Características morfológicas del nervio óptico evaluadas por el tomógrafo láser confocal (HRT3) y polarimetría láser (GDx-VCC) en población normal en la ciudad de Barcelona / Morphological characteristics of the optic nerve evaluated by confocal laser tomography (HRT3) and laser polarimetry (GDx-VCC) in a normal population from the city of Barcelona

OBJETIVO: Evaluar parámetros morfológicos de papila y capa de fibras nerviosas de la retina (CFNR) explorados con el HRT3 y el GDx-VCC en población normal y analizar correlaciones con variables demográficas. PACIENTES Y MÉTODOS: Estudio observacional transversal en el contexto de una campaña de detección de glaucoma en un centro de atención primaria de Barcelona. Se seleccionaron sujetos caucásicos de ascendencia mediterránea, no hipertensos y con riesgo de glaucoma (≥ 60 años o ≥ 40 años con alguno de los siguientes factores de riesgo: antecedentes familiares de glaucoma o de presión intraocular alta o miopía > 3 dioptrías). Se realizó exploración oftalmológica completa incluyendo tomografía láser confocal (HRT3) y polarimetría láser de barrido (GDX-VCC). Todos los sujetos incluidos presentan las pruebas dentro de la normalidad. Se analizaron parámetros estructurales con edad, refracción y paquimetría mediante el test de Spearman. RESULTADOS: Doscientos veinticuatro sujetos incluidos con una media de edad de 63,4 ± 11,1 años. Áreas de disco, excavación y anillo de 2,14 ± 0,52 mm2; 0,44 ± 0,34 mm2 y 1,69 ± 0,38 mm2, respectivamente. Valor medio de la CFNR (GDX) 55,9 ± 6,9 μm. La edad se correlacionó con menor volumen del anillo, mayor índice de morfología de la excavación, mayor profundidad media y máxima de la excavación y menor índice de fibras nerviosas y CFNR (p < 0,05). CONCLUSIÓN: Se proporcionan valores medios y distribución de numerosos parámetros de la papila y la CFNR en población caucásica normal de ascendencia mediterránea. Se observó una pérdida de espesor de la CFNR, adelgazamiento del anillo y aumento de la excavación con la edad

OBJECTIVE: To evaluate morphological parameters of optic disc and retinal nerve fiber layer (RNFL) examined with confocal laser tomography (HRT3) and laser polarimetry (GDx-VCC) in a normal population, and analyze correlations of these parameters with demographic variables. PATIENTS AND METHODS: Cross-sectional study in the context of a glaucoma screening campaign in the primary care center of Barcelona. The individuals selected were non-hypertensive Mediterranean Caucasians with risk for glaucoma development (individuals ≥ 60 years old or ≥ 40 years old with family history of glaucoma or intraocular pressure or myopia > 3 diopter). All subjects underwent a complete ophthalmic examination, confocal laser tomography (HRT3) and scanning laser polarimetry (GDX-VCC), subjects with results within normal limits only being included. Structural parameters were analyzed along with age, refraction, and pachymetry based on the Spearman rank correlation test. RESULTS: A total of 224 subjects included, with a mean age of 63.4 ± 11.1 years. Disc areas, excavation and ring area were 2.14 ± 0.52 mm2, 0.44 ± 0.34 mm 2 and 1.69 ± 0.38 mm2, respectively. The mean RNFL (GDX) was 55.9 ± 6.9 μm. Age was correlated with lower ring volume, highest rate of cup shape measure, largest mean and maximum cup depth, lower nerve fiber index (NFI) and RNFL (all p-values below .05). CONCLUSION: The mean values and distribution of several parameters of the papilla and the RNFL in normal Mediterranean Caucasians population are presented. A loss of thickness of the RNFL, ring thinning, and enlarged cup was observed with increased age

Level of acceptance of solid organ xenotransplantation among personnel in Spanish, Mexican, and Cuban hospitals.

