Efficacy of an aloe vera, chamomile, and thyme cosmetic cream for the prophylaxis and treatment of mild dermatitis induced by radiation therapy in breast cancer patients (the Alantel study).

Objectives: Radiation-induced dermatitis (RD) is one of the most common toxicities in radiation therapy (RT) patients. Corticosteroids, immunosuppressants, and natural products (NPs) have been used as treatment. The objective was to evaluate the efficacy of a NPs-based cream (Alantel®) to reduce the incidence of RD in women with breast cancer undergoing RT treatment. Design: We conducted a controlled, randomized, double-blind clinical trial. Setting: Radiation Oncology Unit of the Reina Sofía Hospital and 5 Primary Care centers of the Cordoba and Guadalquivir Health District (Spain). Interventions: Patients assigned to the experimental group (GTA) were treated with Alantel, while those in the control group (GTE) were treated with a moisturizer and emollient cream. Main outcome measures: The primary outcome variable was the incidence of RD. RD-free time, duration of RD, quality of life, and product safety were also assessed. Results: Seventy patients were included in the study, 35 in the GTA and 35 in the GTE. The incidence of RD was lower in the GTA (71.4%) than in the GTE (91.4%) after 4 weeks of follow-up (RR = 0.78; NNT = 5; p < 0.031). The Skindex-29 questionnaire showed differences in the statement: "My skin condition makes it hard to work or do hobbies" (17.1% in the GTE vs. 2.9% in GTA; p = 0.024). Conclusions: The higher efficacy of Alantel® compared to the control cream in reducing the incidence of RD in women with breast cancer has been demonstrated.

Self-cleaning cellulose acetate/crystalline nanocellulose/polyvinylidene fluoride/Mg0.975Ni0.025SiO3membrane for removal of diclofenac sodium and methylene blue dye in water.

Recalcitrant pollutants present in wastewater, without an effective treatment, have several effects on aquatic ecosystems and human health due to their chemical structure and persistence. Therefore, it is crucial the development of efficient technologies to eliminate such pollutants in water. Nano-photocatalysts are considered a promising technology for water remediation; however, one common drawback is the difficulty of recovering it after water processing. One effective strategy to overcome such problem is its immobilization into substrates such as polymeric membranes. In this study, a polymeric membrane with embedded Mg0.975Ni0.025SiO3is proposed to remove model pollutants diclofenac sodium and methylene blue dye by synergetic adsorption and photocatalytic processes. Mg0.975Ni0.025SiO3was synthesized by the combustion method. The matrix polymeric blend consisting of a blend of cellulose acetate, crystalline nanocellulose and polyvinylidene fluoride was obtained by the phase inversion method. The composite membranes were characterized by FTIR, x-ray diffraction, and scanning electron microscopy. With pollutant solutions at pH 7, the pollutant adsorption capacity of the membranes reached up to 30% and 45% removal efficiencies for diclofenac sodium and methylene blue, respectively. Under simulated solar irradiation photocatalytic removal performances of 70% for diclofenac sodium pH 7, and of 97% for methylene blue dye at pH 13, were reached. The membrane photocatalytic activity allows the membrane to avoid pollutant accumulation on its surface, given a self-cleaning property that allows the reuse of at least three cycles under sunlight simulator irradiation. These results suggest the high potential of photocatalytic membranes using suitable and economical materials such as cellulosic compounds and magnesium silicates for water remediation.

Efficient solar removal of acetaminophen contaminant from water using flexible graphene composites functionalized with Ni@TiO2:W nanoparticles.

