Improving the structure and properties of whey protein emulsion gel using soluble interactions with xanthan and basil seed gum.

Applying hydrocolloids in the structure of protein emulsion gel can improve its properties. Interaction of whey protein concentrate (WPC) (5%) with xanthan gum (XG) and basil seed gum (BSG) at different concentrations (0.2%, 0.4%, and 0.6%) was investigated to improve mechanical and structural properties of emulsion gel. Results illustrated that gums created a stronger structure around the oil droplets, which confocal images approved it. Also, the particle size decreased and uniformed by cooperating 0.6% gum in comparison with WPC (46.87 µm). The lowest and highest hardness values were observed in emulsion gel formed by WPC (1.27 N) and 0.6BSG: WPC (3.03 N), respectively. Also, the increase of gum concentration had a positive on consistency parameter of texture, so the value was 11.48 N s in WPC emulsion gel and it reached 0.6BSG: WPC (25.71 N s) and 0.6XG: WPC (19.96 N s). Evaluating the stability of the treatments by centrifugation indicated that 0.6BSG: WPC (89.10%) and 0.6XG: WPC (74%) had the highest level of stability. Increasing gum concentration increased the consistency and viscosity. Also, the viscoelastic properties of emulsion gel improved by 0.6% BSG. The elastic modulus of the WPC, 0.6XG: WPC, and 0.6BSG: WPC emulsion gels at the same frequency (1 Hz) was 240.90, 894.59, and 1185.61 Pa, respectively. In general, the interaction of WPC solution with hydrocolloids, especially BSG, is suggested to prepare more stable and elastic emulsion gels.

Nuestra experiencia en el manejo diagnóstico-terapéutico a corto plazo del paciente con displasia anal / Our experience in the short-term diagnostic-therapeutic management of the patient with anal dysplasia

Introducción: La neoplasia intraepitelial anal (NIA) es una lesión premaligna del carcinoma escamoso anal. Los varones VIH que tienen sexo con varones, es la población de riesgo más afectada. La citología y anuscopia son los métodos mejor aceptados para su diagnóstico, aunque es controvertido qué pacientes deben completarlo con una biopsia. Tampoco está bien establecido qué pacientes deben someterse a tratamiento y cuál es el mejor. Con este estudio, queremos exponer nuestra experiencia en el manejo diagnóstico-terapéutico de la NIA a corto plazo. Métodos: Estudio observacional retrospectivo de pacientes con riesgo de NIA con una citología anal alterada a los que se les realizó una anuscopia de alta resolución con biopsia. Tras la confirmación histológica de displasia iniciaron tratamiento con ácido tricloroacético. Se comprobó su efectividad con una citología posterior. Se analizaron las variables demográficas de la muestra y los resultados de las pruebas diagnósticas y de tratamiento. Resultados: La mayoría eran varones VIH positivos (104/115) y el 50% mantenían relaciones sexuales con otros varones. Se incluyeron 115 pacientes con citología anal alterada, de los cuales el 92% presentaron displasia en la biopsia. El 97% con atipia de significado incierto en la citología presentaron displasia histológicamente. El 60% de los pacientes normalizó la citología tras el tratamiento. Conclusión: Se debe considerar de forma sistemática la detección precoz de la NIA en poblaciones de riesgo conocidas. Cualquier anormalidad citológica debe ser biopsiada. El ácido tricloroacético puede ser un tratamiento efectivo consiguiendo un alto porcentaje de regresión, aunque actualmente la información con la que contamos es de bajo nivel de evidencia. (AU)

Introduction: Anal intraepithelial neoplasia (AIN) is a premalignant lesion of anal squamous cell carcinoma. HIV-positive males who have sex with males, are the most affected at-risk population. Cytology and anuscopy are the best accepted methods for its diagnosis, although it is controversial which patients should complete it with a biopsy. Neither which patients should undergo treatment nor which is the best treatment is not well established. With this study, we would like to present our experience in the diagnostic-therapeutic management of AIN in the short term. Methods: Retrospective observational study of patients at risk of AIN with altered anal cytology who underwent high-resolution anuscopy with biopsy. After histological confirmation of dysplasia, they started treatment with trichloroacetic acid. Its effectiveness was verified by subsequent cytology. The demographic variables of the sample and the results of both diagnostic and treatment tests were analyzed. Results: The majority were HIV-positive males (104/115) and 50% had sexual relations with other men. We included 115 patients with altered anal cytology, of whom 92% had dysplasia on biopsy. 97% with atypia of uncertain significance on cytology had histological dysplasia. Cytology normalized after treatment in 60% of patients. Conclusion: Early detection of AIN should be routinely considered in known at-risk populations. Any cytological abnormality should be biopsied. Tricholoroacetic acid can be an effective treatment achieving a high percentage of regression, although currently, the information we have is of low level of evidence. (AU)

Impact of acetylation process of kraft lignin in development of environment-friendly semisolid lubricants.

