Purpose
To report the efficacy and safety of 5-fluorouracil as the second line of treatment for two cases of conjunctival intraepithelial neoplasia refractive to topical interferon alpha-2b.
Case ...report
In the first case, a 77-year-old woman was evaluated because of a fleshy vascularized lesion in the temporal conjunctiva on her right eye with leukoplakia of the corneal epithelium from 10- to 5-o’clock limbus. In the second case, an 81-year-old man, a nodular lesion in the temporal conjunctiva on his RE, with corneal adjacent opalescence, one millimeter in extent, was observed. Both patients were initially treated with excisional surgery, the samples being reported as conjunctival intraepithelial neoplasia with high-grade dysplasia. Co-adjuvant treatment with topical interferon alpha-2b 1 mIU/mL was indicated 4 times/day uninterruptedly. In the first case, there was no response despite 8 months of treatment, while in the second, the corneal lesion progressed in an arboriform pattern after 4 months of topical chemotherapy.
Management & outcome
In the absence of efficacy, the treatment was then changed to topical 5-fluorouracil (1%), 4 times/day for 7 days with a time-lapse of 21 days off, which constitutes a course. Two and four courses of treatment with 5-fluorouracil 1% were completed in both cases in the absence of important side effects. After the first course, both patients showed complete remission of the lesions. No clinical signs of relapse were noted after 1 year of follow-up.
Discussion
The treatment with 5-fluorouracil is a good option as the second line of treatment for conjunctival intraepithelial neoplasia who are low-responders to interferon alpha-2b, with fewer side effects than other currently available alternatives.
Purpose
To analyze the prescribing trends over a 7-years period, between 2013 and 2020, in a tertiary hospital (Hospital Clinico San Carlos, Madrid, Spain) and its health area.
Material and methods
A ...retrospective study on the data collected from the information systems, “farm@web” and “Farmadrid”, of glaucoma prescriptions in the framework of a public health system (Spanish National Health System) during the last seven years.
Results
Prostaglandin analogues were the most commonly used drugs in monotherapy during the study period (range: 36.82% − 47.07%). Fixed combinations of topical hypotensives had an upward trend since 2013 (range: 39.99% − 54.21%), becoming the most dispensed drugs in 2020 (48.99%). Preservative-free eye drops (lacking benzalkonium chloride, BAK) have displaced preservative containing topical treatments in all pharmacological groups. In 2013, BAK-preserved eye drops accounted for 91.1% of the total prescriptions, however in 2020 they only accounted for 34.2% of total prescriptions.
Conclusions
The results of the present study highlight the current trend to avoid BAK-preserved eye drops for the treatment of glaucoma.
•There is high clinical variability in the response of chronic central serous chorioretinopathy patients to photodynamic therapy.•Optical coherence tomography is a non-invasive method to accurately ...assess the status of the retina before and after treatment.•A new deep learning algorithm based on the baseline OCT offers an objective and promising tool to predict the response to PDT treatment in clinical practice.
To assess the prediction of the response to photodynamic therapy (PDT) in chronic central serous chorioretinopathy (CSCR) based on spectral-domain optical coherence tomography (SD-OCT) images using deep learning (DL).
Retrospective study including 216 eyes of 175 patients with CSCR and persistent subretinal fluid (SRF) who underwent half-fluence PDT. SD-OCT macular examination was performed before (baseline) and 3 months after treatment. Patients were classified into groups by experts based on the response to PDT: Group 1, complete SRF resorption (n = 100); Group 2, partial SRF resorption (n = 66); and Group 3, absence of any SRF resorption (n = 50). This work proposes different computational approaches: 1st approach compares all groups; 2nd compares groups 1 vs. 2 and 3 together; 3rd compares groups 2 vs. 3.
The mean age was 55.6 ± 10.9 years and 70.3% were males. In the first approach, the algorithm showed a precision of up to 57% to detect the response to treatment in group 1 based on the initial scan, with a mean average accuracy of 0.529 ± 0.035. In the second model, the mean accuracy was higher (0.670 ± 0.046). In the third approach, the algorithm showed a precision of 0.74 ± 0.12 to detect the response to treatment in group 2 (partial SRF resolution) and 0.69 ± 0.15 in group 3 (absence of SRF resolution).
Despite the high clinical variability in the response of chronic CSCR to PDT, this DL algorithm offers an objective and promising tool to predict the response to PDT treatment in clinical practice.
To determine the prevalence of Fuji sign in central serous chorioretinopathy (cCSC) patients and its predictive power of good response to photodynamic therapy (PDT).
Retrospective study, including ...135 eyes of 130 patients diagnosed with cCSC treated with PDT between 2017 and 2021. Optical Coherence Tomography (OCT) images from these patients were compiled and analyzed. The presence of the Fuji sign, an anatomical finding recently described as a predictor of spontaneous resolution of the subretinal fluid (SRF) in cCSC, as assessed in basal images and the maximum height of SRF pre- and post-PDT OCT was measured.
Mean age was 56.6 years, 69.4% were men and the percentage of partial or complete resolution of the SRF after PDT was 75.55%. Only 8.9% of patients (12/135) had positive Fuji sign at baseline OCT. Among them, 50% (6/12) presented a complete response to the PDT (pre-PDT SRF: 109.00 (29.61) µm), 8.3% (1/12) had a partial resolution of the SRF (127 µm to 66 µm) and 41.6% (5/12) did not respond to PDT (pre-PDT SRF: 71.00 (22.82) µm, post-PDT SRF: 83.60 (36.13) µm).