This work presents the morphological, structural and photocatalytic properties of flexible graphene composites decorated with Ni@TiO2:W nanoparticles (TiNiW NPs) with an average size of 27 ± 2 nm. The TiNiW NPs were immobilized on the surface of a flexible graphene composite using a PVA-based slurry-paste (FG/TiNiW composite). The SEM study showed that the TiNiW NPs remained exposed on the surface of the FG/TiNiW composite, which benefited its photocatalytic activity. The photocatalytic performance for the degradation of acetaminophen (ACT) was evaluated using both the TiNiW powders and the FG/TiNiW composite, obtaining maximum degradation efficiencies of 100 and 86%, respectively, after 3 h under natural solar irradiation. The degradation of ACT was caused mainly by the reactive oxygen species such as OH radicals and h+, which was confirmed by scavenger experiments. Photoluminescence, XPS and absorbance experiments revealed that oxygen vacancy defects were created by i) doping the TiNiW NPs with W and by ii) introducing graphene into the composites. These defects enhanced the absorbance of light in the range of 400-800 nm, which in turn, promoted the photocatalytic degradation of ACT. Moreover, the reuse experiments confirmed that both the TiNiW NPs and FG/TiNiW composite were very stable for the degradation of ACT, since degradation efficiencies >82% were obtained after 4 reuse cycles for both photocatalysts. The experimental findings of this work demonstrate that the flexible TiO2/graphene composites are a feasible option for the removal of pharmaceutical contaminants from water using natural solar irradiation.

Saccharification of water hyacinth biomass by a combination of steam explosion with enzymatic technologies for bioethanol production.

In the present work, bioethanol was produced by sugar fermentation obtained from water hyacinth using a novelty hybrid method composed of steam explosion and enzymatic hydrolysis, using hydrolytic enzymes produced by solid-state fermentation and water hyacinth as substrate. The highest activity, 42 U for xylanase and 2 U for cellulase per gram of dry matter, respectively, was obtained. Steam explosion pretreatment was performed at 190 â„ƒ for 1, 5, and 10 min, using water hyacinth sampled from the Maria Lizamba Lagoon, the Arroyo Hondo and the Amapa River. The highest amounts of reducing sugars of water hyacinth were obtained form the samples from the lagoon (5.4 g/50 g of dry matter) after 10 min of treatment. Steamed biomass was hydrolysed using the enzymes obtained by solid-state fermentation, obtained reducing sugars (maximum 15.5 g/L); the efficiency of enzymatic hydrolysis was 0.51 g of reducing sugars per gram of water hyacinth. Finally, reducing sugars were fermented using Saccharomyces cerevisiae for conversion to ethanol, with the highest ethanol concentration (7.13 g/L) and an ethanol yield of 0.23 g/g of dry matter.

Spatiotemporal pattern of glucose in a microfluidic device depend on the porosity and permeability of the medium: A finite element study.

BACKGROUND: Glucose plays an important role as a source of nutrients and influence cellular processes such as differentiation, proliferation and migration. In vitro models based on microfluidic devices represent an alternative to study several biological processes in a more reproducible and controllable method compared to in vivo models. Glucose concentration across a microfluidic chip and its behavior in experimental conditions is not completely understood. OBJECTIVE: This paper investigated the spatiotemporal distribution of glucose across the hydrogel inside a microfluidic chip. The influence of different parameters, boundary and initial conditions of experiments on glucose concentration was studied. METHODS: A finite element model using a two dimensional geometry was developed. With this model, patterns of glucose concentration were investigated for different combinations of flow rate of culture medium, permeability and porosity of the medium. Patterns were also studied for two hydrogels made of collagen type I and fibrin with different initial and boundary conditions for pressure and glucose concentration. RESULTS: Porosity influenced significantly on the chemical gradients generated when interstitial fluid flow was null or neglectable. A difference in concentration lower than 15% was obtained at the input of microchamber and after 90 min, when porosity changed from 0.5 to 0.99. In addition, no significant effects of modifications in permeability were observed. Regarding the collagen and fibrin matrices, in the presence of a pressure gradient of 40 Pa, the permeability significantly influenced on the concentration gradients generated. CONCLUSIONS: Porosity influences importantly on patterns when diffusion is the main transport mechanism. Permeability is the most influencing parameter when a fluid flow is present. Common insertion rates of culture medium does not significantly modify the patterns of glucose inside the chips. Thus, new experiments must consider the impact of such parameters on the distribution and the time span that nutrients occupy the medium. To better contribute with experimental trials, other studies involving cell-cell and cell-extracellular matrix interactions, and different chip geometries should be developed. The results of the present work could assist to develop specific systems for experimentation, to design new experiments and to improve the analysis of the obtained results.

