Determinación de la concentración de fosfatos en los colirios antiglaucomatosos comercializados en España / Determination of phosphate concentration in glaucoma eye drops commercially available in Spain

OBJETIVO: Identificar y determinar la concentración de fosfatos en colirios antiglaucomatosos comercializados en España. MATERIAL Y MÉTODO: Se identificaron colirios antiglaucomatosos según Vademecum 2013 y página web de la Agencia Española del Medicamento y Productos Sanitarios. En los que contenían fosfatos según la ficha técnica se determinó la concentración de estos mediante espectrofotometría de absorción molecular basada en radiación ultravioleta y el pH mediante algoritmos de análisis de imagen por escáner a partir de tiras de papel. RESULTADOS: Se registraron 37 colirios antiglaucomatosos con fosfatos. La media de la concentración de fosfatos fue 97,72 ± 75,52 mM. El principio activo con mayor concentración fue timolol (204,85 ± 42,38 mM) seguido de brimonidina/timolol (200,9 mM). No se registraron diferencias estadísticamente significativas entre los colirios de referencia de especialidad (95,65 ± 71,11 mM) y los genéricos (99,14 ± 80 mM; p = 0,892). Tampoco se observaron diferencias entre aquellos con conservantes (99,24 ± 76,78 mM) y sin ellos (85,17 ± 72,86 mM; p = 0,730), aunque los principios de timolol y latanoprost presentaron menos fosfatos en su composición sin conservantes. Las unidosis presentaron menos fosfatos que las multidosis (102,04 ± 75,39 vs. 22,24 ± 2,98 mM; p < 0,001). El pH medio fue 7,13 ± 0,63. No se encontró correlación estadística entre la concentración de fosfatos y el pH (r: 0,07). CONCLUSIONES: La concentración de fosfatos en todos los colirios superaba la concentración fisiológica en la película lagrimal (1,45 mM). No se observaron diferencias en la cantidad de fosfatos entre los medicamentos genéricos y los de referencia de especialidad. Los antiglaucomatosos sin conservantes en unidosis presentaron menos fosfatos

OBJECTIVES: To identify and analyze the phosphate concentration in glaucoma eye drops available in Spain. MATERIAL AND METHODS: Glaucoma medications containing phosphates were identified according to the 2013 Vademecum and the website of the Spanish Agency for Medicines and Medical Devices. Phosphate concentration was determined in these eye drops using ultraviolet molecular absorption spectrophotometry, and pH was determined using scan image analysis algorithms of pH strips. RESULTS: A total of 37 phosphate containing glaucoma eye drops were identified. The mean phosphate concentration was 97.72 ± 75.52 mM. The group with higher concentration of active substance was timolol (204.85 ± 42.38 mM) followed by brimonidine/timolol (200.9 mM). No statistically significant difference was found between brand name (95.65 ± 71.11 mM) and generic eye drops (99.14 ± 80 mM, P = .892). Although no statistically significant difference was found between products containing preservatives (99.24 ± 76.78 mM) and those without preservatives (85.17±72.86mM) (P = .730), a lower phosphate concentration was observed in the preservative-free Timolol and Latanoprost. Single dose samples showed a lower phosphate concentration than multi-dose ones (102.04 ± 75.39 vs. 22.24 ± 2.98 mM, P <.001). The mean pH was 7.13 ± 0.63. No statistical correlation was found between phosphate concentration and pH (r: 0.07). CONCLUSION: The phosphate concentration in glaucoma eye drops exceeded the tear film physiological level (1.45mM). No difference was observed between brand names and generic eye drops. Lower phosphate concentration was observed in preservative-free single dose eye drops

Determinación de la concentración de fosfatos y pH en los colirios de lágrima artificial / Determination of phosphate concentration and pH in artificial tear drops

