancias así como un alto grado de independencia de gafas y de satisfacción

PURPOSE: To investigate visual outcomes, spectacle independence, and patient satisfaction after trifocal intraocular lens implantation. METHODS: A retrospective study conducted on 5,186 patients who underwent phacoemulsification and were implanted with a diffractive trifocal intraocular lens (FineVision Micro F, PhysIOL SA, Liège, Belgium). RESULTS: The mean pre-operative keratometry was 43.61±1.55 D, and mean keratometric cylinder was -0.86±0.66 D. At 3 months post-operatively, values changed to 43.59±1.56 and -0.71±0.46 D, respectively. Mean sphere varied from 2.04±2.60 to 0.14±0.38 D, and mean spherical equivalent from 1.64±2.61 to -0.05±0.36 D. More than 60% of the patients achieved better corrected distance visual acuity. The majority had a final residual refractive error (predictability) lower than 1 D (99.1%), with 14.3% needing optical adjustment (bioptics). Posterior capsulotomy was performed in 2.2%, and the lens was replaced in 5 patients. A high percentage of patients were satisfied in terms of vision and spectacle independence at all distances. Although 2% referred to worsening of night vision quality, only 2% were not very satisfied and 20 patients were dissatisfied. The causes were: blurred vision (7 cases), spectacle dependence (10), dysphotopsia (7), and dry eye (4). CONCLUSIONS: The implantation of this model provided good visual performance in all distances, as well as high levels of spectacle independence and satisfaction

Visual outcomes, spectacle independence and satisfaction after diffractive trifocal intraocular lens implantation. / Resultados visuales, independencia de gafas e insatisfacción tras implante de una lente intraocular difractiva trifocal.

PURPOSE: To investigate visual outcomes, spectacle independence, and patient satisfaction after trifocal intraocular lens implantation. METHODS: A retrospective study conducted on 5,186 patients who underwent phacoemulsification and were implanted with a diffractive trifocal intraocular lens (FineVision Micro F, PhysIOL SA, Liège, Belgium). RESULTS: The mean pre-operative keratometry was 43.61±1.55 D, and mean keratometric cylinder was -0.86±0.66 D. At 3 months post-operatively, values changed to 43.59±1.56 and -0.71±0.46 D, respectively. Mean sphere varied from 2.04±2.60 to 0.14±0.38 D, and mean spherical equivalent from 1.64±2.61 to -0.05±0.36 D. More than 60% of the patients achieved better corrected distance visual acuity. The majority had a final residual refractive error (predictability) lower than 1 D (99.1%), with 14.3% needing optical adjustment (bioptics). Posterior capsulotomy was performed in 2.2%, and the lens was replaced in 5 patients. A high percentage of patients were satisfied in terms of vision and spectacle independence at all distances. Although 2% referred to worsening of night vision quality, only 2% were not very satisfied and 20 patients were dissatisfied. The causes were: blurred vision (7 cases), spectacle dependence (10), dysphotopsia (7), and dry eye (4). CONCLUSIONS: The implantation of this model provided good visual performance in all distances, as well as high levels of spectacle independence and satisfaction.

Turning a conventional camera into a 3D camera with an add-on.

We propose to add an optical component in front of a conventional camera to improve depth estimation performance of depth from defocus (DFD), an approach based on the relation between defocus blur and depth. The add-on overcomes ambiguity and the dead zone, which are the fundamental limitations of DFD with a conventional camera, by adding an optical aberration to the whole system that makes the blur unambiguous and measurable for each depth. We look into two optical components: the first one adds astigmatism and the other one chromatic aberration. In both cases, we present the principle of the add-on and experimental validations on real prototypes.

Cell-cycle arrest biomarkers in urine to predict acute kidney injury in septic and non-septic critically ill patients.

