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One of the major toxic effects of exposure to ammonia is the resulting pulmonary acute and chronic effects. This study investigated the acute pulmonary effects of exposure to ammonia lower than the recommended threshold limit value (TLV). This cross-sectional study was conducted in 2021 in four chemical fertilizer production industries using ammonia as the main raw material. A total of 116 workers who were exposed to ammonia were investigated. The level of exposure to ammonia was measured by NMAM 6016, and the evaluation of pulmonary symptoms and function parameters was done using the American Thoracic Society and European Respiratory Society protocols in four sessions. The paired-sample t-test, repeated measures test, Chi-square, and Fisher's exact test were run to analyze the collected data. The prevalence rates of pulmonary symptoms, including cough, dyspnea, phlegm, and wheezing, were 24.14, 17.24, 14.66, and 16.38%, respectively, after one exposure shift. It was observed that all pulmonary function parameters were reduced after one exposure shift to ammonia. The results revealed that the parameters of vital capacity, forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), the FEV1/FVC ratio, and peak expiratory flow significantly decreased (p < 0.05) across four exposure shifts. The findings indicated that exposure to ammonia at concentrations lower than one-fifth of TLV could bring about acute pulmonary effects and reduce pulmonary function parameters, similar to the pattern observed in obstructive pulmonary diseases.
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Amônia , Exposição Ocupacional , Humanos , Amônia/toxicidade , Amônia/análise , Níveis Máximos Permitidos , Estudos Transversais , Pulmão/química , Tosse/epidemiologia , Tosse/etiologia , Volume Expiratório Forçado , Capacidade Vital , Exposição Ocupacional/efeitos adversosRESUMO
BACKGROUND: The current study was aimed at evaluating the role of the N-SH2 domain of SHP-2 as a partner protein in the expression of a toxic peptide, laterosporulin (LTS). We also investigated its effects on the formation of the disulfide bond and functional folding of the peptide in vitro. The N-SH2-LTS protein was expressed as a His-tagged fusion protein, capable of undergoing enzymatic cleavage. RESULTS: Based on the data presented herein, the total yield of the folded fusion protein from inclusion bodies was found to be about 105 mg/l, demonstrating a high-level of heterologous expression. After enzymatic cleavage, 1.5 mg of the folded recombinant laterosporulin was obtained from each 10 mg of the fusion protein. The purity of the recombinant laterosporulin was analyzed by RP-HPLC, to yield peptides with suitable purity (85%). CONCLUSIONS: Our findings indicated the advantages of using the N-SH2 domain of SHP-2 as a rapid and easy approach not only in producing easy target proteins but also in its function as a chaperone. N-SH2 domain of SHP-2 can influence on the purification of laterosporulin at reasonable yield and in a cost-effective fashion. The N-SH2 domain of SHP-2 as a protein chaperone may be potentially favorable to produce other proteins with disulfide bonds.
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Bacteriocinas , Domínios de Homologia de src , Proteína Tirosina Fosfatase não Receptora Tipo 6 , Proteínas Tirosina Fosfatases Contendo o Domínio SH2RESUMO
Heat stress causes physiological changes, and changes in hematological parameters and hormonal levels in the human body, known as thermal strain. This study was conducted to determine the effect of exposure to heat stress on hematological parameters and oxidative stress in the bakers of Shahroud City, Iran. A total of 163 bakery workers (exposed group) and 135 office workers (unexposed group) with a minimum of 1-year working experience were selected. Exposure to heat stress was measured using ISO-7243 criteria on the hottest days of the year (late July and August). Wet-bulb globe temperature (WBGT) was calculated based on indoor environments. Oxidative stress indices including malondialdehyde (MDA), nitric oxide (NO), total antioxidant capacity (TAC) in the bakers' and office workers' serum and hematological parameters were measured. Statistical analysis was done through independent t-test, and multivariate linear regression using SPSS v24. Analysis of hematological parameters showed that about 70% and 68% of the bakers had abnormal mean cell volume (MCV) and white blood cell (WBC) count, respectively, while only around 12% of them had abnormal mean cell hemoglobin concentration (MCHC). The counts of red blood cells (RBC), WBC, lymphocytes (LYM), and MCV showed significant differences in different occupational groups (p < 0.05). The levels of MDA and NO were significantly higher in bakers with WBGT more than the threshold value (p < 0.05). The WBGT index for assessing heat stress can be used as a predictor variable for MDA and NO levels. In addition, heat stress exposure could be a risk factor for abnormal WBC, RBC, LYM, and MCV.
