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1.
Arch. Soc. Esp. Oftalmol ; 98(12): 713-717, dic. 2023. ilus
Artigo em Espanhol | IBECS | ID: ibc-228146

RESUMO

Describimos un caso de vasculopatía coroidea polipoidea con líquido subretiniano persistente a pesar de múltiples tratamientos intravítreos con bevacizumab, ranibizumab y aflibercept, así como aflibercept asociado a terapia fotodinámica. El paciente alcanzó la resolución completa después de la inyección intravítrea de brolucizumab, pero experimentó una recurrencia del líquido subretiniano 12 semanas después de la suspensión. Brolucizumab podría ser una opción para tratar el líquido subretiniano después del fracaso de otros agentes anti-VEGF asociados con la terapia fotodinámica. (AU)


We describe one case of polypoidal choroidal vasculopathy with persistent subretinal fluid despite multiple treatment with intravitreal bevacizumab, ranibizumab and aflibercept, as well as aflibercept associated with photodynamic therapy. The patient reached complete resolution after intravitreal brolucizumab injection, but experienced recurrence of subretinal fluid 12 weeks after discontinuation. Brolucizumab might be an option in treating subretinal fluid after failure of other anti-VEGF agents associated with photodynamic therapy. (AU)


Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Anticorpos Monoclonais Humanizados/administração & dosagem , Fotoquimioterapia , /terapia , Resultado do Tratamento
2.
Arch Soc Esp Oftalmol (Engl Ed) ; 98(12): 713-717, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-37951353

RESUMO

We describe one case of polypoidal choroidal vasculopathy with persistent subretinal fluid despite multiple treatment with intravitreal Bevacizumab, Ranibizumab and Aflibercept, as well as Aflibercept associated with photodynamic therapy. The patient reached complete resolution after intravitreal Brolucizumab injection, but experienced recurrence of subretinal fluid 12 weeks after discontinuation. Brolucizumab might be an option in treating subretinal fluid after failure of other anti-VEGF agents associated with photodynamic therapy.


Assuntos
Doenças da Coroide , Fotoquimioterapia , Humanos , Doenças da Coroide/tratamento farmacológico , Doenças da Coroide/complicações , Vasculopatia Polipoidal da Coroide
3.
Meat Sci ; 206: 109324, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-37683507

RESUMO

This research aimed to evaluate the influence of high-intensity ultrasound (HIU) levels (control: 0; high: 747.79; ultra-high: 1344.17 Wcm-2) on pH, instrumental color (redness, R630/580, hue angle and chroma) and oxidative stability (lipid and protein oxidation) of Psoas major (PM) muscle from Nellore cattle raised in two feeding systems: grain and pasture. Using a structural equation modeling (SEM) approach, the relations (P > 0.05) between exogenous (HIU levels) and endogenous (pH, color, lipid and protein oxidation) variables were observed. In beef from grain-fed animals the pH was directly and negatively related to lipid oxidation (γ = -0.321), hue angle (γ = -0.847) and chroma (γ = -0.442) and protein oxidation (γ = -0.752). In PM from pasture-fed HIU exhibited a negative relation with lipid (γ = -0.144) and protein (γ = -0.743) oxidation, suggesting a possible positive influence on the oxidative stability of meat and a positive relation with redness (γ = 0.197) and R630/580 (γ = 0.379). The HIU positively influenced the color and oxidative stability of beef from Bos indicus cattle, and a synergistic effect of HIU and feeding system on beef from pasture-fed animals.

4.
Meat Sci ; 192: 108871, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-35716529

RESUMO

Considering the relevance of meat discoloration for meat production chain and the conflicting results regarding the influence of feeding regimes on color of fresh beef and the lack of meta-analytic studies on this subject we investigated the effect of grain-fed and pasture-fed regimes on color of beef longissimus from Bos cattle through a systematic review with meta-analysis. A systematic search from 2001 to 2021 was performed in two databases and 126 papers were eligible for meta-analysis. Pasture-fed longissimus beef exhibited higher a* (8.21%) and C* (8.61%) values, and lower h* values (17.18%) than grain-fed counterparts, indicating a greater color for longissimus beef from pasture-fed animals. Among the pasture-fed regimes, those containing alfalfa, bermudagrass, cowpea and pearl millet were the most effective for color improvements. Our findings indicate potential feeding regimes to mitigate global economic losses from meat discoloration and suggest the necessity to develop suitable processing strategies to improve the color of beef from grain-fed Bos cattle.


