Características del desprendimiento de retina regmatógeno en pacientes atendidos en la Clínica Oftalmológica OFTALMOLASER, Cuenca- Ecuador en el período 2013-2015

El presente estudio tuvo como objetivo determinar las características epidemiológicas del desprendimiento regmatógeno de retina en la población atendida en la Clínica Oftalmológica Oftalmolaser en el periodo 2013 - 2015. Se realizó un estudio cuantitativo descriptivo basado en la revisión y análisis del registro de historias clínicas, obteniendo los siguientes resultados: la frecuencia del desprendimiento regmatógeno de retina fue mayor en el sexo masculino con 54%; el mayor numero de casos se presento en la sexta década de la vida con 30%, la edad promedio de la población en estudio fue 55 años, los antecedentes patológicos mas frecuentes fueron miopía y pseudofaquia con un 27,4% para cada uno, el 51,08% de la población no presentó ningún antecedente quirúrgico oftalmológico, el 36,02% refirió haber tenido cirugía de catarata, el 63,40% de pacientes presentaron alteración de la agudeza visual como manifestación sintomática mientras que defectos del campo visual se presentaron en un 20,85%, el ojo derecho fue el mas afectado con 56%, el 56% de los pacientes acudieron luego de cuatro semanas del inicio de la sintomatología, el 82,78% presentaron agudeza visual de 20/400 al momento del examen físico y el 56,11% presentaron PIO normal mientras que el 40% presento hipotonía ocular. La localización más frecuente fue la temporal superior con un 30,56% y el 71% presentaron afección de la mácula evidenciada en la retinoscopía

The responsiveness of government revenue to marginal tax rates

Ce document utilise des données fiscales et démographiques pour calculer les changements dans les recettes du gouvernement engendrés par les ajustements dans le taux marginal d'imposition, et cela en mettant l’accent sur la fourchette d'imposition la plus élevée. La portée de l’étude est une sélection de pays de l’O.C.D.E. Une analyse des changement de comportement des contribuables et des différentes alternatives dont le gouvernement dispose en termes de politique fiscale en suivaient. En fin, les possibles faiblesses dans des techniques de référence sont examinées en détail. 

Paleoenvironments and Geochemical Signals from the Late Barremian to the Middle Aptian in a Tethyan Marginal Basin, Northeast Spain: Implications for Carbon Sequestration in Restricted Basins

The hallmark of oceanic anoxic event 1a (OAE1a) (early Aptian ~125 Ma) corresponds to worldwide deposition of black shales with total organic carbon (TOC) content > 2% and a d13C positive excursion up to ~5‰. OAE1a has been related to large igneous province volcanism and dissociation of methane hydrates during the Lower Cretaceous. However, the occurrence of atypical, coeval and diachronous organic-rich deposits associated with OAE1a, which are also characterized by positive spikes of the d13C in epicontinental to restricted marine environments of the Tethys Ocean, indicates localized responses decoupled from complex global forcing factors. The present research is a high-resolution, multiproxy approach to assess the paleoenvironmental conditions that led to enhanced carbon sequestration from the late Barremian to the middle Aptian in a restricted, Tethyan marginal basin prior to and during OAE1a. I studied the lower 240 m of the El Pui section, Organyà Basin, Spanish Pyrenees. The basin developed as the result of extensional tectonism linked to the opening of the Atlantic Ocean. At the field scale the section consists of a sequence of alternating beds of cm – m-scale, medium-gray to grayish-black limestones and marlstones with TOC up to ~4%. The results indicate that the lowest 85 m of the section, from latest Barremian –earliest Aptian, characterize a deepening phase of the basin concomitant with sustained riverine flux and intensified primary productivity. These changes induced a shift in the sedimentation pattern and decreased the oxygen levels in the water column through organic matter respiration and limited ventilation of the basin. The upper 155 m comprising the earliest – late-early Aptian document the occurrence of OAE1a and its associated geochemical signatures (TOC up to 3% and a positive shift in d13C of ~5‰). However, a low enrichment of redox-sensitive trace elements indicates that the basin did not achieve anoxic conditions. The results also suggest that a shallower-phase of the basin, coeval with platform progradation, may have increased ventilation of the basin at the same time that heightened sedimentation rates and additional input of organic matter from terrestrial sources increased the burial and preservation rate of TOC in the sediment.

