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Hemorrhagic shock (HS), a leading cause of preventable death, is characterized by severe blood loss and inadequate tissue perfusion. Reoxygenation of ischemic tissues exacerbates organ damage through ischemia-reperfusion injury. SUMOylation has been shown to protect neurons after stroke and is upregulated in response to cellular stress. However, the role of SUMOylation in organ protection after HS is unknown. This study aimed to investigate SUMOylation-mediated organ protection following HS. Male Wistar rats were subjected to HS (blood pressure of 40 ± 2 mmHg, for 90 min) followed by reperfusion. Blood, kidney, and liver samples were collected at various time points after reperfusion to assess organ damage and investigate the profile of SUMO1 and SUMO2/3 conjugation. In addition, human kidney cells (HK-2), treated with the SUMOylation inhibitor TAK-981 or overexpressing SUMO proteins, were subjected to oxygen and glucose deprivation to investigate the role of SUMOylation in hypoxia/reoxygenation injury. The animals presented progressive multiorgan dysfunction, except for the renal system, which showed improvement over time. Compared to the liver, the kidneys displayed distinct patterns in terms of oxidative stress, apoptosis activation, and tissue damage. The global level of SUMO2/3 in renal tissue was also distinct, suggesting a differential role. Pharmacological inhibition of SUMOylation reduced cell viability after hypoxia-reoxygenation damage, while overexpression of SUMO1 or SUMO2 protected the cells. These findings suggest that SUMOylation might play a critical role in cellular protection during ischemia-reperfusion injury in the kidneys, a role not observed in the liver. This difference potentially explains the renal resilience observed in HS animals when compared to other systems.
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Ratos Wistar , Choque Hemorrágico , Sumoilação , Animais , Masculino , Choque Hemorrágico/metabolismo , Sumoilação/efeitos dos fármacos , Sumoilação/fisiologia , Ratos , Humanos , Rim/metabolismo , Rim/patologia , Rim/efeitos dos fármacos , Traumatismo por Reperfusão/metabolismo , Linhagem CelularRESUMO
BACKGROUND: Hemorrhagic shock (HS), which causes insufficient tissue perfusion, can result in multiple organ failure (MOF) and death. This study aimed to evaluate whether doxycycline (DOX) protects cardiovascular, kidney, and liver tissue from damage in a rat model of HS. Immediately before the resuscitation, DOX (10 mg/kg; i.v.) was administered, and its protective effects were assessed 24 h later. Mean arterial pressure, renal blood flow, heart rate, vasoactive drug response, and blood markers such as urea, creatinine, AST, ALT, CPK, CPR, and NOx levels were determined. RESULTS: We showed that DOX has a significant effect on renal blood flow and on urea, creatinine, AST, ALT, CPK, and NOx. Morphologically, DOX reduced the inflammatory process in the liver tissue. CONCLUSIONS: We conclude that DOX protects the liver and kidney against injury and dysfunction in a HS model and could be a strategy to reduce organ damage associated with ischemia-and-reperfusion injury.
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Sepsis is a severe condition secondary to dysregulated host response to infection leading to tissue damage and organ dysfunction. Cannabinoid CB2 receptor has modulatory effects on the immune response. Therefore, this study investigated the effects of a cannabinoid CB2 receptor agonist on the local and systemic inflammatory process associated with pneumonia-induced sepsis. Pneumonia-induced sepsis was induced in mice by intratracheal inoculation of Klebsiella pneumoniae. Tissue and bronchoalveolar lavage (BAL) were collected 6, 24, or 48 h after surgery. Mice were treated with CB2 agonist (AM1241, 0.3 and 3 mg/kg, i.p.) and several parameters of inflammation were evaluated 24 h after sepsis induction. Polymorphonuclear cell migration to the infectious focus peaked 24 h after pneumonia-induced sepsis induction in male and female animals. Septic male mice presented a significant reduction of cannabinoid CB2 receptor density in the lung tissue after 24 h, which was not observed in females. CB2 expression in BAL macrophages was also reduced in septic animals. Treatment of septic mice with AM1241 reduced cell migration, local infection, myeloperoxidase activity, protein extravasation, and NOS-2 expression in the lungs. In addition, the treatment reduced plasma IL-1ß, increased IL-10 and reduced the severity and mortality of septic animals. These results suggest that AM1241 promotes an interesting balance in the inflammatory response, maintaining lung function and preventing organ injury. Therefore, cannabinoid CB2 receptors are potential targets to control the excessive inflammatory process that occurs in severe conditions, and agonists of these receptors can be considered promising adjuvants in pneumonia-induced sepsis treatment.
