Pitfalls and premature failure of the Freedom SOLO stentless valve

Gebiet: Chirurgie Abstract: Objectives This study reports a series of pitfalls, premature failures and explantations of the third generation Freedom SOLO bovine pericardial stentless valve. – – Methods 149 patients underwent aortic valve replacement (AVR) using the FS. Follow-up was 100% complete with an average observation time of 5.5±2.3 years (max. 8.7 years) and a total of 825 patient years. Following intraoperative documentation, all explanted valve prostheses underwent histological examination. – – Results Freedom from structural valve deterioration (SVD) at 5, 6, 7, 8 and 9 years was 92%, 88%, 80% and 70% and 62%, respectively. 14 prostheses required explantation due to valve-independent dysfunction (n=5, i.e. thrombus formation, oversizing, aortic dilatation, endocarditis and suture dehiscence) or valve-dependent failure (acute leaflet tears, n=4, severe stenosis, n=5). Thus freedom from explantation at 5, 6, 7, 8 and 9 years was 95%, 94%, 91% and 81% and 72%, respectively. An acute vertical tear along the non-coronary/right-coronary commissure to the base occurred at a mean of 6.0 years [range 4.3?7.3 years] and affected size 25 and 27 prostheses exclusively. Four FS required explantation after a mean of 7.5 years [range 7.0?8.3 years] due to severe functional stenosis and gross calcification that included the entire aortic root. – – Conclusions The Freedom SOLO stentless valve is safe to implant and shows satisfying mid-term results in our single institution experience. Freedom from SVD and explantation decreased markedly after only 6 ? 7 years, so that patients with FS require close observation and follow-up. Exact sizing, symmetric positioning and observing patient limitations are crucial for optimal outcome.

Inclination-dependent changes of the critical shoulder angle significantly influence superior glenohumeral joint stability.

BACKGROUND The critical shoulder angle combines the acromion index and glenoid inclination and has potential to discriminate between shoulders at risk for rotator cuff tear or osteoarthritis and those that are asymptomatic. However, its biomechanics, and particularly the role of the glenoid inclination, are not yet fully understood. METHODS A shoulder simulator was used to analyze the independent influence of glenoid inclination during abduction from 0 to 60°. Spindle motors transferred tension forces by a cable-pulley on human cadaveric humeri. A six-degree-of-freedom force transducer was mounted directly behind the polyethylene glenoid to measure shear and compressive joint reaction force and calculate the instability ratio (ratio of shear and compressive joint reaction force) with the different force ratios of the deltoid and supraspinatus muscles (2:1 and 1:1). A stepwise change in the inclination by 5° increments allowed simulation of a critical shoulder angle range of 20° to 45°. FINDINGS Tilting the glenoid to cranial (increasing the critical shoulder angle) increases the shear joint reaction force and therefore the instability ratio. A balanced force ratio (1:1) between the deltoid and the supraspinatus allowed larger critical shoulder angles before cranial subluxation occurred than did the deltoid-dominant ratio (2:1). INTERPRETATION Glenoid inclination-dependent changes of the critical shoulder angle have a significant impact on superior glenohumeral joint stability. The increased compensatory activity of the rotator cuff to keep the humeral head centered may lead to mechanical overload and could explain the clinically observed association between large angles and degenerative rotator cuff tears.

Ultrastructure and Pathoanatomy of the Rotator Cuff

The rotator cuff is a complex musculotendinous unit, which plays a major role in glenohumeral joint stability and mobilization. Tears of the rotator cuff tendon and its subsequent changes of the rotator cuff muscle are common, and the incidence increases with age. Several structures such as the muscle, tendon, and bone may contribute to the development of a tear as well as on the outcome following a rotator cuff repair. Knowledge of these structures may help to improve rotator cuff healing after rotator cuff tear. The goal of this chapter is to discuss the evidence which exists with regard to the pathophysiological changes in the muscle, tendon, and bone that lead to a rotator cuff rupture as well as the changes that occur in these structures after a tear has occurred.

The Role of Cells in Meniscal Guided Tissue Regeneration: A Proof of Concept Study in a Goat Model.