Distribution of Light in the Human Retina under Natural Viewing Conditions

Age-related macular degeneration (AMD) is the leading cause of blindness inAmerica. The fact that AMD wreaks most of the damage in the center of the retina raises the question of whether light, integrated over long periods, is more concentrated in the macula. A method, based on eye-tracking, was developed to measure the distribution of light in the retina under natural viewing conditions. The hypothesis was that integrated over time, retinal illumination peaked in the macula. Additionally a possible relationship between age and retinal illumination was investigated. The eye tracker superimposed the subject’s gaze position on a video recorded by a scene camera. Five informed subjects were employed in feasibility tests, and 58 naïve subjects participated in 5 phases. In phase 1 the subjects viewed a gray-scale image. In phase 2, they observed a sequence of photographic images. In phase 3 they viewed a video. In phase 4, they worked on a computer; in phase 5, the subjects walked around freely. The informed subjects were instructed to gaze at bright objects in the field of view and then at dark objects. Naïve subjects were allowed to gaze freely for all phases. Using the subject’s gaze coordinates, and the video provided by the scene camera, the cumulative light distribution on the retina was calculated for ~15° around the fovea. As expected for control subjects, cumulative retinal light distributions peaked and dipped in the fovea when they gazed at bright or dark objects respectively. The light distribution maps obtained from the naïve subjects presented a tendency to peak in the macula for phases 1, 2, and 3, a consistent tendency in phase 4 and a variable tendency in phase 5. The feasibility of using an eye-tracker system to measure the distribution of light in the retina was demonstrated, thus helping to understand the role played by light exposure in the etiology of AMD. Results showed that a tendency for light to peak in the macula is a characteristic of some individuals and of certain tasks. In these situations, risk of AMD could be increased. No significant difference was observed based on age.

The responsiveness of government revenue to marginal tax rates

Ce document utilise des données fiscales et démographiques pour calculer les changements dans les recettes du gouvernement engendrés par les ajustements dans le taux marginal d'imposition, et cela en mettant l’accent sur la fourchette d'imposition la plus élevée. La portée de l’étude est une sélection de pays de l’O.C.D.E. Une analyse des changement de comportement des contribuables et des différentes alternatives dont le gouvernement dispose en termes de politique fiscale en suivaient. En fin, les possibles faiblesses dans des techniques de référence sont examinées en détail. 

Cotidianidad marginal. La lugbre y frugal vida al interior del lazareto general del Estado de Costa Rica (1833-1850)

Resumen Analiza la problemática, inherente a la asistencia de los internos del lazareto desde su fundación hasta 1845, asi como las diversas estrategias implementadas por los internos para sobrevivir. Abstract The author analizes the problems associated with the care of internees at the lepers asylum from its foundation until 1845,as well as the strategies implemented by the in ternees in order to survive.

Descolamento da retina

Esta imagem integra o curso Oftalmologia na Atenção Básica à Saúde (2016) que tem o objetivo de ampliar a capacidade de resolução clínico-oftalmológica na Atenção Básica à saúde. Apresenta uma demonstração por imagem do Descolamento Retiniano.

Obesogenic Environment By Excess Of Dietary Fats In Different Phases Of Development Reduces Spermatic Efficiency Of Wistar Rats At Adulthood: Correlations With Metabolic Status.

This study compares the impact of obesogenic environment (OE) in six different periods of development on sperm parameters and the testicular structure of adult rats and their correlations with sex steroid and metabolic scenario. Wistar rats were exposed to OE during gestation (O1), during gestation/lactation (O2), from weaning to adulthood (O3), from lactation to adulthood (O4), from gestation to sexual maturity (O5), and after sexual maturation (O6). OE was induced by a 20% fat diet, and control groups were fed a balanced diet (4% fat). Serum leptin levels and adiposity index indicate that all groups were obese, except for O1. Three progressive levels of impaired metabolic status were observed: O1 presented insulin resistance, O2 were insulin resistant and obese, and groups O3, O4, and O5 were insulin resistant, obese, and diabetic. These three levels of metabolic damage were proportional to the increase of leptin and decreased circulating testosterone. The impairment in the daily sperm production (DSP) paralleled these three levels of metabolic and hormonal damage being marginal in O1, increasing in O2, and being higher in groups O3, O4, O5, and O6. None of the OE periods affected the sperm transit time in the epididymis, and the lower sperm reserves were caused mainly by impaired DSP. In conclusion, OE during sexual maturation markedly reduces the DSP at adulthood in the rat. A severe reduction in the DSP also occurs in OE exposure during gestation/lactation but not in gestation, indicating that breast-feeding is a critical period for spermatogenic impairment under obesogenic conditions.