Fuji sign has a low prevalence in cCSC and its presence is not associated with a good response to PDT.
Intensive Care to facilitate Organ Donation (ICOD) consists of the initiation or continuation of intensive care measures in patients with a devastating brain injury (DBI) in whom curative treatment ...is deemed futile and death by neurological criteria (DNC) is foreseen, to incorporate organ donation into their end-of-life plans. In this study we evaluate the outcomes of patients subject to ICOD and identify radiological and clinical factors associated with progression to DNC. In this first prospective multicenter study we tested by multivariate regression the association of clinical and radiological severity features with progression to DNC. Of the 194 patients, 144 (74.2%) patients fulfilled DNC after a median of 25 h (95% IQR: 17-44) from ICOD onset. Two patients (1%) shifted from ICOD to curative treatment, both were alive at discharge. Factors associated with progression to DNC included: age below 70 years, clinical score consistent with severe brain injury, instability, intracranial hemorrhage, midline shift ≥5 mm and certain types of brain herniation. Overall 151 (77.8%) patients progressed to organ donation. Based on these results, we conclude that ICOD is a beneficial and efficient practice that can contribute to the pool of deceased donors.
Objetivo: Determinar las características clínicas y epidemiológicas de los traumatismos deportivos oculares de la población asistencial de un hospital terciario de Madrid. Método: Recopilación ...retrospectiva de los datos clínicos de los pacientes que acudieron al servicio de urgencias del Hospital Clínico San Carlos en el periodo enero 2015-diciembre 2017 y que habían sufrido un traumatismo ocular durante la práctica de algún deporte. Resultados: Se incluyeron en el estudio un total de 54 pacientes. 47 (87.04%) fueron hombres. La edad media fue de 27.26 años ± 13.01 años de desviación estándar. El deporte que causó más traumatismos entre los pacientes incluidos en el estudio fue el fútbol, seguido de deportes de raqueta, fuerza y combate y baloncesto. La iritis traumática fue el diagnóstico más frecuente, seguido de lesión periocular, lesiones de polo anterior, conmoción retiniana, lesiones regmatógenas, fractura orbitaria y desprendimiento de retina. El 87.04% de los cuadros se resolvieron con tratamiento médico. Conclusiones: La mayoría de los traumatismos oculares deportivos son leves y se resuelven apenas con tratamiento médico. Se deben excluir diagnósticos más graves que requieran de un tratamiento más específico. Las campañas de prevención de daños deben ir encaminadas a los grupos con mayor riesgo de presentarlos.
Este trabajo de investigación está basado en la inmigración en la escuela. Debido a que en los últimos años el número de alumnado extranjero se ha incrementando notablemente. La investigación ha sido ...realizada en dos centros educativos pertenecientes al Corredor del Henares, más concretamente en cuatro clases de diferentes niveles de educación primaria. Estos colegios presentan grandes diferencias en el porcentaje de alumnado extranjero matriculado. Al realizar este trabajo nos hemos centrado en los siguientes aspectos a estudiar: en primer lugar, las relaciones sociales con la finalidad de conocer el grado de integración de los alumnos extranjeros con los sus compañeros de clase. A continuación, hemos investigado las medidas adoptadas por los dos centros para la integración y adaptación de estos alumnos al centro escolar y al sistema educativo. Y finalmente hemos analizado como se ajustan esta medidas a la situación de los alumnos extranjeros.
Este trabajo de investigación está basado en la inmigración en la escuela. Debido a que en los últimos años el número de alumnado extranjero se ha incrementando notablemente. La investigación ha sido ...realizada en dos centros educativos pertenecientes al Corredor del Henares, más concretamente en cuatro clases de diferentes niveles de educación primaria. Estos colegios presentan grandes diferencias en el porcentaje de alumnado extranjero matriculado. Al realizar este trabajo nos hemos centrado en los siguientes aspectos a estudiar: en primer lugar, las relaciones sociales con la finalidad de conocer el grado de integración de los alumnos extranjeros con los sus compañeros de clase. A continuación, hemos investigado las medidas adoptadas por los dos centros para la integración y adaptación de estos alumnos al centro escolar y al sistema educativo. Y finalmente hemos analizado como se ajustan esta medidas a la situación de los alumnos extranjeros.
碩士
國立政治大學
亞太研究英語碩士學位學程(IMAS)
103
Since the establishment of the People’s Republic of China (PRC) in 1949, Taiwan has faced a fierce diplomatic battle against China for international recognition. ...There have been many studies regarding the growing presence of China in Latin America and how that affects Taiwan. What are the reasons for these countries to maintain this long-standing relationship with Taiwan? This study has covered the Cold War years to analyse the importance of the United States and their battle against Communism for Taiwan-Central America relations and it also allowed us to understand the reasons why they still support Taiwan. The result of the analysis showed us how the U.S. policy towards Central America, but not the growing presence of China, has been the main factor to shape the relations between the ROC and Central American countries. Three variables have been used to explain why Central American countries recognize Taiwan as a state: Foreign policy, economic factors and regime type. Through this study, I came across the roots of the problem with Taiwan’s status and also acquired a better understanding of the dynamic in U.S. – Central America – Taiwan relations.
PDF