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Culinária/estatística & dados numéricos , Transtornos de Estresse por Calor/sangue , Temperatura Alta/efeitos adversos , Doenças Profissionais/sangue , Estresse Oxidativo/fisiologia , Adulto , Testes Hematológicos , Humanos , Irã (Geográfico)/epidemiologia , Pessoa de Meia-Idade , Exposição Ocupacional , Fatores SocioeconômicosRESUMO
OBJECTIVE: To compare peripapillary vessel density using optical coherence tomography angiography (OCT-A) in eyes of healthy people, primary open-angle glaucoma (POAG), and normal-tension glaucoma (NTG). METHODS: Thirty patients with POAG, 27 patients with NTG, and 29 healthy individuals in the control group were assessed. Capillary vessels in peripapillary retinal nerve fiber layer (RNFL) represented by whole image RPC (radial peripapillary capillary) density in an AngioDisc scan 4.5 × 4.5 mm centered on the optic disc, and ONH morphological variables (disc area, rim area, cup to disc area ratio (CDR)), and average peripapillary RNFL thickness were measured. RESULTS: Differences in mean RPC, RNFL, disc area, rim area, and CDR between the groups were statistically significant (P < 0.05). The difference in RNFL thickness and rim area was not significant between NTG and healthy groups, while RPC and CDR showed a statistically significant difference between all pairs. The vessel density in the POAG group was 8.25% and 11.7% lower compared to the NTG and healthy groups, respectively; while the mean difference was less (2.97%) for the NTG and healthy group. In the POAG group, 67.2% of the variation in RPC can be explained by a model containing CDR and RNFL thickness, and in normal eyes 38.8% of the changes using a model containing RNFL. CONCLUSION: The peripapillary vessel density is reduced in both types of glaucoma. The vessel density in NTG was significantly lower than in the healthy eyes, despite the lack of significant difference in RNFL thickness and neuroretinal rim area between them.
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Glaucoma de Ângulo Aberto , Glaucoma de Baixa Tensão , Disco Óptico , Humanos , Glaucoma de Ângulo Aberto/diagnóstico , Pressão Intraocular , Glaucoma de Baixa Tensão/diagnóstico , Disco Óptico/irrigação sanguínea , Retina , Tomografia de Coerência Óptica/métodos , Vasos RetinianosRESUMO
We examined the evolution of fenofibrate (FNB, drug) particle size distribution (PSD) during the production of nanosuspensions via wet stirred media milling (WSMM) with a cell-based population balance model (PBM). Our objective was to elucidate the potential impacts of batch size, suspension volumetric flow rate, and imperfect mixing in a recirculating WSMM. Various specific breakage rate functions were fitted to experimental PSD data at baseline conditions assuming perfect mixing. Then, the best function was used to simulate the PSD evolution at various batch sizes and flow rates to validate the model. A novel function, which is a product of power-law and logistic functions, fitted the evolution the best, signifying the existence of a transition particle size commensurate with a grinding limit. Although larger batches yielded coarser and wider PSDs, the suspensions had identical PSDs when milled for the same effective milling time. The flow rate had an insignificant influence on the PSD. Furthermore, the imperfect mixing in the mill chamber was simulated by considering more than one cell and different back-mixing flow ratios. The effects were weak and restricted to the first few turnovers. These insights contribute to our understanding of recirculating WSMM, providing valuable guidance for process development.
