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Ao falarmos de arte gráfica ou arte impresa, facemos referencia a unha serie de materiais que se están a mover no campo das artes plásticas e da literatura, entre a obra e o documento, realizados en formatos normalmente baratos e efémeros: carteis, fanzines, revistas, panfletos ou banda deseñada. En Galicia serviron como lugar para a experimentación, sobre todo a partir dos anos setenta: ofreceron o espazo para a crítica política, a disidencia e a procura da liberdade de expresión, esquivando a censura que a ditadura impuxera ata o momento. Na arte gráfica galega puidéronse expresar e difundir os movementos sociais. A loita política antifascista, nacionalista, social, económica, feminista e ecolóxica tivo unha forte presenza na edición, manifestándose a través de iconografías particulares que, en moitas ocasións, seguían a idea de distopía. As viaxes no tempo, os anacronismos e os futuros imaxinados servían como metáforas irónicas para representar unha realidade dura, chea de problemáticas que debían ser denunciadas e combatidas. Dende 2 viaxes, de Xaquín Marín e Reimundo Patiño, ata a resposta do Nunca Máis pola catástrofe do Prestige, o papel impreso recolleu imaxes distópicas como predicións dun futuro apocalíptico que tememos no presente. Neste artigo presentamos unha panorámica para observar puntos en común e diferenzas entre exemplos diversos, que axudarán a comprender o que acontecía na arte contestataria nos momentos de maior revolta social.

El presente artículo analizará las divergencias neuróticas que se camuflan en el espacio urbano de la ciudad fílmica contemporánea: aquellas rupturas sutiles que se relacionan con la vida en la urbe y que están vinculadas al malestar de la metrópolis hiperestimulante, que perviven en la ciudad posmoderna. Así, se aplicará un marco conceptual derivado de las propuestas de autores como Georg Simmel, Sigmund Freud, Michel Foucault, Gilles Deleuze y Felix Guattari sobre el trastorno y el psicoanálisis, para centrarnos en el estudio de dos casos concretos: por un lado, el cine del reconocido neurótico Woody Allen, muy relacionado con Nueva York, pero también con algunas capitales europeas. Por otro, la más reciente serie de televisión Fleabag (2016-2019), creada por Phoebe Waller-Bridge, ambientada en el Londres contemporáneo.

Purpose Analyze clinical features, management and outcomes of patients with sterile endophthalmitis associated with intravitreal antivascular endothelial growth factor. Methods Observational retrospective case series of patients with sterile endophthalmitis following anti-VEGF intravitreal injections. Clinical data of patients treated with intravitreal anti-VEGFs during one year have been revised. Those who have presented an episode of sterile endophthalmitis are analyzed and their causality and management are studied Results Seven patients have had a sterile endophthalmitis onset within 4 days after intravitreal injection (aflibercept n = 5 and ranibizumab n = 2). These patients have some active neovascular condition: age related macular degeneration (n = 4), myopic choroidal neovascularization (n = 1) or macular edema: diabetic macular edema (n = 1), branch retinal vein occlusion (n = 1). Shared signs and symptoms included painless vision loss, anterior chamber and vitreous cell and lack of hypopyon. In all patients, visual acuity returned to within one line of baseline acuity. Conclusion Differentiating cases of sterile from infectious endophthalmitis may be challenging. It is crucial to differentiate both entities as a good diagnosis determines the visual prognosis. We should be aware of minimal inflammation after repeated intravitreal injections in order to establish the adequate treatment.

