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Papers by Andres Gonzalez

Investigative Ophthalmology & Visual Science, 2018

Dermatology Online Journal, 2016

Neutrophilic dermatosis of the dorsal hands is an uncommon variant of Sweet syndrome. We report a... more Neutrophilic dermatosis of the dorsal hands is an uncommon variant of Sweet syndrome. We report a case of a 72-year-old man, recently diagnosed with stage II lung adenocarcinoma, who presented to the clinic with a 14-day history of painful macules that progressed to bullae on the dorsal surface of his hands; decreased range of motion was noted. Examination revealed bilateral small, tender violaceous vesicopustules admixed with larger tense hemorrhagic pus-filled bullae on the dorsal aspect of his hands. Biopsy demonstrated changes consistent with neutrophilic dermatosis of the dorsal hands. The patient had been diagnosed with ulcerative colitis in the 1970s, although the condition was asymptomatic at the time of presentation. Treatment with prednisone 60 mg daily resulted in significant improvement by the next day. This regimen was continued for two weeks and was followed by a 6-week steroid taper. After a review of the approximate 75 cases currently reported, we also discuss the recurrence rate of NDDH of approximately 10%.

Journal of American Association for Pediatric Ophthalmology and Strabismus, 2019

American Journal of Ophthalmology Case Reports, 2018

To report on a severe case of presumed giant cell arteritis (GCA) presenting with partial and com... more To report on a severe case of presumed giant cell arteritis (GCA) presenting with partial and complete ophthalmic artery occlusion along with bilateral central retinal vein occlusions (CRVO). Observations: A 73-year-old female presented with bilateral complete vision loss of sudden onset. The patient also experienced a mild frontal headache prior to onset of vision loss. Fundus examination revealed bilateral central retinal artery occlusion (CRAO) and CRVO. Subsequent fluorescein angiography indicated partial right ophthalmic artery occlusion and complete left ophthalmic artery occlusion. Acute phase reactants were elevated. The patient was clinically diagnosed with GCA and intravenous (IV) steroids were initiated. Four days later, a temporal artery biopsy (TAB) was performed and resulted as negative for granulomatous inflammation. The patient did not regain vision and remained with no light perception (NLP) in both eyes. Conclusions: and Importance: This case highlights the discrepancy between clinical diagnosis and pathologic tissue diagnosis in a patient that presented with such extensive ocular vasculitic disease. Such extensive bilateral disease has not been reported. In addition, there are few studies regarding the effect of pulse-dosed IV steroids on TAB results. This case report suggests that the gradual histologic changes that occur over one or two weeks while on oral steroids may occur over three to four days while on high dose IV steroids, necessitating early biopsy.

Digital journal of ophthalmology : DJO, 2016

We describe the case of a 52-year-old woman with scleritis caused by an imipenem-resistant strain... more We describe the case of a 52-year-old woman with scleritis caused by an imipenem-resistant strain of Nocardia beijingensis. The patient presented with pain, redness, and nodules on the sclera of 8 weeks' duration. A Gram stain from a nodule on the superonasal aspect of the globe was initially negative. After empiric treatment for an autoimmune etiology, cytopathology confirmed filamentous bacteria. A presumptive diagnosis of Nocardia scleritis was made, and medical management was based on a literature review on treatments for Nocardia infections. Cultures returned confirming Nocardia beijingensis. Antibiotic sensitivity testing confirmed the correct initial management. The patient's scleritis resolved with a good visual outcome.

