Thrombophilic mutations: no association with thrombotic events in renal transplant recipients.

Factor V Leiden and mutation of prothrombin gene G20210A have been associated with poor results in the early post-kidney transplantation period. Its long-term importance in stable patients has yet to be evaluated. We studied the prevalence of these inherited mutations and their relationship to thrombotic events in 82 Argentine renal transplant recipients with adequate long-term kidney function. In aggregate, 7.2% of patients were carriers of these mutations; however, their presence did not show any association with thrombotic events or renal function alterations. The routine evaluation for these mutations does not seem to be cost-effective in renal transplant patients.

[Correlation between intraocular pressure, paquimetry and keratometry in a normal population]. / Correlación entre presión intraocular, paquimetría y queratometría en una población normal.

PURPOSE: To study the intraocular pressure (IOP), the corneal thickness and the corneal curvature distribution in a normal population. To investigate the relation between these variables, and to determine if the IOP and the paquimetry will be modified by the refractive error and age. METHODS: A population of 273 subjects, 545 eyes, without ocular pathology was selected. The refractive error, the corneal curvature, the corneal thickness and the IOP [with a non-contact tonometer (NCT) and with a Goldmann tonometer (GT)] were evaluated. RESULTS: The average age of the population was 49.34 (SD 7.23) years (27-68). The average corneal thickness was 544.3 (SD 33) mm in females and 543.1 (SD 29) mm in males. An inverse correlation was found between corneal thickness and age but this was not significant statistically. A mildly statistically significant correlation was found between corneal thickness and intraocular pressure with both methods of measurement of IOP: r = 0.316 (p < 0,001) and r = 0.264 (p < 0,001), with NCT and GT respectively. No correlation was found between corneal thickness and refractive error, or with mean corneal curvature. In the regression model, corneal thickness and mean corneal curvature were significant in the IOP prediction: R = 0.341 (p < 0.001). CONCLUSION: Mean corneal thickness was very similar to that reported in other studies of a latin population. A statistically significant inferior corneal thickness has been found in people older than 54 years. The relationship between the corneal thickness and the corneal curvature with the IOP has been calculated by linear regression analyses.

Correlación entre presión intraocular, paquimetría y queratometría en una población normal / Correlation between intraocular pressure paquimetry and keratometry in a normal population

Objetivo: Estudiar la distribución de la presión intraocular (PIO), paquimetría y queratometría en una población normal. Establecer las relaciones existentes entre estas variables y conocer la influencia de la edad y el estado refractivo. Métodos: En una muestra de 545 ojos de 273 sujetos, sin patología ocular previa, se ha evaluado el estado refractivo, curvatura corneal, grosor corneal central, PIO mediante tonometría de no contacto (TNC) y tonometría Goldman (TG). Resultados: La media de edad de la población fue de 49,34 DE 7,23 años (27-68). La paquimetría media fue de 544,3 DE 33 Ìm en mujeres y de 543,1 DE 29 Ìm en hombres. No se ha encontrado una asociación relevante entre paquimetría y edad. Se ha obtenido una correlación leve, pero significativa entre la paquimetría y la cifra de PIO para ambos métodos r = 0,316 (p < 0,001) y r = 0,264 (p < 0,001), con TNC Y TG respectivamente. No encontramos relación de la paquimetría ni con el estado refractivo ni con la K media. En nuestro modelo de regresión múltiple la paquimetría y la K media aparecieron como variables predictoras del cálculo de la PIO: R = 0,341 (p < 0,001). Conclusiones: La medida de espesor corneal central fue similar a la obtenida por otros estudios sobre población latina. Existe una paquimetría significativamente menor en el grupo de mayores de 54 años. Se ha definido la relación del grosor y la curvatura corneal con la PIO mediante un análisis de regresión lineal