The aim of this work was to study the influence of the acetylation process of kraft lignin on developing dispersions potentially applicable as new bio-based semisolid lubricants. Lignin was functionalized with acetic anhydride and pyridine as a catalyst by modifying different reaction variables (temperature, ratio of pyridine/acetic anhydride and time). Acetylated lignin was analyzed using FTIR, 1H and 13C NMR techniques, TGA, DSC and SEM to evaluate the chemical, morphological and thermal changes induced by the acetylation process. The influence of the acetylation process on the rheological and tribological properties of dispersions was related to the development of different microstructures, which depend on chemical and morphological properties of acetylated lignin. In this sense, two different rheological behaviours (gel-like or fluid-like) were found to depend on the reaction time. From the experimental results obtained, it can be concluded that the acetylation process is a key issue to modulate rheological and morphological properties of dispersions, resulting in an effective method to improve the compatibility of lignin and castor oil. Acetylated lignin with medium degrees of substitution with adequate morphological properties can be potentially used as an effective thickening agent to develop semisolid lubricants.

Our experience in the short-term diagnostic-therapeutic management of the patient with anal dysplasia.

INTRODUCTION: Anal intraepithelial neoplasia (AIN) is a premalignant lesion of anal squamous cell carcinoma. HIV-positive males who have sex with males, are the most affected at-risk population. Cytology and anuscopy are the best accepted methods for its diagnosis, although it is controversial which patients should complete it with a biopsy. Neither which patients should undergo treatment nor which is the best treatment is not well established. With this study, we would like to present our experience in the diagnostic-therapeutic management of AIN in the short term. METHODS: Retrospective observational study of patients at risk of AIN with altered anal cytology who underwent high-resolution anuscopy with biopsy. After histological confirmation of dysplasia, they started treatment with trichloroacetic acid. Its effectiveness was verified by subsequent cytology. The demographic variables of the sample and the results of both diagnostic and treatment tests were analyzed. RESULTS: The majority were HIV-positive males (104/115) and 50% had sexual relations with other men. We included 115 patients with altered anal cytology, of whom 92% had dysplasia on biopsy. 97% with atypia of uncertain significance on cytology had histological dysplasia. Cytology normalized after treatment in 60% of patients. CONCLUSION: Early detection of AIN should be routinely considered in known at-risk populations. Any cytological abnormality should be biopsied. Tricholoroacetic acid can be an effective treatment achieving a high percentage of regression, although currently, the information we have is of low level of evidence.

Impact of the Morphology of Electrospun Lignin/Ethylcellulose Nanostructures on Their Capacity to Thicken Castor Oil.

This study reports on a novel strategy for manufacturing thickened gel-like castor oil formulations by dispersing electrospun lignin/ethylcellulose nanostructures. These thickened formulations were rheologically and tribologically evaluated with the aim of being proposed as alternative ecofriendly lubricating greases. Low-sulfonate kraft lignin (LSL) and ethylcellulose (EC) were dissolved in a DMAc:THF mixture at different concentrations (8, 10, and 15 wt.%) and LSL:EC ratios (50:50, 70:30, and 90:10) and subjected to electrospinning. The resulting electrospun nanostructures were morphologically characterized. EC acting as the cospinning polymer improved both LSL spinnability and the oil structuring ability. Solutions with a high lignin content achieved microsized particles connected by fibrils, whereas solutions with a high EC content (50:50 ratio) and LSL/EC total concentration (10 and 15 wt.%) yielded beaded or bead-free nanofibers, due to enhanced extensional viscoelastic properties and nonNewtonian characteristics. The gel-like properties of electrospun nanostructure dispersions in castor oil were strengthened with the nanostructure concentration and the EC:LSL ratio, as a result of the formation of a more interconnected fiber network. The oleodispersions studied exhibited a satisfactory frictional response in a tribological contact, with friction coefficient values that were comparable to those achieved with traditional lithium-lubricating greases.

Cyttaria hariotii E.Fisch. as a promising source of pullulan and Mn(II)-pullulan complexes for Mn-deficiency remediation in winter cereals.

