RESUMO
PURPOSE: The present review will summarize FECD-associated genes and pathophysiology, diagnosis, current therapeutic approaches, and future treatment perspectives. METHODS: Literature review. RESULTS: Fuchs' endothelial corneal dystrophy (FECD) is the most common bilateral corneal dystrophy and accounts for one-third of all corneal transplants performed in the US. FECD is caused by a combination of genetic and non-heritable factors, and there are two types: early-onset FECD, which affects individuals from an early age and is usually more severe, and late-onset FECD, which is more common and typically manifests around the age of 40. The hallmark findings of FECD include progressive loss of corneal endothelial cells and the formation of focal excrescences (guttae) on the Descemet membrane. These pathophysiological changes result in progressive endothelial dysfunction, leading to a decrease in visual acuity and blindness in later stages. The present review will summarize FECD-associated genes and pathophysiology, diagnosis, current therapeutic approaches, and future treatment perspectives. CONCLUSION: With the characterization and understanding of FECD-related genes and ongoing research into regenerative therapies for corneal endothelium, we can hope to see more significant improvements in the future in the management and care of the disease.
Assuntos
Transplante de Córnea , Distrofia Endotelial de Fuchs , Humanos , Distrofia Endotelial de Fuchs/diagnóstico , Distrofia Endotelial de Fuchs/genética , Distrofia Endotelial de Fuchs/terapia , Células Endoteliais , Endotélio Corneano , CegueiraRESUMO
BACKGROUND: Translational research to develop pharmaceutical and surgical treatments for pterygium requires a reliable and easy to produce animal model. Extracellular matrix and fibroblast are important components of pterygium. The aim of this study was to analyze the effect of the subconjunctival injection of fibroblast cells (NIH3T3 cell line) and exogenous extracellular matrix in rabbits in producing a pterygium-like lesion. METHODS: Six 3-month-old white New Zealand rabbits were injected with 20,000 NIH3T3 cells and 5 µL of Matrigel in the right conjunctiva, and with only 5 µL of Matrigel in the left conjunctiva. The eyes were photographed under a magnification of 16× using a 12-megapixel digital camera attached to the microscope on day 1,3 and 7. Conjunctival vascularization was measured by analyzing images to measure red pixel saturation. Area of corneal and conjunctival fibrovascular tissue formation on the site of injection was assessed by analyzing the images on day 3 and 7 using area measurement software. Histopathologic characteristics were determined in the rabbit tissues and compared with a human primary pterygium. RESULTS: The two treatments promoted growth of conjunctival fibrovascular tissue at day 7. The red pixel saturation and area of fibrovascular tissue developed was significantly higher in right eyes (p < 0.05). Tissues from both treatments showed neovascularization in lesser extent to that observed in human pterygium. Acanthosis, stromal inflammation, and edema were found in tissues of both treatments. No elastosis was found in either treatment. CONCLUSIONS: Matrigel alone or in combination with NIH3T3 cells injected into the rabbits' conjunctiva can promote tissue growth with characteristics of human pterygium, including neovascularization, acanthosis, stromal inflammation, and edema. The combination of Matrigel with NIH3T3 cells seems to have an additive effect on the size and redness of the pterygium-like tissue developed.
Assuntos
Animais , Camundongos , Coelhos , Proteoglicanas/efeitos adversos , Pterígio/etiologia , Colágeno/efeitos adversos , Laminina/efeitos adversos , Modelos Animais de Doenças , Matriz Extracelular/transplante , Fibroblastos/transplante , Proteoglicanas/administração & dosagem , Pterígio/patologia , Colágeno/administração & dosagem , Laminina/administração & dosagem , Células NIH 3T3 , Combinação de MedicamentosRESUMO
Introducción. La diabetes mellitus es una enfermedad metabólica que se caracteriza por la elevación de la glicemia en sangre; la misma que se ha observado un incremento en el número de pacientes adultos. Objetivo. Determinar la frecuencia de diabetes mellitus y los factores epidemiológicos importantes en los pacientes atendidos en el Hospital Universitario de Guayaquil, entre 2014-2015. Metodología. Diseño observacional de tipo transversal descriptivo en los pacientes de la consulta externa, en la que se utilizó un formulario de recolecciónde datos. Resultados. Se obtuvo diabetes mellitus no insulinodependiente el 45,16 %, diabetes insulinodependiente 39,87 %, diabetes mellitus no especificada 14,15 %; mayormente afectados el adulto intermedio (41 a 64 años de edad) con el 60,31 %; en el sexo femenino el 52,14 % comparado con el masculino con el 47,86 %; presentaron comorbilidad en aproximadamente 8,99 %, mayormente complicaciones de tipo circulatorias con el 10,75 %. Conclusiones. Existe mayormente diabetes mellitus no insulinodependiente, con predisposición en el sexo femenino, y en el grupo de adultas intermedias comparados con los masculinos; que quizá la tendencia presentada se deba a otros factores, como la falta de ejercicio, dieta no saludable, sobrepeso, historia familiar; fomentando la prevención y control de la diabetes mellitus mediante campañas integrales de información, educación y comunicación en todos los sectores de la sociedad.