OBJECTIVE Successful repair of defects in the avascular zone of meniscus remains a challenge in orthopedics. This proof of concept study aimed to investigate a guided tissue regeneration approach for treatment of tears in meniscus avascular zone in a goat model. DESIGN Full-depth longitudinal tear was created in the avascular zone of the meniscus and sutured. In the two treatment groups, porcine collagen membrane was wrapped around the tear without (CM) or with injection of expanded autologous chondrocytes (CM+cells), whereas in the control group the tear remained only sutured. Gait recovery was evaluated during the entire follow-up period. On explantation at 3 and 6 months, macroscopic gross inspection assessed healing of tears, degradation of collagen membrane, potential signs of inflammation, and osteoarthritic changes. Microscopic histology scoring criteria were developed to evaluate healing of tears, the cellular response, and the inflammatory response. RESULTS Gait recovery suggested protective effect of collagen membrane and was supported by macroscopical evaluation where improved tear healing was noted in both treated groups. Histology scoring in CM compared to suture group revealed an increase in tear margins contact, newly formed connective tissue between margins, and cell formations surrounded with new matrix after 3 months yet not maintained after 6 months. In contrast, in the CM+cells group these features were observed after 3 and 6 months. CONCLUSIONS A transient, short-term guided tissue regeneration of avascular meniscal tears occurred upon application of collagen membrane, whereas addition of expanded autologous chondrocytes supported more sustainable longer term tear healing.

Los tres cuerpos del boxeador profesional

Basado en tres años de observación participante y aprendizaje en un gimnasio de boxeo para negros de la parte sur de Chicago, este artículo reconstruye las sensaciones vividas por los luchadores profesionales y la experimentación de la instrumentalidad corporal, belleza y ética - los "tres cuerpos" que juntos definen la distintiva "aisthesis" de la práctica pugilística como habilidad corporal y negocio en los barrios pobres. Esto sirve para sostener que el boxeo profesional ofrece no muchas posibilidades de crecimiento económico, como la promesa de diferenciación social y más aún trascendencia: la ética profesional del sacrificio posibilita a los boxeadores escapar del mundo cotidiano y crear un universo sensual y moral "sui generis" donde un trascendente ser masculino puede ser construido.

Los tres cuerpos del boxeador profesional

Basado en tres años de observación participante y aprendizaje en un gimnasio de boxeo para negros de la parte sur de Chicago, este artículo reconstruye las sensaciones vividas por los luchadores profesionales y la experimentación de la instrumentalidad corporal, belleza y ética - los "tres cuerpos" que juntos definen la distintiva "aisthesis" de la práctica pugilística como habilidad corporal y negocio en los barrios pobres. Esto sirve para sostener que el boxeo profesional ofrece no muchas posibilidades de crecimiento económico, como la promesa de diferenciación social y más aún trascendencia: la ética profesional del sacrificio posibilita a los boxeadores escapar del mundo cotidiano y crear un universo sensual y moral "sui generis" donde un trascendente ser masculino puede ser construido.

Los tres cuerpos del boxeador profesional

Basado en tres años de observación participante y aprendizaje en un gimnasio de boxeo para negros de la parte sur de Chicago, este artículo reconstruye las sensaciones vividas por los luchadores profesionales y la experimentación de la instrumentalidad corporal, belleza y ética - los "tres cuerpos" que juntos definen la distintiva "aisthesis" de la práctica pugilística como habilidad corporal y negocio en los barrios pobres. Esto sirve para sostener que el boxeo profesional ofrece no muchas posibilidades de crecimiento económico, como la promesa de diferenciación social y más aún trascendencia: la ética profesional del sacrificio posibilita a los boxeadores escapar del mundo cotidiano y crear un universo sensual y moral "sui generis" donde un trascendente ser masculino puede ser construido.