Purpose: To study the intraocular pressure (IOP), the corneal thickness and the corneal curvature distribution in a normal population. To investigate the relation between these variables, and to determine if the IOP and the paquimetry will be modified by the refractive error and age. Methods: A population of 273 subjects, 545 eyes, without ocular pathology was selected. The refractive error, the corneal curvature, the corneal thickness and the IOP [with a non-contact tonometer (NCT) and with a Goldmann tonometer (GT)] were evaluated. Results: The average age of the population was 49.34 (SD 7.23) years (27-68). The average corneal thickness was 544.3 (SD 33) mm in females and 543.1 (SD 29) mm in males. An inverse correlation was found between corneal thickness and age but this was not significant statistically. A mildly statistically significant correlation was found between corneal thickness and intraocular pressure with both methods of measurement of IOP: r = 0.316 (p < 0,001) and r = 0.264 (p < 0,001), with NCT and GT respectively. No correlation was found between corneal thickness and refractive error, or with mean corneal curvature. In the regression model, corneal thickness and mean corneal curvature were significant in the IOP prediction: R = 0.341 (p < 0.001). Conclusion: Mean corneal thickness was very similar to that reported in other studies of a latin population. A statistically significant inferior corneal thickness has been found in people older than 54 years. The relationship between the corneal thickness and the corneal curvature with the IOP has been calculated by linear regression analyses

[Comparative study between the non-contact pneumotonometer Canon TX10 and the Goldmann tonometer]. / Estudio comparativo entre el neumotonómetro de no contacto Canon TX-10 y el tonómetro de Goldmann.

PURPOSE: To study and contrast the measurement of intraocular pressure (IOP) with an air non-contact tonometer (Canon TX-10) with that obtained with the Goldmann tonometer. METHODS: Intraocular pressure was measured in 649 subjects with both the pneumotonometer and the Goldmann tonometer. Statistically significant differences between the results obtained by both tonometers and the influence of variables including age, corneal thickness, and corneal curvature were studied. RESULTS: The mean age of the study population was 48.5 years, standard deviation (SD) 7.6 years, with a range of 22-68 years. The mean IOP was 15.4, SD 2.7 mm Hg, (range 8-25) with the Goldmann tonometer and 15.6, SD 2.9 mm Hg (range 8-29) with the pneumotonometer. There was a statistically significant difference between the measurements using the air pneumotonometer and the Goldmann tonometer (p<0.001). The mean of the differences between both tonometers was 0.24, SD 2 mm Hg. Seventy-five percent of measurements were in the range of +/-1, 85% in +/-2, and 95% in the Bland and Altman's interval of 4.42, -3.94. These differences were more significant for higher values of IOP, in thicker corneas and in corneas with greater curvature. A correlation between IOP and age was not found (p=0.247). CONCLUSIONS: The pneumotonometer is a useful and reliable instrument for measuring the IOP providing there is additional checking in cases with borderline values of IOP, or excessive corneal thickness and/or curvature.

Estudio comparativo entre el neumotonómetro de no contacto Canon TX-10 y el tonómetro de Goldman / Comparative study between the non-contact pneumotonometer Canon TX10 and the Goldman tonometer

Propósito: Estudiar y comparar las medidas de la presión intraocular (PIO) tomadas mediante un tonómetro de no contacto de aire (CANON TX-10), con las obtenidas con el tonómetro de Goldmann.Métodos: Se ha explorado la PIO en 649 sujetos, con neumotonómetro y tonómetro de Goldmann. Se analizan la existencia de diferencias significativas y la influencia que las variables de edad, espesor y curvatura corneal tienen sobre la PIO.Resultados. La edad media de la población estudiada fue de 48,5 años, con desviación estándar (DE) de 7,6 años (rango entre 22-68). La media de la PIO fue de 15,4 DE 2,7 mmHg (8-25) para el tonómetro de Goldmann y de 15,6 DE 2,9 mmHg (8-29) para el neumotonómetro. Se encontraron diferencias significativas entre las medidas tomadas con el neumotonómetro de aire y el de Goldmann. p<0,001 La media de las diferencias de presión entre ambos tonómetros fue de 0,24 DE de 2 mmHg; el 75% de las mismas estuvieron dentro del rango de ±1, el 85% en ±2, y el 95% en el intervalo definido por Bland y Altman de 4,42, –3,94. Estas diferencias fueron más significativas en niveles límite de PIO, en las corneas más gruesas y con radios corneales extremos. No se ha encontrado correlación entre las cifras de la PIO y la edad (p= 0,247).Conclusiones: La medida de la PIO con un neumotonómetro de no contacto es un método útil y fiable y únicamente podría requerir comprobación en casos de valores extremos de PIO y en córneas de espesor y radios de medidas límite