Pullulan, a water-soluble polysaccharide consisting of maltotriose units used in the preparation of edible films and drug delivery, is generally produced from starch by Aureobasidium pullulans (de Bary & Löwenthal) G.Arnaud fungus. In this article, the characterisation of an alternative pullulan source - the stromata of Cyttaria hariotii E.Fisch. fungus - by elemental analysis, infrared spectroscopy and thermal analysis techniques is reported. With a view to a possible valorisation of this pullulan and its derivatives as bioactive formulations in agriculture, low-molecular-weight pullulan (<7 kDa) complexes with Mn(II), suitable for the remediation of Mn-deficiencies in winter cereal by foliar application, were synthesised and characterised by mass spectrometry.

Electrospun lignin-PVP nanofibers and their ability for structuring oil.

This work explores the electrospinnability of low-sulfonate Kraft lignin (LSL)/polyvinylpyrrolidone (PVP) solutions in N,N-dimethylformamide (DMF) and the ability of the different micro- and nano-architectures generated to structure castor oil. LSL/PVP solutions were prepared at different concentrations (8-15 wt%) and LSL:PVP ratios (90:10-0:100) and physico-chemically and rheologically characterized. The morphology of electrospun nanostructures mainly depends on the rheological properties of the solution. Electrosprayed nanoparticles or micro-sized particles connected by thin filaments were obtained from solutions with low LSL/PVP concentrations and/or high LSL:PVP ratios, whereas beaded or bead-free nanofibers were produced by increasing concentration and/or decreasing LSL:PVP ratio, due to enhanced extensional viscoelastic properties and non-Newtonian characteristics. Electrospun LSL/PVP nanofibers are able to form oleogels by simply dispersing them into castor oil at concentrations between 10 and 30 wt%. The rheological properties of the oleogels may be tailored by modifying the LSL:PVP ratio and nanofibers content. The potential application of these oleogels as bio-based lubricants was also explored in a tribological cell. Satisfactory friction and wear results are achieved when using oleogels structured by nanofibers mats with enhanced gel-like properties as lubricants. Overall, electrospinning of lignin/PVP solutions can be proposed as a simple and effective method to produce nanofibers for oil structuring.

Effects of 6-Month Multimodal Physical Exercise Program on Bone Mineral Density, Fall Risk, Balance, and Gait in Patients with Alzheimer's Disease: A Controlled Clinical Trial.

We aimed to determine the short- and medium-term effects of a multimodal physical exercise program (MPEP) on bone health status, fall risk, balance, and gait in patients with Alzheimer's disease. A single-blinded, controlled clinical trial was performed where 72 subjects were allocated in a 3:1 ratio to an intervention group (IG; n = 53) and control group (CG; n = 19), where the IG's subjects were admitted to live in a State Reference Center of Alzheimer's disease, which offers the targeted exercise program, while the CG's subjects resided in independent living. A multidisciplinary health team assessed all patients before allocation, and dependent outcomes were again assessed at one, three, and six months. During the study, falls were recorded, and in all evaluations, bone mineral density was measured using a calcaneal quantitative ultrasound densitometer; balance and gait were measured using the performance-oriented mobility assessment (POMA), the timed up and go test (TUG), the one-leg balance test (OLB), and the functional reach test (FR). There were no differences between groups at baseline for all outcome measures. The prevalence of falls was significantly lower in the IG (15.09%) than in the CG (42.11%) (χ2 = 5.904; p = 0.015). We also found that there was a significant time*group interaction, with a post hoc Sidák test finding significant differences of improved physical function, especially in gait, for the IG, as assessed by POMA-Total, POMA-Gait, and TUG with a large effect size (ƞ2p = 0.185-0.201). In balance, we found significant differences between groups, regardless of time, and a medium effect size as assessed by POMA-Balance and the OLB (ƞ2p = 0.091-0.104). Clinically relevant effects were observed, although without significant differences in bone health, with a slowing of bone loss. These results show that a multimodal physical exercise program reduces fall risk and produces an improvement in gait, balance, and bone mineral density in the short and medium term in institutionalized patients with Alzheimer's disease.

Role of contrast-enhanced ultrasonography in the management of chronic inflammatory bowel disease.