A return-on-investment framework to identify conservation priorities in Africa

Environmental conservation activities must continue to become more efficient and effective, especially in Africa where development and population growth pressures continue to escalate. Recently, prioritization of conservation resources has focused on explicitly incorporating the economic costs of conservation along with better defining the outcomes of these expenditures. We demonstrate how new global and continental data that spans social, economic, and ecological sectors creates an opportunity to incorporate return-on-investment (ROI) principles into conservation priority setting for Africa. We suggest that combining conservation priorities that factor in biodiversity value, habitat quality, and conservation management investments across terrestrial, freshwater, and coastal marine environments provides a new lens for setting global conservation priorities. Using this approach we identified seven regions capturing interior and coastal resources that also have high ROI values that support further investment. We illustrate how spatially explicit, yet flexible ROI analysis can help to better address uncertainty, risk, and opportunities for conservation, while making values that guide prioritization more transparent. In one case the results of this prioritization process were used to support new conservation investments. Acknowledging a clear research need to improve cost information, we propose that adopting a flexible ROI framework to set conservation priorities in Africa has multiple potential benefits.

Essays on Inequality and Integration

Inequality and integration have been sociology’s two key paradigms since the classics, associated with the names of Marx and Durkheim and Europe’s current economic crisis has forcefully reinvigorated their joint relevance. Above all, the debt crisis has fueled the wheel of social inequality: cash-starved states are further forced to cut back on public expenditures, to minimize the margin for redistribution and to raise new challenges for the integration policies addressing the emerging disparities. At the same time, global environmental and demographic problems, intertwined with escalating migration pressure, tear at the texture of European and all Western societies, in particular, the unequal impact of climate change and the unequal distribution of population growth make migration and integration paramount public policy issues and a soaring source of social conflict. In principle, the inequalities engendered by these cascading processes are also an opportunity. They increase the diversity of society and can bring about innovation and growth. Our desire and ability for social integration depends, above all, on the ultimate balance between these advantages and disadvantages. The chapters in the volume concentrate on the opportunities as well as the risks associated with these social changes from various angles. They are a handpicked set of outstanding contributions from the Congress of the Swiss Sociological Association that took place at the University of Bern, June 26–28, 2013.

The cup anemometer, a fundamental meteorological instrument for the wind energy industry

The cup anemometer has been used widely by the wind energy industry since its early beginning, covering two fundamental aspects: wind mill performance control and wind energy production forecast. Furthermore, despite modern technological advances such as LIDAR and SODAR, the cup anemometer remains clearly the most used instrument by the wind energy industry. Together with the major advantages of this instrument (precision, robustness), some issues must be taken into account by scientists and researchers when using it. Overspeeding, interaction with stream wakes due to allocation on masts and wind- mills, loss of performance due to wear and tear, change of performance due to different climatic conditions, checking of the maintenance status and recalibration, etc. In the present work a review of the research campaigns carried out at the IDR/UPM Institute to analyze cup anemometer performance is included. Several aspects of this instrument are examined: the calibration process, the loss of performances due to aging and wear and tear, the effect of changes of air density, the rotor aerodynamics, and the harmonic terms contained in the anemometer output signal and their possible relation to the anemometer performances.

On the cup anemometer working condition monitoring

The analysis of the harmonic terms related to the rotational speed of a cup anemometer is a way to detect anomalies such as wear and tear, rotor non-symmetries (rotor damage) or problems at the output signal system. The research already done in this matter at the IDR/UPM Institute is now taken to cup anemometers working on the field. A 1-2 year testing campaign is being carried out in collaboration with Kintech Engineering. 2 Thies First Class Advanced installed at 58 m and 73 m height in a meteorology tower are constantly monitored. The results will be correlated to the anemometer performance evolution studied through several calibrations planned to be performed along the testing campaign.

Aplicación de la celulosa bacteriana a la restauración del patrimonio bibliográfico y documental en papel

