Sodium fluorescein and 5-aminolevulinic acid fluorescence- guided biopsy in brain lesions: a systematic review and meta-analysis.

PURPOSE: Stereotactic brain biopsies are highly efficient for diagnosing intracerebral pathologies, particularly when surgical resection is infeasible. Fluorescence-based agents such as 5-aminolevulinic acid (5-ALA) and fluorescein sodium (NaFl) can enhance diagnostic accuracy and safety, improving the visualization of lesional tissues. This meta-analysis aimed to evaluate their effect on diagnostic yield and complication rates of brain biopsies. METHODS: This study adhered to Cochrane and PRISMA guidelines. We assessed studies for diagnostic yield and complication rates. Data was analyzed using a random-effects model in RStudio. Diagnostic accuracy measures such as sensitivity and predictive values were calculated based on fluorescence visibility in biopsy samples. RESULTS: Thirty-two non-randomized studies were included, comprising 947 patients, with a mean age ranging from 37 to 77 years, and a mean sample number ranging from 1 to 15 specimens. Diagnostic yields were high: 93% for NaFl and 96% for 5-ALA. Major complications occurred in 3% of procedures with both agents, while minor complications were reported in 7% and 5% with NaFl and 5-ALA respectively. The Negative-predictive-value (NPV) of 5-ALA and NaFl were 8-11% and 60-80% respectively. NaFl demonstrates higher sensitivity and specificity at 84% and 100% compared to 5-ALA's 66%. and 85% respectively. CONCLUSION: 5-ALA and NaFl provide high diagnostic yields with acceptable safety profiles in stereotactic biopsies. NaFl showed higher sensitivity and specificity. NaFl outperforms 5ALA in terms of NPV making it more efficient for small lesions near eloquent regions or major blood vessels. The significance of these findings can be further ascertained through randomized trials.

A light in the darkness: sodium fluorescein-assisted peripheral nerve sheath tumors resection - a comprehensive systematic review and single-arm meta-analysis.

The treatment for peripheral nerve sheath tumors (PNSTs) is based on surgical excision and the primary goal is to improve symptoms whilst preserving neurological function. In order to improve this technique, surgeons may use sodium fluorescein (SF) to help visualize the neoplasm and, consequently, facilitate its removal. Aiming to assess the efficacy of this emerging surgical strategy, we conducted a systematic review and single-arm meta-analysis. We conducted a systematic search on the PubMed, Embase, and Web of Science databases, following the PRISMA guidelines. Studies without outcomes of interest, case series with less than four patients, letters, comments, technical notes, editorials, reviews, and basic research papers were excluded. The outcomes considered for this study were: the number of tumors that achieved total resection, subtotal resection, or near total resection, the approach/technique utilized by the surgeon, SF-related complications, and total complications. Five studies, with a total of 175 individuals, were included in our survey. Notably, 70% of the neoplasms presented by the patients were schwannomas. Considering extracranial lesions, we found a proportion of 96% (95% CI: 88 - 100%) in total resection, 0% (95% CI: 0-1%) in near total resection, and 4% (95% CI: 0-12%) in subtotal resection, all linked to an amount of 185 analyzed PNSTs. Furthermore, a proportion of 1% (95% CI: 0 - 2%) in SF-related complications was spotted among 183 patients. Finally, total complications analysis accounted for 11% (95% CI: 0 - 25%) among 183 individuals. We concluded that SF-assisted resection of PNSTs is a suitable and relatively safe technique, linked to minimum complications, of which the majority was not associated with the chemical compound itself. Future research is necessary to increase the number of patients available in the current literature and, therefore, enhance future analyses.

Exploring the clinical relevance of "Angico Gum": an effective biopolymer for topical protection of oesophageal mucosa in gastroesophageal reflux disease patients.

OBJECTIVES: Angico gum (AG) (Anadenanthera colubrina var. Cebil [Griseb.] Altschul) is utilized by some Brazilian communities to alleviate symptoms from gastroesophageal reflux disease. Here, we aimed to investigate the "in vitro" topical protective capacity of AG on human esophageal mucosa. METHODS: Biopsies of the distal esophageal mucosa were collected from 35 patients with heartburn (24 non-erosive and 11 with erosive oesophagitis (EE)) and mounted in Üssing chambers. AG was applied topically, followed by exposure with acid solution (pH 2.0 or pH 1.0), where transepithelial electrical resistance (TER) and The transepithelial permeability for fluorescein was assessed. The incubation of the AG labeled with FITC in the esophageal mucosa was localized by fluorescence microscopy. KEY FINDINGS: Pretreatment with AG prevented the drop in TER induced by acid solution, as well as significantly decreases the fluorescein permeability in non-erosive patients. The protective effect of AG was sustained for up to 120 min both in biopsies of non-erosive and erosive esophagitis. Confocal microscope images showed mucosal luminal adherence of FITC-labeled AG. CONCLUSION: AG had a prolonged topical protective effect against acid solution in mucosal biopsies of patients with non-erosive and erosive esophagitis.