PURPOSE: To analyse the usefulness of the composite index of the tissue inhibitor of metalloproteinases-2 (TIMP-2) and insulin-like growth factor-binding protein 7 (IGFBP7) as urinary biomarkers for the early prediction of AKI in septic and non-septic patients. METHODS: This is a prospective, observational study including patients admitted to ICU from acute care departments and hospital length of stay <48 h. The main exclusion criteria were pre-existing eGFR <30 mL/min/1.73 m2 and hospitalisation 2 months prior to current admission. The [TIMP-2]·[IGFBP7] index was analysed twice, within the first 12 h of ICU admission. RESULTS: The sample included 98 patients. AKI incidence during ICU stay was 50%. Sepsis was diagnosed in 40.8%. Baseline renal variables were comparable between subgroups except for a higher baseline eGFR in non-septic patients. Patients were stratified based on the presence of AKI and their highest level of [TIMP-2]·[IGFBP7] within the first 12 h of stay. [TIMP-2]·[IGFBP7] index values were dependent on the incidence of AKI but not of sepsis. [TIMP-2]·[IGFBP7] values were significantly related to AKI severity according to AKIN criteria (p < 0.0001). The AUROC curve to predict AKI of the worst [TIMP-2]·[IGFBP7] index value was 0.798 (sensitivity 73.5%, specificity 71.4%, p < 0.0001). Index values below 0.8 ruled out any need for renal replacement (NPV 100%), whereas an index >0.8 predicted a rate of AKI of 71% and AKIN ≥ 2 of 62.9%. CONCLUSIONS: In our study, urinary [TIMP-2]·[IGFBP7] was an early predictor of AKI in ICU patients regardless of sepsis. Besides, index values <0.8(ng/mL)2/1000 ruled out the need for renal replacement.

Implantación de lente fáquica para corrección de miopía en pacientes con leucoma corneal / Implantable collamer lens for correction of ametropia in eyes with corneal scarring

CASOS: Comunicamos 2 casos en los que la implantación de una lente fáquica corrige defectos refractivos en ojos con leucoma. Ambos sufrieron un accidente hace años, quedando un leucoma lineal central en uno de sus ojos. El primero presentaba la lesión en su ojo izquierdo. Su agudeza visual corregida de lejos fue de 0,3 (−7,75; −4×160°). Tras implantar la lente fáquica alcanzó una agudeza visual no corregida de lejos de 0,3. El segundo mostraba en su ojo derecho una lesión oblicua con agudeza visual corregida de 0,25 (−8,75; −1,25×8°). Tras la intervención alcanzó una agudeza visual no corregida de 0,25. Discusión: Las indicaciones de la implantación de una lente fáquica son susceptibles de ser revisadas y, posiblemente, ampliadas

CASES: Two cases are reported in which implantation of a collagen copolymer phakic intraocular lens (implantable collamer lens) corrected refractive errors in eyes with corneal scarring. A previous accident, in both cases, resulted in a central linear scar on the surface of the cornea of one eye. In the first patient, a corneal scar was visible in the left eye. The distance corrected visual acuity was 0.3 (-7.75 -4×160°). An uncorrected distance visual acuity of 0.25 was obtained by implanting an implantable collamer lens. In the second patient an oblique corneal scar was visible in the right eye. The distance corrected visual acuity was 0.25 (-8.75 -1.25×8°), and after implantation of the implantable collamer lens, uncorrected distance visual acuity was 0.25. Discussion: The indications of the implantable collamer lens should be reviewed and possibly expanded

Implantable collamer lens for correction of ametropia in eyes with corneal scarring. / Implantación de lente fáquica para corrección de miopía en pacientes con leucoma corneal.

CASES: Two cases are reported in which implantation of a collagen copolymer phakic intraocular lens (implantable collamer lens) corrected refractive errors in eyes with corneal scarring. A previous accident, in both cases, resulted in a central linear scar on the surface of the cornea of one eye. In the first patient, a corneal scar was visible in the left eye. The distance corrected visual acuity was 0.3 (-7.75 -4×160°). An uncorrected distance visual acuity of 0.25 was obtained by implanting an implantable collamer lens. In the second patient an oblique corneal scar was visible in the right eye. The distance corrected visual acuity was 0.25 (-8.75 -1.25×8°), and after implantation of the implantable collamer lens, uncorrected distance visual acuity was 0.25. DISCUSSION: The indications of the implantable collamer lens should be reviewed and possibly expanded.

