Primary sternal osteomyelitis caused by Actinomyces israelii.
Explore the source record for details and available documents.
Actinomyces↗
Biomedical subjects
I Pinilla
Publications and source records attributed to I Pinilla.
[Update on retinal transplantation and its clinical limitations].
Explore the source record for details and available documents.
Humans↗
Role of computed tomography and magnetic resonance imaging in aortobronchial fistula diagnosis following aortic coarctation reparative surgery. Report of two cases.
Aortobronchial fistula (ABF) is an uncommon complication of aortic coarctation repair which may occur years after successful coarctation correction. It is invariably fatal if not diagnosed and treated. ABF diagnosis poses a challenge for clinicians and radiologists because of the difficulty in detecting the fistula and the risks associated with some of the diagnostic procedures. Two cases of ABF occurring 1 and 20 years after reparative surgery of aortic coarctation are reported. The advantages and disadvantages of different imaging procedures for the evaluation of patients with suspected ABF are reviewed and the role of computed tomography angiography and magnetic resonance imaging is underlined.
Adolescent↗
Partial preservation of rod and cone ERG function following subretinal injection of ARPE-19 cells in RCS rats.
We quantified rod- and cone-related electroretinogram (ERG) responses following subretinal injections of the human-derived retinal pigment epithelial (hRPE) cell line ARPE-19 at age P23 to prevent progressive photoreceptor loss in the Royal College of Surgeons (RCS) rat. Culture medium-injected eyes served as sham controls. At P60, in comparison with sham-injected eyes, all recordings from hRPE-injected eyes showed preserved scotopic a- and b-waves, oscillatory potentials, double-flash-derived rod b-waves and photopic cone b-waves, and flicker critical fusion frequencies and amplitudes. Although the actual preservation did not exceed 10% of a-wave and 20% of b-wave amplitude values in non-dystrophic RCS and deteriorated rapidly by P90, rod- and cone-related ERG parameters were still recordable up to P120 unlike the virtually unresponsive sham-injected eyes.
Animals↗
Grepafloxacin concentration in ocular tissues after intravenous infusion in rabbits with intraocular inflammation.
PURPOSE: To determine the penetration of grepafloxacin into ocular tissues during experimental ocular inflammation. METHODS: 10 albino and 10 pigmented rabbits underwent a continuous intravenous infusion of the drug 24 h after injecting Salmonella typhimurium toxin intravitreously, creating ocular inflammation. The animals were killed and grepafloxacin levels were determined in plasma and ocular tissues using high performance liquid chromatography. RESULTS: Grepafloxacin levels achieved a steady-state plasma concentration of 1.5 microg/ml. The drug diffused more towards vascularized tissues (chorioretina and iris) in both albino and pigmented rabbits with a tissue/serum ratio higher than 1. Grepafloxacin showed more affinity to pigmented tissue, rising levels of 40,000-50,000 ng/g in the chorioretina and iris in pigmented animals. After inflammation, grepafloxacin intraocular penetration increased in albino animals with levels exceeding the minimum inhibitory concentration for the most common ocular pathogens. CONCLUSION: Grepafloxacin intraocular penetration is higher in pigmented tissues. Ocular inflammation increases the drug penetration into the vitreous.
Animals↗
Enhanced cone dysfunction in rats homozygous for the P23H rhodopsin mutation.
The heterozygous P23H transgenic rat is a model of autosomal dominant retinitis pigmentosa, in which a mutation in the rhodopsin gene leads to a rapid loss of rods and a more protracted loss of cones. It has been suggested that rods play an essential role in preserving cones. We tested this hypothesis by examining whether higher levels of dysfunctional rhodopsin in rats homozygous for the P23H mutation would result in exacerbated cone dysfunction when compared with heterozygous P23H rats. Electroretinogram (ERG) responses were recorded from P21 to P250 in Sprague-Dawley (SD) and homozygous P23H rats. Both scotopic and photopic intensity response ERGs were severely depressed already at P21 when compared with age-matched SD rats. Furthermore, flicker amplitudes and critical fusion frequencies were also lower in P23H compared with SD rats at P21. Scotopic and photopic intensity responses as well as flicker amplitude and critical fusion frequencies declined rapidly up to P60, reaching a steady state that was maintained up to P200. We conclude that in rats homozygous for P23H rhodopsin mutations, the severe loss of rod function already seen by P21 is accompanied by substantial cone functional loss at that age. While rod-related responses are more severely affected than cone-related responses at all ages, their actual rate of decline with age is surprisingly similar. Both undergo a biphasic temporal pattern of decline: very rapid (P21-P60) followed by very slow (P60-P200) deterioration in response parameters, implying a tight link between rod and cone functional deterioration.
Aging↗
Cone function studied with flicker electroretinogram during progressive retinal degeneration in RCS rats.
