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ABSTRACT This note proposes a technical approach towards the disaster occurred on January 8, 2022, in the tourism region of Capitólio (Minas Gerais state, Brazil), where a massive quartzite rock broke from a cliff and toppled on to pleasure boaters drifting on a lake, leaving 10 people dead and 30 others injured. Even though the rockfall was decisive in the tragedy, it is reasonable to affirm that the submersion-wave impact certainly potentialized the accident. Along these lines, this work not only aims to videographically explore the geometric / kinematic characteristics of the solid block, but also to discuss the specificities pertaining the event. Lastly, with basis on the Noda Method (1970), this manuscript also estimates the resulting wave amplitude (near the impact) and the energy-transfer coefficient between the block and the body of water.

Ensiling sorghum with tropical forages has been shown to be a promising alternative for ruminant feed production, as this approach improves the quality of the sorghum silage. In this context, the goal of this study was to evaluate the fermentation characteristics and nutritive value of sweet sorghum silage made with different levels of Paiaguas palisadegrass and Ipypora grass. The experiment was conducted in a completely randomized 2 x 6 factorial design with four replications. Two forages (Paiaguas palisadegrass and Ipypora grass) were added to sorghum at six levels (0, 20, 40, 60, 80 and 100%), for a total of 48 experimental silos. After 50 days of fermentation, the silos were opened, and the fermentation profile and chemical composition of the silage were analysed. The results showed that the addition of Paiaguas palisadegrass and Ipypora grass to the sorghum silage increased the pH, buffering capacity and NH3-NT of the silage and reduced its dry matter content but did not affect its fermentation characteristics, which remained within an appropriate range. The addition of increasing levels of Paiaguas palisadegrass and Ipypora grass to the sorghum silage increased the crude protein and in vitro dry matter digestibility (IVDMD) of the silage and decreased the fibre fraction (neutral detergent fibre, acid detergent fibre and lignin) and ether extract contents. Adding tropical forages to sorghum silage material at levels above 40% is recommended. Among forage crops, addition of Paiaguas palisadegrass to sorghum silage resulted in higher content of crude protein and IVDMD. Mixed silages can be an effective alternative to improve the quality of forage sorghum silage.

RESUMEN Objetivo: Evaluar la efectividad del tratamiento combinado con dorzolamida tópica en pacientes con edema quístico macular poscirugía de catarata. Métodos: Se realizó un estudio experimental en pacientes atendidos en el Servicio de Vítreo-Retina del Instituto Cubano de Oftalmología "Ramón Pando Ferrer”, en el año 2018. Se definió el grupo de casos (dorzolamida y tratamiento convencional) y el grupo control (tratamiento convencional), los cuales se evaluaron en la consulta inicial y al mes de tratamiento. Resultados: La edad media fue de 60,73 ± 11,25 años. Predominó el sexo femenino (53,33 %), el ojo afectado derecho (60,00 %), el tiempo posquirúrgico ≤ 3 meses (63,33 %), sin factores de riesgo asociados (56,67 %). El edema sin alteraciones asociadas fue más frecuente (80,00 %). La media del grosor macular disminuyó en ambos grupos (de 529,27 ± 183,58 a 349,93 ± 221,35 en los casos y de 498,87 ± 213,26 a 373,53 ± 215,51 en los controles). Resultó mayor la variación en el grupo de casos (179,33 p= 0,008). La agudeza visual aumentó en ambos grupos. Se observó un porcentaje mayor de ojos que mejoraron la visión en el grupo de casos (52,38 %). La mejoría de la agudeza visual se relacionó con la recuperación del grosor macular. Conclusiones: En los casos con edema quístico macular poscirugía de catarata, en los que está indicado el tratamiento tópico con antinflamatorios, la combinación con dorzolamida resulta efectiva para la reducción del grosor macular y la mejoría de la agudeza visual corregida.

RESUMEN Objetivo: Determinar las características clínico-epidemiológicas del trauma ocular a globo abierto. Métodos: Se realizó un estudio descriptivo, observacional y transversal en pacientes con trauma ocular a globo abierto y afectación del segmento posterior en pacientes hospitalizados en el Servicio de Vítreo-Retina del Instituto Cubano de Oftalmología “Ramón Pando Ferrer” entre julio del año 2017 y julio de 2018. Resultados: El 68,18 % de los pacientes fue menor de 50 años y el 88,64 % fueron hombres. El trauma más común fue el penetrante (91,11 %); el 68,89 % de las lesiones ocurrió en zona 1, con predominio de las heridas menor o igual a 4 mm (75,56 %). La circunstancia más común del trauma fue la laboral (50 %). El mecanismo de producción predominante fue el martilleo sobre metal (71,11 %); el 65,91 % de los traumas ocurrieron en zona urbana; el 96,46 % no usaba protección; el 57,77 % tenía una agudeza visual inicial de cuenta dedo o mejor, y la presencia de cuerpo extraño intraocular ocupó el 77,78 %. Conclusiones: En el trauma ocular a globo abierto predominan la edad por debajo de 50 años, el sexo masculino y los traumas penetrantes. La mayor parte se presenta de forma unilateral, durante las actividades laborales y sin protección ocular. Más de la mitad de los pacientes presentan agudeza visual inicial de cuenta dedos o mejor. Los signos oculares asociados más frecuentes son el cuerpo extraño intraocular y la catarata traumática.