LASIK y ablación de superficie en pacientes tratados con amiodarona / LASIK and surface ablation in patients treated with amiodarone

OBJETIVO: Determinar los resultados anatómicos y funcionales de los pacientes intervenidos con cirugía refractiva corneal que estaban en tratamiento con amiodarona, la cual ha sido considerada como una posible contraindicación en estas intervenciones. MATERIAL Y MÉTODOS: Se ha realizado un estudio observacional retrospectivo. Los pacientes se incluyeron consecutivamente. Se incluyó a todos los pacientes que tomaban amiodarona y fueron operados mediante LASIK o ablación de superficie entre enero de 2003 y diciembre de 2014. Se pretenden describir los resultados funcionales (visuales y refractivos). RESULTADOS: Se incluyó a un total de 20 pacientes (33 ojos). No se encontraron complicaciones intraoperatorias o postoperatorias significativas. CONCLUSIONES: En nuestra experiencia los pacientes tratados con amiodarona e intervenidos mediante LASIK o ablación de superficie no presentaron complicaciones clínicas significativas. La contraindicación absoluta por tomar determinadas medicaciones sistémicas debería ser reconsiderada

OBJECTIVE: To determine the anatomical and functional outcomes of corneal refractive surgery in patients on amiodarone, a drug listed as being contraindicated in patients undergoing this procedure. MATERIAL AND METHODS: A retrospective observational study was conducted on all consecutive patients who took amiodarone and who underwent LASIK or surface ablation from January 2003 to December 2014. Functional (visual and refractive) outcomes are described. RESULTS: A total of 20 patients (33 eyes) were included. No significant intraoperative or postoperative complications were found. CONCLUSIONS: In our experience, LASIK and surface ablation did not produce significant clinical complications in selected patients taking amiodarone. The absolute exclusion of certain systemic medications should be reconsidered

LASIK and surface ablation in patients treated with amiodarone. / LASIK y ablación de superficie en pacientes tratados con amiodarona.

OBJECTIVE: To determine the anatomical and functional outcomes of corneal refractive surgery in patients on amiodarone, a drug listed as being contraindicated in patients undergoing this procedure. MATERIAL AND METHODS: A retrospective observational study was conducted on all consecutive patients who took amiodarone and who underwent LASIK or surface ablation from January 2003 to December 2014. Functional (visual and refractive) outcomes are described. RESULTS: A total of 20 patients (33 eyes) were included. No significant intraoperative or postoperative complications were found. CONCLUSIONS: In our experience, LASIK and surface ablation did not produce significant clinical complications in selected patients taking amiodarone. The absolute exclusion of certain systemic medications should be reconsidered.

The Role of Omega-3 Polyunsaturated Fatty Acids in the Treatment of Patients with Acute Respiratory Distress Syndrome: A Clinical Review.

Acute respiratory distress syndrome (ARDS) is defined as the acute onset of noncardiogenic edema and subsequent gas-exchange impairment due to a severe inflammatory process. Recent report on the prognostic value of eicosanoids in patients with ARDS suggests that modulating the inflammatory response through the use of polyunsaturated fatty acids may be a useful strategy for ARDS treatment. The use of enteral diets enriched with eicosapentaenoic acid (EPA) and gamma-linolenic acid (GLA) has reported promising results, showing an improvement in respiratory variables and haemodynamics. However, the interpretation of the studies is limited by their heterogeneity and methodology and the effect of ω-3 fatty acid-enriched lipid emulsion or enteral diets on patients with ARDS remains unclear. Therefore, the routine use of ω-3 fatty acid-enriched nutrition cannot be recommended and further large, homogeneous, and high-quality clinical trials need to be conducted to clarify the effectiveness of ω-3 polyunsaturated fatty acids.

NVP-QBE170: an inhaled blocker of the epithelial sodium channel with a reduced potential to induce hyperkalaemia.