Effect of upper eyelid blepharoplasty on the ocular surface, tear film, and corneal microstructure.

PURPOSE: This study aimed to investigate the effect of upper eyelid blepharoplasty with the removal of the skin and a strip of orbicularis oculi muscle on the ocular surface, tear film, and dry eye-related symptoms. METHODS: Twenty-two eyes of 22 consecutive patients operated by a single surgeon (21 females; mean age, 61 years; age range, 41-75 years) were included. All subjects completed the Ocular Surface Disease Index questionnaire, underwent in vivo confocal microscopy, tear film breakup time measurements, the Schirmer test with anesthesia, and fluorescein and lissamine green staining measurements before, 1 month, and 6 months after upper blepharoplasty alone with preseptal orbicularis excision. RESULTS: A significant increase in Ocular Surface Disease Index, and corneal fluorescein and lissamine green staining and a significant decrease in tear film breakup time were observed after 1 month (p=0.003, p=0.004, p=0.029, and p=0.024 respectively) and 6 months (p=0.001 for all findings). No significant difference in the Schirmer test score was observed during the follow-up. None of the in vivo confocal microscopy parameters showed significant changes during the study. CONCLUSIONS: An increase in dry eye symptoms and a decrease in tear film stability along with ocular surface staining were observed in patients undergoing upper eyelid blepharoplasty.

Análise do filme lacrimal e dos sintomas de olho seco em pacientes submetidos à facoemulsificação / Analysis of the tear film and dry eye symptoms in patients undergoing phacoemulsification

RESUMO Objetivo: Avaliar o filme lacrimal e os sintomas de olho seco antes e após a realização da facoemulsificação. Métodos: Participaram deste estudo clínico 51 pacientes diagnosticados com catarata (55% mulheres; 78% brancos; 71,2 ± 6,5 anos de idade; sem uso de colírio lubrificante) que foram submetidos à facoemulsificação em um hospital na cidade de Aparecida (SP). A análise do filme lacrimal foi feita pelo teste de ruptura do filme lacrimal, e os sintomas de olho seco foram avaliados pelo Índice de Doença da Superfície Ocular, ambos antes da cirurgia e 30 e 60 dias de pós-operatório. Resultados: Na análise pré-operatória, 25,5% dos pacientes tinham olho seco pelo critério subjetivo (Índice de Doença da Superfície Ocular ≥ 25%), enquanto a proporção de pacientes com olho seco foi de 92,2% pelo critério objetivo (teste de ruptura do filme lacrimal < 10 segundos). Não houve correlação entre o teste de ruptura do filme lacrimal e o Índice de Doença da Superfície Ocular (r = −0,14; p = 0,33). Não foi observada redução dos sintomas de olho seco (15,9 ± 17,6 versus 12,2 ± 13,2 versus 7,8 ± 11,5; p < 0,001) e nem do tempo de ruptura do filme lacrimal (6,2 ± 2,2 vs. 4,3 ± 2,0 versus 6,9 ± 2,0 segundos; p < 0,001) no pré, 30 e 60 dias após a cirurgia. Conclusão: A facoemulsificação desencadeia sintomas de olho seco e altera os valores do teste de ruptura do filme lacrimal e do Índice de Doença da Superfície Ocular, havendo melhora depois da cirurgia, com o passar dos dias. Observou-se que, após os 60 dias, os sintomas de olho seco avaliados pelo Índice de Doença da Superfície Ocular apresentaram melhora. Em relação ao filme lacrimal, avaliado pelo teste de ruptura do filme lacrimal, observou-se que houve piora estatisticamente significativa aos 30 dias, seguida de melhora no pós-operatório de 60 dias. Os resultados sugerem que a análise clínica do olho seco deve ser realizada por diferentes métodos, preferencialmente objetivos.