The use of silage has been an efficient alternative to feed supply during the shortage of roughage in dry periods, providing quality feed that is widely used in ruminant feeding. Thus, the objective of this study was to evaluate the fermentative characteristics and nutritive value of corn silage with Tamani guinea grass (Panicum maximum BRS cv. Tamani) through chemical composition, in vitro dry matter digestibility and protein fractionation. The experiment was conducted in a completely randomized design with four replications. The treatments consisted of five silages: corn; corn with 10% Tamani guinea grass; corn with 20% Tamani guinea grass; corn with 30% Tamani guinea grass; and corn with 40% Tamani guinea grass, totalling 20 experimental silos. The addition of tamani grass to silages was determined based on fresh matter. For ensiling, corn was harvested with 320 g kg-1 DM (dry matter) and Tamani guinea grass in a 30-day development cycle with 286 g kg-1 DM. After 50 days of silage, the silos were opened to analyse the fermentative characteristics, chemical composition and protein fractionation of the silage. The results showed that the addition of Tamani guinea grass in corn silage increased the pH and buffering capacity and reduced the dry matter and lactic acid concentration but did not compromise the fermentative characteristics of silages. The addition of 40% Tamani guinea grass in corn silage provided increased levels of crude protein, in vitro dry matter digestibility, protein A, B1 and C, and decreased the fractions B3 and C, which makes Tamani guinea grass an alternative to improve the quality of exclusive corn silage, resulting in better quality silage.

Objetivo: identificar contenidos relacionados con la temática sexualidad en las redes municipal y estatal de enseñanza; e identificar dificultades y necesidades de los docentes en el enfoque temático. Métodos: estudio transversal con 79 docentes de las instituciones educativas mediante cuestionario auto administrado. Para análisis, se utilizó como criterio pertenecer a la red municipal o estatal. Resultado: mayoría de los profesores trabaja en la red estatal de enseñanza. La temática sexualidad no es trabajada según el Parámetro Curricular Nacional. Profesores de la red municipal trabajan más el tema embarazo (p=0,04), y más citado por profesores del sistema estatal para formación (p=0,03). Mayoría sin experiencia y formación en la temática (p=0,04). Conclusión: son necesarias alianzas con el área de la salud para instrumentalización del profesor. Es importante reconocer la actuación del enfermero en el trabajo de la educación sexual como componente esencial en la atención integral para fortalecer el área de la salud escolar.

A utilização de bolsas seladas hermeticamente é uma alternativa aos métodos tradicionais de armazenagem de grãos em nível de fazenda. Em vista disso, objetivou-se com este trabalho avaliar a qualidade de milho armazenado hermeticamente em silos bolsa. O produto, com teores de água de 14,5 e 18,0% b.u, foi acondicionado em mini-bolsas devidamente seladas nas temperaturas de 25; 30 e 35 ºC. Foram realizadas análises de teor de água, de classificação dos grãos, de massa específica aparente, de percentual de germinação e de condutividade elétrica, no início do armazenamento e após 30; 60; 90; 135 e 180 dias. Verificou-se que não houve variação do teor de água dos grãos de milho armazenados nos silos bolsa. Os grãos de milho foram classificados como Tipo 1 ao longo do período de armazenamento, exceto para os com 18,0% (b.u.) de teor de água na temperatura de 35 ºC. Não houve decréscimo significativo da massa especifica aparente do produto ao longo do armazenamento. Em geral, ocorreu decréscimo do percentual de germinação dos grãos de milho armazenados úmidos e secos e acréscimo da condutividade elétrica da solução que continha os grãos, exceto para os armazenados com 14,5% nas temperaturas de 25 e 30 ºC. Conclui-se que é possível armazenar milho em silos bolsa, durante 180 dias, grãos com teor de água de 14,5% (b.u.) nas temperaturas de 25; 30 e 35 ºC e grãos com teor de água de 18,0% por 180 dias nas temperaturas de 25 e 30 ºC.Airtight storage in sealed bags provides an alternative to traditional methods for on-farm grain storage. The objective of this work was therefore to evaluate the quality of corn stored in airtight sealed bags. Grain with moisture content (m.c.) of about 14.5 and 18.0% (w.b.) was properly stored in sealed mini-bags at 25; 30; and 35 ºC. Analyses included moisture content, grain classification, apparent specific mass, percentage of germination and electrical conductivity at the beginning of storage and after 30; 60; 90; 135 and 180 days. There was no variation in the moisture content of corn grain stored in the silo bags. Corn was classified as Type 1 during the storage period, except for grain with 18% m.c. at 35 ºC. There was no significant decrease in the apparent specific mass in the grain during storage. In general, the percentage of germination decreased in humid and dry corn stored and the electrical conductivity increased in the solution containing the grain, except for grain stored with 14.5% m.c. at 25 and 30 ºC. It is therefore possible to store corn grain in silo bags with 14.5% m.c. at 25; 30 and 35 ºC for 180 days, and grain with 18% m.c. at 25 and 30 ºC for 180 days.

