Oculomotor Behaviour in Individuals with Long COVID-19.

OBJECTIVE: To determine, the impact of long COVID-19 on oculomotor behaviour. DESIGN: A case-control study. SETTING: Spanish Association of Persistent COVID. PARTICIPANT: Participants were 75 cases (64 women, 11 men, mean age 46.4 years ±8.9) and 42 controls (22 women, 20 men, mean age 53.5 years ±13.13). INTERVENTION: An eye-tracking test based on visual search paradigm and the Adult Developmental Eye Movement Test were used to evaluate the participants. MAIN MEASURES: The primary outcomes in the Adult Developmental Eye Movement Test were horizontal reading time, vertical reading time, and their ratio. And for the eye-tracking test the time to find the target, the duration, and the number of eye fixations. RESULTS: In cases and controls, eye movement test results were horizontal(Hadj) reading time 74.2 ± 22.7 s vs 52.0 ± 6.1 s (p < .0001); vertical(Vadj) reading time 67.6 ± 17.8 s vs 50.4 ± 6.9 s (p < .0001); Hadj/Vadj ratio 0.9 ± 0.1 vs 1.0 ± 0 (p = .0032), respectively; and eye-tracking test results were fixation number 11.3 ± 3.07 vs 3.51 ± 2.57 (p < .0001); fixation duration 2.01 ± 0.79 s vs 1.5 ± 0.4 s (p = .0013), and time to find target 24.5 ± 8.0 vs 18 ± 9.4 (p = .0034), respectively. CONCLUSIONS: Data showed a lower performance in oculomotor behaviour in people with long COVID-19, compared to healthy individuals. It cannot be affirmed an ocular musculature dysfunction; the differentiated behaviour could be associated to cognitive alterations affected in these people. Both tests used could be an useful tool for the clinical assessment of these participants. Further studies are needed to explore the utility of these procedures.

Clinical importance of neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio and systemic immune-inflammation index in dogs with leishmaniasis.

Leishmaniasis is a zoonotic disease caused by Leishmania spp., impacts multiple systems and organs. While hematological and biochemical profiles aren't definitive for diagnosis, recent studies have identified the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and systemic immune-inflammation index (SII) as predictors of morbidity and mortality in critically ill human and dog patients. This study examined 100 dogs diagnosed with leishmaniasis, categorized by the International Renal Interest Society (IRIS) stages 1-4. Additionally, the dogs were divided based on whether they survived less or more than one year (L1Y and G1Y). Control group consisted of 43 dogs. The NLR increased as the disease progressed (IRIS 1-4), presenting statistically significant differences (P<0.05) when compared to the control group (2,37±2,08) IRIS 3 and 4 (4,59±13,39 and 6,99±12,86, respectively), and G1Y and L1Y (3,60±4,02 and 4,87±5,82, respectively). Significant changes in SII were only evident in short-term survivors (L1Y 951,93±1402) and advanced renal disease cases (IRIS 4 stage 1073,68±1901,09). Conversely, PLR remained largely unchanged. In conclusion, these results suggest that the neutrophil-to-lymphocyte ratio (NLR) and systemic immune-inflammation index (SII) may serve as potential markers for assessing disease progression and prognosis in dogs diagnosed with leishmaniasis.

PLIO: a generic tool for real-time operational predictive optimal control of water networks.

This paper presents a generic tool, named PLIO, that allows to implement the real-time operational control of water networks. Control strategies are generated using predictive optimal control techniques. This tool allows the flow management in a large water supply and distribution system including reservoirs, open-flow channels for water transport, water treatment plants, pressurized water pipe networks, tanks, flow/pressure control elements and a telemetry/telecontrol system. Predictive optimal control is used to generate flow control strategies from the sources to the consumer areas to meet future demands with appropriate pressure levels, optimizing operational goals such as network safety volumes and flow control stability. PLIO allows to build the network model graphically and then to automatically generate the model equations used by the predictive optimal controller. Additionally, PLIO can work off-line (in simulation) and on-line (in real-time mode). The case study of Santiago-Chile is presented to exemplify the control results obtained using PLIO off-line (in simulation).