Purpose: To study and contrast the measurement of intraocular pressure (IOP) with an air non-contact tonometer (Canon TX-10) with that obtained with the Goldmann tonometer. Methods: Intraocular pressure was measured in 649 subjects with both the pneumotonometer and the Goldmann tonometer. Statistically significant differences between the results obtained by both tonometers and the influence of variables including age, corneal thickness, and corneal curvature were studied. Results: The mean age of the study population was 48.5 years, standard deviation (SD) 7.6 years, with a range of 22-68 years. The mean IOP was 15.4, SD 2.7 mm Hg, (range 8-25) with the Goldmann tonometer and 15.6, SD 2.9 mm Hg (range 8-29) with the pneumotonometer. There was a statistically significant difference between the measurements using the air pneumotonometer and the Goldmann tonometer (p<0.001). The mean of the differences between both tonometers was 0.24, SD 2 mm Hg. Seventy-five percent of measurements were in the range of ±1, 85% in ±2, and 95% in the Bland and Altman’s interval of 4.42, -3.94. These differences were more significant for higher values of IOP, in thicker corneas and in corneas with greater curvature. A correlation between IOP and age was not found (p=0.247). Conclusions: The pneumotonometer is a useful and reliable instrument for measuring the IOP providing there is additional checking in cases with borderline values of IOP, or excessive corneal thickness and/or curvature

[Epidemiologic study of ocular emergencies in a general hospital]. / Estudio epidemiológico de las urgencias oftalmológicas en un hospital general.

PURPOSE: To provide epidemiological data about patients attending an ophthalmic emergencies center of a general hospital. METHODS: A retrospective analysis of all patients attending the emergency department (ED) of Rio Hortega Hospital during a 9-month period was carried out. Pathology was identified by International Classification of Diseases ((ICD9-CM) codes. RESULTS: A total of 2914 visits have been examined: 6% of patients were under 20 years of age, 35.4% between 21-50, 29% between 51-70, and 23.3% over 71 years. Thirteen per cent of visits were due to injuries, 50.7% of which occurred in patients 21 to 50 years old. Almost half of visits were due to inflammatory conditions of the cornea, conjunctiva and eyelids. CONCLUSIONS: ED plays a major role in the ophthalmology departments in a hospital. Certainly a considerable proportion of these patients had conditions which could have been dealt with in an ophthalmic outpatient clinic or by general practitioners. Ocular trauma is a common cause of visits to the ED.

[Cost-effectivity analysis of the most used antiglaucoma drugs]. / Análisis coste-eficacia hipotensora de los fármacos antiglaucomatosos más utilizados.

PURPOSE: To evaluate the yearly cost and the cost-effectiveness of commercially available topical products in treatment of glaucoma. METHODS: This analysis evaluates 12 topical agents in glaucoma: Betoptic, Betagan, Timoftol, Timogel, Alphagan, Lumigan, Travatan, Xalatan, Trusopt, Azopt. The number of drops per bottle of glaucoma medications is determined for all commercially tested products. The yearly cost of the dosage schedules was compared. We selected for each one 5 to 10-reported comparative hypotensive efficacy studies and we calculated the cost-effectiveness as the ratio between the yearly cost and the mean hypotensive efficacy. RESULTS: The range of hypotensive efficacy of monotherapy components is from 13.8% to 31.9%. Lumigan and Xalatan present the highest hypotensive efficacy, 31.9% and 28.6% respectively. The cheapest medication is the beta-blockers group. The cost-efficacy ratio of glaucoma therapy is 1.5 for Timoftol, 2.8 for Betagan, 9.6 for Alphagan, 9.1 for Lumigan, 10.7 for Xalatan and 11.3 for Travatan. CONCLUSIONS: Over time, Lumigan is significantly most effective in controlling IOP. The cost-effectiveness for managing IOP will depend on both price and hypotensive efficacy. The beta-blockers group has lower hypotensive efficacy than prostaglandin analogs but cost-effectiveness is better in the former because of its low price.

