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Intense pulsed light‑based treatment for the improvement of symptoms in glaucoma patients treated with hypotensive eye drops

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Eye and Vision 2024年第2期10卷 12-21页

作者： Jose Maria Martinez‑de‑la‑Casa Carlos Oribio‑Quinto Almudena Milans‑del‑Bosch Pilar Perez‑Garcia laura morales‑fernandez Javier Garcia‑Bella Jose Manuel Benitez‑del‑Castillo Julian Garcia‑Feijoo David P.Pinero Ophthalmology Unit Department of Ophthalmology and ORLFaculty of MedicineHospital Clinico San-CarlosUniversidad Complutense de MadridInstituto de Investigacion Sanitaria del Hospital Clinico San-Carlos(IdISSC)28040 MadridSpain Department of Immunology Ophthalmology and ORLSchool of MedicineInstituto de Investigaciones Oftalmologicas Ramon CastroviejoUniversidad Complutense de MadridMadridSpain Department of Optics Pharmacology and AnatomyUniversity of AlicanteAlicanteSpain

Background:Ocular surface disease in glaucoma patients is a significant ocular co-morbidity that can affect 40%to 59%of these patients worldwide.The current study was aimed at evaluating the potential clinical benefit of an intense pulsed light(IPL)-based treatment in glaucomatous patients with ocular surface disease due to prolonged hypotensive eyedrop treatments.To our knowledge,this is the first series analyzing the therapeutic effect of this treatment option in this type of patients.Methods:This non-comparative prospective case series study enrolled a total of 30 glaucoma patients ranging in age from 57 to 94 years old and treated with hypotensive eyedrops for years with dry eye symptomatology.All patients received four sessions of IPL treatment using the Optima IPL system(Lumenis,Yokneam,Israel)adjusted to the official optimized Lumenis setting.Changes in symptomatology,corneal staining,conjunctival hyperemia,non-invasive break-up time(NIBUT),tear osmolarity,tear meniscus height(TMH),meiboscore and meibomian gland expressibility was analyzed after treatment.Results:Statistically significant reductions were observed after IPL treatment in the symptomatology scores measured with different questionnaires[ocular surface disease index(OSDI),standard patient evaluation of eye dryness(SPEED)and symptom assessment questionnaire in dry eye(SANDE)]as well as with the visual analogue scale(P<0.001).Mean change in OSDI was−15.0±11.3.A significant reduction was found after treatment in the corneal staining score(P<0.001).A significant reduction was found in tear film meniscus height(P=0.012),as well as in tear film osmolarity(P=0.001).A significant reduction was also found in meibomian gland expressibility(P=0.003),changing the percentage of grade 3 eyes from 44.4%before IPL to 17.2%after treatment.Conclusions:IPL therapy combined with meibomian gland expression(MGX)seems to be an effective option to improve symptomatology in glaucomatous patients with ocular surface disease due to prolonged hypotensive eyedrop treatment

关键词： Glaucoma Intense pulsed light Dry eye Meibomian glands

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Correlations between corneal and optic nerve head variables in healthy subjects and patients with primary open angle glaucoma

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International Journal of Ophthalmology(English edition) 2015年第6期8卷 1156-1161页

作者： Federico Saenz-Frances Luis Janez Lara Borrego-Sanz Clara Berrozpe-Villabona Jose Maria Martinez-de-la-Casa laura morales-fernandez Julian Garcia-Sanchez Enrique Santos-Bueso Julian Garcia-Feijoo Department of Ophthalmology Clinico San Carlos HospitalComplutense University of Madrid Technology of Knowledge Institute Complutense University of Madrid

AIMTo correlate corneal variables (determined using the Pentacam) with optic nerve head (ONH) variables determined using the Heidelberg retina tomograph (HRT) in healthy subjects and patients diagnosed with primary open angle glaucoma (POAG).METHODSMeasurements were made in 75 healthy eyes and 73 eyes with POAG and correlations examined through Pearson correlation coefficients between the two sets of variables in the two subject groups. The corneal variables determined were corneal volume (CVol), central corneal thickness (CCT), overall corneal thickness (OvCT), the mean thickness of a circular zone centered at the corneal apex of 1 mm radius (zone I) and the mean thickness of several concentric rings, also centered at the apex until the limbus, each of 1 mm width (zones II to VI respectively). The ONH variables were determined using the HRT.RESULTSThe following pairs of variables were correlated in the control group: CCT-disc area (DAr) (-0.48; P<0.0001), Zone I-DAr (-0.503; P<0.0001) and Zone II-DAr (-0.443; P<0.0001); and in the POAG group: CCT-cup-to-disc area ratio (CDRa) (-0.402; P<0.0001), Zone I-CDRa (-0.418; P<0.0001), Zone II-CDRa (-0.405; P=0.006), Zone I-cup shape measure (CSM) (-0.415; P=0.002), Zone II-CSM (-0.405; P=0.001), Zone IV-height variation contour (HVC) (0.378; P=0.002); Zone V-HVC (0.388, P<0.0001).CONCLUSIONSIn the healthy subjects, significant negative correlation was detected between central and paracentral corneal thickness and optic disc area. In contrast, the POAG patients showed significant negative correlation between central and paracentral corneal thickness and the cup-disc ratio and CSM, and positive correlation between peripheral corneal thickness and HVC.

