W-band tunable, multi-channel, frequency comb Doppler backscattering diagnostic in the ASDEX-Upgrade tokamak.

This article presents the design, implementation, and first data of a uniquely flexible, multi-channel, frequency comb Doppler backscattering diagnostic recently made operational in the ASDEX-Upgrade tokamak [A. Gruber and O. Gruber, Fusion Sci. Technol. 44, 569 (2003)]. It uses a double side-band signal fed into a ×6 frequency multiplier to produce a multiple-frequency output spectrum. Seven of these frequencies are simultaneously measured in the receiver via a two-step frequency down-conversion and traditional I/Q demodulation. The frequency comb spectrum is fully tunable to sit anywhere in the W-band. The inter-frequency separation is also uniquely tunable remotely between 0.1 and 6 GHz without any hardware changes. The diagnostic can be operated in both O and X-mode polarizations and at both oblique and normal incidence to the cutoff layer. The time evolution of backscattered signals, in excess of 30 dB, from seven distinct frequencies sampled simultaneously is presented across an L-to-H-mode confinement regime transition.

Prevalencia de infección por Chlamydia trachomatis y relación con el perfil de conductas sexuales en adolescentes y mujeres jóvenes de la Provincia de Osorno, Chile

Introducción: La infección por Chlamydia trachomatis es la ITS bacteriana más frecuente del mundo. En el cervix se presenta mayormente de forma asintomática y afecta especialmente a mujeres jóvenes y adolescentes. Puede producir daño permanente en el tracto reproductor femenino, se asocia a parto prematuro, infecciones neonatales transmitidas vía vertical y mayor riesgo de adquirir otras ITS como VIH Y VPH. Por estos motivos se han establecido estrategias de tamizaje para detectar y tratar precozmente la infección asintomática por C. trachomatis en diferentes países. En nuestro país no contamos con un programa nacional de tamizaje. Objetivo: Determinar la prevalencia de infección asintomática por Chlamydia trachomatis en mujeres entre 12 y 21 años de la Provincia de Osorno, Región de Los Lagos, Chile. Pacientes y Métodos: Se desarrolló un estudio de diseño transversal con una cohorte única de mujeres adolescentes y jóvenes consultantes en el Policlínico de Alto Riesgo Obstétrico y de Ginecología Infantil y Adolescente, del Hospital Base de Osorno, entre enero de 2019 y enero 2020. Se determinó el estado de infección asintomática mediante RPC en tiempo real para C. trachomatis. Se realizó una encuesta a fin de determinar características demográficas, hábitos y conductas sexuales de las pacientes estudiadas. Resultados: Fueron reclutadas 124 mujeres entre 12 a 21 años de edad, de las cuales, 36 (29,3%) se encontraban embarazadas al momento del estudio. La prevalencia de infección asintomática por C. trachomatis fue de 14/124 (11,3%). En las mujeres gestantes se encontraron 6/36 (16,7%) casos positivos de infección por C. trachomatis y 8/88 (9,1%) en las no gestantes. Existe una mayor frecuencia de infección asintomática a menor edad de inicio de actividad sexual (33,3% en aquellas que inician entre 11-12 años vs. 16,2% en las que inician entre 1314 años, 7,4% entre 15-16 y 8% entre 17-21 años; p < 0,05). Esta tendencia no fue observada al comparar el estado de infección con el tiempo de vida sexual activa. Sólo 15,7% de las pacientes utilizó preservativo en todas sus relaciones sexuales. Discusión: La infección asintomática por C. trachomatis es frecuente en las mujeres adolescentes y jóvenes sexualmente activas. Las pacientes con inicio más temprano de la actividad sexual coital (bajo 13 años de edad) podrían estar en mayor riesgo. Se requiere con urgencia establecer la frecuencia nacional de infección para desarrollar una estrategia sanitaria para su pesquisa y manejo oportuno en nuestro país.

