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A 62-year-old black woman with uncontrolled chronic narrow-angle glaucoma on 3-drug therapy underwent phaco-non-perforating deep sclerectomy of her left eye. During surgery it was revealed that she had long zonule trait. She later required goniopuncture and conjuntival needling, presenting an iris herniation in the goniopuncture that could be reduced conservatively. Long anterior zonule trait should be suspected in those patients presenting with a combination of narrow angle and pigment dispersion syndrome. The management of ocular hypertension and glaucoma associated to this trait is not protocolized. This communication discusses on the best action in this rare form of glaucoma.
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Glaucoma de Ângulo Aberto , Glaucoma , Hipertensão Ocular , Humanos , Feminino , Pessoa de Meia-Idade , Pressão Intraocular , Glaucoma de Ângulo Aberto/cirurgia , Iris/cirurgiaRESUMO
RESUMEN Introducción En abril del 2020, la pandemia del COVID-19 ha causado más de un millón de contagios y 54 600 muertes a nivel mundial. El contagio del SARS-CoV-2 es rápido y su transmisión se da a través de gotas de saliva. De allí su importancia en la odontología. Objetivo Identificar los principales riesgos, vías de transmisión y medidas de prevención frente al COVID-19. Métodos Se realizó una revisión de literatura científica de los últimos dos años sobre el tema, en las bases de datos PubMed, ScienceDirect, Google Scholar y Research Gate. Los descriptores utilizados fueron los siguientes: "coronavirus", "COVID-19", "dental", "dentistry", "oral", "stomatology" y "aerosol". Se encontraron 350 artículos, de lo que se seleccionaron 50 por su actualidad, relación y enfoque. La transmisión del COVID-19 se da principalmente a través de gotas de saliva, aerosoles y fómites. El virus puede subsistir por un tiempo en el ambiente y en las superficies. Los odontólogos son trabajadores de la salud con peligro de contagiarse debido que varios de sus procedimientos liberan aerosoles. La bioseguridad en el ejercicio de esta profesión debe ser estricta y extrema, también la limpieza y desinfección del ambiente y superficies de contacto. Conclusiones En la profesión odontológica el riesgo potencial de contaminación entre operados, asistentes y pacientes es alto. El conocimiento del agente causal y de la enfermedad permitirá reducir la posibilidad de contagio. El odontólogo debe considerar a los pacientes como sospechosos de COVID-19 y aplicar la bioseguridad a todo nivel.
ABSTRACT Introduction In April 2020 The COVID-19 pandemic caused more than one million infections and 54 600 deaths to date around the world. The spread of SARS-CoV-2 is rapid, and its transmission is through droplets of saliva, hence its importance in dentistry. Objective Identify the main risks, transmission routes and prevention measures against COVID-19. Methods A review of the scientific literature of the last two years on the subject was carried out in the PubMed, ScienceDirect, Google Scholar and Research Gate databases. The descriptors used were: "coronavirus", "COVID-19", "dental", "dentistry", "oral", "stomatology", and "aerosol". 350 articles were found, but 50 were selected for their topicality, relationship, and focus. The transmission of the COVID-19 is carried out mainly through saliva drops, aerosols and fomites. The virus can subsist for a time on the environment and surfaces. Dentists are health workers who are at risk of contagion because several of their procedures release aerosols. The biosecurity in the exercise of this profession must be strict and extreme, also the cleaning and disinfection of the environment and contact surfaces. Conclusions In the dental profession the potential risk of contamination among operators, assistants and patients is high. Knowing the causative agent and the disease allows you to reduce the possibility of contagion. The dentist must consider patients as suspects to COVID-19 and apply biosecurity at all levels.
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INTRODUCTION: In April 2020 The COVID-19 pandemic caused more than one million infections and 54 600 deaths to date around the world. The spread of SARS-CoV-2 is rapid, and its transmission is through droplets of saliva, hence its importance in dentistry. OBJECTIVE: Identify the main risks, transmission routes and prevention measures against COVID-19. METHODS: A review of the scientific literature of the last two years on the subject was carried out in the PubMed, ScienceDirect, Google Scholar and Research Gate databases. The descriptors used were: "coronavirus", "COVID-19", "dental", "dentistry", "oral", "stomatology", and "aerosol". 350 articles were found, but 50 were selected for their topicality, relationship, and focus. The transmission of the COVID-19 is carried out mainly through saliva drops, aerosols and fomites. The virus can subsist for a time on the environment and surfaces. Dentists are health workers who are at risk of contagion because several of their procedures release aerosols. The biosecurity in the exercise of this profession must be strict and extreme, also the cleaning and disinfection of the environment and contact surfaces. CONCLUSIONS: In the dental profession the potential risk of contamination among operators, assistants and patients is high. Knowing the causative agent and the disease allows you to reduce the possibility of contagion. The dentist must consider patients as suspects to COVID-19 and apply biosecurity at all levels.