Photic maculopathy: A review of the literature (ii). / Maculopatía fótica: revisión de la literatura (ii).

The human retina, as transducer of light energy, is especially exposed to light toxicity. Solar maculopathy has been the only form of photic maculopathy for millennia, often secondary to the observation of an eclipse. During the last century, technological advances have led to the appearance of new forms of photic maculopathy, related to the exposure to new forms of artificial light, such as welding devices and lasers. In recent years the general use of laser pointers has led to an upturn in interest in this pathology. The aim of this review is to offer an integrated view of the different types of photic maculopathy. Due to the extension of the topic, the review is presented divided into 2 parts. In this second part, atomic bomb maculopathy, laser maculopathy, iatrogenic forms of photic maculopathy, and foveomacular retinitis are presented.

Photic maculopathy: A review of the literature (I). / Maculopatía fótica: revisión de la literatura (I).

The human retina, as transducer of light energy, is especially exposed to light toxicity. Solar maculopathy has been the only form of photic maculopathy for millennia, often secondary to the observation of an eclipse. During the last century, technological advances have led to the appearance of new forms of photic maculopathy, related to the exposure to new forms of artificial light, such as welding devices and lasers. In recent years, the general use of laser pointers has led to an upturn in interest in this pathology. The aim of this review is to offer an integrated view of the different types of photic maculopathy. Due to the extension of this topic, the review is presented divided into two parts. In this first part solar maculopathy and welding arc maculopathy are presented.

[An experimental model to measure real intraocular pressure (IOP) during LASIK]. / Modelo experimental para medir la presión intraocular (PIO) durante LASIK.

PURPOSE: To design a model to measure real IOP during lasik in pig eyes. METHODS: A reusable blood pressure transducer was used. Each eye was placed on a stand with sufficient support for the surgical procedure. The globes were inflated with 5% glucosated solution through the optic nerve to attain an IOP of 10-20 mmHg. A 27-gauge catheter was then inserted from the pars plana to the anterior chamber cavity. Real IOP was transmitted via the catheter liquid column to an external sensor. A suction ring was applied and a flap was created. During the procedure, IOP was registered with the ML110 Bridge Amplifier connected to a baro transducer. RESULTS: Values of real IOP were measured in freshly enucleated pig eyes during the lasik procedure. The model was able to instantaneously register the changes in IOP induced by the application of a suction ring and the creation of a flap in the pig eyes with good reproducibility. At the end of the procedure the IOP values remained stable. CONCLUSIONS: We have developed an experimental model to observe the course of suctioning and changes in IOP simultaneously. This model seems to be accurate in obtaining IOP values from the anterior chamber cavity during LASIK.

Surprising characteristics of visual systems of invertebrates. / Curiosidades sobre el sistema visual de los invertebrados.

OBJECTIVE: To communicate relevant and striking aspects about the visual system of some close invertebrates. MATERIAL AND METHODS: Review of the related literature. RESULTS: The capacity of snails to regenerate a complete eye, the benefit of the oval shape of the compound eye of many flying insects as a way of stabilising the image during flight, the potential advantages related to the extreme refractive error that characterises the ocelli of many insects, as well as the ability to detect polarised light as a navigation system, are some of the surprising capabilities present in the small invertebrate eyes that are described in this work. CONCLUSIONS: The invertebrate eyes have capabilities and sensorial modalities that are not present in the human eye. The study of the eyes of these animals can help us to improve our understanding of our visual system, and inspire the development of optical devices.

The visual system of diurnal raptors: updated review. / El sistema visual de las rapaces diurnas: revisión actualizada.

