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BACKGROUND AND OBJECTIVE: There is currently no objective measure of the visual deficits experienced by patients with symptomatic vitreous opacities (SVOs) that would also correlate with the functional improvement they report following vitrectomy. This study aims to determine whether reading speed can be used as a reliable outcome measure to assess objectively the impact of both SVOs and vitrectomy on patients' visual performance. PATIENTS AND METHODS: Twenty adult patients seeking surgery for SVO were included. Measures of visual function were obtained before and after vitrectomy using the Early Treatment Diabetic Retinopathy Study acuity chart, the National Eye Institute Visual Function Questionnaire, and the MNREAD acuity chart. RESULTS: In patients with nonopacified lenses (n = 10), maximum reading speed increased significantly from 138 to 159 words per minute after complete removal of SVOs by vitrectomy (95% confidence interval, 14–29; P < .001). CONCLUSIONS: Reading speed is impaired with SVOs and improves following vitrectomy in phakic and pseudophakic eyes with clear lenses. Reading speed is a valid objective measure to assess the positive effect of vitrectomy for SVOs on near-distance daily life activities. [ Ophthalmic Surg Lasers Imaging Retina . 2020;51:456–466.]

Purpose To present a case of central serous chorioretinopathy (CSC) treatment with spironolactone in a challenge-rechallenge pattern. Methods At presentation, fundus photography, fluorescein angiography, spectral domain optical coherence tomography, and enhanced depth imaging ocular coherence tomography were performed in both eyes. The patient was prescribed 25 mg spironolactone daily along with serum potassium monitoring. At follow-ups, spectral domain optical coherence tomography and enhanced depth imaging ocular coherence tomography were performed. Results A 37-year-old white male accountant presenting with CSC. Spironolactone treatment resolved the CSC. After the patient discontinued treatment, it returned. After returning to daily treatment, the CSC again resolved. Conclusion Spironolactone was an effective treatment of CSC in this case. Other groups have reported similar findings with eplerenone, a similar drug.

OBJECTIVE: To better understand what influences interindividual differences in ability to navigate in the wilderness, we hypothesized that better performance would be seen in (a) BDNF (rs6265) Val/Val homozygotes increased use of a spatial strategy, (b) KIBRA rs17070145 T/T homozygotes superior episodic memory, (c) CHRNA4 (rs1044396) T allele carriers better ability to focus visuospatial attention. METHOD: Military cadets (n = 382) genotyped for BDNF, KIBRA, and CHRNA4 SNPs used a map and compass to navigate in unmarked woods. Participants completed a morning course within 3.0 km and an afternoon course within 7.0 km. RESULTS: Success or failure in finding each point was analyzed in a logistic regression model with KIBRA, BDNF, and CHRNA4 genotypes as fixed effects. For the morning course, the adjusted odds ratio for the effect of KIBRA T/T over KIBRA C/C was 2.58 (95% CI of 1.31, 5.06) demonstrating a statistical benefit of the KIBRA T/T genotype over individuals with KIBRA C/C genotype. BDNF did not have an independent association with navigational success. For the afternoon course, the adjusted odds ratio for the effect of CHRNA4 C/T over C/C was 1.67 (95% CI of 1.24, 2.25) demonstrating a statistical benefit of CHRNA4 T allele carriers over the C/C genotype. CONCLUSIONS: Ability to navigate in the wilderness benefits less from sense of direction (BDNF and Santa Barbara Sense of Direction) and more from episodic memory (KIBRA) in the first course and heightened ability to focus attention (CHRNA4) after experience in the 2nd course. (PsycINFO Database Record(c) 2016 APA, all rights reserved). Language: en

Scarce information exists regarding the usefulness of the endovascular approach in patients with thromboangiitis obliterans and critical ischemia. A 41-old-man diagnosed with Buerger’s disease had rest pain and a severe ulceration on the big toe. He had been scheduled for a big toe amputation. Typical findings of Buerger’s disease were found in the angiogram including below-the-knee involvement and corkscrew collateral arteries. Stenoses of the posterior tibial artery were angioplastied and the plantar artery was recanalized and angioplastied. Healing was achieved and the patient remains asymptomatic 21 months after the procedure. The outcome achieved in this case and recent series should encourage doctors dealing with this problem to attempt limb salvage by means of the endovascular approach.

