Factors related to filtration-bleb morphology after Ex-PRESS® surgery

Purpose: We investigated the factors influencing the morphology of filtration blebs after Ex-PRESS® surgery. We analyzed the thickness of the bleb wall and the height and the volume of blebs. Methods: This was a retrospective non-randomized study. After excluding patients who had undergone an additional glaucoma surgery, we analyzed the cases of 145 consecutive patients (180 eyes) who underwent trabeculectomy with Ex-PRESS® for the first time at Toyama University Hospital and were followed for >1 year. We used anterior segment optical coherence tomography to analyze the morphology of the blebs after Ex-PRESS surgery. We also examined potential influencing factors including age, central corneal thickness, type of glaucoma (primary open-angle glaucoma [POAG] or pseudo-exfoliation glaucoma [PEXG]), preoperative intraocular pressure (IOP), postoperative IOP, history of trabeculotomy, and operation method: Ex-PRESS surgery only, or simultaneous cataract surgery. Results: Ex-PRESS surgeries significantly decreased the IOP from 24.5 ± 8.8 mmHg to 11.1 ± 3.4 mmHg after 1 year (P < 0.001). The cases with higher blebs, larger volume of blebs, and thinner bleb wall had better surgical outcomes. Conclusion: Advanced age, higher postoperative IOP, PEXG, and simultaneous cataract surgeries were found to decrease the volume and height of blebs. Younger age, higher postoperative IOP, POAG, and simultaneous cataract surgeries were found to thicken the wall of blebs. Among the younger patients, there were many cases in which surgery was unsuccessful in spite the large volume of blebs. The reason for this may be that the wall of the bleb is thick.

Dermatite micobacteriana atípica em gato: relato de caso / Atypical mycobacterial dermatitis in cat: a case report

Relata-se, pela primeira vez no Brasil, um caso de dermatite decorrente de infecção por micobactéria atípica do complexo Mycobacterium fortuitum-peregrinum, em espécie felina, sem raça definida, fêmea, com cinco anos de idade. Há oito meses, evoluía com lesões maculares equimóticas, nodulares, erosadas, ulceradas, acompanhadas de fístulas exsudativas, com intenso prurido e algia. Evidenciou-se a presença de micobactéria do complexo Mycobacterium fortuitum-peregrinum (grupo IV de Runyon ) identificada após evidenciação histopatológica, cultivo bacteriano e por testes bioquímicos. Após dois meses de terapia sistêmica com enrofloxacina (5mg/kg/Bid/VO) e tópica (triclosan e rifamicina) houve involução das lesões, com efeitos colaterais discretos.

A case of dermatitis caused by atypical mycobateria of Mycobacterium fortuitum peregrinum complex was observed for the first time in Brazil. A five-year-old female mixed breed cat had a dermatitis process which had started eight months before. Lesions were characterized by macules, nodules, erosions, ulcers and exsudative fistulas, with intensive pruritus and pain. It had failed to respond to clinical treatment and surgical excision. The diagnosis was based on history, physical and dermatologic examination and complementary tests (cytologic, bacterioscopic, bacterial culture, histopathological, hemathological, ultrasonographic, radiographic and electrocardiographic). The presence of mycobacteria of Mycobacterium fortuitum-peregrinum complex (group IV of Runyon) was observed and identified after histopathological evidence, bacterial culture and biochemical tests. After two months of systemic therapy with enrofloxacin (5mg/kg, orally/twice a day) and topic treatment with triclosan and rifamicin, rapid improvement of the clinical appearance of the lesions were observed with low incidence of side-effects.

Eficácia das lactonas macrocíclicas sistêmicas ( ivermectina e moxidectina ) na terapia da demodicidose canina generalizada / Efficacy of systemics macrocyclic lactones ( ivermectin and moxidectin ) for the treatment of generalized canine demodicosis

Avaliou-se a eficácia de lactonas macrocíclicas (ivermectina e moxidectina) sobre a eventual ocorrência de efeitos colaterais e acompanharam-se, após a alta parasitológica, por 12 meses, os cães tratados, visando detectar a recidiva do quadro dermatopático. Dos 63 animais, 59 por cento eram fêmeas, 76 por cento apresentavam precisa definição racial e 67 por cento tinham pelame curto. A ivermectina (0,6mg/kg/dia) foi administrada por via oral a 31 cães, e a moxidectina (0,5mg/kg/cada 72 horas), pela mesma via, a 32 animais. Os tempos médios para a obtenção da primeira negativação do exame parasitológico do raspado cutâneo e para a consecução da alta foram, respectivamente, de 90 e 130 dias para a ivermectina e de 108 e 147 dias para a moxidectina. A ivermectina acarretou menos (16,1 por cento) efeitos colaterais em relação à moxidectina (37,5 por cento) (P=0,03). As recidivas foram, respectivamente, 10,3 por cento e 13 por cento para ivermectina e moxidectina. Não houve diferença entre os dois protocolos de terapia quanto aos percentuais de recidiva (P=0,67) e eficácia (P=0,61). Ambas as lactonas macrocíclicas mostraram-se eficazes: ivermectina 89,7 por cento e moxidectina 87 por cento.

The efficacy of ivermectin and moxidectin for treatment of generalized canine demodicosis, was evaluated to detect the eventual occurrence of side effects caused by the use of these drugs, and to follow the treated dogs for 12 months after obtaining parasitologic cure. Of 63 dogs, 59 percent were females, 76 percent were defined as purebred and 67 percent had short hair. Ivermectin (0.6mg/kg/daily) was orally administered to 31 dogs and moxidectin (0.5mg/kg/every 72 hours) to 32 dogs. The average number of days to obtain the first negative skin scraping results and the parasitologic cure were, respectively, 90 and 130 days for ivermectin, and 108 and 147 days for moxidectin. Ivermectin caused fewer side effects (16.1 percent) than moxidectin (37.5 percent) (P<0.05). The percentages of relapse were, respectively, 10.3 percent and 13.0 percent when ivermectin and moxidectin were administered. No difference between protocols of therapy was found for percentage of relapse (P> or =0.67) and efficacy (P> or =0.61). Both drugs were effective and safe to treat generalized canine demodicosis: ivermectin 89.7 percent and moxidectin 87.0 percent.

Criptococose canina: relato de caso / Canine ocular cryptococcosis: a case report

Descreve-se, pela primeira vez no Brasil, um caso de criptococose canina com acometimento oftalmo e dermatopático, com diagnóstico intra-vitam, em animal da raça Pastor Alemão, fêmea, com 24 meses de vida, criado em São Paulo, em contacto com outros cinco cães assintomáticos, que havia se infectado pelo contato com dejetos de pombos (Columba livia). Evoluia há 90 dias, com quadro tegumentar e ósseo, sintomas e lesões características, sendo, ainda, detectada forma assintomática de coriorretinite, de início unilateral. O diagnóstico foi estabelecido pelos dados da anamnese, dos exames físico, dermatológico e complementares (radiográfico, cultivo micológico, histopatologia de pele) tendo-se evidenciado e isolado cepa de Criptococcus neoformans var. neoformans. Após nove meses de terapia com itraconazol (9mg/kg/SID/VO) houve involução total do quadro, sem qualquer efeito adverso à droga.

Estudo dinâmico de Magnesia carbonica / Dynamic study of Magnesia carbonica

O referido trabalho visa o estudo e a compreensäo global do medicamento Magnesia carbonica, baseando-se no perfil psicodinâmico do experimentador e comparando-o com as características inerentes da substância em questäo