BACKGROUND: Xenotransplantation is still a long way from becoming a clinical reality. However, in an emergency situation, it could be used as a bridge for replacing vital organs until the arrival of a human organ. To analyze the attitude toward xenotransplantation among hospital personnel from several hospitals in Spain and Latin America. METHODS: A random sample stratified according to the type of hospital and job category (n = 2618) in 10 hospitals in three different countries: Spain (n = 821), Mexico (n = 1595), and Cuba (n = 202). A validated questionnaire (PCID-XenoTx Rios) was self-administered and completed anonymously by the respondents. RESULTS: If the results of xenotransplantation were similar to those achieved using human donor organs, 61% (n = 1591) of the respondents would be in favor, while 9% (n = 234) would be against and 30% (n = 793) would be unsure. The analysis of the variables affecting attitude toward xenotransplantation revealed that attitude varied according to the country of reference and was more favorable among personnel in Cuban hospitals (70% a favor) than in Spanish (57%) and Mexican ones (62%; P = 0.000). However, these differences are mainly determined by job category with the physicians having the most favorable attitude. The ancillary staff, in contrast, had the least favorable attitude (76 vs. 51% respectively; P = 0.000). Of the remaining variables, attitude is significantly related to variables connected to human donation: attitude toward the different kinds of human organ donation (deceased [P < 0.001] and living [P < 0.001]), the possibility of needing a transplant oneself in the future (P < 0.001), and attitude toward donating the organs of a deceased family member (P = 0.004). CONCLUSIONS: A third of healthcare personnel from several hospitals are not in favor of xenotransplantation. It is necessary to provide more information about the matter, especially in hospitals where there is a preclinical xenotransplantation program or where there is access to one, such as in the hospitals in this study.

Detección de glaucoma mediante telemedicina con SisGlaTel: satisfacción y aceptación entre los participantes y problemas detectados / Detección of glaucoma using SisGlaTel: acceptability and satisfaction among participants, and problems detected

Propósito: Evaluar las dificultades y el grado de aceptación y satisfacción entre la población participante durante una campaña de detección de glaucoma por telemedicina. Este trabajo es parte de un estudio global de desarrollo, aplicación y evaluación del SisGlaTel financiado por el Fondo de Investigaciones Sanitarias (FIS) y Pfizer Ophthalmics. Método: Se desarrolló un sistema de telemedicina sobre un programa específico en JAVA™. Se instaló la estación remota en el Centro de Atención Primaria. Los sujetos participantes firmaron un consentimiento informado, y fueron sometidos a varias pruebas diagnósticas (perimetría de duplicación de frecuencia-FDT, oftalmoscopia con láser confocal-HRT y tonometría). Se analizaron los resultados de las pruebas y los problemas observados en la aplicación del sistema. Se realizó una encuesta a 99 personas que acababan de participar voluntariamente en el programa de detección de glaucoma entre población de riesgo. La encuesta incluyó 7 preguntas. Cuatro de ellas requerían evaluar entre muy malo: 1 y excelente: 5 distintos aspectos de la campaña. Resultados: Se evaluaron 641 sujetos con riesgo de sufrir glaucoma. El 22,3% (143) realizaron un FDT patológico y un 4,2% (27) presentaron un HRT patológico. El 100% de los encuestados afirmó su deseo de volver a participar en una campaña similar. La valoración media (DS) fue de 4,5 (0,6), 4,5 (0,6), 4,8 (0,5), y 4,3 (0,7) para la opinión general, la utilidad, la atención recibida, y las instalaciones, respectivamente. Conclusión: El SisGlaTel permite integrar la información de distintas pruebas diagnósticas para detección de glaucoma por telemedicina. El grado de satisfacción entre los participantes fue bueno

Purpose: To evaluate the problems, and the degree of acceptability and satisfaction among participants in a telemedicine screening program. This study forms part of a global project for the design, implementation and evaluation of SisGlaTel funded by the Fondo de Investigaciones Sanitarias (Spain) and Pfizer Ophthalmics. Method: A telemedicine system was built based on a specific program written in JAVA™. The remote station was located at a Primary Care Center. Participants signed an informed consent, and completed a questionnaire and undertook different tests (frequency doubling perimetry-FDT, confocal scanning laser tomografy-HRT and tonometry). Test results and problems detected were analysed. Ninety-nine subjects completed a satisfaction questionnaire after voluntarily participating in the screening program among an at-risk population. The questionnaire included 7 questions, four of which required participants to categorise their responses, ranging from very bad (1) to excellent (5), to questions about the screening program, its usefulness, the care received and the installations. Results: Six hundred and forty-one at-risk subjects were examined. After 2 exams per eye, 22.3% (143) presented abnormal FDT and 4.2% (27) had pathologic HRT. One hundred percent of respondents affirmed they would participate again in a similar program. The mean qualification (SD) was 4.5 (0.6), 4.5 (0.6), 4.8 (0.5), and 4.3 (0.7) for global opinion, usefulness, care and equipment. Conclusion: SisGlaTel allows integration of several diagnostic tests useful for glaucoma tele-screening. The global degree of satisfaction among participants was good (Arch Soc Esp Oftalmol 2008; 83: 533-538)

Grado de satisfacción del usuario tras el traslado de un recién nacido entre hospitales de la misma ciudad / The user’s degree of satisfaction after the transfer of a new born baby between hospitals in the same city

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