Objective: to identify content related to the sexuality theme at schools from municipal and state networks; and to identifythe difficulties and needs of teachers in the approach to this theme. Methods: cross-sectional study with 79 teachersof educational institutions using self-administered questionnaire. For analysis one used as an endpoint to belong to themunicipal or state school networks. Result: most teachers work in the state school network. The theme sexuality is not dealtwith as recommended by the National Curriculum Parameters. Teachers from the municipal network deal more with thepregnancy issue (p=0.04), and it was more mentioned by the state system teachers for training (p=0.03). Most do not haveexperience and training in the subject (p=0.04). Conclusion: partnerships with the health area are necessary for teachers’training. It is also important to recognize the work of nurses in the work of sex education as an essential component in thecomprehensiveness of care in order to strengthen the area of school health.

Relato de experiência de acadêmicas do curso de graduação em enfermagem em uma Unidade de Atenção Básica à Saúde da Família (UABSF) da Região Leste de Goiânia-Goiás, Brasil, realizado em 2009. Objetivou construir de forma participativa o planejamento estratégico da unidade. Foram realizadas duas oficinas durante o estágio que promoveram um ambiente favorável para a identificação e questionamentos dos problemas da unidade. Diante dos problemas elaborou-se objetivos, discussão de ações criativas e possíveis para a resolução dos mesmos e a partir disso foi elaborado o plano de atuação. Ações decorrentes do planejamento estratégico desenvolvidas pelos profissionais da UABSF, já tiveram resultados imediatos e significativos para a equipe de saúde e comunidade de usuários do Sistema Único de Saúde. Planificación estratégica de una unidad de salud de la familia - Región del este de Goiãna RESUMEN Relato de experiencia de académicos del curso de graduación en enfermería en una Unidad de Atención Primaria en Salud Familiar (UAPSF) de la Región Este de Goiania-Goiás, Brasil, realizada en 2009. Objetivó construir de forma participativa el planeamiento estratégico de la unidad. Fueron realizados dos oficinas durante el estagio que promoverán un ambiente favorable para la identificación y preguntas de los problemas de la unidad. Dados los problemas he sido elaborado objetivos, discusión de acciones creativas y posibles para hacer frente a ellos y de esto fue elaborado un plan de acción. Acciones derivadas del plan estratégico desarrolladas por los profesionales de UAPSF, já tuvieron resultados inmediatos y significativos para el equipo de salud y comunidad de usuarios del Sistema Único de Salud

Resumen Se estudiaron los 240 recién nacidos correspondientes al total de nacimientos del año 2000, para conocer las afecciones oftalmológicas neonatales que más inciden en el policlínico "Luis A. Turcios Lima", del municipio de 10 de Octubre, y su relación con algunos factores de riesgo. Se confeccionó una encuesta mixta, para la recogida de la información, que incluyó los datos de la madre y el recién nacido, los resultados se analizaron comparándolos con la literatura revisada y se constató que algo más de la tercera parte del grupo estudiado presentó algún tipo de patología ocular, y la más relevante en primer lugar fue la hemorragia subconjuntival, y en segundo la conjuntivitis. El total de los neonatos cuyas madres presentaron rotura prematura de membrana, padecieron de conjuntivitis séptica, y hubo un incremento en los neonatos nacidos por parto instrumentado, de las hemorragias subconjuntivales. También el peso al nacer determinó un incremento de las patologías oftalmológicas en los pacientes estudiadosSummary 240 newborn infants corresponding to the total of births occurred in 2000 were studied in order to know the most commom neonatal ophthalmologic affections in "Luis A. Turcios Lima" Polyclinic, in "10 de Octubre" municipality, and their relationship with some risk factos. A mixed survey that included data of the mother and of the child was done to gather information. The results were analyzed and compared with the reviewed literature and it was proved that the third part of the group had some type of ocular pathology. The most significant was subconjunctival hemorrhage, followed by conjunctivitis. The total of infants whose mothers had a premature rupture of the membrane suffered from septic conjunctivitis and there was an increase of subconjunctival hemorrhages among the infants who were delivered by instrumental labor