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Canabinoides , Pneumonia , Sepse , Feminino , Camundongos , Masculino , Animais , Agonistas de Receptores de Canabinoides/farmacologia , Pneumonia/tratamento farmacológico , Canabinoides/farmacologia , Inflamação/tratamento farmacológico , Inflamação/metabolismo , Receptores de Canabinoides , Sepse/complicações , Sepse/tratamento farmacológico , Sepse/metabolismo , Receptor CB2 de Canabinoide , Receptor CB1 de CanabinoideRESUMO
Objective To assess the risk factors involving longer hospital stays and early postoperative complications (first 30 days after surgery) in patients undergoing total knee arthroplasty (TKA). Materials and Methods A cross-sectional study was conducted with collection of data of patients who underwent TKA in a private hospital between 2015 and 2019. The following data were collected: age, gender, body mass index, and clinical comorbidities. We also collected intraoperative data such as the grade on the classification of the American Society of Anesthesiologists (ASA), the duration of the surgery, the length of stay, the postoperative complications, and readmission within 30 days. Statistical models were used to investigate the possible risk factors associated with longer hospital stays and postoperative complications. Results There was evidence of an increase in the length of hospital stay in older patients, with higher grades on the ASA classification or who suffered postoperative complications. For each increase in 1 year of age, we expect the length of stay to be multiplied by 1.008 (95% confidence interval [95%CI]: 1.004 to 1.012; p < 0,001). In patients who were ASA grade III, the time is expected to be multiplied by 1.297 (95%CI: 1.083 to 1.554; p = 0,005) when compared with grade-I patients. In patients who suffered postoperative complications, the time is expected to be multiplied by 1.505 (95%CI: 1.332 to 1.700; p < 0.001) compared with patients without complications. Conclusion The present study demonstrated that, in patients who underwent primary TKA, preoperative characteristics such as older age and ASA grade ≥ III, as well as the development of postoperative complications, independently predict the increase in the length of hospital stay.
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Abstract Objective To assess the risk factors involving longer hospital stays and early postoperative complications (first 30 days after surgery) in patients undergoing total knee arthroplasty (TKA). Materials and Methods Across-sectional study was conducted with collection of data of patients who underwent TKA in a private hospital between 2015 and 2019. The following data were collected: age, gender, body mass index, and clinical comorbid-ities. We also collected intraoperative data such as the grade on the classification of the American Society of Anesthesiologists (ASA), the duration of the surgery, the length of stay, the postoperative complications, and readmission within 30 days. Statistical models were used to investigate the possible risk factors associated with longer hospital stays and postoperative complications. Results There was evidence of an increase in the length of hospital stay in older patients, with higher grades on the ASA classification or who suffered postoperative complications. For each increase in 1 year of age, we expect the length of stay to be multiplied by 1.008 (95% confidence interval [95%CI]: 1.004 to 1.012; p < 0,001). In patients who were ASA grade III, the time is expected to be multiplied by 1.297 (95%CI: 1.083 to 1.554; p = 0,005) when compared with grade-I patients. In patients who suffered postoperative complications, the time is expected to be multiplied by 1.505 (95%CI: 1.332 to 1.700; p < 0.001) compared with patients without complications. Conclusion The present study demonstrated that, in patients who underwent primary TKA, preoperative characteristics such as older age and ASA grade > III, as well as the development of postoperative complications, independently predict the increase in the length of hospital stay.
Resumo Objetivo Avaliar os fatores de risco relacionados a um tempo de internação mais longo e às complicações pós-operatórias precoces (primeiros 30 dias após a cirurgia) em pacientes submetidos a artroplastia total do joelho (ATJ). Materiais e Métodos Este é um estudo transversal com coleta de dados de pacientes submetidos a ATJ em um hospital privado entre 2015 e 2019. Os seguintes dados foram coletados: idade, gênero, índice de massa corporal, e comorbidades clínicas. Também coletamos dados intraoperatórios, como o grau na classificação da American Society of Anesthesiologists (ASA) e a duração da cirurgia, além do tempo de internação, as complicações pós-operatórias, e a readmissão em 30 dias. Os possíveis fatores de risco associados a um tempo de internação mais longo e às taxas de complicações pós-operatórias foram investigados por meio de modelos estatísticos. Resultados Os pacientes mais velhos, com graus mais elevados na classificação da ASA ou que sofreram complicações pós-operatórias, ficaram internados por mais tempo. Para cada aumento em um ano de idade, esperamos que o tempo de internação seja multiplicado por 1,008 (intervalo de confiança de 95% [IC95%]: 1,004 a 1,012; p < 0,001). Em pacientes de grau III na classificação da ASA, espera-se que o tempo seja multiplicado por 1,297 (IC95%: 1,083 a 1,554; p = 0,005) em comparação com pacientes de grau I. Em pacientes com complicações pós-operatórias, espera-se que o tempo seja multiplicado por 1,505 (IC95%: 1,332 a 1,700; p < 0,001) em comparação com pacientes sem complicações. Conclusão Este estudo demonstrou que, em pacientes submetidos a ATJ primária, características pré-operatórias, como idade avançada e grau ≥ III na classificação da ASA, e o desenvolvimento de complicações pós-operatórias predizem o aumento do tempo de internação hospitalar de forma independente.