Introduction. Diabetes Mellitus is a metabolic disease characterized by elevated blood glucose levels; the same has been observed an increase in the number of adult patients. Objective. To determine the frequency of Diabetes Mellitus and the important epidemiological factors in the patients treated at the University Hospital of Guayaquil between 2014-2015. Methodology. Observational design of descriptive transversal type; in the patients of the external consultation, in which a form of data collection was used. Results. Non-insulin dependent Diabetes Mellitus (NID) was obtained 45.16%, Insulin Dependent Diabetes (ID) 39.87%, Diabetes Mellitus Unspecified 14.15%; Mainly affected Intermediate Adult (41 to 64 years old) with 60.31%; In the female sex 52.14% compared to the male with 47.86%; Presented comorbidity in approximately 8.99%, mostly circulatory type complications with 10.75%. Conclusions. There is mainly Diabetes Mellitus Non-insulin dependent, predisposed in the female sex, and in the group of intermediate adults compared to the male; That the tendency presented may be due to other factors, such as lack of exercise, unhealthy diet, overweight, family history; Promoting the prevention and control of Diabetes Mellitus through comprehensive campaigns of information, education and communication in all sectors of society.
Assuntos
Humanos , Predisposição Genética para Doença , Diabetes Mellitus Tipo 1 , Sobrepeso , Prevenção Primária , Fatores EpidemiológicosRESUMO
Introducción. El dengue es una infección vírica transmitida por mosquitos cuya infección va desde síntomas leves que en ocasiones evolucionan hasta un cuadro clínico llamado dengue grave. Objetivo. Caracterizar clínicamente los casos con diagnóstico de dengue con signos de alarma y dengue grave entre las semanas epidemiológicas 19 al 26 del 2014 ingresados en el Hospital de Niños Francisco de Icaza Bustamante y en adultos del hospital de Infectología de la ciudad de Guayaquil. Metodología. No experimental de tipo descriptivo, comparativo, de corte transversal; donde se comparan sus características clínicas, antecedentes y valores en pruebas hemáticas. Resultados. La fiebre re registró en el total de los pacientes, que se acompañan en los niños con nausea o vómito, dolor abdominal, artralgias, mialgias, cefaleas, entre otros, con variedad sintomática, mientras que en los adultos concuerda con la definición de casos. En las pruebas de laboratorio se detectaron casos con hemoconcentración y plaquetopenia mayormente en adultos; TGO y TGP elevadas por encima del 70 % de los casos; presencia de IgM en aproximadamente 1 de cada 2 en niños y adultos al momento de su ingreso, con anticuerpos IgG en 2 de cada 3 niños que revela una previa exposición al dengue. Conclusiones. Mayor afectación en los niños con variedad sintomática, entre 3 a 7 días de evolución, acompañados de hemoconcentración y plaquetopenia; así como, leucopenia, linfocitosis, neutropenia y las enzimas hepáticas elevadas en gran número de casos. Las pruebas serológicas específicas para dengue demuestran la infección reciente y antecedentes de infección pasada.
Introduction. Dengue is a viral infection transmitted by mosquitoes; whose infection ranges from mild symptoms that sometimes evolve to a clinical condition called severe dengue. Objective. Clinically characterize the cases with diagnosis of dengue with signs of alarm and severe dengue among the epidemiological weeks 19 to 26 of 2014 admitted to the Hospital of children Francisco de Icaza Bustamante and in adults of the Hospital of Infectología of the city of Guayaquil. Methodology. Non-experimental descriptive, comparative, cross-sectional type; where their clinical characteristics, antecedents and values are compared in blood tests. Results. Fever had the total number of patients, who were accompanied in children with nausea or vomiting, abdominal pain, arthralgia, myalgias, headaches, among others, with symptomatic variety, while in adults it was consistent with the definition of cases. In laboratory tests cases with hemoconcentration and thrombocytopenia were detected mainly in adults; TGO and TGP elevated above 70% of the cases; Presence of IgM in approximately 1 in 2 in children and adults at the time of admission, with IgG antibodies in 2 of 3 children revealing a previous exposure to Dengue. Conclusions. Major affectation in children with symptomatic variety, between 3 and 7 days of evolution, accompanied by hemoconcentration and thrombocytopenia; As well as leukopenia, lymphocytosis, neutropenia and elevated liver enzymes in a large number of cases. Specific serological tests for dengue demonstrate recent infection and history of past infection.