Comparative treatment with hyperbaric oxygen therapy in a model of systemic loxoscelism in rats.

Objectives: Spiders of the Loxosceles genus, known as violin spiders, produce venom with dermonecrotic and systemic effects, as it is a species widely distributed in the world, its study represents a high medical relevance. Systemic loxoscelism, which occurs in 1 in 5 cases and is the most frequent in children, can be fatal, so the study of effective therapy is of great relevance. In the present study, we compared different therapeutic options to mitigate the systemic effects of Loxosceles boneti venom in a model in which prepubertal rats were used. Materials and Methods: A model of systemic intoxication by L. boneti venom was provoked in male Wistar rats. Study groups were formed: healthy control, with venom and untreated control, treatment with N-acetylcysteine, and/or hyperbaric oxygenation therapy. Subsequently, pathological analysis of the kidney and lung was performed. The oxidant-antioxidant response was evaluated, and molecular analysis of the COX-1 and COX-2 enzymes was performed. Results: Regenerative changes were observed at the cellular level in both treatments, being more noticeable in the hyperbaric oxygen therapy (HBO) group. The anti-oxidant response was outstanding in the same group. Conclusion: Both treatments offer considerable benefits, however; further studies are needed to provide adequate therapeutics.

Ganglion cell layer thinning in diabetic patients without retinopathy: related or unrelated to total macular thickness?

PURPOSE: Reduction of ganglion cell layer thickness may occur in diabetic patients without retinopathy. The relationships of this preclinical finding with retinal thickness or reduced parafoveal vessel density have not been established. This study investigated the relationships of ganglion cell layer thickness with retinal thickness and parafoveal vessel density in patients with and without diabetes. METHODS: This was an observational, cross-sectional, prospective study that used optical coherence tomography angiography to compare non-diabetic patients (group 1) with diabetic patients without retinopathy (group 2). Ganglion cell layer thickness, macular thickness, and parafoveal vessel density (central, inner, and complete) medians were compared between groups (Mann-Whitney U test), and their relationships were assessed in each group (Spearman Rho test). RESULTS: In total, 68 eyes were included in this study: 34 in group 1 and 34 in group 2. Ganglion cell layer thickness did not differ between groups in any sector. There were strong positive correlations between fields 2 (superior parafoveal), 3 (temporal parafoveal), and 4 (inferior parafoveal) of the optical coherence tomography macular thickness map and the ganglion cell layer thickness in all sectors in both groups. Central vessel density mean was lower in diabetic patients. In group 1 alone, thickness changes in the inferior and nasal inferior ganglion cell layer sectors were partially explained by inner vessel density (r2=0.32 and r2=0.27). CONCLUSIONS: Mean ganglion cell layer thickness was not lower in diabetic patients without retinopathy than in non-diabetic patients. Moreover, it exhibited a substantial correlation with total macular thickness. Parafoveal vessel density decreased before ganglion cell layer thinning was observed.

Anxiety, depression, and stress in response to the coronavirus disease-19 pandemic.

OBJECTIVE: The objective of the study was to determine the state of anxiety, depression, and stress present in the society during the development of the 2019 coronavirus pandemic. METHODS: Mixed methods study; a three-section questionnaire was developed which included sociodemographic, perceptions, emotions, and behaviors related to the 2019 coronavirus pandemic, and two emotional assessment psychometric tests. The proportions and confidence intervals of the variables were calculated and compared using the Chi-square test. RESULTS: More than 40% of the subjects presented some degree of anxiety and 41.3% depression; the proportion of stress was < 30%. Of the subjects who experienced anxiety, 18.6% also had moderate-to-very severe depression or stress. CONCLUSION: There are emotional indicators derived from the 2019 coronavirus pandemic in almost half of the study population. The identification and timely treatment of these states could lessen the psychological impact due to 2019 coronavirus.

OBJETIVO: Determinar el estado de ansiedad, depresión y estrés en la sociedad durante el desarrollo de la pandemia de COVID-19. MÉTODO: Estudio de métodos mixtos. Se desarrolló un cuestionario de tres secciones que incluía aspectos sociodemográficos, percepciones, emociones y comportamientos relacionados con la pandemia de COVID-19, y dos pruebas psicométricas de evaluación emocional. Las proporciones y los intervalos de confianza de las variables se calcularon y compararon mediante la prueba de ji al cuadrado. RESULTADOS: Más del 40% de los sujetos presentaron algún grado de ansiedad y el 41,3% de depresión; la proporción de estrés fue inferior al 30%. De los sujetos que experimentaron ansiedad, el 18.6% también tenía depresión o estrés moderado a muy intenso. CONCLUSIÓN: Existen indicadores emocionales derivados de la pandemia de COVID-19 en casi la mitad de la población del estudio. La identificación y el tratamiento oportuno de estos estados podrían disminuir el impacto psicológico debido al COVID-19.