INTRODUCCIÓN: En abril del 2020, la pandemia del COVID-19 ha causado más de un millón de contagios y 54 600 muertes a nivel mundial. El contagio del SARS-CoV-2 es rápido y su transmisión se da a través de gotas de saliva. De allí su importancia en la odontología. OBJETIVO: Identificar los principales riesgos, vías de transmisión y medidas de prevención frente al COVID-19. MÉTODOS: Se realizó una revisión de literatura científica de los últimos dos años sobre el tema, en las bases de datos PubMed, ScienceDirect, Google Scholar y Research Gate. Los descriptores utilizados fueron los siguientes: "coronavirus", "COVID-19", "dental", "dentistry", "oral", "stomatology" y "aerosol". Se encontraron 350 artículos, de lo que se seleccionaron 50 por su actualidad, relación y enfoque. La transmisión del COVID-19 se da principalmente a través de gotas de saliva, aerosoles y fómites. El virus puede subsistir por un tiempo en el ambiente y en las superficies. Los odontólogos son trabajadores de la salud con peligro de contagiarse debido que varios de sus procedimientos liberan aerosoles. La bioseguridad en el ejercicio de esta profesión debe ser estricta y extrema, también la limpieza y desinfección del ambiente y superficies de contacto. CONCLUSIONES: En la profesión odontológica el riesgo potencial de contaminación entre operados, asistentes y pacientes es alto. El conocimiento del agente causal y de la enfermedad permitirá reducir la posibilidad de contagio. El odontólogo debe considerar a los pacientes como sospechosos de COVID-19 y aplicar la bioseguridad a todo nivel.
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COVID-19 , Humanos , COVID-19/prevenção & controle , SARS-CoV-2 , Pandemias/prevenção & controle , Aerossóis e Gotículas Respiratórios , OdontólogosRESUMO
The depth to which Jupiter's observed east-west jet streams extend has been a long-standing question. Resolving this puzzle has been a primary goal for the Juno spacecraft, which has been in orbit around the gas giant since July 2016. Juno's gravitational measurements have revealed that Jupiter's gravitational field is north-south asymmetric, which is a signature of the planet's atmospheric and interior flows. Here we report that the measured odd gravitational harmonics J3, J5, J7 and J9 indicate that the observed jet streams, as they appear at the cloud level, extend down to depths of thousands of kilometres beneath the cloud level, probably to the region of magnetic dissipation at a depth of about 3,000 kilometres. By inverting the measured gravity values into a wind field, we calculate the most likely vertical profile of the deep atmospheric and interior flow, and the latitudinal dependence of its depth. Furthermore, the even gravity harmonics J8 and J10 resulting from this flow profile also match the measurements, when taking into account the contribution of the interior structure. These results indicate that the mass of the dynamical atmosphere is about one per cent of Jupiter's total mass.
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Jupiter's atmosphere is rotating differentially, with zones and belts rotating at speeds that differ by up to 100 metres per second. Whether this is also true of the gas giant's interior has been unknown, limiting our ability to probe the structure and composition of the planet. The discovery by the Juno spacecraft that Jupiter's gravity field is north-south asymmetric and the determination of its non-zero odd gravitational harmonics J3, J5, J7 and J9 demonstrates that the observed zonal cloud flow must persist to a depth of about 3,000 kilometres from the cloud tops. Here we report an analysis of Jupiter's even gravitational harmonics J4, J6, J8 and J10 as observed by Juno and compared to the predictions of interior models. We find that the deep interior of the planet rotates nearly as a rigid body, with differential rotation decreasing by at least an order of magnitude compared to the atmosphere. Moreover, we find that the atmospheric zonal flow extends to more than 2,000 kilometres and to less than 3,500 kilometres, making it fully consistent with the constraints obtained independently from the odd gravitational harmonics. This depth corresponds to the point at which the electric conductivity becomes large and magnetic drag should suppress differential rotation. Given that electric conductivity is dependent on planetary mass, we expect the outer, differentially rotating region to be at least three times deeper in Saturn and to be shallower in massive giant planets and brown dwarfs.