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Humanos , Complicações Pós-Operatórias , Avaliação de Resultados em Cuidados de Saúde , Artroplastia do Joelho , Tempo de InternaçãoRESUMO
SUMOylation is described as a posttranslational protein modification (PTM) that is involved in the pathophysiological processes underlying several conditions related to ischemia- and reperfusion-induced damage. Increasing evidence suggests that, under low oxygen levels, SUMOylation might be part of an endogenous mechanism, which is triggered by injury to protect cells within the central nervous system. However, the role of ischemia-induced SUMOylation in the periphery is still unclear. This article summarizes the results of recent studies regarding SUMOylation profiles in several diseases characterized by impaired blood flow to the cardiorenal, gastrointestinal, and respiratory systems. Our review shows that although ischemic injury per se does not always increase SUMOylation levels, as seen in strokes, it seems that in most cases the positive modulation of protein SUMOylation after peripheral ischemia might be a protective mechanism. This complex relationship warrants further investigation, as the role of SUMOylation during hypoxic conditions differs from organ to organ and is still not fully elucidated.
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Processamento de Proteína Pós-Traducional , Sumoilação , PerfusãoRESUMO
Sepsis is one of the leading causes of acute kidney injury (AKI), and several mechanisms including microcirculatory alterations, oxidative stress, and endothelial cell dysfunction are involved. Nitric oxide (NO) is one of the common elements to all these mechanisms. Although all three nitric oxide synthase (NOS) isoforms are constitutively expressed within the kidneys, they contribute in different ways to nitrergic signaling. While the endothelial (eNOS) and neuronal (nNOS) isoforms are likely to be the main sources of NO under basal conditions and participate in the regulation of renal hemodynamics, the inducible isoform (iNOS) is dramatically increased in conditions such as sepsis. The overexpression of iNOS in the renal cortex causes a shunting of blood to this region, with consequent medullary ischemia in sepsis. Differences in the vascular reactivity among different vascular beds may also help to explain renal failure in this condition. While most of the vessels present vasoplegia and do not respond to vasoconstrictors, renal microcirculation behaves differently from nonrenal vascular beds, displaying similar constrictor responses in control and septic conditions. The selective inhibition of iNOS, without affecting other isoforms, has been described as the ideal scenario. However, iNOS is also constitutively expressed in the kidneys and the NO produced by this isoform is important for immune defense. In this sense, instead of a direct iNOS inhibition, targeting the NO effectors such as guanylate cyclase, potassium channels, peroxynitrite, and S-nitrosothiols, may be a more interesting approach in sepsis-AKI and further investigation is warranted.
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Injúria Renal Aguda , Sepse , Injúria Renal Aguda/etiologia , Humanos , Rim/metabolismo , Microcirculação , Óxido Nítrico , Óxido Nítrico Sintase Tipo I/metabolismo , Óxido Nítrico Sintase Tipo II/metabolismo , Óxido Nítrico Sintase Tipo III/metabolismo , Isoformas de Proteínas , Sepse/complicaçõesRESUMO
Abstract Objective The objective of the present work was to compare the measurement of acetabular component version on anteroposterior (AP) and on cross-table radiographs after total hip arthroplasty (THA). Methods Radiographs of 60 hips with a primary THA were selected. Version was calculated on the AP radiograph using the Lewinnek method and, on the cross-table, using the Woo and Morrey direct method. Results Mean and standard deviation (SD) were different on both radiographs, being 9.7° ± 5.5° on the AP, whereas in the cross-table the measurements were 20.6° ± 8.4° (p < 0.001). Minding our aim of 10°, the cross-table measurements were statistically different from it (p < 0.001), while the AP measurement did not differ (p = 0.716). Conclusion The present study showed that the best way to correctly evaluate the acetabular component positioning following a THA is by measuring anteversion and abduction on an AP radiograph after confirming, in a cross-table radiograph, that the component is not retroverted.