关键词： glaucoma optic nerve head corneal thickness

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Anatomical characterization of central, apical and minimal corneal thickness

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International Journal of Ophthalmology(English edition) 2014年第4期7卷 668-672页

作者： Federico Saenz-Frances Martha Cecilia Bermúdez-Vallecilla Lara Borrego-Sanz Luis Jaez J osé Marìa Martinez-de-la-Casa laura morales-fernandez Enrique Santos-Bueso Julián Garcia-Sanchez Julián Garcia-Feijoo Department of Ophthalmology Hospital Clínico San CarlosUniversidad Complutense de Madrid Instituto de Tecnologìa del Conocimiento Universidad Complutense de Madrid

·AIM: To anatomically locate the points of minimum corneal thickness and central corneal thickness(pupil center) in relation to the corneal apex.·METHODS: Observational, cross-sectional study, 299 healthy volunteers. Thickness at the corneal apex(AT),minimum corneal thickness(MT) and corneal thickness at the pupil center(PT) were determined using the pentacam. Distances from the corneal apex to MT(MD)and PT(PD) were calculated and their quadrant position(taking the corneal apex as the reference) determined:point of minimum thickness(MC) and point of central thickness(PC) depending on the quadrant position. Two multivariate linear regression models were constructed to examine the influence of age, gender, power of the flattest and steepest corneal axes, position of the flattest axis, corneal volume(determined using the Pentacam)and PT on MD and PD. The effects of these variables on MC and PC were also determined in two multinomial regression models.·RESULTS: MT was located at a mean distance of 0.909 mm from the apex(79.4% in the inferior-temporal quadrant). PT was located at a mean distance of 0.156 mm from the apex. The linear regression model for MD indicated it was significantly influenced by corneal volume(B =-0.024; 95% CI:-0.043 to-0.004). No significant relations were identified in the linear regression model for PD or the multinomial logisticregressions for MC and PC.·CONCLUSION: MT was typically located at the inferiortemporal quadrant of the cornea and its distance to the corneal apex tended to decrease with the increment of corneal volume.

关键词： cornealthickness anatomy glaucoma

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Effectiveness of statins vs.exercise on reducing postprandial hypertriglyceridemia in dyslipidemic population:A systematic review and network meta-analysis

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Journal of Sport and Health Science 2022年第5期11卷 567-577页

作者： laura Alvarez-Jimenez Alfonso Moreno-Cabanas Miguel Ramirez-Jimenez Felix morales-Palomo Juan FOrtega Ricardo Mora-Rodriguez Exercise Physiology Lab at Toledo Sports Science DepartmentUniversity of Castilla-La ManchaToledo 45004Spain

Background:Individuals at risk of suffering cardiovascular disease(CVD) present with larger increases in blood trigyceride(TG) concentration after a high-fat meal than do healthy individuals.These postprandial hypertriglyceride levels are an independent risk factor for CVD.Prescription of statins and a bout of prolonged exercise are both effective in lowering postprandial hypertriglyceride levels.We aimed to evaluate the comparative effectiveness of statins vs.a bout of aerobic exercise in reducing fasting and postprandial TG(PPTG) concentrations in indiv、duals at high nsk of developing CVD.Methods:Thirty-seven sltudies from a systematic literature search of the PubMed,EMBASE,and Cochrane databases were included in this review.The selected studies conducted trials involving statin therapy(n=20) or a bout of aerobic exercise(n=19) and measured their impact on PPTG levels as the outcome.Two studies analyzed both treatments and were included in duplicate.The meta-analysis was constructed using a random-effects model to calculate the mean difference(MD).The Student t test was used to compare the data sets for statins vs.exercise.Results:Overall,statin and exercise interventions showed similar reductions in PPTG levels,with an MD of-0.65 mmol/L for statins(95% confidence interval(95%CI):-0.54 to-0.77;p <0.001) and-0.46 mmol/L for exercise(95%CI:-0.21 to-0.71;p <0.01).However,statins lowered fasting TG levels more than exercise(MD=-1.54 mmol/L,95%CI:-2.25 to-0.83;p=0.009).Conclusion:Although aerobic exercise is effective in lowering blood TG levels,statins seem to be more efficient,especially in the fasted state.A combination of exercise and statins might reveal a valuable approach to the treatment and prevention of CVD.More studies are required to determine the underlying mechanisms and the possible additive effects of these interventions.