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The gravity harmonics of a fluid, rotating planet can be decomposed into static components arising from solid-body rotation and dynamic components arising from flows. In the absence of internal dynamics, the gravity field is axially and hemispherically symmetric and is dominated by even zonal gravity harmonics J2n that are approximately proportional to qn, where q is the ratio between centrifugal acceleration and gravity at the planet's equator. Any asymmetry in the gravity field is attributed to differential rotation and deep atmospheric flows. The odd harmonics, J3, J5, J7, J9 and higher, are a measure of the depth of the winds in the different zones of the atmosphere. Here we report measurements of Jupiter's gravity harmonics (both even and odd) through precise Doppler tracking of the Juno spacecraft in its polar orbit around Jupiter. We find a north-south asymmetry, which is a signature of atmospheric and interior flows. Analysis of the harmonics, described in two accompanying papers, provides the vertical profile of the winds and precise constraints for the depth of Jupiter's dynamical atmosphere.
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On 27 August 2016, the Juno spacecraft acquired science observations of Jupiter, passing less than 5000 kilometers above the equatorial cloud tops. Images of Jupiter's poles show a chaotic scene, unlike Saturn's poles. Microwave sounding reveals weather features at pressures deeper than 100 bars, dominated by an ammonia-rich, narrow low-latitude plume resembling a deeper, wider version of Earth's Hadley cell. Near-infrared mapping reveals the relative humidity within prominent downwelling regions. Juno's measured gravity field differs substantially from the last available estimate and is one order of magnitude more precise. This has implications for the distribution of heavy elements in the interior, including the existence and mass of Jupiter's core. The observed magnetic field exhibits smaller spatial variations than expected, indicative of a rich harmonic content.
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CASE REPORT: The case is presented of a severe Intraoperative Floppy Iris Syndrome (IFIS) in a patient that had been treated with duloxetine. DISCUSSION: Tamsulosin is the main etiological agent involved in IFIS. However several cases of IFIS, supposedly secondary to drugs of different groups have recently been reported in the literature. The authors use this case report as a means to discuss why most of these cases should be considered anecdotal evidence.
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Antidepressivos/efeitos adversos , Cloridrato de Duloxetina/efeitos adversos , Complicações Intraoperatórias/induzido quimicamente , Doenças da Íris/induzido quimicamente , Idoso , Feminino , Humanos , SíndromeRESUMO
Poly(tetrafluoroethylene) (PTFE) was irradiated by CF4 plasma produced in the gas discharge ion source facility to produce stable and robust superhydrophobic surfaces and to enhance the materials' oleophilic property for biological applications. The characterizations employed on the samples are contact angle measurements, analysis of the surface morphology (scanning electron microscopy), surface roughness measurements (atomic force microscopy) and analysis of the surface chemistry (Fourier transform infrared spectroscopy). Superhydrophobic behavior with water contact angles as high as 156° was observed. The wettability of all the treated samples was found to be stable in time as evidenced by the statistically insignificant differences in the hysteresis contact angles. The level of enhanced hydrophobicity depended on the plasma energies (i.e. irradiation times, discharge current, and discharge voltage); higher plasma energies produced surfaces with high hydrophobicity. The plasma treatment also enhanced the oleophilic property of the materials' surface as evidenced by the decrease in the PDMS-oil contact angle from 33° to as low as 10°. The superhydrophobicity of the modified PTFE and the enhancement of its oleophilic property were due to (1) the changes in the roughness of the surface, (2) the formation of nanoparticles or nanostructures on the surface, and (3) the changes in the surface chemistry.
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Fluorocarbonos/química , Gases em Plasma , Microscopia de Força Atômica , Microscopia Eletrônica de Varredura , Espectroscopia de Infravermelho com Transformada de Fourier , Propriedades de SuperfícieRESUMO
In this paper, the extent of the knowledge of the academic community on campus III of the Federal University of Paraná about biosafety and health service waste (HSW) is assessed. A survey was carried out between 2009 and 2011, among students of degree courses in Dentistry, Nutrition, Pharmacy, Occupational Therapy and Nursing, in their second, fifth, sixth, fourth and sixth semester, respectively, the course coordinators, campus environmental managers and waste handlers of the company contracted by UFPR. The method employed was participatory, based on the application of an assessment tool specific to each group surveyed. The results were that between 75 and 100% of the students recognized HSW as a risk to health and the environment when it is managed in adequately, but only 50 to 60% identified different types of health servicewaste. According to the course coordinators, only in Dentistry was Biosafety a taught subject. In other courses, the topics Biosafety and HSW were covered in other subjects. The environmental management sector managers reported that every waste-generating unit must have its own management plan, conduct training and possess an informative website. Regarding waste handlers, 33% said that during the handling of HSW they used gloves and uniforms, while 22% did not know what the rules said. The research revealed a gap in both the knowledge and practice of biosafe and responsible measures...
