Qualidade de vida e visão pós-facectomia / Quality of life and vision post-facectomy

Resumo Objetivo: A catarata é a principal causa de cegueira reversível no mundo e seu tratamento é baseado em cirurgia, facectomia. A evolução do procedimento tem se baseado em vários pilares, mas é no desenvolvimento de novos tipos de lentes intraoculares que vem mostrando inovações consideráveis. As lentes atuais são capazes, além de tratar a catarata, de corrigir erros refracionais. O objetivo deste estudo foi avaliar a qualidade de vida e de visão pós-facectomia, comparando as lentes multifocais (Restor), tóricas, monofocais esféricas (SN60AT) e monofocais asféricas. Métodos: A pesquisa abrangeu 54 pacientes submetidos a facectomia com implantação de uma das lentes há, pelo menos, 3 meses. Os pacientes responderam questionário de qualidade de vida Cataract TyPE Specification sobre satisfação de visão, dependência de óculos para diversas atividades diárias e presença de fenômenos disfóticos. Para análise dos dados foram utilizados os testes de Kolmogorov-Smirnov, quanto a normalidade e ANOVA com teste de Tukey, quanta parametria. Em comparações não paramétricas, utilizou-se o teste de Mann-Whitney. Em todas as análises foi usado o mesmo nível de significância (p<0,05). Resultados: Numa escala de 0 a 10, a pesquisa mostrou que as lentes SN60AT, esféricas monofocais, foram as que obtiveram menor nível de satisfação entre as 4 lentes, obtendo média de 8,7 (DP= 1,30; IC ± 0,655), seguido das esféricas monofocais (média= 8,3 - DP= 1,83; IC ± 0,927), das esféricas multifocais (Restor) (média = 8,9 - DP = 1,42; IC ± 0,721) e as tóricas (média = 9,1 - DP = 1,67; IC ± 0,844) como a de maior nível de satisfação. Em relação à dependência dos óculos, a lente Restor foi a que mostrou melhor desempenho, com menor dependência dos óculos. Fenômenos disfóticos foram mais frequentes nos pacientes que tiveram implantada a lente SN60AT seguida de lente Restor. Conclusão: Conclui-se que as lentes SN60AT foram as lentes que causaram menor grau de satisfação, tendo os fenômenos disfóticos umas das principais queixas, associada a dependência dos óculos pós-cirurgia. Os pacientes que tiveram as lentes Restor implantadas, apesar dos sintomas disfóticos mais presentes do que as lentes monofocais tóricas e monofocais esféricas, tem o mesmo nível de satisfação, e ainda proporciona maior independência dos óculos.

Abstract Objective: Cataract is the leading cause of reversible blindness in the world and its treatment is based on surgery, facectomy. The evolution of the procedure has been based on several pillars, but it is in the development of new types of intraocular lenses that has been showing considerable innovations. Current lenses are capable, in addition to treating cataracts, of correcting refractive errors. The aim of this study was to evaluate the quality of life and post-facectomy vision, comparing multifocal lenses (Restor), toric, spherical monofocals (SN60AT) and aspheric monofocals. Methods: The study included 54 patients undergoing a facectomy with implantation of one of the lenses for at least 3 months. The patients answered questionnaire quality of life Cataract TyPE Specification on vision satisfaction, glasses dependence for various daily activities and presence of dysphothetic phenomena. For the analysis of the data, the Kolmogorov-Smirnov tests were used, regarding normality and ANOVA with Tukey's test, how much parametric. In non-parametric comparisons, the Mann-Whitney test was used. In all analyzes, the same level of significance was used (p <0.05). Results: On a scale of 0 to 10, the research showed that single-spherical spherical SN60AT lenses were the ones that obtained the lowest level of satisfaction among the four lenses, obtaining an average of 8.7 (SD = 1.30, CI ± 0.655), followed (mean = 8.9 - SD = 1.42, CI ± 0.721) and the toric (mean = 8.3 - SD = 1.83, CI ± 0.927), multifocal spherical (Restor) 9.1 - SD = 1.67, CI ± 0.844) as the highest level of satisfaction. Regarding the dependence of the glasses, the Restor lens showed the best performance, with less dependence on the glasses. Dysphasic phenomena were more frequent in patients who had implanted the SN60AT lens followed by Restor lens. Conclusion: It is concluded that the SN60AT lenses were the lenses that caused less satisfaction, and the dysphothetic phenomena were one of the main complaints, associated with the postoperative glasses dependence. Patients who had restored Restor lenses, despite the more present dysphoric symptoms than spherical monofocal and single-focal lenses, have the same level of satisfaction, and still provide greater independence of the glasses.

UGT74B1 from Arabidopsis thaliana as a versatile biocatalyst for the synthesis of desulfoglycosinolates.

Thioglycosides, even if rare in Nature, have gained increased interest for their biological properties. Chemical syntheses of this class of compounds have been largely studied but little has been reported on their biosynthesis. Herein, combining experiments from the different fields of enzymology, bioorganic chemistry and molecular modeling, we wish to demonstrate the versatility of the glucosyltransferase UGT74B1 and its synthetic potency for the preparation of a variety of natural and unnatural desulfoglycosinolates.

Synthesis of benzofuran derivatives as selective inhibitors of tissue-nonspecific alkaline phosphatase: effects on cell toxicity and osteoblast-induced mineralization.

Tissue-nonspecific alkaline phosphatase (TNAP) by hydrolyzing pyrophosphate, an inhibitor of apatite formation, promotes extracellular matrix calcification during bone formation and growth, as well as during ectopic calcification under pathological conditions. TNAP is a target for the treatment of soft tissue pathological ossification. We synthesized a series of benzofuran derivatives. Among these, SMA14, displayed TNAP activity better than levamisole. SMA14 was found to be not toxic at doses of up to 40µM in osteoblast-like Saos-2 cells and primary osteoblasts. As probed by Alizarin Red staining, this compound inhibited mineral formation in murine primary osteoblast and in osteoblast-like Saos-2 cells.

Inhibitors of tissue-nonspecific alkaline phosphatase: design, synthesis, kinetics, biomineralization and cellular tests.

Chronic kidney disease (CKD) is associated with numerous metabolic and endocrine disturbances, including abnormalities of calcium and phosphate metabolism and an inflammatory syndrome. The latter occurs early in the course of CKD and contributes to the development and progression of vascular calcification. A few therapeutic strategies are today contemplated to target vascular calcification in patients with CKD: vitamin K2, calcimimetics and phosphate binders. However, none has provided complete prevention of vascular calcification and there is an urgent need for alternate efficient treatments. Recent findings indicate that tissue-nonspecific alkaline phosphatase (TNAP) may represent a very promising drug target due to its participation in mineralization by vascular smooth muscle cells. We report the synthesis of four levamisole derivatives having better inhibition property on TNAP than levamisole. Their IC50, Ki and water solubility have been determined. We found that the four inhibitors bind to TNAP in an uncompetitive manner and are selective to TNAP. Indeed, they do not inhibit intestinal and placental alkaline phosphatases. Survival MTT tests on human MG-63 and Saos-2 osteoblast-like cells have been performed in the presence of inhibitors. All the inhibitors are not toxic at concentrations that block TNAP activity. Moreover, they are able to significantly reduce mineralization in MG63 and Saos-2 osteoblast-like cells, indicating that they are promising molecules to prevent vascular calcification.