Comparison Of Different Transfer Impression Techniques Accuracy For Osseointegrated Implants.

Abstract The aim of this study was to evaluate three transfer techniques used to obtain working casts of implant-supported prostheses through the marginal misfit and strain induced to metallic framework. Thirty working casts were obtained from a metallic master cast, each one containing two implant analogues simulating a clinical situation of three-unit implant-supported fixed prostheses, according to the following transfer impression techniques: Group A, squared transfers splinted with dental floss and acrylic resin, sectioned and re-splinted; Group B, squared transfers splinted with dental floss and bis-acrylic resin; and Group N, squared transfers not splinted. A metallic framework was made for marginal misfit and strain measurements from the metallic master cast. The misfit between metallic framework and the working casts was evaluated with an optical microscope following the single-screw test protocol. In the same conditions, the strain was evaluated using strain gauges placed on the metallic framework. The data was submitted to one-way ANOVA followed by the Tukey's test (α=5%). For both marginal misfit and strain, there were statistically significant differences between Groups A and N (p<0.01) and Groups B and N (p<0.01), with greater values for the Group N. According to the Pearson's test, there was a positive correlation between the variables misfit and strain (r=0.5642). The results of this study showed that the impression techniques with splinted transfers promoted better accuracy than non-splinted one, regardless of the splinting material utilized.

Strain Gauges's Analysis On Implant-retained Prosthesis' Cast Accuracy.

A proper cast is essential for a successful rehabilitation with implant prostheses, in order to produce better structures and induce less strain on the implants. The aim of this study was to evaluate the precision of four different mold filling techniques and verify an accurate methodology to evaluate these techniques. A total of 40 casts were obtained from a metallic matrix simulating three unit implant-retained prostheses. The molds were filled using four different techniques in four groups (n = 10): Group 1 - Single-portion filling technique; Group 2 - Two-step filling technique; Group 3 - Latex cylinder technique; Group 4 - Joining the implant analogs previously to the mold filling. A titanium framework was obtained and used as a reference to evaluate the marginal misfit and tension forces in each cast. Vertical misfit was measured with an optical microscope with an increase of 120 times following the single-screw test protocol. Strain was quantified using strain gauges. Data were analyzed using one-way ANOVA (Tukey's test) (α =0.05). The correlation between strain and vertical misfit was evaluated by Pearson test. The misfit values did not present statistical difference (P = 0.979), while the strain results showed statistical difference between Groups 3 and 4 (P = 0.027). The splinting technique was considered to be as efficient as the conventional technique. The strain gauge methodology was accurate for strain measurements and cast distortion evaluation. There was no correlation between strain and marginal misfit.

The Tadpole Of Sphaenorhynchus Caramaschii, With Comments On Larval morphology Of Sphaenorhynchus (anura: Hylidae).

We describe the tadpole of Sphaenorhynchus caramaschii. It differs from tadpoles of other species of Sphaenorhynchus in having a short spiracle, submarginal papillae, and alternating short and large marginal papillae in the oral disc. Some larval characteristics, like morphology and position of the nostrils, length of the spiracle, and size of the marginal papillae on the oral disc are discussed for tadpoles of other species of Sphaenorhynchus.  

Increased Circulating Pedf And Low Sicam-1 Are Associated With Sickle Cell Retinopathy.