Abstract Background Management of the open abdomen is an increasingly common part of surgical practice. The purpose of this review is to examine the scientific background for the use of temporary abdominal closure (TAC) in the open abdomen as a way to modulate the local and systemic inflammatory response, with an emphasis on decompression after abdominal compartment syndrome (ACS). Methods A review of the relevant English language literature was conducted. Priority was placed on articles published within the last 5 years. Results/Conclusion Recent data from our group and others have begun to lay the foundation for the concept of TAC as a method to modulate the local and/or systemic inflammatory response in patients with an open abdomen resulting from ACS.

La fotocoagulación láser (panfotocoagulación) es indicación absoluta en la retinopatía diabética proliferativa (RDP) sin y con características de alto riesgo de pérdida visual severa. Con el objetivo de evaluar este tratamiento en la RDP, se realizó este estudio desde enero de 2004 a diciembre de 2005 en el Centro de Atención al Diabético del Instituto de Endocrinología. Se estudiaron 120 pacientes con RDP, que se fotocoagularon. Las variables estudiadas fueron: edad, sexo, tiempo de evolución de la diabetes y presencia de hipertensión arterial y/o neuropatía. Se realizó examen oftalmológico y se comparó la agudeza visual y el estadio de la retinopatía antes y después del tratamiento. Para el análisis estadístico se utilizó la prueba de chi cuadrado. La forma avanzada de RDP se encontró en pacientes con más de 20 años de evolución de la enfermedad. Después del tratamiento en las mujeres predominó la RDP sin características de alto riesgo (CAR) (38,1 %) y en los hombres la RDP con CAR (38,9 %); 11 pacientes pasaron a la forma de retinopatía diabética (RD) no proliferativa. La hipertensión arterial y la nefropatía diabética predominaron en la RDP con CAR y avanzada. Se concluye que la forma más grave de RD se asoció a mayor tiempo de evolución. La hipertensión arterial y la nefropatía son factores de riesgo asociados a las formas más severas de RD. La fotocoagulación no mejoró la visión de forma significativa, pero sí detiene la progresión de la retinopatía, e incluso, es capaz de modificar la severidad pasando a formas no proliferativas.Laser photocoagulation (panphotocoagulation) is an absolute indication in the proliferative diabetic retinopathy (PDR) without or with characteristics of high risk for severe visual loss. This study was undertaken at the Diabetic Care Center of the Institute of Endocrinology from January 2004 to December 2005 in order to evaluate this treatment in PDR. 120 patients with PDR that were photocoagulated were studied. The studied variables were: age, sex, time of evolution of diabetes and presence of arterial hypertension and/or neuropathy. An ophthalmologic examination was made, and visual acuity and the retinopathy staging were compared before and after the treatment. Chi square test was used for the statistical analysis. The advanced form of PDR was found in patients with more than 20 years of evolution of the disease. After the treatment, PDR without high risk characteristics predominated in females (38.1 %), whereas PDR with high risk characteristics prevailed in males (38.9 %). 11 patients passed to the form of nonproliferative diabetic retinopathy. Arterial hypertension and diabetic nephropathy predominated in the PDR with high risk characteristics and in advanced PDR. It was concluded that the most severe form of DR was associated with a longer time of evolution. Arterial hypertension and nephropathy are risk factors connected with the most severe forms of DR. Photocoagulation does not improve vision in a significant way, but it stops the progression of retinopathy, and it is capable of modifying severity, reaching nonproliferative forms.

Focuses on active hypoallergenicity. Allergic contact dermatitis from Ginkgo biloba extract; Downregulation of skin immune response.