BACKGROUND AND PURPOSE: Inhaled amiloride, a blocker of the epithelial sodium channel (ENaC), enhances mucociliary clearance (MCC) in cystic fibrosis (CF) patients. However, the dose of amiloride is limited by the mechanism-based side effect of hyperkalaemia resulting from renal ENaC blockade. Inhaled ENaC blockers with a reduced potential to induce hyperkalaemia provide a therapeutic strategy to improve mucosal hydration and MCC in the lungs of CF patients. The present study describes the preclinical profile of a novel ENaC blocker, NVP-QBE170, designed for inhaled delivery, with a reduced potential to induce hyperkalaemia. EXPERIMENTAL APPROACH: The in vitro potency and duration of action of NVP-QBE170 were compared with amiloride and a newer ENaC blocker, P552-02, in primary human bronchial epithelial cells (HBECs) by short-circuit current. In vivo efficacy and safety were assessed in guinea pig (tracheal potential difference/hyperkalaemia), rat (hyperkalaemia) and sheep (MCC). KEY RESULTS: In vitro, NVP-QBE170 potently inhibited ENaC function in HBEC and showed a longer duration of action to comparator molecules. In vivo, intratracheal (i.t.) instillation of NVP-QBE170 attenuated ENaC activity in the guinea pig airways with greater potency and duration of action than that of amiloride without inducing hyperkalaemia in either guinea pig or rat. Dry powder inhalation of NVP-QBE170 by conscious sheep increased MCC and was better than inhaled hypertonic saline in terms of efficacy and duration of action. CONCLUSIONS AND IMPLICATIONS: NVP-QBE170 highlights the potential for inhaled ENaC blockers to exhibit efficacy in the airways with a reduced risk of hyperkalaemia, relative to existing compounds.

Ectasia corneal post-LASIK en pacientes con diferencias significativas en las lecturas queratométricas de ambos ojos / Post-lasik corneal ectasia in patients with significant differences in keratometry readings between both eyes

OBJETIVOS: Investigar la incidencia de ectasia corneal tras queratomileusis in situ asistida por láser excímer (LASIK) en pacientes con diferencias significativas en la lectura queratométrica media (KM) entre ambos ojos (AO). Además se evalúan los resultados visuales. MÉTODOS: Se han revisado las historias clínicas de 164.603 pacientes (315.259 ojos) intervenidos con LASIK de enero de 2003 a diciembre de 2011 para identificar pacientes con una diferencia de KM ≥ 1,25 D entre AO. Además de este criterio, debían ser pacientes miopes con topografía corneal normal. Las principales variables de estudio fueron la incidencia de ectasia tras LASIK y el resultado visual. RESULTADOS: Un total de 35 ojos de 20 pacientes cumplieron con los criterios de inclusión y exclusión. Los resultados funcionales y visuales fueron los esperados para las refracciones estudiadas. No se encontraron ectasias en la serie estudiada tras un seguimiento mínimo de 2 años. CONCLUSIONES: La posibilidad de encontrar en un paciente asimetría de KM y topografía normal es pequeña (0,021%) y no parece ser una contraindicación para realizar LASIK. A pesar de no encontrarse ectasias en la serie estudiada, ya que esta es una complicación potencialmente grave para la visión, los pacientes con elevadas diferencias en la KM entre AO deben ser estudiados cuidadosamente antes de ser intervenidos mediante LASIK

OBJECTIVES: A study is made on the incidence of corneal ectasia after laser in situ keratomileusis (LASIK) in patients with large differences in mean keratometry (MK) readings between both eyes (OU). Visual outcomes were also evaluated. METHODS: The medical records of 164,603 patients (315,259 eyes) who underwent LASIK from January 2003 to December 2011 were reviewed in order to identify patients with a difference in MK of ≥ 1.25 D between OU. The main outcome measures were incidence of ectasia after LASIK, and visual outcome. RESULTS: A total of 35 eyes that met the inclusion criteria were found. Functional and visual results were those expected for myopia studies. After a minimum follow-up of 2 years, no corneal ectasia was found in 3 eyes (2 patients). CONCLUSIONS: The possibility of finding a patient with an asymmetry in MK and normal topography is low (0.021%), and it does not seem to be a contraindication of LASIK. Although no corneal ectasia was found in this case series, and as it is a potentially sight-threatening complication, patients with very different MK between OU should be studied carefully before undergoing LASIK

[Post-lasik corneal ectasia in patients with significant differences in keratometry readings between both eyes]. / Ectasia corneal post-LASIK en pacientes con diferencias significativas en las lecturas queratométricas de ambos ojos.

