[Training and clinical activity of Spanish retinologists: a preliminary approach. Retina 2 project. Descriptive analysis]

PURPOSE

To create a database of Spanish ophthalmologists mainly dedicated to retinal pathology care, describing their training period characteristics and their daily activity (clinical and surgical).

METHODS

A postal questionnaire was sent to 504 possible retinologists identified through the information supplied by the Spanish Ophthalmological Society and the Spanish Vitreous-Retina Society, with a minimum of 3 retinologists per Autonomous Region.

RESULTS

267 (52.9% of the sample population) responses were collected and processed. Most of the respondents had started their residency after 1980 (82.4%). Ninety-four percent had received specific training in retinal pathology, mostly during the residency period (82.1%) and from more experienced colleagues (62.9%). Official fellowships were held in a minority of cases (around 12%). Twelve percent of retinologists performed retinal surgery only, 14.6% performed anterior segment surgery, and 60.7% performed both types of surgery.

CONCLUSIONS

Despite not having taken into consideration non-response bias, this study provides the first reported data on the professional profile of Spanish retinologists.

A phase II randomized trial of gemcitabine-docetaxel versus gemcitabine-cisplatin in patients with advanced non-small cell lung carcinoma

PURPOSE

To test efficacy and tolerability of non-platinum regimens for advanced non-small-cell lung cancer (NSCLC).

METHODS

Chemonaive patients with measurable stage IIIB/IV NSCLC treated with gemcitabine and cisplatin (GC), or gemcitabine and docetaxel (GD), maximumsix cycles in a phase IIB trial.

RESULTS

A total of 108 patients were randomized. Response rates (GC vs. GD, respectively): complete 3.6/2.0%, Partial 30.9/38.0%. Median Overall Survival (OS): 8.9 months in both groups (P = 0.53); and median time to progression (TTP): 6.2/5.5 months respectively (P = 0.61). Toxicities included (GC vs. GD, respectively): grade 3-4 neutropenia 49.1/41.2%; grade 3 thrombocytopenia 30.9/3.9%; grade 3 anemia 14.5/3.9%. Non-haematological toxicity was similar, except for nausea and vomiting, (16.3/2%); renal toxicity (3.7/0%) and hepatic toxicity (5.6/12.7%).

CONCLUSIONS

With a higher overall response rate and lower toxicity, GD is a good first treatment option for advanced NSCLC.

Post-treatment of effluents from anaerobic digesters by the Anammox process

The application of the Anammox process was studied under two different approaches for the post-treatment of anaerobic digester supernatants: two independent units, the combined SHARON-Anammox system, performed in a chemostate and a SBR, respectively, and, a single unit system composed by an air pulsing SBR to carry out the CANON process. The technology based on the combination of the SHARON-Anammox process was used to treat the effluent of an anaerobic digester from a fish canning industry. The presence of organic matter in the influent caused fluctuations in the efficiency of the SHARON unit and an optimal nitrite to ammonium ratio was not achieved in this system to feed the Anammox reactor. Nevertheless an overall percentage of nitrogen removal of 40-80% was obtained when the Anammox reactor operated at nitrite limited conditions. In those periods when the effluent from the SHARON unit contained a NO2(-)-N/NH4(+)-N molar ratio higher than 1.3 the Anammox process lost its stability due to nitrite accumulation. The effluent from an anaerobic digester placed at a WWTP was treated by a CANON system operated at room temperature (20-24 degrees C). This system was developed from a nitrifying air pulsing reactor working at limiting dissolved oxygen conditions which was inoculated with Anammox biomass. A quick start-up of the system was observed and the reactor reached a nitrogen removal rate of 0.25 g N/(L d) 40 days after inoculation. The maximum nitrogen removal rate reached 0.5 g N/(L d). These results indicate the feasibility of the treatment of effluents from psychrophilic anaerobic digesters using the Anammox process.

[The use of laser technology for the treatment of ureterointestinal stenosis]

Ureteral-intestinal anastomosis represent on important problem in patients undergoing radical cystectomy with urinary diversion using intestinal segments, either small or large intestine. With the incorporation of laser technology in urology, new therapeutic possibilities have been opened for the section of these ureteral intestinal stenosis. Various types of laser had been employed to perform the incision, Nd:YAG, KTP:YAG, Ho:YAG, Er:YAG, and Th:YAG. The experience is limited in terms of use and results don't give clear therapeutic orientation. The section of ureteral-intestinal stenosis with laser has advantages and disadvantages, but the application of this energy source with various techniques of endoscopic section, such as the Lovaco's technique of endoluminal invagination and endoureterotomy gives satisfactory results in the short-midterm.