Assuntos
Ração Animal , Carne , Músculo Esquelético , Ração Animal/estatística & dados numéricos , Animais , Bovinos , Cor , Grão Comestível , Carne/análise
5.
J Dairy Sci ; 103(11): 10022-10035, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32896416

RESUMO

The aim of this study was to evaluate the effect of ricotta whey (RW), cheese whey (CW), and butter whey (BUW) as replacers of whole milk (WM) at different ratios (0:100, 25:75, 50:50, 75:25, and 100:0) in the physicochemical and sensory qualities of ice cream. All formulations, including a commercial sample used as reference, were analyzed for nutritional composition, energy value, pH, titratable acidity (TA), melting behavior, desorption index, instrumental color properties, instrumental hardness, and consumer sensory testing. Overall, the addition of RW, CW, and BUW increased the moisture content, TA, melting rate, and redness (a*) and yellowness (b*) values but decreased the pH, lightness (L*) value, energy value, levels of ash, protein, lipid, and carbohydrate. As exception, CW did not influence the TA, and BUW resulted in lower lipid reduction and in lower hardness changes, and it did not affect the content of ash, protein, and a* and b* values of ice creams. Any ice cream formulation had dietary fibers and a desorption index. Ricotta whey and CW at all ratios and BUW at 25% did not affect overall liking compared with the commercial sample, whereas purchase intention was only decreased by the addition of BUW from 50 to 100%. Ricotta whey at 75 and 100% decreased melting velocity and creaminess, and BUW at 50, 75, and 100% increased hardness, TA, and cream flavor but decreased creaminess, which contributed negatively to overall liking. Therefore, the evaluated dairy by-products, especially RW and CW, have great potential for replacing milk in ice creams.


Assuntos
Queijo/análise , Sorvetes/normas , Substitutos do Leite/química , Soro do Leite/química , Carboidratos/análise , Fenômenos Químicos , Comportamento do Consumidor , Laticínios/análise , Concentração de Íons de Hidrogênio , Lipídeos/análise , Proteínas/análise , Paladar
6.
Food Chem ; 169: 471-7, 2015 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-25236253

RESUMO

The physicochemical profile of Dulce de Leche (DL) was determined by both routine analysis and others techniques (HPLC, GC-MS and ICP-OES). Seven Brazilian commercial brands were characterised for moisture content, protein, fat, ash, pH and titratable acidity, mineral content (sodium, potassium, calcium, and phosphorus), colour parameters and instrumental analysis (carbohydrates content and volatile compounds). Overall, extensive variability among all the parameters evaluated were observed, suggesting different operational procedures in the dairy factories along the DL processing. In this sense, an increase of intrinsic quality of DL is related closely the standardization of operational parameters using during the manufacture.


Assuntos
Análise de Alimentos/métodos , Contaminação de Alimentos/análise , Leite/química , Animais , Brasil , Cálcio/química , Carboidratos/química , Cromatografia Líquida de Alta Pressão , Cor , Laticínios , Cromatografia Gasosa-Espectrometria de Massas , Glucose/química , Concentração de Íons de Hidrogênio , Lactose/química , América Latina , Fósforo/química , Potássio/química , Análise de Componente Principal , Sódio/química
7.
Poult Sci ; 93(10): 2651-6, 2014 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-25143592

RESUMO

The effect of high-dose irradiation on the physical, chemical, and bacteriological parameters of ready-to-eat vacuum-packed broiler breast meat after 430 d of storage at room temperature was investigated. Ready-to-eat broiler breast fillets were immersed in brine with garlic powder and then drained, grilled, and vacuum-packed (primary packaging). The high-dose irradiation used was approximately 48 kGy. The treatments were designated as A (irradiated samples stored at room temperature), B (irradiated samples stored at -25°C), and C (nonirradiated samples stored at -25°C). All samples were packaged in polyethylene bags containing aluminum to exclude light (secondary packaging). Proximate composition, pH, 2-thiobarbituric acid reactive substance (TBARS), and heterotrophic aerobic mesophilic bacteria were analyzed during 430 d of storage. Results were analyzed using 1-way ANOVA and the Tukey test. Linear regression was used to analyze the correlation between the results for each parameter and storage time of the different treatments. The gamma radiation caused slight changes (P < 0.05) in the moisture and fat content, regardless of storage temperature. After storage d 110, TBARS values remained stable (P > 0.05) in all the treatments. The preservation methods used were effective in maintaining the mesophilic counts below the detection level during the entire storage period. We concluded that, among the treatments studied, high-dose irradiation with storage at room temperature showed potential for the preservation of ready-to-eat products made from poultry meat, to provide foods safe for consumption.