OBJECTIVE: Diurnal birds of prey (raptors) are considered the group of animals with highest visual acuity (VA). The purpose of this work is to review all the information recently published about the visual system of this group of animals. MATERIAL AND METHODS: A bibliographic search was performed in PubMed. The algorithm used was (raptor OR falcon OR kestrel OR hawk OR eagle) AND (vision OR «visual acuity¼ OR eye OR macula OR retina OR fovea OR «nictitating membrane¼ OR «chromatic vision¼ OR ultraviolet). The search was restricted to the «Title¼ and «Abstract¼ fields, and to non-human species, without time restriction. RESULTS: The proposed algorithm located 97 articles. CONCLUSIONS: Birds of prey are endowed with the highest VA of the animal kingdom. However most of the works study one individual or a small group of individuals, and the methodology is heterogeneous. The most studied bird is the Peregrine falcon (Falco peregrinus), with an estimated VA of 140 cycles/degree. Some eagles are endowed with similar VA. The tubular shape of the eye, the large pupil, and a high density of photoreceptors make this extraordinary VA possible. In some species, histology and optic coherence tomography demonstrate the presence of 2foveas. The nasal fovea (deep fovea) has higher VA. Nevertheless, the exact function of each fovea is unknown. The vitreous contained in the deep fovea could behave as a third lens, adding some magnification to the optic system.

Nonsurgical Procedures for Keratoconus Management.

OBJECTIVES: To describe the past 20 years' correction modalities for keratoconus and their visual outcomes and possible complications. METHODS: A review of the published literature related to the visual outcomes and possible complications in the context of keratoconus management using nonsurgical procedures for the last 20 years (glasses and contact lenses) was performed. Original articles that reported the outcome of any correction modalities of keratoconus management were reviewed. RESULTS: The most nonsurgical procedure used on keratoconus management is the contact lens fitting. Soft contact lenses and soft toric contact lenses, rigid gas-permeable contact lenses, piggyback contact lens system, hybrid contact lenses, and scleral and corneoscleral contact lenses form the contemporary range of available lens types for keratoconus management with contact lenses. All of them try to restore the vision, improve the quality of life, and delay surgical procedures in patients with this disease. Complications are derived from the intolerance of using contact lens, and the use of each depends on keratoconus severity. CONCLUSIONS: In the context of nonsurgical procedures, the use of contact lenses for the management of keratoconic patients represents a good alternative to restore vision and improve the quality of live in this population.

Failure of adjusted doses of subcutaneous heparin to prevent thromboembolic phenomena in pregnant patients with mechanical cardiac valve prostheses.

OBJECTIVES: This report describes our experience with the use of an anticoagulant regimen of adjusted doses of subcutaneous heparin during pregnancy in women with cardiac valve prostheses. BACKGROUND: Gravid patients with prosthetic heart valves require long-term anticoagulant therapy. To avoid the increased incidence of fetal morbidity and mortality associated with the use of coumarin agents in such patients during pregnancy, anticoagulation with subcutaneous heparin has been suggested. Controversy exists concerning the appropriate treatment of these patients. METHODS: Forty pregnancies in 37 women with prosthetic heart valves were prospectively followed up. Subcutaneous heparin was administered from the 6th until the end of the 12th week and in the last 2 weeks of gestation. Heparin was given every 8 h in the first 36 cases and every 6 h in the last 4 cases, and the dose adjusted to maintain the activated partial thromboplastin time at 1.5 to 2.5 times the control level. Acenocoumarol was used at other times. RESULTS: The incidence rate of spontaneous abortions was 37.5%; there was one neonatal death (2.5%) due to cerebral hemorrhage. No signs of coumarin-induced embryopathy were found in any of the 16 live-born infants studied by the geneticist. One mother died of gastrointestinal bleeding while receiving oral anticoagulant agents. There were two cases of fatal massive thrombosis of a mitral tilting-disk prosthesis during heparin therapy. The study was interrupted after the last of these two cases. CONCLUSIONS: The regimen of adjusted doses of subcutaneous heparin used in this study is not effective to prevent thrombosis of mechanical valve prostheses during pregnancy. The use of heparin from the 6th to the 12th week of gestation does not decrease the high incidence of fetal wastage associated with anticoagulant therapy. Coumarin agents provide adequate protection against thromboembolism during pregnancy in patients with mechanical valve prostheses.