OBJETIVO: Determinar la concentración de fosfatos y el pH de los colirios de lágrima artificial disponibles comercialmente en España. MATERIAL Y MÉTODOS: Se identificaron 71 lágrimas artificiales según Vademécum 2014 y página web de la Agencia Española del Medicamento y Productos Sanitarios. En las 24 lágrimas cuya ficha técnica indicaba que contenían fosfatos, se determinó la concentración de estos mediante espectrofotometría de absorción molecular basada en radiación ultravioleta y el pH mediante algoritmos de análisis de imagen por escáner a partir de tiras de papel. RESULTADOS: Se identificaron 71 lágrimas artificiales, de las cuales 24 contenían fosfatos entre sus excipientes; en 3 lágrimas la concentración de estos era menor al umbral de detección (< 0,1 mM). La media de la concentración de fosfatos fue 17,91 ± 23,87 mM. La lágrima artificial con mayor concentración fue Colircusi Humectante (87,1mM). Las que contenían hipromelosa como principio activo presentaban las concentraciones más elevadas (41,59 ±32,11 mM), observándose diferencias estadísticamente significativas respecto a povidona (p = 0,0196) e hialuronato (p = 0,0067). También se registraron diferencias estadísticamente significativas entre lágrimas con conservantes (32,39 ± 20,91 mM) y sin ellos (8,49 ± 11,98 mM) (p = 0,0498). Sin embargo, no se observaron entre lágrimas con presentación multidosis (20,21 ±26,91 mM) o monodosis (9,31 ± 14,39 mM) ni entre marcas comerciales (15,44 ±23,3 mM) y genéricos (20,81 mM). La media del pH hallado fue de 6,93 ± 0,26 (6,2-7,22), sin observar una correlación entre este valor y la concentración de fosfatos (Rho de Spearman: −0,1089 con p = 0,6125). CONCLUSIÓN: El 33,8% de las lágrimas contenían fosfatos (24 de 71). Consideramos que conocer la concentración de fosfatos de las lágrimas artificiales es una información útil que nos permitirá evitar complicaciones potencialmente graves en pacientes de riesgo

OBJECTIVE: To determine phosphate concentration and pH in artificial tear eye drops commercially available in Spain. MATERIALS AND METHODS: A total of 71 examples of artificial tear preparations were identified in a search of Vademecum 2014 and the Spanish Medicines Agency website. In the 24 artificial tear products containing phosphates, quantification of these was performed by ultraviolet molecular absorption spectrophotometry, and the determination of pH was performed using scan image analysis algorithms of pH strips. RESULTS: Of the 71 artificial tears tested, 24 contained phosphate among their excipients in the data sheet, three of which had a concentration level below detection limit (<0.1mM). The mean phosphate concentration was 17.91±23.87mM. The artificial tear sample containing a higher concentration was Colircusi Humectante (87.1mM). Lubricants based on hypromellose showed the highest phosphate concentration (41.59±32.1mM), showing statistically significant differences compared to povidone (P = .0196) and hyaluronate (P = .0067). Statistically significant differences were found between products containing preservatives (32.39 ± 20.91 mM), and preservative free ones (8.49±11.98 mM) (P=.0498). However, no difference was found between multidose (20.21 ± 26.91 mM) and unidose (9.31 ±14.39 mM) samples, or between brand name (15.44 ± 23.3 mM) and generic eye drops (20.81 mM). The mean pH was 6.93 ± 0.26 (6.2-7.22). No statistical correlation was detected between phosphate concentration and pH (Spearman's Rho −0.1089 and P = .6125). CONCLUSION: A total of 24 (33.8%) of the 71 artificial tears contained phosphate. We believe identifying the phosphate concentration of artificial tears is useful information in order to avoid complications in high-risk patients

Determination of phosphate concentration in glaucoma eye drops commercially available in Spain. / Determinación de la concentración de fosfatos en los colirios antiglaucomatosos comercializados en España.

OBJECTIVES: To identify and analyze the phosphate concentration in glaucoma eye drops available in Spain. MATERIAL AND METHODS: Glaucoma medications containing phosphates were identified according to the 2013 Vademecum and the website of the Spanish Agency for Medicines and Medical Devices. Phosphate concentration was determined in these eye drops using ultraviolet molecular absorption spectrophotometry, and pH was determined using scan image analysis algorithms of pH strips. RESULTS: A total of 37 phosphate containing glaucoma eye drops were identified. The mean phosphate concentration was 97.72±75.52mM. The group with higher concentration of active substance was timolol (204.85±42.38mM) followed by brimonidine/timolol (200.9mM). No statistically significant difference was found between brand name (95.65±71.11mM) and generic eye drops (99.14±80mM, P=.892). Although no statistically significant difference was found between products containing preservatives (99.24±76.78mM) and those without preservatives (85.17±72.86mM) (P=.730), a lower phosphate concentration was observed in the preservative-free Timolol and Latanoprost. Single dose samples showed a lower phosphate concentration than multi-dose ones (102.04±75.39 vs. 22.24±2.98mM, P<.001). The mean pH was 7.13±0.63. No statistical correlation was found between phosphate concentration and pH (r: 0.07). CONCLUSION: The phosphate concentration in glaucoma eye drops exceeded the tear film physiological level (1.45mM). No difference was observed between brand names and generic eye drops. Lower phosphate concentration was observed in preservative-free single dose eye drops.

Determination of phosphate concentration and pH in artificial tear drops. / Determinación de la concentración de fosfatos y pH en los colirios de lágrima artificial.