Vitreo-retinal disorders constitute a significant portion of treatable ocular diseases. These pathologies often require vitreo-retinal surgery and, as a consequence, the use of vitreous substitutes. Nowadays, the vitreous substitutes that are used in clinical practice are mainly divided into gases (air, SF6, C2F6, C3F8) and liquids (perfluorocarbon liquids, silicone oils, and heavy silicone oils). There are specific advantages and drawbacks to each of these, which determine their clinical indications. However, developing the ideal biomaterial for vitreous substitution continues to be one of the most important challenges in ophthalmology, and a multidisciplinary approach is required. In this sense, recent research has focused on the development of biocompatible, biodegradable, and injectable hydrogels (natural, synthetic, and smart), which also act as medium and long-term internal tamponade agents. This comprehensive review aims to cover the main characteristics and indications for use of the extensive range of vitreous substitutes that are currently used in clinical practice, before going on to describe the hydrogels that have been developed recently and which have emerged as promising biomaterials for vitreous substitution C.M.-G., E.B.-V., L.G.-Q., and A.F.-F. are grateful to the Carlos III Health Institute for financing the CM18/00090, CM20/00135, CM20/00024, and JR18/00014 personnel contracts. This work was partially supported by the following projects of Carlos III Health Institute (PI17/00940 and PI20/00719) SI

Econazole is a feasible alternative treatment in the management of fungal keratitis. Nevertheless, its low water solubility is considered the main limitation to the incorporation into ophthalmic formulations. In this work, econazole nitrate is solubilized by using cyclodextrins to achieve an optimum therapeutic concentration. Phase solubility diagrams suggest α-cyclodextrin as the most effective cyclodextrin and later the inclusion complex formed with this one was characterized in solution by 1D, 2D-NMR, and molecular modeling. Econazole-α-cyclodextrin inclusion complex was included in 2 types of ocular hydrogels: a natural polysaccharides ion-sensitive hydrogel and a hyaluronic acid hydrogel. Both of them show no ocular irritation in the hen's egg test on chorioallantoic membrane assay and a controlled econazole release over time. Permeability studies suggest that hydrogels do not modify the econazole nitrate permeability through bovine cornea in comparison with an econazole-α-cyclodextrin inclusion complex solution. Finally, ocular biopermanence studies performed using positron emission tomography show these hydrogels present a high retention time on the eye. Results suggest the developed formulations have a high potential as vehicles for the econazole topical ocular administration as fungal keratitis treatment.

Ocular cystinosis is a rare disease characterised by the deposit of cystine crystals on the corneal surface, which hinder patients' eyesight. Oral cysteamine is given as cysteamine; however, it does not reach the cornea due to the lack of corneal vascularization making necessary its administration by the topical ocular route. The aim of the present study is to determine the stability of an ophthalmic hydrogel of cysteamine, which can be potentially prepared at hospital pharmacy departments, under different preservation conditions during a follow-up of 30 days. Different physical and chemical parameters were evaluated: osmolality, pH and cysteamine concentration, which has been measured by a method of ultra performance liquid chromatography-tandem mass spectrometer (UPLC-MS/MS). Descriptive assays were also performed, such as transparency measurement and microbiological assays in order to verify its sterility. The obtained results allow us to conclude that the cysteamine hydrogel is stable during 30 days, being recommendable its preservation in refrigerated conditions.La cistinosis ocular es una enfermedad rara que se caracteriza por el depósito de cristales de cistina a nivel corneal, los cuales dificultan la visión de los pacientes. La cisteamina oral se administra en forma de cisteamina, pero esta no alcanza la córnea debido a la falta de vascularización corneal, por lo que es necesaria la aplicación tópica ocular. El objetivo del presente trabajo es determinar la estabilidad de un hidrogel oftálmico de cisteamina, potencialmente formulable en servicios de farmacia hospitalaria, conservado este bajo diferentes condiciones de almacenamiento durante un periodo de 30 días. Los parámetros físicos y químicos evaluados han sido la osmolalidad, el pH y la concentración de cisteamina, siendo esta última valorada mediante un método de cromatografía líquida de ultra alta presión, empleando un detector de masas en tándem (UPLC-MS/MS). Los ensayos descriptivos se han basado en la medición de la transparencia y los ensayos microbiológicos en la realización de pruebas de esterilidad. Los resultados obtenidos permiten concluir que el hidrogel de cisteamina es estable durante un periodo de 30 días, recomendándose que su conservación sea en nevera.