La preservación del patrimonio bibliográfico y documental en papel es uno de los mayores retos a los que se enfrentan bibliotecas y archivos de todo el mundo. La búsqueda de soluciones al problema del papel degradado ha sido abordada históricamente desde dos líneas de trabajo predominantes: la conservación de estos documentos mediante la neutralización de los ácidos presentes en ellos con agentes alcalinos, y su restauración mediante el método de laminación fundamentalmente con papel de origen vegetal. Sin embargo, no se ha explorado con éxito la posibilidad de reforzar la celulosa dañada, y el problema sigue sin encontrar una solución satisfactoria. Hasta el día de hoy, el desarrollo de tratamientos basados en biotecnología en la conservación del patrimonio documental ha sido muy escaso, aunque la capacidad de ciertas bacterias de producir celulosa lleva a plantear su uso en el campo de la conservación y restauración del papel. La celulosa bacteriana (CB) es químicamente idéntica a la celulosa vegetal, pero su organización macroscópica es diferente. Sus propiedades únicas (alto grado de cristalinidad, durabilidad, resistencia y biocompatibilidad) han hecho de este material un excelente recurso en diferentes campos. En el desarrollo de esta tesis se ha estudiado el uso de la celulosa bacteriana, de alta calidad, generada por Gluconacetobacter sucrofermentans CECT 7291, para restaurar documentos deteriorados y consolidar los que puedan estar en peligro de degradación, evitando así su destrucción y proporcionando al papel que se restaura unas buenas propiedades mecánicas, ópticas y estructurales. Se desarrollan asimismo protocolos de trabajo que permitan la aplicación de dicha celulosa. En primer lugar se seleccionó el medio de cultivo que proporcionó una celulosa adecuada para su uso en restauración. Para ello se evaluó el efecto que tienen sobre la celulosa generada las fuentes de carbono y nitrógeno del medio de cultivo, manteniendo como parámetros fijos la temperatura y el pH inicial del medio, y efectuando los ensayos en condiciones estáticas. Se evaluó, también, el efecto que tiene en la CB la adición de un 1% de etanol al medio de cultivo. Las capas de celulosa se recolectaron a cuatro tiempos distintos, caracterizando en cada uno de ellos el medio de cultivo (pH y consumo de fuente de carbono), y las capas de CB (pH, peso seco y propiedades ópticas y mecánicas). La mejor combinación de fuentes de carbono y nitrógeno resultó ser fructosa más extracto de levadura y extracto de maíz, con o sin etanol, que proporcionaban una buena relación entre la producción de celulosa y el consumo de fuente de carbono, y que generaban una capa de celulosa resistente y homogénea. La adición de etanol al medio de cultivo, si bien aumentaba la productividad, causaba un descenso apreciable de pH. Las capas de CB obtenidas con los medios de cultivo optimizados se caracterizaron en términos de sus índices de desgarro y estallido, propiedades ópticas, microscopía electrónica de barrido (SEM), difracción de rayos-X, espectroscopía infrarroja con transformada de Fourier (FTIR), grado de polimerización, ángulos de contacto estáticos y dinámicos, y porosimetría de intrusión de mercurio. Por otro lado hay que tener en cuenta que el material restaurado debe ser estable con el tiempo. Por ello esta misma caracterización se efectuó tras someter a las capas de CB a un proceso de envejecimiento acelerado. Los resultados mostraron que la CB resultante tiene un elevado índice de cristalinidad, baja porosidad interna, buenas propiedades mecánicas, y alta estabilidad en el tiempo. Para desarrollar los protocolos de trabajo que permitan la restauración con esta celulosa optimizada, se comienzó con un proceso de selección de los papeles que van a ser restaurados. Se eligieron tres tipos de papeles modelo, hechos con pasta mecánica, química y filtro (antes y después de ser sometidos a un proceso de envejecimiento acelerado), y tres libros viejos adquiridos en el mercado de segunda mano. Estos ejemplares a restaurar se caracterizaron también en términos de sus propiedades mecánicas y fisicoquímicas. El primer protocolo de restauración con CB que se evaluó fue el denominado laminación. Consiste en aplicar un material de refuerzo al documento mediante el uso de un adhesivo. Se seleccionó para ello la CB producida en el medio de cultivo optimizado con un 1% de etanol. Se aplicó un método de purificación alcalino (1 hora a 90 °C en NaOH al 1%) y como adhesivo se seleccionó almidón de trigo. El proceso de laminación se efectuó también con papel japonés (PJ), un material habitualmente utilizado en conservación, para comparar ambos materiales. Se concluyó que no hay diferencias significativas en las características estudiadas entre los dos tipos de materiales de refuerzo. Se caracterizó el material reforzado y, también, después de sufrir un proceso de envejecimiento acelerado. Los papeles laminados con CB mostraban diferencias más marcadas en las propiedades ópticas que los restaurados con PJ, con respecto a los originales. Sin embargo, el texto era más legible cuando el material de restauración era la CB. La mojabilidad disminuía con ambos tipos de refuerzo, aunque en los papeles laminados con CB de manera más marcada e independiente del material a restaurar. Esto se debe a la estructura cerrada de la CB, que también conduce a una disminución en la permeabilidad al aire. Este estudio sugiere que la CB mejora la calidad del papel deteriorado, sin alterar la información que contiene, y que esta mejora se mantiene a lo largo del tiempo. Por tanto, la CB puede ser utilizada como material de refuerzo para laminar, pudiendo ser más adecuada que el PJ para ciertos tipos de papeles. El otro método de restauración que se estudió fue la generación in situ de la CB sobre el papel a restaurar. Para ello se seleccionó el medio de cultivo sin etanol, ya que el descenso de pH que causaba su presencia podría dañar el documento a restaurar. El método de purificación elegido fue un tratamiento térmico (24 horas a 65 °C), menos agresivo para el material a restaurar que el tratamiento alcalino. Se seleccionó la aplicación del medio de cultivo con la bacteria mediante pincel sobre el material a restaurar. Una vez caracterizado el material restaurado, y éste mismo tras sufrir un proceso de envejecimiento acelerado, se concluyó que no hay modificación apreciable en ninguna característica, salvo en la permeabilidad al aire, que disminuye de manera muy evidente con la generación de CB, dando lugar a un material prácticamente impermeable al aire. En general se puede concluir que ha quedado demostrada la capacidad que