Low recurrence of diabetic macular edema, 6 months after focal photocoagulation.

OBJECTIVE: To identify the proportion of eyes with recurrence of diabetic macular edema, six months after focal photocoagulation. METHOD: Non-experimental, analytical, cross-sectional and prospective study in patients with diabetic macular edema treated with focal photocoagulation. The proportion and 95% confidence intervals (95% CI) of eyes with recurrence of edema were identified; the distribution of anatomical variables and visual acuity was compared between eyes with and without recurrence, using Mann-Whitney's U. RESULTS: 145 eyes were evaluated, and only 10 (95%CI: 2.8-11) had a recurrence. Center point thickness and center field thickness means were higher in eyes with recurrence than in eyes without it, but the difference of change mean betwwen groups was not statistically significant. CONCLUSION: The proportion of recurrent diabetic macular edema recurrence six months after successful focal photocoagulation was lower than the one reported for other treatments of diabetic macular edema, and by recent studies that used photocoagulation.

OBJETIVO: Identificar la proporción de ojos que presentan recurrencia del edema macular diabético a los 6 meses de la fotocoagulación focal. MÉTODO: Estudio observacional, analítico, transversal y prospectivo, en pacientes con edema macular diabético tratados con fotocoagulación focal. Se identificaron la proporción y los intervalos de confianza del 95% (IC 95%) en los ojos que presentaron recurrencia, y se compararon las medianas de las variables anatómicas y la agudeza visual mediante U de Mann-Whitney. RESULTADOS: Se evaluaron 145 ojos y solo 10 (IC 95%: 2.8-11) presentaron recurrencia del edema macular diabético. Los promedios de grosor del punto central y del campo central fueron mayores en los ojos con recurrencia, pero la diferencia de promedio de cambio entre grupos no fue significativa. CONCLUSIÓN: La proporción de recurrencia del edema macular 6 meses después de la fotocoagulación focal es menor que la reportada para otros tratamientos de esta enfermedad y menor también que en otros estudios en los que se utilizó fotocoagulación.

[Sensibilidad foveal en ojos con edema macular diabético con y sin engrosamiento temporal perifoveal]. / Foveal sensitivity in eyes with diabetic macular edema with and without temporal perifoveal thickening.

BACKGROUND: Visual improvement after photocoagulation in focal diabetic macular edema is more frequent when temporal perifoveal area is not affected; functional status before treatment could be worse in eyes with perifoveal temporal thickening. The correlation between visual acuity and foveal sensitivity (usually significant), would allow to compare macular function. OBJECTIVE: To compare the correlation between retinal sensitivity and visual acuity in eyes with diabetic macular edema, with and without temporal perifoveal thickening. METHOD: Non-experimental, retrospective, comparative, cross-sectional study in type 2 diabetics with macular edema. The correlation between foveal sensitivity and visual acuity was compared in eyes without temporal perifoveal thickening (group 1) and eyes with it (group 2). Multiple regression analysis was used to identify the contribution of foveal sensitivity to the changes of visual acuity; other variables were: center point thickness, center field thickness, temporal perifoveal thickness and macular volume. RESULTS: 60 eyes in group 1, 29 eyes in group 2. Mean sensitivity did no differ between groups (30.0 ± 0.59 vs. 28.4 ± 1.05 dB; p = 0.2), but the correlation between sensitivity and visual acuity did it (group 1, rho: -0.41; group 2, rho: -0.25). In group 1, foveal sensitivity was the only explaining variable of the regression model (beta: -0.52), in group 2 no one explaining variable was included and temporal perifoveal thickness had a negative correlation with foveal sensitivity (rho: -0.60). CONCLUSIONS: Temporal perifoveal thickening reduces the correlation between foveal sensitivity and visual acuity in eyes with diabetic macular edema.

OBJETIVO: Comparar la correlación entre la sensibilidad foveal y la agudeza visual en ojos con edema macular diabético, con y sin engrosamiento temporal perifoveal, característica asociada con mala respuesta terapéutica. MÉTODO: Estudio observacional, prospectivo, comparativo, transversal, en diabéticos con edema macular. Se comparó la correlación entre la sensibilidad foveal y la agudeza visual entre ojos sin (grupo 1) y con (grupo 2) engrosamiento temporal perifoveal (Rho de Spearman). Mediante regresión múltiple se determinó la contribución de la sensibilidad a los cambios de agudeza visual. Se evaluaron también los grosores del punto central y temporal perifoveal, y el volumen macular. RESULTADOS: 60 ojos del grupo 1, 29 ojos del grupo 2. El promedio de sensibilidad no difirió entre grupos (30.0 ± 0.59 vs. 28.4 ± 1.05 dB; p = 0.2), pero la correlación entre sensibilidad y agudeza visual sí (grupo 1, rho: −0.41; grupo 2, rho: −0.25). En el grupo 1, la sensibilidad fue la variable explicativa de la agudeza visual (beta: −0.52); en el grupo 2, ninguna variable se incluyó en el modelo y el grosor temporal perifoveal correlacionó inversamente con la sensibilidad (rho: −0.60). CONCLUSIONES: el engrosamiento temporal perifoveal reduce la correlación entre la agudeza visual y la sensibilidad foveal en ojos con edema macular diabético.