Background: Chlamydia trachomatis infection is the world most common bacterial STI. At uterine cervix it presents mostly asymptomatically and especially affects young women and adolescents. It can cause permanent damage to the female reproductive tract and is associated with premature birth, connatal infections and increased risk of acquiring other STIs such as HIV and HPV. For these reasons, other countries have established screening strategies to detect and treat asymptomatic C. trachomatis infection. Our country don't have a national screening program. Aim: To determine the prevalence of C. trachomatis asymptomatic infection in adolescent and young women in Osorno province, Los Lagos Region, Chile. Methods: A crosssectional study was performed in adolescent and young women who consult at Hospital Base Osorno in the MaternoFetal and PediatricAdolescent Gynecology ambulatory clinics, between January 2019 and January 2020. The status of asymptomatic infection was determined by PCR for C. trachomatis. A survey was carried out to determine the demographic characteristics, habits and sexual behaviors. Results: 124 women between 12 and 21 years of age were recruited, of which 36 (29,3%) were pregnant at the time of the study. The prevalence of asymptomatic infection by C. trachomatis was 11.3.%. In pregnant women, there were 6/36 (16.7%) positive cases for C. trachomatis and 8/88 (9.1%) in nonpregnant women. We found a higher frequency of asymptomatic infection at younger age of first sexual intercourse (33% in adolescents at 11-12 years old vs. 16.2% at 13-14, 7.4% at 15-16 and 8% at 17-21; p<0.05). Only 15.7% of the patients utilized condoms in all their intercourses. Discussion: Asymptomatic C. trachomatis infection is common in adolescent and young women, with a higher risk in those who onset sexual activity at an early age (less than 13 years old). It is urgently required to determine the national frequency of asymptomatic C. trachomatis infection to develop a national strategy for screening and timely treatment.

La competencia motriz real y percibida en contexto de ruralidad según el sexo y la participación deportiva extraescolar / Competência motora real e percebida num contexto rural de acordo com o género e a participação desportiva extracurricular / Actual and perceived motor competence in a rural context according to gender and extracurricular sports participation

La presente investigación tiene como propósito determinar si existen diferencias en la competencia motriz real y percibida en escolares de contexto rural, en función del sexo y de la participación en actividades deportivas extraescolares; así como determinar la existencia de relaciones entre competencia motriz real, competencia motriz percibida, participación en actividades deportivas extraescolares y tipo de actividad deportiva. Participaron 120 estudiantes de enseñanza primaria (60.0% niñas, edad M=11.05 DE=1.05 años) de la comuna de Perquenco de la Región de La Araucanía, Chile. Se utilizó el Test MOBAK para la evaluación de la competencia motriz real y el Cuestionario SEMOK para la evaluación de la competencia motriz percibida. Los niños presentaron mejores resultados que las niñas en el control de objetos de la competencia motriz real, diferenciándose significativamente (p<.001; PSest=.69); mientras que en la competencia motriz percibida no se encontraron diferencias significativas entre ambos sexos. Los estudiantes que participan en actividades deportivas extraescolares presentan mayores valores en la competencia motriz real (control de objetos: p<.001; PSest=.27; control del cuerpo: p<.001; PSest=.23) y percibida (control de objetos: p=.005; PSest=.35; control del cuerpo: p<.001; PSest=.31), diferenciándose significativamente de los que no participan. Se encontraron relaciones significativas entre la competencia motriz real, percibida y participación en actividades deportivas. El tipo de actividad deportiva extraescolar se asoció sólo con la competencia motriz real, en donde los deportes colectivos se relacionan con el control de objetos (r=.378) y losdeportes individuales con el control del cuerpo (r=-.350). Los resultados sugieren que el sexo y las actividades deportivas extraescolares cumplen un rol relevante en la competencia motriz de los estudiantes rurales. (AU)

The purpose of this study is to determine if there are differences in actual and perceived motor competence in rural schoolchildren, according to gender and participation in extracurricular sports; and if there is a relationship between actual motor competence, perceived motor competence, participation in extracurricular sports activities and the type of sports. A total of 120 primary school students (60.0% girls, age M=11.05 SD=1.05 years) from the commune of Perquenco in the La Araucanía Region, Chile, participated. The MOBAK Test was used for the assessment of actual motor competence and the SEMOK Questionnaire for the assessment of perceived motor competence. Boys performed better than girls in the object control of actual motor competence, with a significant difference (p<.001; PSest=.69); while no significant differences were found in perceived motor competence according to gender. Students who participate in extracurricularsports show higher values in actual (object control: p<.001; PSest=.27; self-movement: p<.001; PSest=.23) and perceived motor competence (object control: p=.005; PSest=.35; self-movement: p<.001; PSest=.31), with significant differences compared to those who do not participate in any extracurricular sports activity. Significant relationships were found between actual and perceived motor competence and participation in sports. The type of extracurricular sports was only associated with actual motor competence, where group sports were related to the object control (r=.378) and individual sports to the self-movement (r=-.350). The results suggest that gender and extracurricular sports play a relevant role in the motor competence of students from rural areas. (AU)

