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Una película lagrimal estable es requisito indispensable para el adecuado funcionamiento óptico y metabólicodel ojo. Alto porcentaje de condiciones asociadas con ojo seco, las complicaciones debidas al usode lentes de contacto y, en general, las alteraciones de la lágrima están relacionadas con la inestabilidad de la película lagrimal. Por tanto, es importante conocer y entender los conceptos inherentes a la estabilidad lagrimal, los fenómenos involucrados en las diferentes teorías propuestas y las técnicas para evaluarla, para poder realizar diagnósticos más precisos que permitan tratamientos efectivos. En esta revisión bibliográfica se presentarán diferentes modelos planteados para explicar de la estabilidad lagrimal y su inestabilidad con el fin de tener una visión más ampliade este importante fenómeno fisico químico algo desconocido y aún menos entendido por los profesionales de la salud visual y ocular.

stable tear film is pre requisite for the proper functioning optical and metabolic eye. High percentage of conditions associated with dry eye, complications due to use of contact lenses and alterations of the tear are generally related to the instability of the tear film. Therefore, it is important to know and understand the terms related to tear stability, phenomena involved in different proposed theories and techniques to evaluate it, in order to make more accurate diagnosis, enabling effective treatments. Based on This literature review it will present models to explain the tear stability and instability to have a broader view of this important physico-chemical phenomenon unknown and even less understood by visual and ocular health professionals.

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La colonización de hongos en los lentes de contacto blandos puede ocasionar infecciones oculares severas que pueden prevenirse con el uso de soluciones multipropósito. Objetivo: evaluar la eficacia antimicrobiana in vitro de cinco soluciones multipropósito comerciales frente a dos hongos, Cándida albicans (levadura) y Aspergillus fumigatus (moho).Resultados: Para C. albicans, las soluciones 1, 2, 3 y 5 presentaron 100 por ciento de eliminación en el tiempo 0 y en el tiempo sugerido por el fabricante (4 ó 6 horas); la solución 4 presentó, en las 6 horas de desinfección (recomendadas por la casa comercial): 85 por ciento de eliminación con la concentración más baja de Cándida, 31 por ciento de eliminación con la segunda concentración y -74 por ciento (resultado negativo) en la concentración más alta del microorganismo. Para A. fumigatus, la solución 5 mostró 100 por ciento de eliminación en el tiempo 0 y en las 6 horas de desinfección frente a las tres concentraciones; en el tiempo recomendado por el fabricante (4 ó 6 horas) la solución más efectiva fue la 2 (91,33 por ciento) en promedio con las tres concentraciones, seguida de la solución 1 (84,6 por ciento), la solución 3 (71,6 por ciento). La solución 4 presentó el menor porcentaje promedio de eliminación (38,66 por ciento). Conclusiones: de las cinco soluciones multipropósito evaluadas, la 4 mostró menos efectividad. Las soluciones 1, 2 y 3 mostraron efecto cidal frente a C albicans, y efecto fungistático contra A. fumigatus. La solución 5 evidenció efecto fungicida contra los dos hongos evaluados. El Aspergillus fumigatus presentó mayor resistencia a las soluciones que la C. albicans, excepto para la 5, con principio activo peróxido de hidrógeno.

Colonization by fungi in the soft contact lenses can cause severe ocular infections that can be prevented with solutions multipurpose. Objective: to evaluate the antimicrobial effectiveness in vitro of five commercialsolutions multipurpose against two fungi, Candida albicans (leavening) and Aspergillus fumigatus(mould). Conclusions: Among the five solutions multipurposeevaluated, the Solution 4 demonstrated less effectiveness. Solutions 1 and 2 demonstrated cidal effect for C albicans, and fungistatic effect against A. fumigatus. The solution 3 presented effectiveness of the 100 percent for C. albicans, and for A. fumigatus its effect was microbiostatic. Solution 5 demonstrated fungicidal effect against both fungi evaluated. The Aspergillus fumigatus offered greater resistance to the solutions that the C. albicans, except for the solution 5 with active principle hydrogen peroxide.

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The aim of the study was to assess the prevalence of malocclusion in a population of Bogotanian children and adolescents in terms of different degrees of severity in relation to sex and specific stages of dental development, in order to evaluate the need for orthodontic treatment in this part of Colombia. A sample of 4724 children (5-17 years of age) was randomly selected from a population that attended the Dental Health Service; none had been orthodontically treated. Based on their dental stages the subjects were grouped into deciduous, early mixed, late mixed and permanent dentition. The registrations were performed according to a method by Björk et al. (1964). The need for orthodontic treatment was evaluated according to an index used by the Swedish National Board of Health. The results showed that 88 per cent of the subjects had some type of anomaly, from mild to severe, half of them recorded as occlusal anomalies, one-third as space discrepancies, and one-fifth as dental anomalies. No clear sex differences were noted, except for maxillary overjet, spacing, tooth size (all more frequent in boys), and crowding (more frequent in girls). Occlusal anomalies and space discrepancies varied in the different dental developmental periods, as did tipped and rotated teeth. Little need for orthodontic treatment was found in 35 per cent and moderate need in 30 per cent. A great need was estimated in 20 per cent, comprising children with prenormal occlusion, maxillary overjet, or overbite (> 6 mm), posterior unilateral crossbite with midline deviation (> 2 mm), severe crowding or spacing, congenitally missing maxillary incisors, impacted maxillary canines or anterior open bite (> 3 mm in the permanent dentition). Urgent need for treatment was estimated to be 3 per cent, comprising subjects with extreme post- and pre-normal occlusion, impacted maxillary incisors or extensive aplasia.

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AIM: To study the epidemiology of invasive pneumococcal infections in infants and young children in Santiago, Chile, as a representative pediatric population in a newly industrializing country where pneumococcal conjugate vaccines may be used in the future. METHODS: A 5-year retrospective laboratory-based review (1989 to 1993) was followed by a 3-year prospective laboratory and hospital surveillance study in two of the six health administrative areas of Santiago to detect all hospitalized cases of invasive pneumococcal disease (defined as Streptococcus pneumoniae isolated from blood, cerebrospinal fluid or another normally sterile site) among infants and children (0 to 23 months of age in the retrospective and 0 to 59 months of age in the prospective study). RESULTS: During the 5-year retrospective survey the incidence of invasive pneumococcal disease was 90.6 cases per 10(5) infants 0 to 11 months old and 18.5 cases per 10(5) toddlers 12 to 23 months old. Similar rates (60.2 per 10(5) infants and 18.1 per 10(5) toddlers) were recorded during the 3 years of prospective surveillance. Among the 110 cases in children 0 to 59 months of age detected during the 3-year prospective surveillance, 2 clinical forms, pneumonia and meningitis, accounted for 87.2% of all cases; 13 of the 49 pneumonia patients (26%) had empyema as a complication. Notably 40 of the 110 cases (36.4%) occurred before 6 months of age (63.4% of the 63 infant cases). Serotypes 1, 14, 5 and 6B were the most prevalent. Overall 76 and 69%, respectively, of S. pneumoniae isolates were antigenic types that would be covered by the 11- or 9-valent conjugate vaccines under development. CONCLUSIONS: Invasive pneumococcal infections in Santiago, Chile, exhibit an epidemiologic pattern intermediate between that of developing and industrialized countries. The high burden of disease in early infancy dictates that an accelerated immunization schedule (beginning in the perinatal period) or maternal immunization with pneumococcal vaccines should be explored.

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