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OBJECTIVES: This study aimed to evaluate the clinical and microbiological risk factors associated with mortality in patients treated with ceftazidime-avibactam for carbapenem-resistant Gram-negative bacterial infections. METHODS: This multicentric prospective cohort study included hospitalized adult patients with a microbiologically confirmed infection treated with ceftazidime-avibactam for ≥48 hours. The clinical and microbiological risk factors for 30-day mortality were evaluated using a Cox regression model. RESULTS: Of the 193 patients evaluated from the five tertiary hospitals, 127 were included in the study. Thirty-five patients (27.6%) died within 30 days. Infections with AmpC beta-lactamase-carrying bacteria were independently related to 30-day mortality (adjusted hazard ratio [aHR] 2.49, 95% confidence interval [CI] 1.28-4.84, P < 0.01) after adjusting for time from infection to antimicrobial prescription (P = 0.04). Further, these bacterial infections were also related to higher in-hospital mortality (aHR 2.17, 95% CI 1.24-3.78, P < 0.01). Only one patient developed resistance to ceftazidime-avibactam during treatment. CONCLUSIONS: Treatment with ceftazidime-avibactam had worse clinical outcomes in patients with infections with bacteria with chromosomally encoded AmpC beta-lactamase. However, these findings should be confirmed in future studies.

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BACKGROUND: The purpose of this study was to compare the impact of intravitreal dexamethasone (DEX) implant during a 12-month period in nondiabetic and diabetic patients without diabetic retinopathy (DR) as a treatment for refractory pseudophakic cystoid macular edema (PCME) following prior treatment with topical nepafenac 0.1% and prednisolone 1%. METHODS: Forty-two consecutive medical records of patients diagnosed with PCME after uneventful cataract surgery were included. The outcomes measured included best corrected visual acuity (BCVA) and central foveal thickness (CFT). Linear regression analysis was statistically applied. RESULTS: Following topical treatment, nondiabetic and diabetic subjects presented a mean ± SD gain of - 0.11 ± 0.11 and - 0.18 ± 0.11 BCVA logMAR and a CFT reduction of - 43.42 ± 53.66 µm and - 58.76 ± 36.28 µm, respectively. The mean BCVA gain at month 12 subsequent to DEX implantation was - 0.35 ± 0.17 in nondiabetic (p < 0.001) and - 0.55 ± 0.26 in diabetic patients (p < 0.001), with CFT reductions of - 195.71 ± 93.23 µm (p < 0.001) and - 260.81 ± 198.69 µm (p < 0.001), respectively. Patients who responded with better VA after topical treatment presented better visual outcomes at month 12 following DEX implantation (r2 = 0.46; rho = - 0.71, p < 0.01). CONCLUSION: Nondiabetic and diabetic patients without DR demonstrated similar results after DEX implant after combined topical therapy, suggesting that selected diabetic patients may have a response comparable to that of nondiabetic patients with PCME.

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ABSTRACT We report the case of a 39-year-old male patient who presented with visual loss in the right eye for 6 weeks. The best-corrected visual acuity was counting fingers in the right eye and 20/30 in the left eye. The fundus examination demonstrated a right retinal detachment inferiorly extending to the fovea and a left macular serous detachment. After multimodal imaging study, the patient was diagnosed as having a bullous variant of central serous chorioretinopathy and treated with oral spironolactone associated with adjuvant laser photocoagulation. The retinal changes resolved after 6 months. The final visual acuity was 20/20 in both eyes.

RESUMO Relatamos o caso de um homem de 39 anos apresentando perda visual no olho direito há seis semanas. A melhor acuidade visual corrigida foi conta-dedos no olho direito e 20/30 no esquerdo. A fundoscopia demonstrou descolamento de retina direito inferiormente com extensão à fóvea e descolamento macular seroso à esquerda. Após estudos de imagem multimodal, o paciente foi diagnosticado com uma variante bolhosa de coriorretinopatia serosa central e tratado com espironolactona oral associada à fotocoagulação a laser adjuvante. As alterações retinianas resolveram após seis meses. A acuidade visual final foi 20/20 em ambos os olhos.