Increased blood homocysteine levels are a known cardiovascular risk factor. Epileptic patients on long-term treatment with antiepileptic drugs may present higher homocysteine levels and, consequently, a potential increase in cardiovascular risk.We conducted an observational case-control study to compare plasma levels of homocysteine, folic acid, and vitamin BOur study included a total of 88 subjects: 52 patients with epilepsy and 36 controls. Epileptic patients showed higher homocysteine levels (P=.084) and lower levels of folic acid (P.05).Homocysteine levels should be monitored in epileptic patients on long-term treatment with antiepileptic drugs. We suggest starting specific treatment in patients with high homocysteine levels.

To present our experience in the treatment of nasolacrimal occlusion by means of polyurethane stents.Forty polyurethane stents were placed under fluoroscopic guidance in 35 consecutive patients with epiphora due to total or partial obstruction of the nasolacrimal system. The set designed by Song was used in all patients. The procedure was performed by introducing a guidewire through the superior punctum into the canaliculus and advancing it across the obstruction into the inferior meatus of the nasal cavity. After pulling out the guidewire, the stent was advanced in retrograde fashion and released into the sac and the nasolacrimal duct.The technical success rate was 100%. The average time for the procedure was 25 min (range 10-60 min). Immediate complications were: mild pain (n = 5), severe pain (n = 1), minimal epistaxis (n = 7), and moderate epistaxis (n = 1). No major complications occurred. The last clinical control revealed complete resolution of epiphora in 35 eyes and partial resolution in four; one patient did not improve.This technique for treatment of obstruction of the nasolacrimal system is simple and safe, and may obviate the use of more invasive procedures.

Seventy-seven transjugular liver biopsies were performed with a coaxial, spring-loaded, 18-gauge cutting needle, the Biopty gun (Bard Biopsy System, Covington, GA, USA) on consecutive patients between July 1993 and February 1995. Fifty men and 27 women were included in the study; the mean age was 45 years (range 15-69 years). The average number of punctures per patient was 5.2, with a range of 2-9, yielding an average of 4.8 samples per patient (range 1-7). The length of the samples varied from 10 to 22 mm with a constant diameter of 1 mm. The mean time required to complete the procedure was 48 min (43-52 min). Histological diagnoses were obtained in 74 of 77 patients (96%), with non-diagnostic specimens attributed to excessive fragmentation (3 cases). Complications occurred in 10 patients (puncture site hematoma, carotid artery puncture, abdominal pain, vasovagal reaction, hepatic capsule perforation, and hemobilia). The latter two complications were self-limited. In our experience this transjugular hepatic biopsy method is promising for performing biopsies in patients with chronic liver disease, due to its high success rate and low morbidity rate.

BACKGROUND & AIMS: Uncontrolled studies suggest that placement of a transjugular intrahepatic portosystemic shunt (TIPS) could be useful in the treatment of variceal bleeding. The aim of this study was to evaluate the efficacy and safety of TIPS in the elective treatment of hemorrhage from esophageal varices in a randomized controlled study that compared the effects of TIPS with those of endoscopic sclerotherapy (ES). METHODS: Sixty-three consecutive cirrhotic patients with hemorrhage from esophageal varices were included. Thirty-two patients were randomly allocated to ES and 31 to TIPS groups. RESULTS: One patient in each group died before the therapeutic procedure could be performed. During a mean follow-up period of 15 months, variceal rebleeding occurred in 51.6% of the patients in the ES group and 23% of those in the TIPS group. Uncontrolled rebleeding occurred in 10 of 31 patients in the ES group, whereas rebleeding did not occur in any patient of the TIPS group. Hepatic encephalopathy was more frequent in TIPS patients (33.3%) than in those treated by ES (13%). However, mortality was similar in both treatment groups. CONCLUSIONS: These preliminary results suggest that TIPS is more effective than ES in the prevention of variceal rebleeding in cirrhotic patients, even though no difference in survival was observed. (Gastroenterology 1996 Mar;110(3):832-9)

