Antonio Eito Mateo

Evaluation of Early Graft Detachment After Descemet Membrane Endothelial Keratoplasty Using New Swept-Source Optical Coherence Tomography.

Purpose: To evaluate the ability of Swept-source optical coherence tomography (SS-OCT) in detecting early endothelial graft detachment after Descemet membrane endothelial keratoplasty (DMEK) and to determine the possible causes of graft detachment using 2 different protocols for anterior segment (AS) imaging. Methods: Eight eyes from 8 consecutive DMEK surgeries were evaluated. High-resolution images were captured with SS-OCT using 2 different radial protocols for AS imaging (16- and 6-mm radial protocols). Central and peripheral corneal changes were evaluated. Results: All eyes developed early graft detachment detectable with the SS-OCT. The 16-mm radial protocol scanned the cornea detecting early graft detachment in 6 out of 8 cases. The 6-mm radial protocol provided detailed images of the cornea, detecting early detachment in all cases. Stromal irregularities and small remnants only detectable using SS-OCT were the possible cause of detachment in 3 cases. One of the 8 eyes had air reinjection. The detachment in that eye was apparent by slit-lamp examination. The detachments spontaneously resolved in the other 7 eyes. AS SS-OCT evaluation was found to have added diagnostic value to biomicroscopy in 5 of these eyes (64.5%). Conclusions: AS SS-OCT is sensitive in detecting early graft detachment after DMEK. The 16-mm radial protocol of Triton SS-OCT is superior regarding quick scan of the entire cornea providing a general visualization of the DMEK graft. The 6-mm radial protocol provides detailed corneal imaging of a selected area, which is useful for evaluating structural alterations that are not detectable with larger scans and may affect the adherence of the endothelial graft.

Medio y contexto de la trabajadora social de atención primaria en Aragón

espanolEste articulo presenta los resultados preliminares de una investigacion en curso sobre el papel de las trabajadoras sociales —pues son mayoritariamente mujeres— en la ejecucion y puesta en practica de las politicas publicas en materia de servicios sociales en Aragon. A partir de un analisis del imaginario de las profesionales, recogido mediante entrevistas en profundidad, se revisan las experiencias, posiciones y valoraciones de su labor en los servicios sociales de atencion primaria aragoneses. Desde sus discursos se revisan procesos, trayectorias y situacion actual del sistema de proteccion, asi como la profesion y las expectativas respecto a ella. Las transformaciones sociales, politicas y economicas vividas en nuestro pais han marcado y configurado la labor diaria en los centros donde se gestionan estos servicios sociales. Su exito depende del buen hacer de los diferentes profesionales, donde destaca como figura esencial la trabajadora social. Es la referencia de usuarios y responsables politicos. EuskaraArtikulu honetan aztergai hartzen da Aragoiko politika publikoen arloan gizarte-zerbitzuak abian jartzerakoan emakumezko gizarte-langileen rolaren inguruko —gehienak emakumezko baitira— aribidean dagoen azterlan baten aurretiko emaitzak. Sakonean eginiko elkarrizketen bidezko profesional horien iruditeria oinarri hartuz, berrikusten dira Aragoiko oinarrizko arreta-zerbitzuetako jardueraren inguruko esperientzia, jarrera eta balorazioak. Berauen diskurtsoa baliagarri gertatzen da gizarte-babeseko sistemaren prozesu, ibilbide eta gaur eguneko egoera ezagutzeko, eta horren bitartez bai lanbidearen eguneko egoera bai dituzten itxaropenen ezaguera izateko. Gure herrialdean bizi izandako aldaketa sozial, politiko eta ekonomikoek baldintzatu eta itxuratu dute gizarte-zerbitzuak kudeatzen diren zentroetako eguneroko jarduna. Arrakastaren oinarrian dago profesional desberdinen jarduera egokia, eta horien artetik nabarmentzen da gizarte-langilearen zeregina; izan ere, berauek baitira erabiltzaile eta ardura politikoa dutenen erreferentzia.

New pathogenic variant in the FGF10 gene in the agenesis of lacrimal and salivary gland syndrome: Ophthalmological and genetic study

ABSTRACT Aplasia/agenesis of lacrimal and salivary glands is a rare congenital defect that has been associated with disturbances in fibroblast growth factor 10 (FGF10). It can present with symptoms of congenital lacrimal obstruction, dry eye, and dry mouth. We report the ophthalmological and genetic study of a 19-year-old woman and her relatives suffering from this syndrome. A new probably pathogenic variant is described in the FGF10 gene.