The incidence of inflammatory bowel disease (IBD) has increased over the past few decades. Also, the management of patients with IBD is associated with a relevant use of healthcare resources, and requires a multidisciplinary approach, with patients being cared for in monographic units. The umbrella term IBD includes ulcerative colitis (UC) and Crohn's disease (CD). The former condition involves the colonic mucosa alone, from the rectum in a cephalad direction with a variable extent, whereas the latter is a segmental transmural condition that may involve any portion of the gastrointestinal (GI) tract. Ileocolonoscopy is the gold standard for the diagnosis and follow-up of IBD, but can only assess intraluminal findings, hence it must be supplemented with techniques capable of transmural evaluation and of exploring scarcely accessible bowel segments, namely gastrointestinal ultrasound (GIUS), computed tomography (CT), and MR enterography (MRE).

Effects of Postharvest Water Deficits on the Physiological Behavior of Early-Maturing Nectarine Trees.

The physiological performance of early-maturing nectarine trees in response to water deficits was studied during the postharvest period. Two deficit irrigation treatments were applied, moderate and severe, and these were compared with a control treatment (fully irrigated). Stem water potential and leaf gas exchange (net CO2 assimilation rate, ACO2; transpiration rate, E; and stomatal conductance, gs) were measured frequently. Drought avoidance mechanisms included a decrease in stomatal conductance, especially in the case of the severe deficit treatment, which also showed a strong dependence of ACO2 on gs. Intrinsic water-use efficiency (ACO2/gs) was more sensitive than instantaneous water-use efficiency (ACO2/E) as an indicator to detect water deficit situations in nectarine trees. However, in contrast to the results obtained for other deciduous fruit trees, a poor correlation was found between ACO2/E and ACO2/gs, despite the important relation between E and gs. ACO2/E was also weakly correlated with gs, although this relationship clearly improved when the vapor pressure deficit (VPD) was included, along with gs as the independent variable. This fact reveals that apart from stomatal closure, E depends on the boundary layer conductance (gb), which is mediated by VPD through changes in wind speed. This suggests low values of the decoupling coefficient for this water-resilient species.

Antifungal Agents Based on Chitosan Oligomers, ε-polylysine and Streptomyces spp. Secondary Metabolites against Three Botryosphaeriaceae Species.

Grapevine trunk diseases (GTDs) are a major threat to the wine and grape industry. The aim of the study was to investigate the antifungal activity against Neofusicoccum parvum, Diplodia seriata, and Botryosphaeria dothidea of ε-polylysine, chitosan oligomers, their conjugates, Streptomyces rochei and S. lavendofoliae culture filtrates, and their binary mixtures with chitosan oligomers. In vitro mycelial growth inhibition tests suggest that the efficacy of these treatments, in particular those based on ε-polylysine and ε-polylysine:chitosan oligomers 1:1 w/w conjugate, against the three Botryosphaeriaceae species would be comparable to or higher than that of conventional synthetic fungicides. In the case of ε-polylysine, EC90 values as low as 227, 26.9, and 22.5 µg·mL-1 were obtained for N. parvum, D. seriata, and B. dothidea, respectively. Although the efficacy of the conjugate was slightly lower, with EC90 values of 507.5, 580.2, and 497.4 µg·mL-1, respectively, it may represent a more cost-effective option to the utilization of pure ε-polylysine. The proposed treatments may offer a viable and sustainable alternative for controlling GTDs.

Tratamiento de la periodontitis apical persistente: cirugía periapical versus retratamiento endodóncico no quirúrgico / Treatment of persistent apical periodontitis: periapical surgery versus nonsurgical retreatment

Se denomina Periodontitis Apical Crónica Persistente (PACP) al proceso inflamatorio periapical que se desarrolla o persiste tras el tratamiento de conductos. Las opciones terapéuticas en el tratamiento de la PACP, cuando el diente puede conservarse, son el retratamiento de conductos por vía ortógrada o la cirugía periapical, e incluso puede ser necesaria una combinación de ambos tratamientos. El objetivo de este trabajo ha sido buscar respuesta a la siguiente pregunta: ¿En un paciente con un diente al que se le ha realizado tratamiento endodóncico que ha fracasado y sufre periodontitis apical crónica persistente (PACP), se obtiene mayor tasa de curación del proceso inflamatorio periapical mediante el retratamiento por vía ortógrada o con la cirugía periapical? La búsqueda realizada proporcionó 7 artículos: 3 ensayos clínicos aleatorios, 3 revisiones sistemáticas y 1 revisión no sistemática. La evidencia científica disponible sugiere que no existen diferencias significativas en las tasas de éxito a largo plazo del retratamiento endodóncico por vía ortógrada y la cirugía periapical, en casos de periodontitis apical crónica persistente tras el tratamiento endodóncico. El retratamiento endodóncico por vía ortógrada obtiene mejores resultados a largo plazo, mientras que la cirugía periapical tiene una tasa de curación más rápida. El retratamiento ortógrado conlleva un mejor postoperatorio para el paciente, mientras que la cirugía periapical implica una mayor necesidad de trata-miento analgésico y antiinflamatorio en los primeros 7 días