[Hypothyroidism in adults in a basic health area]. / Hipotiroidismo adulto en una zona básica de salud.

INTRODUCTION: The objective of the present study is to study the prevalence, as well as the clinical and epidemiological characteristics of hypothyroid disease in adults using the computerised clinical records. MATERIAL AND METHODS: Observational, descriptive and cross-sectional study. The target population was the patients of the health centres of Lucena I and II (Córdoba). INCLUSION CRITERIA: Patients 14 years or older, diagnosed with hypothyroidism, born and resident in Lucena. Two hundred and fourteen patients were recruited by random sampling, who then underwent a clinical interview using a questionnaire. RESULTS: The mean age of the patients was 49.71 years (SD 17.03; 95% CI 47.34-51.98), with 85.5% women. A diagnosis of sub-clinical hypothyroidism was found in 74.8%, compared to 18.7% of primary hypothyroidism, and 6.5% of secondary hypothyroidism. The 53.7% (95% CI 46.81-60.59) of patients diagnosed with hypothyroidism did not have thyroid antibodies results. However, 75.2% (95% CI 68.89-80.86) were being treated with levothyroxine. The prevalence of hypothyroidism was 5.7% (95% CI 5.46-5.96). CONCLUSIONS: Sub-clinical hypothyroidism is very common in Primary Care clinics. Many patients are not correctly diagnosed and many are over-medicated, suggesting a need to review the diagnosis.

Dose-dependent S-allyl cysteine ameliorates multiple sclerosis disease-related pathology by reducing oxidative stress and biomarkers of dysbiosis in experimental autoimmune encephalomyelitis.

Garlic is a component of the Mediterranean diet. S-allyl cysteine (SAC), the most common organosulphur present in garlic, possesses neuroprotective properties. This investigation was performed to evaluate the dose-dependent protective action of SAC on oxidative damage, inflammation and gut microbiota alterations biomarkers. Experimental autoimmune encephalomyelitis (EAE) as a model of multiple sclerosis (MS) was induced by the myelin oligodendrocyte glycoprotein (MOG), whose effects were quantified by examining the changes in: clinical score, lipid peroxidation products, carbonylated proteins, glutathione system, tumor necrosis factor alpha (TNFα), and lipopolysaccharide membrane bacteria (LPS). Our results reveal that MOG induces paralysis, oxidative damage and increases in LPS binding protein (LBP) and LPS levels. In this work, two doses of SAC were compared with two dose of N-acetyl cysteine (NAC). SAC was more effective than NAC and it prevented the harmful effects induced by MOG more effectively at the dose of 50mg/kg than that of 18mg/kg. Surprisingly, NAC increases LBP levels while SAC had not such negative effect. In conclusion the data show the ability of SAC to modify EAE evolution.

Clinical and microbiological profile of chronic Burkholderia cepacia complex infections in a cystic fibrosis reference hospital in Brazil.

