Nothing is impossible if you have the right tools and techniques to support

Background: Zonular weakness is a known complication that a surgeon can encounter during cataract surgery. Purpose: The purpose of this video is to make surgeons aware about the different tools and techniques available to handle zonulopathy. Synopsis: This video describes the various causes of zonular weakness and different tools available to manage zonular weakness intraoperatively. The surgical technique of using the tools is also demonstrated in the video. Highlights: Causes of zonular weakness and surgical techniques to handle it intraoperatively.

Altered cisplatin pharmacokinetics during nonalcoholic steatohepatitis contributes to reduced nephrotoxicity

Disease-mediated alterations to drug disposition constitute a significant source of adverse drug reactions. Cisplatin (CDDP) elicits nephrotoxicity due to exposure in proximal tubule cells during renal secretion. Alterations to renal drug transporter expression have been discovered during nonalcoholic steatohepatitis (NASH), however, associated changes to substrate toxicity is unknown. To test this, a methionine- and choline-deficient diet-induced rat model was used to evaluate NASH-associated changes to CDDP pharmacokinetics, transporter expression, and toxicity. NASH rats administered CDDP (6 mg/kg, i.p.) displayed 20% less nephrotoxicity than healthy rats. Likewise, CDDP renal clearance decreased in NASH rats from 7.39 to 3.83 mL/min, renal secretion decreased from 6.23 to 2.80 mL/min, and renal CDDP accumulation decreased by 15%, relative to healthy rats. Renal copper transporter-1 expression decreased, and organic cation transporter-2 and ATPase copper transporting protein-7b increased slightly, reducing CDDP secretion. Hepatic CDDP accumulation increased 250% in NASH rats relative to healthy rats. Hepatic organic cation transporter-1 induction and multidrug and toxin extrusion protein-1 and multidrug resistance-associated protein-4 reduction may contribute to hepatic CDDP sequestration in NASH rats, although no drug-related toxicity was observed. These data provide a link between NASH-induced hepatic and renal transporter expression changes and CDDP renal clearance, which may alter nephrotoxicity.

The effect of different final intracanal irrigants on the bond strength of silicone-based sealer to root canal walls / 天津医药

Objective To evaluate the bond strength of GuttaFlow sealers to root canal walls after final rinse with two novel fi nal irrigation regimens, QMiX and 17%EDTA+0.2%Cetrimide (CTR). Methods Thirty single-canal teeth were prepared chemomechanically using 5.25% sodium hypochlorite (NaOCl) as root canal irrigants. The teeth were then randomly distributed into three groups(n=10)according to the final irrigation protocol:QMiX group,17% EDTA followed by CTR group and control group(normal saline,NS).After the filling with GuttaFlow using a lentulo spiral,the roots were transversally sectioned to obtain 2 mm thick dentinal slices.Then a push-out bond strength test was carried out,and failure mode was determined at×24 magnification.Results The push-out bond strength was significantly higher in QMiX group than that of EDTA+CTR group and NS group(P<0.05),and no significant difference was observed between EDTA+CTR and NS groups(P>0.05).The failure patterns were mainly mixed.Conclusion The QMiX,as the final irrigant,can improve the bond strength of silicone-based sealer GuttaFlow.

Cardiothoracic ratio and vertebral heart size (VHS) to standardize the heart size of the tufted capuchin (Cebus apella Linnaeus, 1758) in computerized radiographic images / Índice cardiotorácico e vertebral heart size (VHS) para a padronização do tamanho cardíaco do macaco-prego (Cebus apella Linnaeus, 1758) em imagens radiográficas computadorizadas

The VHS and CTR were assessed using computerized thoracic radiographs of ten clinically healthy tufted capuchin monkeys (five males and five females) from the Wild Animal Screening Center in São Luís (Centro de Triagem de Animais Silvestres de São Luís-MA-CETAS). Radiographs were taken in laterolateral and dorsoventral projections to calculate the cardiothoracic ratio (VHS) and vertebral heart size (CTR). The VHS showed mean values of 9.34±0.32v (males) and 9.16±0.34v (females) and there was no statistical difference between males and females (p>0.05). The CTR showed mean values of 0.55±0.04 (males) and 0.52±0.03 (females) and there was no statistical difference between the sexes (p>0.05). There was positive correlation between VHS and CTR (r=0.78). The thoracic and heart diameters showed mean values of 5.70±0.48cm and 2.16±0.40cm in the males, respectively. In the females they measured 5.32±0.39cm and 2.94±0.32cm. There was no statistical difference between the sexes. Our results show that the high correlation found between VHS and CTR permitted the verification with similar clinical precision between the two methods to estimate alterations in the heart silhouette by radiographic examination of tufted capuchin, making it an easy technique to apply that can be considered in the investigation of heart problems for this wild species...