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Síndrome de burnout y satisfacción laboral en enfermeras españolas en tiempo de crisis económica / Burnout Syndrome and job satisfaction among Spanish nurses at a time of economic crisis

Objetivo: analizar el grado de burnout y de satisfacción laboral en enfermeras españolas en tiempos de crisis económica. Método: la población de estudio fueron enfermeras españolas que desarrollaban su actividad en España o en el extranjero. Se distribuyó una encuesta online a través de redes sociales desde octubre de 2017 hasta mayo de 2018 que contenía el cuestionario CUBO para valorar burnout y el de satisfacción laboral de Warr, Cook y Wall. El muestreo fue por conveniencia. Se llevó a cabo un análisis descriptivo y analítico con pruebas paramétricas y no paramétricas. Resultados: participaron 1.346 enfermeras. El 39,67% tenía síndrome de burnout, el 37,07% estaba en riesgo de padecerlo. La satisfacción laboral era de grado medio y se asociaba negativamente al grado de burnout. El 16,34% pensaba que se había equivocado de profesión, el 43,16% se había planteado comenzar otros estudios para orientar su vida profesional hacia otra área y el 59,29% pensaba que se había endurecido emocionalmente. Los profesionales de Enfermería estaban insatisfechos fundamentalmente con su salario, las relaciones sociales entre dirección y trabajadores, las oportunidades de promoción, la forma de dirección de la empresa, la atención que se presta a sus sugerencias y las horas de trabajo. Se encontró correlación negativa entre la satisfacción laboral y el síndrome de burnout. La mayoría consideraba que la crisis había afectado a sus condiciones laborales. Conclusiones: se ha detectado un elevado grado de burnout y de insatisfacción laboral en profesionales de Enfermería españoles. Se presenta asociación negativa entre el síndrome de burnout y la satisfacción laboral. Los profesionales de Enfermería consideran que la crisis económica ha repercutido negativamente en la profesión

Objectives: to analyze the level of burnout and job satisfaction among Spanish nurses at times of economic crisis. Methods: the study population consisted in Spanish nurses carrying out their activity in Spain or abroad. An online survey was distributed through the social networks from October, 2017 until May, 2018, including the CUBO questionnaire for burnout assessment, and the Warr, Cook, and Wall's Job Satisfaction Scale. Convenience sampling was used, and descriptive and analytical analysis was conducted with parametric and non-parametric tests. Results: the study included 1,346 nurses; 39.67% of them had Burnout Syndrome, and 37.07% were at risk of suffering it. Also, 16.34% of them thought that they had chosen the wrong profession, 43.16% had considered studying something different in order to orientate their professional life towards another area, and 59.29% of them thought that they had become emotionally tougher. Nursing professionals were essentially unsatisfied with their salary, the social relationships between management and workers, promotion opportunities, the way in which the company was managed, the attention paid to their suggestions, and their working hours. A negative correlation was found between job satisfaction and Burnout Syndrome. The majority considered that the crisis had had an impact on their working conditions. Conclusions: a high level of burnout and job dissatisfaction has been detected among the Spanish Nursing professionals. There is a negative association between Burnout Syndrome and job satisfaction. Nursing professionals consider that the economic crisis has had a negative impact on their profession

Polymorphisms in Receptors Involved in Opsonic and Nonopsonic Phagocytosis, and Correlation with Risk of Infection in Oncohematology Patients.

High-risk hematological malignancies are a privileged setting for infection by opportunistic microbes, with invasive mycosis being one of the most serious complications. Recently, genetic background has emerged as an unanticipated risk factor. For this reason, polymorphisms for genes encoding archetypal receptors involved in the opsonic and nonopsonic clearance of microbes, pentraxin-3 (PTX3) and Dectin-1, respectively, were studied and correlated with the risk of infection. Fungal, bacterial, and viral infections were registered for a group of 198 patients with high-risk hematological malignancies. Polymorphisms for the pentraxin-3 gene (PTX3) showed a significant association with the risk of fungal infection by Candida spp. and, especially, by Aspergillus spp. This link remained even for patients undergoing antifungal prophylaxis, thus demonstrating the clinical relevance of PTX3 in the defense against fungi. CLEC7A polymorphisms did not show any definite correlation with the risk of invasive mycosis, nor did they influence the expression of Dectin-1 isoforms generated by alternative splicing. The PTX3 mRNA expression level was significantly lower in samples from healthy volunteers who showed these polymorphisms, although no differences were observed in the extents of induction elicited by bacterial lipopolysaccharide and heat-killed Candidaalbicans, thus suggesting that the expression of PTX3 at the start of infection may influence the clinical outcome. PTX3 mRNA expression can be a good biomarker to establish proper antifungal prophylaxis in immunodepressed patients.