Burkholderia sp. infections are extremely complex in cystic fibrosis (CF) patients, especially considering the lack of knowledge regarding its behavior, its relationship with prognosis, as well as its transmissibility and multidrug resistance features. This study evaluated the frequency of chronic infection by Burkholderia, using microbiological and clinical data. Ninety-eight patients with CF attended from July 2011 to April 2014 in a Brazilian reference hospital were included. Antimicrobial activity, molecular epidemiology, Shwachman score, body mass index, exacerbations, and lung function were analyzed. Nine patients had chronic colonization, and all of them showed preserved pulmonary function levels, body mass index, and Shwachman score. Meropenem was the most effective antibiotic; however, divergent results were shown by other studies. Cross-contamination may have occurred in only two unrelated patients of different ages, who were colonized by B. vietnamiensis, which does not occur frequently. Twelve new sequence types (STs) were identified and three STs have presented intercontinental distribution. None of the patients presented known epidemic strains. In conclusion, a relatively low number of patients with chronic colonization and suspected cross-infection were identified. Different from other studies that have found CF patients chronically colonized with Burkholderia sp. having a greater deterioration of lung function, more frequent antibiotic therapy, and increased mortality, in the current study, the patients showed good clinical outcomes and favorable options for antibiotics therapy. This study also updated the epidemiological database, which facilitates the multicentric collaborative analysis and assists in the control of global infection by these pathogens.

[Validation of taking arterial pulse in Primary Care for the detection of atrial fibrillation and other cardiac rhythm disorders in patients over 65 years old]. / Validación de la toma del pulso arterial en atención primaria para la detección de fibrilación auricular y otros trastornos del ritmo cardiaco en mayores de 65 años.

INTRODUCTION: Atrial fibrillation (AF) is the most frequent arrhythmia in clinical practice and has important prognostic implications. The objective of this study was to demonstrate the validity and the reliability of taking the arterial pulse (TAP) in patients over 65 years for detecting in AF and other rhythm disorders. MATERIALS AND METHODS: A descriptive, observational, multicentre study to validate a diagnostic test within in a controlled clinical trial. SETTING: 39 Primary Care Centres in the Spanish National Health Service. A total of 318 physicians and nurses took part in the analysis of validity, and 166 of them took part in the analysis of reliability. The professionals were previously called to a meeting in which they took the arterial pulses, and were given 4 ECGs to interpret. The participants TAP of 864 patients followed by an ECG to confirm the cardiac rhythm. Sensitivity, specificity and predictive values were estimated to assess the criterial validity and the simple concordance index to check reproducibility. RESULTS: The sensitivity of pulse measurement for detecting AF detection was 99.4% (95% CI: 97.9-100.0), with a specificity of 30.7% (95% CI: 26.1-35.3), a positive predictive value of 36.6% (95% CI 32.0-41.2), and negative predictive value of 99.2% (97.3-100.0). The simple concordance between the researchers and the cardiologist for the ECG diagnosis of AF ranged between 84.9% and 91.6%. CONCLUSIONS: The TAP has a high sensitivity but a low specificity to detect AF. It is a reliable test for the opportunistic screening of arrhythmias in patients aged over 65 years.

Optimizing CIGB-300 intralesional delivery in locally advanced cervical cancer.

BACKGROUND: We conducted a phase 1 trial in patients with locally advanced cervical cancer by injecting 0.5 ml of the CK2-antagonist CIGB-300 in two different sites on tumours to assess tumour uptake, safety, pharmacodynamic activity and identify the recommended dose. METHODS: Fourteen patients were treated with intralesional injections containing 35 or 70 mg of CIGB-300 in three alternate cycles of three consecutive days each before standard chemoradiotherapy. Tumour uptake was determined using (99)Tc-radiolabelled peptide. In situ B23/nucleophosmin was determined by immunohistochemistry. RESULTS: Maximum tumour uptake for CIGB-300 70-mg dose was significantly higher than the one observed for 35 mg: 16.1 ± 8.9 vs 31.3 ± 12.9 mg (P = 0.01). Both, AUC24h and biological half-life were also significantly higher using 70 mg of CIGB-300 (P < 0.001). Unincorporated CIGB-300 diffused rapidly to blood and was mainly distributed towards kidneys, and marginally in liver, lungs, heart and spleen. There was no DLT and moderate allergic-like reactions were the most common systemic side effect with strong correlation between unincorporated CIGB-300 and histamine levels in blood. CIGB-300, 70 mg, downregulated B23/nucleophosmin (P = 0.03) in tumour specimens. CONCLUSION: Intralesional injections of 70 mg CIGB-300 in two sites (0.5 ml per injection) and this treatment plan are recommended to be evaluated in phase 2 studies.