ABSTRACT Objective: To evaluate the tear film and dry eye symptoms before and after phacoemulsification. Methods: Fifty-one patients diagnosed with cataracts participated in this clinical study (55% female; 78% white; 71.2 ± 6.5 years old; without the use of lubricating eye drops) and underwent phacoemulsification at a hospital in Aparecida (SP). Tear film analysis was performed by the tear film break-up test and dry eye symptoms were assessed by the Ocular Surface Disease Index, both before surgery and 30 and 60 days after surgery. Results: In the preoperative analysis, 25.5% of the patients had dry eye according to the subjective criterion (Ocular Surface Disease Index ≥ 25%), while the proportion of patients with dry eye was 92.2% according to the objective criterion (tear film break-up test < 10 seconds). There was no correlation between tear film break-up test and Ocular Surface Disease Index (r = −0.14; p = 0.33). There was no reduction in dry eye symptoms (15.9 ± 17.6 versus 12.2 ± 13.2 versus 7.8 ± 11.5; p<0.001) nor in tear film break-up time (6.2 ± 2.2 versus 4.3 ± 2.0 versus 6.9 ± 2.0 seconds; p < 0.001) before, 30 and 60 days after surgery. Conclusion: Phacoemulsification triggers dry eye symptoms and changes Ocular Surface Disease Index and tear film break-up test values, with improvement over the postoperative days. Sixty days after surgery, the symptoms of dry eye assessed according to the Ocular Surface Disease Index improved. Regarding the tear film, evaluated by tear film break-up test, it was observed that there was a statistically significant worsening at 30 days, followed by an improvement in the postoperative period of 60 days. The results suggest that the clinical analysis of dry eye should be performed using different methods, preferably objective ones.

Fluorescein-guided resection for pediatric low-grade gliomas: institutional experience on two cases and a narrative literature review.

PURPOSE: Low-grade gliomas compose 30% of pediatric central nervous system tumors and outcomes of disease-free progression, and survival is directly correlated to the extent of resection. The use of sodium fluorescein (Na-Fl) is an intraoperative method in the localization of tumor cells in adult patients to optimize resection. Our purpose is to describe the use of Na-Fl in pediatric low-grade gliomas and its outcomes. METHODS: Patients under 18 years of age with low-grade gliomas at the author's institution underwent resection with the use of Na-Fl, with review of preoperative imaging findings, intraoperative results, and follow-up. Then, a comprehensive, narrative literature review of the use of Na-Fl in pediatric low-grade glioma was performed. RESULTS: Our single-institution use of Na-Fl in pediatric patients with suspected low-grade glioma demonstrated excellent results of intraoperative enhancement of tumor cells as well as gross total resection. The literature demonstrated 84% Na-Fl staining and 59.2% of gross total resection in pediatric low-grade gliomas with few small case studies, a range of reported findings, and few side effects. CONCLUSION: Na-Fl has a promising use in low-grade glioma resection in the pediatric patient population. Further research is warranted, such as randomized controlled studies, to assess Na-Fl as a potential tool in improving resection and long-term favorable outcomes.

New Benzotriazole and Benzodithiophene-Based Conjugated Terpolymer Bearing a Fluorescein Derivative as Side-Group: In-Ternal Förster Resonance Energy Transfer to Improve Organic Solar Cells.

A new benzodithiophene and benzotriazole-based terpolymer bearing a fluorescein derivative as a side group was synthesized and studied for organic solar cell (OSC) applications. This side group was covalently bounded to the backbone through an n-hexyl chain to induce the intramolecular Förster Resonance Energy Transfer (FRET) process and thus improve the photovoltaic performance of the polymeric material. The polymer exhibited good solubility in common organic chlorinated solvents as well as thermal stability (TDT10% > 360 °C). Photophysical measurements demonstrated the occurrence of the FRET phenomenon between the lateral group and the terpolymer. The terpolymer exhibited an absorption band centered at 501 nm, an optical bandgap of 2.02 eV, and HOMO and LUMO energy levels of −5.30 eV and −3.28 eV, respectively. A preliminary study on terpolymer-based OSC devices showed a low power-conversion efficiency (PCE) but a higher performance than devices based on an analogous polymer without the fluorescein derivative. These results mean that the design presented here is a promising strategy to improve the performance of polymers used in OSCs.

A plethora of ocular surface manifestations in a multidisciplinary ocular graft-versus-host disease unit.