Purpose: Acanthamoeba keratitis causes frequent epithelial lesions that fully expose the corneal stroma. The aim of this study was to determine the toxic profile of chlorhexidine and propamidine eye drops. Methods: We used primary human keratocytes in cell culture in combination with a novel technology that evaluates dynamic real-time cytotoxicity through impedance analysis. Additional studies such as a classic cell viability test (WST-1®), a bovine corneal opacity and permeability assay, and an irritation eye study (Hen's Egg Test [HET]) have been made. Results: Both eye drop formulations showed a time- and concentration-dependent toxicity profile, in which long periods and high concentrations were more detrimental to cells. In prolonged times of exposure, propamidine is more harmful to cells than chlorhexidine. On the contrary, no irritation has been detected in using the HET-chorioallantoic membrane test and no alterations in the corneal transparency nor permeability was produced by the treatm...

Intravitreal administration of anti-vascular endothelial growth factor (VEGF) antibodies has become the standard treatment for Age-Related Macular Degeneration; however, the knowledge of their pharmacokinetics is limited. A comprehensive review of the preclinical and clinical pharmacokinetic data that were obtained in different studies with intravitreal bevacizumab, ranibizumab, and aflibercept has been conducted. Moreover, the factors that can influence the vitreous pharmacokinetics of these drugs, as well as the methods that were used in the studies for analytical determination, have been exposed. These anti-VEGF drugs present different charge and molecular weights, which play an important role in vitreous distribution and elimination. The pharmacokinetic parameters that were collected differ depending on the species that were involved in the studies and on physiological and pathological conditions, such as vitrectomy and lensectomy. Knowledge of the intravitreal pharmacokinetics of the anti-VEGF drugs that were used in clinical practice is of vital importance. This work was partially supported by the ISCIII (PI17/00940, RETICS Oftared, RD16/0008/0003 and RD12/0034/0017) cofunded by FEDER and by the Spanish Ministry of Science, Innovation and Universities (RTI2018-099597-B-100) SI

Introducción. A pesar de los beneficios ampliamente conocidos, un hecho observado en la consulta del niño sano es que muchos de ellos no iniciaban la lactancia materna o no la mantenían el tiempo recomendado. Objetivo. Describir la situación de la lactancia materna en nuestra Zona Básica de Salud y analizar los factores sociosanitarios que pueden condicionarla. Material y métodos. Estudio descriptivo transversal a mujeres que fueron madres durante 2014 y 2015. Las variables estudiadas fueron edad, gestaciones previas, deseo de embarazo, tipo de parto, asistencia a preparación al parto, apoyo a la lactancia materna, recomendación de lactancia artificial, nivel educativo, situación laboral, estructura familiar, tipo de lactancia al alta, tiempo de lactancia materna exclusiva, tiempo de lactancia materna total y motivo de abandono de lactancia materna. Los datos fueron recogidos mediante hojas de registro y entrevista estructurada a las madres, y estudiados en el programa SPSS 22. Resultados. Se obtuvieron datos de 137 madres (81,5%). La edad media fue 26,8 años. El 47,4% cursó estudios primarios, un 31,1% no tenían estudios. La situación laboral era desempleo en el 66,7% de los casos. Al alta tras el nacimiento, solo el 43,8% de los recién nacidos recibían lactancia materna exclusiva. La duración media fue 1,7 meses, únicamente el 11,7% alcanzó los 6 meses. El principal motivo de abandono referido fue la insuficiente producción (38,1%). Conclusiones. Las mujeres estudiadas fueron madres a edad temprana. Pertenecen a una clase socioeconómica media-baja. El tiempo de lactancia materna exclusiva y total está por debajo las recomendaciones. Abstract Introduction. Despite the widely known benefits, one of the facts observed in the pediatric consultation is that many of them do not initiate or do not maintain breastfeeding during the recommended time. Objective. To describe the current situation of breastfeeding in our primary care healths centre and analyze the socioeconomic factors conditioning its maintenance. Material and methods. Transversal descriptive study to the total of women who had a child during 2014 and 2015. Variables studied included age, previous pregnancies, desire for pregnancy, type of delivery, attendance at childbirth preparation, support for breastfeeding, recommendation for breastfeeding, educational level, employment status, family structure, type of lactation when was discharged, full breastfeeding duration, total duration of breastfeeding and cause of suppression. Data were collected through structured interviews. Statistical analyses were performed using the SPSS Windows statistical software package version 22. Results. Data were collected from 137 mothers (81.5%). The average age was 26.8 years. 47.4% had primary studies, 31.1% had no studies. The employment situation was unemployment in 66.7% of the cases. At discharge after birth, 43.8% of infants received full breastfeeding. The average length was 1.7 months, only 11.7% of the women reached 6 months of full breastfeeding. The main reason for breastfeeding suppression was insufficient production (38.1%). Conclusions. The women studied became mothers at an early age. They belong to a middle-low socioeconomic level. The full breastfeeding and total breastfeeding duration were shorter than international recommendations.

