Outdoor exposure in children from Buenos Aires Province, Argentina.

OBJECTIVES: To evaluate myopia risk factors, mainly outdoor exposure and reading habits, in a country with low prevalence of myopia (Buenos Aires Province, Argentina). METHODS: Consecutive children interviewed in a clinical private practice setting were autorefracted under cycloplegia with cyclopentolate 1%. Their parents consented to fill a questionnaire about schooling, tutorial classes, outdoor exposure, reading habits, and cellphone use, both on weekdays and weekends. The Spanish questionnaire was based on past English questionnaires of myopia clinical trials. The spherical equivalent of the right eye was used for the refractive distribution. The average daily hours spent for each activity were calculated. RESULTS: This study involved 115 children aged 10.48 ±â€¯3.65 years (range 5-18 years), with 56.5% being girls. Children had 8 h of schooling per day in 62.6% of cases, and only 14.8 % had tutorial classes after school. There were 38.3% myopes (<-0.50 D), 24.3% hyperopes (>+2.00 D) and the rest were emmetropes. The mean time that these children spent outdoors per day was 3.94 ±â€¯1.45 h (27.60 ±â€¯10.16 h per week). The total mean time spent reading and writing per day was 1.50 ±â€¯0.98 h, and that spent using cellphones and tablets was 2.43 ±â€¯1.66 h. CONCLUSION: In an environment with low myopia prevalence, children spend almoast 4 h per day outdoors, much more than the usual recommendation of 2 h a day for myopia prevention.

Exposición al aire libre en niños de la Provincia de Buenos Aires, Argentina / Outdoor exposure in children from Buenos Aires Province, Argentina

Objetivos Evaluar los factores de riesgo de la miopía, principalmente la exposición al aire libre y los hábitos de lectura, en una región con baja prevalencia de miopía (Provincia de Buenos Aires, Argentina). étodos Los niños entrevistados consecutivamente entre febrero y marzo de 2020 fueron refraccionados bajo cicloplejía con ciclopentolato al 1%. Sus padres consintieron llenar un cuestionario sobre escolaridad, clases extracurriculares, exposición al aire libre, hábitos de lectura y uso del teléfono móvil, tanto entre semana como los fines de semana. Se utilizó el equivalente esférico del ojo derecho para la distribución refractiva. Se calculó el promedio de horas diarias dedicadas a cada actividad. Resultados En este estudio participaron 115 niños de 10,48±3,65 años y el 56,5% eran niñas. Los niños tenían 8h de escolaridad al día en el 62,6% de los casos y solo el 14,8% tenía clases de extracurriculares después de la escuela. Había 38,3% miopes (<−0,50 D), el 24,3% hipermétropes (>+2,00 D) y el resto eran emétropes. El tiempo medio pasado al aire libre por día fue de 3,94±1,45h (27,60±10,16h por semana). El tiempo medio total dedicado a la lectura y a la escritura por día fue de 1,50±0,98h, y el de uso de teléfonos móviles y tabletas fue de 2,43±1,66h. Conclusión En un entorno con baja prevalencia de miopía, los niños pasan al menos 4h diarias al aire libre, mucho más que la recomendación habitual de 2h diarias para la prevención de la miopía (AU)

Objectives To evaluate myopia risk factors, mainly outdoor exposure and reading habits, in a country with low prevalence of myopia (Buenos Aires Province, Argentina). Methods Consecutive children interviewed in a clinical private practice setting were autorefracted under cycloplegia with cyclopentolate 1%. Their parents consented to fill a questionnaire about schooling, tutorial classes, outdoor exposure, reading habits, and cellphone use, both on weekdays and weekends. The Spanish questionnaire was based on past English questionnaires of myopia clinical trials. The spherical equivalent of the right eye was used for the refractive distribution. The average daily hours spent for each activity were calculated. Result This study involved 115 children aged 10.48±3.65 years (range 5 to 18 years), with 56.5% being girls. Children had 8h of schooling per day in 62.6% of cases, and only 14.8% had tutorial classes after school. There were 38.3% myopes (<−0.50 D), 24.3% hyperopes (>+2.00 D) and the rest were emmetropes. The mean time that these children spent outdoors per day was 3.94±1.45 hs. (27.60±10.16 hs. per week). The total mean time spent reading and writing per day was 1.50±0.98h, and that spent using cellphones and tablets was 2.43±1.66h. Conclusion In an environment with low myopia prevalence, children spend almoast 4hours per day outdoors, much more than the usual recommendation of 2hours a day for myopia prevention (AU)

Utilidad de la puntuación de boey y portsmouth-possum fisiológico en pacientes con úlcera péptica perforada / Performance of boey score and physiologic portsmouth-possum in patients with perforated peptic ulcer