A prospective study of the risk of tuberculosis among HIV-infected patients.

OBJECTIVE: To evaluate the risk of developing active tuberculosis (TB) in a cohort of HIV-1-infected patients. METHODS: Prospective longitudinal follow-up of 839 HIV-infected patients, of whom 505 (60%) were parenteral drug users and 269 (32%) homosexual men. Tuberculin skin tests were performed at baseline and annually thereafter. Prophylaxis with isoniazid (300 mg daily for 9 months) was offered to those with a positive tuberculin test (induration > or = 5 mm). Diagnosis of TB was accepted if it could be confirmed microbiologically (acid-fast bacilli seen in Ziehl-Neelsen stains or grown in Lowenstein-Jensen cultures) or pathologically (presence of caseating granulomas) and patients had consistent clinical manifestations. RESULTS: Active TB developed in 23 out of the 733 (3.1%) patients with a negative tuberculin skin test after a mean follow-up of 16 +/- 11 months (range, 2-52 months), with an estimated cumulative probability of 1.5 and 7% after 1 and 3 years, respectively (or 2.4 per 100 patient-years). None of the 87 patients with a negative tuberculin test but a positive Multitest developed TB. Conversely, 106 patients had a positive tuberculin skin test (97 at baseline and nine who converted during follow-up). Active TB developed in seven out of the 26 not receiving prophylaxis or in whom prophylaxis had to be discontinued (16.2 per 100 patient-years), in four out of 61 patients 3-27 months after having completed 9 months of prophylaxis with isoniazid (8.9 per 100 patient-years) and in none of the 19 still receiving isoniazid. When TB was diagnosed, the mean CD4 lymphocyte count of the 34 patients who developed it during follow-up was 77 +/- 103 x 10(6)/l (range, 1-400 x 10(6)/l). CONCLUSIONS: Among HIV-infected patients in whom the tuberculin skin test is negative, the risk of developing active TB is sufficient to consider prophylaxis if the CD4 count falls below 400 x 10(6)/l, at least in those patients with skin anergy living in high-risk geographical areas such as Spain. When the tuberculin skin test was positive, isoniazid (9 months) provided a 45% protection beyond the period of its administration.

PIP: This study sought to evaluate the risk of developing active tuberculosis (TB) in a cohort of HIV-1-infected patients. A prospective longitudinal follow-up was carried out on 839 HIV-infected patients, of whom 505 (60%) were parenteral drug users and 269 (32%) were homosexual men. Tuberculin skin tests were performed at baseline and annually thereafter. Prophylaxis with isoniazid (300 mg daily for 9 months) was offered to those with a positive tuberculin test (induration or= 5 mm.). Diagnosis of TB was accepted if it could be confirmed microbiologically (acid-fast bacilli seen in Ziehl-Neelsen stains or grown in Lowenstein-Jensen cultures) or pathologically (presence of caseating granulomas) and patients had consistent clinical manifestations. Active TB developed in 23 of the 733 (3.1%) patients with a negative tuberculin skin test after a mean follow-up of 16 +or- 11 months (range, 2-52 months), with an estimated cumulative probability of 1.5 and 7% after 1 and 3 years, respectively (or 2.4 per 100 patient-years). None of the 87 patients with a negative tuberculin test, but a positive Multitest, developed TB. Conversely, 106 patients had a positive tuberculin skin test (97 at baseline and 9 who converted during follow-up). Active TB developed in 7 of the 26 not receiving prophylaxis or in whom prophylaxis had to be discontinued (16.2 per 100 patient-years), in 4 of 61 patients 3-27 months after having completed 9 months of prophylaxis with isoniazid (8.9 per 100 patient-years), and in none of the 19 still receiving isoniazid. When TB was diagnosed, the mean CD4 lymphocyte count of the 34 patients who developed it during follow-up was 77 +or- 103 x 106/L (range, 1-400 x 106/L). Among HIV-infected patients in whom the tuberculin skin test is negative, the risk of developing active TB is sufficient to consider prophylaxis if the CD4 count falls below 400 x 106/L, at least in those patients with skin anergy living in high-risk geographical areas such as Spain. When the tuberculin skin test was positive, isoniazid (9 months) provided a 45% protection beyond the period of its administration.