This work aimed at describing the time course of vitreous clearance through the use of positron emission tomography (PET) as a noninvasive tool for pharmacokinetic studies of intravitreal injection.The pharmacokinetic profile of intravitreal injections of molecules labeled with 18Fluorine (18F) was evaluated in adult Sprague Dawley rats by using a dedicated small-animal PET/computed tomography scanner. Different conditions were studied: three molecules radiolabeled with 18F (18F-FDG, 18F-NaF, and 18F-Choline), three volumes of intravitreal injections (7, 4, and 2 μL), and absence or presence of eye inflammation (uveitis).Our results showed that there are significant pharmacokinetic differences among the radiolabeled molecules studied but not among the injected volumes. The presence or absence of uveitis was an important factor in vitreous clearance, since the elimination of the drug was clearly increased when this condition is present.Intravitreal pharmacokinetic studies based on the use of dedicated PET imaging can be of potential interest as noninvasive tools in ophthalmic drug development in small animals.

This work is aimed at describing the utility of positron emission tomography/computed tomography (PET/CT) as a noninvasive tool for pharmacokinetic studies of biopermanence of topical ocular formulations.The corneal biopermanence of a topical ophthalmic formulation containing gellan gum and kappa carragenan (0.82% wt/vol) labeled with 18Fluorine (18F) radiotracers (18F-FDG and 18F-NaF) was evaluated by using a dedicated small-animal PET/CT, and compared with the biopermanence of an aqueous solution labeled with the same compounds. Regions of interest (ROIs) were manually drawn on the reconstructed PET images for quantifying the radioactivity concentration in the eye. The biopermanence of the formulations was determined by measuring the radioactivity concentration at different times after topical application. Additionally, cellular and ex vivo safety assays were performed to assess the safety of the performed procedures.Differences were observed in the ocular pharmacokinetics of the two formulations. After 1.5 hours of contact, 90% of the hydrogel remained in the ocular surface, while only 69% of the control solution remained. Furthermore, it was observed that flickering had a very important role in the approach of the trial. The application of 18F-FDG in the eye was neither irritating nor cytotoxic for human corneal epithelial cells.The use of small-animal PET and 18F radiotracers in ocular pharmacokinetics of ophthalmic formulations is feasible and could be a safe method for future ocular pharmacokinetic studies in humans.