To describe the experience in a recently created ocular graft-versus-host disease unit in a tertiary hospital and to detail ocular surface features and complications after allogeneic hematopoietic stem cell transplantation (allo-HSCT). This retrospective study included all patients who underwent allo-HSCT, with or without chronic GVHD and were being monitored in the Hematopoietic Stem Cell Transplantation Unit in the UNICAMP Clinical Hospital (Campinas, Sao Paulo, Brazil) from 2015 to 2020. Patients were concomitantly evaluated by hematology and ophthalmology teams of the Ocular GVHD Unit. Hematologists performed a comprehensive systemic evaluation searching and grading mouth, skin, lungs, gastrointestinal tract, liver and genitalia GVHD. While ophthalmologists evaluated ocular symptoms through specific questionnaire (Ocular Surface Disease Index-OSDI) and a protocol of distinct ocular surface parameters for dry eye disease (1) and ocular complications, which encompassed meniscometry, non-invasive tear break-up time (NITBUT) measurement, conjunctival hyperemia quantification, meibography, fluorescein and lissamine staining and Schirmer's test. Patients were diagnosed with chronic GVHD using the National Institutes of Health (NIH) Consensus Criteria for Chronic Graft-versus-Host Disease. The International Chronic Ocular GVHD Consensus Group (ICOGCG) score was obtained at the onset of ocular disease presentation or afterwards. A total of 82 patients underwent allo-HSCT (97.6% full matched and 2.4% haploidentical), mainly for cases of leukemia and 73.2% had chronic GVHD. Mean onset time for chronic GVHD was 232 ± 7.75 days. The mouth, skin, and eyes were the main organs involved (63%, 50%, and 48%, respectively). Symptom scores and all ocular surface parameters differ in patients with and without chronic GVHD and along different timepoints of the follow-up. Ocular complications mostly involved were severe DED and meibomian gland dysfunction, conjunctival scarring, cataract and infections resulting in keratitis and corneal perforation. As therapeutic strategies, 73% patients received preservative-free lubricants, 27% autologous serum, 48% topical steroids, 27% oral tetracycline derivatives, 22% mucolytic eye drops and 3 patients needed bandage contact lens. Ocular GVHD is a complex and challenging disease with varied manifestations, resulting in a broad range of ocular test endpoints, and inconsistent treatment responses. The main ocular presentations were dry eye, meibomian gland dysfunction and cataracts. The therapeutic approach often involves topical steroids and autologous serum tears. It is important to monitor these patients closely, so the ocular GVHD Unit may improve the care, providing prompt identification of ocular manifestations and faster treatment of complications.

Profile of IL-6 and TNF in Foam Cell Formation: An Improved Method Using Fluorescein Isothiocyanate (FITC) Probe. / Perfil de IL-6 e TNF na Formação de Células Espumosas: Um Método Aprimorado Usando a Sonda de Isotiocianato de Fluoresceína (FITC).

BACKGROUND: The formation of foam cells occurs due to the increase in low-density plasma lipoprotein (LDL) and dysregulation of inflammation, which is important for the development of atherosclerosis. OBJECTIVE: To evaluate the profile of tumor necrosis factor-alpha (TNF-α) and Interleukin-6 (IL-6) in the existing foam cell formation method, optimizing this protocol. METHODS: The LDL was isolated, oxidized, and labeled with a Fluorescein isothiocyanate (FITC) probe. Foam cells were generated from THP-1 human monocyte-derived cells and incubated in the absence (control) or presence of FITC-ox-LDL (10, 50, 100, 150, or 200 µg/mL), for 12, 24, 48, or 72 hours. The accumulated FITC-ox-LDL in the cell was quantified by microscopy. The enzyme-linked immunosorbent assay was evaluated to quantify the IL-6 and TNF-α, with p < 0.05 considered significant. RESULTS: All the FITC-ox-LDL concentrations tested showed a higher fluorescence when compared to the control, showing a greater accumulation of lipoprotein in cells. The higher the concentration of FITC-ox-LDL, the greater the production of TNF-α and IL-6. The production of IL-6 by foam cells was detected up to the value of 150 µg/mL of the maximum stimulus for LDL. Concentrations above 50 µg/mL LDL stimulated greater release of TNF-α compared to control. CONCLUSIONS: Our model contributes to the understanding of the release of IL-6 and TNF-α in response to different concentrations of ox-LDL, using an optimized method for the formation of foam cells.