OBJECTIVE: To determine phosphate concentration and pH in artificial tear eye drops commercially available in Spain. MATERIALS AND METHODS: A total of 71 examples of artificial tear preparations were identified in a search of Vademecum 2014 and the Spanish Medicines Agency website. In the 24 artificial tear products containing phosphates, quantification of these was performed by ultraviolet molecular absorption spectrophotometry, and the determination of pH was performed using scan image analysis algorithms of pH strips. RESULTS: Of the 71 artificial tears tested, 24 contained phosphate among their excipients in the data sheet, three of which had a concentration level below detection limit (<0.1mM). The mean phosphate concentration was 17.91±23.87mM. The artificial tear sample containing a higher concentration was Colircusi Humectante (87.1mM). Lubricants based on hypromellose showed the highest phosphate concentration (41.59±32.1mM), showing statistically significant differences compared to povidone (P=.0196) and hyaluronate (P=.0067). Statistically significant differences were found between products containing preservatives (32.39±20.91mM), and preservative free ones (8.49±11.98mM) (P=.0498). However, no difference was found between multidose (20.21±26.91mM) and unidose (9.31±14.39mM) samples, or between brand name (15.44±23.3mM) and generic eye drops (20.81mM). The mean pH was 6.93±0.26 (6.2-7.22). No statistical correlation was detected between phosphate concentration and pH (Spearman's Rho -0.1089 and P=.6125). CONCLUSION: A total of 24 (33.8%) of the 71 artificial tears contained phosphate. We believe identifying the phosphate concentration of artificial tears is useful information in order to avoid complications in high-risk patients.

Automatized large diameter lamellar keratoplasty and stem cell transplantation for the treatment of ocular surface diseases with limbal insufficiency.

PURPOSE: To report a new surgical procedure for the treatment of ocular surface diseases associated with severe limbal insufficiency. METHODS: A retrospective review of four patients with severe ocular surface disease who required stem cell transplantation and keratoplasty for the correction of limbal insufficiencies. They underwent large diameter lamellar keratoplasty with microkeratome. When limbal dysfunction was associated with limited alteration of the ocular surface and transparent deep corneal stroma only the anterior corneal stroma was transplanted. When the entire corneal thickness was compromised, both anterior and deep donor buttons were transplanted. RESULTS: Patients remained stable and improved their visual acuity after surgery. Best-corrected visual acuity ranged from 20/200 to 20/30. No corneal graft rejections were found. The main complication found in one of our patients was a central stromal opacity which required a secondary penetrating keratoplasty. CONCLUSIONS: Automatized large diameter lamellar keratoplasty provides a safe and successful alternative to limbal transplantation for limbal insufficiency associated with corneal opacity. This technique enables a single-stage surgical procedure and the use of a single donor which reduces the risk of rejection. In addition, better refractive results are achieved due to the quality of the interface and the absence of corneal sutures.

[Two different intra-corneal inlay surgical technique in rabbit eyes]. / Comparación de dos técnicas de implantación de lentes intracorneales en ojos de conejo.

OBJECTIVE: To compare two different surgical techniques of intracorneal lens implantation. To determine the incidence of corneal and lens complications in two groups of rabbits subjected to such surgery. METHOD: The first group (7 rabbits) initially had a keratectomy performed with the microkeratome following which the corneal flap was sutured to the stromal layer. In the second group (7 rabbits), a pocket-shaped stromal dissection was performed manually. Both groups of rabbits had a secondary lens implantation in the corneal inlay. The follow up period was of 2 months duration. RESULTS: The incidence of corneal edema in the first month was higher in group 1 (71.4%) than in group 2 (14.3%) (p = 0.0155); during the second month, the incidence was 42.9% in group 1 and 28.6% in group 2 (p= 0.2927). Flap dislocation and retraction of the flap was seen in 4 of the 7 rabbits in group 1, whereas no complication of this type was observed in the manual pocket group (group 2). The incidence of lens subluxation was 28.6% in group 1 and 0% in group 2. Finally, there was a 71.4% (5/7) loss of the intracorneal lens in the rabbits treated with the microkeratome (group 1) while only 1 of 7 rabbits (14.3%) lost the lens in group 2 (P = 0.0155). DISCUSSION: Eyes in which the corneal pocket shape was made by manual stromal dissection had a higher stability of the lens and less post-operative corneal complications.