Critical Factors Involved in the Determination of the Optimal Concentration of Ophthalmic Anti-infective Compounded Drugs

In last years, sensitive hydrogels have become a breakthrough in ophthalmic pharmaceutical technology aimed at developing new strategies to increase the residence time of active substances. In a previous paper, we qualitatively demonstrated the capacity of a new ion sensitive hydrogel to increase the residence time. Nevertheless, the clearance of the gel from the ocular surface was not quantifiable with the used methodology. The aim of the present work was to use a well-established approach based on scintigraphy to quantitatively estimate the residence time of the previously proposed hydrogel. The rat corneal residence time of a topic ophthalmic formulation containing gellan gum and kappa carragenan (0.82% w/v) labeled with 99mTc-DTPA radiotracer was evaluated and compared with the residence of an aqueous solution. Ophthalmic safety studies such as eye irritation or passage through the cornea were also carried out. After 1.5 h of contact, 77% of the hydrogel remained in the ocular surface, presenting kinetics of disappearance one-phase decay and a half time of 262 min. We conclude that the novel ophthalmic hydrogel developed with kappa carrageenan and gellan gum remains for long periods of time on the corneal surface, presenting a drop that fits an exponential decay.

Although intravitreal administration of anti-infectives represents the standard treatment for infectious endophthalmitis, the knowledge about their pharmacokinetics is still limited. In this review, we aimed to summarise the factors influencing the pharmacokinetics of the anti-infective agents. We have conducted a comprehensive review of the preclinical pharmacokinetic parameters obtained in different studies of intravitreal injections of anti-infectives performed on animals, mainly rabbits. The two aspects with the biggest influence on pharmacokinetics are the distribution in the vitreous humour and the elimination through the posterior segment. The distribution can be affected by the molecular weight of the drug, the convection flow of the vitreous, the condition of the vitreous humour depending on the age of the patient, the possible interactions between the drug and the components of the vitreous, and the presence of vitrectomy. Meanwhile, the elimination includes the metabolism of the drug, the clearance via the anterior and posterior routes, and the possible inflammation of the eye resulting from the disease. Understanding the pharmacokinetics of the anti-infectives used in clinical practice is essential for a correct application. The information provided in this review could offer guidance for selecting the best therapeutic option according to the characteristics of the drugs.

Non-steroidal anti-inflammatory drug (NSAID) eye drops are widely used to treat ocular inflammatory conditions related to ophthalmic surgical procedures, such as pseudophakic cystoid macular edema, and they have been used for off-label treatments. The most commonly used NSAIDs are diclofenac and ketorolac and the new molecules bromfenac and nepafenac have also been used. We used primary human keratocytes in cell culture in combination with a novel technology that evaluates dynamic real-time cytotoxicity through impedance analysis. This study also included classic cell viability tests (WST-1(®) and AlamarBlue(®)), wound healing assay, Hen's Egg Test and an ex vivo histopathological assay. NSAIDs were shown to have important cytotoxicities and to retard the healing response. Furthermore, the new eye drops containing bromfenac and nepafenac were more cytotoxic than the more classical eye drops. Nevertheless, no immuno-histochemical changes or acute irritation processes were observed after the administration of any eye drops tested. Due to cytotoxicity and the total absence of discomfort and observable injuries after the administration of these drugs, significant corneal alterations, such as corneal melts, can develop without any previous warning signs of toxicity.

Gellan gum, kappa-carrageenan and alginates are natural polysaccharides able to interact with different cations that can be used to elaborate ion-activated in situ gelling systems for different uses. The interaction between fluid solutions of these polysaccharides and cations presents into the tear made these biopolymers very interesting to elaborate ophthalmic drug delivery systems. The main purpose of this study is to evaluate the ability of mixtures of these polymers to obtain ion-activated ophthalmic in situ gelling systems with optimal properties for ocular use. To achieve this purpose different proportion of the biopolymers were analyzed using a mixture experimental design evaluating their transparency, mechanical properties and bioadhesion in the absence and presence of simulated tear fluid. Tear induces a rapid sol-to-gel phase transition in the mixtures forming a consistent hydrogel. The solution composed by 80% of gellan gum and 20% kappa-carrageenan showed the best mechanical and mucoadhesive properties. This mixture was evaluated for rheological behavior, microstructure, cytotoxicity, acute corneal irritancy, ex-vivo and in vivo ocular toxicity and in vivo corneal contact time using Magnetic Resonance Images (MRI) techniques. Result indicates that the system is safe at ophthalmic level and produces an extensive ocular permanence higher than 6h.