关键词： Aerobic exercise Cardiovascular disease Hydroxymethylglutaryl-CoA reductase inhibitor Meta-analysis Metabolic syndrome

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Effects of chlorpyrifos on enzymatic systems of Cydia pomonella （Lepidoptera： Tortricidae） adults

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Insect Science 2017年第3期24卷 455-466页

作者： laura Beatriz Parra morales Raul Adolfo Alzogaray Liliana Cichon Silvina Garrido Jimena Soleno Cristina Monica Montagna Laboratorio de Investigaciones Bioquimicas Quimicas y de Medio Ambiente Facultad de Ingenieria Universidad Nacional del ComahueBuenos Aires 1400 (Q83001BX) Neuquen Facultad de Ciencias del Ambiente y la Salud Universidad Nacional del Comahue Buenos Aires 1400 Neuquen Centro de Investigaciones de Plagas e Insecticidas (CIPEIN-UNIDEFICONICET) Villa Martelli Buenos Aires Instituto de Investigacion e Ingenieria Ambiental (3iA-UNSAM) San Martin Provincia de Buenos Aires Instituto Nacional de Tecnologia Agropecuaria Estacion Experimental Alto Valle General Roca Argentina

The control program of codling moth （Cydia pomonella L.） in the Rio Negro and Neuqu6n Valley is intended to neonate larvae. However, adults may be subjected to sublethal pesticide concentrations generating stress which might enhance both mutation rates and activity of the detoxification system. This study assessed the exposure effects of chlorpyrifos on target enzyme and, both detoxifying and antioxidant systems of surviving adults from both a laboratory susceptible strain （LSS） and a field population （FP）. The results showed that the FP was as susceptible to chlorpyrifos as the LSS and, both exhibited a similar chlorpyrifos-inhibitory concentration 50 （IC50） of acetylcholinesterase （ACHE）. The FP displayed higher carboxylesterase （CarE） and 7-ethoxycoumarine O-deethylase （ECOD） activities than LSS. Both LSS and FP showed an increase on CarE activity after the exposure to low-chlorpyrifos concentrations, followed by enzyme inhibition at higher concentrations. There were no significant differences neither in the activities of glutathione S-transferases （GST）, catalase （CAT） and superoxide dismutase （SOD） nor in the reduced glutathione （GSH） content between LSS and FP. Moreover, these enzymes were unaffected by chlorpyrifos. In conclusion, control adults from the FP exhibited higher CarE and ECOD activities than control adults from the LSS. AChE and CarE activities were the most affected by chlorpyrifos. Control strategies used for C. pomonella, such as rotations of insecticides with different modes of action, will probably delay the evolution of insecticide resistance in FPs from the study area.

关键词： acetylcholinesterase antioxidant system chlorpyrifos codling moth detoxification enzymes

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Anti-inflammatory potential of human corneal stroma-derived stem cells determined by a novel in vitro corneal epithelial injury model

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World Journal of Stem Cells 2019年第2期11卷 84-99页

作者： Mariana Lizeth Orozco morales Nagi M Marsit Owen D McIntosh Andrew Hopkinson laura E Sidney Academic Ophthalmology Division of Clinical Neuroscience University of Nottingham

