High frequency of digital eye strain and dry eye disease in teleworkers during the coronavirus disease (2019) pandemic.

Objectives. This study aimed to evaluate visual display terminal (VDT)-related digital eye strain (ES) and dry eye disease (DED) symptoms in subjects whose work was changed to teleworking (TW) during the coronavirus pandemic. Methods. A digital self-reported survey was conducted on subjects in TW, including demographics, medical history, VDT time and ES-related symptoms before and during the pandemic and DED (dry eye questionnaire 5 [DEQ-5] questionnaire). Results. A total of 1797 questionnaires were analyzed. Mean age was 40.5 (SD 11.1) years, and 69.9% were female. The mean number of TW weeks was 10.2 (SD 3.0). The total VDT total hours increased from 7.4 (SD 3.3) to 9.5 (SD 3.3) (p < 0.001). All ES symptoms presented a significant increase (p < 0.001). The mean DEQ-5 score was 8.3 (SD 4.9). The oldest group presented lower values, and women had a higher score (p < 0.001). Additionally, 28.6% of the subjects were classified with severe DED, and the variables associated with a logistic regression model were total VDT hours, female gender, refractive surgery, rosacea, depression, previous DED, keratoconus and blepharitis. Conclusions. The number of VDT hours seemed to be a relevant factor for increase in ES symptoms and a high prevalence of DED during the pandemic period.

[Validation of the Ocular Surface Disease Index Questionnaire for Chilean patients]. / Adaptación cultural y validación del cuestionario Ocular Surface Disease Index en una población chilena.

BACKGROUND: Ocular Surface Disease Index (OSDI) is the most commonly used questionnaire worldwide to detect dry eye disease. Although it is massively used in clinical practice in Chile, its use has not been validated yet in the country. AIM: To develop a cultural adaptation and to validate the OSDI questionnaire for the Chilean population. MATERIAL AND METHODS: For cultural adaptation, a translation, retro-translation and an expert panel review was carried out. The resulting questionnaire was applied to a pilot group of twelve participants and their comments were considered for the final questionnaire version. The final questionnaire was applied to a non-random sample of 200 patients aged 53 ± 17 years (75% women). Internal consistency and construct validity were evaluated by Cronbach's alpha and exploratory factor analysis respectively. RESULTS: According to the OSDI score, 81% of respondents had dry eye (55% severe). Reliability was 0.91 and factor analysis resulted in three factors explaining 75.4% of the total variance. CONCLUSIONS: The OSDI questionnaire version obtained in this study demonstrated excellent internal consistency values and adequate construct validity making it applicable to clinical practice and dry eye research.

Adaptación cultural y validación del cuestionario Ocular Surface Disease Index en una población chilena / Validation of the Ocular Surface Disease Index Questionnaire for Chilean patients

Background: Ocular Surface Disease Index (OSDI) is the most commonly used questionnaire worldwide to detect dry eye disease. Although it is massively used in clinical practice in Chile, its use has not been validated yet in the country. Aim: To develop a cultural adaptation and to validate the OSDI questionnaire for the Chilean population. Material and Methods: For cultural adaptation, a translation, retro-translation and an expert panel review was carried out. The resulting questionnaire was applied to a pilot group of twelve participants and their comments were considered for the final questionnaire version. The final questionnaire was applied to a non-random sample of 200 patients aged 53 ± 17 years (75% women). Internal consistency and construct validity were evaluated by Cronbach's alpha and exploratory factor analysis respectively. Results: According to the OSDI score, 81% of respondents had dry eye (55% severe). Reliability was 0.91 and factor analysis resulted in three factors explaining 75.4% of the total variance. Conclusions: The OSDI questionnaire version obtained in this study demonstrated excellent internal consistency values and adequate construct validity making it applicable to clinical practice and dry eye research.

Biomarker expression patterns that correlate with high grade features in treatment naive, organ-confined prostate cancer.