FUNDAMENTO: A formação de células espumosas ocorre devido ao aumento em lipoproteína plasmática de baixa densidade (LDL) e desregulação da inflamação, sendo importante para o desenvolvimento da aterosclerose. OBJETIVO: Avaliar o perfil do fator de necrose tumoral alfa (TNF-α) e da interleucina-6 (IL-6) no método de formação da célula espumosa existente, otimizando esse protocolo. MÉTODOS: A LDL foi isolada, oxidada e marcada com sonda de isotiocianato de fluoresceína (FITC). As células espumosas foram geradas de célula derivada de monócitos humanos THP-1 e incubadas na ausência (controle) ou presença de FITC-ox-LDL (10, 50, 100, 150 ou 200 µg/mL), por 12, 24, 48 ou 72 horas. A FITC-ox-LDL na célula foi quantificada por microscopia. O ensaio de imunoabsorção enzimática foi avaliado para quantificar a IL-6 e o TNF-α, com um p <0,05 considerado significativo. RESULTADOS: Todas as concentrações de FITC-ox-LDL testadas apresentaram fluorescência mais alta em comparação com o controle, demonstrando maior acúmulo de lipoproteínas nas células. Quanto mais alta a concentração de FITC-ox-LDL, maior a produção de TNF-α e IL-6. A produção de IL-6 pelas células espumosas foi detectada até o valor de 150 µg/mL da LDL máxima de estímulo. Concentrações acima de 50 µg/mL de LDL estimularam maior liberação de TNF-α comparado ao controle. CONCLUSÕES: Nosso modelo contribui para o entendimento da liberação de IL-6 e TNF-α em resposta a várias concentrações de ox-LDL usando o método otimizado para a formação de células espumosas.

Application of lectins for detection of glycomic differences in the epididymal duct in water buffalo (Bubalus bubalis) and dromedary camel (Camelus dromedarius) / Aplicación de lectinas para la detección de diferencias glucómicas en el conducto epididimario en búfalos de agua (Bubalus bubalis) y dromedarios (Camelus dromedarius)

SUMMARY: The present study was conducted to detect the differences in glycohistochemical features in the epididymal duct of the dromedary camel and the water buffalo. Epididymal sections (caput, corpus and cauda) from both species were stained with fluorescein isothiocyanate (FITC) conjugated lectins. Binding sites for five lectins (DBA, GSA-1, HPA, PNA and WGA) have been found in both species. The binding sites of different lectins showed significant variations in the pattern of distribution in both a species. This included both species-specific and region-specific order. Additionally, only three (GSA-1, PNA and WGA) out the five lectins studied exhibited binding sites in all epididymal regions in both species. The other two lectins (DBA and HPA) followed the same order recorded for the other three (GSA-1, PNA and WGA) in buffalo, but failed to show any binding sites in cauda epididymis in camel. In conclusion, the variable regional and species-specific distribution features of lectins revealed that both species have diverse glycomic characteristics that may be related to their different reproductive patterns. However, the glycome-associated functional capacities remain obscured and need further profound investigations.

RESUMEN: El presente estudio se realizó para detectar las diferencias en las características glicohistoquímicas del conducto epididimal del dromedario y el búfalo de agua. Las secciones del epidídimo (cabeza, cuerpo y cola) de ambas especies se tiñeron con lectinas conjugadas con isotiocianato de fluoresceína (FITC). Se encontraron sitios de unión para cinco lectinas (DBA, GSA-1, HPA, PNA y WGA) en ambas especies. Los sitios de unión de diferentes lectinas mostraron variaciones significativas en el patrón de distribución en ambas especies. Esto incluía tanto el orden específico de la especie como el específico de la región. Además, solo tres (GSA-1, PNA y WGA) de las cinco lectinas estudiadas exhibieron sitios de unión en todas las regiones del epidídimo en ambas especies. Las otras dos lectinas (DBA y HPA) siguieron el mismo orden registrado para las tres restantes (GSA-1, PNA y WGA) en búfalos, pero no mostraron ningún sitio de union en la cola del epidídimo en camellos. En conclusión, las características de distribución regionales y específicas de especies variables de las lectinas revelaron que ambas especies tienen características glucómicas diversas que pueden estar relacionadas con sus diferentes patrones reproductivos. Sin embargo, las capacidades funcionales asociadas con el glicoma permanecen desconocidas y requieren mayor investigación.