Introduction: Surgical scores such as Boey and physiologic Portsmouth-POSSUM have been independently applied to patients with perforated ulcer to stratify their surgical risk. However, there are no studies comparing both scores. The purpose of this study was to compare the performance of Boey score and Portsmouth-POSSUM in patients with perforated peptic ulcer. Methods: A retrospective comparative study was performed including 108 consecutive patients older than 15-years submitted to emergency surgery from January 2002 to June 2012. Patients operated on for perforated gastric cancer were excluded. The primary outcome measure was to compare the performance of Portsmouth-POSSUM and Boey score. Secondary outcome measures were to determine cutoff points for Portsmouth-POSSUM, Boey score, C-reactive protein (CRP), and white blood cells (WBC) count, to predict patients at risk for complications. Results: The best cutoff point for CRP was 37.5 mg/l, and for WBC was 11.600 mm³ (OR 2.9 and 4.4). The best cutoff point for physiologic Portsmouth-POSSUM was 14, for surgical Portsmouth-POSSUM were 12, and for predictive Portsmouth-POSSUM was 0.8 percent. A time of perforation higher than 24 h had an OR of 35, and Boey score of 3 had an OR of 38.3. When Boey score was 2, with preoperative shock and time of perforation higher than 24 h being the positive variables, the OR was 194.3. Conclusions: Boey score performed better than Portsmouth-POSSUM, remaining a more specific score to stratify patients submitted to emergency surgery for perforated peptic ulcer.

Introducción: Puntuaciones pronósticas como la de Boey y el Portsmouth-POSSUM han sido utilizadas en pacientes con úlcera perforada para estratificar el riesgo quirúrgico. No existen estudios que comparen ambas puntuaciones. El objetivo del presente estudio es el de comparar el rendimiento de estas puntuaciones en pacientes con úlcera péptica perforada. Métodos: Se diseñó un estudio comparativo retrospectivo que incluyó 108 pacientes consecutivos mayores de 15 años sometidos a cirugía de urgencia entre enero de 2002 y junio de 2012. Se excluyeron pacientes operados por cáncer gástrico perforado. El objetivo principal fue comparar el rendimiento de la puntuación de Boey con Portsmouth-POSSUM. Los objetivos secundarios fueron determinar los puntos de corte para Portsmouth-POSSUM, puntuación de Boey, proteína C-reactiva (PCR) y recuento de leucocitos (RL) como factores predictivos de riesgo. Resultados: El mejor punto de corte para PCR fue 37,5 mg/l y para RL 11.600 mm³ (OR 2,9 y 4,4). El mejor punto de corte para Portsmouth-POSSUM fisiológico fue 14, para Portsmouth-POSSUM quirúrgico fue 12 y para Portsmouth-POSSUM predictivo fue 0,8 por ciento. Un tiempo de perforación mayor a 24 h tenía un OR de 35 y un puntaje de Boey de 3 tenía un OR de 38,3. Cuando el puntaje de Boey fue 2 con las variables choque preoperatorio y perforación mayor a 24 h, el OR fue 194,3. Conclusiones: La puntuación de Boey presentó mejor rendimiento que Portsmouth-POSSUM, representando una puntuación más específica para estratificar pacientes sometidos a cirugía de urgencia por úlcera perforada.

Tumores malignos del apéndice cecal en pacientes operados por apendicitis en la IV Región de Chile / Malignant appendicular tumors

Background: The most common malignant appendicular neoplasm is the neuroendocrine well-differentiated tumor (NET). Other malignant tumors are uncommon, reported with a frequency of 0.2 percent of all appendectomies. Aim: To describe the characteristics of appendiceal malignant tumors found in regional hospitals of Northern Chile. Material and Methods: All patients operated for acute appendicitis between 2005 and 2011, in which a malignant appendiceal tumor was found in the pathological study, were analyzed. Clinical and survival information was obtained from medical records and national death registries. Results: We analyzed 8.972 appendectomy records. Appendicular tumors were found in 40 patients (0.4 percent). Thirty patients (0.3 percent) had malignant tumors. NET was the most common tumor found in 19 patients (63 percent). The tumor was smaller than 1 cm in 16 cases (53 percent). In 5 patients (17 percent), the tumor was larger than 2 cm with the appendicular base infiltrated by malignant cells. Most patients (83 percent) presented with stage I tumors. In 23 patients (77 percent, the appendectomy was considered sufficient and definitive treatment. Conclusions: In this series of patients, appendicular tumors had similar characteristics to those reported abroad. All patients had a favorable evolution without associated mortality or tumor relapse...