Hemodynamic effect of hydralazine in advanced, stable chronic obstructive pulmonary disease with cor pulmonale. Immediate and short-term evaluation at rest and during exercise.

Hydralazine was administered to eight patients (mean age, 69 +/- 2 years) who had stable, advanced chronic obstructive pulmonary disease (COPD), pulmonary arterial hypertension (mean pulmonary arterial pressure, 31 +/- 3 mm Hg), and cor pulmonale. All of the patients were studied at rest and during exercise. After intravenous administration of hydralazine at rest, there were statistically significant increases in pulmonary arterial pressure (p less than 0.05), cardiac index (p less than 0.005), arterial oxygen saturation (p less than 0.01), and mixed venous saturation (SvO2) (p less than 0.005). Pulmonary vascular resistance did not change, and systemic resistance decreased (p less than 0.005). During exercise, pulmonary arterial pressure increased in all patients, and this increase was not blunted by hydralazine; however, cardiac index (p less than 0.005), arterial oxygen pressure (p less than 0.005), and SvO2 (p less than 0.001) increased further during exercise. The increase in pulmonary vascular resistance was significantly blunted by hydralazine (p less than 0.005). Therapy with the drug was continued orally in seven patients because one patient showed a deleterious response in pulmonary hemodynamics. After seven days of oral hydralazine, pulmonary arterial pressure and pulmonary vascular resistance were not statistically different from control. There were statistically significant increases in cardiac index (p less than 0.005) and SvO2 (p less than 0.05), systemic resistance decreased (p less than 0.01). The same condition was found during exercise; however, only two patients showed pulmonary gas exchange and pulmonary hemodynamic benefit at rest and during exercise with hydralazine therapy. Our results suggest that it is unlikely that vasodilator therapy with hydralazine will be useful in patients with advanced stable COPD and cor pulmonale who seem to have fixed pulmonary vascular disease.

Hemodynamic effect of hydralazine in interstitial lung disease patients with cor pulmonale. Immediate and short-term evaluation at rest and during exercise.

Hydralazine was administered short-term to 13 patients who had stable interstitial lung disease (ILD), pulmonary arterial hypertension (PAH); mean pulmonary arterial pressure ( [PAP]=26 +/- 9 mm Hg), and cor pulmonale (CP). All patients were studied at rest and during exercise. After intravenous hydralazine at rest, there were statistically significant increases in cardiac index (CI) (p less than 0.001), arterial oxygen saturation (SaO2) (p less than 0.01), and mixed venous saturation (S-vO2) (p less than 0.01). Pulmonary vascular resistance (Rp) (p less than 0.005) and systemic resistance (Rs) decreased (p less than 0.001), and PAP did not change. During exercise, PAP did not change; however, CI (p less than 0.01), PaO2 (p less than 0.001), and S-vO2 (p less than 0.01) increased further. The increase in Rp was significantly reduced (p less than 0.01). After continuation of oral hydralazine therapy in 12 patients for 7 days, PAP at rest was not statistically different from control; Rp and Rs remained decreased (p less than 0.001). The same results were found for CI, PaO2, S-vO2, and Rs during exercise. Although PAP did not change from control values, the drug significantly reduced the increase in Rp (p less than 0.005). Vasodilator therapy with hydralazine could be useful in patients with stable ILD who have inflammation with minimal to moderate fibrosis and PAH and might be used as an adjunct to conventional therapy for ILD and CP.

[Non-Hodgkin's lymphomas associated with the acquired immunodeficiency syndrome. A multicenter clinical study of 77 cases]. / Linfomas no hodgkinianos asociados al síndrome de la inmunodeficiencia adquirida. Estudio clínico multicéntrico de 77 casos.