O trabalho avaliou o conhecimento da comunidade acadêmica do campus III ? Jardim Botânico, da Universidade Federal do Paraná (UFPR) sobre Biossegurança e Resíduos de Serviços de Saúde (RSS). A pesquisa ocorreu entre 2009 e 2011, com acadêmicos dos cursos de graduação em Odontologia, Nutrição e Farmácia, do segundo, quinto e sexto período, respectivamente, Terapia Ocupacional e Enfermagem, quarto e sexto período, coordenadores dos cursos, gestores ambientais do campus e manipuladores de resíduos da empresa contratada pela UFPR. A metodologia empregou pesquisa-ação, baseada na aplicação de um instrumento de avaliação específico para cada grupo pesquisado. Como resultados, 75 a 100% dos alunos reconheceram os RSS como risco à saúde e ao meio ambiente quando seu manejo é inadequado, porém apenas 50 a 60% identificaram os diferentes grupos de RSS. Segundo os coordenadores, apenas no curso de Odontologia era ministrada a disciplina de Biossegurança. Nos outros cursos, os temas: Biossegurança e Resíduos de Serviços de Saúde, integravam outras disciplinas. O setor de gestão ambiental informou que todo órgão gerador de resíduos deve ter seu próprio plano de gerenciamento, além de realizar treinamentos e possuir página web informativa. Em relação aos manipuladores, 33% afirmaram que durante a manipulação dos RSS utilizam luvas e uniformes, 22% destes não souberam dizer quais são as normas. A pesquisa evidenciou uma lacuna no conhecimento e na aplicação de medidas biosseguras e responsáveis...
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Humanos , Masculino , Feminino , Resíduos de Serviços de Saúde , UniversidadesRESUMO
OBJECTIVE: Intraoperative-floppy iris syndrome (IFIS) has been recently described. It has been demonstrated that this new syndrome complicates cataract surgery. In this paper we have reviewed the syndrome, and offer practical information specially related to the origin and management of this syndrome and we offer practical information. MATERIAL AND METHODS: A review of the related medical literature using PubMed and Cochrane databases. Combining the search terms tamsulosin, cataract, IFIS and intraoperative floppy iris syndrome, more than 200 articles were found. Eighty-two of them were obtained and analysed. In the remaining only the abstract could be studied. RESULTS: The aetiological association between IFIS and tamsulosin (and to a lesser degree between IFIS and other alpha-antagonists) is well established. Other aetiological associations are doubtful. Most of the literature is centred on cataract surgery. However, a similar syndrome has been described during trabeculectomy. A possible association between these drugs and choroidal detachments has also been described. Undoubtedly tamsulosin treatment makes cataract surgery more difficult and increases the probability of intraoperative complications. Protocols to manage the syndrome have not yet been developed. Intracameral injection of alpha-adrenergic agonists seems to be useful. However there is no evidence of the usefulness of discontinuing the drug or using preoperative mydriatics. CONCLUSION: The aetiological and clinic features of the syndrome are well established. More studies are needed to provide scientific evidence on the most appropriate way to cope with this syndrome.
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Complicações Intraoperatórias , Doenças da Íris , Antagonistas de Receptores Adrenérgicos alfa 1/efeitos adversos , Extração de Catarata/efeitos adversos , Humanos , Complicações Intraoperatórias/etiologia , Complicações Intraoperatórias/terapia , Doenças da Íris/etiologia , Doenças da Íris/terapia , Sulfonamidas/efeitos adversos , Síndrome , TansulosinaRESUMO
OBJECTIVE: [corrected] To determine the relative importance of the different forms of anisocoria in a General Hospital. METHODS: A prospective, longitudinal study was conducted including all patients referred for this reason to the Neuro-Ophthalmology Unit of the Henares University Hospital, Madrid (Spain), from November 2008 to October 2011. The differences in pupil diameter were studied under high and low luminosity. The patients were given a full ophthalmological examination, as well as performing the apraclonidine, cocaine, pilocarpine 0.125% and pilocarpine 2% tests, if they were considered necessary. RESULTS: Thirty-two cases of anisocoria were referred during the three years of the study. No relationship was found with age or gender. The diagnostic results were: Adie's pupil, 4 cases; Horner syndrome, 5 cases; benign episodic unilateral mydriasis, 3 cases; local causes, 4 cases; physiological anisocoria, 5 cases. Despite a full clinical history and examination, the cause of the anisocoria could not be determined in 11 cases. In 4 of these cases, the patient suffered from migraines and in another 4 psychotropic drugs were taken. Both risk factors were present in 3 cases. In one case the anisocoria was the initial clue that led to the diagnosis of a cervical paraganglioma. CONCLUSIONS: Anisocoria is a clinical sign that does not usually signify a serious disease. With our protocols, a high number of anisocoria cases are still of unknown origin. Migraines and psychotropic drugs could be linked to these forms of anisocoria.
