Distribution of acid-volatile sulfides and simultaneously extracted metals in Guanabara Bay: combination of anthropogenic, sedimentological, and geochemical processes.

Coastal sedimentary systems are affected by continental and marine metal pollutant inputs associated with different hydrodynamic characteristics and geochemical processes. These include the formation of acid-volatile sulfides (AVS) within sediments, which affects metal bioavailability and associated aquatic biota toxicity risks. Physicochemical changes in these environments in the face of extreme natural or man-made environmental influences can dramatically alter metal bioavailability and toxicity through metal binding and immobilization as insoluble sulfides. Surface sediments from Guanabara Bay, river mouths, and two mangrove areas were collected, and AVS and simultaneously extracted metals Cd, Cu, Fe, Mn, Ni, Pb, and Zn and ΣSEM were determined to assess sediment quality. A severe eutrophication history favored AVS concentrations exceeding or close to the sum-SEM concentrations, demonstrating that AVS play an important role in making trace metals unavailable for assimilation by living organisms, mitigating the risks of contamination for the local biota. This eutrophication-driven sulfide accumulation may attenuate the sediment toxicity in sites heavily polluted by metals, while some fewer eutrophic sites became more exposed to metals in excess to AVS.

Diversity of Microbiomes Across a 13,000-Year-Old Amazon Sediment.

The microbiome is fundamental for understanding bacterial activities in sediments. However, only a limited number of studies have addressed the microbial diversity of Amazonian sediments. Here, we studied the microbiome of sediments from a 13,000-year BP core retrieved in a floodplain lake in Amazonia using metagenomics and biogeochemistry. Our aim was to evaluate the possible environmental influence over a river to a lake transition using a core sample. To this end, we sampled a core in the Airo Lake, a floodplain lake in the Negro River basin. The Negro River is the largest tributary of the Amazon River. The obtained core was divided into three strata: (i) surface, almost complete separation of the Airo Lake from the Negro River when the environment becomes more lentic with greater deposition of organic matter (black-colored sediment); (ii) transitional environment (reddish brown); and (iii) deep, environment with a tendency for greater past influence of the Negro River (brown color). The deepest sample possibly had the greatest influence of the Negro River as it represented the bottom of this river in the past, while the surface sample is the current Airo Lake bottom. In total, six metagenomes were obtained from the three different depth strata (total number of reads: 10.560.701; sequence length: 538 ± 24, mean ± standard deviation). The older (deeper) sediment strata contained a higher abundance of Burkholderia, Chitinophaga, Mucilaginibacter, and Geobacter, which represented ~ 25% of the metagenomic sequences. On the other hand, the more recent sediment strata had mainly Thermococcus, Termophilum, Sulfolobus, Archaeoglobus, and Methanosarcina (in total 11% of the metagenomic sequences). The sequence data were binned into metagenome-assembled genomes (MAGs). The majority of the obtained MAGs (n = 16) corresponded to unknown taxa, suggesting they may belong to new species. The older strata sediment microbiome was enriched with sulfur cycle genes, TCA cycle, YgfZ, and ATP-dependent proteolysis in bacteria. Meanwhile, serine-glyoxylate cycle, stress response genes, bacterial cell division, cell division-ribosomal stress protein cluster, and oxidative stress increased in the younger strata. Metal resistance and antimicrobial resistance genes were found across the entire core, including genes coding for fluoroquinolones, polymyxin, vancomycin, and multidrug resistance transporters. These findings depict the possible microbial diversity during the depositional past events and provided clues of the past microbial metabolism throughout time.

Retinopathy of prematurity: risk factors for its development in two neonatal intensive care units in Paraná-Brazil / Retinopatia da prematuridade: fatores de risco para seu desenvolvimento em duas unidades de terapia intensiva neonatais do Paraná-Brasil