tiene la celulosa generada por la bacteria Gluconacetobacter sucrofermentans CECT 7291 para ser utilizada como material de refuerzo en la restauración del patrimonio documental en papel. Asimismo se han desarrollado dos métodos de aplicación, uno ex situ y otro in situ, para efectuar esta tarea de restauración. ABSTRACT The preservation of bibliographic and documentary heritage is one of the biggest challenges that libraries and archives around the world have to face. The search for solutions to the problem of degraded paper has historically been focused from two predominants lines of work: the conservation of these documents by the neutralization of acids in them with alkaline agents, and their restoration by lining them with, basically, cellulose from vegetal sources. However, the possibility of strengthening the damaged cellulose has not been successfully explored, and the problem still persists. Until today, the development of biotechnology-based treatments in documentary heritage conservation has been scarce, although the ability of certain bacteria to produce cellulose takes to propose its use in the field of conservation and restoration of paper. The bacterial cellulose (BC) is chemically identical to the plant cellulose, but its macroscopic organization is different. Its unique properties (high degree of crystallinity, durability, strength and biocompatibility), makes it an excellent resource in different fields. The use of high-quality BC generated by Gluconacetobacter sucrofermentans CECT 7291 to restore damaged documents and to consolidate those that may be at risk of degradation, has been studied in this thesis, trying to prevent the document destruction, and to get reinforced papers with good mechanical, optical and structural properties. Protocols that allow the implementation of the BC as a reinforcing material were also developed. First of all, in order to select the culture medium that provides a cellulose suitable for its use in restoration, it has been evaluated the effect that the carbon and nitrogen sources from the culture medium have on the generated BC, keeping the temperature and the initial pH of the medium as fixed parameters, and performing the culture without shaking. The effect of the addition of 1% ethanol to the culture medium on BC properties was also evaluated. The cellulose layers were collected at four different times, characterizing in all of them the culture medium (pH and carbon source consumption), and the BC sheets (pH, dry weight and optical and mechanical properties). The best combination of carbon and nitrogen sources proved to be fructose plus yeast extract and corn steep liquor, with or without ethanol, which provided a good balance between the cellulose production and the consumption of carbon source, and generating BC sheets homogeneous and resistant. The addition of ethanol to the culture medium increased productivity but caused a noticeable decrement in pH. The BC layers generated with these optimized culture media, have been characterized in terms of tear and burst index, optical properties, scanning electron microscopy (SEM), X-ray diffraction, infrared Fourier transform spectroscopy (FTIR), polymerization degree, static and dynamic contact angles, and mercury intrusion porosimetry. Moreover it must be kept in mind that the restored materials should be stable over time. Therefore, the same characterization was performed after subjecting the layers of BC to an accelerated aging process. The results showed that the BC sheets obtained have a high crystallinity index, low internal porosity, good mechanical properties, and high stability over time. To develop working protocols to use this optimized BC in paper restoration, the first step was to select the samples to restore. Three types of model papers, made from mechanical pulp, chemical pulp and filter paper (before and after an accelerated aging process), and three old books purchased in the second hand market, were chosen. These specimens to be restored were also characterized in terms of its mechanical and physicochemical properties. The first protocol of restoration with BC to be evaluated is called linning. It consists on applying a reinforcing material to the document using an adhesive. The BC produced in the optimized culture medium with 1% ethanol was selected. An alkali purification method (1 hour at 90 °C in 1% NaOH) was applied, and wheat starch was selected as adhesive. The linning process was also carried out with Japanese paper (JP), a material commonly used in conservation, in order to compare both materials. It was concluded that there are no significant differences in the characteristics studied of the two types of reinforcing materials. The reinforced materials were characterized before and after undergoing to an accelerated aging. Papers lined with BC showed more marked differences in the optical properties that papers restored with JP. However, the text was more readable when BC was the reinforcing material. Wettability decreased with both types of reinforcement, although in the papers linned with BC it happened more marked and independently of the sample to restore. This is due to the closed structure of BC, which also leads to a decrement in air permeance. This study suggests that BC improves the deteriorated paper quality, without altering the information on it, and that this improvement is maintained over time. Therefore, the BC may be used as reinforcing material for linning, being more suitable than the JP to restore certain types of papers. The other restoration method to be evaluated was the in situ generation of BC over the paper to restore. For this purpose the culture medium without ethanol was selected, as the pH decrement caused by his presence would damage the document to restore. As purification method a heat treatment (24 hours at 65 °C) was chosen, less aggressive to the material to restore than the alkaline treatment. It was decided to apply the culture medium with the bacteria onto the material to restore with a brush. The reinforced material was characterized before and after an accelerated aging process. It was concluded that there was no substantial change in any characteristic, except for air permeance, which decreases very sharply after the generation of BC, getting a substantially air impermeable material. In general, it can be concluded that the ability of BC produced by Gluconacetobacter sucrofermentans CECT 7291 for its use as a reinforcing material in the restoration of paper documentary heritage, has been demonstrated. Also, two restoration methods, one ex situ and another in situ have been developed.