Resumo Objetivo O objetivo do presente trabalho foi comparar a medição da versão do componente acetabular em radiografias em incidência anteroposterior (AP) e crosstable após artroplastia total do quadril (ATQ). Métodos Foram selecionadas radiografias de 60 quadris com ATQ primário. A versão foi calculada na radiografia AP usando o método de Lewinnek e, na cross-table, usando o método direto do Woo e Morrey. Resultados A média e o desvio padrão (DP) foram diferentes em ambas as radiografias, sendo 9,7° ± 5,5° no AP, enquanto na cross-table foram 20,6° ± 8,4° (p < 0,001). Considerando nosso objetivo de 10°, as medidas da cross-table foram estatisticamente diferentes dele (p < 0,001), enquanto a medição AP não diferiu (p = 0,716). Conclusão O presente estudo mostrou que a melhor maneira de avaliar corretamente o posicionamento do componente acetabular após uma ATQ é medindo a anteversão e a abdução em uma radiografia AP após confirmar, em uma radiografia cross-table, que o componente não é retrovertido.
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Radiografia , Artroplastia de Quadril , AcetábuloRESUMO
Several secondary metabolites have been isolated from Zornia brasiliensis (Leguminosae), mainly flavonoids. These compounds are known for many pharmacological actions, such as antispasmodic and antidiarrheal. Therefore, we evaluated the antidiarrheal effect of the ethanolic extract obtained from Zornia brasiliensis aerial parts (ZB-EtOHAP), as well as its underlying mechanisms. Castor-oil-induced diarrhea, fluid accumulation, and intestinal transit (normal and castor oil induced) were performed to assess the antidiarrheal, antisecretory, and antipropulsive activities of the extract. The involvement of opioid and adrenergic pathways was also investigated. ZB-EtOHAP inhibited, in a dose-dependent manner, both total defecation frequency and the number of watery stools. The extract showed no effect on fluid accumulation or normal intestinal transit. On the other hand, when the animals were pretreated with castor oil, the extract decreased the distance traveled by the marker in the small intestine. Investigation of the involvement of opioid and adrenergic systems showed that the pharmacological potency of the extract did not change in the presence of naloxone, but it was reduced in the presence of yohimbine. The data indicate that Zornia brasiliensis has an antidiarrheal effect due to inhibition of the intestinal motility through adrenergic pathway activation.
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PURPOSE: To determine visual field findings in Boston type 1-KPro (BI-KPro) patients without glaucoma. Characterize normal threshold values and global indices using standard automated perimetry and characterize visual field amplitude using Goldmann's manual perimetry. METHODS: This cross-sectional prospective noninterventional study included patients (n=6 patients, 6 eyes) with BI-KPro who had normal optical coherence tomography and fundoscopic evaluation of the optic disc and retina. None had a previous history of glaucoma. Visual acuity, reliable and reproducible standard automated perimetry (24-2 and 30-2), and manual perimetry examinations were obtained from all patients. Each patient answered the National Eye Institute Visual Function Questionnaire, and the results were correlated with visual field indices. RESULTS: The mean visual acuity was 0.35±0.31 logMAR (0.84 to 0.10). All visual fields had good reliability indices. The standard automated perimetry mean deviation values were -7.25±3.63 decibels (dB) and -7.75±3.23 (24-2 and 30-2 values, respectively), whereas pattern SD values were 2.72±0.82 and 3.30±1.13 (24-2 and 30-2, respectively). The manual visual field mean values of the 4 quadrants (superior, temporal, inferior, and nasal), were 39.7±4.5, 61.8±6.2, 54.0±4.3, and 48.2±7.6 degrees, respectively. The authors found a significant correlation between the VFQ-25 indexes of general sight and close-range activities with the values of total deviation at 10 degrees. VFQ-25 peripheral vision indexes also correlated significantly with values of total deviation at 30 degrees (outermost locations in the 30-degree area). CONCLUSIONS: Patients with BI-KPro presented reliable and reproductive visual field measurements. The authors found a consistent reduction in visual field extension and a global sensitivity reduction in these patients. Despite visual field changes, our patients had a good quality of life scores. Overall, these results could be useful to improve early glaucoma diagnosis and to follow-up BI-KPro patients.
