RESUMO
PURPOSE: To evaluate the influence of pupil dilation on retinal nerve fibre layer (RNFL) measurements with spectral domain optical coherence tomography (OCT). PATIENTS AND METHODS: In total, 29 healthy individuals and 26 glaucoma patients underwent RNFL measurements with the Cirrus HD-OCT Model 4000 (Carl Zeiss Meditec Inc.) before and 30-40 min after pupil dilation with one drop of tropicamide 1%. Average thickness, quadrant thickness, and clock-hour thickness measurements were compared with the paired Student's t-test. We also compared the quality scores of the images obtained pre- and post-pupil dilation. RESULTS: Mean ages in the glaucoma and control groups were 58.3+/-13.4 and 41.6+/-16.4 years respectively (P<0.001). Mean deviation values were -6.96+6.31 dB in the glaucoma group and -1.26+0.79 dB in the control group (P<0.001). Mean RNFL measurements obtained in the glaucoma group were significantly lower than those obtained in the control group (P<0.001). There were no statistically significant differences between mean quality scores obtained before and after dilation neither in the glaucoma group (7.73+/-0.92 vs 7.54+/-1.10, P=0.232) nor in the control group (8.14+/-0.88 vs 8.00+/-0.71, P=0.380). There was no statistically significant difference between mean RNFL measurements obtained pre- and post-pupil dilation neither among normal individuals (P>0.05), nor among glaucoma patients (P>0.05). CONCLUSION: The results of this study indicate that RNFL measurements obtained with spectral domain OCT are not influenced by pupil size.
Assuntos
Fibras Nervosas/patologia , Disco Óptico/patologia , Pupila/fisiologia , Tomografia de Coerência Óptica/métodos , Adulto , Idoso , Estudos de Casos e Controles , Feminino , Glaucoma/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Disco Óptico/anatomia & histologiaRESUMO
AIM: To measure the central corneal thickness (CCT) of children with congenital cataract and surgical aphakia. METHODS: Children with congenital cataract or surgical aphakia were prospectively recruited and divided into four groups: unilateral cataract (group 1, n = 14), bilateral cataract (group 2, n = 17), unilateral aphakia (group 3, n = 32) and bilateral aphakia (group 4, n = 44). An age-, sex-, and race-matched control group of normal individuals was selected. Ultrasonic pachymetry was performed by the same observer. RESULTS: The mean CCT of the control group was not significantly different from the normal (p = 0.747) and cataractous eyes of group 1 (p = 0.252). The mean CCTs of both eyes of group 2 were significantly higher than the control group (p<0.01). The mean CCT of the aphakic eyes in group 3 was significantly higher than the contralateral healthy eyes and control eyes (p<0.001). The mean CCTs of both eyes of group 4 were significantly higher than the control group (p<0.001). The mean CCT was significantly higher in aphakic eyes of groups 3 and 4 than in cataractous eyes of groups 1 and 2 (p<0.001). CONCLUSIONS: Aphakic eyes due to congenital cataract show thicker corneas than normal phakic eyes. Aphakic eyes after congenital cataract extraction show thicker corneas than eyes with congenital cataracts, suggesting that the increase in CCT occurs postoperatively.
Assuntos
Afacia/diagnóstico por imagem , Catarata/congênito , Catarata/diagnóstico por imagem , Córnea/diagnóstico por imagem , Adolescente , Estudos de Casos e Controles , Extração de Catarata , Distribuição de Qui-Quadrado , Criança , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Lactente , Masculino , Período Pós-Operatório , Estudos Prospectivos , UltrassonografiaAssuntos
Carlavirus/classificação , Carlavirus/genética , Carlavirus/imunologia , Carlavirus/patogenicidade , Ensaio de Imunoadsorção Enzimática , Ordem dos Genes , Genoma Viral/genética , Dados de Sequência Molecular , Doenças das Plantas/virologia , RNA Viral/genética , Análise de Sequência de DNA , Homologia de Sequência de Aminoácidos , Sintenia , Nicotiana/virologia , Proteínas Virais/imunologiaRESUMO
OBJECTIVE: In children with idiopathic short stature (ISS) we studied the growth-promoting effect at 4 years of recombinant human growth hormone (rhGH) therapy in three dose regimens and evaluated whether increasing the dosage after the first year could prevent a decline in height velocity (HV). DESIGN: Included were 223 patients who were treated with subcutaneous administrations of rhGH 6 days per week. They were randomized to three groups: 3 IU/m2 body surface/day, 4.5 IU/m2/day, and 3 IU/m2/day during the first year and 4.5 IU/m2/day thereafter, corresponding with dosages of 0.2 and 0.3 mg/kg body weight/week, respectively. Growth was compared with a standard of 229 untreated children with ISS [ISS standard]. RESULTS: During the first year of treatment HV almost doubled and was higher with 4.5 IU/m2 than with 3 IU/m2. In the second year HV no longer differed among the groups, but increasing the dosage slowed the rate of the fall of HV. During 4 years of therapy the height SD score for age increased by a mean (SD) of 2.5 (1.0) [ISS standards], or 1.2 (0.7) (British standards), bone age increased by 4.8 (1.3) years, and predicted adult height SD score increased by 1.5 (0.7). After 4 years the results of the group with 4.5 IU/m2 were slightly better than those of the other groups. When dropouts were included in the analysis (assuming a stable height SD score after discontinuation of rhGH therapy), height gain was still significant. CONCLUSIONS: During 4 years of rhGH therapy, growth and final height prognosis improved, slightly more with 4.5 IU/m2 than with 3 IU/m2 or 3 to 4.5 IU/m2. However, bone age advanced on average 4.8 years during this period; therefore, any effect on final height will probably be modest.