[Prevalence and factors associated with peripheral artery disease in patients with type 2 diabetes mellitus in Primary Care]. / Prevalencia y factores asociados a la enfermedad arterial periférica en pacientes con diabetes mellitus tipo 2 en Atención Primaria.

INTRODUCTION: Peripheral artery disease in the lower limbs (PAD) is a prevalent condition that entails high morbidity in diabetic patients; this study assesses PAD in these patients and its socio-demographic and clinic associated variables. MATERIAL AND METHODS: Descriptive study in a systematic sample of diabetic patients (DM2) aged 50-80 years, in Primary Care settings. The dependent variable was the presence of PAD diagnosed by ankle-brachial index (ABI) ≤ 0.9; independent variables: socio-demographic, clinical and laboratory. STATISTICS: bivariate and multiple logistic regression analyses were performed to determine the variables associated with low ABI. RESULTS: A sample of 251 patients, 52.6% women; mean age: 68.5 ±8.5. A low ABI was detected in 18.3% (95% Confidence Interval (95% CI):13.3-23.3%), with 6 subjets (2.4%) previously diagnosed as suffering PAD. Age (OR=1.07; 95% CI: 1.02-1.12) and retinopathy (OR=2.69; 95% CI: 1.06-6.81) were associated (multiple logistic regression analysis) with ABI. CONCLUSIONS: The percentage of patients diagnosed with PAD is very low, although PAD prevalence is high among DM2 patients attending Primary Care clinics, especially in older patients and those with retinopathy. We emphasize the recommendation of performing the ABI test in this population at risk.

Prevalence of renal stones in Andalusian population: results of PreLiRenA study.

INTRODUCTION: Urolithiasis is a disease having a high recurrence rate and associated morbidity. A not well quantified increase is being seen in recent years that could be related with various factors. The main purpose of our study has been to estimate urolithiasis prevalence and incidence in the region of Andalusia, determining which factors are associated. MATERIAL AND METHODS: We performed an observational and cross-sectional study. Using a multistage randomized procedure, we selected a sample of 2439 subjects, aging from 40 to 65 years old, who currently lived in Andalusia. Data was collected through phone interviews, questioning the chosen subjects about their kidney stones history, comorbidity and socio-demographic characteristics. We conducted a descriptive, bivariate and multivariate analysis with logistic regression. RESULTS: A total of 2439 subjects were surveyed. Subjects had mean age of 51.1±7.61 years - standard deviation; (95% confidence interval - 95% CI: 50.70-51.30), 48.7% of whom were male. Prevalence of urolithiasis obtained was 16.4% (95% CI: 14.87-17.85%) and an incidence of 1.2 (95% CI: .74-1.64). Variables significantly associated with the presence of urolithiasis found in the multivariate study were: presence of a family history of kidney stones (odds ratio -OR: 1.91; 95% CI: 1.51-2.40, P<.001), hypertension (OR:1.58; 95% CI:1.24-2.02; P<.001), gout (OR:1.98; 95% CI: 1.26-3,12; P=.003) and a high BMI (OR: 1.60; 95% CI 1.19-2.17; p=.008). CONCLUSIONS: A significant increase in the prevalence and incidence of urolithiasis is observed in the environment in regards to the previously available figures. The presence of a family history of urolithiasis, hypertension, gout as well as having a high BMI could influence the observed epidemiological changes in renal lithiasis.

Toxic effects of xylazine on endothelial cells in combination with cocaine and 6-monoacetylmorphine.