A presente investigação, a fim de determinar se existem diferenças na competência motora real e percebida em crianças das zonas rurais, de acordo como género e a participação em actividades desportivas extracurriculares; bem como para determinar a existência de relações entre competência motora real, competência motora percebida, participação em actividades desportivas extracurriculares e tipo de actividade desportiva. Um total de 120 estudantes do ensino primario (60.0% raparigas, idade M=11.05 SD=1.05 anos) da comunidade de Perquenco na região de La Araucanía, Chile, participaram no estudo. O teste MOBAK foi utilizado para a avaliação da competência motora real e o questionário SEMOK para a avaliação da competência motora percebida. Os rapazes apresentaram melhores resultados do que as raparigas no control de objectos da competência motora real, diferindo significativamente (p<.001; PSest=.69); enquanto na percepção da competência motora não foram encontradas diferenças significativas entre ambos os sexos. Os estudantes que participam em actividades desportivas extracurriculares apresentam valores mais elevados na competência motora real (control do objecto: p<.001; PSest=.27; control do corpo: p<.001; PSest=.23) e percebida (control do objecto: p=.005; PSest=.35; control do corpo: p<.001; PSest=.31), diferindo significativamente dos que não participam. Foram encontradas relaçõessignificativas entre a competência motora real e percebida e a participação em actividades desportivas. O tipo de actividade desportiva extracurricular foi associado apenas à competência motora real, onde os desportos colectivos estão relacionados com control do objecto (r=.378) e os desportos individuais com control do corpo (r=-.350). Os resultados sugerem que o género e as actividades desportivas extracurriculares desempenham um papel relevante na competência motora dos estudantes rurais. (AU)

In vitro amoebicidal effects of arabinogalactan-based ophthalmic solution.

The main corneal infections reported worldwide are caused by bacteria and viruses but, recently, the number of Acanthamoeba keratitis (AK) cases has increased. Acanthamoeba genus is an opportunistic free living protozoa widely distributed in environmental and clinical sources, with two life-cycle stages: the trophozoite and the cyst. AK presents as primary symptoms eye redness, epithelial defects, photophobia and intense pain. An early diagnosis and an effective treatment are crucial to avoid blindness or eye removal but, so far, there is no established treatment to this corneal infection. Diverse research studies have reported the efficacy of commercialized eye drops and ophthalmic solutions against the two life cycle stages of Acanthamoeba strains, that usually present preservatives such as Propylene Glycol of Benzalkonium chloride (BAK). These compounds present toxic effects in corneal cells, favouring the inflammatory response in the so sensitive eye tissue. In the present work we have evaluated the efficacy of nine proprietary ophthalmic solutions with and without preservatives (ASDA Dry Eyes Eyedrops, Miren®, ODM5®, Ectodol®, Systane® Complete, Ocudox®, Matrix Ocular®, Alins® and Coqun®) against the two life cycle stages of three Acanthamoeba strains. Our work has demonstrated the high anti-Acanthamoeba activity of Matrix Ocular®, which induces the programmed cell death mechanisms in Acanthamoeba spp. trophozoites. The high efficacy and the absence of ocular toxic effects of Matrix Ocular®, evidences the use of the Arabinogalactan derivatives as a new source of anti-AK compounds.

Focal laser for idiopathic macular telangectasia type 1 refractory to ozurdex, ranibizumab and aflibercept. / Láser focal para telangectasia macular idiopática tipo 1 refractario a ozurdex, ranibizumab y aflibercept.

We present a case of a woman with idiopathic macular telangiectasia type 1, characterized by the presence of a capillary macroanaeurysm associated with macular edema with a macular star pattern. Several differential diagnoses were proposed, in which the study with a multimodal image was key to clarify the diagnosis. In addition, the various treatments used and their effectiveness are discussed.