Target gene search for the metal-responsive transcription factor MTF-1

Activation of genes by heavy metals, notably zinc, cadmium and copper, depends on MTF-1, a unique zinc finger transcription factor conserved from insects to human. Knockout of MTF-1 in the mouse results in embryonic lethality due to liver decay, while knockout of its best characterized target genes, the stress-inducible metallothionein genes I and II, is viable, suggesting additional target genes of MTF-1. Here we report on a multi-pronged search for potential target genes of MTF-1, including microarray screening, SABRE selective amplification, a computer search for MREs (DNA-binding sites of MTF-1) and transfection of reporter genes driven by candidate gene promoters. Some new candidate target genes emerged, including those encoding α-fetoprotein, the liver-enriched transcription factor C/EBPα and tear lipocalin/von Ebner’s gland protein, all of which have a role in toxicity/the cell stress response. In contrast, expression of other cell stress-associated genes, such as those for superoxide dismutases, thioredoxin and heat shock proteins, do not appear to be affected by loss of MTF-1. Our experiments have also exposed some problems with target gene searches. First, finding the optimal time window for detecting MTF-1 target genes in a lethal phenotype of rapid liver decay proved problematical: 12.5-day-old mouse embryos (stage E12.5) yielded hardly any differentially expressed genes, whereas at stage 13.0 reduced expression of secretory liver proteins probably reflected the onset of liver decay, i.e. a secondary effect. Likewise, up-regulation of some proliferation-associated genes may also just reflect responses to the concomitant loss of hepatocytes. Another sobering finding concerns γ-glutamylcysteine synthetasehc (γ-GCShc), which controls synthesis of the antioxidant glutathione and which was previously suggested to be a target gene contributing to the lethal phenotype in MTF-1 knockout mice. γ-GCShc mRNA is reduced at the onset of liver decay but MTF-1 null mutant embryos manage to maintain a very high glutathione level until shortly before that stage, perhaps in an attempt to compensate for low expression of metallothioneins, which also have a role as antioxidants.