Assuntos
Irradiação de Alimentos , Qualidade dos Alimentos , Armazenamento de Alimentos , Carne/análise , Músculos Peitorais/efeitos da radiação , Animais , Galinhas , Embalagem de Alimentos , Conservação de Alimentos , Fatores de Tempo
8.
Poult Sci ; 93(9): 2304-13, 2014 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-24974390

RESUMO

Radiation from UV-C has been demonstrated as a potential surface decontamination method in addition to several advantages over regular sanitation methods. However, UV-C radiation possibly affects the physicochemical properties of meat products. To determine the optimum exposure time for bacterial reduction, 39 chicken breasts, inoculated with a pool of Salmonella spp., were submitted to 3 levels of UV-C intensities (0.62, 1.13, and 1.95 mW/cm²) for up to 120 s. After the optimum exposure time of 90 s was determined, changes in the biogenic amines, total aerobic mesophilic bacteria, Enterobacteriaceae, lipid oxidation, pH, and instrumental color were evaluated in 84 chicken breasts that were irradiated (0.62, 1.13, and 1.95 mW/cm²) and stored at 4°C for 9 d. The groups treated with UV-C radiation exhibited an increase in tyramine, cadaverine, and putrescine contents (P < 0.05). The highest UV-C intensity (1.95 mW/cm²) promoted a decrease in the initial bacterial load, and extended the lag phase and the shelf life. The groups irradiated with 1.13 and 1.95 mW/cm² exhibited a more stable b* value than the other groups; similar trends for L*, a*, pH, and TBA reactive substance values were observed among all groups. The UV-C light was demonstrated to be an efficient alternative technology to improve the bacteriological quality of chicken meat without negatively affecting the physical and chemical parameters of chicken breast meat. Nonetheless, the increases on the biogenic amines content should be considered as an effect of the UV processing and not as an indicator of bacterial growth.


Assuntos
Bactérias/efeitos da radiação , Aminas Biogênicas/efeitos da radiação , Microbiologia de Alimentos/métodos , Conservação de Alimentos/métodos , Carne/efeitos da radiação , Carne/normas , Raios Ultravioleta , Animais , Bactérias/crescimento & desenvolvimento , Aminas Biogênicas/análise , Aminas Biogênicas/química , Galinhas , Temperatura Baixa , Contagem de Colônia Microbiana , Concentração de Íons de Hidrogênio/efeitos da radiação , Metabolismo dos Lipídeos/efeitos da radiação , Carne/análise , Carne/microbiologia , Oxirredução/efeitos da radiação , Músculos Peitorais/microbiologia , Músculos Peitorais/fisiologia , Músculos Peitorais/efeitos da radiação , Salmonella/crescimento & desenvolvimento , Salmonella/efeitos da radiação , Fatores de Tempo
9.
Eye (Lond) ; 28(4): 390-8, 2014 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-24406417