Intractable and recurrent ureteral stricture presents a continuous challenge to the urologist. We report on 5 patients with severe ureteral stricture who were successfully treated with self-expanding metallic stents. Ureteral stricture occurred at ureteroileal anastomotic sites after neoplasm resection in 2 cases, multiple upper ureteral strictures were related to multiple surgical procedures for correction of bladder exstrophy in 1 and a ureteral kink developed in 1. Treatment with transluminal balloon dilation provided poor results but self-expanding metallic stents were used successfully with no major complications. In the last patient the stent and the overlying ureter were removed due to recurrent reflux; the gross and histological ureteral changes are discussed in detail. The technical approach is described, alternative therapeutic options are considered and pertinent literature is reviewed.

The clinical results of percutaneous transluminal angioplasty (PTA) were evaluated in patients with renovascular hypertension, and the effect of PTA on blood pressure and renal function was determined.Between February 1982 and December 1990, 93 hypertensive patients underwent 123 renal artery PTA procedures. Mean patient age was 43.4 years (range, 12-78 years). Average baseline blood pressure was 162/111 mm Hg (range, 140-230/95-150 mm Hg). The cause of renovascular hypertension, as determined with angiography, was atherosclerosis in 37 patients, fibromuscular dysplasia in 27, and mixed disease in one; 28 patients had renal transplant arterial stenosis.In patients with atherosclerotic renal vascular disease or fibromuscular renal artery stenosis, systolic and diastolic blood pressure decreased significantly (P.001) at 96 months after PTA. In patients with renal transplant arterial stenosis, blood pressure also decreased significantly (P.001) at 12 months after PTA. Technical success was achieved in 78% of patients with atherosclerosis, 92% of patients with fibromuscular dysplasia, and 76% of patients with renal transplants. Complications were seen in 4.8% and were related to renal failure and vessel dissection.PTA is the therapy of choice in patients with renovascular hypertension due to fibromuscular dysplasia. Patients with atherosclerotic renal artery stenosis or stenosis of a renal artery in a transplanted kidney should be selected according to the anatomy of the lesion and clinical patient characteristics.

To measure the overall satisfaction of obstetrics patients with epidural analgesia during labour, and in particular, with the technique and other subjective factors.An anonymous questionnaire was administered over a three-month period to patients who received analgesia to control pain during labour and who had vaginal delivery, in order to obtain information of the satisfaction with technique and their care.Of the 100 patients who responded to the questionnaire, 92% were satisfied with the technique. The mild satisfaction measured by SERVQHOS score was 3.98 (SD ± 0.64). The score for the subjective aspects was 4.10 (± 0.68), which was better than objective ones. The recommendation rate was 98% for satisfied patients and 85.7% for those who were not satisfied. There were no differences between Spanish and foreign patients in their evaluation of the satisfaction.The proportion of patients satisfied with the technique was very high, and was the top rated subjective aspect (treatment and public confidence).

Celiac disease is an immune-mediated disease, triggered in genetically susceptible individuals by ingested gluten from wheat, rye, barley, and other closely related cereal grains. The only treatment for celiac disease is a strict gluten-free diet for life. This paper presents a systematic review of the scientific literature on the safety of pure oats for individuals with celiac disease, which historically has been subject to debate. Limitations identified within the scientific database include: limited data on long-term consumption, limited numbers of participants in challenge studies, and limited reporting about the reasons for withdrawals from study protocols. Furthermore, some evidence suggests that a small number of individuals with celiac disease may be intolerant to pure oats and some evidence from in vitro studies suggests that an immunological response to oat avenins can occur in the absence of clinical manifestations of celiac disease as well as suggesting that oat cultivars vary in toxicity. Based on the majority of the evidence provided in the scientific database, and despite the limitations, Health Canada and the Canadian Celiac Association (CCA) concluded that the majority of people with celiac disease can tolerate moderate amounts of pure oats. The incorporation of oats into a gluten-free diet provides high fiber and vitamin B content, increased palatability, and beneficial effects on cardiovascular health. However, it is recommended that individuals with celiac disease should have both initial and long-term assessments by a health professional when introducing pure oats into a gluten-free diet.