OBJECTIVES: A study is made on the incidence of corneal ectasia after laser in situ keratomileusis (LASIK) in patients with large differences in mean keratometry (MK) readings between both eyes (OU). Visual outcomes were also evaluated. METHODS: The medical records of 164,603 patients (315,259 eyes) who underwent LASIK from January 2003 to December 2011 were reviewed in order to identify patients with a difference in MK of ≥ 1.25 D between OU. The main outcome measures were incidence of ectasia after LASIK, and visual outcome. RESULTS: A total of 35 eyes that met the inclusion criteria were found. Functional and visual results were those expected for myopia studies. After a minimum follow-up of 2 years, no corneal ectasia was found in 3 eyes (2 patients). CONCLUSIONS: The possibility of finding a patient with an asymmetry in MK and normal topography is low (0.021%), and it does not seem to be a contraindication of LASIK. Although no corneal ectasia was found in this case series, and as it is a potentially sight-threatening complication, patients with very different MK between OU should be studied carefully before undergoing LASIK.

Auto-adaptive robot-aided therapy using machine learning techniques.

This paper presents an application of a classification method to adaptively and dynamically modify the therapy and real-time displays of a virtual reality system in accordance with the specific state of each patient using his/her physiological reactions. First, a theoretical background about several machine learning techniques for classification is presented. Then, nine machine learning techniques are compared in order to select the best candidate in terms of accuracy. Finally, first experimental results are presented to show that the therapy can be modulated in function of the patient state using machine learning classification techniques.

Robotic assessment of the influence of age on upper-limb sensorimotor function.

PURPOSE: This paper examines the influence of age on several attributes of sensorimotor performance while performing a reaching task. Our hypothesis, based on previous studies, is that aged persons will show differences in one or more of the attributes of sensorimotor performance. PATIENTS AND METHODS: Fifty-one subjects (aged 20-80 years) with no known neuromotor disorders of the upper limbs participated in the study. Subjects were asked to grasp the end-effector of a pneumatic robotic device with two degrees of freedom in order to reach peripheral targets (1.0 cm radius), "quickly and accurately", from a centrally located target (1.0 cm radius). Subjects began each trial by holding the hand within the central target for 2000 milliseconds. Afterwards, a peripheral target was illuminated. Then participants were given 3000 milliseconds to complete the movement. When a target was reached, the participant had to return to the central target in order to start a new trial. A total of 64 trials were completed and each peripheral target was illuminated in a random block design. RESULTS: SUBJECTS WERE DIVIDED INTO THREE GROUPS ACCORDING TO AGE: group 1 (age 20-40 years), group 2 (age 41-60 years), and group 3 (age 61-80 years). The Kruskal-Wallis test showed significant differences (P < 0.05) between groups, except for the variables postural speed in the dominant arm, and postural speed and initial deviation in the non-dominant arm (P > 0.05). These results suggest that age introduces significant differences in upper-limb motor function. CONCLUSION: Our findings show that there are objective differences in sensorimotor function due to age, and that these differences are greater for the dominant arm. Therefore for the assessment of upper-limb function, we should take into account the influence of age. Moreover, these results suggest that robotic systems can provide a new and effective approach in the assessment of sensorimotor function.

Solid organ transplant training objectives for residents.

With the aim of analyzing the current state of the educational objectives in the training of medical residents in solid organ transplantation (SOT), we conducted a review of the status of the official programs of the specialities involved in SOT, focusing particularly on lung transplantation. A survey of medical residents was also conducted to allow reflexion about the topic. We obtained 44 surveys from 4 University Hospitals with active programs in SOT, mainly from intensive care medicine and anesthesiology residents. We detected an important number of courses oriented to organ donation but very limited in terms of basic training in the management of the immediate postoperative period, principles of immunosuppression and updates on immunosuppressive therapy and complications (particularly rejection and infection). We also identified that these educational aspects should be directed not only to medical residents from specialities with a close retation to SOT, but also to all who may at some time have a relation to such patients. The use of information and communication techniques (ICTs), on-line courses and also simulations should be instruments to take into account in the biomedical training of medical residents. We conclude that we need a specific training program in complications of SOT, as well as fundamental principles in immunology and immunosuppressor pharmacology.