Effect of intravenous lidocaine on ischemia-reperfusion injury in DIEP microsurgical breast reconstruction. A prospective double-blind randomized controlled clinical trial.

BACKGROUND: Ischemia-reperfusion injury in free flaps is associated with tissue damage and is one of the main factors causing flap failure in reconstructive microsurgery. The aim of this study is to assess whether any ischemia-reperfusion injury takes place during a microsurgical flap reconstruction as seen through the levels of malondialdehyde (MDA) and superoxide dismutase, biomarkers of oxidative stress, and to analyze the effect of lidocaine in this process. METHODS: Twenty-four patients operated for immediate breast reconstruction using the Deep Inferior Epigastric Perforator free flap technique were divided into two groups: one group was treated with a lidocaine intravenous perfusion and the other group with a saline perfusion. MDA and superoxide dismutase (SOD) levels were measured at several points before, during, and after surgery. RESULTS: There was an increase in MDA levels in both groups, but the lidocaine group experienced a decrease during reperfusion. On the other hand, we observed a rise in SOD levels in both groups, but a decrease during reperfusion in the placebo group. However, these differences between groups were not statistically significant. CONCLUSIONS: The decreased SOD activity and increased MDA content in our research prove a redox imbalance and high reactive oxygen species levels in flaps, indicating that tissues experience ischemia-reperfusion injury during microsurgical reconstruction. Lidocaine may have a protective effect in free flap surgery, but our results were not statistically significant, so further studies will be required.

[Effect of nutritional status on mortality and functional recovery in older adults with hip fracture]. / Efecto del estado nutricional en la mortalidad y recuperación funcional en adultos mayores con fractura de cadera.

INTRODUCTION: Malnutrition is a common problem in the elderly population but has not been fully studied in elderly people with hip fractures. The goal is to estimate annual mortality based on nutrition in the elderly with hip fracture and compare motor functionality. MATERIAL AND METHODS: Retrospective cohort of patients over 65 years of age with hip fracture included in the Institutional Register of The Elderly with Hip Fracture of a University Hospital, between July 2014 and July 2018. Nutritional status with Mini Nutritional Assessment Short-Form (MNA-SF) was assessed at hospital admission. Motor functional capacity was evaluated with Parker Scale (PS) basal, at three and 12 months. RESULTS: 1,253 patients were included. 49.92% (CI95% 47.12-52.72) were malnourished. The annual mortality of the well-nourished (WN) was 9.45% (CI95% 7.23-12.30) against 21.52% (CI95% 18.12-25.45; p 0.001) of the malnourished (MN). The risk of death was associated with malnutrition HR 2.45 (CI95% 1.75-3.43; p 0.001). After adjusting it by age, sex, fragility, AVD, Charlson comorbility index and dementia, the risk remained HR 1.71 (CI95% 17-2.49; p = 0.005). With respect to functionality, the basal Parker Scale median (EP) for the WN group was 9 (RIC6-9) and for MN was 5 (RIC3-9) p 0.001, 6 months (RIC3-6) and 4 (RIC2-6) p 0.001 and 12 months 6 (RIC4-7) and 3 (RIC2-6) p 0.001. CONCLUSIONS: There is an association between the malnutrition of the elderly with hip fracture and its mortality with a year of evaluation; we also find a difference in motor functionality.