An electron microscopic study of skeletal muscle biopsies from euthyroid and hypothyroid patients with autoimmune thyroid disease (ATD) showed the existence of capillary alterations and a mononuclear cell infiltrate. Microvascular abnormalities included thickening and lamination of basement membrane, endothelial proliferation with progressive lumen occlusion, and hypertrophied pericytes. Capillary degeneration was also observed. Macrophages, and scarce lymphocytes and mast cells formed the cell infiltrate. This pathological picture is similar to that found in the muscular compromise of other autoimmune diseases, particularly Graves' hyperthyroidism. This study shows that patients with ATD may have skeletal muscle capillary abnormalities that could probably be related to autoimmunity and are independent of thyroid functional status.

to report our experience in the diagnosis and treatment of gastrointestinal hemorrhage.from April 1987 to April 1997, 196 patients with gastrointestinal hemorrhage (134 men and 62 women) were studied. 165 (84%) were diagnosed as presenting upper gastrointestinal hemorrhage, and 31 (16%) presented lower gastrointestinal hemorrhage. The patients were studied with endoscopy and arteriography, and embolization was prescribed in 131 (67%). Patients with bleeding from esophageal varices were excluded from this study.a bleeding point was identified angiographically in 33% (n = 65) patients. 131 (67%) patients were treated with therapeutic embolization, which was successful in 89% (n = 116) patients. The bleeding was resolved in 80% (n = 93) of the patients. Complications included arterial spasm (n = 12), pain (n = 24), coil migration (n = 8), allergic reaction (n = 2) and celiac trunk dissection (n = 2). During follow-up 16 patients presented rebleeding that stopped after reembolization in 9 cases, whereas in 7 cases surgery was needed.in our experience, diagnostic angiography and percutaneous therapeutic embolization are effective, less aggressive methods that lead to few complications. Both methods have become indispensable tools in managing patients with gastrointestinal hemorrhage that does not respond to conservative therapy. Even in patients with no evidence of angiographic bleeding, embolization in selected patients is successful.

Purpose: To evaluate the diagnostic usefulness of CO 2 as a radiologic contrast medium in pre and post-embolization of hemodynamically active vascular malformations. Material and methods: Eight pre and post-embolization angiographies were performed on five patients with hemodynamically active vascular malformations. In all cases sequentially iodinated contrast medium and CO 2 were used. Procedures were performed using Philips Integris V equipped with specific software to process images obtained with CO 2 as contrast medium and with a purpose-built gas injector pump. The images were assessed by three interventional radiologists who evaluated the findings by consensus. They were asked whether uptake of the malformations were better, worse or the same with iodinated contrast and CO 2 . The images were judged according to the following characteristics; quality, the filling in of the contrast in afferent artery of the HAVM, caliber and number of vessels and existence of pathologic communications in HAVM. These characteristics were assessed in all the patients of the study, both before and after embolization. Results: The CO 2 angiographic results were compared to those obtained using iodinated contrast material. Iodinated contrast provided superior image quality in all performed studies. The filling of arterial afference of HAVM was well defined with both contrast media. In all performed cases with CO 2 , the malformations showed more vessels. No inmediate nor subsequent complications developed with CO 2 injections, except in one female patient, who presented an intense sensation of cramps in the lower limbs. Conclusion: CO 2 is a useful diagnostic and assessment tool before and especially during the embolization of hemodynamically active vascular malformations. It improves quantification and uptake of the malformation’s vascular architecture, detecting collateral circulation and arteriovenous shunts. It also detects residual post-embolization disease when iodinated contrast agent is unsuccessful.