ABSTRACT Purpose: Evaluate the patients in two neonatal intensive care units in Paraná/Brazil and identify the risk factors for the development of retinopathy of prematurity. Methods: We performed a prospective cohort study on premature infants with gestational age ≤32 wk and/or with birth weight ≤1500 g who were admitted to the neonatal intensive care unit of Hospital do Trabalhador and Hospital Infantil Waldemar Monastier. These hospitals admit patients referred from other maternity hospitals in the state of Paraná. The study duration was 12 mon. Results: The incidence of retinopathy of prematurity was higher in the Hospital Infantil Waldemar Monastier than in the Hospital do Trabalhador for premature infants who needed to be transported from their birthplace to the intensive care unit (52.2% vs. 29.6%). The following risk factors were associated with the development of the disease: longer hospitalization, low gestational age at birth, longer oxygen use, vasoactive drugs use, no antenatal corticosteroids use, intracranial hemorrhage, and any glycemic disorder. Low birth weight was an independent risk factor for the development of retinopathy of prematurity. Conclusion: Early neonatal care and transportation of premature infants may influence the occurrence and prognosis of retinopathy of prematurity.

RESUMO Objetivos: Avaliar duas unidades de terapia intensiva neonatais do Paraná e identificar os fatores de risco que levam ao desenvolvimento da retinopatia da prematuridade nestas unidades neonatais. Metodos: Foi realizado um estudo de coorte, prospectivo, com avaliação dos bebês prematuros examinados no período de 12 meses com idade gestacional ≤32 semanas e/ou com peso de nascimento ≤1500 gramas, internados na unidade de cuidados intensivos neonatais do Hospital do Trabalhador e do Hospital infantil Waldemar Monastier, que recebe neonatos transportados das maternidades de todo o estado do Paraná. Resultados: A incidência de retinopatia da prematuridade foi maior no Hospital Infantil Waldemar Monastier, entre os prematuros que necessitaram de transporte do local de nascimento para a unidade de cuidados intensivos (52,2% vs 29,6%), Os fatores de risco associados ao desenvolvimento da doença foram; Maior número de dias de internamento, baixa idade gestacional ao nascimento, maior tempo de uso de oxigênio, uso de drogas vasoativas, ausência de uso de corticoide pré-natal, presença de hemorragia intracraniana e qualquer tipo de alteração da glicemia. Conclusão: Os cuidados neonatais precoces e o transporte do recém-nascido pré- termo podem influenciar a ocorrência e o prognostico da retinopatia da prematuridade.

Tropical forests as drivers of lake carbon burial.

A significant proportion of carbon (C) captured by terrestrial primary production is buried in lacustrine ecosystems, which have been substantially affected by anthropogenic activities globally. However, there is a scarcity of sedimentary organic carbon (OC) accumulation information for lakes surrounded by highly productive rainforests at warm tropical latitudes, or in response to land cover and climate change. Here, we combine new data from intensive campaigns spanning 13 lakes across remote Amazonian regions with a broad literature compilation, to produce the first spatially-weighted global analysis of recent OC burial in lakes (over ~50-100-years) that integrates both biome type and forest cover. We find that humid tropical forest lake sediments are a disproportionately important global OC sink of ~80 Tg C yr-1 with implications for climate change. Further, we demonstrate that temperature and forest conservation are key factors in maintaining massive organic carbon pools in tropical lacustrine sediments.

Qualidade de vida: análise do aspecto funcional, social e emocional em uma população com perda visual severa / Quality of life: analysis of functional, social and emotional aspects in a population with severe visual loss

A visão é responsável pela integração entre os demais sentidos dos seres humanos, além da interação do indivíduo com o meio onde vive. O objetivo deste estudo foi verificar a qualidade de vida dos deficientes visuais frequentadores do Instituto Paranaense de Cegos. É estudo transversal e observacional. Foram utilizados um questionário SF-36 (Medical Outcomes Study 36 - Item Short Health Survey) e um sociocultural em 15 pessoas cegas. No SF-36, a maior média foi da capacidade funcional, os itens com pior avaliação foram aspectos sociais e físicos. Conclui-se que 60% dos entrevistados estavam satisfeitos com a qualidade de vida e a pontuação média no SF-36 foi de 272,62 no componente mental e de 285,33 no físico.

The vision is responsible for integrating the other senses of human beings, beyond the individual's interaction with the environment where he lives. The objective of this study was to assess the quality of life of visually impaired users of Blind Institute of Paraná. It was cross-sectional and observational. Were used the SF-36 (Medical Outcomes Study 36 - item Short Health Survey) and a socio-cultural questionnaire in 15 people. In the SF-36, the highest average was functional capacity, the items with poor rating were social and physical. In conclusion, 60% of respondents are satisfied with their quality of life and the average score in the SF-36 questionnaire was 272,62 in the mental and 285,33 in the physical components.