Circularity of the foveal avascular zone and its correlation with parafoveal vessel density, in subjects with and without diabetes.

PURPOSE: To characterize the distribution of the foveal avascular zone circularity and its correlation with parafoveal vessel density, in subjects with and without diabetes. METHODS: Observational, descriptive, cross-sectional, and prospective study; subjects without diabetes (Group 1), with diabetes without retinopathy (Group 2), or with diabetic retinopathy (Group 3) were included. Means of foveal avascular zone circularity and parafoveal vessel density were compared between groups (Kruskal-Wallis) and their correlation was calculated with Spearman's Rho test. RESULTS: Seventy-seven eyes; central vessel density mean was higher in Group 1 than in Group 2 and higher in Group 2 than in Group 3; inner and complete vessel density means were also higher in Group 2 than in Group 3. The mean of the foveal avascular zone circularity did not differ between groups, and in Group 3 it had a positive correlation with central (0.45), inner (0.56), and complete (0.53) vessel densities. CONCLUSIONS: Circularity does not differ between subjects with diabetes, with and without retinopathy, and has only a low correlation with parafoveal vessel density in people with diabetic retinopathy, which does not allow anticipating a reduction of vessel density in this disease.

OBJETIVO: Caracterizar la distribución de la circularidad de la zona avascular foveal y su correlación con la densidad vascular perifoveal, en sujetos con y sin diabetes. MÉTODO: Estudio observacional, descriptivo, transversal y prospectivo; se incluyeron sujetos sin diabetes (Grupo 1), con diabetes sin retinopatía (Grupo 2) y con retinopatía diabética (Grupo 3). Los promedios de circularidad de la zona avascular foveal y de la densidad vascular parafoveal se compararon entre grupos (Kruskal-Wallis), y se calculó su correlación mediante la prueba Rho de Spearman. RESULTADOS: Se estudiaron 77 ojos. El promedio de la densidad vascular central fue mayor en el Grupo 1 que en el Grupo 2, y mayor en el Grupo 2 que en el Grupo 3. Los promedios de la densidad vascular interna y completa también fueron mayores en el Grupo 2 que en el Grupo 3. El promedio de la circularidad de la zona avascular foveal no difirió entre grupos, y en el Grupo 3 tuvo una correlación positiva con la densidad vascular central (0.45), interna (0.56) y completa (0.53). CONCLUSIONES: La circularidad no difiere entre sujetos con y sin diabetes, con y sin retinopatía, y solo tiene una baja correlación con la densidad vascular parafoveal en sujetos con retinopatía diabética, lo cual no permite anticipar una reducción de la densidad vascular en esta enfermedad.

Reduction of foveal sensitivity in diabetic macular edema with visual acuity 20/20.

OBJECTIVE: To compare foveal sensitivity in eyes with and without diabetic macular edema, with 20/20 visual acuity. METHODS: Non-experimental, comparative, prospective, cross sectional study in eyes with and without retinopathy and focal macular edema, with 20/20 visual acuity. The sample was divided in 3 groups: (1) non-diabetic subjects, (2) diabetics without retinopathy, and 3) diabetics with non-proliferative retinopathy and clinically significant macular edema. Median foveal sensitivity was compared between groups (Kruskal Wallis test). RESULTS: 86 eyes (28 in group 1, 26 in group 2 and 32 in group (3). Medians shown a statistical difference between groups (p = 0.001). Median foveal sensitivity was significantly lower in group 3 than in group 1 (p = 0.001) and than in group 2 (p = 0.03). Median foveal sensitivity did not differ between groups 1 and 2 (p = 0.10). CONCLUSION: Foveal sensitivity in diabetic macular edema and visual acuity 20/20 is lower in eyes with center sparing clinically significant macular edema and 20/20 visual acuity. The prognostic value of this dysfunction requires evaluation, in order to learn whether early treatment is required in these eyes.