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Doenças da Córnea , Glaucoma , Córnea , Estudos Transversais , Glaucoma/diagnóstico , Humanos , Pressão Intraocular , Estudos Prospectivos , Próteses e Implantes , Qualidade de Vida , Reprodutibilidade dos Testes , Transtornos da Visão/diagnóstico , Testes de Campo Visual , Campos VisuaisRESUMO
Oceanapia magna Santos-Neto, Nascimento, Cavalcanti and Pinheiro sponges are distributed across tropical worldwide seas. Some studies of marine products have shown interesting activities in smooth muscle models. Hence, we assessed the effect of the ethanolic extract of Oceanapia magna. (OC-EtOH) on acute toxicity and gastrointestinal motility (in vitro and in vivo) in rodent models. On guinea pig ileum, OC-EtOH induced a concentration dependent contraction on basal tonus, which was not inhibited by atropine, but in the presence of pyrilamine or verapamil, the effect was antagonized. Contrastingly, on KCl- or histamine-induced contractions, OC-EtOH presented a transient contraction followed by a concentration-dependent relaxation. Moreover, OC-EtOH presented a relaxant profile on cumulative curves to CaCl2 and tonic contraction induced by S-(-)-BayK8644, through Cav blockade. The acute toxicity assay showed that OC-EtOH (2,000 mg/kg, p.o.) did not present any sign of toxicity in female mice. Additionally, OC-EtOH presented antidiarrheal effect in mice, increased the intestinal normal transit and reduced the castor oil-induced intestinal transit. Thus, OC-EtOH presented a dual effect on guinea pig ileum promoting contraction through activation of H1 and CaV, and relaxation through CaV blockade, besides the effect on upper gastrointestinal transit in mice, showing a potential medicinal use of this sponge in intestinal diseases such as diarrhea.
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A necessidade da inovação em produtos funcionais vem tornando-se cada vez mais exigida com o passar dos anos, pois a preocupação com a qualidade de vida virou um marco da atualidade. Diante disso, o presente trabalho teve como objetivo desenvolver um doce ligth de maracujá com chuchu, avaliar suas características sensoriais, microbiológicas. Para a preparação empregou matéria prima oriunda do comércio local da cidade de Imperatriz Maranhão, e elaborado no Laboratório de Análise Sensorial - UFMA. Produziu três formulações, F1, F2 e F3 tendo açúcar cristal, stevia e sucralose, respectivamente. Posteriormente, as amostras foram submetidas as análises microbiológicas e análise sensorial. As análises foram aceitáveis em seus parâmetros microbiológicos e sensoriais.
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Cucurbitaceae/microbiologia , Passiflora/microbiologia , Alimento Funcional/análise , Alimentos/economiaRESUMO
O objetivo desta pesquisa foi avaliar a resistência da união, pelo método depush out, de pinos de fibra de vidro cimentados com cimento resinoso dual associado ao sistema adesivo Single Bond Universal, através de diferentes estratégias adesivas. Em 40 incisivos bovinos, um pino de fibra de vidro (Whitepost DC nº3) foi cimentado com cimento resinoso dual (RelyX ARC) e adesivo (Single Bond Universal). Os dentes foram divididos em 4 grupos (n = 10), de acordo com a estratégia de união. No Grupo 1 não se realizou nenhum tratamento do substrato dentinário. O Grupo 2 recebeu condicionamento com ácido fosfórico 37%. O Grupo 3 recebeu a aplicação de clorexidina 2% e o Grupo 4 recebeu condicionamento com ácido fosfórico 37% e aplicação da clorexidina 2%. Os grupos foram fatiados (1,8 mm) em três porções (cervical, média e apical) e tiveram seus pinos deslocados pela máquina universal de ensaios mecânicos. A análise estatística foi feita pelos testes ANOVA e Post Hoc de Tukey (p = 0,05). A técnica autocondicionante obteve maiores valores em MPa, mostrando a não necessidade de condicionamento ácido para melhoria da resistência adesiva. Para a técnica com condicionamento ácido, com e sem clorexidina, os valores de resistência adesiva foram estatisticamente semelhantes nos três terços radiculares. Para a técnica autocondicionante, com e sem o uso da clorexidina, a região cervical exibiu os maiores valores de resistência adesiva. Em ambas as técnicas, convencional e autocondicionante, não houve diferença significativa nos valores imediatos de resistência adesiva ao uso da clorexidina (AU).
The aim of this research was to evaluate by the push up method the bonding strength of fiberglass pins cemented with dual resin cement associated to the Single Bond Universal adhesive system through different adhesive strategies. In 40 bovine incisors, a fiberglass pin (Whitepost DC nº3) was cemented with dual resin cement (RelyX ARC) and adhesive (Single Bond Universal). The teeth were divided in 4 groups (n = 10), according to the union strategy. In Group 1, no treatment of the dentin substrate was performed. Group 2 received conditioning with 37% phosphoric acid. Group 3 received 2% chlorhexidine and Group 4 received conditioning with 37% phosphoric acid and 2% chlorhexidine application. The groups were sliced (1.8 mm) in three portions (cervical, middle, and apical) and had their pins displaced by the universal machine of mechanical tests. Statistical analysis was performed by ANOVA and Tukey's Post Hoc tests (p = 0.05). The self-etching technique obtained higher values in MPa, showing no need of acid conditioning to improve the adhesive strength. For the acid-conditioning technique with and without chlorhexidine, adhesive strength values were statistically similar in the three-thirds root. For the self-etching technique with and without the use of chlorhexidine, the cervical region exhibited the highest values of adhesive strength. In both techniques, conventional and self-etching, there was no significant difference in the immediate values of adhesive resistance to the use of chlorhexidine (AU).