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We report the case of a 39-year-old male patient who presented with visual loss in the right eye for 6 weeks. The best-corrected visual acuity was counting fingers in the right eye and 20/30 in the left eye. The fundus examination demonstrated a right retinal detachment inferiorly extending to the fovea and a left macular serous detachment. After multimodal imaging study, the patient was diagnosed as having a bullous variant of central serous chorioretinopathy and treated with oral spironolactone associated with adjuvant laser photocoagulation. The retinal changes resolved after 6 months. The final visual acuity was 20/20 in both eyes.

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Resumen El estudio tiene como propósito analizar la fiabilidad de la prueba de 8 lanzamientos de 3 diferentes variantes de lanzamientos de balonmano en estudiantado universitario. 33 varones, 20 ±1,9 años; peso 72,39±8,9 kg; altura 176,75 ±6,07 cm; IMC 23,14±2,3. Los sujetos participantes fueron evaluados en 2 sesiones separadas entre sí por un lapso de una semana. Ejecutaron lanzamientos hasta quedar registrados 8 mediciones en cada una de las pruebas, lanzamientos inespecíficos, en apoyo y en carrera con 3 pasos, se registró la velocidad de lanzamiento con un radar posterior a la portería. La fiabilidad del promedio de las puntuaciones del test de 8 medidas entre la primera sesión y la segunda con una prueba test-retest, se obtuvieron los siguientes resultados: en el lanzamiento inespecífico se obtuvo un ICC= (0,86) entre el 95% de confianza, un de CV= (7,43%) y un ES= (0,08). Para el lanzamiento con apoyo se obtuvo un ICC= (0,94) al 95 % de confianza, un de CV= (4,71 %) y un ES= (-0,09). Para el lanzamiento con carrera se obtuvo un ICC= (0,96) al 95 % de confianza, un de CV= (4,00 %) y un ES= (0,05). Este estudio ha demostrado que la prueba de 8 lanzamientos y las 3 variantes es una medida de rendimiento confiable y estable para estudiantes de nivel universitario sin experiencia en el balonmano, en relación con las variables del lanzamiento, las 3 fueron fiables, solo la variable inespecífica fue menor en comparación al lanzamiento con apoyo y con carrera.

Abstract This study aims to analyze the reliability of the test of 8 throws of 3 different variants of handball throws in university students. The participants were 33 males, 20 ± 1.9 years; weight 72.39 ± 8.9 kg; height 176.75 ± 6.07 cm; BMI 23.14 ± 2.3. They were evaluated in 2 sessions separated from each other by a period of one week. The participants executed throws until 8 measurements were recorded in each of the tests, unspecific throws, in support and in the race with 3 steps; the launch speed was recorded with a radar behind the goal. The reliability of the average of the test scores of 8 measurements between the first session and the second was measured with a test-retest test. The following results were obtained: in the nonspecific launch, an ICC= (0.86) was obtained between 95% of confidence, one of CV= (7.43%) and one ES = (0.08). For the toss with support, an ICC = (0.94) was obtained at 95% confidence, one of CV = (4.71%) and an ES = (-0.09). For the running throw, an ICC = (0.96) was obtained at 95% confidence, one of CV = (4.00%) and one ES = (0.05). This study has shown that the test of 8 throws and the 3 variants is a reliable and stable performance measure for university-level students without experience in handball; in relation to the throw variables, all 3 were reliable. Only the nonspecific variable was lower compared to the supported and running pitch.

Resumo O estudo tem como objetivo analisar a confiabilidade do teste de 8 arremessos de 3 variantes diferentes de arremessos de handebol em estudantes universitários. 33 homens, 20 ±1,9 anos; peso 72,39±8,9 kg; altura 176,75 ±6,07 cm; IMC 23,14±2,3. Os participantes foram testados em 2 sessões separadas por um lapso de 1 semana. Os participantes executaram arremessos até poder registrar 8 medições em cada um dos testes, arremessos não específicos, com apoio e correndo com 3 passos. A velocidade de arremesso foi registrada com um radar pós-gol. A confiabilidade da média dos resultados dos testes de 8 medições entre a primeira sessão e a segunda com um teste de retorno, deu os seguintes resultados: no teste de lançamento não específico, foi obtido um ICC= (0,86) com 95% de confiança, um CV= (7,43%) e um ES= (0,08). Para o lançamento apoiado obtivemos um ICC= (0,94) a 95% de confiança, um CV= (4,71%) e um ES= (-0,09). Para o arremesso de corrida obtivemos um ICC= (0,96) a 95% de confiança, um CV= (4,00%) e um ES= (0,05). Este estudo mostrou que o teste de 8 lances e as 3 variantes é uma medida de desempenho confiável e estável para estudantes universitários sem experiência em handebol. Em relação às variáveis de arremesso, todas as 3 foram confiáveis, apenas a variável não específica foi menor em comparação com o arremesso com suporte e com corrida.