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Intraperitoneal (IP) chemotherapy is a promising treatment approach for patients diagnosed with peritoneal carcinomatosis, allowing the direct delivery of therapeutic agents to the tumor site within the abdominal cavity. Nevertheless, limited drug penetration into the tumor remains a primary drawback of this method. The process of delivering drugs to the tumor entails numerous complications, primarily stemming from the specific pathophysiology of the tumor. Investigating drug delivery during IP chemotherapy and studying the parameters affecting it are challenging due to the limitations of experimental studies. In contrast, mathematical modeling, with its capabilities such as enabling single-parameter studies, and cost and time efficiency, emerges as a potent tool for this purpose. In this study, we developed a numerical model to investigate IP chemotherapy by incorporating an actual image of a tumor with heterogeneous vasculature. The tumor's geometry is reconstructed using image processing techniques. The model also incorporates drug binding and uptake by cancer cells. After 60 min of IP treatment with Doxorubicin, the area under the curve (AUC) of the average free drug concentration versus time curve, serving as an indicator of drug availability to the tumor, reached 295.18 mol·m-3·s-1. Additionally, the half-width parameter W1/2, which reflects drug penetration into the tumor, ranged from 0.11 to 0.14 mm. Furthermore, the treatment resulted in a fraction of killed cells reaching 20.4% by the end of the procedure. Analyzing the spatial distribution of interstitial fluid velocity, pressure, and drug concentration in the tumor revealed that the heterogeneous distribution of tumor vasculature influences the drug delivery process. Our findings underscore the significance of considering the specific vascular network of a tumor when modeling intraperitoneal chemotherapy. The proposed methodology holds promise for application in patient-specific studies.
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Background: The aim of this study was to assess stress-strain index (SSI) and corneal biomechanical parameters in eyes with granular corneal dystrophy (GCD). Methods: This case-control study included 12 eyes of 12 patients with GCD (mean age 45.2 ± 18.7 years) and 20 eyes of 20 healthy individuals (mean age 54.4 ± 3.8 years). In addition to SSI, dynamic corneal response (DCR) parameters were assessed at the first and second applanation, including length (AL1, AL2), velocity (AV1, AV2), time (AT1, AT2), and deformation amplitude (DA A1, DA A2), and at the highest concavity (HC) phase, including DA, peak distance (PD), radius (HCR), and DA ratio (DAR 1 and 2 mm), by Corvis ST. Central corneal thickness (CCT) and biomechanically corrected intraocular pressure (bIOP) were considered covariates in comparing DCR parameters between the two groups. Results: SSI was statistically significantly lower in eyes with GCD than in normal eyes (p = 0.04). The corneal velocity towards the first applanation was 0.02 m/s faster in the GCD eyes AV1 (0.15 ± 0.02 vs. 0.13 ± 0.02 m/s, p < 0.001) and IR (7.48 ± 1.01 vs. 6.80 ± 1.22 mm, p = 0.003) parameters were significantly higher in the GDC group, while AT1 (7.33 ± 0.66 vs. 7.47 ± 0.36 ms, p = 0.002) and HCR (7.42 ± 0.76 vs. 8.20 ± 1.08 mm, p = 0.014) were significantly lower in the normal group. Conclusions: GCD led to a change in biomechanical properties of the cornea. SSI refers to fewer stiff corneas in GDC than normal.
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OBJECTIVES: Leishmaniasis is a neglected and widespread parasitic disease that can lead to serious health problems. The current review study aimed to synthesize the relationship between ecologic and environmental factors (e.g., weather conditions, climatology, temperature and topology) and the incidence of cutaneous leishmaniasis (CL) in the Old World. CONTENT: A systematic review was conducted based on English, and Persian articles published from 2015 to 2020 in PubMed/Medline, Science Direct, Web of Science and Google Scholar. Keywords used to search articles were leishmaniasis, environmental factors, weather condition, soil, temperature, land cover, ecologic* and topogr*. All articles were selected and assessed for eligibility according to the titles or abstracts. The quality screening process of articles was carried out by two independent authors. The selected articles were checked according to the inclusion and exclusion criteria. SUMMARY AND OUTLOOK: A total of 827 relevant records in 2015-2020 were searched and after evaluating the articles, 23 articles met the eligibility criteria; finally, 14 full-text articles were included in the systematic review. Two different categories of ecologic/environmental factors (weather conditions, temperature, rainfall/precipitation and humidity) and land characteristics (land cover, slope, elevation and altitude, earthquake and cattle sheds) were the most important factors associated with CL incidence. CONCLUSIONS: Temperature and rainfall play an important role in the seasonal cycle of CL as many CL cases occurred in arid and semiarid areas in the Old World. Moreover, given the findings of this study regarding the effect of weather conditions on CL, it can be concluded that designing an early warning system is necessary to predict the incidence of CL based on different weather conditions.