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Animais , Bovinos , Tratamento do Canal Radicular/métodos , Resistência à Tração , Teste de Materiais/métodos , Adesivos Dentinários , Pinos Dentários , Brasil , Análise de Variância , Estatísticas não Paramétricas , IncisivoRESUMO
O objetivo deste estudo foi avaliar através de um ensaio clínico randomizado, a eficácia e segurança do laser cirúrgico de diodo durante as incisões circunvestibulares para osteotomia Le Fort I. Os pacientes foram divididos aleatoriamente em 3 grupos: incisão feita com bisturi, com eletrocautério ou a laser cirúrgico de diodo com comprimento de onda de 808nm. Os parâmetros clínicos utilizados para avaliar a eficácia e segurança dos diferentes métodos de incisão foram: velocidade de incisão, tempo cirúrgico total, sangramento transoperatório, alterações funcionais de fala e alimentação, dor e edema pós-operatório, tempo de cicatrização das feridas e taxas de infecção. Foram incluídos 30 pacientes no estudo, 10 em cada grupo. O laser cirúrgico de diodo foi eficaz durante o corte, porém levou maior tempo para a realização das incisões quando comparado às técnicas convencionais (p=0,00). Em contrapartida, não foi encontrada diferença estatisticamente significativa entre os grupos em relação ao tempo cirúrgico total (p=0,88). Em relação ao sangramento, as incisões realizadas com o laser cirúrgico promoveram menor sangramento quando comparadas ao bisturi e eletrocautério (p=0,00). Não foram encontradas associações estatisticamente significativas entre os grupos em relação aos outros parâmetros clínicos estudados. Conclui-se que o laser cirúrgico de diodo provou ser eficaz e seguro durante as incisões circunvestibulares para osteotomia Le Fort I.(AU)
The aim of this study was to evaluate through a randomized clinical trial the efficacy and safety of diode laser during the circumvestibular incision for the Le Fort I osteotomy. Patients were randomly allocated in one of three groups based on the technique employed to perform incisions: scalpel, electrocautery or 808nm high-power diode laser. Clinical parameters were used to evaluate the efficacy and safety of the diode laser: incision velocity, duration of the surgery, bleeding, postoperative functions alterations (eating and speech), pain, oedema, wound clinical healing and secondary infection. Thirty patients were enrolled in the study, 10 in each group. The diode surgical laser was effective during cut, but was slower to perform the incisions when compared to conventional techniques (p<0.05). However, no statistically difference was found between the groups in relation to the total surgical time (p>0.05). Regarding bleeding, the incisions performed with diode laser promoted lower bleeding rate in comparison to the scalpel and electrocautery (p=0.00). No statistically significant associations were found between the groups in relation to other clinical parameters studied. In conclusion, the diode laser is effective and safe during the circumvestibular incision for Le Fort I osteotomy.(AU)
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Humanos , Masculino , Feminino , Adolescente , Adulto , Deformidades Dentofaciais , Terapia a Laser , Lasers Semicondutores , Cirurgia Ortognática , Osteotomia de Le Fort , Ensaio Clínico , Ortodontia , Ferida CirúrgicaRESUMO
Objetivo: Avaliar a função visual dos pacientes com implante bilateral da LIO multifocal difrativa AT-Lisa 809 MTM por meio dos exames de acuidade visual com e sem correção óptica, curva de sensibilidade ao contraste, curva de desfoco e questionário de qualidade de função visual (VQF39). Métodos: Estudo clínico, prospectivo e de intervenção, que avaliou os resultados de 20 olhos de 10 pacientes, submetidos à facoemulsificação e implante de LIO, entre fevereiro e junho de 2012. Resultados: A ametropia residual média pós-operatória foi de 0,05 ± 0,42 (-0,75 a +1,25 D) dioptrias esféricas e -0,30 ± 0,42 (0 a -1,25 D) dioptrias cilíndricas. Na curva de desenfoque mono e binocular, a melhor acuidade visual média obtida com 0.00 D de desenfoque (AV de longe). O segundo pico foi obtido com desenfoque de -3,00 D, o que equivale à visão de perto a 33 cm. Entre esses picos, observamos uma perda de desempenho visual, com desenfoque de -2,00 D, que equivale a visão intermediária a 50 cm. A sensibilidade ao contraste foi similar aos relatados na literatura com este tipo de LIO, tanto com quanto sem ofuscamento, e é mostrada em gráficos. O questionário de função visual (VFQ-39) teve valor médio de 91,91 +- 6,82. Conclusão: A LIO multifocal difrativa AT-Lisa 809MTM (Carl Zeiss Meditec Company - Alemanha) apresentou resultados condizentes com a literatura quando avaliada pelos exames de acuidade visual com e sem correção óptica, sensibilidade ao contraste, curva de desfoco e questionário de qualidade de função visual (VQF 39). .