The use of xylazine as a drug of abuse has emerged worldwide in the last 7 years, including Puerto Rico. Clinical findings reported that xylazine users present greater physiological deterioration, than heroin users. The aim of this study was to assess the xylazine toxicity on endothelial cells, as this is one of the first tissues impact upon administration. Human umbilical vein endothelial cells in culture were treated with xylazine, cocaine, 6-monoacetylmorphine (heroin metabolite) and its combinations, at concentrations of 0.10-400 µM, for periods of 24, 48 and 72 h. IC50 were calculated and the Annexin V assay implemented to determine the cell death mechanism. Results indicated IC50 values at 24h as follow: xylazine 62 µM, cocaine 210 µM, 6-monoacetylmorphine 300 µM. When these drugs were combined the IC50 value was 57 µM. Annexin V results indicated cell death by an apoptosis mechanism in cells treated with xylazine or in combination. Results demonstrated that xylazine use inhibits the endothelial cell proliferation, at lower concentrations than cocaine and 6-monoacetylmorphine. These findings contribute to the understanding of the toxicity mechanisms induced by xylazine on endothelial cells.

[Food consumption patterns among adolescents]. / La alimentación en el adolescente.

BACKGROUND: Adolescence is a critical time for the establishment of healthy eating habits. The objective was to analyze food consumption patterns among adolescents and their relationship with family and social factors. METHODS: Multicentre observational cross-sectional descriptive study using a food frequency questionnaire for the last week. It was answered anonymously. The adolescent's age/gender, parents' studies/occupation and school's location/type were included. The population sample was composed of 1,095 adolescents in sixth grade at primary schools from an Andalusian region. They were chosen by polietapic random sampling that distinguished between public/private and capital/provincial schools. RESULTS: 1,005 surveys were analyzed. The mean age is 11.45 (SD: 0.59). Fifty-three percent were male. The intake of dairy products (only two-thirds taken daily), pasta, fruit and vegetables (daily consumption of 30%) is deficient. Sixty-four point five percent consume legumes weekly. Fish consumption is equal to meat, with a preference for poultry. More than half consume red meat daily. Olive oil is preferred. The intake of "empty calories" (fast food, candies, soft drink) is high. Through multivariate analysis the existence of clusters of healthy and unhealthy foods, related to the social status of the parents and the type of school, is proved. CONCLUSIONS: A healthy diet based on the nutritional pyramid is not the consumption pattern in the adolescents surveyed. There is a low consumption of diary products, legumes, fruits and vegetables. There is a relationship between the social class of the family and consumption patterns (healthy and unhealthy). Health strategies are needed to modify such inappropriate consumption.

Luminescence concentration quenching mechanism in Gd2O3:Eu3+.

Luminescence concentration quenching in Gd2O3:Eu(3+) nanocrystals results from strong interactions among O(2-) ions and Eu(3+) ions. Because all synthesized Gd2O3:Eu(3+) nanocrystals present the same cubic crystalline phase regardless of Eu(3+) concentration, it is possible to study the optical properties as a function of the dopant concentration. The emission intensities and lifetime curves for Gd2O3:Eu(3+) were analyzed by a simple rate equation model to study the interaction between the O(2-) ions and Eu(3+) ions. The rate equation model considers that such interaction is driven by the following energy transfer processes: the direct energy transfer (O(2-) → Eu(3+)), back-transfer (Eu(3+) → O(2-)), and direct energy migration (Eu(3+) → Eu(3+)). The exact solution of this model agrees with the experimental results, luminescence concentration quenching is reproduced and the corresponding energy transfer rates are reported. Quantitative results suggest that the direct energy transfer and direct energy migration processes are the main responsible for the luminescence concentration quenching, whereas the back-transfer process promotes the Eu(3+) emission.

Lung function in hyper IgE syndrome.

Pneumatoceles and bronchiectasis are secondary complications of respiratory infections in patients with hyper IgE syndrome (HIgES). We report on a patient with HIgES and recurrent pneumonias since 1 year of age, with progression to pneumatoceles and bronchiectasis and fatal outcome, with disseminated infection and suspected allergic bronchopulmonary aspergillosis, who was subjected to sequential spirometric assessment. We describe the early beginning of respiratory infections, difficulties in the management of pulmonary sequelae and the impact of an early functional diagnosis and follow-up of the patient regarding a disease for which lung function has not been fully described.