Validation of a preclinical dry eye model in New Zealand white rabbits during and following topical instillation of 1% ophthalmic atropine sulfate.

BACKGROUND: The objective of this study was to validate an animal model for dry eye during and after the administration of 1% ophthalmic atropine sulfate (OAS) in New Zealand white (NZW) rabbits. METHODS: OAS (1%) was applied three times per day to 30 eyes of 15 healthy NZW rabbits. Sacrifice, enucleation, and lacrimal gland removal took place on days 15, 21, and 30 (OAS group). A second group (n = 5) was used as control. Clinical evaluations took place on days 3, 10, 15, 18, 21, 24 and 30. The primary endpoints were: Schirmer I test, tear break-up time (TBUT), and corneal fluorescein staining. As secondary endpoints, clinical changes including intraocular pressure, and histopathology were evaluated. RESULTS: While OAS was administered, the Schirmer I test showed a statistically significant reduction for OAS group versus control (p < 0.001), and versus basal production (p < 0.001). TBUT showed statistically significant differences between groups (days 3 and 10; p = 0.001) and versus basal values (day 3; p < 0.001). Fluorescein staining showed a statistically significant difference (day 3; p = 0.001). The most frequent clinical finding was conjunctival hyperemia (76.9% OAS vs. 20% control). For histopathology, all OAS subjects presented some degree of inflammation (86.7% minimal; 13.3% mild) whereas the control presented only 30% minimal inflammation. Goblet cell density showed no difference. CONCLUSIONS: The effectiveness of the OAS dry eye model in NZW rabbits as reported in previous studies was confirmed, provided that the application of the drug is maintained throughout the intervention; it is not a viable model after OAS administration is suspended.

Fast ORAC-SIA method for antioxidant capacity determination in food samples.

A novel fluorescent ORAC-SIA method to determine antioxidant capacity in several food samples using fluorescein as the probe was developed. The optimization of the method was through a multivariable design, decreasing the analysis time to 5 min and the AAPH concentration to 67% compared with 90 min in the standard 96-well microplate method. The aspiration order was AAPH-sample/standard-fluorescein injected into a stream of a water-based carrier. The calculation of the antioxidant capacity was done from the fluoresceine peak heigh, so neither delay time nor area measurement was necessary. The proposed method showed excellent precision (RDS < 3%) with a LOD of 3.13 µmol L-1 and recoveries from 90% to 107%. The results from the ORAC-SIA method did not show a significant difference from the microplate method.

Eye diseases associated with psoriatic arthritis in the Amazon.

PURPOSE: Ocular disorders are among the most frequent manifestations of psoriatic arthritis. The incidence, type, and severity of these disorders may be influenced by genetics, local environmental factors, and access to ophthalmic treatment. Here we describe the ocular manifestations of psoriatic arthritis among denizens of the Amazon region of Para, Brazil, treated by the rheumatology service of Universidade do Estado do Pará. METHODS: This cross-sectional study examined 23 psoriatic arthritis patients (median age 47.78 years, no sex predominance) diagnosed according to Caspar's criteria. Disease activity was evaluated according to the Clinical Disease Activity Index for Psoriatic Arthritis. Ophthalmological examinations performed included visual acuity with distance correction, biomicroscopy, applanation tonometry, fundoscopy, Schirmer test I, tear breakup time, fluorescein staining, and lissamine green staining. Patients also completed The Ocular Surface Disease Index questionnaire. RESULTS: The most common ophthalmic disorders were dry eye (60.9%), cataracts (56.5%), blepharitis (47.8%), keratitis (43.5%), meibomitis (30.4%), pterygium (26, 1%), and pinguecula (13%). More than half of all patients demonstrated recent onset (>5 years), the peripheral disease type, and severe symptoms according to Clinical Disease Activity Index for Psoriatic Arthritis. CONCLUSION: The ocular manifestations of psoriatic arthritis are varied and mainly affect the ocular surface. Regular ophthalmological follow-up is recommended for patients in the early stage with high disease activity.