BACKGROUND An in vitro injury model mimicking a corneal surface injury was optimised using human corneal epithelial cells(hCEC).AIM To investigate whether corneal-stroma derived stem cells(CSSC) seeded on an amniotic membrane(AM) construct manifests an anti-inflammatory, healing response.METHODS Treatment of hCEC with ethanol and pro-inflammatory cytokines were compared in terms of viability loss, cytotoxicity, and pro-inflammatory cytokine release, in order to generate the in vitro injury. This resulted in an optimal injury of 20%(v/v) ethanol for 30 s with 1 ng/mL interleukin-1(IL-1) beta. Co-culture experiments were performed with CSSC alone and with CSSC-AM constructs.The effect of injury and co-culture on viability, cytotoxicity, IL-6 and IL-8 production, and IL1 B, TNF, IL6, and CXCL8 mRNA expression were assessed.RESULTS Co-culture with CSSC inhibited loss of hCEC viability caused by injury. Enzyme linked immunosorbent assay and polymerase chain reaction showed a significant reduction in the production of IL-6 and IL-8 pro-inflammatory cytokines, and reduction in pro-inflammatory cytokine mRNA expression during co-culture with CSSC alone and with the AM construct. These results confirmed the therapeutic potential of the CSSC and the possible use of AM as a cell carrier for application to the ocular surface.CONCLUSION CSSC were shown to have a potentially therapeutic anti-inflammatory effectwhen treating injured hCEC, demonstrating an important role in corneal regeneration and wound healing, leading to an improved knowledge of their potential use for research and therapeutic purposes.

关键词： Cornea Corneal injuries Injury model epithelium stromaderived stem cells Amnion Anti-inflammatory Cell therapy

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Derailment risk and dynamics of railway vehicles in curved tracks： Analysis of the effect of failed fasteners

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Journal of Modern Transportation 2016年第1期24卷 38-47页

作者： Silvia morales-Ivorra Julia Irene Real Cesar Hernandez laura Montalbain University Institute for Multidisciplinary Mathematics Polytechnic University of Valencia 46022 Valencia Spain

The effect of the fastener＇s failure in a railway track on the dynamic forces produced in the wheel-rail contact is studied using the simulation software VAMPIRE to assess the derailment risk of two different vehicles in two curves with distinct characteristics. First, a 3D-FEM model of a real track is constructed, paying special attention to fasteners, and calibrated with displacement data obtained experimentally during a train passage. This numerical model is subsequently used to determine the track vertical and lateral stiffness. This study evidences that although the track can practically lose its lateral stiffness as a consequence of the failure of 7 consecutive fasteners, the vehicle stability would not be necessarily compromised in the flawed zone. Moreover, the results reveal that the uncompensated acceleration and the distance along which the fasteners are failed play an important role in the dynamic behavior of the vehicle-track system, influencing strongly the risk of derailment.

关键词： Railway dynamics Fasteners Derailment Curved track

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Fragile X Messenger Ribonucleoprotein 1(FMR1), a novel inhibitor of osteoblast/osteocyte differentiation, regulates bone formation, mass, and strength in young and aged male and female mice

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Bone Research 2023年第2期11卷 384-397页

作者： Padmini Deosthale Julián Balanta-Melo Amy Creecy Chongshan Liu Alejandro Marcial laura morales Julita Cridlin Sylvia Robertson Chiebuka Okpara David J.Sanchez Mahdi Ayoubi Joaquín N.Lugo Christopher J.Hernandez Joseph M.Wallace Lilian I.Plotkin Department of Anatomy Cell Biology&PhysiologyIndiana University School of MedicineIndianapolisIN46202USA Roudebush Veterans Administration Medical Center IndianapolisIN46202USA Indiana Center for Musculoskeletal Health IndianapolisIN46202USA Universidad del Valle School of Dentistry Cali 760043Colombia Department of Biomedical Engineering Indiana University-Purdue University Indianapolis46202 IndianapolisIN46202USA Sibley School of Mechanical and Aerospace Engineering Cornell UniversityIthacaNY 14853USA Department of Materials Science and Engineering Cornell UniversityIthacaNY14853USA Department of Psychology and Neuroscience Baylor UniversityWacoTX76798USA

Fragile X Messenger Ribonucleoprotein 1(FMR1)gene mutations lead to fragile X syndrome,cognitive disorders,and,in some individuals,scoliosis and craniofacial abnormalities.Four-month-old(mo)male mice with deletion of the FMR1 gene exhibit a mild increase in cortical and cancellous femoral bone mass.However,consequences of absence of FMR1 in bone of young/aged male/female mice and the cellular basis of the skeletal phenotype remain unknown.We found that absence of FMR1 results in improved bone properties with higher bone mineral density in both sexes and in 2-and 9-mo mice.The cancellous bone mass is higher only in females,whereas,cortical bone mass is higher in 2-and 9-mo males,but higher in 2-and lower in 9-mo female FMR1-knockout mice.Furthermore,male bones show higher biomechanical properties at 2mo,and females at both ages.Absence of FMR1 increases osteoblast/mineralization/bone formation and osteocyte dendricity/gene expression in vivo/ex vivo/in vitro,without affecting osteoclasts in vivo/ex vivo.Thus,FMR1 is a novel osteoblast/osteocyte differentiation inhibitor,and its absence leads to age-,site-and sex-dependent higher bone mass/strength.