Assuntos
Transtornos do Crescimento/tratamento farmacológico , Hormônio do Crescimento/administração & dosagem , Crescimento/efeitos dos fármacos , Estatura/efeitos dos fármacos , Criança , Relação Dose-Resposta a Droga , Feminino , Retardo do Crescimento Fetal , Transtornos do Crescimento/fisiopatologia , Humanos , Masculino , Análise de RegressãoAssuntos
Transplante de Medula Óssea , Gônadas/fisiologia , Leucemia/terapia , Doença Aguda , Adolescente , Adulto , Feminino , Humanos , Leucemia/radioterapia , MasculinoRESUMO
OBJECTIVES: To study final height after long-term growth hormone (GH) treatment in girls with Turner syndrome (TS). PATIENTS: One hundred fifty three patients with TS, participating in five European trials, were included. They started GH treatment in 1987-1989 at an age of 10 years or older. Mean age at start of treatment ranged between 11.7 and 14.6 years among countries and mean bone age between 9.4 and 11.8 years. Fourteen girls were lost to follow-up, leaving 139 for analysis. Most girls have now attained final height (FH), defined as a linear growth velocity (GV) of 4 mm/yr or less, measured over at least 6 months (group 1, n = 56), or near-FH, defined as a GV of 5 to 9 mm/yr (group 2, n = 22). Sixty-one girls were still growing 10 mm/yr or more. METHODS AND MAIN RESULTS: At the last measurement, mean (SD) height was 150.7 (4.9) cm in group 1 and 148.5 (5.1) cm in group 2. The differences between FH and projected final height based on extrapolation of the initial height-standard deviation score on Turner syndrome reference values, were 2.9 (3.8) and 3.0 (3.3) cm, respectively. The mean gain over the Bayley-Pinneau prediction of FH was 3.3 (3.9) cm in both groups. No significant differences between countries were found. The range of gains over projected height (-4.7 to 12.1 cm) was large, and 25% of gains were 5 cm or more. Gain over initial projection was strongly related to initial growth delay and to growth response during the first 2 years of treatment. A logistic regression model is presented that predicts gain of more than 5 cm with a positive predictive value of 62% and a negative predictive value of 84%. CONCLUSIONS: Long-term GH treatment in girls with TS, starting treatment at a relatively advanced age ( > 10 years) resulted in a modest mean gain in FH of 3 cm, with wide interindividual variation.
Assuntos
Estatura/efeitos dos fármacos , Hormônio do Crescimento/uso terapêutico , Síndrome de Turner/tratamento farmacológico , Adolescente , Criança , Europa (Continente) , Feminino , Humanos , Modelos Lineares , Modelos Logísticos , Proteínas Recombinantes/uso terapêutico , Sensibilidade e Especificidade , Síndrome de Turner/fisiopatologiaRESUMO
Se revisa el tema de DI, a raiz de tres casos familiares de la enfermedad, presentados y controlados en el Hospital de Castro. Se resumen sus historias clinicas, se destaca la gran poliuria de baja densidad, la presencia de un caracter hereditario dominante, la excelente respuesta a la terapia sustitutiva hormonal (Extracto de hipofisis posterior) y la ausencia de complicaciones