Microcirugía mínimamente invasiva para aneurisma de la arteria comunicante anterior: abordaje supraorbitario lateral más angiografía con fluoresceína intraoperatoria / Minimally invasive micro surgery for aneurysm of the anterior communicating artery: supra-orbitary lateral approach with intraoperative Fluorescein Angiography

RESUMEN Los aneurismas de la arteria comunicante anterior son complejos y requieren de tratamiento endovascular o microquirúrgico según sus características. El uso de enfoques mínimamente invasivos en microcirugía continúa evolucionando. Presentamos el caso de un paciente de 34 años con un aneurisma cerebral no roto de AcoA de cuello ancho, con escala de Glasgow de 15 puntos. Se realizó un abordaje supraorbitario lateral más "clipaje" total del aneurisma usando angio fluoresceína intraoperatoria. Se logró el objetivo con seguridad y eficacia; al mismo tiempo se optimizó el tiempo quirúrgico y hospitalario, maximizando la comodidad del paciente, estética y reanudación a sus actividades tempranas. (AU)

SUMMARY Anterior communicating artery aneurisms (ACAA) are complex and require endovascular or microsurgery approaches. The use of minimally invasive microsurgery techniques is evolving. We present the case of a 34-yearold patient with a broad neck, non-broken, ACAA with a Glasgow coma scale of 15 points. A lateral supra-orbitary approach with total clipping of the ACAA using intra-operatory fluorescein angiography was performed. The objective was accomplished successfully and safe, optimizing both intra-operative and hospitalization times, thus,maximizing patient comfort, esthetic and prompt return to normal duties. (AU)

Oral pilocarpine for the treatment of dry eye in patients with Sjögren's syndrome.

PURPOSE: To evaluate the efficacy of oral pilocarpine (20 mg daily) for the treatment of dry eye in patients with Sjogren's Syndrome. The frequency of side effects reported during the treatment was also investigated. METHODS: In this placebo-controlled crossover study, 32 patients with Sjögren's syndrome were enrolled to receive either oral pilocarpine or placebo for 10 weeks. Following a 2-week washout period, the treatment was inverted for each patient for the same duration. Assessments included the quality of life National Eye Institute Visual Function Questionnaire-25 (NEI-VFQ-25), dry eye specific questionnaire Ocular Surface Disease Index, non-invasive breakup time, invasive breakup time with fluorescein, corneal and conjunctival staining patterns with the use of fluorescein and rose bengal staining, Schirmer's test, and tear ferning test. RESULTS: According to the NEI-VFQ-25, there was statistically significant improvement in the quality of life following oral pilocarpine. Similar results were observed for ocular discomfort, as determined by the Ocular Surface Disease Index. All clinical tests showed favorable and statistically significant results following the use of oral pilocarpine. Regarding the analysis of tear samples, there was an improvement in the quality of tear film. This was evidenced by the modification of the patterns observed in the tear ferning test. Side effects were reported by 96.8% and 56.2% of the patients who received pilocarpine and placebo, respectively. Sweating was the most frequently reported side effect (67.74% versus 11.11%, respectively). CONCLUSIONS: Although the treatment was associated with a high frequency of side effects, oral pilocarpine (20 mg daily) was able to relieve discomfort related to dry eyes in patients with Sjögren's syndrome and induce favorable structural changes in the tear film.

Modified dry bean pod waste (Phaseolus vulgaris) as a biosorbent for fluorescein removal from aqueous media: Batch and fixed bed studies.

This study presents the use of dry bean pods as a solid phase for fluorescein removal from water. The non-pretreated solid phase did not display any sorption properties for the chosen dye. However, interesting sorption properties were observed following a chemical derivative treatment with nitric acid. The study was carried out using both batch and column approaches. Regarding the batch study, all parameters that influence sorption capacity, such, as pH, adsorbent mass, ionic strength, temperature and contact time, were evaluated. A sorptive capacity of 36.80 mg g-1 was obtained in the optimized condition. In the fixed column bed study, the influence of particle size, flow rate and initial concentration of the dye were evaluated through breakthrough curves and a sorptive capacity of 4.35 mg g-1 was obtained. Thermodynamic studies revealed that the adsorption is exothermic and spontaneous. Four different models, Langmuir, Freundlich, Temkin and Redlich-Patterson, were employed. The Akaike information criterion (AIC) was employed to rank the best equilibrium model, which was determined as the Freundlich isotherm. The method was applied to a real sample and the same removal rate was obtained, thus indicating its suitability to wastewater treatment.