Introducción: El tumor apendicular maligno encontrado con mayor frecuencia es el tumor neuroendocrino bien diferenciado (NET). Otros tumores malignos se reportan con una frecuencia menor a 0,2 por ciento de todas las apendicectomías. El objetivo del presente estudio es describir las características de los tumores malignos del apéndice en la IV Región de Chile. Material y Método: Se estudió una cohorte histórica constituida por pacientes operados en los hospitales de La Serena, Coquimbo y Ovalle entre enero de 2005 y diciembre de 2011. Los resultados se reportan mediante estadística descriptiva. Resultados: Se estudiaron 8.972 apendicectomías. En 40 pacientes (0,4 por ciento) se diagnosticaron tumores apendiculares de los cuales 30 (0,3 por ciento) fueron malignos y fueron incluidos en este análisis. El tipo histológico maligno más frecuente fue el NET en 19 casos (63 por ciento). En 16 casos (53 por ciento) el tumor fue menor a 1 cm. En 5 casos (17 por ciento) el tumor fue mayor a 2 cm con compromiso de la base. La mayoría de los pacientes (83 por ciento) se presentaron con tumores en estadio I y los demás con tumores en estadio II. En 23 pacientes (77 por ciento) la apendicectomía fue considerada como el tratamiento definitivo. Conclusiones: Las características generales de los tumores malignos del apéndice en los pacientes operados por apendicitis en la IV Región de Chile son similares a las características reportadas en series nacionales e internacionales. En la presente cohorte, los pacientes tuvieron una evolución favorable sin mortalidad asociada al tumor y sin recurrencias conocidas hasta la fecha actual...

Factores pronóstico de las variantes de cáncer papilar de tiroides / Association between pathological variants of papillary thyroid cancer and prognosis

Background: Papillary thyroid carcinoma had a survival over 90 percent in stages I , II and III. Treatment failures are observed in advanced tumors, when there is lymph node involvement or when there is vascular invasion. Aim: To assess the prognostic value of pathological variants of papillary thyroid carcinoma. Material and Methods: Review of pathological records of patients with papillary thyroid cancer operated between January 1999 and December 2008 in a regional hospital. The pathological variant of the tumor was revised and classified again as follicular variant, sclerosing, solid, tall cell variant, columnar variant, oncocytic, cribriform, microcarcinoma, insular variant and poorly differentiated. Results: The records of 51 females aged 48 +/- 16 years and 12 males aged 42 +/- 18 years were identified. Forty patients had a well differentiated carcinoma (63 percent), 16 had a follicular variant (25 percent), four had a sclerosing variant and three other types. Capsule involvement was observed in six of 27 stage I, four of nine stage II, 20 of 26 stage III and one of one stage four tumor. Peritumoral lymphatic invasion was observed in 12 of 27 stage I, four of nine stage II, 21 of 26 stage III and one of one stage IV tumor. Lymph node relapse was observed in three patients without and nine patients with capsule involvement (p < 0.01) and in 11 of 38 patients without and 27 of 38 patients with lymphatic invasion (p < 0.01). Two patients in stage III and one in stage IV died. Lethality was 3 percent. Conclusions: Relapse of papillary carcinoma was associated with capsule involvement and lymphatic invasion. Tumor variants were not associated with relapse or mortality.

Objetivo del estudio: Identificar la incidencia de las variantes del cáncer papilar de tiroides (CPT), factores de mal pronóstico asociados a variantes histológicas, comparar la recurrencia y estadio de la enfermedad según la variedad, e identificar pacientes de alto riesgo de recurrencia. Material y Método: Cohorte única longitudinal entre Enero de 1999 y Diciembre de 2008. La clasificación de los subtipos fue: papilar bien diferenciado, variante folicular, esclerosante, sólido, células altas, células columnares, oncocítico, cribiforme, microcarcinoma, insular y pobremente diferenciado. Resultados: Incidencia: papilar bien diferenciado 40 casos (63,5 por ciento), variante folicular 16 casos (25,4 por ciento), esclerosante 4 casos, otros 3 casos. Hubo compromiso de la cápsula del tiroides en 6/27 casos en estadio I, 4/9 casos en estadio II, 20/26 casos en estadio III y 1/1 caso en estadio IV, p < 0,01. Hubo 3 recurrencias ganglionares sin compromiso tumoral de la cápsula y 9 recurrencias con compromiso tumoral, p < 0,05. Hubo invasión linfática peritumoral en 12/27 en estadio I; 4/9 casos en estadio II, 21/ 26 casos en estadio III, y 1/1 en estadio I V, p < 0,05. En 11/38 pacientes sin invasión linfática hubo recurrencia ganglionar y 27/38 con invasión linfática hubo recurrencia, p < 0,01. Fallecieron 2 casos en estadio III y 1 en estadio I V, p < 0,01. La letalidad fue 3,2 por ciento. Conclusión: La recurrencia se asoció a estadio avanzado, compromiso de cápsula e infiltración linfática. No identificamos asociación entre recurrencia y variedades del CPT. La mortalidad se asoció a estadio avanzado. No identificamos asociación entre variante histológica y mortalidad, p = 0,48.