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Clima , Geografia , Leishmaniose Cutânea/epidemiologia , Tempo (Meteorologia) , África , Ásia , Australásia , Europa (Continente) , Incidência , Leishmaniose Cutânea/parasitologia , TemperaturaRESUMO
BACKGROUND: Outdoor workers are exposed to heat caused by atmospheric conditions and solar radiation. More specifically, those working in palm groves are more in danger of heat stresses since they harvest their crops in hot seasons. OBJECTIVE: This study was aimed at investigating heat stresses and strains in date harvesting workers in groves around Jiroft, Southeastern Iran. METHODS: This study was a descriptive-analytical one of cross-sectional type. In this study, three environmental indices including Wet Bulb Globe Temperature index (WBGT), Environmental Stress Index (ESI) and Discomfort Index (DI), the physiological strain index (PSI) as well as perceptual strain index (PeSI) were analyzed to investigate stresses and strains in workers. For this purpose, 59 date harvesting workers (36 men and 23 women) in palm groves in Jiroft were analyzed. With accordance to date harvesting season, data collection was carried out from August to September, 2017. RESULTS: In this research, the means of environmental indices including WBGT, ESI and DI were 32.77°C, 30.39°C and 33.22°C, respectively and they all revealed direct and significant correlation. Moreover, Time-Weighted Average for Wet Bulb Globe Temperature index (WBGT.TWA) was significantly different from Threshold Limit Values for Wet Bulb Globe Temperature index (WBGT.TLV). The scores of the PSI and PeSI were 2.28 and 6.61, respectively. CONCLUSION: The results of this study indicated that date picking workers were exposed to heat stress more than the reference value of WBGT recommended by American Conference of Governmental Industrial Hygienists (ACGIH). In addition, workers suffered a low degree of physiological strain and a moderate degree of perceptual strain caused by heat stress in palm groves in Jiroft.
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Transtornos de Estresse por Calor , Exposição Ocupacional , Estudos Transversais , Transtornos de Estresse por Calor/etiologia , Resposta ao Choque Térmico , Temperatura Alta , Humanos , Irã (Geográfico) , Masculino , Exposição Ocupacional/efeitos adversos , Exposição Ocupacional/análiseRESUMO
OBJECTIVE: This study aimed to investigate respiratory disorders associated with exposure to low concentrations of ammonia. METHOD: This cohort study was conducted on 122 industrial workers. Data gathering were based on the officially registered data, the NMAM 6016 and the American Thoracic Society and European Respiratory Society protocols. RESULTS: The prevalence rate of respiratory disorders significantly increased in the exposure group over 5 years (Pâ<â0.05). The frequencies of these symptoms in the exposure group were significantly higher than non-exposure group (Pâ<â0.05). Respiratory functions were decrease significantly in the exposure group and were lower than non-exposure group (Pâ<â0.05). Exposure and the amount of exposure to ammonia had a significant relationship with respiratory disorders and respiratory functions (Pâ<â0.05). CONCLUSION: Exposure to ammonia lower than threshold limit value (TLV), can act as a risk factor of respiratory disorders.
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Amônia/efeitos adversos , Exposição Ocupacional , Doenças Respiratórias , Estudos de Coortes , Humanos , Exposição Ocupacional/efeitos adversos , Doenças Respiratórias/induzido quimicamente , Níveis Máximos PermitidosRESUMO
BACKGROUND: Various parameters can affect the performance of firefighters. Thermal stress in firefighters is one of the most important harmful factors, which causes impaired performance and subsequent occupational accidents. Therefore, this study aimed to evaluate the effect of personal protective equipment (PPE) on thermal stress in firefighters. MATERIALS AND METHODS: This descriptive-analytical cross-sectional study was performed on 30 firefighters. Heart rate, metabolism and temperature parameters were measured with and without using PPE in a simulated standard chamber. Then, the two indices of predicted mean vote (PMV) and predicted percentage dissatisfied (PPD) were calculated. Data analysis was performed using SPSS version 22.0. RESULTS: The results showed that PPE-induced weight directly increased heart rate and indirectly led to an increase in metabolism and temperature as well as significant changes in PMV and PPD indices (pâ<â0.001). In addition, our results showed that the effect of thermal resistance of clothing (Clo) on PMV and PPD indices was very high (pâ<â0.001). CONCLUSION: The findings of the study indicated that heat stress in firefighters is influenced by PPE weight and thermal resistance of clothing. Therefore, cooling vests can be used to reduce the thermal stress induced by temperature rise resulted from metabolism, PPE weight and thermal resistance of clothing. Reduced thermal stress will lead to the cooling of body temperature to acceptable levels of PMV and PPD.