BACKGROUND: The aim of the present was to study the prevalence of non Hodgkin's lymphoma (NHL) in AIDS patients as well as the clinicopathologic characteristics, response to treatment and survival. METHODS: From January 1984 to January 1991, 77 patients with NHL associated with AIDS diagnosed in 9 hospitals in Madrid were retrospectively studied. RESULTS: Ninety-two per cent of the patients were men (mean age 30 years: range: 9-66 years), 62% were intravenous drug abusers and 20 (26%) homosexuals. Pathologic study determined that 62 (80%) patients had high grade NHL (44% small noncleaved), 17% immunoblastic and 20% unclassifiable, and 15 (20%) had intermediate grade (16% diffuse large cell) being all the cases of the B immunophenotype. Sixty-five per cent were in advanced stages and 69% had B symptoms. Extranodal localizations were present in 88%, bone marrow in 29% and CNS in 29%. Six cases had primary CNS lymphomas. 50% of the patients had less than 200 x 10(6)/l CD4 lymphocytes. Forty-seven patients were evaluable for response to chemotherapy: 12 (26%) showed a complete response 27 (57%) a partial response and 8 (17%) did not respond. Opportunistic infections developed in 18%. The estimated survival at 3 years was 14% (median 6 months). On univariate analysis the parameters related to the worst survival were: primary CNS lymphoma, liver involvement, lack of treatment response, LDH > or = 300 UI/l, alkaline phosphatase > or = 500 UI/l and ESR > or = 70 mm. CONCLUSIONS: Non Hodgkin's lymphomas associated with AIDS usually behave in an "aggressive" way with a high frequency of advanced stages, B symptoms, high grade histologic subtypes and extranodal involvement. Response to treatment is poor, bone marrow toxicity frequent and survival short.

[Expression of different HIV-1 phenotypic subpopulations through the natural history of the infection]. / Expresión de diferentes subpoblaciones fenotípicas del virus de la inmunodeficiencia humana tipo 1 a lo largo de la historia natural de la infección.

BACKGROUND: Multiple viral subpopulations coexist in an HIV infected patient with dynamics of selection established between them. In order to get insight on the phenotype of these subpoblations, and its relation with disease progression, we have studied the biological variability of HIV-1 in 113 patients. Variability was related with CD4+ T lymphocyte counts, clinical status, way of viral transmission and antiretroviral treatment. PATIENTS AND METHODS: 113 patients (80 adults and 33 children) were studied for HIV-1 isolation in cocultures of infected and non infected lymphocytes. Viral replication was evaluated as rapid (R)/slow (S) or high (H)/low (L). Syncytia formation was estimated in MT2 cell line (SI/NSI). The tropism toward lymphocytes and monocytes (LM) was studied on H9 and U937 cell lines. RESULTS: Up to 86.7% of viral isolates were R, 56.6% were H and 49.6% were SI. These percentages increased with disease progression. Eight viral strains were R/H/NSI cocultivated in MT2 cells and SI in cocultured lymphocytes (NSI/SI), which may be considered as a new phenotype. All the SI isolates and all the R/H (SI and NSI) isolates were LM. Three categories were established: R/H/SI/LM, R/H/NSI/LM and S/L/NSI/NLM. The first two categories corresponded to patients with CD4+ T lymphocytes <200 x 10(6)/I (56%, 50%). The third category corresponded to patients with > 500 x 10(6)/I (53.3%). CONCLUSIONS: Viral replication and SI phenotype, independently, are useful markers for severity of HIV infection. The biological differences among NSI of the 3 viral phenotype categories, including the new subgroup NSI/SI, may indicate the existence of more pathogenic NSI subpopulations.

[Renal carcinoma and acquired cystic disease of the kidney in a patient after transplantation and under hemodialysis]. / Carcinoma renal y enfermedad quística adquirida del riñón en paciente trasplantado y en hemodiálisis.

Renal Acquired Cystic Disease (RACD) is a frequent entity in patients with a long standing renal failure under hemodialysis treatment. Incidence of a tumor pathology is higher in those patients than in the general population. A new case is presented and some possible etiopathologenical factors of RACD and neoplasias on such pathology are established.