Comparación de dos técnicas de implantación de lentes intracorneales en ojos de conejo / Two different intra-corneal inlay surgical technique in rabbit eyes

Objetivos: Comparación de dos técnicas quirúrgicas para la implantación de lentes intracorneales. Incidencia de complicaciones corneales y lenticulares en 2 grupos de conejos intervenidos con las técnicas descritas.Método: Estudio experimental en 2 grupos de conejos. Grupo 1 (siete conejos): se practica una queratectomía con microqueratomo, se implanta la lente y se sutura la córnea con dos puntos. Grupo 2 (siete conejos): se talla un bolsillo estromal según técnica manual, se implanta la lente y se sutura la zona de la incisión con 2 puntos. En ambos grupos se realizó un seguimiento por 2 meses.Resultados: La incidencia de edemas corneales en el primer mes fue superior (71,43%) en el grupo 1 y menor en el 2 (14,28%) (p: 0,0155), así como en el segundo mes (42,86% vs 28,57%) (p: 0,2927). Se observaron adhesiones incompletas y retracciones de la queratectomía (4/7) en el grupo 1, complicaciones no observadas en el grupo 2. La incidencia de descentramientos de la lente fue del 28,57% en el grupo 1 y del 0% en el grupo 2. La pérdida de lente intracorneal se produjo en cinco de los siete casos (71,43%) del grupo 1 y en solo 1 de 7 (14,28%) del grupo 2 (P: 0,0155).Conclusiones: Los ojos intervenidos por medio de la técnica manual denominada de bolsillo, fueron los que presentaron más seguridad en cuanto a estabilidad de la lente intracorneal (descentramientos y pérdida de lentículo) y menor incidencia de complicaciones postoperatorias corneales

Objective: To compare two different surgical techniques of intracorneal lens implantation. To determine the incidence of corneal and lens complications in two groups of rabbits subjected to such surgery. Method: The first group (7 rabbits) initially had a keratectomy performed with the microkeratome following which the corneal flap was sutured to the stromal layer. In the second group (7 rabbits), a pocket-shaped stromal dissection was performed manually. Both groups of rabbits had a secondary lens implantation in the corneal inlay. The follow up period was of 2 months duration. Results: The incidence of corneal edema in the first month was higher in group 1 (71.4%) than in group 2 (14.3%) (p= 0.0155); during the second month, the incidence was 42.9% in group 1 and 28.6% in group 2 (p= 0.2927). Flap dislocation and retraction of the flap was seen in 4 of the 7 rabbits in group 1, whereas no complication of this type was observed in the manual pocket group (group 2). The incidence of lens subluxation was 28.6% in group 1 and 0% in group 2. Finally, there was a 71.4% (5/7) loss of the intracorneal lens in the rabbits treated with the microkeratome (group 1) while only 1 of 7 rabbits (14.3%) lost the lens in group 2 (P= 0.0155). Discussion: Eyes in which the corneal pocket shape was made by manual stromal dissection had a higher stability of the lens and less post-operative corneal complications

Pseudotumor cerebral en probable relación a ceftriaxona / Pseudomotor cerebri probably due to ceftriaxone

No disponible

[Surgical arteriovenous decompression (sheathotomy) in branch retinal vein occlusion: retrospective study]. / Descompresión venosa quirúrgica en las oclusiones de rama venosa retinianas: estudio retrospectivo.

PURPOSE: To evaluate best-corrected visual acuity (BCVA), incidence of neovascularization and angiographic changes in patients with branch retinal vein occlusion (BRVO) treated with surgical decompression by sheathotomy. METHODS: Retrospective study including 17 cases of temporal BRVO with macular edema treated with surgical decompression. Results of BCVA, incidence of neovascularization and vitreous hemorrhage 6 months following surgery are included. Angiographic changes in the first 8 cases a month after decompression are also evaluated. RESULTS: The mean postoperatory BCVA was 0.40 with a mean improvement of 0.26. Seventy one percent of patients (12/17) improved 2 or more visual acuity lines and 53% of patients (9/17) improved 4 or more lines. Only in one case the vision worsened. There was no evidence of retinal neovascularization or rubeosis iridis six months after surgery. CONCLUSIONS: Surgical decompression is a therapeutical option for those patients suffering BRVO with macular edema. Our initial results are encouraging, not only regarding visual acuity improvement, but also because of a decreased risk of neovascularization. No patient included in our study developed neovascularization.

[Predictors of tobacco addiction in young adults]. / Predictores de adicción al tabaco en adultos jóvenes.

To identify smoking dependence predictors, 150 active smokers were interviewed. To assess tobacco dependence Fagerström's test was used. The potential associations between smoking dependence and some variables related to life style were investigated. In a case-control study design an induction period > or = 2 months was assumed. After estimating crude odds ratios, a logistic regression model was fitted. The dependent variable was dependence to tobacco smoking. In the multivariate analysis independent predictors, in addition to age, were: a) an earlier hour for starting smoking (OR: 6.08; 95% CI: 2.29-16.2), b) thinking that smoking avoids getting fat (OR: 4.36; 95% CI: 1.50-12.7) and c) not knowing any person with smoking-related pathology (OR: 3.75; 95% CI: 1.36-10.3). Exercise appeared to protect against smoking addiction (OR: 0.36; 95% CI: 0.13-0.98). The knowledge of these factors could help to avoid the development of smoking addiction.