The aim of this study was to evaluate our results in treatment and management of symptomatic hepatic venous malformations using transcatheter embolization therapy. From 1991 to 1997 five venous malformations were embolized in one man and four women ranging in age from 31 to 50 years. All patients presented nonspecific abdominal pain and were assessed in the general surgery unit. Percutaneous embolization was recommended. In all cases polyvinyl alcohol was used to embolize the afferent arterioles. Clinical and echographic control follow-up was carried out on an outpatient basis in our Vascular and Interventional Radiology Unit. Embolization was possible in all cases. No complications developed during the procedure, except in one case where the subject suffered a spasm of the hepatic artery. Mean follow-up time was 42 months (6–73 months). Four patients remained asymptomatic during the entire follow-up period, whereas one patient required reembolization. In our experience, transcatheter embolization of hepatic venous malformations is a noninvasive technique which requires few admissions and presents few complications. With further use, it could become the treatment of choice in symptomatic hepatic venous malformations as an alternative to surgery.

Vascular malformations are uncommon pathologic entities in which surgery is usually not possible or is inefficient. Our experience with the percutaneous treatment of peripheral vascular malformations, by means of transarterial embolization or direct puncture is here reported.During the 1993-1997 period a total of 35 patient, 20 females (57%) and 15 males (43%) aged 11 to 75 years, were treated at our Unit. Sixteen vascular malformations were hemodynamically active (45.7%) and 19 hemodynamically inactive (54.3%). A total of 126 embolizations (mean 3.6) were performed. Malformations were studied by means of doppler-echography, magnetic resonance, arteriography and direct puncture angiography. Considering location, size and hemodynamic characteristics a specific approach and therapy was performed in each case. In two cases (5.7%) a surgical exeresis after embolization was performed.A technical success, defined as the possibility of embolizing the malformation, was achieved in 100% of cases. No technical complications during the procedure occurred. The mean follow-up time was 23 months (6-69). All patients but one improved both objectively and subjectively and all but one have recovered their daily activities in the following days. The exception was one patient who developed a severe complication--cutaneous necrosis--a few days after the procedure which required repairing surgery. All patient had edema, pain and increased functional impairment after the embolization which subsided with medical treatment.Percutaneous embolization of vascular malformations is an effective method associated with a low complication rate. Our results are encouraging although more extensive investigation are required to draw definite conclusions.

To evaluate the effectiveness of metallic Strecker stents for palliation of malignant dysphagia.From June 1992 to August 1995, 66 Strecker stents were inserted in 55 consecutive patients, 50 male and 5 female, with a mean age of 62 years (range 25-83). The cause of dysphagia was incurable malignant obstruction of the esophagus. Three patients presented with dysphagia grade I, 8 grade II, 27 grade III and 17 grade IV. All the procedures were performed under fluoroscopic control.Exact positioning of the stent was technically feasible in all patients. No procedure-related mortalities or major complications occurred. Immediate complications were transient chest pain (n = 11), blood stain sputum (n = 8) and gastroesophageal reflux (n = 8). During follow-up, 7 patients (12.7%) had recurrent dysphagia due to tumor ingrowth or overgrowth. In these patients an additional overlapping stent was successfully placed in six cases and balloon dilatation in one. Latest evaluation revealed dysphagia grade O in five patients (9%), 10 dysphagia grade I (18%), 14 grade II (25%), 13 grade III (23.6%) and seven grade IV.Implantation of Strecker stents is an effective and safe method of palliating severe malignant dysphagia. Placement of the stents was feasible without major procedure complications.

Purpose: Intramuscular hemodynamically inactive vascular malformations are infrequent entities whose surgical treatment is often impossible, crippling, or inefficient. We describe a nonsurgical therapeutic approach consisting on embolization by direct puncture with schlerosant substances. Methods: Four patients have been treated from April to November 1994, three female and one male, ranging in age from 13 to 31 years. Three vascular malformations were located in the quadriceps and one in the deltoid muscle. The point of access was determined with information provided by MR. The skin was cleaned with an antiseptic solution and puncture was performed with a 22 gauge Chiva needle. Blood flow inside the malformation was slow in all cases and no afference to the normal venous system was detected. We embolized with 5-15 cc (mean 7.5 cc) of a mixture of ethibloc and ethanol. Results: The mean follow-up period was 17 months (range 14-21). All patients remain asymptomatic and have resumed normal daily life activities. There were no complications. Conclusion: Percutaneous embolization by direct puncture of intramuscular vascular malformations is a feasible and simple procedure. Our preliminary results are promising, although more extensive studies need to be to performed in order to reach definite conclusions.