Métodos anticoncepcionais para longo tempo de uso têm sido buscados em vários lugares. O método Norplant é um deles, baseado em cápsulas de levonorgestrel introduzidas no braço das mulheres, através da liberação hormonal diária com efeito de dois a cinco anos. Norplant é produzido sob licença do "Population Council" e industrializado por "Leiras Pharmaceuticals", tendo sido usado na Tailândia, Egito, Indonésia, Suécia, Dinamarca e Brasil. Avaliam-se os resultados deste método, no Município do Rio de Janeiro (Brasil), onde 175 usuárias de Norplant foram entrevistadas em suas casas, e as respostas comparadas com dois grupos-controle (usuárias de pílulas à base de levonorgestrel e usuárias de métodos não-hormonais). Os resultados mostram aumento dos riscos relativos das usuárias de Norplant para desordens menstruais, hipertensão, graves distúrbios de peso e hipertricose, todos estes estatisticamente significantes. Outros achados não significantes foram angina pectoris, encefalopatia hipertensiva, acne e duodenite. Alguns sintomas graves como cefaléia e alterações de comportamento foram mencionados e desapareceram após a retirada das cápsulas. É discutida a relevância de todos os efeitos colaterais em mulheres que decidiram interromper o uso do Norplant. Nestes casos, as medidas de acompanhamento são necessárias, uma vez que hemorragia, ganho de peso acentuado e dificuldades na gravidez podem se desenvolver.Anticonceptional methods for long-term have been searched for in many places. Norplant is one such, based on the use levonorgestrel capsules which introduced into women's arms, produce a daily secretion of hormones and have from two to five years' effect. It is produced under license from the Population Council and industrialised by Leiras Pharmaceutical. It has been used in Thailand, Egypt, Indonesia, Sweden, Denmark and Brazil. It is assessed the results of this method in Rio de Janeiro, where 175 Norplant users were interviewed at home, and their answers compared with those of two control groups (levonorgestrel pill-users and no-hormonal methods-users). The results show increased relative risks in Norplant users in menstrual disorders, hypertension, severe weight disturbances and hypertrichoses, all of them of statistical significance. Other non-statistical findings were angina pectoris, hypertensive encephalopaty, acne and duodenites. Some severe symptoms like headaches and behavioural disturbances were mentioned and these disappeared after the capsules had been withdrawn. It is discussed the relevance of all the side-effects in women who decided to interrupt the use of Norplant. In these cases follow-up measures are needed, in view of the fact that hemorrhage, marked weight gain and difficulties in pregnancy may developed.

El agujero macular idiopático es causado por fuerzas traccionales tangenciales, asociadas al desprendimiento de vítreo posterior perifoveal degenerativo, cuyo tratamiento es actualmente quirúrgico, en pacientes con estadio 2, 3 o 4. Presentamos un caso clínico donde se describen las alteraciones anatómicas y funcionales producidas por el edema macular quístico posterior a la cirugía de agujero macular idiopático estadio 3, y que luego de un cierre exitoso anatómico y funcional de este comenzó con edema macular quístico recurrente, sin reapertura del agujero macular; respondió al uso de esteroides locales recomendable en estos casos y logró mejorar los resultados visuales iniciales posquirúrgicos.

RESUMEN El edema quístico macular es, actualmente, una de las complicaciones posoperatorias más prevalentes después de la cirugía de cataratas. En no pocos casos acarrea una disminución en la agudeza visual posquirúrgica de los pacientes. Por la heterogeneidad de criterios diagnósticos, su incidencia ha sido reportada entre el 1 y el 30 %. Con el objetivo de mostrar los resultados del uso de la dorzolamida en el edema quístico macular poscirugía de catarata se realizó la presente revisión de la literatura, mediante búsquedas en diferentes publicaciones relacionadas con la especialidad, en la que fueron utilizadas bases de datos de revistas líderes de Oftalmología de los últimos 10 años. Como la complicación posoperatoria más frecuente de la cirugía de catarata, puede traducirse con pérdida de la visión posoperatoria y cobra importancia el abordaje de aspectos relacionados con el tratamiento, específicamente los resultados de investigaciones que promueven en la actualidad el uso de inhibidores de la anhidrasa carbónica tópicos. En tal sentido, se muestra que la dorzolamida ha cobrado importancia como una opción de tratamiento, con resultados tangibles y pocos efectos adversos en comparación con el empleo sistémico de este grupo de medicamentos.

RESUMEN La toxocariasis es una zoonosis parasitaria. Se describen las alteraciones anatómicas y funcionales producidas por membranas que traccionan el polo posterior y la periferia de la retina, las cuales provocan hemorragia vítrea parcial asociada a neovascularización del disco óptico con membrana epirretiniana, y un agujero macular lamelar relacionado con la presencia de granuloma periférico. Se presenta un caso clínico de un paciente sano, quien comenzó con disminución de la agudeza visual del ojo izquierdo y se le diagnosticó, por cuadro clínico y examen oftalmológico con resultado positivo de la prueba de Toxocara, una toxocariasis ocular complicada. Se le realizó cirugía de vitrectomía mínimamente invasiva 23 G asociada a membranectomía, y pelado de la membrana limitante interna, así como endofotocoagulación con láser panretiniana. Se usó como tamponador al final de la cirugía el gas SF6 y el posicionamiento del paciente. Se aplicó tratamiento antiparasitario y esteroideo sistémico previo a la cirugía, y se obtuvieron resultados satisfactorios tanto anatómicos como funcionales del paciente.