The Royal College of Surgeons (RCS) rat has a primary defect in retinal pigment epithelial cells that leads to the progressive loss of photoreceptors and central visual responsiveness. While most rods are lost by 90 days of age (P90), cones degenerate more slowly, and can be detected anatomically up to 2 years of age, despite massive neuronal death and retinal remodelling. To examine how this progressive degenerative process impacts on cone function, we recorded the electroretingram to white light flashes (1.37 log cd s m(-2)) presented at frequencies ranging from 3 to 50 Hz, under light adapted conditions (29.8 cd m(-2)). Pigmented dystrophic and congenic non-dystrophic RCS rats aged from 18 to 300 days were studied. In all responsive animals at all ages, maximal amplitudes were obtained at 3 Hz. In both non-dystrophic and dystrophic rats, there was an increase from P18 to P21 in response amplitude and critical fusion frequency. After P21, these two parameters declined progressively with age in dystrophic rats. Other changes included prolongation in latency, which was first detected prior to the initiation of amplitude reduction. While phase shifts were also detected in dystrophic RCS rats, they appeared at later degenerative stages. The latest age at which responses could be elicited in dystrophic rats was at P200, with positive waves being replaced by negative deflections. The effect of increments in the intensity of background illumination was tested at P50 in both groups. This caused a diminution in flicker response amplitude and critical fusion frequencies in non-dystrophics, while in dystrophic animals, response amplitudes were reduced only at low frequencies and critical fusion frequencies were unaltered. In conclusion, although dystrophic RCS rats undergo a progressive decline in cone function with age, the flicker responsiveness at P21 is comparable to that of non-dystrophic congenic rats, suggesting normal developmental maturation of the cone system in this animal model of retinal degeneration. Flicker responses can be recorded up to P200, at which point the retina has undergone severe regressive and reactive changes in its connectivity patterns. The fact that responses at this age consist of solely negative deflections might be a reflection of the highly pathological state of the retina.
Aging↗
Measuring the cone contribution to the ERG b-wave to assess function and predict anatomical rescue in RCS rats.
Subretinal injections of human retinal pigment epithelial (RPE) cells early in the course of retinal degeneration in Royal College of Surgeons (RCS) rats can rescue photoreceptors. Fourteen injected animals were studied using a double flash electroretinogram (ERG): 10 were examined longitudinally and four terminally with immunohistochemistry. The proportion of cone contribution to the ERG b-wave rather than the absolute size of isolated cone response proved to be a reliable indicator of function over time and a predictor of the proportion of cones identified anatomically in the area of optimal photoreceptor rescue.
Animals↗
Regressive and reactive changes in the connectivity patterns of rod and cone pathways of P23H transgenic rat retina.
We have used the P23H line 1 homozygous albino rat to study how progressive photoreceptor degeneration affects rod and cone relay pathways. We examined P23H retinas at different stages of degeneration by confocal microscopy of immunostained sections and electroretinogram (ERG) recordings. By 21 days of age in the P23H rat retina, there is already substantial loss of rods and reduction in rod bipolar dendrites along with reduction of metabotropic glutamate receptor 6 (mGluR6) and rod-associated bassoon staining. The cone pathway is relatively unaffected. By 150 days, when rods are absent from much of the retina, some rod bipolars remain and dendrites of rod and cone bipolar cells form synaptic complexes associated with cones and horizontal cell processes. These complexes include foci of mGluR6 and bassoon staining; they develop further by 270 days of age. Over the course of degeneration, beginning at 21 days, bipolar axon terminals atrophy and the inner retina undergoes further changes including a reduced and disorganized AII amacrine cell population and thinning of the inner plexiform layer. Electroretinogram (ERG) results at 23 days show reductions in a-wave amplitude, in rod and cone-associated b-waves (using a double flash paradigm) and in the amplitude of oscillatory potentials (OPs). By 38 days, rod scotopic a-wave responses and OPs are lost. B-wave amplitudes decline until 150 days, at which point they are purely cone-driven and remain stable up to 250 days. The results show that during the course of photoreceptor loss in the P23H rat, there are progressive degenerative changes, particularly in the rod relay pathway, and these are reflected in the changing ERG response patterns. Later reactive changes involving condensation of cone terminals and neurotransmitter receptors associated with rod and cone bipolar dendrites and with horizontal cell processes suggest that at this stage, there are likely to be complex changes in the relay of sensory information through the retina.
Amacrine Cells↗
Contribution of rod and cone pathways to the dark-adapted electroretinogram (ERG) b-wave following retinal degeneration in RCS rats.