Acta Scientiae, Aug 19, 2014

Se reporta una investigacion realizada con estudiantes para profesor de matematica de la Universi... more Se reporta una investigacion realizada con estudiantes para profesor de matematica de la Universidad Pedagogica Experimental Libertador en su nucleo de Maracay, estado Aragua en Venezuela, y que forma parte de un estudio mucho mas amplio del tipo cualitativo que tiene por titulo Desarrollo del Pensamiento Algebraico en Entornos de Aprendizaje Mediados Tecnologicamente que tiene entre sus objetivos construir un sistema categorico conceptual explicativo de las relaciones entre el desarrollo de los procesos del pensamiento algebraico y la mediacion tecnologica. En lo concerniente a investigaciones del tipo cualitativista-interpretativos, que involucran la mediacion tecnologica, existen muchos aspectos por aclarar en lo que respecta a las tecnicas, instrumentos y procedimientos. Por ello puede resultar esclarecedor ensayar metodos con un espectro pequeno contenido en la investigacion amplia en aras de ir conformando, junto a la teoria existente y la emergente, una metodologia definitiva. Desde esta perspectiva, este trabajo trata de la presentacion de un resultado parcial basado en el analisis de un caso particular de interaccion virtual entre estudiantes y profesor en relacion con un ejercicio de Algebra Lineal, esperando allanar el camino en la metodica del trabajo macro con miras a la exploracion definitiva de la informacion que se recoja. Como interrogantes de investigacion se plantean las siguientes, (1) ?Cuales son las caracteristicas de las interacciones virtuales cuando se ensena y aprende un contenido matematico especifico?, y (2) ?Que conocimientos metodologicos, en relacion con la investigacion macro, puede aportar el estudio de un caso particular de teleinteraccion? A fin de darle respuestas a estas interrogantes se trazaron los siguientes objetivos:(1) examinar algunos elementos eventuales de la dinamica de las teleinteracciones durante el proceso de ensenanza y aprendizaje de un contenido matematico especifico en un contexto de mediacion tecnologica, y (2) explicitar el aprendizaje que puede aportar el estudio de un caso particular en la construccion de la metodologia definitiva para el analisis de la informacion global. Los sujetos involucrados fueron los integrantes de dos secciones del Curso Algebra Lineal del Instituto Pedagogico de Maracay durante el periodo academico 2008-II, los instrumentos empleados fueron los Foros de la Plataforma Moodle, el procedimiento consistio en la organizacion e implementacion de un foro virtual el cual se inserta en un curso presencial de Algebra Lineal con apoyo de esta plataforma. El analisis de la informacion consistio en el examen de los errores y aciertos cometidos por los estudiantes en relacion con un problema particular de Algebra Lineal.

Applied Psychological Measurement, 2010

Practitioners are increasingly becoming interested in Differential Item Functioning (DIF) forimpr... more Practitioners are increasingly becoming interested in Differential Item Functioning (DIF) forimproving the validity of test and scale interpretations. Among the statistical procedures availableto assess DIF in dichotomous and polytomous items, the Mantel-Haenszel chi-square (1959) andother standardization proceduresmay beparticularly attractive to practitioners.Some of the statis-tics associated with Mantel-Haenszel procedure can be performed using specific software such asEZ-DIF (Waller, 1998), DIFAS (Penfield, 2005), and MH-DIF (Fidalgo, 1994). However, usingthese programs requires being familiar with the statistics of DIF procedures in order to understandoutput. In addition, key characteristics of the Mantel-Haenszel procedures, such as the matchingstrategy (thick or thin), purification of the matching criteria, and so on, are not currently availablein all statistical software packages. As a result, EASY-DIF was developed to provide easy-to-usesoftware for performing the most common and useful MH and standardization procedures, witha view to guiding practitioners through the analyses and helping them interpret the output.EASY-DIFanalyzesuniformandnonuniformDIFforthetotalsampleandseparatelyforlow-performing and high-performing groups (Clauser, Mazor, & Hambleton, 1994). Users canexplore possible cancellation and amplification DIF effects by establishing different cut scoresfor each group. Up to six different matching strategies based on total score distributions can beimplemented: thinmatching,equal interval, percentage of totalsample, percentage of focalsam-ple, censored matching, and minimum cell frequency (Donoghue & Allen, 1993). In addition,users can use a procedure purification of matching criteria through the selection of a validsubtest.For dichotomous items, EASY-DIF computes the Mantel-Haenszel chi-square (Holland T Mantel & Haenszel, 1959), the Mantel-Haenszel common odds ratio (CamilliSMantel&Haenszel,1959),theMH-DeltaDIF,thestandarderrorofMH-DeltaComputer Program Exchange