INTRODUCCIÓN: La malnutrición es una problemática frecuente en la población anciana, pero no ha sido completamente estudiado en ancianos con fractura de cadera. El objetivo es estimar mortalidad anual según nutrición en ancianos con fractura de cadera y comparar la funcionalidad motora. MATERIAL Y MÉTODOS: Cohorte retrospectiva de pacientes mayores de 65 años con fractura de cadera incluidos en el Registro Institucional de Ancianos con Fractura de Cadera de un Hospital Universitario, entre Julio de 2014 y Julio de 2018. Se evaluó el estado nutricional con Mini Nutritional Assessment Short-Form (MNA-SF) al ingreso hospitalario. La capacidad funcional motora fue evaluada con escala de Parker (EP) basal, a los tres y 12 meses. RESULTADOS: Se incluyeron 1,253 pacientes. 49.92% (IC95% 47.12-52.72) estaba malnutrido. La mortalidad anual de los bien nutridos (BN) fue de 9.45% (IC95% 7.23-12.30) contra 21.52% (IC95% 18.12-25.45; p 0.001) de los malnutridos (MN). El riesgo de muerte se asoció a la malnutrición HR 2.45 (IC95% 1.75-3.43; p 0.001). Luego de ajustarlo por edad, sexo, fragilidad, AVD, índice de comorbilidades de Charlson y demencia, el riesgo se mantuvo HR 1.71 (IC95% 17-2.49; p = 0.005). Con respecto a la funcionalidad, la mediana de la escala de Parker (EP) basal para el grupo BN fue 9 (RIC6-9) y para MN fue 5 (RIC3-9) p 0.001, a los tres meses 6 (RIC3-6) y 4 (RIC2-6) p 0.001 y a los 12 meses 6 (RIC4-7) y 3 (RIC2-6) p 0.001. CONCLUSIONES: Existe asociación entre la malnutrición del anciano con fractura de cadera y su mortalidad al año, asimismo una diferencia en la funcionalidad motora.

Hemophagocytic syndrome in patients infected with the human immunodeficiency virus: A study of 15 consecutive patients.

OBJECTIVE: Hemophagocytic syndrome (HPS) is characterized by various clinical and biological data derived from cytokine hyperproduction and cell proliferation. The objectives of this study were to evaluate the epidemiological, etiological, clinical and evolutionary characteristics of patients diagnosed with hemophagocytic syndrome and HIV infection, as well as their comparison with data from the literature. METHODS: A retrospective descriptive observational study was performed, including all adult patients with a diagnosis of HPS and HIV infection treated in the Infectious Diseases and Tropical Medicine Unit of the Hospital Universitario Insular, Las Palmas, Gran Canaria from June 1, 1998 to December 31, 2018. RESULTS: An analysis of this series of case reports of 15 patients showed a higher percentage of males than females, with a mean age of 42 years. With respect to the diagnostic criteria for HPS, presence of fever, cytopenias and hyperferritinemia were a constant in all patients. Clinical neurological manifestations were frequent and clinical respiratory signs and symptoms absent. HPS was confirmed in some patients who were not severely immune-depressed and had undetectable viral loads. Furthermore, 40% of cases were not receiving ART. The most frequent triggering causes of HPS were viral, especially HHV-8. In addition, two new HPS triggers were identified: Blastocystis dermatitidis and Mycobacterium chelonae. CONCLUSIONS: Administration of treatment in HPS is arbitrary. This, together with the high mortality rate and the fact that it is underdiagnosed, indicates the importance of conducting future studies.

Efecto del estado nutricional en la mortalidad y recuperación funcional en adultos mayores con fractura de cadera / Effect of nutritional status on mortality and functional recovery in older adults with hip fracture

Resumen: Introducción: La malnutrición es una problemática frecuente en la población anciana, pero no ha sido completamente estudiado en ancianos con fractura de cadera. El objetivo es estimar mortalidad anual según nutrición en ancianos con fractura de cadera y comparar la funcionalidad motora. Material y métodos: Cohorte retrospectiva de pacientes mayores de 65 años con fractura de cadera incluidos en el Registro Institucional de Ancianos con Fractura de Cadera de un Hospital Universitario, entre Julio de 2014 y Julio de 2018. Se evaluó el estado nutricional con Mini Nutritional Assessment Short-Form (MNA-SF) al ingreso hospitalario. La capacidad funcional motora fue evaluada con escala de Parker (EP) basal, a los tres y 12 meses. Resultados: Se incluyeron 1,253 pacientes. 49.92% (IC95% 47.12-52.72) estaba malnutrido. La mortalidad anual de los bien nutridos (BN) fue de 9.45% (IC95% 7.23-12.30) contra 21.52% (IC95% 18.12-25.45; p ≤ 0.001) de los malnutridos (MN). El riesgo de muerte se asoció a la malnutrición HR 2.45 (IC95% 1.75-3.43; p ≤ 0.001). Luego de ajustarlo por edad, sexo, fragilidad, AVD, índice de comorbilidades de Charlson y demencia, el riesgo se mantuvo HR 1.71 (IC95% 17-2.49; p = 0.005). Con respecto a la funcionalidad, la mediana de la escala de Parker (EP) basal para el grupo BN fue 9 (RIC6-9) y para MN fue 5 (RIC3-9) p < 0.001, a los tres meses 6 (RIC3-6) y 4 (RIC2-6) p ≤ 0.001 y a los 12 meses 6 (RIC4-7) y 3 (RIC2-6) p < 0.001. Conclusiones: Existe asociación entre la malnutrición del anciano con fractura de cadera y su mortalidad al año, asimismo una diferencia en la funcionalidad motora.