RESUMEN La oclusión de la arteria central de la retina es considerada una urgencia oftalmológica con mal pronóstico visual, a pesar de los métodos convencionales de tratamiento. Los recientes avances en neurorradiología permiten realizar un cateterismo selectivo en la arteria oftálmica e inyectar un agente fibrinolítico cerca del lugar de la obstrucción. Esta intervención podría ser efectiva en ciertos tipos de oclusiones y se han obtenido resultados prometedores en pacientes con oclusiones de la arteria central de la retina. Se realizaron búsquedas en diferentes publicaciones relacionadas con la especialidad en los últimos 10 años en bases de datos de revistas líderes de Oftalmología, con el objetivo de mostrar la trombolisis intrarterial como opción de tratamiento para la oclusión de la arteria central de la retina. La baja incidencia de esta enfermedad, además de que los pacientes acuden a consulta con frecuencia fuera del periodo de ventana, son justificantes por las que no se recogen respuestas definitivas, lo que se suma a la heterogenicidad de tratamiento coadyuvante empleado en los diferentes centros y al uso de fibrinolíticos y de dosis variados. Se requieren ensayos clínicos aleatorizados que permitan determinar su superioridad frente a las medidas convencionales, el grado de beneficio en contraposición al riesgo de eventos adversos y el tipo de pacientes que son candidatos a esta medida terapéutica que se avecina de manera prometedora para mejorar el pronóstico visual de estos pacientes.

El trauma ocular es una causa importante de morbilidad oftalmológica en el mundo con implicaciones socioeconómicas importantes para el paciente y sus familiares. Ocurre generalmente en adultos jóvenes, con una buena agudeza visual al inicio del evento traumático, la cual se verá comprometida según la severidad del trauma, las estructuras oculares que afecte y las complicaciones que puedan aparecer. Presentamos dos pacientes con rotura escleral posterior secundario a trauma ocular a globo abierto contuso. Se describe el manejo personalizado el seguimiento en cada caso y sus resultados visuales.

Se exponen las consecuencias a largo plazo del uso del implante de miragel como tratamiento del desprendimiento de retina. Se presentan las características durante la cirugía y el postoperatorio de la explantación de este tipo de implante en 3 pacientes que acudieron a la consulta de Retina del Hospital Oftalmológico «Amistad Argelia Cuba» en Djelfa, Republica Popular y Democrática de Argelia, con el diagnóstico de cirugía convencional de retina con implante de miragel realizado en Francia en la primera mitad de la década del 90. Predominó el disconfort por la limitación de los movimientos oculares. Dos casos presentaban exposición del implante y sepsis periocular. A los tres casos se les retiró el implante que se fragmentaba con mucha facilidad y dificultaba su extracción, además se encontró marcada distensión muscular que se recuperó paulatinamente en el postoperatorio al igual que los movimientos oculares.

RESUMEN Con este trabajo nos proponemos revisar las evidencias científicas relacionadas con el tratamiento de la retinopatía diabética. Para la investigación documental se examinaron los artículos de la temática indexados en las bases de datos Pubmed, Pubmed Central y Scielo, que correspondieron a los descriptores DeCs-MeSH: retinopatía diabética y tratamiento actual. La evaluación de los datos se realizó mediante el análisis de contenido de tipo directo. El progreso de la retinopatía diabética va desde los estados más benignos hasta los más severos cuando no se aplica una intervención médica apropiada. Es importante reconocer cada estado de la retinopatía diabética para que el tratamiento sea más efectivo. Varias décadas de estudios clínicos han proporcionado excelentes datos sobre el curso natural de la enfermedad y la estrategia de tratamiento que son efectivas en alrededor de un 90 % para prevenir la pérdida visual severa.

