Prevalence and associations of epiretinal membranes in latinos: the Los Angeles Latino Eye Study

PURPOSE: To determine age- and gender-specific prevalence and associations of epiretinal membranes (ERMs) in adult Latinos. METHODS: The Los Angeles Latino Eye Study (LALES) is a population-based study of eye disease among Latinos aged 40 or more years. Complete ophthalmic examinations included stereoscopic fundus photography. Masked photographic grading was used to identify and classify ERMs as cellophane macular reflex (CMR) without retinal folds or preretinal macular fibrosis (PMF) with folds. RESULTS: Of the 6142 persons examined at the clinic, 5982 (97%) had gradable retinal photographs. The mean age of the participants was 54.7 +/- 10.7 years; 58% were women. ERMs were present in 18.5% (95% confidence interval [CI]: 17.5%-19.5%) of the participants. Of the participants with ERMs, 19.9% had bilateral ERMs. The prevalence of ERMs increased from 10.1% in persons 40 to 49 years of age to 35.7% in those aged 70 to 79 years and was 22.5% in persons aged 80 years or more. The prevalence was similar in men and women. CMR was present in 16.3% (95% CI: 15.3%-17.2%) and PMF in 2.2% (95% CI: 1.9%-2.6%). Retinal folds involved the fovea in 11% of PMF cases. On average, eyes with central PMF had poorer visual acuity than did eyes without (P < 0.0002). Epiretinal membranes (ERMs) were present in 71% of eyes with macular holes. ERMs were also more common in individuals who had undergone cataract surgery (39.9%), those with proliferative diabetic retinopathy (25.7%), and those with any retinal disease (27.5%). CONCLUSIONS: ERMs occur frequently in Latinos, often bilaterally. The associations of ERMs with proliferative retinopathy, retinal lesions, macular holes, and cataract surgery were confirmed. Central PMF is associated with reduced visual acuity.     

Prevalence of age-related macular degeneration in Latinos: the Los Angeles Latino eye study

OBJECTIVE: To estimate the age- and gender-specific prevalence of early age-related macular degeneration (AMD; drusen and retinal pigmentary abnormalities) and advanced AMD (exudative AMD and geographic atrophy) in Latinos. DESIGN: Population-based, cross-sectional study. PARTICIPANTS: Six thousand three hundred fifty-seven Latinos 40 years and older from 6 census tracts in Los Angeles, California. METHODS: The study cohort consisted of self-identified Latinos 40 years and over. Participants underwent a complete ophthalmologic examination, including stereoscopic macular photographs. Photographs were graded using a modified Wisconsin Age-Related Maculopathy Grading System. MAIN OUTCOME MEASURES: Prevalence of early AMD, drusen, geographic atrophy, and exudative AMD. RESULTS: Of the 7789 eligible subjects, 6357 participants (82%) completed an interview and clinical examination, and 5875 (75%) had gradable photographs. Prevalence of advanced AMD increased from 0% in those 40-49 years of age to 8.5% in those 80 or older; that of early AMD from 6.2% to 29.7%, that of retinal pigment abnormalities from 4.1% to 19.3%, that of large drusen (> or =125 microm in diameter) from 8.5% to 45.3%, that of soft drusen from 15.4% to 58.1%, and that of soft indistinct drusen from 3.6% to 30.8%. The prevalence of early AMD and advanced AMD lesions increased with age (P<0.0001). Early AMD was significantly more common in males than in females. Of all participants with early or late AMD, only 57% reported ever visiting an eye care practitioner, and only 21% in the last year. CONCLUSION: Detailed population-based estimates of AMD in Latinos are provided. Despite relatively high rates of early AMD, corresponding rates of advanced AMD are not high. Data on progression of the high rates of early AMD in Latinos require further study.     

The Los Angeles Latino Eye Study: design, methods, and baseline data

OBJECTIVE: To describe the study design, operational strategies, procedures, and baseline characteristics of the Los Angeles Latino Eye Study (LALES), a population-based assessment of the prevalence of visual impairment, ocular disease, and visual functioning in Latinos. DESIGN: Population-based, cross-sectional study. PARTICIPANTS: Six thousand three hundred fifty-seven Latinos 40 years and older from 6 census tracts in Los Angeles, California. METHODS: A detailed interview and eye examination were performed on each eligible participant. The interview included an assessment of demographic, behavioral, and ocular risk factors and health-related and vision-related quality of life. The eye examination included a measurement of visual acuity, intraocular pressure, and visual fields; fundus and optic disc photography; a detailed anterior and posterior segment examination; and measurement of blood pressure, glycosylated hemoglobin levels, and blood glucose levels. MAIN OUTCOME MEASURES: Prevalence of visual impairment, blindness, cataract, glaucoma, diabetic retinopathy, and age-related macular degeneration constitute the study's primary outcome variables. Secondary outcomes include odds ratios for risk factors associated with eye disease, health-related quality of life, and vision-related quality of life. Response rates and baseline characteristics are presented. RESULTS: Of the 7789 individuals eligible for LALES, 6357 (82%) had a clinical examination; an additional 524 completed only an in-home interview. The majority of participants were female (58%), the average (+/- standard deviation) age was 54.9 (+/-10.8) years, and 80.0% were of Mexican origin and 0.4% self-identified as American Indian or Alaskan Native. The age distribution of LALES participants was similar to that of Latinos of Mexican origin in the rest of the United States. CONCLUSION: The LALES has recruited Latinos 40 and older for an ophthalmic epidemiologic study. The LALES cohort will provide information about the prevalence and risk factors of ocular disease in the largest and fastest growing minority in the United States.     