Purpose: To evaluate the visual function of patients with bilateral implantation of multifocal diffractive IOL AT Lisa 809MTM by visual acuity with and without correction, contrast sensitivity curve, defocus curve and visual function questionnaire (39 VQF). Methods: Interventional clinical prospective study, which evaluated the results of 20 eyes of 10 patients who underwent phacoemulsification and IOL implantation between february and june 2012. Results: The average of residual postoperative ametropia was 0.05 ± 0.42 (-0.75 to +1.25 D) spherical diopters and -0.30 ± 0.42 (0 to -1.25 D) cylindrical diopters. In the mono and binocular defocus curve, the best visual acuity was obtained with 0.00 D of defocus (far VA). The second peak was obtained with -3.00 D (near vision at 33 cm) and among these peaks, it was observed a loss of visual performance with -2.00 D, which corresponds to intermediate vision at 50 cm. Contrast sensitivity was similar to those reported in the literature with this type of IOL, both with and without glare, and is shown in the figures. The visual function questionnaire (VFQ-39) had a mean value of 91.91 + - 6.82. Conclusion: The diffractive multifocal IOL-AT LISA 809M presented results consistent with the literature as measured by tests of visual acuity with and without optical correction, contrast sensitivity curve, defocus curve and visual function questionnaire (39 VQF). .
Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Implante de Lente Intraocular/métodos , Lentes Intraoculares Multifocais , Testes Visuais , Catarata , Atividades Cotidianas , Sensibilidades de Contraste/fisiologia , Visão Binocular , Visão Monocular , Acuidade Visual/fisiologia , Estudos Prospectivos , Inquéritos e Questionários , Biometria , Resultado do Tratamento , Satisfação do Paciente , Facoemulsificação/métodos , ÓculosRESUMO
PURPOSE: To identify the frequency and causes of uveitis leading to visual impairment in patients referred to the Low Vision Service - Department of Ophthalmology - UNIFESP, over a twenty years period. METHODS: In a retrospective study, medical records of 5,461 patients were reviewed. Data from the first clinical evaluation at the Low Vision Service were collected, patient's age, gender and cause of visual impairment were analyzed. Patients with uveitis had their chart reviewed for anatomical classification and clinical diagnosis. RESULTS: The mean age of the patients referred to the Low Vision Service was 42.86 years and the mean age of patients with uveitis diagnosis was 25.51 years. Retinal disorders were the most common cause of visual impairment (N=2,835 patients; 51.9%) followed by uveitis (862 patients, 15.7%). Uveitis was posterior in 792 patients (91.9% of uveitis) and toxoplasmosis was the most common diagnosis (765 patients, 88.7%). CONCLUSIONS: In our study, uveitis represents the second cause of visual impairment in patients referred for visual rehabilitation and toxoplasmic retinochoroiditis was the most common clinical diagnosis. It affects a young working age population with a relevant social and economic impact, but the early diagnosis and treatment can improve the quality of life of these patients.