Early Changes in Visual Quality and Corneal Structure after DMEK: Does DMEK Approach Optical Quality of a Healthy Cornea?

Purpose To evaluate early changes in visual function and visual quality parameters after Descemet membrane endothelial keratoplasty (DMEK) and to compare the outcomes with healthy controls. Methods Thirteen patients who underwent DMEK and 14 controls were evaluated. All subjects underwent visual function evaluation, including visual acuity under photopic and mesopic lighting conditions and contrast sensitivity (CSV) tests CSV 1000 and Pelli-Robson. Corneal parameters were assessed with Oculus Pentacam. Corneal mean keratometry (Km), corneal densitometry values, and low and high order aberrations (LOA and HOA) were recorded. In DMEK patients, all tests were performed before surgery and 1 and 6 months after surgery. Results In patients who underwent DMEK, photopic visual acuity improved from 0.59 to 0.31 at 1 month (p=0.013) and 0.13 at 6 months (p=0.008); mesopic visual acuity and all contrast sensitivity values (both CSV and Pelli-Robson test) improved significantly in the first month (p < 0.005). A significant decrease was observed in corneal density in the 0–2 mm ring (from 43.83 to 35.60, p=0.043) and mean posterior Km (from −5.84 to −6.80, p=0.005) in the first month. Corneal HOAs and all corneal densities improved at 6 months after DMEK (p < 0.05). All visual function parameters and corneal aberrations remained lower and higher, respectively, compared with healthy controls (p < 0.05). Corneal densities were comparable with controls at 6 months after DMEK (p > 0.05). Conclusions Patients undergoing DMEK present visual function improvement and a decrease in corneal density at 1 month after surgery. Decrease in corneal posterior HOAs can be observed at 6 months. However, visual function outcomes and corneal aberrations remained worse compared with healthy controls.

New Regenerating Agents (RGTA): New Indications in Persistent Corneal Thinning Caused By Fungal Keratitis

Purpose: To assess the effectiveness of new RGTA like Cacicol20 in two cases of persistent corneal ulceration refractory to maximum medical treatment in the context of fungal keratitis. Methods: Case 1 was a 75-year-old woman with malocclusion after ptosis surgery who presented Candida albicans keratitis (yeast). Case 2 was a contact lens wearer 39-year-old man who presented Fusarium keratitis (filamentous fungus). They both improved with antifungals. However, the corneal thinning caused by the infection persisted despite artificial tears, autologous serum and a bandage contact lense (BCL). OCT showed 226 microns corneal thickness in Case 1 and descemetocele in Case 2. Cacicol 20 one drop every two days for one month was prescribed to both of them at that moment, when the infiltrates still persisted. Results: After that regimen, Case 1 corneal thickness rose to 391 microns, and Case 2 rose to 224 microns. Complete epithelial healing was achieved in both cases. The infiltrates continued to decrease and they were eventually replaced by sterile leukomas. None of the patients presented new signs of infection afterwards. No precipitates appeared on the BCLs. None of the patients reported any adverse effects. Conclusion: New RGTA like Cacicol20 could be an effective option for persistent corneal ulceration refractory to maximum conventional medical treatment, which would save surgical procedures. Moreover, they could be prescribed during fungal infection, despite the contraindication in case of active ocular infection that appears in the leaflet of Cacicol20.

e-Social work in practice: a case study

ABSTRACT This paper presents a theoretical reflection on e-social work by considering a case study: an intervention programme with vulnerable people, included in the services catalogue of a non-governmental organization (NGO), Zaragoza Red Cross Assembly. This programme cares for older people with a home assistance system mediated by information and communication technologies (ICTs). The digital convergence of the Spanish Red Cross and the digitalization of internal processes were accelerated by the use of ICTs as a tool in the aftermath of the 2008 crisis: first, to manage bureaucratic matters; second, to coordinate professionals and third, to interact with users. The text is divided into five sections including an introduction and final remarks. The first section describes the intervention programme and its evolution from a traditional social work vision to an e-social work perspective. The second section describes and analyses the intervention programme and the incorporation of ICTs in this NGO, over more than two decades. The third section describes professional contributions to the implementation and adaptation of social work to new social and technological circumstances and users’ requirements based on these intervention experiences.This paper presents a theoretical reflection on e-social work by considering a case study: an intervention programme with vulnerable people, included in the services catalogue of a non-governmental...