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Bombeiros , Transtornos de Estresse por Calor , Equipamento de Proteção Individual , Roupa de Proteção , Temperatura Corporal , Estudos Transversais , Metabolismo Energético , Frequência Cardíaca , Transtornos de Estresse por Calor/prevenção & controle , Temperatura Alta , HumanosRESUMO
OBJECTIVES: Stomach cancer (SC) is one of the most common and deadly types of cancer. It is the third leading cause of cancer deaths worldwide. The effect of environmental and ecological factors in SC have been assessed in some studies. Thus, we aimed to synthesize the environmental and ecological factors of SC incidence and mortality. CONTENT: In this systematic review study, the scientific databases, including Web of Science, Scopus and PubMed, were searched from inception to November 2019 for all primary articles written in English by using relevant Medical Subject Heading (Mesh) terms. Two independent authors conducted the screening process to decide on the eligibility and inclusion of the articles in the study. The third author acted as an arbiter to resolve any disagreements. SUMMARY AND OUTLOOK: A total of 157 potentially relevant articles were identified from the initial search 38 of which met the eligibility criteria; finally, 34 articles were included in the systematic review. The results revealed that soil arsenic exposure, coal and other opencast mining installations, living near incinerators and installations for the recovery or disposal of hazardous waste, installations for the production of cement, lime, plaster, and magnesium oxide, proximity to a metal industry sources, dietary iron, ingested asbestos, farming, arsenic in soil, altitude, organochlorines and environmental exposure to cadmium and lead have positive associations with SC incidence or death. Most of the ecological and environmental factors such as living near the mineral industries, the disposal of hazardous waste, metal industry sources and environmental exposure to cadmium and lead are positively related to SC mortality and incidence. However, solar UV-B, heat index and dietary zinc can be taken into account as protective factors against SC mortality and incidence.
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Exposição Ambiental/efeitos adversos , Poluentes Ambientais/efeitos adversos , Poluição Ambiental/efeitos adversos , Neoplasias Gástricas/epidemiologia , Humanos , Incidência , Neoplasias Gástricas/induzido quimicamente , Neoplasias Gástricas/mortalidadeRESUMO
Occupational exposure to hydrochloric acid in pickling of steel for remove rust or iron oxide scale from iron processing occurs at low concentration. This study aimed to investigate the respiratory symptoms and pulmonary dysfunction caused by exposure to low concentration of hydrochloric acid in acid washing unit in one of the steel industries. A case control study was carried out in the acid washing unit of the cold rolling of the steel industry in 2017. The exposed group included 45 male workers, and another 41 unexposed employees from official employees were enrolled as control group. A questionnaire was used to collect personal and occupational data and pulmonary function tests, including forced vital capacity (FVC), forced expiratory volume in the first second and peak expiratory flow rate followed guidelines given by the American Thoracic Society and measured with a portable calibrated vitalograph spirometer. For determination of acid concentration, 21 breathing zone air samples were collected in accordance with Method 7903 NIOSH. The findings showed that nose sensitivity, throat irritation and shortness of breath were the highest prevalence symptoms among exposed persons (30.4% to 32.6%). Also, the results showed that FVC and forced expiratory volume in the first second had highest and direct or positive correlation with height (0.965 and 0.927, respectively). Age and weight put in the next priorities (P < 0.01). On the other hand, based on the results of multivariate linear regression, exposing to the acid and job history are two main predictor factors for FVC. So that, the exposing to acid, by itself can reduce FVC as 4.386 units. This value is equal to 1.117 for the job history. Exposure to low concentrations of hydrochloric acid alone could increase the risk of respiratory tract damage and pulmonary function disorders. But the extent to which it can cause respiratory complications for occupational exposure is still unknown and requires further study. This study was approved by Ethical Committee of Qom University of Medical Sciences (approval No. IR.MUQ.REC.1397.118) on November 6, 2018.