Sickle cell retinopathy (SCR) develops in up to 30% of sickle cell disease patients (SCD) during the second decade of life. Treatment for this affection remains palliative, so studies on its pathophysiology may contribute to the future development of novel therapies. SCR is more frequently observed in hemoglobin SC disease and derives from vaso-occlusion in the microvasculature of the retina leading to neovascularization and, eventually, to blindness. Circulating inflammatory cytokines, angiogenic factors, and their interaction may contribute to the pathophysiology of this complication. Angiopoietin (Ang)-1, Ang-2, soluble vascular cell adhesion molecule-1, intercellular adhesion molecule (ICAM)-1, E-selectin, P-selectin, IL1-β, TNF-α, pigment epithelium derived factor (PEDF) and vascular endothelial growth factor plasmatic levels were determined in 37 SCD patients with retinopathy, 34 without retinopathy, and healthy controls. We observed that sICAM-1 is significantly decreased, whereas PEDF is elevated in HbSC patients with retinopathy (P=0.012 and P=0.031, respectively). Ang-1, Ang-2 and IL1-β levels were elevated in SCD patients (P=0.001, P<0.001 and P=0.001, respectively), compared to controls, and HbSS patients presented higher levels of Ang-2 compared to HbSC (P<0.001). Our study supports the possible influence of sICAM-1 and PEDF on the pathophysiology of retinal neovascularization in SCD patients.

Ontogenia e estrutura do pericarpo de Prestonia riedelii (Müll. Arg.) Markgr. (Apocynaceae)

The aim of this work was to describe the morphology and ontogeny of P. riedelii fruits to aid in taxonomic, ecological and phylogenetic studies in Apocynaceae. Fruits were fixed in FAA, embedded in plastic resin, sectioned at 10 ìm and stained with toluidine blue, for structural analysis. The fruit of P. riedelii is a follicarium, with two follicular fruitlets. The epicarp is one-cell-layered, with trichomes and thick cuticle. The mesocarp, originating from fundamental ovary tissue, is parenchymatous with laticifers, non-lignified fibers and vascular bundles. The endocarp sensu lato is two-celllayered of crossed sclereids, originating from the inner ovary epidermis and from a single layer of parenchyma cells of fundamental ovary tissue. Follicle dehiscence is lateral and the dehiscence process involves anatomical characteristics such as a dehiscence zone with thin-walled cells, non-lignified fibers in the mesocarp and crossed sclereids in the endocarp.

Estudo da circulação retrobulbar e do campo visual após dose única oral de citrato de sildenafil (Viagra®)

Purpose: To analyze the effects of 100 mg of sildenafil citrate (Viagra®) on the retrobulbar circulation and visual field. Methods: A double masked, placebo controlled study was conducted in 10 males with a mean age of 27.7 + 5.68 years. The right eye of each volunteer underwent orbital color Doppler imaging and automated perimetry (Humphrey, program 30-2, Full-Threshold Strategy) at 3 occasions: baseline, 1 hour after placebo and 1 hour after 100 mg of sildenafil. The foveal threshold and the mean deviation (MD) were analyzed by automated perimetry on the three occasions. Color Doppler imaging allowed the measurement of the peak systolic velocity (PSV), end diastolic velocity (EDV) and Pourcelot index (PI) in the central retinal artery and ophthalmic artery. Results: The foveal threshold and the mean deviation did not show a significant change following the administration of sildenafil. The ophthalmic artery peak systolic velocity and end diastolic velocity significantly increased after the administration of sildenafil (p<0.001). The hemodynamic parameters in the central retinal artery and the ophthalmic artery PI did not significantly change. Conclusions: Sildefanil citrate increased the blood flow velocities in the ophthalmic artery in normal subjects, with no significant changes in the foveal threshold and mean deviation in the automated perimetry.

Central retinal vein thrombosis as an initial manifestation of heterozygous protein C deficiency: case report

The purpose of this paper is to report a case of central retinal vein thrombosis associated with isolated heterozygous protein C deficiency. Acute occlusion of the central retinal vein presents as one of the most dramatic pictures in ophthalmology. It is often a result of both local and systemic causes. A rare systemic cause is heterozygous protein C deficiency, and it usually occurs in combination with other thrombophilic conditions. This case highlights that isolated heterozygous protein C deficiency may be the cause of central retinal vein thrombosis and underscores the importance of its screening in young patients with this ophthalmologic disease.