Abstract: Introduction: Malnutrition is a common problem in the elderly population but has not been fully studied in elderly people with hip fractures. The goal is to estimate annual mortality based on nutrition in the elderly with hip fracture and compare motor functionality. Material and methods: Retrospective cohort of patients over 65 years of age with hip fracture included in the Institutional Register of The Elderly with Hip Fracture of a University Hospital, between July 2014 and July 2018. Nutritional status with Mini Nutritional Assessment Short-Form (MNA-SF) was assessed at hospital admission. Motor functional capacity was evaluated with Parker Scale (PS) basal, at three and 12 months. Results: 1,253 patients were included. 49.92% (CI95% 47.12-52.72) were malnourished. The annual mortality of the well-nourished (WN) was 9.45% (CI95% 7.23-12.30) against 21.52% (CI95% 18.12-25.45; p ≤ 0.001) of the malnourished (MN). The risk of death was associated with malnutrition HR 2.45 (CI95% 1.75-3.43; p ≤ 0.001). After adjusting it by age, sex, fragility, AVD, Charlson comorbility index and dementia, the risk remained HR 1.71 (CI95% 17-2.49; p = 0.005). With respect to functionality, the basal Parker Scale median (EP) for the WN group was 9 (RIC6-9) and for MN was 5 (RIC3-9) p < 0.001, 6 months (RIC3-6) and 4 (RIC2-6) p ≤ 0.001 and 12 months 6 (RIC4-7) and 3 (RIC2-6) p < 0.001. Conclusions: There is an association between the malnutrition of the elderly with hip fracture and its mortality with a year of evaluation; we also find a difference in motor functionality.

V-band nanosecond-scale pulse reflectometer diagnostic in the TCV tokamak.

This article describes the realization of a novel approach to short pulse (∼1 ns) reflectometry (SPR) recently implemented in the tokamak configuration variable tokamak. Taking advantage of a fast arbitrary waveform generator and vector-network-analyzer extension modules, the design offers flexibility regarding pulse output frequency, duration, and repetition rate. Such flexibility allows the instrument to overcome traditional SPR spatial sampling limitations while reducing hardware complexity. In order to measure the group-delay of nanosecond-scale pulses, both traditional analog and novel digital sampling techniques have been explored. A group-delay range resolution of 17 ps (2.6 mm) in average over the V-band has been achieved with both timing techniques against a waveguide mirror featuring 10 dB power fluctuations. Direct pulse sampling during L-mode plasmas shows that reflected pulse widths increase only by 4% in average. However, pulse width dispersion does occur in L-mode plasmas and leads to an increase in the group-delay uncertainty up to 40 ps (6 mm). Raw histograms of group-delay data show interesting qualitative changes from the L mode to the H-mode. Frequency spectra of group-delay data allow the identification of macroscopic density fluctuations as well as edge quasicoherent modes during edge-localized mode-free H-modes. Finally, fast changes to the density profile have been measured with microsecond time resolution and subcentimeter spatial resolution in both O and X-mode polarizations.

V-band Doppler backscattering diagnostic in the TCV tokamak.