A Selective Fluorescent Probe for the Determination and Imaging of Fluoride in Living Cells

Abstract Fluoride anions are indispensable trace elements required for sustaining life. To investigate the homeostasis and action of fluoride in the body, a new highly sensitive and selective fluorescence detection method was designed for fluoride in aqueous solutions. A fluorescent probe for fluoride (FP-F) was synthesized for imaging F- in living cells. The design strategy for the probe was based on the specific reaction between fluoride and silica to mediate deprotection of this probe to fluorescein. Upon treatment with F-, FP-F, a closed and weakly fluorescent lactone, was transformed into an open and strongly fluorescent product. Under the optimum conditions, the detection limit for fluoride was 0.526 nM. FP-F could detect micromolar changes in F- concentrations in living cells by confocal microscopy.

Evaluation of microbial contamination in multi-dose fluorescein eyedrops in a reference eye center.

PURPOSE: To analyze the presence of microorganisms in fluorescein eyedrops used in a reference eye center in Recife-PE. METHODS: This real-life and masked study evaluated fluorescein eyedrops used at the Altino Ventura Foundation in May 2019. Cultures were performed according to exposure times; I) three eyedrop bottles were analyzed after one day of use, II) three eyedrop bottles after 4 d of use, III) three eyedrop bottles after 8 d of use, and IV) three unopened bottles used as control. Samples were collected from the bottle's tip, instilled drop, and residual fluid. After incubation, all colonies were analyzed and identified through biochemical tests. RESULTS: The contamination rate of the fluorescein eyedrop bottles in this study was 55.5% (5/9 vials). There was no contamination in the control group. The highest contamination was seen in one day exposed eyedrops, in 100% of the bottles. The bottle's tip had a higher rate of contamination compared to the drop and residual fluid. Gram-positive bacteria were isolated in 7/27 (25.9%) samples. Growth of fungi or gram-negative bacteria was not observed. CONCLUSION: The identification of gram-positive bacteria predominantly on the tip of the fluorescein eyedrop bottles suggests inadequate handling as the main cause of contamination.

Determination of Antioxidant Activity by Oxygen Radical Absorbance Capacity (ORAC-FL), Cellular Antioxidant Activity (CAA), Electrochemical and Microbiological Analyses of Silver Nanoparticles Using the Aqueous Leaf Extract of Solanum mammosum L.

PURPOSE: The importance of studying polyphenolic compounds as natural antioxidants has encouraged the search for new methods of analysis that are quick and simple. The synthesis of silver nanoparticles (AgNPs) using plant extracts has been presented as an alternative to determine the total polyphenolic content and its antioxidant activity. METHODS: In this study, aqueous leaf extract of Solanum mammosum, a species of plant endemic to South America, was used to produce AgNPs. The technique of oxygen radical absorption capacity using fluorescein (ORAC-FL) was used to measure antioxidant activity. The oxidation of the 2´,7´-dichlorodihydrofluorescein diacetate (DCFH2-DA) as fluorescent probe was used to measure cellular antioxidant activity (CAA). Electrochemical behavior was also examined using differential pulse voltammetry (DPV) and cyclic voltammetry (CV). Total polyphenolic content (TPH) was analyzed using the Folin-Ciocalteu method, and the major polyphenolic compound was analyzed by high performance liquid chromatography with diode array detector (HPLC/DAD). Finally, a microbial analysis was conducted using Escherichia coli and Bacillus sp. RESULTS: The average size of nanoparticles was 5.2 ± 2.3 nm measured by high-resolution transmission electron microscopy (HR-TEM). The antioxidant activity measured by ORAC-FL in the extract and nanoparticles were 3944 ± 112 and 637.5 ± 14.8 µM ET/g of sample, respectively. Cellular antioxidant activity was 14.7 ± 0.2 for the aqueous extract and 12.5 ± 0.2 for the nanoparticles. The electrochemical index (EI) was 402 µA/V for the extract and 324 µA/V for the nanoparticles. Total polyphenolic content was 826.6 ± 20.9 and 139.7 ± 20.9 mg EGA/100 g of sample. Gallic acid was the main polyphenolic compound present in the leaf extract. Microbiological analysis revealed that although leaf extract was not toxic for Escherichia coli and Bacillus sp., minor toxic activity for AgNPs was detected for both strains. CONCLUSION: It is concluded that the aqueous extract of the leaves of S. mammosum contains nontoxic antioxidant compounds capable of producing AgNPs. The methods using AgNPs can be used as a fast analytical tool to monitor the presence of water-soluble polyphenolic compounds from plant origin. Analysis and detection of new antioxidants from plant extracts may be potentially applicable in biomedicine.