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Anisocoria/diagnóstico , Anisocoria/epidemiologia , Adolescente , Adulto , Idoso , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Atenção Secundária à Saúde , Adulto JovemRESUMO
Cement-based materials are ubiquitous in almost all built environment. In spite of this, little is known about the formation and the role played by the silicate chains always present in the cement nanostructure. By means of first principles simulations we provide compelling evidence on the pivotal role played by certain ionic species in the formation of the silicate chains inside the cementitious matrix. Moreover, we corroborate the experimental evidence which shows that the length of the most stable chains with m Si atoms follows a magic-number sequence: m = 3n-1 with n = 1,2,... Our results have been applied in the development of new higher performance cement-based materials by adding nanosilica.
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BACKGROUND: Clevidipine is an ultrashort-acting, third-generation IV dihydropyridine calcium channel blocker that exerts rapid and titratable arterial blood pressure reduction, with fast termination of effect due to metabolism by blood and tissue esterases. As an arterial-selective vasodilator, clevidipine reduces peripheral vascular resistance directly, without dilating the venous capacitance bed. In this randomized, double-blind, placebo-controlled multicenter trial we evaluated the efficacy and tolerability of clevidipine in treating preoperative hypertension. METHODS: One-hundred-fifty-two patients scheduled for cardiac surgery with current or recent hypertension were randomized to receive clevidipine or placebo preoperatively. One-hundred-five patients met postrandomization entrance criteria (systolic blood pressure [SBP] > or =160 mm Hg after inserting an arterial catheter) for reduction by > or =15% from baseline in SBP. The patients thus received infusions of clevidipine (0.4-8.0 microg x kg(-1) x min(-1)) or 20% lipid emulsion (placebo) for at least 30 min. Treatment failure was defined as failure to reduce SBP by > or =15% from baseline or discontinuance of drug for any reason. RESULTS: Patients treated with clevidipine demonstrated a 92.5% rate of treatment success and a significantly lower rate of treatment failure (7.5%, 4 of 53) than patients receiving placebo (82.7%, 43 of 52; P < 0.0001). Clevidipine achieved target blood pressures (SBP reduced by > or =15%) at a median of 6.0 min (95% confidence interval 6-8 min). A modest increase in heart rate from baseline occurred during clevidipine administration. Adverse events for each treatment group were similar. CONCLUSIONS: Clevidipine was effective in rapidly decreasing blood pressure preoperatively to targeted blood pressure levels and was well tolerated in patients scheduled for cardiac surgery.
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Anti-Hipertensivos/uso terapêutico , Pressão Sanguínea/efeitos dos fármacos , Bloqueadores dos Canais de Cálcio/uso terapêutico , Procedimentos Cirúrgicos Cardíacos , Hipertensão/tratamento farmacológico , Cuidados Pré-Operatórios , Piridinas/uso terapêutico , Idoso , Método Duplo-Cego , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento , Vasodilatadores/uso terapêuticoRESUMO
A new polymer-supported chromium porphyrin has been prepared and fully characterised; its catalytic activity and recyclability were investigated for the ring-opening copolymerisation of 1,2-cyclohexene oxide (CHO) and carbon dioxide (CO2).
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There are many new analytical techniques for the characterization of resin-bound substrates and solid-phase reaction monitoring. The aim of this review is to focus on applications of the different IR techniques used in solid-phase synthesis highlighting some of the recent advances in the field that allow us to obtain more than just the usual qualitative information. Many examples will be discussed where these new IR techniques have been used for mechanistic and kinetic studies of solid-phase reactions.
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Espectroscopia de Infravermelho com Transformada de Fourier/métodos , Estrutura MolecularRESUMO
Efficient methods for the preparation of combinatorial libraries of receptors have been reported recently and, in most cases, these have led to the identification of host-like molecules that bind a particular substrate selectively. Dynamic libraries of macrocycles have also been synthesised that could open the way to a new selection approach to receptors and catalysts.