Evaluation of residual stresses due to bone callus growth: a computational study.

Mechanical environment in callus is determinant for the evolution of bone healing. However, recent mechanobiological computational works have underestimated the effect that growth exerts on the mechanical environment of callus. In the present work, we computationally evaluate the significance of growth-induced stresses, commonly called residual stresses, in callus. We construct a mechanobiological model of a callus in the metatarsus of a sheep in two different stages: one week and four weeks after fracture. The magnitude of stresses generated during callus growth is compared with the magnitude of stresses when only external loads are applied to the callus. We predict that residual stresses are relevant in some areas, mainly located at the periosteal side far from the fracture gap. Therefore, the inclusion of these residual stresses could represent a significant impact on the callus growth and predict a different evolution of biological processes occurring during bone healing.

[Patients' perception on attention received from Health Centres non-sanitary staff]. / Percepción de los pacientes sobre la atención recibida por el personal no sanitario en los centros de salud.

AIMS: To know patients' perceptions about relational aspects and technical procedures when they are attended by the administrative staff in Health Centres. To assess the utility of two ways for measuring satisfaction. MATERIAL AND METHODS: Cross-sectional study carried out in people attending the administrative sections of Health Centres for diverse reasons. Just after the interaction with the administrative they were interviewed using two different questions for assessing their opinions and satisfaction with communicational and technical aspects related with their demands. Descriptive analysis. Significant differences among mean was explored by χ(2) test. Open-ended questions were grouped in categories in a process involving three researchers independently. RESULTS: Over than 90% (360) of the attendees declared to be satisfied or very satisfied with the service received from the staff personal. Nevertheless, among 18-36% gave suggestions for improving the service after their consultation. Independently the domain explored, people suggested the communicational, personal capability, quality and quantity of explanations and waiting time as the main aspects to be improved. CONCLUSIONS: Surveys with open-ended questions are more useful to assess the quality of the attention the citizens receive from no-sanitary staff in Health Centres. These type of questions are also more useful for detecting problems and planning new interventions. Relational and informative issues seem to be the most prioritary areas to improve in this section of Health Centres.

[Analysis of incidence of ocular surface disease index with objective tests and treatment for dry eye]. / Relación de índice de enfermedad de la superficie ocular con pruebas objetivas y tratamiento del ojo seco.

OBJECTIVE: To correlate ocular surface disease index (OSDI) with objective tests on patients with dry eye on first consultation and evaluate the efficiency of topical medication administered depending on severity of symptoms reported by patients who were evaluated at 3 months. MATERIALS AND METHODS: We studied a sample of 144 patients with dry eye who were evaluated with OSDI and basic diagnostic tests at first consultation: Height of lacrimal meniscus, Schirmer II test (with anesthetic), Break-up time test (BUT), and lissamine green staining. The sample was divided into four groups depending on clinical severity, taking into account results of OSDI questionnaire. Treatment was determined for each group taking into account lubricant viscosity properties: OSDI (mild) = carboxymethylcelullose, OSDI (moderate) = hidroxypropylmethylcelullose, OSDI (severe) = polyethyleneglycol and OSDI (very severe) = polyethyleneglycol + cyclosporine A 0.05%. Final OSDI was established for 56 patients who were assessed at 3 months. RESULTS: Results of objective tests at first consult showed a correlation between the severity of symptoms and the grade of lissamine green staining (p = 0.0421). We found significant improvement in OSDI values after topical treatment was administered in all groups of patients (p = 0.0066) at three months post treatment. CONCLUSIONS: Conjuntival lissamine green staining is a useful guideline that could be routinely used to confirm diagnosis in subjective evaluations and patient follow-up. Patients with dry eye show a decrease in OSDI after being treated with the appropriate medication prescribed for each particular group, depending on severity.