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The constant golden tides of Sargassum spp., identified to be a mixture of Sargassum natans and Sargassum fluitans, observed recently in the Mexican Caribbean have affected the marine ecosystem and the local economy and have created the need for solutions for their management and use. The Sargassum arrivals have thus been considered as third-generation feedstock for biofuel. Their potential for energetic conversion to biomethane was investigated, with hydrolysis as the limiting step due to its complex composition; therefore, in the present study, different physical, chemical, and enzymatic pretreatments and a combination of them have been evaluated, with the additional use of granular activated carbon, to determine the best yield and methane quality. The combined pretreatments of 2.5% hydrogen peroxide, followed by an enzymatic pretreatment (enzymatic extract from Trametes hirsuta isolated from decomposing wood in the Yucatán Peninsula-Mexico), was the best option, reaching a biodegradability of 95% and maximum methane yield of 387 ± 3.09 L CH4/kg volatile solid. The use of a conductive material, such as granular activated carbon, did not generate significant changes in performance and methane concentration.

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O objetivo do estufo foi analisar as estratégias de coping e a motivação de prati-cantes de corrida de rua do município de Maringá ­ PR. Trata-se de um estudo transversal, cuja mostra foi composta por 55 praticantes de corrida de rua, de ambos os sexos, com idade mínima de 20 anos de idade. Como instrumentos foram utilizados uma ficha de identificação, o Exercise Motivation Inventory (EMI-2) e o Inventário de Estratégias de Coping (IEC). A análise dos dados foi feita através de estatística descritiva e inferencial (p<0,05). Os resultados evidenciaram que os homens apresentaram um perfil mais competidor em relação às mulheres (p=0,019), além de utilizarem as estratégias rendimento máximo sob pressão (p=0,017), concentração (p=0,030) e confiança e moti-vação (p=0,021). Os indivíduos com maior tempo de prática utilizam mais da estratégia concentração (p=0,020). Os que treinavam até três vezes na semana se motivavam mais pela reabilitação da saúde. A estratégia de formulação de objetivos foi o domínio que mais obteve correlações com a motivação (p<0,05). Conclui-se que existem inúmeros motivos para a prática dos corredores de rua, assim como as estratégias de enfrentamento utilizadas.

The purpose of the study was to analyze coping strategies and motivation of street runners in the city of Maringá ­ PR. This is a cross-sectional study, in which the sample consisted of 55 street runners, from both sexes, with a minimum age of 20 years old. As instruments, an identification form, the Exercise Motivation Inventory (EMI-2) and the Coping Strategies Inventory (CSI) were used. Data analysis was performed using descriptive and inferential statistics (p<0.05). The results have evinced that men had a more competitive profile than women (p=0.019), also using the following strategies: maximum performance under pressure (p=0.017), concentration (p=0.030) and confi-dence and motivation (p=0.021). Individuals with longer practice time use the concentration strategy more often (p=0.020). Individuals who used to train up to three times a week were more motivated by health rehabilitation. The strategy of formulating objectives was the domain that most correlated with motivation (p<0.05). It is concluded that there are numerous reasons for the practice of street runners, as well as the coping strategies they use.

El propósito del estudio fue analizar las estrategias de afrontamiento y la motivación de los corredores callejeros en la ciudad de Maringá - PR. Se trata de un estudio transversal, en el que la muestra estuvo compuesta por 55 corredores callejeros, de ambos los sexos, con una edad mínima de 20 años. Como instrumentos se utilizó un formulario de identificación, el Inventario de Motivación para el Ejercicio (EMI-2) y el Inventario de Estrategias de Afrontamiento (IEC). El análisis de los datos se realizó mediante estadística descriptiva e inferencial (p <0,05). Los resultados mostraron que los hombres tenían un perfil más competitivo que las mujeres (p = 0,019), además de utilizar las estrategias rendimiento máximo bajo presión (p = 0,017), concentración (p = 0,030) y confianza y motivación (p = 0,021). Las personas con mayor tiempo de práctica utilizan más la estrategia de concentración (p = 0.020). Los que entrenaron hasta tres veces por semana estaban más motivados por la rehabilitación de la salud. La estrategia de formulación de objetivos fue el dominio que más se correlacionó con la motivación (p <0,05). Se concluye que existen numerosas razones para la práctica de los corredores callejeros, así como las estrategias de afrontamiento empleadas.