Alteração refracional após capsulotomia posterior com laser Nd: YAG / Change on refraction after Nd: YAG laser posterior capsulotomy

RESUMO Objetivo: Identificar se há mudança refracional significativa após realização de capsulotomia posterior com laser Nd:YAG em olhos pseudofácicos. Métodos: Estudo retrospectivo com análise de prontuários de pacientes atendidos em um hospital com diagnóstico de opacificação de cápsula posterior do cristalino tratada com capsulotomia posterior com laser Nd:YAG no período de outubro de 2019 a março de 2021. A comparação entre a refração antes e após o procedimento foi realizada calculando-se o equivalente esférico. Também foi avaliada a mudança da acuidade visual, aferida por LogMAR. Resultados: Foram analisados 90 prontuários, totalizando 140 olhos, de pacientes submetidos à capsulotomia posterior com laser Nd:YAG. O equivalente esférico médio pré-procedimento foi de -0,07±0,89D, mínimo de -3,0D e máximo de +2,5D, mediana (intervalo interquartil) de 0,0D (-0,50D a +0,375D). A média pós-procedimento foi de -0,18±0,86D, mínimo de -3,5D e máximo de +2,25D, mediana (intervalo interquartil) de -0,125D (-0,50D a 0,0D). com p<0,0082. Dos 140 olhos, 66 sofreram miopização e 37 hipermetropização. A média de alteração do equivalente esférico geral foi de -0,12±0,51D, mínimo de -2,50D e máximo de +1,25D, mediana (intervalo interquartil) de 0,0D (-0,375D a +0,125D). Ao se comparar a diferença entre o equivalente esférico antes e após o procedimento do grupo de olhos que sofreu miopização (n=66) ou hipermetropização (n=37), separadamente, ambos obtiveram p<0,0001. Ao se compararem todos os olhos que sofreram alguma alteração refracional (n=103), foi encontrado p=0,008. A acuidade visual média pré-procedimento foi de 0,23±0,32, mínimo de 0,0 e máximo de 2,3. Pós-procedimento, a média foi de 0,06±0,13, mínimo de -0,12 e máximo de 0,7, com p<0,0001. Conclusão: A capsulotomia posterior com laser Nd:YAG gerou melhora significativa da acuidade visual nos pacientes do estudo, porém também gerou alteração refracional significativa após o procedimento, tanto para miopização (a mais frequente), quanto para hipermetropização.

ABSTRACT Objective: To identify if there is a significant change on refraction after Nd:YAG laser posterior capsulotomy in pseudophakic eyes. Methods: A retrospective study with analysis of medical records of patients treated at a hospital, with diagnosis of opacification of posterior lens capsule treated with Nd:YAG laser posterior capsulotomy, from October 2019 to March 2021. The comparison of refraction before and after the procedure was performed by calculating the spherical equivalent. Changes in visual acuity (VA), measured by LogMAR, were also evaluated. Results: A total of 90 medical records (140 eyes) of patients submitted to Nd:YAG laser posterior capsulotomy were analysed. The mean pre-procedure spherical equivalent was -0.07±0.89D, minimum of -3.0D and maximum of +2.5D, median (interquartile range) of 0.0D (-0.50D to +0.375D). The post-procedure mean was -0.18±0.86D, minimum of -3.5D and maximum of +2.25D, median (interquartile range) of -0.125D (-0.50D to 0.0D), with p <0.0082. Of the 140 eyes, 66 underwent myopia and 37 hyperopia, the mean change in the general spherical equivalent was -0.12±0.51D, minimum -2.50D and maximum +1.25D, median (interquartile range) of 0.0D (-0.375D to +0.125D). When comparing the difference between the spherical equivalent before and after the procedure of the group of eyes that underwent myopia (n=66) or hyperopia (n=37), separately, both obtained p<0.0001. When comparing all eyes that suffered any change on refraction (n=103), the p value was 0.008. The mean pre-procedure visual acuity was 0.23±0.32, minimum of 0.0 and maximum of 2.3. After the procedure, the mean was 0.06±0.13, minimum of -0.12 and maximum of 0.7, p<0.0001. Conclusion: Nd:YAG laser posterior capsulotomy significantly improved visual acuity of patients in this study; however, it also led to a significant change on refraction after the procedure, both for myopization, which was more frequent, and for hyperopization.