A variable configuration V-band heterodyne Doppler back-scattering diagnostic has been recently made operational in the tokamak à configuration variable. This article describes the hardware setup options, flexible quasi-optical launcher antenna, data-analysis techniques, and first data. The diagnostic uses a fast arbitrary waveform generator as the main oscillator and commercial vector network analyzer extension modules as the main mm-wave hardware. It allows sweepable single or multi-frequency operation. A flexible quasi-optical launcher antenna allows 3D poloidal (10°-58°) and toroidal (-180° to 180°) steering of the beam with 0.2° accuracy. A pair of fast HE11 miter-bend polarizers allow flexible coupling to either O or X mode and programmable polarization changes during the shot. These have been used to measure the magnetic-field pitch angle in the edge of the plasma by monitoring the backscattered signal power. Ray-tracing simulations reveal an available k⊥ range between 3 and 16 cm-1 with a resolution of 2-4 cm-1. Perpendicular rotation velocity estimates compare well against ExB plasma poloidal rotation estimates from charge exchange recombination spectroscopy.

Desprendimiento del epitelio pigmentario de la retina en la retinopatía por malaria / Detachment of retinal pigment epithelium in retinopathy due to malaria

CASO CLÍNICO: Varón de 45 años de edad, acude diagnosticado de paludismo con afectación neurológica. Dos meses más tarde refiere metamorfopsia en el ojo izquierdo. En el fondo de ojo se aprecia retinopatía palúdica bilateral, observándose en la tomografía de coherencia óptica (OCT) macular un desprendimiento del epitelio pigmentario (DEP) parafoveal en el ojo izquierdo. Se inicia tratamiento específico antipalúdico, evidenciándose desaparición de la retinopatía. DISCUSIÓN: El Plasmodium falciparum es responsable de la retinopatía en el paludismo neurológico. Debiéndose realizar en estos pacientes una exploración fundoscópica y OCT macular porque está asociado a una mortalidad mayor cuando existe afectación retiniana

CASE REPORT: A 45-year-old man was diagnosed with malaria with neurological involvement. Two months later he referred metamorphopsia in the left eye. Malarial retinopathy was observed in the fundus examination. The Optic Coherence Tomography (OCT) of the macula showed parafoveal pigment epithelium detachment (DEP). Specific anti-malarial treatment was initiated, with the disappearance of the retinopathy being observed. DISCUSSION: Plasmodium falciparum is responsible for the retinopathy in neurological malaria. A funduscopic examination and macular OCT should be performed in these patients, as it is associated with a higher mortality when there is a retinal involvement

Detachment of retinal pigment epithelium in retinopathy due to malaria. / Desprendimiento del epitelio pigmentario de la retina en la retinopatía por malaria.

CASE REPORT: A 45-year-old man was diagnosed with malaria with neurological involvement. Two months later he referred metamorphopsia in the left eye. Malarial retinopathy was observed in the fundus examination. The Optic Coherence Tomography (OCT) of the macula showed parafoveal pigment epithelium detachment (DEP). Specific anti-malarial treatment was initiated, with the disappearance of the retinopathy being observed. DISCUSSION: Plasmodium falciparum is responsible for the retinopathy in neurological malaria. A funduscopic examination and macular OCT should be performed in these patients, as it is associated with a higher mortality when there is a retinal involvement.

Variante genética del síndrome de Stickler / Genetic variant of Stickler's syndrome

Casos clínicos: Se remiten para estudio tres pacientes miopes de una misma familia por presentar vítreo degradado de manera severa, membranas ecuatoriales, hiperplasia del epitelio pigmentario de la retina, envainamiento vascular y esclerosis de predominio periférico. Se solicita estudio genético que confirma el diagnóstico de síndrome de Stickler con una variante en la mutación del gen COL2A1. Discusión: El síndrome de Stickler se debe sospechar en familias que presenten un fenotipo característico con sinéresis vítrea y las referidas alteraciones en la retina, pudiendo existir en ocasiones variantes genéticas que no expresan en su totalidad el fenotipo clásico (AU)

Cases reports: Three myopic components of a same family came for study because presented severely degraded vitreous, equatorial membranes, retinal pigment epithelium hyperplasia, vascular sheathed and sclerosis of peripheral predominance. A genetic study confirmed the diagnosis of Stickler syndrome with a variant in the mutation of the COL2A1 gene. Discussion: Stickler's syndrome should be suspected in families with a characteristic phenotype with vitreous syneresis and alterations in the retina, but there may be genetic variants that do not express the classic phenotype (AU)