RESUMO

PURPOSE: To evaluate the ability of frequency domain-optical coherence tomography (FD-OCT)-measured macular thickness parameters to differentiate between eyes with resolved chronic papilledema and healthy eyes and to evaluate the correlation between FD-OCT measures and visual field (VF) loss on standard automated perimetry (SAP). METHODS: Fifty-two eyes from 29 patients suffering from pseudotumor cerebri syndrome (PTC) and 62 eyes from 31 normal controls underwent FD-OCT scanning and ophthalmic evaluation including VF with SAP. All patients had previously been submitted to treatment of PTC and had clinically resolved papilledema and stable VF for at least 6 months before the study. Macular and peripapillary retinal nerve fiber layer (RNFL) thickness measurements were determined for both groups. Comparisons were made using Generalized Estimated Equations. Correlations between FD-OCT and VF measurements were verified. RESULTS: In eyes with resolved papilledema, the macular thickness parameters corresponding to the inner and outer superior, temporal, inferior and nasal segments, average macular thickness and most RNFL thickness measurements were significantly reduced when compared with controls. The discrimination ability was similar for macular thickness measurements and RNFL thickness measurements. Both sets of OCT measurements correlated well with VF sensitivity loss. CONCLUSIONS: Eyes with resolved chronic papilledema show a significant reduction in macular thickness, which is well correlated with the severity of VF loss. Macular thickness measurements can potentially be used to estimate and monitor the amount of ganglion cell loss in eyes with papilledema from patients with PTC.


Assuntos
Macula Lutea/patologia , Papiledema/patologia , Pseudotumor Cerebral/complicações , Tomografia de Coerência Óptica/métodos , Adulto , Axônios/patologia , Estudos de Casos e Controles , Doença Crônica , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Papiledema/etiologia , Estudos Prospectivos , Células Ganglionares da Retina/patologia , Sensibilidade e Especificidade , Transtornos da Visão/fisiopatologia , Campos Visuais/fisiologia
10.
AJNR Am J Neuroradiol ; 33(8): 1602-7, 2012 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-22442048

RESUMO

BACKGROUND AND PURPOSE: DON, a serious complication of GO, is frequently difficult to diagnose clinically in its early stages because of confounding signs and symptoms of congestive orbitopathy. We evaluated the ability of square area measurements of orbital apex crowding, calculated with MDCT, to detect DON. MATERIALS AND METHODS: Fifty-six patients with GO were studied prospectively with complete neuro-ophthalmologic examination and MDCT scanning. Square measurements were taken from coronal sections 12 mm, 18 mm, and 24 mm from the interzygomatic line. The ratio between the extraocular muscle area and the orbital bone area was used as a CI. Intracranial fat prolapse through the superior orbital fissure was recorded as present or absent. Severity of optic nerve crowding was also subjectively graded on coronal images. Orbits were divided into 2 groups (with or without clinical evidence of DON) and compared. RESULTS: Ninety-five orbits (36 with and 59 without DON) were studied. The CIs at all 3 levels and the subjective crowding score were significantly greater in orbits with DON (P < .001). No significant difference was observed regarding intracranial fat prolapse (P = .105). The area under the ROC curves was 0.91, 0.93, and 0.87 for CIs at 12, 18, and 24 mm, respectively. The best performance was at 18 mm, where a cutoff value of 57.5% corresponded to 91.7% sensitivity, 89.8% specificity, and an odds ratio of 97.2 for detecting DON. A significant correlation (P < .001) between the CIs and VF defects was observed. CONCLUSIONS: Orbital CIs based on area measurements were found to predict DON more reliably than subjective grading of orbital crowding or intracranial fat prolapse.


Assuntos
Oftalmopatia de Graves/diagnóstico por imagem , Tomografia Computadorizada Multidetectores , Doenças do Nervo Óptico/diagnóstico por imagem , Órbita/diagnóstico por imagem , Adulto , Feminino , Oftalmopatia de Graves/complicações , Humanos , Processamento de Imagem Assistida por Computador , Masculino , Pessoa de Meia-Idade , Doenças do Nervo Óptico/diagnóstico , Doenças do Nervo Óptico/etiologia , Valor Preditivo dos Testes , Sensibilidade e Especificidade , Campos Visuais
11.
Eye (Lond) ; 24(8): 1382-90, 2010 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-20431609