Fatores associados a anormalidades na cintilografia de perfusão miocárdica de pacientes diabéticos / Factors associated with abnormalities on myocardial perfusion scintigraphy in diabetic patients

O diabetes melito é o maior fator de risco para doença arterial coronariana. Além da longa duração de diabetes, outros fatores, como presença de doença arterial periférica e tabagismo são fortes preditores para anormalidades na cintilografia de perfusão do miocárdio. O objetivo deste estudo foi avaliar o impacto dos fatores de risco de pacientes diabéticos nos resultados da cintilografia de perfusão do miocárdio e comparar com os resultados de pacientes não diabéticos em uma clínica de medicina nuclear. Foi realizado um estudo transversal retrospectivo por meio da análise de prontuários de pacientes que realizaram cintilografia miocárdica no período de 2010 a 2019. Foram avaliados 34.736 prontuários. Analisando a fase de estresse da cintilografia de perfusão do miocárdio, os portadores de diabetes melito precisaram receber estímulo farmacológico duas vezes mais que os não diabéticos para sua realização. Também foram avaliados fatores que tivessem impacto negativo no resultado da cintilografia de perfusão do miocárdio, e foi visto que o diabetes melito (33,6%), a insulinoterapia (18,1%), a hipertensão arterial sistêmica (69,9%), a dislipidemia (53%), o sedentarismo (83,1%), o uso de estresse farmacológico (50,6%), a dor torácica típica (8,5%) e a angina limitante durante o teste (1,7%) estiveram associados significativamente (p<0,001) a anormalidades neste exame. (AU)

Diabetes mellitus (DM) is the greatest risk factor for coronary artery disease. In addition to a long duration of diabetes, the presence of peripheral arterial disease and smoking are strong predictors of abnormalities on myocardial perfusion scintigraphy (MPS). This study aimed to assess the impact of risk factors in diabetic patients on MPS results and compare them with those of non-diabetic patients in a nuclear medicine clinic. A retrospective cross-sectional study was performed through the analysis of the medical records of patients who underwent MPS in 2010­2019. A total of 34,736 medical records were evaluated. Analyzing the stress phase of MPS, DM patients required two-fold more pharmacological stimulation than non-diabetic patients for MPS. Factors that negatively impact the MPS results were also evaluated, and DM (33.6%), insulin therapy (18.1%), systemic arterial hypertension (69.9%), dyslipidemia (53%), sedentary lifestyle (83.1%), use of pharmacological stress (50.6%), typical chest pain (8.5%), and limiting angina during the test (1.7%) were significantly associated (p < 0.001) with test abnormalities. (AU)

Retinopathy of prematurity: risk factors for its development in two neonatal intensive care units in Paraná-Brazil.

PURPOSE: Evaluate the patients in two neonatal intensive care units in Paraná/Brazil and identify the risk factors for the development of retinopathy of prematurity. METHODS: We performed a prospective cohort study on premature infants with gestational age ≤32 wk and/or with birth weight ≤1500 g who were admitted to the neonatal intensive care unit of Hospital do Trabalhador and Hospital Infantil Waldemar Monastier. These hospitals admit patients referred from other maternity hospitals in the state of Paraná. The study duration was 12 mon. RESULTS: The incidence of retinopathy of prematurity was higher in the Hospital Infantil Waldemar Monastier than in the Hospital do Trabalhador for premature infants who needed to be transported from their birthplace to the intensive care unit (52.2% vs. 29.6%). The following risk factors were associated with the development of the disease: longer hospitalization, low gestational age at birth, longer oxygen use, vasoactive drugs use, no antenatal corticosteroids use, intracranial hemorrhage, and any glycemic disorder. Low birth weight was an independent risk factor for the development of retinopathy of prematurity. CONCLUSION: Early neonatal care and transportation of premature infants may influence the occurrence and prognosis of retinopathy of prematurity.