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El hemangioma coroideo circunscrito es un tumor vascular hamartomatoso benigno de baja incidencia. Se presenta este caso debido a su evolución lenta y la pobre respuesta a tratamiento con terapia fotodinámica. El paciente, de sexo masculino, 49 años de edad, con disminución de la visión del ojo derecho de ocho meses de evolución y sin otra sintomatología asociada. Las exploraciones complementarias realizadas (retinografia, OCT, Ecografía y Angiografía flurosceínica) evidencian un tumor yuxtapapilar nasal que es diagnosticado como hemangioma circunscrito de coroides. Se decide tratarlo con terapia fotodinámica. En este caso, aunque el resultado en la ganancia visual no es el esperado, en los exámenes complementarios realizados se observa una discreta mejoría. La lenta evolución de este paciente responde, a criterio de los autores, a varios factores como la edad, el deterioro de la visión en el momento del diagnóstico, el número de aplicaciones de tratamiento con la TFD realizadas, el tiempo de evolución del tumor y el tamaño de la lesión.

Background: Previously, a quantitative risk assessment suggested there was no risk of induction of fragrance allergy from minor residues of fragrance chemicals on washed fabrics., Objective: To investigate whether there was any risk of the elicitation of contact allergy from fragrance chemical residues on fabric in individuals who were already sensitized., Methods: Thirty-six subjects with a positive patch test to isoeugenol (n = 19) or hydroxyisohexyl 3-cyclohexene carboxaldehyde (n = 17) were recruited. Dose-response and fabric patch tests were performed, respectively, with filter paper and a cotton sample loaded with fragrance in ethanol-diethylphthalate (DEP) and applied in a Finn Chamber or a Hill Top Chamber., Results: Only two subjects reacted to an isoeugenol patch test concentration of 0.01% (>20x the estimated likely skin exposure level), none reacted to lower concentrations. Of 36 subjects, 18 reacted to the fabric patch treated with ethanol-DEP vehicle alone and 20 to the fragrance-chemical-treated fabric patch. These were only minor non-specific skin reactions. They were also quite evenly distributed between the two fragrance chemical allergic groups., Conclusions: On the basis of the examples studied, fragrance chemical residues present on fabric do not appear to present a risk of the elicitation of immediate or delayed allergic skin reactions on individuals already sensitized.

Four multi-elementary metal and metalloid quantification methods using inductively coupled plasma mass spectrometry (ICP-MS) were developed and validated in human whole blood, plasma, urine and hair by means of a single preparation procedure for each sample. The ICP-MS measurements were performed using a Thermo Elemental X7CCT series and PlasmaLab software without a dynamic reaction cell. With this procedure 27-32 elements can be simultaneously quantified in biological matrices: Li, Be, B, Al, V, Cr, Mn, Co, Ni, Cu, Zn, Ga, Ge, As, Se, Rb, Sr, Mo, Pd, Ag, Cd, Sn, Sb, Te, Ba, W, Pt, Hg, Tl, Pb, Bi, U. Whole blood, plasma and urine samples (0.4 ml each) were diluted with purified water, acid, triton X100 and butanol. Rhodium was used as internal standard. The urine sample results were corrected for enzymatic creatinine determination. Twenty-five milligrams hair samples were acid mineralized after a decontamination procedure and diluted as previously described for biological fluids. To be validated, each element had to show linearity with a correlation coefficient higher than 0.99. The intra-assay and inter-assay inaccuracy, measured as the variation coefficient, were below 5 and 10% respectively. Global performance was assessed by a quality control program. Our laboratory is a registered participant of the Institut National de Santé Publique du Québec (Sainte-Foy, Canada) inter-laboratory comparison program for whole blood, urine, and beard hair of non-occupationally exposed individuals spiked with selected elements. In our study multi-element metal and metalloid analysis was assessed for 27 elements in whole blood, 27 elements in plasma, 30 elements in urine and 32 elements in hair, from 0 to 25, or 250 to 1000 ng/ml, depending on the element. Quantification limits ranged from 0.002 ng/ml (U) to 8.1 ng/ml (Al) for whole blood, from 0.002 ng/ml (U) to 7.7 ng/ml (Al) for plasma, from 0.001 ng/ml (U) to 2.2 ng/ml (Se) for urine, and from 0.2 pg/mg (Tl) to 0.5 ng/mg (B) for hair. Normal values were determined in whole blood (n=100), plasma (n=100), urine (n=100), and hair (n=45) of healthy volunteers, leading to approximately 10,000 analyses. All results are presented and discussed. Clinical toxicology and forensic toxicology applications are also reported. ICP-MS has made significant advances in the field of clinical biology, particularly in toxicological analysis. This is due to the use of extremely effective equipment that permits better clinical and forensic toxicological analysis of metal and metalloid status of each individual patient.