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ABSTRACT Combined hamartoma of the retina and retinal pigment epithelium is a rare, benign intraocular tumor. Hamartoma of the retina and retinal pigment epithelium has been described in the literature as a condition presenting with variable retinal damage, ranging from partial epiretinal involvement to complete distortion of the retinal layers and retinal pigment epithelium. We report the case of an 8-year-old girl presenting with longstanding strabismus who was diagnosed with Hamartoma of the retina and retinal pigment epithelium based on multimodal imaging assessment. We explored the particular imaging findings from studies using spectral-domain optical coherence tomography, fundus autofluorescence, optical coherence tomography angiography, and fluorescein angiography.

RESUMO O hamartoma combinado de retina e epitélio pigmentar da retina consiste em um tumor intraocular raro com comportamento benigno. O hamartoma combinado de retina e epitélio pigmentar da retina foi descrito na literatura apresentando dano retiniano variável, desde o envolvimento epirretiniano parcial até distorção completa das camadas retinianas e do epitélio pigmentar da retina. Relatamos o caso de uma menina de 8 anos com estrabismo de longa data que foi diagnosticada com hamartoma combinado de retina e epitélio pigmentar da retina, com base na avaliação de imagem multimodal. Exploramos os achados de imagem específicos de estudos usando tomografia de coerência óptica de domínio espectral, autofluorescência, angiografia por tomografia de coerência óptica e angiografia fluorescente.

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Despite notable efforts and significant therapeutical advances, age-related macular degeneration remains the single most common reason for vision loss. Retinal progenitor cells (RPCs) are considered promising candidates for cellular treatments that repair and restore vision. In this allogenic study, the phenotypic profile of pig and human RPCs derived using similar manufacturing processes is compared. The long-term (12-week) survival of green fluorescent protein-pig retinal progenitor cells GFP-pRPC after subretinal transplantation into normal miniature pig (mini-pig) retina is investigated. Human eyes are both anatomically and physiologically mimicked by pig eyes, so the pig is an ideal model to show an equivalent way of delivering cells, immunological response and dosage. The phenotypic equivalency of porcine and clinically intended human RPCs was established. Thirty-nine mini-pigs are used in this study, and vehicle-injected eyes and non-injected eyes serve as controls. Six groups are given different dosages of pRPCs, and the cells are found to survive well in all groups. At 12 weeks, strong evidence of integration is indicated by the location of the grafted cells within the neuro-retina, extension of processes to the plexiform layers and expression of key retinal markers such as recoverin, rhodopsin and synaptophysin. No immunosuppression is used, and no immune response is found in any of the groups. No pRPC-related histopathology findings are reported in the major organs investigated. An initial dose of 250 k cells in 100 µl of buffer is established as an appropriate initial dose for future human clinical trials.

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OBJECTIVES: This study analysed the impact of antimicrobial stewardship team (AST) evaluation on time to susceptible in vitro therapy and mortality of patients with carbapenem-resistant Enterobacterales (CRE) bacteraemia. METHODS: We performed a retrospective cohort study (February 2018 to July 2020) to evaluate the impact of AST evaluation, along with other clinical and microbiological variables, on time to appropriate antibiotics, 14-day mortality and in-hospital mortality in patients aged >18 years with CRE bacteraemia. A Cox regression model was used for multivariate analysis. RESULTS: A total of 142 patients were included. The proportion of patients who received appropriate antibiotics in the first 5 days after bacteraemia was 82/92 (89.1%) versus 29/50 (58.0%) evaluated and not evaluated by the AST, respectively (P < 0.01). AST evaluation reduced the median time to appropriate therapy (49.8 h vs. 71.1 h; P = 0.01). AST intervention was independently associated with earlier prescription of appropriate therapy (P = 0.02) when controlled for septic shock (P < 0.01) and CRE isolation in the previous 90 days (P = 0.04). Regarding mortality, 51 patients (35.9%) died within 14 days (25.8% vs. 44.7% with and without AST intervention, respectively; P = 0.02) and 82 patients (57.7%) in hospital (52.2% vs. 68.0% evaluated and not evaluated by the AST, respectively; P = 0.08). AST intervention was independently protective for 14-day mortality (P = 0.03) when controlled for septic shock status (P < 0.01). CONCLUSION: AST guidance improves the quality of antibiotic prescriptions and clinical outcomes in patients with CRE bacteraemia.