Quais são as afecções oftalmológicas mais prevalentes em UTI neonatal? / What are the most prevalent ophthalmological affections in neonatal intensive care unit?

Racional: Várias afecções oculares podem ser prevenidas ou diagnosticadas clinicamente nas primeiras horas ou dias de vida. Objetivo: Verificar a prevenção das doenças oculares neonatais e suas incidências em UTI neonatal. Métodos: Análise de prontuários de puérperas e recém-natos em UTI neonatal no período de um mês, verificando: comorbidade materna, número de consultas pré-natais, idade gestacional, via de parto, presença de sofrimento fetal peri ou intraparto, Apgar e peso ao nascer, leucocorias (pelo teste do reflexo vermelho ocular), conjuntivites neonatais (pela inspeção/cultura ocular) e retinopatia da prematuridade (por exame de fundo de olho). Resultados: 15 recém-natos foram internados devido à prematuridade, baixo peso ou intercorrências intraparto. Destes, 4 apresentaram secreção ocular e 3 retinopatias da prematuridade no período neonatal. Mães dos recém-natos com alterações oculares realizaram consultas pré-natais insuficientes, média de 3. Conclusão: Prevenção e detecção precoce das doenças oculares mostraram-se efetivas em UTI neonatal, reduzindo o número de casos/complicações, mostrando a importância desse cuidado.

Background: Several eye conditions can be prevented or diagnosed clinically in the first hours or days of life.Objective: Verify the prevention and incidences of neonatal eye diseases in a neonatal ICU. Methods: Analysis of medical records of puerperal women and newborns in a neonatal ICU, in the period of one month, verifying: maternal comorbidity, prenatal consultations, gestational age, delivery method, presence of peri or intrapartum fetal distress, Apgar and birth weight. Leukocoria (verified with red eye reflex test), neonatal conjunctivitis (according to eye inspection/culture) and retinopathy of prematurity (through the fundus examination). Results: 15 newborns were hospitalized due to prematurity, low weight, or intrapartum complications. Four of them had ocular discharge and 3 had retinopathy of prematurity in the neonatal period. Mothers of newborns with ocular disorders had insufficient prenatal consultations, an average of 3. Conclusion: Prevention and early detection of eye diseases proved to be effective in this neonatal ICU, reducing the number of cases/complications, showing the importance of this care.

New bacterial and archaeal lineages discovered in organic rich sediments of a large tropical Bay.

The nutrient and oxygen gradient present in marine sediments promotes high levels of microbial diversity. We applied metagenomics and biogeochemical tools to analyze microbial communities in different sediment depths (0-4 m below sea floor, mbsf) from Guanabara Bay, Brazil, a brackish tropical ecosystem with a history of massive anthropogenic impacts, and a largely unknown sediment microbial diversity. Methanogens (e.g. Methanosarcinales, Methanomicrobiales) were more abundant at 1 mbsf, while sulphate-reducing microbes (Desulfurococcales, Thermoprotales, and Sulfolobales) were more abundant at deeper layers (4 mbsf; corresponding to 3 K Radiocarbon years before present, Holocene Epoch). Taxonomic analyzes and functional gene identification associated with anaerobic methane oxidation (e.g. monomethylamine methyltransferase (mtmB), trimethylamine methyltransferase (mttB) and CO dehydrogenase/acetyl-CoA synthase delta subunit) and sulfate reduction indicated the dominance of Campylobacteria (Sulfurimonas) at deeper sediment layers. Gene sequences related to assimilation of inorganic sulfur increased with depth, while organic sulfur related sequences decrease, accompanying the clear reduction in the concentration of sulfur, organic carbon and chla torwards deeper layers. Analyzes of metagenome assembled genomes also led to the discovery of a novel order within the phylum Acidobacteriota, named Guanabacteria. This novel order had several in silico phenotyping features that differentiate it from closely related phylogenetic neighbors (e.g. Acidobacteria, Aminicenantes, and Thermoanaerobaculum), including several genes (carbon monoxide dehydrogenase, CO dehydrogenase/CO-methylating acetyl-CoA synthase complex subunit beta, heterodisulfide reductase, sulfite exporter TauE/SafE family protein, sulfurtransferase) that relevant for the S and C cycles. Furthermore, the recovered Bathyarchaeota genome SS9 illustrates the methanogenic potential in deeper sediment layer.