[Temporal relationship between gastroesophageal reflux and cardiorespiratory events]

The acid and non acidic gastroesophageal reflux can trigger apnoea, desaturation and bradicardia events, as well as chronic pulmonary pathology due to microaspirations, whereas the acute or chronic airway closing increase the intrathoracic pressure, triggering the reflux. Our aims were to measurement in preterms newborn the correlations between cardiorespiratory events and gastroesophageal reflux, find out the direction of this relation, identify the patients with association GER->CRE and decide the suitability of antireflux surgery.

METHOD

The study was made in the Motility Unit and in the Intensive Neonatal Care Unit, to preterms newborns without associated pathology except apnoea and/or bradicardia and/or desaturation.

MATERIAL

3 hours manometry study in the Motility Unit. 24 hours impedance, pH and cardiorespiratory parameters monitoring (respiratory and cardiac frequent, O2 saturation and CO2) in Intensive Neonatal Care Unit. We characterised the gastroesophageal barrier, all the reflux events and the association between GER and CRE.

RESULTS

We made 28 records to 28 patients with CRE. The average of the total number of reflux was 61 (22,25-103,00), 29,2% acid reflux and 70,8% weakly acidic. 12 patients had some GER associated with CRE but in only 2 cases was statistically significant (Sympton index: SI; Sympton Sensitivity Index: SSI) (SI > or = 50%; SSI > or = 10%). The surgical management was successfully in these two babies and nowadays they are asymptomatic.

CONCLUSION

There is not any general association between GER and CRE, nevertheless, in a little percentage of patients, this relationship is fulfilled and it is possible to measurement with impedance, pH and cardiorespiratory parameters. In these cases, the surgical management is the right treatment.

[Limbal transplantation: multicenter retrospective case series analysis]

PURPOSE

To report the results of limbal transplantation (LT) in patients with limbal stem cell deficiency (LSCD) in the context of ocular surface diseases.

MATERIALS AND METHODS

A multicenter (5 centers) retrospective case series analysis of patients who underwent LT between 1996 and 2004 was performed. Data were collected by the same researcher using a customized database. Success was defined by the absence of a persistent corneal epithelial defect, on-going inflammation or recurrence of a pterygium.

RESULTS

Data from 72 LT performed in 61 patients (65 eyes) with a mean follow-up of 20.8 months (SD 23.5; range, 3-115) were analyzed. There were 33 males and 28 females with a mean age of 55.8 years (SD: 15.6; range, 20-89). Fifty-eight (80.6%) LT were autografts (40 pterygia, 12 alkali burns, 3 iatrogenic cases, 2 viral infections, 1 neoplasia case) and 14 (19.4%) were allografts from cadaveric donors (7 immune-based disorders, 6 alkali burns, 1 iatrogenic case); all patients receiving allografts also received systemic immunosuppression. Of the total number of LT, 48 (66.7%) were successful. This proportion increased to 81.0% (47/58) when autografts were used. However, only 7.1% (1/14) of all allografts were successful. The success rate was higher (80.0%) when performed for a pterygium and lower when done for immune-based inflammation (14.3%).

CONCLUSION

Autograft tissue for LT is always preferable to allografts to surgically treat LSCD, as clinical success is significantly higher, and systemic immunosuppression is avoided. As expected, immune-based disorders are the most difficult cases to treat. LT has been shown to be an excellent option for recurrent pterygium, although prospective studies need to be performed to further corroborate these results.

Short- and long-term effects of temperature on the Anammox process

The application of the Anammox process has been usually focused on the treatment of wastewater with temperatures around 30 degrees C in order to operate under optimum conditions. In this work, the feasibility of the application of the Anammox process at lower temperatures has been tested. First, the short-term effects of temperature on the Anammox biomass were studied using batch tests. An activation energy of 63 kJ mol(-1) was calculated and the maximum activity was found at 35-40 degrees C. Activity tests done at 45 degrees C showed an irreversible loss of the activity due to the biomass lysis. A SBR was operated at different temperatures (from 30 to 15 degrees C) to determine the long-term effects. The system was successfully operated at 18 degrees C but when temperature was decreased to 15 degrees C, nitrite started to accumulate and the system lost its stability. Adaptation of biomass to low temperatures was observed when the specific activities obtained during first batch tests are compared to those obtained during the operation of the SBR.

Technical note: a novel method for routine genotyping of horse coat color gene polymorphisms

The aim of this note is to describe a reliable, fast, and cost-effective real-time PCR method for routine genotyping of mutations responsible for most coat color variation in horses. The melanocortin-1 receptor, Agouti-signaling peptide, and membrane-associated transporter protein alleles were simultaneously determined using 2 PCR protocols. The assay described here is an alternative method for routine genotyping of a defined number of polymorphisms. Allelic variants are detected in real time and no post-PCR manipulations are required, therefore limiting costs and possible carryover contamination. Data can be copied to a Microsoft Excel spreadsheet for semiautomatic determination of the genotype using a macro freely available at http://www.igijon.com/personales/fgoyache/software_i.htm (last accessed February 26, 2007). The performance of the method is demonstrated on 156 Spanish Purebred horses.