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Combined hamartoma of the retina and retinal pigment epithelium is a rare, benign intraocular tumor. Hamartoma of the retina and retinal pigment epithelium has been described in the literature as a condition presenting with variable retinal damage, ranging from partial epiretinal involvement to complete distortion of the retinal layers and retinal pigment epithelium. We report the case of an 8-year-old girl presenting with longstanding strabismus who was diagnosed with Hamartoma of the retina and retinal pigment epithelium based on multimodal imaging assessment. We explored the particular imaging findings from studies using spectral-domain optical coherence tomography, fundus autofluorescence, optical coherence tomography angiography, and fluorescein angiography.

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PURPOSE: We report a case of paracentral acute middle maculopathy secondary to cholesterol embolization syndrome after an endovascular aortic aneurism repair (EVAR). METHODS: Functional and anatomical damage was assessed by Snellen visual acuity, fundoscopy, and optical coherence tomography. RESULTS: A 67-year-old man presented with sudden vision loss in the right eye for one day with concomitant livedo reticularis in both feet. His medical history included an abdominal EVAR repair three days before the symptoms. The best-corrected visual acuity was 20/40 in the right eye and 20/20 in the left eye. Fundoscopy showed intraarteriolar cholesterol plaques (Hollenhorst) bilaterally, and a localized retinal whitening in the right eye. Optical coherence tomography at the lesion site revealed a hyperreflective band on the level of inner nuclear layer. The patient was referred for imaging and complete systemic evaluation. He was then closely followed up by a vascular team, without additional intervention. Retinal stigma partially regressed at six months with visual improvement. CONCLUSION: This case describes paracentral acute middle maculopathy as a rare ocular sign of cholesterol embolization in postoperative intraaortic operations. The diagnosis of this complication led to prompt clinical care with a multidisciplinary approach.

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ABSTRACT Objective: A unusual case of ocular toxoplasmosis with significant vitreomacular traction is reported. The patient improved significantly following pars plana vitrectomy combined with visual stimulation and occlusion therapy. Methods: The case of a 5-year-old girl with significant unilateral vision loss associated with vitreous condensation and macular traction is described. Results: Pars plana vitrectomy was carried out for vitreomacular traction release. This was followed by visual stimulation and occlusion therapy. Significant improvement was observed. Conclusion: Despite structural damage, the combination of properly indicated surgery and amblyopia management strategies allowed the achievement of maximum vision goals in this case, suggesting structural damage may be associated with functional amblyopia.

RESUMO Objetivo: Relata-se um caso de apresentação atípica de toxoplasmose ocular, com importante tração vitreomacular. A paciente apresentou melhora significativa após vitrectomia via pars plana, com estimulação visual e oclusão. Métodos: Descreve-se o caso de uma menina de 5 anos, com importante perda de visão unilateral associada à condensação vítrea e à tração macular. Resultados: Foi realizada vitrectomia via pars plana para alívio da tração vitreomacular, seguida de estimulação visual e oclusão. Foi observada melhora significativa. Conclusão: Apesar dos danos estruturais, a combinação de cirurgia bem indicada com estratégias de tratamento da ambliopia permitiu alcançar o máximo do potencial visual nesta paciente, sugerindo que os danos estruturais podem estar associados à ambliopia funcional.