[Acute and bilateral uveitis secondary to moxifloxacin]. / Uveítis anterior aguda bilateral secundaria a moxifloxacino.

CASE REPORT: We report a case of a 77-year-old woman with an anterior acute bilateral uveitis and pigmentary dispersion after treatment of a neumococic pneumonia with moxifloxacin. Her response to treatment was good but she presented as a result of treatment abundance of pigment over all the structures of the anterior segment. DISCUSSION: Many drugs can produce uveitis. After Med-line revision, we can not find any previously reported case of anterior Uveitis associated with fourth generation quinolones.

Análisis coste-eficacia hipotensora de los fármacos antiglaucomatosos más utilizados / Cost-effectivity analysis of the most used antiglaucoma drugs

Objetivo: Evaluar el coste/año y el coste/eficacia hipotensora de los fármacos tópicos antiglaucomatosos. Métodos: Este análisis evalúa 12 fármacos: Betoptic, Betagan, Timoftol, Timogel, Alphagan, Lumigan, Travatan, Xalatan, Trusopt, Azopt. Se analizan el numero de gotas por bote de colirio para todos los fármacos comerciales. Se compara el coste/año de los fármacos a las pautas recomendadas. Se han seleccionado de 5 a 10 análisis comparables de eficacia hipotensora de cada uno de los fármacos, y se calcula el coste eficacia hipotensora como el ratio entre el coste anual y la eficacia hipotensora media. Resultados: El rango de eficacia hipotensora de los fármacos en monoterapia se encuentra entre 13,8 y 31,9 por ciento. Lumigan y Xalatan presentan las eficacias hipotensoras más altas, 31,9 y 28,6 por ciento respectivamente. Los costes anuales más altos son para los fármacos análogos de las prostaglandinas, siendo los más bajos los del grupo de beta bloqueantes. El ratio coste eficacia hipotensora es de 1,5 para timoftol, 2,8 para Betagan, 9,6 para Alphagan, 9,1 para Lumigan, 10,7 para Xalatan, 11,3 para Travatan. Conclusiones: Lumigan es significativamente el más eficaz en controlar la presión intraocular. El análisis coste eficacia hipotensora depende del precio y la eficacia hipotensora. El grupo de beta-bloqueantes presenta una eficacia hipotensora menor que los análogos de las prostaglandinas, y sin embargo por su bajo precio el ratio coste eficacia hipotensora es más bajo (AU)

Uveítis anterior aguda bilateral secundaria a moxifloxacino / Acute and bilateral uveitis secondary to moxifloxacin

Caso clínico: Se presenta el caso de una paciente de 77 años que tras tratamiento de una neumonía neumocócica con Moxifloxacino presentó una uveítis anterior aguda bilateral con dispersión de pigmento en ambos ojos (A.O.). Su respuesta al tratamiento fue buena, presentando como secuela persistencia de abundante pigmento sobre todas las estructuras del segmento anterior. Discusión: Son numerosos los fármacos capaces de producir uveítis anterior. Tras una revisión bibliográfica, no encontramos ningún caso descrito de esta patología asociada con el empleo de quinolonas de 4.ª generación(AU)

Case report: We report a case of a 77-year-old woman with an anterior acute bilateral uveitis and pigmentary dispersion after treatment of a neumococic pneumonia with moxifloxacin. Her response to treatment was good but she presented as a result of treatment abundance of pigment over all the structures of the anterior segment. Discussion: Many drugs can produce uveitis. After Med-line revision, we can not find any previously reported case of anterior Uveitis associated with fourth generation quinolones(AU)