Investigative Ophthalmology & Visual Science, 2018

Dermatology Online Journal, 2016

Neutrophilic dermatosis of the dorsal hands is an uncommon variant of Sweet syndrome. We report a... more Neutrophilic dermatosis of the dorsal hands is an uncommon variant of Sweet syndrome. We report a case of a 72-year-old man, recently diagnosed with stage II lung adenocarcinoma, who presented to the clinic with a 14-day history of painful macules that progressed to bullae on the dorsal surface of his hands; decreased range of motion was noted. Examination revealed bilateral small, tender violaceous vesicopustules admixed with larger tense hemorrhagic pus-filled bullae on the dorsal aspect of his hands. Biopsy demonstrated changes consistent with neutrophilic dermatosis of the dorsal hands. The patient had been diagnosed with ulcerative colitis in the 1970s, although the condition was asymptomatic at the time of presentation. Treatment with prednisone 60 mg daily resulted in significant improvement by the next day. This regimen was continued for two weeks and was followed by a 6-week steroid taper. After a review of the approximate 75 cases currently reported, we also discuss the recurrence rate of NDDH of approximately 10%.

Journal of American Association for Pediatric Ophthalmology and Strabismus, 2019

American Journal of Ophthalmology Case Reports, 2018

To report on a severe case of presumed giant cell arteritis (GCA) presenting with partial and com... more To report on a severe case of presumed giant cell arteritis (GCA) presenting with partial and complete ophthalmic artery occlusion along with bilateral central retinal vein occlusions (CRVO). Observations: A 73-year-old female presented with bilateral complete vision loss of sudden onset. The patient also experienced a mild frontal headache prior to onset of vision loss. Fundus examination revealed bilateral central retinal artery occlusion (CRAO) and CRVO. Subsequent fluorescein angiography indicated partial right ophthalmic artery occlusion and complete left ophthalmic artery occlusion. Acute phase reactants were elevated. The patient was clinically diagnosed with GCA and intravenous (IV) steroids were initiated. Four days later, a temporal artery biopsy (TAB) was performed and resulted as negative for granulomatous inflammation. The patient did not regain vision and remained with no light perception (NLP) in both eyes. Conclusions: and Importance: This case highlights the discrepancy between clinical diagnosis and pathologic tissue diagnosis in a patient that presented with such extensive ocular vasculitic disease. Such extensive bilateral disease has not been reported. In addition, there are few studies regarding the effect of pulse-dosed IV steroids on TAB results. This case report suggests that the gradual histologic changes that occur over one or two weeks while on oral steroids may occur over three to four days while on high dose IV steroids, necessitating early biopsy.

Digital journal of ophthalmology : DJO, 2016

We describe the case of a 52-year-old woman with scleritis caused by an imipenem-resistant strain... more We describe the case of a 52-year-old woman with scleritis caused by an imipenem-resistant strain of Nocardia beijingensis. The patient presented with pain, redness, and nodules on the sclera of 8 weeks' duration. A Gram stain from a nodule on the superonasal aspect of the globe was initially negative. After empiric treatment for an autoimmune etiology, cytopathology confirmed filamentous bacteria. A presumptive diagnosis of Nocardia scleritis was made, and medical management was based on a literature review on treatments for Nocardia infections. Cultures returned confirming Nocardia beijingensis. Antibiotic sensitivity testing confirmed the correct initial management. The patient's scleritis resolved with a good visual outcome.