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This study aimed to analyze the concentrations of VEGF, b-FGF, TNF, interleukin (IL)-1, IL-6, IL-8, IL-10, and IL-12 in the aqueous humor of patients with diabetic macular edema with and without peripheral retinal ischemia and to ascertain the changes in the levels of these molecules during treatment with ranibizumab. A therapeutic, prospective, randomized interventional study was carried out. Twenty-four eyes from 24 patients were studied and divided into 3 groups. Group 1 (9 eyes) included patients with diabetic macular edema without peripheral ischemia. Group 2 (10 eyes) included patients with diabetic macular edema with peripheral ischemia. Group 3 (5 eyes), the control group, included patients without systemic and/or eye diseases. Patients in Groups 1 and 2 received 3 intravitreal injections of 2 mg/0.05 ml ranibizumab at an interval of approximately 30 days. Before administering the injections, the aqueous humor was collected. In the control group, aqueous humor was collected before facetectomy. During treatment, the median IL-6 concentration significantly increased in Group 1 but showed a slight but not significant decrease in Group 2. Interleukin 8 levels were significantly different at the end of treatment compared to the beginning in Groups 1 and 2. TNF, IL-1, IL-10, and IL-12 levels were practically unchanged in both groups. VEGF was significantly reduced at the end of the study in Groups 1 and 2. B-FGF was not detected in most of the studied patients, and in those with detectable levels, there was no significant variation. There was a significant increase in the median level of interleukin 6 in the group without ischemia and a significant decrease in VEGF in both groups. The cytokines TNF, IL-1, IL-10, and IL-12 did not show significant variation.

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Background: This study developed a photo and video database of 4-to-6-year-olds expressing the seven induced and posed universal emotions and a neutral expression. Children participated in photo and video sessions designed to elicit the emotions, and the resulting images were further assessed by independent judges in two rounds. Methods: In the first round, two independent judges (1 and 2), experts in the Facial Action Coding System, firstly analysed 3,668 emotions facial expressions stimuli from 132 children. Both judges reached 100% agreement regarding 1,985 stimuli (124 children), which were then selected for a second round of analysis between judges 3 and 4. Results: The result was 1,985 stimuli (51% of the photographs) were produced from 124 participants (55% girls). A Kappa index of 0.70 and an accuracy of 73% between experts were observed. Lower accuracy was found for emotional expression by 4-year-olds than 6-year-olds. Happiness, disgust and contempt had the highest agreement. After a sub-analysis evaluation of all four judges, 100% agreement was reached for 1,381 stimuli which compound the ChildEFES database with 124 participants (59% girls) and 51% induced photographs. The number of stimuli of each emotion were: 87 for neutrality, 363 for happiness, 170 for disgust, 104 for surprise, 152 for fear, 144 for sadness, 157 for anger 157, and 183 for contempt. Conclusions: The findings show that this photo and video database can facilitate research on the mechanisms involved in early childhood recognition of facial emotions in children, contributing to the understanding of facial emotion recognition deficits which characterise several neurodevelopmental and psychiatric disorders.

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ABSTRACT Central giant cell granuloma is a rare osseous tumor affecting young patients with anatomical and functional compromise of the maxilla and mandible. Steroid injection therapy constitutes a less invasive treatment modality for disease control in selected cases. Retinal ischemia is a reported complication of multiple medical procedures, including dental interventions, and may lead to loss of vision with poor prognosis. We report a case of retinal arteriolar ischemic disease following central giant cell granuloma management with local injected corticosteroids.

RESUMO O granuloma central de células gigantes é um tumor ósseo raro que afeta pacientes jovens com comprometimento anatômico e funcional da maxila e mandíbula. A terapia com injeção de esteroides constitui uma modalidade de tratamento menos invasiva para o controle da doença em casos selecionados. A isquemia retiniana é uma complicação relatada em vários procedimentos médicos, incluindo intervenções odontológicas, e pode levar à perda da visão com mau prognóstico. Relatamos um caso de doença isquêmica arteriolar da retina após o tratamento com granuloma central de células gigantes com corticosteroides injetados locais.