Although the RCS rat is widely used as a model of progressive photoreceptor loss, it is unclear how the relative rod and cone functions change with age. Rod and cone b-waves were isolated using a double flash ERG paradigm. In contrast to cones, rods never reached normal functional maturity levels, and the ERG b-wave changed from being predominantly rod-driven to being purely cone-driven by age 74 days, at which point, b-waves were progressively replaced by negative STR-like (scotopic threshold response) waves that persisted up to age 180 days. A double flash commonly abolished this wave and unveiled a b-wave.
Aging↗
Pharmacokinetics and ocular penetration of grepafloxacin in albino and pigmented rabbits.
The pharmacokinetics of grepafloxacin were determined in albino and pigmented rabbits following a single 10 mg/kg intravenous administration. The penetration of grepafloxacin into various ocular tissues was also determined after continuous intravenous infusion in both types of animal. Grepafloxacin showed a bicompartmental model of distribution in both pigmented and albino rabbits with significant differences in the pharmacokinetics between the two types of animal. After continuous intravenous infusion, significantly greater penetration of grepafloxacin was found in the iris, cornea and chorioretina of pigmented rabbits compared with albino rabbits.
Animals↗
Optimum criteria for short-wavelength automated perimetry.
OBJECTIVE: To determine the optimum perimetric criteria for short-wavelength automated perimetry on the basis of probabilistic maps that best discriminate between normal and glaucoma. DESIGN: Comparative cross-sectional study. PARTICIPANTS: Ninety-five glaucomatous eyes and 128 normal eyes were included in the study. INTERVENTIONS: The subjects underwent retinal nerve fiber layer photographic evaluation and short-wavelength automated perimetry. MAIN OUTCOME MEASURES: A probabilistic map of differential points for short-wavelength automated perimetry was elaborated, and the number of altered points was calculated for each visual field and level of significance (95%, 98%, 99%, and 99.5%). RESULTS: The presence of a cluster of four or more points outside 95% normal probability limit showed a good combination of sensitivity and specificity. At deeper levels, P: < 1% and P: < 0.5%, the best combination is achieved with three points outside the normal probability limits. CONCLUSIONS: The optimum criterion to define glaucomatous abnormalities in short-wavelength automated perimetry is the presence of a cluster of four points lower than P: < 5% or a cluster of three points lower than P: < 1%.
Adult↗
Functional and structural measurements in a multifactorial glaucoma risk model.
PURPOSE: To evaluate the relationship between a multifactorial probability risk model of developing glaucomatous visual field defects and the assessment of the retinal nerve fiber layer (RNFL) and short-wavelength automated perimetry (SWAP) in glaucoma suspects. METHODS: 157 eyes of 157 glaucoma suspects were included in the study. The risk of developing glaucomatous defects was assessed by applying a multifactorial model that included intraocular pressure, vertical cup-to-disk ratio, age and family history. Photographs of the RNFL and SWAP were performed. RESULTS: The SWAP was abnormal in 54 cases (34.3%); 21% of abnormal perimetries were obtained in the low-risk group, 37% in the moderate risk group and 56% in the high risk group. The nerve fiber layer evaluation in the different risk stages showed a pattern similar to the results obtained with SWAP. Multiple regression analyses, performed with the four variables included in the model with SWAP and RNFL evaluation, showed the relationship between the risk factors and the presence of glaucomatous damage--evaluated by RNFL and SWAP (p<0001). CONCLUSIONS: The probability model showed a good correlation between the risk scale and the RNFL and SWAP assessment.
Adult↗
[Early glaucomatous changes in neuroretinal rim shape].
PURPOSE: To assess the differences in neuroretinal rim shape in ocular hypertensive patients (normal white-white automated perimetry) with and without perimetric injury in the short wave length automated perimetry (blue-yellow). MATERIAL AND METHODS: 72 eyes from 72 hypertensive ocular patients with normal achromatic automated perimetry examination were included. Forty eyes had normal short wave length automated perimetries while 32 subjects presented an abnormal condition. The neuroretinal rim morphology was quantified by means of a planimetric study from the papillary images obtained with confocal laser scanning. RESULTS: The subjects with abnormal blue-yellow perimetry showed a decrease in the neuroretinal rim area in the inferior and temporal positions. The differences were significant (p<0.05) at the 9 o'clock position (below the middle line) and almost significant (p<0.10) at the 10 o'clock position. CONCLUSIONS: There are differences in the neuroretinal rim shape in ocular hypertensive subjects with normal achromatic perimetry according to whether there are abnormalities in the blue-yellow perimetry.
Adult↗
[Neuroretinal rim width in normal, hypertensive and glaucomatous subjects].