[Impact of cataract surgery upon functional capacity of the elderly]. / Repercusión de la intervención de cataratas en la capacidad funcional del anciano.

PURPOSE: To determine the impact of cataract intervention on visual function of the elderly and on autonomy in daily activities, analyzing the influence of clinical and sociodemographic variables. METHODS: Observational and longitudinal study. 185 elderly patients having undergone cataract surgery were compared with 179 elderly patients on a surgical waiting list. The first group was evaluated prior to surgery and at 4 months post-intervention. Control group patients were evaluated at the same times, without having received surgery. For all subjects, the state of visual function was determined by the Activities of Daily Vision Scale (ADVS). Degree of dependence in carrying out basic daily activities, cognitive state and self-perception of vision were also measured. Other variables were visual acuity, other ocular diseases and sociodemographic characteristics. RESULTS: Amongst the elderly patients having undergone surgery, the proportion of subjects able to carry out basic activities 4 months post-intervention (60.7%) was very similar to the initial pre-intervention figure (62.2%). However, in the control group, the proportion (63.1%) diminished significantly at the 4-month mark (48.8%) (p= 0.0001). Of the intervened subjects, 75.7% demonstrated improved self-perception of vision after 4 months as opposed to 15.4% of the non-intervened patients (p= 0.00001). Post-intervention, the mean score on the ADVS rose from 51.0 S.D. 28.4 to 76.0 S.D. 25.4 (p < 0.001). In contrast, the control group's mean score dropped from 54.8 S.D. 24.8 to 46.5 S.D. 27.1 (p < 0.001). CONCLUSIONS: Cataract surgery in the elderly improves visual function and prevents loss of autonomy, delaying dependency in carrying out basic daily activities.

[Hyperhomocysteinemia as risk factor in a Mexican population]. / La hiperhomocisteinemia como factor de riesgo en una población mexicana.

Hyperhomocysteinemia is considered one of the emerging risk factors for the development of coronary artery disease (CAD). In order to know the prevalence of this metabolic disorder in a Mexican population with early CAD (< 50 years), we studied a group of these patients and compared the levels of homocysteine with a group of patients, paired by age and gender, without angiographic evidence of coronary atherosclerosis. Preliminary results show that the population with early CAD has more traditional risk factors, specially diabetes mellitus, and higher levels of homocysteine in plasma. Moreover there is a genetic factor with higher incidence of a TT homozygotic mutation of the MTHFR that increases homocysteine because of an altered folate metabolism.

[Colony-stimulating factors and HIV-related neoplasms]. / Factores estimulantes de colonias y neoplasias asociadas al VIH.

OBJECTIVE: it is analyzed a group of patients with HIV related malignancy treated with myelosuppressive therapy with granulocyte colony stimulating factor (G-CSF) to study the efficacy of hematopoietic growth factors in these subjects. PATIENTS AND METHODS: it was studied the clinical and hematological evolution of 20 patients with HIV related malignancy treated with standard dose of chemotherapy and 5 micrograms/Kg/day of G-CSF starting 24 hours after the completion of chemotherapy administration. It was done an epidemiological study and was determined haemoglobin level, and the number of leukocytes, monocytes, neutrophils, lymphocytes, CD4+ lymphocytes and platelets before and after the chemotherapy administration. RESULTS: all of the patients were men with mean age of 37 +/- 2 years. The mean of lymphocyte CD4+ count was 17 x 10(6)/l and the tumor was the first aids manifestation in 50% of the subjects. The mean days of hospitalization was 14 +/- 3 days. As the result of the G-CSF administration, the leucocyte and the neutrophil count was statistically elevated (p < 0.01) and the platelets, the lymphocytes and the monocytes were not statistically elevated. Only one patient had a severe adverse reaction. Seventeen patients (85%) are dead, but only in 3 the cause was an infectious disease. CONCLUSION: the use of G-CSF prophylactically can elevate the neutrophil count and avoid the apparition of febrile neutropenia in patients with HIV related malignancies.