To report our experience with long term external catheters and implantable ports in the last 8 years.From December 1987 to August 1995 a total of 617 central venous catheters were implanted in 541 patients in our Interventionist Vascular Radiology Unit, 265 men (49%) and 276 women (51%), with a mean age of 46 years. A total of 335 (54%) were partially implantable external catheters and 241 (39%) implantable ports in chest and 41 (7%) in the forearm.A technical success--defined as the possibility of implanting the catheter--was achieved in 98% of cases. Immediate complications included 5 pneumothorax (0.8%), 11 accidental carotid artery puncture (2%) with no clinical relevance, 18 catheter misplacement (3%), and 8 vein spasm (1%). Fifty-two catheters (8%) were removed on account of infectious complications. Currently, 71 catheters are still in use (12%), 433 (70%) have been removed or the catheter was patent until patients's death.Partially implantable central venous catheters and totally implantable ports are a safe alternative in patients requiring a central venous access for prolonged treatments. The low number of immediate complications renders the Interventionist Vascular Radiology Unit the proper place where to perform these procedures.

The objective of this study was to present our experience with metallic stents (Wallstent) for palliation of dysphagia due to malignant esophageal obstruction and esophagotracheal fistula.From August 1994 to July 1996 20 uncovered and 6 covered stents were inserted in 16 consecutive patients with dysphagia grade 3 (n = 4) or grade 4 (n = 12) caused by incurable malignant obstructions. The obstruction was in the proximal (n = 4), in the middle (n = 3) and the distal (n = 9) third of the esophagus. Five patients presented with esophagotracheal fistula. The stent insertion was performed under fluoroscopic control.Exact positioning of the stent with reduction of the dysphagia was obtained in all patients. There were no complications related with the procedure. Esophagotracheal fistula was solved in those patients treated with covered stents. Six patients had recurrent dysphagia due to tumor ingrowth or overgrowth. In these patients an additional overlapping stent was placed. In latest evaluation 2 patients presented dysphagia grade I, 5 grade III, and 4 grade IV.Implantation of stents proved to be an effective and safe method of palliating dysphagia and occluding esofagotracheal fistula. Placement of stents was feasible without major procedure-related complications.

The purpose of this study was to determine the feasibility of using a flexible trocar/catheter system to create a transjugular intrahepatic portosystemic shunt (TIPS).A flexible needle/trocar was used to connect the hepatic vein to the portal vein in 23 patients with portal hypertension and a history of bleeding gastroesophageal varices. Five patients had signs and symptoms of encephalopathy before shunting; in four, the disease was classified as Child's class C and in one, as Child's class B. Nine-millimeter self-expandable metallic stents were used in all patients.The procedure was technically successful in all patients. The mean portosystemic pressure gradient decreased from 26 to 16 mm Hg (range, 7-23 mm Hg). Eight patients have died. One patient in a hepatic coma with hepatorenal failure survived percutaneous portosystemic shunting, but died 2 days after the TIPS procedure was done. After creation of the shunt, three other patients died of unrelated disease without recurrence of bleeding from gastroesophageal varices. Two patients died of massive bleeding from esophageal varices, one 24 hr after shunting and one of disseminated intravascular coagulation after a second attempt to establish a shunt. One patient died of sepsis associated with infected ascitic fluid 2 months after the TIPS procedure was done, and one died of unknown causes 4 months after the procedure was done. The mean follow-up time in the surviving 15 patients was 12 months. Seven patients had recurrence of gastrointestinal bleeding; the recurrence was due to a thrombosed shunt in two, to hepatic vein stenosis in four, and to a high portosystemic pressure gradient (22 mm Hg) after creation of the shunt in one. Hepatic vein stenosis was noted on portal venograms in another three otherwise asymptomatic patients. In four of five patients, encephalopathy was adequately controlled after shunting. The fifth patient with encephalopathy (Child's class C) and an additional patient in whom encephalopathy (Child's class C) developed after the TIPS procedure have had two additional hospital admissions because of difficulty in controlling the encephalopathy. The amount of ascitic fluid decreased or totally disappeared after treatment in all cases. No severe complications associated with creation of a TIPS were observed.Use of a flexible trocar/catheter system to create a TIPS is a simple, safe, and moderately reliable means of decompressing the portal vein in patients with portal hypertension.