RESUMO

PURPOSE: The aim of this study was to test the correlation between Fourier-domain (FD) optical coherence tomography (OCT) macular and retinal nerve fibre layer (RNFL) thickness and visual field (VF) loss on standard automated perimetry (SAP) in chiasmal compression. METHODS: A total of 35 eyes with permanent temporal VF defects and 35 controls underwent SAP and FD-OCT (3D OCT-1000; Topcon Corp.) examinations. Macular thickness measurements were averaged for the central area and for each quadrant and half of that area, whereas RNFL thickness was determined for six sectors around the optic disc. VF loss was estimated in six sectors of the VF and in the central 16 test points in the VF. The correlation between VF loss and OCT measurements was tested with Spearman's correlation coefficients and with linear regression analysis. RESULTS: Macular and RNFL thickness parameters correlated strongly with SAP VF loss. Correlations were generally stronger between VF loss and quadrantic or hemianopic macular thickness than with sectoral RNFL thickness. For the macular parameters, we observed the strongest correlation between macular thickness in the inferonasal quadrant and VF loss in the superior temporal central quadrant (rho=0.78; P<0.001) whereas for the RNFL parameters the strongest correlation was observed between the superonasal optic disc sector and the central temporal VF defect (rho=0.60; P<0.001). CONCLUSION: Although FD-OCT RNFL and macular thickness measurements were both correlated with VF loss, the correlation was stronger with quadrantic macular than with RNFL thickness measurements in patients with temporal hemianopia. Such measurements could potentially be used to quantify neuronal loss in patients with chiasmal compression.


Assuntos
Macula Lutea/patologia , Quiasma Óptico/fisiopatologia , Neoplasias do Nervo Óptico/fisiopatologia , Células Ganglionares da Retina/patologia , Tomografia de Coerência Óptica/métodos , Campos Visuais/fisiologia , Adulto , Idoso , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Testes de Campo Visual/métodos , Adulto Jovem
12.
Eye (Lond) ; 23(4): 767-73, 2009 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-18535592

RESUMO

AIM: To compare morphometric data of the eyelid fissure and the levator muscle function (LF) before and up to 6 months after transcutaneous injection with five units of Botox in patients with upper lid retraction (ULR) from congestive or fibrotic thyroid eye disease (TED). METHODS: Twenty-four patients with ULR from TED were submitted to transcutaneous injection of 5 units (0.1 ml) of Botox in one eye only. Patients were divided into two groups: 12 with congestive-stage TED (CG), and 12 with fibrotic-stage TED (FG). Bilateral lid fissure measurements using digital imaging and computer-aided analysis were taken at baseline and at regular intervals 2 weeks, 1 month, 3 months and 6 months after unilateral Botox injection. Mean values taken at different follow-up points were compared for the two groups. RESULTS: Most patients experienced marked improvement in ULR, with a mean reduction of 3.81 mm in FG and 3.05 mm in CG. The upper eyelid margin reflex distance, fissure height and total area of exposed interpalpebral fissure were significantly smaller during 1 month in CG and during 3 months in FG. Reduction in LF and in the difference between lateral and medial lid fissure measurements was observed in both groups. The treatment lasted significantly longer in FG than in CG. CONCLUSIONS: A single 5-unit Botox injection improved ULR, reduced LF and produced an adequate lid contour in patients with congestive or fibrotic TED. The effect lasts longer in patients with fibrotic orbitopathy than in patients with congestive orbitopathy.


Assuntos
Toxinas Botulínicas Tipo A/uso terapêutico , Doenças Palpebrais/tratamento farmacológico , Fármacos Neuromusculares/uso terapêutico , Adulto , Doenças Palpebrais/etiologia , Doenças Palpebrais/fisiopatologia , Músculos Faciais/fisiologia , Feminino , Oftalmopatia de Graves/tratamento farmacológico , Oftalmopatia de Graves/fisiopatologia , Humanos , Processamento de Imagem Assistida por Computador , Injeções Intramusculares , Masculino , Pessoa de Meia-Idade , Doenças da Glândula Tireoide/complicações
13.
Eye (Lond) ; 22(5): 641-8, 2008 May.
Artigo em Inglês | MEDLINE | ID: mdl-17259920