BACKGROUND: The early detection of prostate cancer has resulted in an increase in the number of patients with localized prostate cancer and has paralleled the reported reduction in prostate cancer mortality. The increased rate of detection of patients with localized prostate cancer may also increase the risk of potentially morbid therapy in a patient with indolent cancer. Defining the biomarker correlates of prostate cancer virulence will facilitate the appropriate application and development of therapy for patients with early disease. METHODS: A 255 core prostate cancer tissue microarray (TMA) from 47 prostatectomy specimens with organ confined tumor was constructed. Prostate cancer foci of transition and peripheral zone origin were represented on the TMA. Further, replicate cores of the two Gleason grades comprising the Gleason score, representative of Gleason scores 5-9, were arrayed from each prostatectomy specimen. Standard immunohistochemical techniques were used to assess expression of nine, cell death and cell cycle regulatory proteins implicated in the pathogenesis of prostate cancer (bax, bcl-2, bcl-xL, bin1, CD95, mdm2, p21, p53, and NFkappaB). RESULTS: The Spearman correlation coefficient revealed a strong correlation of bax, bin1, FAS, p65 and p21 expression with Gleason grade. Spearman correlation coefficients showed that expression of, bax and bin1, bax and MDM2, Bax and p21, and bax and p65 NFkappaB was highly associated. Other significant associations were identified between bin1 and p21, bin1 and MDM2, bin1 and p65 NFkappaB and between p21 and p65 NFkappaB. A model for predicting the biological potential of Gleason score 7 prostate cancer using multivariable logistic regression methods was developed. The findings also indicate that the profile of specific markers for Gleason grade 3 prostate cancer correlates with the overall context of the Gleason score. CONCLUSION: These data support the view that important molecular differences exist among and between the Gleason scores. Furthermore, there is significant molecular heterogeneity among prostatectomy specimens containing Gleason grade 3 cancer. This observation may have broader implications regarding the determination of risk among patients with prostate cancer that is currently considered to be of either good prognosis or unclear prognosis, i.e. Gleason score 7 tumors.

Clinical and biomarker correlates of androgen-independent, locally aggressive prostate cancer with limited metastatic potential.

PURPOSE: We have identified a subset of patients exhibiting extended survival with metastases from androgenindependent prostate cancer of which the principal site of progression was the tumor primary. The purpose of this study was to evaluate the expression of selected biomarkers to characterize this subset of prostate cancer patients. EXPERIMENTAL DESIGN: A 105 core tissue microarray was constructed from primary tumor samples from 16 patients, with matched lymph node metastases in 5 cases. Immunohistochemistry was used to evaluate selected biomarkers associated with prostate cancer progression. Standard statistical methodologies were used to compute the distribution of time to progression and overall survival associations between pairs of biomarkers. Hierarchical clustering was done between groups of biomarkers, and we devised new methods to assess homogeneity of biomarker expression. RESULTS: The median interval from diagnosis to salvage surgery was 65 months. The profile of biomarker expression was notable for virtual absence of neuroendocrine features, high CD10, low matrix metalloproteinase (MMP)-9, high E-cadherin expression, and high membranous beta-catenin. The mean proliferative index was 12.1 +/- 10.1%, and the mean apoptotic index was 3.48 +/- 2.22%, and there was a significant correlation between these indices. Expression of the epidermal growth factor receptor was associated with phospho-AKT and proliferative index but inversely associated with phospho-STAT3. CONCLUSIONS: The cohort of prostate cancer patients, characterized by locally aggressive disease rather than lethal metastatic progression, was associated with a distinctive biomarker signature. The biomarker profile was, in general, more consistent with low-grade prostate cancer exhibiting local growth rather than metastatic progression. Ongoing studies will establish whether this unique subset of patients can be identified prospectively.

Acidosis tubular renal distal y litiasis renal en tres casos de síndrome de Sjögren primario / Distal renal tubular acidosis and renal lithiasis in 3 cases of primary Sjögren's syndrome

Tubulo interstitial nephritis, the main manifestation of renal involvement in Sjögren syndrome, may lead to a tubular dysfunction that is usually subclinical. We report 3 women, aged 32, 35 and 35 years old, with a primary Sjögren's syndrome and symptomatic type I or distal tubular acidosis. Two patients had nephrolithiasis and one a nephrocalcinosis. Two had a basal hyperchloremic metabolic acidosis. The ammonium chloride acidification test was abnormal in all, demonstrating a distal tubular defect. None had proximal tubular dysfunction. All had an urinary pH over 6.5 and hypocitraturia and none had hypercalciuria. Renal calculi were composed of calcium oxalate and calcium phosphate in 2 patients and calcium phosphate and ammonium phosphate in the other. All women had positive antinuclear antibodies with mottled pattern, 2 had anti Ro antibodies and positive rheumatoid factor and 1 had hypergammaglobulinemia. None had anti La antibodies, crioglobulinemia or monoclonal proteins