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Volume Expiratório Forçado/efeitos dos fármacos , Ácido Clorídrico/toxicidade , Exposição Ocupacional , Capacidade Vital/efeitos dos fármacos , Adulto , Poluentes Ocupacionais do Ar/química , Poluentes Ocupacionais do Ar/toxicidade , Estudos de Casos e Controles , Tosse/etiologia , Dispneia/etiologia , Humanos , Indústrias , Modelos Lineares , Masculino , Testes de Função RespiratóriaRESUMO
This study describes optimization of headspace solid phase microextraction followed by gas chromatography equipped with a flame ionization detector for toluene at trace level in spiked urine. The parameters affecting the extraction and gas chromatographic determination of analytes were studied: extraction time and temperature; desorption time and temperature; addition of NaCl; and pH, volume and agitation of the sample. Optimized headspace extraction was carried out at 30 degrees C for 6 min in the presence of 0.2 g.m(-1)of NaCl in the sample solution. Also, sample volume and sample pH were optimized at 5 ml and 7 (neutral pH), respectively. Desorption of the analytes was carried out at 250 degrees C for 60 s. The optimized procedure was validated with 3 different pools of spiked urine; it showed good reproducibility over 6 consecutive days and 6 within-day experiments. The study also determined the accuracy, linearity and detection limits of this method.
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Cromatografia Gasosa/normas , Microextração em Fase Sólida , Tolueno/análise , Humanos , Tolueno/urinaRESUMO
OBJECTIVES: The aims of this study were (a) to assess the agreement coefficient between tympanic temperatures and the most popular and valid heat stress index, wet bulb globe temperature (WBGT), in outdoor environments; (b) to determine a cut-off point for tympanic temperature as a heat strain index for evaluation of outdoor workers. METHODS: 1452 measurements of WBGT index and tympanic temperature were recorded for outdoor workers from nine different climatic regions. Consistency of the WBGT and tympanic temperature were tested. The cut-off point for tympanic temperature in outdoor environments regarding WBGT evaluation was suggested based on obtained sensitivity and specificity from a receiver operating characteristic curve. RESULTS: The results showed that there were numerous situations in which WBGT exceeded the reference value, whilst the measured values of tympanic temperature rarely reached a permissible value for core temperature (38 °C). Therefore, appropriate consistency of results between the heat stress and strain indices was not achieved. CONCLUSION: The criterion of tympanic temperature equaling 37 °C was suggested as a cut-off point for tympanic temperature as a heat strain index for outdoor environment evaluation.
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Transtornos de Estresse por Calor/diagnóstico , Temperatura Alta , Membrana Timpânica/fisiologia , Adolescente , Adulto , Clima , Humanos , Irã (Geográfico) , Masculino , Pessoa de Meia-Idade , Exposição Ocupacional/efeitos adversos , Curva ROCRESUMO
BACKGROUND: Heat stress is common among workers in arid and semi-arid areas. In order to take every preventive measure to protect exposed workers against heat-related disorders, it is crucial to choose an appropriate index that accurately relates environmental parameters to physiological responses. OBJECTIVE: To investigate the consistency between 2 heat stress and strain indices, ie, sweat rate and wet bulb globe temperature (WBGT), for the assessment of heat stress of people working outdoor in arid and semi-arid regions in Iran. METHODS: During spring and summer, 136 randomly selected outdoor workers were enrolled in this study. Using a defined protocol, the sweat rate of these workers was measured 3 times a day. Simultaneously, the environmental parameters including WBGT index were recorded for each working station. RESULTS: The level of agreement between sweat rate and WBGT was poor (κ<0.2). Based on sweat rate, no case exceeding the reference value was observed during the study. WBGT overestimated the heat stress in outdoor workers compared to sweat rate. CONCLUSION: It seems that the sweat rate standards may need some modifications related to real condition of work in arid and semi-arid regions in Iran. Moreover, it seems that judging workers solely based on monitoring their sweat rate in such regions, can probably result in underestimation of heat stress.