RESUMO

AIM: To compare the ability of scanning laser polarimeter (SLP) with variable corneal compensation (GDx VCC) and optical coherence tomograph (Stratus OCT) to discriminate between eyes with band atrophy (BA) of the optic nerve and healthy eyes. METHODS: The study included 37 eyes with BA and temporal visual field (VF) defects from chiasmal compression, and 29 normal eyes. Subjects underwent standard automated perimetry (SAP) and retinal nerve fibre layer (RNFL) scans using GDx VCC and Stratus OCT. The severity of the VF defects was evaluated by the temporal mean defect (TMD), calculated as the average of 22 values of the temporal total deviation plot on SAP. Receiver operating characteristic (ROC) curves were calculated. Pearson's correlation coefficients were used to evaluate the relationship between RNFL thickness parameters and the TMD. RESULTS: No significant difference was found between the ROC curves areas (AUCs) for the GDx VCC and Stratus OCT with regard to average RNFL thickness (0.98 and 0.99, respectively) and the superior (0.94; 0.95), inferior (0.96; 0.97), and nasal (0.92; 0.96) quadrants. However, the AUC in the temporal quadrant (0.77) was significantly smaller (P<0.001) with GDx VCC than with Stratus OCT (0.98). Lower TMD values were associated with smaller RNFL thickness in most parameters from both equipments. CONCLUSION: Adding VCC resulted in improved performance in SLP when evaluating eyes with BA, and both technologies are sensitive in detecting average, superior, inferior, and nasal quadrant RNFL loss. However, GDx VCC still poorly discriminates RNFL loss in the temporal quadrant when compared with Stratus OCT.


Assuntos
Lasers , Atrofia Óptica/diagnóstico , Nervo Óptico/patologia , Tomografia de Coerência Óptica/métodos , Transtornos da Visão/diagnóstico , Adulto , Idoso , Estudos Transversais , Técnicas de Diagnóstico Oftalmológico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Adulto Jovem
15.
Eye (Lond) ; 21(1): 16-22, 2007 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-16311523

RESUMO

AIMS: To compare retinal nerve fibre layer (RNFL) measurements were carried out with two different versions of an optical coherence tomography device in patients with band atrophy (BA) of the optic nerve and in normal controls. METHODS: The RNFL of 36 eyes (18 with BA and 18 normals) was measured using an earlier version of an optical coherence tomography device (OCT-1). The measurements were repeated using a later version of the same equipment (OCT-3), and the two sets of measurements were compared. RESULTS: Using OCT-1, the peripapillary RNFL thickness (mean+/-SD, in microm) in eyes with BA measured 80.42+/-6.94, 99.81+/-14.00, 61.69+/-13.02, 101.70+/-12.54, and 57.36+/-16.52 corresponding to the total RNFL average, superior, temporal, inferior, and nasal quadrants, respectively. Using OCT-3, the corresponding measurements were 63.11+/-6.76, 81.22+/-13.34, 39.50+/-8.27, 86.72+/-15.16, and 45.05+/-8.03. Each of these measurements was significantly smaller with OCT-3 than with OCT-1. In normal eyes, RNFL average and temporal quadrant OCT-3 values were significantly smaller than OCT-1 values, but there was no significant difference in measurements from the superior, inferior, and nasal quadrant. CONCLUSIONS: RNFL measurements were smaller with OCT-3 than with OCT-1 for almost all parameters in eyes with BA and in the global average and temporal quadrant measurements in normal eyes. Investigators should be aware of this fact when comparing old RNFL measurement with values obtained with later versions of the equipment.


Assuntos
Fibras Nervosas/patologia , Atrofia Óptica/patologia , Retina/patologia , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Tomografia de Coerência Óptica/instrumentação , Tomografia de Coerência Óptica/métodos
16.
Gut ; 55(12): 1711-6, 2006 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-16603633

RESUMO

AIM: To prospectively assess the antibacterial resistance rate in Helicobacter pylori strains obtained from symptomatic children in Europe. METHODS: During a 4-year period, 17 paediatric centres from 14 European countries reported prospectively on patients infected with H pylori, for whom antibiotic susceptibility was tested. RESULTS: A total of 1233 patients were reported from Northern (3%), Western (70%), Eastern (9%) and Southern Europe (18%); 41% originated from outside Europe as indicated by mother's birth-country; 13% were <6 years of age, 43% 6-11 years of age and 44% >11 years of age. Testing was carried out before the first treatment (group A, n = 1037), and after treatment failure (group B, n = 196). Overall resistance to clarithromycin was detected in 24% (mean, A: 20%, B: 42%). The primary clarithromycin resistance rate was higher in boys (odds ratio (OR) 1.58; 1.12 to 2.24, p = 0.01), in children <6 years compared with >12 years (OR 1.82, 1.10 to 3.03, p = 0.020) and in patients living in Southern Europe compared with those living in Northern Europe (OR 2.25; 1.52 to 3.30, p<0.001). Overall resistance rate to metronidazole was 25% (A: 23%, B: 35%) and higher in children born outside Europe (A: adjusted. OR 2.42, 95% CI: 1.61 to 3.66, p<0.001). Resistance to both antibiotics occurred in 6.9% (A: 5.3%, B: 15.3%). Resistance to amoxicillin was exceptional (0.6%). Children with peptic ulcer disease (80/1180, 6.8%) were older than patients without ulcer (p = 0.001). CONCLUSION: The primary resistance rate of H pylori strains obtained from unselected children in Europe is high. The use of antibiotics for other indications seems to be the major risk factor for development of primary resistance.