Para a avaliação do VHS e ICT foram utilizadas radiografias torácicas computadorizadas de 10 macacos-prego (05 machos e 05 fêmeas) clinicamente saudáveis, oriundos do Centro de Triagem de Animais Silvestres de São Luís-MA-CETAS. Foram tomadas radiografias em projeções laterolaterais e dorsoventrais, para cálculo do Vertebral Heart Scale (VHS) e Índice Cardiotorácico (ICT). O VHS evidenciou valores médios de 9,34±0,32v (machos) e 9,16±0,34v (fêmeas), não ocorrendo diferença estatística entre machos e fêmeas (p>0,05). O ICT evidenciou valores médios de 0,55±0,04 (machos) e de 0,52±0,03 (fêmeas), não sendo verificada diferença estatística entre sexos (p>0,05). Verificou-se correlação positiva entre VHS e ICT (r=0,78). Os diâmetros torácico e cardíaco demonstraram valores médios de 5,70±0,48cm e 3,16±0,40cm nos machos, respectivamente. Nas fêmeas mediram 5,32±0,39cm e 2,94±0,32cm. Não houve diferença estatística entre os sexos (p>0,05). Os nossos resultados demonstraram que a alta correlação encontrada entre o VHS e o ICT permitiu verificar precisão clínica semelhante entre os dois métodos, para estimar alterações da silhueta cardíaca ao exame radiográfico de macacos-prego, constituindo-se como uma técnica de fácil aplicação, poddevendo ser considerada na investigação de problemas cardíacos para esta espécie silvestre...

HIV counseling, testing and referral service for drug users with HIV (+) in the Centers of Social Labor Education No.1 and intervention model

Background: There is an increase in HIV/AIDS among rehabilitation practitioners in Centers of social labor education. Objective: (1) to evaluate prevalence of HIV and morbidity model of rehabilitation practitioners with HIV(+). (2) To describe knowledge of HIV-infection and health of rehabilitation practitioners with HIV(+). (3) To determine need of counseling related to test, treatment and care of rehabilitation practitioners with HIV (+). Subjects and methods: 297 rehabilitation practitioners in Centers of Social Labor Education No.1 surveyed using structured questionnaire, group discussion, in-depth interview. Results: There were 103 rehabilitation practitioner with HIV(+) accounting for 36%. Morbidity patterns among HIV(+) carriers: 36.2% had combined diseases; HCV 74%; co-infected with HBV (18%); recurrence of one disease 11.%; still good immunology response (74.3% hadTCD4>500 cells/mm3). \r\n', u'49.5% perceived AIDS conversion time, about 30% understood on preventing HIV transmission. Common practice was self-treatment (46%) or checking in local general hospitals (38.5%). There was a great need of drug users in Centers of Social Labor Education No.1 for counseling, testing, providing information, ARV treatment and referral system, connecting them to their relatives. Conclusion: HIV-CTR (counseling, testing and referrals services) model should be soon developed in the Center)\r\n', u'\r\n', u'\r\n', u'

Comparison of Anterior Capsule Opening after Silicone Intraocular Lens Implantation with and without Capsular Tension Ring

To evaluate the effect of capsular tension ring on prevention of capsular opening reduction induced by CCC in Phacoemulsification with silicone intraocular lens implantation, we prospectively studied 60 patients (60 eyes)who were operated from Sept, 1997 to Jun, 1998 at our hospital.All patients had standardized Phacoemulsification, continuous curvilinear capsulorhexis, and intraocular lens implantation performed by the same surgeon.Patients were randomized into two groups based on capsular tension ring insertion.We compared uncorrected visual acuity (UCVA), spherical equivalent (SE), astigmatism and the data obtained by the Anterior Eye Segment Analysis System (EAS-1000), anterior chamber depth, IOL tilting, decenteration, and anterior capsule opening area at 1 week and 1, 3, 6 months after surgery.Two groups showed a similar pattern of change of UCVA, SE and astigmatism. There are no statistical significances in comparison of anterior chamber depth and IOL decenteration in two groups, but IOL tilting of group II is greater than that of group I at 6 months after surgery.The mean anterior capsular opening area at 1, 3, 6 months postoperatively was smaller than that of 1 week in two groups, but no statistical significances were observed in group II (1, 3, 6 months, P = or > .05).The mean percentage reduction of group I was significantly smaller than that of group II at 3 and 6 months (P<.05)after surgery.Capsular tension ring might prevent a contraction of capsular opening and might enhance the stability of IOL.