Percutaneous transluminal angioplasty is limited by a high percentage of restenosis in the medium and long runs. Other arterial recanalization systems to be combined with or to be used in alternative to angioplasty are under investigation. Atherectomy with Simpson's catheter (Atherocath) allows mechanical removal of the atheromatous plaque, leaving a smooth lumen, and vessel dilatation with the same effects as those of angioplasty and coaxial Dotter catheters. A Hundred and ten atherectomies with Atherocath were performed by the authors in 103 patients for the treatment of 77 stenoses and 33 total occlusions. All patients had 36 months' follow-up. Immediate and medium patency rates are encouraging in femoropopliteal arteries; the actual role of the method in iliac arteries is still to be demonstrated. Atherectomy with Aterocath can be useful not only in the treatment of arterial stenoses, but also in complete obstructions, in combination with angioplasty. Other relevant indications are the removal of partially or totally obstructive intimal flaps complicating angioplasty, and treatment of such ulcerated lesions as the blue-digit syndrome.

The Simpson atherectomy catheter has been used successfully to recanalise eleven complete occlusions of the iliac and femoropopliteal arteries. Atherectomy and angioplasty were used in combination in 8 cases. Following atherectomy, all patients showed clinical improvement. Distal pulses returned in 7; rest pain and/or claudication disappeared in the other 4. Ischaemic ulcers healed in the 2 affected patients. Overall, ankle-arm indices (AAI) improved by an average of 0.43, with the improvement being greatest (0.55) in patients in whom the lumen was recanalised to within 91-100% of the native luminal diameter. Seven patients have remained with stable AAI values and without change in their clinical status at 18 months follow-up.

The authors performed two studies to clarify the characteristics, analogies and differences of three loop diuretics (furosemide, bumetanide and piretanide) aiming at more precise indications for their clinical use. In the first study, they compared bumetanide and piretanide by the method of compensated diuresis; in the second, they tested the three loop diuretics' efficacy in refractory ascites. The authors demonstrated that with the three substances analogous results were obtained when administered at equivalent doses and that only intensive diuresis was able to resolve refractory ascites.

This study examined the relationship between Perceived Emotional Intelligence (PEI) and Life Satisfaction in university teachers. To assess the nature of these relationships and to predict the factors implied on life satisfaction, positive and negative affect, work satisfaction and alexithymia measures were used. 52 university teachers (30 men and 22 women) completed the Spanish version of the Trait Meta-Mood Scale for emotional intelligence (TMMS, Fernández-Berrocal, ExtremeraRamos, 2004). Alexithymia was measured by the Spanish version of the TAS-20 (Martínez-Sánchez, 1996), and life satisfaction was measured by SWLS (Díaz Morales, 2001). Also, Work Satisfaction Scale was used (JWS, GrajalesAraya, 2001). Our results yield a strong correlation between life satisfaction and TMMS subscales (emotional Clarity and emotional Repair), TAS-20 subscales (difficulty to describe emotions and external oriented thinking), and Work Satisfaction Scale. Further analyses show that the life satisfaction most significant predictors were positive and negative affect and emotional Clarity. These results support the incremental validity of self-report measures, as the TMMS, and the capacity of constructs related to emotional intelligence to explain the differences on life satisfaction independently from personality traits and mood states constructs.