Neumotórax secundario a ablación por radiofrecuencia de neuralgia postherpética / Pneumothorax Due to Radiofrequency Ablation for Post-herpetic Neuralgia

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Geminación y fusión: un desafío en la práctica clínica / Gemination and fusion: a challenge for clinical practice

Los términos geminación y fusion dentaria son utilizados para describir dos anomalías dentarias por unión en las que se afectan el número, la estructura, la forma, y el tamaño dentario. Su diagnóstico diferencial es muy complicado, a pesar de los numerosos casos que se pueden encontrar en la literatura. Es por ello, que muchos autores denominan a este grupo de anomalías como «diente doble» o «diente gemelo», considerándolos así como términos sinónimos. El diagnóstico y tratamiento del «diente doble» es un desafío para el dentista, así como su nomenclatura. Debe llevarse a cabo un diagnóstico diferencial con la macrodoncia. Los dientes afectados representan frecuentemente un problema estético, siendo más susceptibles a la caries y a la enfermedad periodontal. Es necesario llevar a cabo un examen clínico y radiográfico exhaustivo, para obtener un diagnóstico correcto que permita alcanzar un tratamiento temprano, en caso de que sea necesario. La opción de tratamiento del «diente doble» depende del tipo de dentición afectada, la repercusión estética, la morfología del arco dental y el patrón de oclusión. Cuando se requiere tratamiento endodóncico, es obligatorio prestar más atención durante determinadas fases, especialmente en el diagnóstico radiológico, y en el acceso y localización de conductos. Este artículo discute la prevalencia, etiología, patogenia, diagnóstico diferencial y tratamiento del diente doble mediante cuatro casos clínicos

Gemination and fusion are terms used to describe two dental anomalies by union, where number, shape, structure and tooth size are affected. Differential diagnosis is complicated, in spite of numerous cases described in literature. Thereby, many authors describe this group of anomalies as «double teeth» or «twin-teeth», considering them as synonymous terms. «Double teeth» diagnosis and treatment are a challenge for dentist, as well as its nomenclature. Differential diagnosis with macrodontia must be carried out. Affected tooth frequently show poor aesthetic, being more susceptible to caries and periodontal disease. It is necessary to carry out an exhaustive clinical and radiographic examination to provide a correct diagnosis for achieving an early treatment, if necessary. Treatment choice in double-teeth depends upon the type of affected dentition, aesthetic involvement, dental arch morphology and occlusion pattern. When requiring endodontic treatment, more attention during certain stages, especially in diagnostic radiology, and in access, and location of roots canals are compulsory. This article discuss the prevalence, etiology, pathogenesis, differential diagnosis and treatment of double-teeth through four clinical cases

Evaluation of the Ex-PRESS(®) P-50 implant under scleral flap in combined cataract and glaucoma surgery.

AIM: To evaluate the efficacy and safety of glaucoma drainage device Ex-PRESS(®) P-50 for combined cataract surgery and glaucoma. METHODS: Patients having cataract and open angle glaucoma or patients with open advanced glaucoma which needed two or more antiglaucoma medications were included. Combined cataract surgery and glaucoma with Ex-PRESS(®) P-50 model placed under scleral flap was performed. RESULTS: Out of 40 eyes of 40 patients (55% male and 45% female) completed the study during one-year follow-up. The mean of age was 76.6±11.02y. The intraocular pressure (IOP) decreased significantly during the 12-month follow-up from 23.5 mm Hg to 16.8 mm Hg (Wilcoxon signed ranks test, P<0.001). A 59.5% of patients did not need any topical treatment, 10.8% of them needed one active principle, 27% needed two active principles, and 2.7% of them needed three active principles for successful IOP control (<21 mm Hg). CONCLUSION: Combined surgery of phacoemulsification with ExPRESS(®) P-50 lowers IOP from the preoperative baseline and reduces significantly the number of antiglaucoma active principles for IOP control after the operation.