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Transtornos de Estresse por Calor/diagnóstico , Suor/metabolismo , Adulto , Monitoramento Ambiental/métodos , Ocupações em Saúde , Voluntários Saudáveis , Transtornos de Estresse por Calor/patologia , Temperatura Alta , Humanos , MasculinoRESUMO
PURPOSE: To assess the diagnostic capability of corneal shape and biomechanical parameters for distinguishing normal eyes from frank keratoconus (KCN). METHODS: This is a retrospective analysis of eyes of 137 control subjects and 145 patients with KCN, with one of their eyes randomly selected as the study eye. Corneal biomechanical parameters were assessed using the Corvis ST (Oculus Optikgeräte GmbH) and Oculus Response Analyzer (Reichert Ophthalmic Instruments). Corneal tomography was performed using the Oculus Pentacam. The clinical diagnosis of KCN was based on slit-lamp findings (eg, Fleischer ring, Vogt striae) and abnormal topographic patterns on the sagittal (axial) front curvature map, disregarding tomographic and biomechanical findings. The discriminative ability for each parameter was tested using the Mann-Whitney U test. The accuracy of each parameter with statistically significant differences was determined using receiver operating characteristic curves, which were compared using the DeLong method. RESULTS: Statistically significant differences were observed for all corneal shape and biomechanical parameters tested (P < 0.05) except peak distance at the highest concavity (P = 0.504). The area under the curve (AUC), sensitivity, and specificity for corneal hysteresis (CH) and corneal resistance factor (CRF) were 0.894, 80.7%, and 84.7% and 0.946, 85.5%, and 89.1%, respectively. The dynamic corneal response parameters from the Corvis ST, stiffness parameter at first applanation, integrated radius (IR), and deformation amplitude ratio at 2 mm (DA-2 mm) had AUC, sensitivity, and specificity of 0.965, 86.2%, and 94.9%; 0.961, 87.6%, and 93.4%; and 0.950, 80.7%, and 98.5%. The Corvis biomechanical index had an AUC of 0.998 (95% confidence interval, 0.983-1.000), with 96.6% sensitivity and 99.3% specificity. The Belin-Ambrósio enhanced ectasia deviation index (BAD-Dv3) and the tomographical/biomechanical index (TBI) had an AUC of 1.0 (95% confidence interval, 0.987-1.000), with sensitivity and specificity of 100%. The combined indices, Corvis biomechanical index, BAD-D, and TBI, had a statistically higher AUC than that of all corneal biomechanical parameters (DeLong, P < 0.001). CONCLUSIONS: The Scheimpflug-derived shape and biomechanical parameters are able to accurately distinguish normal corneas from frank (clinical) keratoconic corneas. However, the combined parameters were more effective. Further studies should test milder ectasia cases.
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Córnea/fisiopatologia , Paquimetria Corneana/métodos , Topografia da Córnea/métodos , Ceratocone/diagnóstico , Adolescente , Adulto , Córnea/patologia , Estudos Transversais , Elasticidade , Feminino , Humanos , Ceratocone/fisiopatologia , Masculino , Pessoa de Meia-Idade , Curva ROC , Estudos Retrospectivos , Adulto JovemRESUMO
PURPOSE: To compare the long-term changes in corneal biomechanics, topography, and tomography before and 4 years after corneal cross-linking (CXL) with the Dresden protocol and correlate these changes with visual acuity. METHODS: In this longitudinal study, 18 eyes of 18 patients with progressive keratoconus who were treated with CXL were included. All patients received a standard ophthalmological examination and were examined by Placido disc-based topography, Scheimpflug tomography, and biomechanical assessments with the Corvis ST (OCULUS Optikgeräte GmbH, Wetzlar, Germany) and Ocular Response Analyzer (ORA; Reichert Ophthalmic Instruments, Buffalo, NY) before and 4 years after CXL. The main outcome measures were dynamic corneal response (DCR) parameters obtained from the Corvis ST, corneal hysteresis (CH), corneal resistance factor (CRF), visual acuity, refraction, corneal curvature, and corneal thickness. RESULTS: There were no significant differences in mean visual acuity, refraction, intraocular pressure, corneal topography, corneal astigmatism in both corneal surfaces, maximum keratometry, corneal thickness at apical and thinnest points, thickness profile indices, corneal volume, and specular microscopy before and 4 years after CXL (P > .05). Significant changes were observed in many DCR parameters, including radius at highest concavity and integrated inverse radius, both of which were consistent with stiffening. The CH and CRF values after CXL were not statistically significant. The new parameters using the Corvis ST include integrated inverse concave radius, which showed a significant decrease 1.07 ± 0.93 mm-1, consistent with stiffening. The corneal stiffness parameter at the first applanation, Ambrósio's Relational Thickness to the horizontal profile, deformation amplitude ratio, and Corvis Biomechanical Index as a combined biomechanical screening parameter did not show significant changes. CONCLUSIONS: CXL is a minimally invasive treatment option to prevent keratoconus progression over 4 years. Pressure-derived biomechanical parameters obtained from the ORA did not show any change following CXL at 4 years of follow-up, whereas the Corvis ST DCR parameters detected changes in corneal biomechanical properties. [J Refract Surg. 2018;34(12):849-856.].