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PURPOSE: This study aims to compare the anatomical success rates of vitrectomy and SF6 gas tamponade for macular hole surgery with and without postoperative face-down posturing. METHODS: This was an observational, longitudinal, and retrospective case series analysis. The study included 52 eyes from 52 patients who underwent pars plana vitrectomy with trypan blue-assisted internal limiting membrane peeling and 25% SF6 tamponade for stages 2, 3, and 4 macular holes. After surgery, all patients were provided with a postoperative postural regimen: 31 patients were instructed not to maintain face-down posturing, whereas 21 were instructed to maintain face-down posturing for 7 days. The primary outcome measure was the macular hole closure rate. Statistical analysis was performed using Epi Info 7.1. RESULTS: A total of 47 (90.3%) patients achieved hole closure. The nonface-down posturing group and face-down posturing group obtained closure rates of 90.3% and 90.4%, respectively; these rates were not significantly different. Statistical analysis revealed that no significant differences existed in sex, age, hole duration, hole stage, preoperative visual acuity, or postoperative visual acuity between the two groups. CONCLUSION: Our results suggest that macular hole surgery with the use of short duration gas (SF6) is safe and effective and that maintaining a postural orientation of nonface-down posturing is also safe. However, these recommendations should be assessed further in a prospective and randomized study to comprehensively delineate the associated benefits and risks.

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Abstract Purpose: Study aimed to determine compliance of patients with strabismic amblyopia undergoing occlusion treatment, followed from January 1 st, 2011 to January 1 st, 2017 at an Ophthalmology Reference Center, and identify risk factors for poor compliance. Methods: Retrospective, consecutive cohort study. Compliance reported at each visit was related to visual acuity, family history, changes in occlusion schedules and in patients' care team during treatment. The patients were divided into two groups according to the compliance: poor compliance group and compliance group (subdivided in full compliance subgroup and partial compliance subgroup). Results: Age at treatment beginning vary from 3.7 to 13.7 years, esotropia was the most frequent deviation and the occlusion was realized from 5 to 7 hours a day. Of 220 patients, compliance was achieved by 193 (87.7%), 114 (51.8%) in full compliance subgroup and 79 (35.9%) in partial compliance subgroup, and 27 do not achieved compliance (12.3%). Poor compliance was significantly related to a history of epilepsy, higher rate of suspension of treatment due to inefficacy, higher evasion rate, lower recurrence, and lower rate of maintenance of prophylactic occlusion after treatment. Good compliance was related to family history of strabismus, higher recurrence rate, and higher maintenance of prophylactic occlusion after treatment. No relations were found between poor compliance and changes in occlusion schedules or in patients' care team during treatment. Conclusion: Compliance with occlusion treatment of strabismic ambliopia was similar to other studies that included refractive and strabismic amblyopia and not related to changes in occlusion schedules or in patients' care team during treatment. Family history of strabismus was a protective factor.

Resumo Objetivo: Determinar a adesão de pacientes com ambliopia estrabísmica submetidos a tratamento oclusivo, acompanhados em Centro de Referência em Oftalmologia do Centro-Oeste do Brasil, e identificar fatores de risco para baixa adesão. Métodos: Estudo de coorte retrospectivo e consecutivo. A adesão relatada em cada visita foi relacionada à acuidade visual, história familiar, mudanças no tempo de oclusão e na equipe de atendimento ao paciente durante o tratamento. Os pacientes foram divididos em dois grupos de acordo com a adesão: grupo de não-adesão e grupo adesão (subdividido em subgrupo adesão total e subgrupo adesão parcial). Resultados: A idade ao início do tratamento variou de 3,7 a 13,7 anos, o desvio mais frequente foi a esotropia, o tempo médio de oclusão foi de 5 a 7 horas por dia. Dos 220 pacientes, 193 (87,7%) obtiveram adesão, 114 (51,8%) no subgrupo de adesão total e 79 (35,9%) no subgrupo de adesão parcial, e 27 não aderiram (12,3%). A não-adesão foi relacionada à história de epilepsia, maior taxa de suspensão do tratamento devido à ineficácia, maior taxa de evasão, menor recorrência e menor taxa de manutenção da oclusão profilática pós tratamento. A boa adesão foi relacionada à história familiar de estrabismo, maior taxa de recorrência e maior manutenção da oclusão profilática pós tratamento. Não houve relação entre não-adesão e mudanças nos horários de oclusão ou na equipe de atendimento durante o tratamento. Conclusão: A adesão ao tratamento oclusivo da ambliopia estrabísmica foi semelhante aos estudos que incluíram ambliopia refracional e estrabísmica e não se correlacionou a mudanças no tempo de oclusão ou na equipe de atendimento. A história familiar de estrabismo foi um fator de proteção.

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