To prevent contact dermatitis to oxidative hair colouring products, a consumer test (skin allergy test, SAT) consisting of the open application of the colourant base prior to mixing with the developer is recommended 48 hours before hair colouring. We investigated the sensitivity and specificity of the SAT to detect and prevent contact allergy to oxidative hair colouring products that contained a range of concentrations of para-phenylenediamine (PPD) and corresponded to different shades (light, medium and dark). Test colouring products containing increasing concentrations of PPD (0.1, 0.5, 1.0 or 1.5%) were applied to 34 PPD-positive hair dye-allergic individuals and to 49 non-allergic control subjects. Allergic reactions were elicited in all PPD-positive subjects whereas none occurred in control PPD-negative subjects. For each subject the eliciting concentration of PPD in the SAT was compared with the PPD concentration range of the group of commercial shades reported as causing reactions by the consumer. In all PPD-positive subjects the eliciting concentrations of PPD in the SAT was within or lower than the range of PPD concentrations in the reported eliciting colourant base of commercial products. In conclusion, our results confirm the excellent predictive value of the SAT over the entire range of PPD concentrations used in oxidative hair colouring products and suggest that the test is a suitable tool for the secondary prevention of contact allergic reactions to hair colouring products.

Tobacco smoking is a major risk factor for cancer, cardiovascular diseases and respiratory illnesses. Smoking is increasing among children and adolescents with subsequent consequences on the health. Furthermore, maternal tobacco smoking during pregnancy adversely affects prenatal growth. Nicotine, the most important tobacco alkaloid, is responsible for maintaining tobacco addiction. According to a recent Circulaire de la direction générale de la santé, nicotine dependence should be determined through questionnaires and quantitative estimate of nicotine metabolites. Nicotine blood level fluctuates and urinary nicotine excretion is of short duration. Nicotine is intensively metabolized in the liver and oxidized into cotinine. Urinary measurement of cotinine appears to be highly related with the degree of intoxication and to allow the differentiation between non exposed and exposed non-smokers. In order to check the present application of nicotine metabolites measurement, a survey was conducted in 340 smoking cessation units. Forty percent physicians (n = 137) answered the survey. For 17% of them, the quantification of nicotine metabolites is included in their daily practise and for 79%, guidelines about cotinine measurement should be given in France. Sixty-seven biologists answered the survey. Recommendations for immunoassay and HPLC determination of cotinine should be given as reported by 66 and 44% of them respectively. Indeed, urinary cotinine measurement with high performance liquid chromatography is highly sensitive and specific. However, immunoassays are more convenient. These two approaches are presently under investigation in order to provide guidelines for optimal use in various clinical situations. Traditional measures for nicotine dependence are the number of cigarettes smoked per day, nicotine intake expressed as mg per day, Fagerstr m questionnaire, expired air carbon monoxide, thiocyanates and cotinine levels in biological fluids. Urinary cotinine measurement is the most useful for the follow-up of smoking cessation including adjustment of nicotine replacement therapy, especially after a clinical event or for the follow-up of smoking pregnant women. It allows the detection of passive smoke exposure in children who are hospitalized for recurrent respiratory illnesses.

CPK and its MB iso-enzymatic fraction were measured in 240 patients, 180 of whom suffered from myocardial infarction. MB iso-enzyme was expressed as a percentage of total CPK and a minimum figure of 4 per cent of MB isoenzyme was taken as indicative of a diagnosis of myocardial infarction. In the 180 patients with an infarction, the average MB level as a percentage of total CPK was 12.1 +/- 5.4 per cent. Five patients with a proven infarct had an MB iso-enzyme level of less than 4 per cent. Amongst the 60 patients without a myocardial infarction who were included in view of a pathological level of CPK, the average maximum level of MB was 1 +/- 2.5 per cent. Five of these 60 patients (false positives: 8.3%) had an MB iso-enzyme level of greater than 4 per cent. It is concluded that the estimation of MB iso-enzyme of CPK using a chromatographic technic is a highly valuable laboratory method for confirming or eliminating a diagnosis of myocardial infarction in the numerous clinical circumstances when such a diagnosis is difficult or even impossible on the basis of standard data.

A new case of analbuminaemia is described in a 6 month old child of algerian origin. The condition was discovered fortuitously, the clinical manifestations consisting only of slight oedema. Serum albumin concentration was 64 mg/l and its immunochemical behavior identical to that of normal albumin. The body react by an increase in the synthesis of globulins. In the propositus, levels of alpha, antitrypsin, caeruloplasmin, haptoglobin, jalpha2 macroglobulin, transferrin, immunoglobulin M were more than 3 times normal. Analysis of non-esterified fatty acids normally carried by albumin was normal. By contrast, it was shown that the presence of free bilirubin not bound to proteins was detected from 17 micronmol/l. Study of the family showed a normal distribution of albumin and globulins. The genetic origin seen in previously reported cases was confirmed by the co-sanguinity of the parents.