Increased hyperopia with ageing based on cycloplegic refractions in adults: the Tehran Eye Study.

AIM: To determine the trend in the prevalence of hyperopia in Tehran, Iran. METHODS: Using a stratified random cluster sample of the population of Tehran, all participants 5 years of age and older were studied with cycloplegic autorefraction 30 min after instilling two drops of cyclopentolate 1%. Prevalence rates of cycloplegic hyperopia for different cut points were determined, stratified by age. RESULTS: The prevalence rates of hyperopia as a spherical equivalent equal to or more than +0.5, +1.0, +2.0 and +3.0 D were 56.6%, 28.1%, 6.3% and 2.2%, respectively. With all these definitions, the prevalence of cycloplegic hyperopia reached a minimum in the 25-35-year age group, and then significantly increased until the age of 70. Multivariable regression analysis with variables such as age, gender, diabetes and cataract showed that only age was significantly correlated with hyperopia. CONCLUSIONS: Although an age-cohort effect cannot be ruled out, these results provide the first population-based evidence of increasing hyperopia with age using cycloplegic refraction. The results obtained suggest that the contribution of decreasing accommodation to observed hyperopic shifts in distance refraction in longitudinal studies is small, raising the question of the underlying causes of the hyperopic shift in refraction with age.

Effect of cumulative nearwork on accommodative facility and asthenopia.

PURPOSE: To investigate quantitatively in young adults the relationship between long-term cumulative nearwork, degradation of dynamic accommodative ability and the presence of asthenopic symptoms. METHODS: Subjects consisted of 87 young students and office workers between 18 and 31 years of age with uncorrected visual acuity of 20/30 or better in each eye. The amounts of nearwork, dynamic accommodative facility, and level of asthenopic symptoms were measured for each subject. RESULTS: Total cumulative nearwork time was negatively correlated with accommodative facility and positively correlated with the number of asthenopic symptoms. Furthermore, significant correlations were found between total nearwork time and blurred vision, and blurred vision and reduced accommodative facility. Moreover, the sub-category of "hours spent reading over the years" was found to be significantly correlated with decreased accommodative facility. CONCLUSIONS: The correlations suggest a relationship between cumulative amount of nearwork, decreased accommodative facility and asthenopia.

Genistein is a natural inhibitor of hexose and dehydroascorbic acid transport through the glucose transporter, GLUT1.

Genistein is a dietary-derived plant product that inhibits the activity of protein-tyrosine kinases. We show here that it is a potent inhibitor of the mammalian facilitative hexose transporter GLUT1. In human HL-60 cells, which express GLUT1, genistein inhibited the transport of dehydroascorbic acid, deoxyglucose, and methylglucose in a dose-dependent manner. Transport was not affected by daidzein, an inactive genistein analog that does not inhibit protein-tyrosine kinase activity, or by the general protein kinase inhibitor staurosporine. Genistein inhibited the uptake of deoxyglucose and dehydroascorbic acid in Chinese hamster ovary (CHO) cells overexpressing GLUT1 in a similar dose-dependent manner. Genistein also inhibited the uptake of deoxyglucose in human erythrocytes indicating that its effect on glucose transporter function is cell-independent. The inhibitory action of genistein on transport was instantaneous, with no additional effect observed in cells preincubated with it for various periods of time. Genistein did not alter the uptake of leucine by HL-60 cells, indicating that its inhibitory effect was specific for the glucose transporters. The inhibitory effect of genistein was of the competitive type, with a Ki of approximately 12 microM for inhibition of the transport of both methylglucose and deoxyglucose. Binding studies showed that genistein inhibited glucose-displaceable binding of cytochalasin B to GLUT1 in erythrocyte ghosts in a competitive manner, with a Ki of 7 microM. These data indicate that genistein inhibits the transport of dehydroascorbic acid and hexoses by directly interacting with the hexose transporter GLUT1 and interfering with its transport activity, rather than as a consequence of its known ability to inhibit protein-tyrosine kinases. These observations indicate that some of the many effects of genistein on cellular physiology may be related to its ability to disrupt the normal cellular flux of substrates through GLUT1, a hexose transporter universally expressed in cells, and is responsible for the basal uptake of glucose.