Background Colircusi double anaesthetic eye drops (CAD) are mainly used in minor eye surgery and in diagnostic examination procedures in ophthalmology. Ocular tolerance for these eye drops is poor and it often causes weeping in the paediatric patient after instillation. Purpose The aim of this study was to present an ophthalmic anaesthetic compounded alternative to CAD, with suitable characteristics for its use in the paediatric population. Material and methods Initially the composition, pH and osmolality of CAD were analysed. Next, a bibliographic research on the active ingredients with anaesthetic activity, potentially likely to be made as ophthalmic master formulas, was done (Martindale, Pubmed, Micromedex). Subsequently, anaesthetic eye drops with the chosen active ingredients were made and its pH (pHmeter- WTW Inolab) and osmolality (VAPRO 5520) were measured. Finally, after use of these eye drops for 3 months in paediatric patients, subjective perception of the paediatric ophthalmologist about ocular tolerance was recorded. Results Every 1 mL of CAD contains 1 mg of tetracaine hydrochloride and 4 mg of oxybuprocaine hydrochloride, and also the excipients, chlorobutanol, monopotassium phosphate, disodium phosphate and purified water. It has an osmolality of 231 mmol/kg and a pH of 4.5. The active ingredient chosen to be formulated was lidocaine hydrochloride. Lidocaine eye drops at a concentration of 4% (CL4) were formulated—2 g of lidocaine hydrochloride were weighted in an analytical balance and, in a horizontal laminar flow cabin, the solid was solved in 50 mL of BSS, subsequently filtering it through a 0.22 µm filter to pack it in sterile amber glass bottles of 5 mm. The osmolality of CL4 was 594 mmol/kg and its pH was 7.0. The paediatric ophthalmologist had a positive perception about ocular tolerance and efficacy of these eye drops because they did not cause weeping of the patient’s eye after instillation and no significant adverse reactions were detected on the eye’s surface. Conclusion CL4 as anaesthetic eye drops was safe and well tolerated in paediatric patients due to the pH and osmolality being similar to physiological values. No conflict of interest.

Background It is essential to determine the safety of ophthalmic drugs. Purpose To demonstrate any in vitro cytotoxicity of antifungal eye drops manufactured by the Hospital Pharmacy Department. Material and methods Three antifungal eye drops (voriconazole 28.67 mM, fluconazole 6.53 mM and amphotericin 1.62 mM) were tested in Human Corneal Keratocytes (HCK). Toxicity to these cells was assessed using the novel label-free and real-time monitoring xCELLigence system. Under this platform, the Cell index (CI) was used to represent cell status based on the measurement of electrical impedance. Briefly, 3,000 cells/well (E-plates 16 wells) were seeded and incubated for 24 h until the CI reached the range of 1.0–1.2 indicating about 60% cell confluence. At this stage, cell culture medium was aspirated to perform cell treatment using different concentrations of antifungal eye drops. CI values were recorded throughout the test, obtaining real-time graphs of the cells’ behaviour in contact with the antifungal and IC50 was determined (corresponding to the concentrations of compounds that inhibit cell growth by 50% compared to controls). Results The kinetic curves clearly showed that cellular response depends upon concentration and time in all antifungals tested. (These graphics will be displayed on the poster). The IC50 values obtained were 5.85 mM, 0.16 mM and 0.5 mM for voriconazole, amphotericin and fluconazole respectively. Conclusion These results may be helpful in warning of cytotoxic effects of antifungal eye drops manufactured by Hospital Pharmacy Departments which are being used in concentrations that exceed the IC50 determined. References and/or acknowledgements This work was supported by Fundacion Espanola de Farmacia Hospitalaria and Fundacion Mutua Madrilena No conflict of interest.