RESUMEN
PURPOSE: To evaluate preliminarily and compare the level of plasmatic biomarkers of vascular risk in patients with and without exudative age-related macular degeneration (ARMD) and to relate it to vascular resistance alterations in the ophthalmic artery (OA), central retinal artery (CRA), posterior temporal ciliary artery (PTCA), and posterior nasal ciliary artery (PNCA). METHODS: Color Doppler imaging of the OA, CRA, PTCA, and PNCA was performed in 30 eyes of 30 cataract patients (control group) as well as in 30 eyes of 30 patients with naive exudative ARMD (study group), measuring the peak systolic velocity, end-diastolic velocity (EDV), and Pourcelot resistive index (RI). Likewise, in both groups, a blood test was performed to determine the plasmatic levels of homocysteine, C-reactive protein (CRP), B12 vitamin, and folic acid. RESULTS: A positive and significant correlation was found between the level of CRP and RI of the OA in the ARMD group (r = 0.498, P = 0.005), with an increased RI in all arteries compared to controls, although differences only reached statistical significance for the PTCA (P = 0.035). Likewise, a significantly lower EDV for the CRA was found in ARMD eyes compared to controls (P = 0.041). In the study group, significantly higher plasmatic levels of homocysteine (P = 0.042) and CRP (P = 0.046) were found. In contrast, no significant differences were found between groups in the levels of folic acid (P = 0.265) and B12 vitamin (P = 0.520). CONCLUSION: The decrease of the choroidal perfusion related to hyperhomocysteinemia, and increase in the CRP plasmatic levels may play an etiological role on the exudative ARMD. This should be investigated in future studies with larger samples of patients.
Asunto(s)
Biomarcadores/sangre , Circulación Sanguínea/fisiología , Arteria Oftálmica/diagnóstico por imagen , Órbita/irrigación sanguínea , Ultrasonografía Doppler en Color/métodos , Degeneración Macular Húmeda/diagnóstico , Anciano , Anciano de 80 o más Años , Proteína C-Reactiva/metabolismo , Arterias Ciliares/diagnóstico por imagen , Arterias Ciliares/fisiopatología , Femenino , Ácido Fólico/sangre , Homocisteína/sangre , Humanos , Masculino , Persona de Mediana Edad , Arteria Oftálmica/fisiopatología , Órbita/diagnóstico por imagen , Proyectos Piloto , Arteria Retiniana/diagnóstico por imagen , Arteria Retiniana/fisiopatología , Índice de Severidad de la Enfermedad , Vitamina B 12/sangre , Degeneración Macular Húmeda/sangre , Degeneración Macular Húmeda/fisiopatologíaRESUMEN
El juego patológico afecta entre el 0.4% y el 1.5% de la población mundial. Aunque existen procedimientos terapéuticos eficaces, la escasa adherencia terapéutica y las recaídas amenazan los resultados. El objetivo es determinar la relación entre el apoyo social, la adherencia terapéutica y el cese del juego. Se evaluó convivencia, acompañamiento, implicación e intervención del acompañante en una muestra de 68 jugadores patológicos. Los resultados muestran una asociación no significativa entre apoyo social y adherencia al tratamiento y éxito terapéutico. Se mantuvieron en tratamiento el 76.0% de los que tenían apoyo social alto frente al 42.1% que tenían apoyo social bajo. El éxito terapéutico presenta una asociación significativa con el estado civil. Las personas que mantienen una relación de pareja estable tienen el doble de probabilidad de finalizar el tratamiento con éxito. Los resultados sugieren considerar el apoyo social como una variable decisiva en el tratamiento de la ludopatía
Pathological gambling affects 0.4-1.5 percent of the global population. Therapy has proved effective, even though low therapeutic compliance and frequent withdrawals weakens good treatment results. The aim of this paper is to evaluate the relationship between social support, therapeutic adherence, and gambling cessation. Four aspects of social support were measured: cohabitation, patient's companion, commitment, and intervention with patient's companion, in a sample of 68 pathological gamblers. Results show a non-significant trend for social support and treatment compliance to be associated to treatment success. Seventy-six percent of high social support patients kept the treatment up to the end vis-à-vis42.1% of low social support patients. Therapeutic success shows a significant relationship to a stable couple relationship. Individuals who had stable couple relationship were twice likely to finish treatment successfully. Results suggest that social support should be considered as a critical variable in pathological gambling treatment