OBJETIVO: Identificar a frequência e as causas de uveítes que resultam em deficiência visual, em pacientes encaminhados ao Serviço de Visão Sub-Normal do Departamento de Oftalmologia - UNIFESP, durante um período de 20 anos. MÉTODOS: Em um estudo retrospectivo foram revisados 5.461 prontuários. Foram coletados os dados da primeira avaliação clínica realizada no Setor de Visão Sub-Normal, que inclui idade do paciente, sexo e a causa da deficiência visual. Os registros clínicos dos pacientes com diagnóstico de uveíte foram revisados para classificação anatômica e diagnóstico. RESULTADOS: A média de idade dos pacientes encaminhados para o Setor de Visão Sub-Normal foi de 42.86 anos e a média de idade dos pacientes com diagnóstico de uveíte foi de 25.51 anos. As doenças retinianas foram as causas mais comuns de deficiência visual (N=2.835 pacientes; 51.9%), seguida por uveítes (N=862 pacientes, 15.7%). Foi observado uveíte posterior em 792 pacientes (91.9% dos casos de uveíte) e, dentre estes, toxoplasmose foi o diagnóstico mais comum (765 pacientes, 88.7%). CONCLUSÕES: Em nosso estudo, uveíte representa a segunda causa de deficiência visual nos pacientes encaminhados para reabilitação visual e retinocoroidite por toxoplasmose foi o diagnóstico clínico mais comum. Uveíte afeta uma população jovem e em idade laboral, portanto com relevante impacto social e econômico, mas o diagnóstico e tratamento precoce podem melhorar a qualidade de vida destes pacientes.
Assuntos
Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Uveíte/epidemiologia , Transtornos da Visão/epidemiologia , Fatores Etários , Análise de Variância , Brasil/epidemiologia , Hospitais Universitários , Prevalência , Estudos Retrospectivos , Distribuição por Sexo , Uveíte/complicações , Acuidade Visual , Transtornos da Visão/etiologiaRESUMO
O diário reflexivo foi adotado na Residência Multiprofissional em Saúde da Família da Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz (Ensp/Fiocruz), Rio de Janeiro, Brasil. Durante dois anos acompanhamos uma equipe multiprofissional de três residentes em um módulo da Estratégia de Saúde da Família (ESF), buscando compreender as origens do instrumento no diário de campo da antropologia e no portfólio reflexivo da educação. O instrumento mostrou-se eficaz, possibilitando acompanhar as atividades práticas e a atuação das equipes e fornecendo subsídios para avaliação dos estudantes como recurso para a reformulação da prática; também propicia o desenvolvimento dos princípios éticos e da relação para com os indivíduos e comunidade. No momento em que os alunos se viram diante do desafio de enfrentar a realidade, o dia a dia da comunidade, ficou clara a importância do Diário.
Reflective diaries were brought into use for Multiprofessional Residence in Family Health at the National School of Public Health, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil. Over a two-year period, we monitored a multiprofessional team of three residents at a Family Health Strategy module, seeking to understand the origins of this tool in anthropological field diaries and in reflective portfolios within education. The tool was shown to be effective tool and made it possible to monitor the practical activities and operations of teams. It provided support for assessing the students as a resource for reformulation of practice, and for developing ethical principles and relationships with individuals and the community. At the time when the students were faced with the challenge of dealing with reality, i.e. the daily life of the community, the importance of the diary became clear.
Presentamos el diario reflexivo adoptado en la Residencia Multi-profesional en Salud de la Familia de la Escuela Nacional de Salud Pública, Fundación Oswaldo Cruz, Rio de Janeiro, Brasil. Durante dos años seguimos un equipo multi-profesional de tres residentes en un módulo de la Estrategia de Salud de la Familia (ESF), buscando comprender sus orígenes en el diario de campo de la antropología y en el portafolio reflexivo de la educación. La herramienta se mostró eficaz en lo seguimiento de las actividades prácticas y la forma de actuar de los equipos. Provee subsidios para la evaluación de los estudiantes como recurso para la re-formulación de la práctica y de la relación para con los individuos y la comunidad. En el momento en que los alumnos se vieron ante el desafío de afrontar la realidad, el día a día de la comunidad, se quedó clara la importancia del diario.
RESUMO
PURPOSE: To identify the frequency and causes of uveitis leading to visual impairment in patients referred to the Low Vision Service - Department of Ophthalmology - UNIFESP, over a twenty years period. METHODS: In a retrospective study, medical records of 5,461 patients were reviewed. Data from the first clinical evaluation at the Low Vision Service were collected, patient's age, gender and cause of visual impairment were analyzed. Patients with uveitis had their chart reviewed for anatomical classification and clinical diagnosis. RESULTS: The mean age of the patients referred to the Low Vision Service was 42.86 years and the mean age of patients with uveitis diagnosis was 25.51 years. Retinal disorders were the most common cause of visual impairment (N=2,835 patients; 51.9%) followed by uveitis (862 patients, 15.7%). Uveitis was posterior in 792 patients (91.9% of uveitis) and toxoplasmosis was the most common diagnosis (765 patients, 88.7%). CONCLUSIONS: In our study, uveitis represents the second cause of visual impairment in patients referred for visual rehabilitation and toxoplasmic retinochoroiditis was the most common clinical diagnosis. It affects a young working age population with a relevant social and economic impact, but the early diagnosis and treatment can improve the quality of life of these patients.