Acta Scientiae, Aug 19, 2014

Se reporta una investigacion realizada con estudiantes para profesor de matematica de la Universi... more Se reporta una investigacion realizada con estudiantes para profesor de matematica de la Universidad Pedagogica Experimental Libertador en su nucleo de Maracay, estado Aragua en Venezuela, y que forma parte de un estudio mucho mas amplio del tipo cualitativo que tiene por titulo Desarrollo del Pensamiento Algebraico en Entornos de Aprendizaje Mediados Tecnologicamente que tiene entre sus objetivos construir un sistema categorico conceptual explicativo de las relaciones entre el desarrollo de los procesos del pensamiento algebraico y la mediacion tecnologica. En lo concerniente a investigaciones del tipo cualitativista-interpretativos, que involucran la mediacion tecnologica, existen muchos aspectos por aclarar en lo que respecta a las tecnicas, instrumentos y procedimientos. Por ello puede resultar esclarecedor ensayar metodos con un espectro pequeno contenido en la investigacion amplia en aras de ir conformando, junto a la teoria existente y la emergente, una metodologia definitiva. Desde esta perspectiva, este trabajo trata de la presentacion de un resultado parcial basado en el analisis de un caso particular de interaccion virtual entre estudiantes y profesor en relacion con un ejercicio de Algebra Lineal, esperando allanar el camino en la metodica del trabajo macro con miras a la exploracion definitiva de la informacion que se recoja. Como interrogantes de investigacion se plantean las siguientes, (1) ?Cuales son las caracteristicas de las interacciones virtuales cuando se ensena y aprende un contenido matematico especifico?, y (2) ?Que conocimientos metodologicos, en relacion con la investigacion macro, puede aportar el estudio de un caso particular de teleinteraccion? A fin de darle respuestas a estas interrogantes se trazaron los siguientes objetivos:(1) examinar algunos elementos eventuales de la dinamica de las teleinteracciones durante el proceso de ensenanza y aprendizaje de un contenido matematico especifico en un contexto de mediacion tecnologica, y (2) explicitar el aprendizaje que puede aportar el estudio de un caso particular en la construccion de la metodologia definitiva para el analisis de la informacion global. Los sujetos involucrados fueron los integrantes de dos secciones del Curso Algebra Lineal del Instituto Pedagogico de Maracay durante el periodo academico 2008-II, los instrumentos empleados fueron los Foros de la Plataforma Moodle, el procedimiento consistio en la organizacion e implementacion de un foro virtual el cual se inserta en un curso presencial de Algebra Lineal con apoyo de esta plataforma. El analisis de la informacion consistio en el examen de los errores y aciertos cometidos por los estudiantes en relacion con un problema particular de Algebra Lineal.

Applied Psychological Measurement, 2010

Practitioners are increasingly becoming interested in Differential Item Functioning (DIF) forimpr... more Practitioners are increasingly becoming interested in Differential Item Functioning (DIF) forimproving the validity of test and scale interpretations. Among the statistical procedures availableto assess DIF in dichotomous and polytomous items, the Mantel-Haenszel chi-square (1959) andother standardization proceduresmay beparticularly attractive to practitioners.Some of the statis-tics associated with Mantel-Haenszel procedure can be performed using specific software such asEZ-DIF (Waller, 1998), DIFAS (Penfield, 2005), and MH-DIF (Fidalgo, 1994). However, usingthese programs requires being familiar with the statistics of DIF procedures in order to understandoutput. In addition, key characteristics of the Mantel-Haenszel procedures, such as the matchingstrategy (thick or thin), purification of the matching criteria, and so on, are not currently availablein all statistical software packages. As a result, EASY-DIF was developed to provide easy-to-usesoftware for performing the most common and useful MH and standardization procedures, witha view to guiding practitioners through the analyses and helping them interpret the output.EASY-DIFanalyzesuniformandnonuniformDIFforthetotalsampleandseparatelyforlow-performing and high-performing groups (Clauser, Mazor, & Hambleton, 1994). Users canexplore possible cancellation and amplification DIF effects by establishing different cut scoresfor each group. Up to six different matching strategies based on total score distributions can beimplemented: thinmatching,equal interval, percentage of totalsample, percentage of focalsam-ple, censored matching, and minimum cell frequency (Donoghue & Allen, 1993). In addition,users can use a procedure purification of matching criteria through the selection of a validsubtest.For dichotomous items, EASY-DIF computes the Mantel-Haenszel chi-square (Holland T Mantel & Haenszel, 1959), the Mantel-Haenszel common odds ratio (CamilliSMantel&Haenszel,1959),theMH-DeltaDIF,thestandarderrorofMH-DeltaComputer Program Exchange