OBJETIVO: Comparar la sensibilidad foveal en ojos con y sin edema macular diabético, con agudeza visual 20/20. MÉTODO: Estudio observacional, comparativo, transversal y prospectivo, en ojos con y sin retinopatía y edema macular focal, con agudeza visual 20/20. La muestra se dividió en tres grupos: 1) sujetos sin diabetes, 2) diabéticos sin retinopatía, y 3) diabéticos con retinopatía diabética no proliferativa y edema macular focal. Se compararon las medianas de la sensibilidad foveal entre grupos mediante la prueba de Kruskal-Wallis. RESULTADOS: Se evaluaron 86 ojos (28 del grupo 1, 26 del 2 y 32 del 3). La comparación de medianas mostró una diferencia significativa entre grupos (p = 0.001). La sensibilidad foveal fue significativamente menor en el grupo 3 que en el grupo 1 (p = 0.001) y que en el grupo 2 (p = 0.03). La mediana de la sensibilidad foveal no difirió entre los grupos 1 y 2 (p = 0.10). CONCLUSIÓN: La sensibilidad foveal en el edema macular diabético con agudeza visual 20/20 es menor en ojos con edema macular clínicamente significativo sin engrosamiento del centro de la mácula y agudeza visual 20/20. Determinar el valor pronóstico de esta disfunción requiere una evaluación adicional para identificar si se necesita tratamiento temprano en estos ojos.

Ganglion cell layer thinning in diabetic patients without retinopathy: related or unrelated to total macular thickness? / Afinamento da camada de células ganglionares em pacientes diabéticos sem retinopatia: relacionados ou não à espessura macular total?

ABSTRACT Purpose: Reduction of ganglion cell layer thickness may occur in diabetic patients without retinopathy. The relationships of this preclinical finding with retinal thickness or reduced parafoveal vessel density have not been established. This study investigated the relationships of ganglion cell layer thickness with retinal thickness and parafoveal vessel density in patients with and without diabetes. Methods: This was an observational, cross-sectional, prospective study that used optical coherence tomography angiography to compare non-diabetic patients (group 1) with diabetic patients without retinopathy (group 2). Ganglion cell layer thickness, macular thickness, and parafoveal vessel density (central, inner, and complete) medians were compared between groups (Mann-Whitney U test), and their relationships were assessed in each group (Spearman Rho test). Results: In total, 68 eyes were included in this study: 34 in group 1 and 34 in group 2. Ganglion cell layer thickness did not differ between groups in any sector. There were strong positive correlations between fields 2 (superior parafoveal), 3 (temporal parafoveal), and 4 (inferior parafoveal) of the optical coherence tomography macular thickness map and the ganglion cell layer thickness in all sectors in both groups. Central vessel density mean was lower in diabetic patients. In group 1 alone, thickness changes in the inferior and nasal inferior ganglion cell layer sectors were partially explained by inner vessel density (r2=0.32 and r2=0.27). Conclusions: Mean ganglion cell layer thickness was not lower in diabetic patients without retinopathy than in non-diabetic patients. Moreover, it exhibited a substantial correlation with total macular thickness. Parafoveal vessel density decreased before ganglion cell layer thinning was observed.

RESUMO Objetivo: Pode ocorrer redução da espessura da camada de células ganglionares em pacientes diabéticos sem retinopatia. As relações desse achado pré-clínico com a espessura da retina ou a densidade reduzida de vasos parafoveais não foram estabelecidas. Este estudo investigou as relações da espessura da camada de células ganglionares com a espessura da retina e densidade dos vasos parafoveais em pacientes com e sem diabetes. Métodos: Estudo prospectivo, observacional, transversal que utilizou angiotomografia de coerência óptica para comparar pacientes não diabéticos (grupo 1) com pacientes diabéticos sem retinopatia (grupo 2). As médias da espessura da camada de células ganglionares, espessura macular e densidade dos vasos parafoveais (central, interno e completo) foram comparadas entre os grupos (teste U de Mann-Whitney) e suas relações foram avaliadas em cada grupo (Teste de Spearman Rho). Resultados: No total, 68 olhos foram incluídos neste estudo: 34 no grupo 1 e 34 no grupo 2. A espessura da camada de células ganglionares não diferiu entre os grupos em nenhum setor. Houve fortes correlações positivas entre os campos 2 (parafoveal superior), 3 (parafoveal temporal) e 4 (parafoveal inferior) do mapa da espessura macular da tomografia de coerência óptica e a espessura da camada de células ganglionares em todos os setores dos dois grupos. A média da densidade central dos vasos foi menor nos pacientes diabéticos. Somente no grupo 1, as alterações de espessura da camada de células ganglionares nos setores inferior e nasal inferior foram parcialmente explicadas pela densidade do vaso interno (r2=0,32 e r2=0,27). Conclusões: A média da espessura da camada de células ganglionares não foi menor em pacientes diabéticos sem retinopatia do que em pacientes não diabéticos. Além disso, exibiu uma correlação substancial com a espessura macular total. A densidade dos vasos parafoveais diminui antes do desbaste da camada de células ganglionares.