Retinopatía MEK. Casos clínicos / MEK Retinopathy. Clinical case reports

CASOS CLÍNICOS: Se presentan 3 casos clínicos de retinopatía MEK asociados al uso de la combinación de cobimetinib y vemurafenib, caracterizados por la alteración del epitelio pigmentario de la retina y desprendimiento neurosensorial. Dos de ellos conservaron la visión de la unidad, el tercero desarrolló un gran desprendimiento neurosensorial bilateral con una agudeza visual final de 0,6 en el ojo derecho y de 0,1 en el izquierdo. DISCUSIÓN: Las nuevas estrategias terapéuticas frente al melanoma cutáneo metastásico condicionan la aparición de alteraciones del epitelio pigmentario de la retina con desprendimientos serosos, lo que obliga a una vigilancia estrecha bajo tomografía de coherencia óptica macular

CASE REPORTS: Three clinical cases are presented of MEK retinopathy associated with the combination of cobimetinib and vemurafenib characterised by alteration of the retinal pigment epithelium and neurosensory detachment. Two of the cases conserved the vision of the unit, and the third developed a large bilateral neurosensory detachment with final visual acuity of 0.6 for the right eye and 0.1 for the left one. DISCUSSION: The new therapeutic strategies against metastatic cutaneous melanoma condition the appearance of alterations of the pigmentary epithelium of the retina with serous detachments, leading to close monitoring with macular optical coherence tomography

MEK Retinopathy. Clinical case reports. / Retinopatía MEK. Casos clínicos.

CASE REPORTS: Three clinical cases are presented of MEK retinopathy associated with the combination of cobimetinib and vemurafenib characterised by alteration of the retinal pigment epithelium and neurosensory detachment. Two of the cases conserved the vision of the unit, and the third developed a large bilateral neurosensory detachment with final visual acuity of 0.6 for the right eye and 0.1 for the left one. DISCUSSION: The new therapeutic strategies against metastatic cutaneous melanoma condition the appearance of alterations of the pigmentary epithelium of the retina with serous detachments, leading to close monitoring with macular optical coherence tomography.

Genetic variant of Stickler's syndrome. / Variante genética del síndrome de Stickler.

CASES REPORTS: Three myopic components of a same family came for study because presented severely degraded vitreous, equatorial membranes, retinal pigment epithelium hyperplasia, vascular sheathed and sclerosis of peripheral predominance. A genetic study confirmed the diagnosis of Stickler syndrome with a variant in the mutation of the COL2A1 gene. DISCUSSION: Stickler's syndrome should be suspected in families with a characteristic phenotype with vitreous syneresis and alterations in the retina, but there may be genetic variants that do not express the classic phenotype.

Mácula en cúpula asociada a la retinocoroidosis miópica. Utilidad de la espironolactona / Dome shaped macula associated with myopic retinochoroidosis. Use of spironolactone

Casos clínicos: Se presentan los casos de 3 mujeres de 22, 36 y 55 años de edad con retinocoroidosis miópica bilateral. Las pacientes presentan disminución de agudeza visual unilateral, tonometría y biomicroscopia bilateral normal. En la funduscopia se evidencia maculopatía unilateral, y en la tomografía de coherencia óptica (OCT), mácula en cúpula con desprendimiento neurosensorial (DNS). Iniciado tratamiento con espironolactona, en todos los casos se comprueba mejoría por OCT. Discusión: Se discute el mecanismo etiopatogénico de la mácula en cúpula. La OCT se demuestra como técnica fundamental en el seguimiento de esta patología. Tras la evidencia mostrada, se postula tratamiento inicial con espironolactona (AU)

Cases reports: The cases are presented of three women of 22, 36 and 55 years old with bilateral myopic retinochoroidosis. They had unilateral decreased visual acuity, normal bilateral tonometry, and biomicroscopy. Funduscopy showed bilateral and unilateral myopic maculopathy, and Optical Coherence Tomography (OCT) showed a dome shaped macula with neurosensory detachment. Treatment was started with spironolactone and an improvement by OCT was shown in all cases. Discussion: The etiopathogenic mechanism of the dome shaped macula is discussed. OCT demonstrated to be the fundamental test in the follow-up of this condition. After the evidence shown, initial treatment with spironolactone is suggested (AU)