Assuntos
Anti-Infecciosos/uso terapêutico , Farmacorresistência Bacteriana , Infecções por Helicobacter/tratamento farmacológico , Helicobacter pylori/efeitos dos fármacos , Adolescente , Distribuição por Idade , Amoxicilina/uso terapêutico , Criança , Pré-Escolar , Claritromicina/uso terapêutico , Farmacorresistência Bacteriana Múltipla , Europa (Continente)/epidemiologia , Feminino , Infecções por Helicobacter/complicações , Infecções por Helicobacter/epidemiologia , Humanos , Masculino , Metronidazol/uso terapêutico , Úlcera Péptica/complicações , Estudos Prospectivos , Distribuição por Sexo , Falha de Tratamento
17.
Arq. neuropsiquiatr ; 63(3B): 885-888, set. 2005. ilus
Artigo em Português | LILACS | ID: lil-445124

RESUMO

Hypertrophic pachymeningitis is a rare disorder characterized by meningeal thickness, that can be caused by infection, tumoral infiltration, inflammatory disorders or idiopathic. We report the case of a 40 year-old man that presented with longstanding headache and progressive bilateral visual loss and proptosis. Cranial and orbital magnetic resonance imaging revealed diffuse dural thickness and bilateral extraconal orbital lesion. Extensive investigation did not reveal any systemic condition. Histopathological study after meningeal and orbital biopsy disclosed a chronic inflammatory process compatible respectively with idiopathic hypertrophic pachymeningitis (IHP) and orbital pseudotumor. This case emphasizes that orbital involvement can occur in IHP and that its early identification is of great importance in order to improve the visual prognosis of this condition.


Paquimeningite hipertrófica se caracteriza por espessamento das meninges, podendo ser decorrente de infecção, infiltração tumoral, doença inflamatória ou idiopática. Relatamos sobre um homem de, 40 anos, com queixa de cefaléia de longa data e perda progressiva da visão em ambos os olhos acompanhadas de proptose bilateral. A imagem por ressonância magnética de crânio e órbitas revelou espessamento dural difuso e lesão orbitária bilateral. Extensa investigação não revelou qualquer afecção sistêmica. Estudo anatomopatológico realizado após biópsias de meninges e da massa orbitária evidenciou processo inflamatório crônico compatível com paquimeningite hipertrófica idiopática (PHI) e com pseudotumor orbitário respectivamente. Este caso evidencia que o acometimento orbitário pode ocorrer na PHI e que a sua identificação precoce é de fundamental importância para o prognóstico visual.


Assuntos
Adulto , Humanos , Masculino , Dura-Máter , Doenças Orbitárias/etiologia , Hipertrofia/complicações , Meningite/complicações , Biópsia , Doenças Orbitárias/patologia , Dura-Máter/patologia , Hipertrofia/patologia , Imageamento por Ressonância Magnética , Meningite/patologia , Órbita/patologia
18.
Br J Ophthalmol ; 88(7): 896-9, 2004 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-15205233