Células-tronco de membrana amniótica de cão como terapia alternativa para o tratamento de ceratoconjuntivite seca em cães

A Ceratoconjuntivite Seca (KCS Keratoconjunctivitis Sicca) é uma desordem imunomediada e resulta de alterações do componente aquoso do filme lacrimal e da deficiência dos componentes lipídicos e mucoso.Seu diagnóstico é baseado no Teste Lacrimal de Schirmer (TLS) e no Teste de Ruptura do Filme Lacrimal (TRFL) e tem como sinais clínicos: secreção mucopurulenta, hiperemia conjuntival, blefaroespasmos, fotofobia, incômodo, dor, vascularização, opacidade corneana e pigmentação, além de cegueira em casos avançados. O tratamento convencional consiste em aplicações diárias de Ciclosporina 0,2% ou Tacrolimus 0,03% (pomada ou colírio oftálmicos), que apesar de controlar a doença, são custosos, não curativos e exigem alto comprometimento da interação paciente-proprietário. A terapia celular usando células-tronco (CT) traz uma nova esperança para doenças sem tratamento efetivo. Neste trabalho utilizamos CT mesenquimais (CTM) obtidas a partir de membrana amniótica (CTMA) de cães obtidas a partir do descarte destes tecidos em campanhas de castrações em diferentes tempos gestacionais, sem formação tumoral quando submetidas ao teste tumorigênico durante 60 dias. Dois animais com KCS crônica foram tratados com duas injeções de CTMA com intervalo de 30 dias, sendo a primeira de 0,5x106 células e a segunda de 1x106 células em cada glândula. Na segunda semana após a terapia foi observado aumento da TLS sugerindo um benéficio da terapia que foi diminuindo com o passar das semanas. O TRFL oscilou durante os testes e não apresentou diferenças significativas. A terapia celular utilizando CTMA de cães melhorou a condição ocular nos dois casos em momentos e parâmetros variados, com repercussão na melhoria da superfície, mas não houve regressão do quadro clínico. Investigações futuras em estágios menos avançados da doença podem ajudar a elucidar os mecanismos pelos quais esse efeito foi obtido

Alteraciones oculares y visuales en personas que trabajan con ordenador y son usuarias de lentes de contacto: una revisión bibliográfica

Fundamentos: El elevado número de personas que trabajando con ordenador utiliza lentes de contacto plantea la cuestión sobre si la suma de estos dos factores de riesgo para la salud visual puede originar un agravamiento del Síndrome Visual Informático. El objetivo de esta revisión es sintetizar el conocimiento científico sobre las alteraciones oculares y visuales relacionadas con la exposición a ordenador en usuarios de lentes de contacto. Métodos: Revisión de artículos científicos (2003-2013) en español e inglés, realizando una búsqueda bibliográfica, en Medline a través de PubMed y en Scopus. Resultados: La búsqueda inicial aportó 114 trabajos, después de aplicar criterios de inclusión/exclusión se incluyeron seis artículos. Todos ellos ponen de manifiesto que las alteraciones al utilizar el ordenador son más frecuentes en las personas usuarias de lentes de contacto, con prevalencias que oscilan de 95,0% al 16,9% que en las que no utilizan lentes de contacto, cuya prevalencia va del 57,5% al 9,9% y con una probabilidad cuatro veces mayor de padecer ojo seco [OR: 4,07 (IC 95%: 3,52-4,71)]. Conclusiones: Las personas usuarias de ordenador padecen más alteraciones oculares y visuales cuando además son usuarias de lentes de contacto, pero los estudios son escasos y poco contundentes. Se precisan nuevas investigaciones que analicen la influencia según los tipos de lentes y sus condiciones de uso, tanto en la sintomatología como en la calidad de la lágrima y la superficie ocular. Las lentes de hidrogel de silicona son las que se asocian a mayor confort.