关键词： female Messenger agile

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Simultaneous pars plana vitrectomy,panretinal photocoagulation,cryotherapy,and Ahmed valve implantation for neovascular glaucoma

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International Journal of Ophthalmology(English edition) 2021年第9期14卷 1396-1401页

作者： Carolina Bernal-morales Marina Dotti-Boada Alvaro Olate-Perez Manuel J.Navarro-Angulo laura Pelegrín Marc Figueras-Roca Institut Clínic d’Oftalmologia(ICOF) Hospital ClínicBarcelona 08028Spain August Pi i Sunyer Biomedical Research Institute(IDIBAPS) Barcelona 08028Spain

AIM:To describe and evaluate the efficacy of Ahmed glaucoma valve implantation(AGV)combined with pars plana vitrectomy(PPV)in a single surgical act for the treatment of advanced neovascular glaucoma(NVG).METHODS:Retrospective observational case series included 51 eyes from 50 patients with severe NVG treated with PPV,AGV,and panretinal photocoagulation and/or cryotherapy in a single surgical act during a 13-year period(2005-2018).Preoperative,intraoperative and postoperative data at day 1 and months 1,3,6,21,and 24 were systematically collected.Definition of surgical success was stablished at IOP between 6 and 21 mm Hg with or without topical treatment.RESULTS:Main indications for surgery were NVG secondary to proliferative diabetic retinopathy(39.2%)and central retinal vein occlusion(37.3%).Mean(±SD)preoperative IOP was 42.0±11.2 mm Hg decreasing to 15.5±7.1 mm Hg at 12 mo and 15.8±9.1 mm Hg at 24 mo of follow up.Cumulative incidence of success of IOP control was 76.0%at first postoperative month,reaching 88.3%at 6 mo.Prevalence of successful IOP control at long term was 74.4%at 12 mo and 71.4%at 24 mo.Eye evisceration for unsuccessful NVG management was required in 1 case(2.0%).CONCLUSION:Combination of AGV implantation and PPV in a single act may be a suitable option for severe forms of NVG in a case-by-case basis for effective IOP control and a complete panretinal photocoagulation.

关键词： neovascular glaucoma Ahmed valve pars plana vitrectomy panretinal photocoagulation cryotherapy

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Duodenal biopsy may be avoided when high transglutaminase antibody titers are present

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世界胃肠病学杂志：英文版 2009年第38期15卷 4775-4780页

作者： Santiago Vivas Jose G Ruiz de morales Sabino Riestra laura Arias Dolores Fuentes Noemi Alvarez Sara Calleja Mercedes Hernando Blanca Herrero Javier Casqueiro Luis Rodrigo Department of Gastroenterology Hospital de León Institute of Biomedicine University of León Immunology Section Hospital de León Department of Gastroenterology Hospital Universitario Central de Asturias Department of Pathology Hospital de León Department of Pediatrics Hospital de León Faculty of Biology and Environmental Sciences University of León

AIM:To evaluate the predictive value of tissue transglutaminase (tTG) antibodies for villous atrophy in adult and pediatric populations to determine if duodenal biopsy can be avoided.METHODS: A total of 324 patients with celiac disease (CD; 97 children and 227 adults) were recruited prospectively at two tertiary centers. Human IgA class anti-tTG antibody measurement and upper gastrointestinal endoscopy were performed at diagnosis. A second biopsy was performed in 40 asymptomatic adults on a gluten-free diet (GFD) and with normal tTG levels.RESULTS: Adults showed less severe histopathology (26% vs 63%, P<0.0001) and lower tTG antibody titers than children. Levels of tTG antibody correlated with Marsh type in both populations (r=0.661, P<0.0001). Multiple logistic regression revealed that only tTG antibody was an independent predictor for Marsh type 3 lesions, but clinical presentation type and age were not. A cut-off point of 30 U tTG antibody yielded the highest area under the receiver operating characteristic curve (0.854). Based on the predictive value of this cut-off point, up to 95% of children and 53% of adults would be correctly diagnosed without biopsy. Despite GFDs and decreased tTG antibody levels, 25% of the adults did not recover from villous atrophy during the second year after diagnosis.CONCLUSION: Strongly positive tTG antibody titers might be sufficient for CD diagnosis in children. However, duodenal biopsy cannot be avoided in adults because disease presentation and monitoring are different.

关键词：转谷氨酰胺酶十二指肠抗体滴度活检

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