RESUMO

AIMS: To measure axonal loss in patients with band atrophy of the optic nerve caused by optic chiasm compression using optical coherence tomography and to evaluate its ability in identifying this pattern of retinal nerve fibre layer (RNFL) loss. METHODS: Twenty eyes from 16 consecutive patients with band atrophy of the optic nerve and permanent temporal hemianopia due to chiasmal compression, and 20 eyes from an age and sex matched control group of 16 healthy individuals, were studied prospectively. All patients were submitted to an ophthalmic examination including perimetry and evaluation of the RNFL using optical coherence tomography. Mean RNFL thickness around the optic disc was compared between the two groups. RESULTS: The mean (SD) peripapillary RNFL thickness of eyes with band atrophy was 101.00 (9.89) microm, 62.21 (12.71) microm, 104.89 (12.60) microm, and 50.13 (16.88) microm in the superior, temporal, inferior, and nasal regions, respectively. The total RNFL mean was 79.94 (7.17) microm. In the control group, the corresponding values were 140.10 (16.06) microm, 86.50 (12.17) microm, 144.60 (15.70) microm, and 97.94 (16.02) microm. The total RNFL mean was 117.72 (9.53) microm. The measurements were significantly different between the two groups. Measurements in each of twelve 30 degrees divisions provided by the equipment also showed significantly different values between eyes with band atrophy and normal controls. CONCLUSIONS: Optical coherence tomography was able to identify axonal loss in all four quadrants as well as in each of the twelve 30 degrees segments of the disc. Thus, it seems to be a promising instrument in the diagnosis and follow up of neuro-ophthalmic conditions responsible for RNFL loss, even if predominantly in the nasal and temporal areas of the optic disc.


Assuntos
Axônios/patologia , Atrofia Óptica/patologia , Tomografia de Coerência Óptica/métodos , Adulto , Idoso , Feminino , Hemianopsia/etiologia , Hemianopsia/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Fibras Nervosas/patologia , Atrofia Óptica/complicações , Quiasma Óptico/patologia , Disco Óptico/patologia , Estudos Prospectivos , Retina/patologia
20.
Br J Ophthalmol ; 87(1): 32-7, 2003 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-12488259

RESUMO

AIMS: To measure axonal loss in patients with band atrophy from optic chiasm compression using scanning laser polarimetry (GDx, Laser Diagnostic Technologies, Inc, San Diego, CA, USA) and to evaluate the ability of this instrument to identify this pattern of retinal nerve fibre layer (RNFL) loss. METHODS: 19 eyes from 17 consecutive patients with band atrophy of the optic nerve and permanent temporal hemianopia due to chiasmal compression, and 19 eyes from an age and sex matched control group of 17 healthy individuals were prospectively studied. All patients were submitted to an ophthalmic examination including Goldmann perimetry and evaluation of the RNFL using scanning laser polarimetry. Mean RNFL thickness around the optic disc were compared between the two groups. The diagnostic performance of the deviation from normal analysis provided by the GDx software was also assessed. RESULTS: The peripapillary RNFL thickness (mean (SD)) of eyes with band atrophy was 47.9 (7.63) micro m, 37.1 (8.48) micro m, 57.0 (9.31) micro m, and 37.2 (8.86) micro m in the superior, temporal, inferior, and nasal regions, respectively. The total average was 43.7 (12.0) micro m. In the control group, the corresponding values were 71.1 (12.2) micro m, 40.4 (10.9) micro m, 85.4 (14.0) micro m, and 49.8 (10.1) micro m. The total average measured 67.9 (11.2) micro m. The measurements from eyes with optic atrophy were significantly different from those in the control group in all regions but the temporal. The deviation from normal analysis provided by the GDx software failed to identify the majority of abnormalities in the temporal and nasal regions of patients with band atrophy. CONCLUSIONS: Scanning laser polarimetry was able to identify axonal loss in the superior, inferior, and nasal regions, but failed to detect it in the temporal region of the optic disc, despite the fact that this area was clearly altered in eyes with band atrophy. This examination also showed poor sensitivity to detect axonal loss in the nasal region when GDx software analysis was used. The results of this study emphasise that RNFL evaluation using scanning laser polarimetry should be interpreted with caution in the study of eye diseases that lead to axonal loss predominantly in the nasal and temporal areas of the optic disc.


Assuntos
Axônios/patologia , Lasers , Atrofia Óptica/patologia , Quiasma Óptico/patologia , Adulto , Idoso , Diagnóstico por Computador/métodos , Feminino , Hemianopsia/patologia , Humanos , Masculino , Microscopia Confocal/métodos , Pessoa de Meia-Idade , Fibras Nervosas/patologia , Retina/patologia
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