Hereditary mixed polyposis syndrome. First report in Mexico

OBJECTIVE: Report for first time in Mexico a case of hereditary mixed polyposis and review the literature. BACKGROUND: The hereditary mixed polyposis syndrome (HMPS) is an uncommon condition, distinguished by presence of a different histological pattern of polyps in digestive tract, clinically manifested by diarrhea, anemia and weight loss. CASE REPORT: Male patient, 38 years old, with familiar antecedent (dead sister) with polyps and gastric cancer. With history of a 1 year with bleeding and mucous diarrhea, and weight loss of a 28.6 pounds. Pale at physical examination, without abdominal signs. At blood test with hemoglobin of 9.7 g/dL, and colonoscopy with multiple polyps within colon and rectum, upper endoscopy with a big esophageal polyp and multiple polyps in gastric and duodenal lining smaller than 1 cm. Contrast study of intestine was normal. Histopathologic study of the polyps report mixed pattern of polyps: (hyperplasic-adenomatous, juvenile-adenomatous, adenoma-inflammatory-hyperplasic, hyperplasic-adenomatous with a high degree dysplasia); juvenile in esophagus, and hyperplasic in stomach and duodenum. Patient was undergone to totalproctocolectomy and reconstruction by "J" ileoanal pouch with good outcome, and endoscopic esophageal polypectomy, with actual surveillance.     

Clinical utility of the new Sysmex XE 2100 parameter - reticulocyte hemoglobin equivalent - in the diagnosis of anemia

Our aim was to establish the reference values of the new parameter reticulocyte hemoglobin equivalent (RET-He) and to investigate its role in differentiating between iron deficiency anemia and anemia of chronic diseases. We found that RET-He was useful for diagnosing iron deficiency anemia. A cut-off point of 25 pg provided a specificity of 0.81 and a sensitivity of 0.76.     

Distribution of GABA, calbindin and nitric oxide synthase in the developing chick entopallium

The distribution of GABA, calbindin and neuronal nitric oxide synthase (nNOS) was analyzed in the developing avian entopallium. The study was carried out in chick embryos from embryonic day (E)8 to hatching postnatal day (P)0, using immunohistochemical methods. At E8, GABA-positive cells were observed in pallial regions. Neither calbindin nor nNOS-immunoreactive cells were observed. At E10, the number of GABA neurons in the prospective entopallium increased and also nNOS cells were observed. Lightly stained nNOS neurons predominated over intensely stained ones. Calbindin immunoreactivity was not observed in the entopallium. At E12, the entopallial complex appeared as the pallial region displaying the highest density of GABA neurons. Also the whole entopallium displayed an intensely stained calbindin neuropil with many embedded stained cells. From E12 on, there was a decrease in the expression of nNOS. At E14-16, both GABA and calbindin-immunoreactive neurons were numerous and homogeneously distributed within the entopallium. The whole entopallium displayed a moderately stained neuropil. From E18 to P0, GABA and nNOS immunoreactivities remained similar to previous stages. At these stages, calbindin immunoreactivity within the entopallium consisted of a moderately stained central region bordered dorsally by a pale stained region. These two areas could correspond to the entopallial core and the perientopallial belt, respectively.     

Distribution of nitric oxide-producing neurons in the developing and adult mouse amygdalar basolateral complex

We analysed the expression of neuronal nitric oxide synthase (nNOS) in the mouse amygdalar basolateral complex (BLC) from embryonic day 15.5 to adult, using standard immunohistochemical methods. Our results indicate that each nucleus of the amygdalar basolateral complex displays a distinct nNOS expression pattern, which is established during the ontogenesis with minor changes in the adult. The basomedial nucleus (BM) exhibited the highest nNOS immunoreactivity in the basolateral complex, observable from early embryonic stages, whereas the lateral nucleus displayed the lowest level of immunoreactivity. The expression pattern for nNOS in the basolateral nucleus differed substantially from that of the lateral and basomedial nuclei, showing a slightly increase in the number of nNOS cells and neuropil staining from intermediate developmental until early postnatal stages. Two distinct types of nitrergic neurons, densely and lightly stained neurons, were observed in the developing basolateral complex. Both types of putative nitrergic neurons were unevenly distributed in the basolateral complex. On the basis of previous data regarding the colocalization between nNOS and GABA in the mouse claustrum, we suggest that nNOS expressing neurons in the basolateral amygdalar complex are both GABAergic and non-GABAergic.