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Córnea/fisiopatologia , Reagentes de Ligações Cruzadas , Elasticidade/fisiologia , Ceratocone/tratamento farmacológico , Ceratocone/fisiopatologia , Fotoquimioterapia/métodos , Adolescente , Adulto , Fenômenos Biomecânicos , Colágeno/metabolismo , Substância Própria/metabolismo , Topografia da Córnea , Feminino , Humanos , Pressão Intraocular , Ceratocone/metabolismo , Estudos Longitudinais , Masculino , Fármacos Fotossensibilizantes/uso terapêutico , Refração Ocular/fisiologia , Riboflavina/uso terapêutico , Tomografia , Raios Ultravioleta , Acuidade Visual/fisiologia , Adulto JovemRESUMO
Two water-soluble mono-nuclear macrocyclic lanthanum(III) complexes of 2,6-diformyl-4-methylphenol with 1,3-diamino-2-propanol (C1) or 1,3-propylenediamine (C2) were synthesized and characterized by UV-Vis, FT-IR, 13C and 1H NMR spectroscopy and elemental analysis. C1 complex was structurally characterized by single-crystal X-ray diffraction, which revealed that the complex was mononuclear and ten-coordinated. The coordination sites around lanthanum(III) were occupied with a five-dentate ligand, two bidentate nitrates, and one water molecule. The interaction of complexes with DNA was studied in buffered aqueous solution at pH7.4. UV-Vis absorption spectroscopy, emission spectroscopy, circular dichroism (CD) and viscometric measurements provided clear evidence of the intercalation mechanism of binding. The obtained intrinsic binding constants (Kb) 9.3×103 and 1.2×103M-1 for C1 and C2, respectively confirmed that C1 is better intercalator than C2. The DNA docking studies suggested that the complexes bind with DNA in a groove binding mode with the binding affinity of C1>C2. Moreover, agarose gel electrophoresis study of the DNA-complex for both compounds revealed that the C1 intercalation cause ethidium bromide replacement in a competitive manner which confirms the suggested mechanism of binding. Finally, the anticancer experiments for the treated cancerous cell lines with both synthesized compounds show that these hydrophilic molecules need a suitable carrier to pass through the hydrophobic nature of cell membrane efficiently.
Assuntos
Quitosana/química , Complexos de Coordenação/química , Complexos de Coordenação/farmacologia , Clivagem do DNA , DNA/metabolismo , Sistemas de Liberação de Medicamentos , Lantânio/química , Nanopartículas de Magnetita/química , Morte Celular/efeitos dos fármacos , Linhagem Celular Tumoral , Sobrevivência Celular/efeitos dos fármacos , Dicroísmo Circular , Cristalografia por Raios X , Elétrons , Humanos , Iodetos/química , Cinética , Conformação Molecular , Simulação de Acoplamento Molecular , Concentração Osmolar , Espectrometria de Fluorescência , Viscosidade , Água/químicaRESUMO
BACKGROUND: Heat stress evaluation and timely notification, especially using meteorological data is an important issue attracted attention in recent years. Therefore, this study aimed at answering the following research questions: 1) can enthalpy as a common environmental parameter reported by meteorological agencies be applied accurately for evaluation of thermal condition of outdoor settings, and 2) if so, what is it's the best criterion to detect areas in stress or stress-free situations, separately. METHODS: Nine climatic regions were selected throughout Iran covering a wide variety of climatic conditions like those, which exist around the world. Three types of parameters including measured (ta, RH, Pa and WBGT), estimated (metabolic rate and cloth thermal insulation), and calculated parameters (enthalpy and effective WBGT) were recorded for 1452 different situations. Enthalpy as a new indicator in this research was compared to WBGT in selected regions. RESULTS: Altogether, a good consistency was obtained between enthalpy and WBGT in selected regions (Kappa value: 0.815). Based on the good ROC curve obtained using MedCal software, the criterion of the values more than 74.24 for the new index was determined to explain heat stress situation for outdoor environments. CONCLUSIONS: Because of simplicity in measurement, applicability of the indicator for weather agencies, the consistency observed between enthalpy and a valid as well as accurate index (WBGT), sensor requirements which take only a few seconds to reach equilibrium and so on, enthalpy indicator can be introduced and applied as a good substitute for WBGT for outdoor settings.