PURPOSE: To determine width and shape of neuro-retinal rim in normal hypertensive subjects and patients with glaucomatous damage. MATERIAL AND METHOD: Patients underwent a perimetry and a photographic retinal nerve fiber evaluation. Patients were divided in three groups: normal subjects (n=34), ocular hypertension subjects (n=38) and glaucoma patients (n=34). Neuro-retinal rim was measured using 40 degrees stereoscopic photographs with center in the optic nerve head based on a biomorphometry technique. RESULTS: In normal subjects neuro-retinal rim appeared wider in the lower pole, followed by the upper, nasal and temporal aspects. Optic nerve fiber layer showed a decreased thickness in hypertensive and glaucoma patients, particularly in sectors of the temporal aspect of the optic nerve (p<0.05). CONCLUSIONS: A Planimetry study of the optic nerve is able to detect alterations in normal neuro-retinal rim configuration and can as well detect thinning of the rim, particularly in temporal, upper and lower areas.
Adolescent↗
Central retinal vein occlusion and HELLP syndrome.
PURPOSE: To present a rare case of central retinal vein occlusion in conjunction with the HELLP syndrome. METHODS: A 30-year-old woman presented in the 28th week of her second pregnancy with severe pre-eclampsia with HELLP syndrome; delivery by caesarean section was recommended. Ten days later, the patient complained of severely decreased visual acuity in her right eye. RESULTS: Ophthalmoscopy revealed a central retinal vein occlusion with venous engorgement and tortuosity, multiple flame hemorrhages, and disc and macular edema. Electroretinography revealed a reduction of b-wave/a-wave ratio. Fluorescein-angiography showed a blockage due to extensive retinal hemorrhages with late mild staining of the walls of veins. The patient presented a spontaneous improvement in visual acuity (0.8 two months after) and a complete resolution of ophthalmoscopic findings. CONCLUSION: Ophthalmic complications are possible during and soon after this syndrome. This is the first description of a patient suffering a central retinal vein occlusion during puerperium after the HELLP syndrome.
Adult↗
Long-term liver dysfunction after allogeneic bone marrow transplantation: clinical features and course in 61 patients.
This retrospective study has aimed at determining the prevalence, aetiology and clinical evolution of chronic liver disease (CLD) after allogeneic bone marrow transplantation (BMT). A total of 106 patients who had been transplanted in a single institution and who had survived for at least 2 years after BMT were studied. The prevalence of CLD was 57.5% (61/106). In 47.3% of cases more than one aetiopathogenic agent coexisted. The causes of CLD were iron overload (52.4%), chronic hepatitis C (47.5%), chronic graft-versus-host disease (C-GVHD) (37.7%), hepatitis B (6.5%), non-alcoholic steatohepatitis (NASH) (4.9%), autoimmune hepatitis (AIH) (4.9%) and unknown two (3.3%). Twenty-three patients with iron overload underwent venesections which were well tolerated. An improvement in liver function tests (LFTs) was observed in 21 (91%) patients. All six patients with siderosis as the only cause of CLD normalized LFT as well as three patients with HCV infection. Clinical evolution was satisfactory for patients with GVHD, AIH, NASH and hepatitis B. At the last visit 23 patients continued with abnormal LFTs, and 19 of them were infected by the HCV. A sustained biochemical and virologic response was achieved in only one case out of six patients with CHC who received interferon. We have found that CLD is a common complication in long-term BMT survivors. The aetiology is often multifactorial, iron overload, CHC and C-GVHD being the main causes. The CLD followed a rather 'benign' and slow course in our patients as none of them developed symptoms or signs of liver failure and we did not observe an increase in morbidity or mortality in these patients, but a longer follow-up is necessary in HCV infected patients based on the natural history of this infection in other populations.
Adolescent↗
Anatomic results and complications in a long-term follow-up of pneumatic retinopexy cases.
BACKGROUND: The use of pneumatic retinopexy is controversial because 1) intraocular gas could increase the risk of proliferate vitreoretinopathy and 2) it has been reported to achieve low rates of success after a single procedure. METHODS: A total of 219 consecutive cases of SF6 pneumatic retinopexy were reviewed retrospectively. The follow-up period ranged from 2 to 5 years. RESULTS: A total of 179 (81.73%) of 219 eyes were treated successfully with a single procedure. The success rate increased with reoperations to 98.89%. Preoperative factors related to primary failure or redetachment were aphakia or pseudophakia (P = 0.0058) and breaks localized on horizontal meridia (P = 0.0305). Cryopexy was significantly associated with failure (P = 0.0007). A total of 31.05% of eyes showed early complications. The most frequent incidence was delay in subretinal fluid reabsorption (36.76%), followed by new breaks (26.47%). Late complications were observed in 6.84% of the eyes (six eyes with macular pucker, three with new retinal detachments, three with cataracts, and three with new breaks without detachment). CONCLUSIONS: Failures of pneumatic retinopexy were related to lens status, localization of the break, and cryopexy. The occurrence of early and late complications was similar to that in other procedures.
Cryosurgery↗