Comparação de eficácia entre as sondas monocanalicular e bicanalicular no tratamento da obstrução congênita das vias lacrimais / Efficacy of monocanalicular versus bicanalicular intubation in the treatment of congenital nasolacrimal duct obstruction

Resumo Objetivo: Avaliar e comparar a taxa de sucesso da intubação monocanalicular ou bicanalicular em pacientes com obstrução congênita do ducto lacrimonasal (OCDLN), levando-se em consideração a taxa de sucesso, a dificuldade do procedimento e o custo dos tubos. Métodos: Foram analisados retrospectivamente 54 prontuários, totalizando 58 vias lacrimais com diagnóstico de OCDLN, que realizaram intubação das vias lacrimais monocanalicular ou bicanalicular com tubos de silicone. Anamnese, exame oftalmológico geral, testes específicos, como o Teste do Desaparecimento do Corante (TDC) e Teste de Observação de Fluoresceína na Orofaringe (TOFO), e, caso necessário, exames complementares como a dacriocistografia, foram utilizados para diagnóstico e inclusão na pesquisa. Foram tratados com intubação os pacientes sem resposta adequada ao tratamento prévio, ou seja, que permaneceram com sintomas de secreção e epífora contínua após a realização de massagem de Crigler e sondagem. Resultados: A intubação monocanalicular foi realizada em 27 vias lacrimais e a intubação bicanalicular, em 31 vias lacrimais. A taxa de sucesso foi alta em ambos os métodos, com melhora em 26 (96,3%) vias lacrimais com sonda monocanalicular e em 30 (96,8%), com sonda bicanalicular (p=0,718). As duas técnicas apresentaram 100% de sucesso nos pacientes com até 2 anos e acima de 4 anos de idade (p=1). A taxa de sucesso entre os 2 e 4 anos de idade foi de 91,5% para as monocanaliculares e 87,5% para as bicanaliculares, (p=0,652). Conclusão: o presente estudo não mostrou diferença significativa no sucesso da intubação quando utilizando sondas mono ou bicanaliculares. A intubação monocanalicular mostrou-se de mais fácil execução, ao passo que o tubo bicanalicular possui menor custo.

Abstract Objective: to evaluate and to compare the success rate of monocanalicular or bicanalicular intubation in congenital nasolacrimal duct obstruction (CNDO) carriers in terms of success rate, difficulty of the procedure, and cost of the tubes. Methods: fifty-four CNDO carriers with 58 obstructed lacrimal vies (LV) who were submitted to lacrimal system intubation using mono or bicanalicular stent had their medical records analyzed. A clinical history, a general ophthalmologic examination, specific tests such as the fluorescein dye disappearance test (FDDT) and observation test of fluorescein in the oropharynx (OTFO) were used for diagnosis and inclusion in the study. Patients who continued exhibiting discharge and continuous epiphora after previous treatment, Crigler massage and probing, were treated surgically with intubation. Results: Monocanalicular intubation was performed on 27 LV and bicanalicular intubation was performed on 31 LV. High success rates were observed, with improvement in 26 (96.3%) with monocanalicular intubation and in 30 LV (96.8%) with bicanalicular intubation (p=0.718). Furthermore, both techniques were 100% successful in patients up to 2 and over 4 years of age (p=1). The success rates between 2-4 years of age were 91.6% in monocanalicular intubation and 87.5% in bicanalicular intubation (p=0.652). Conclusion: The success rate using monocanalicular or bicanalicular intubation to treat CNDO had no significant difference in the studied children. Furthermore, the monocanalicular tube was easier to use, while the bicanalicular tube had a lower cost.

Bupivacaine Injection in the Extra Ocular Muscle of Rabbits: Analysis of Global and Orbital Layers.

PURPOSE: To verify the cross sectional area (CSA) of fibers positive for myosin type 1 in the global and orbital layers after bupivacaine (BUP) injection in the superior rectus of the right eye of rabbits. MATERIALS AND METHODS: A total of 40 rabbits were studied; 32 specimens received a 0.3 mL injection of BUP at 1.5% in the superior rectus of the right eye and were euthanised after 7, 28, 60 and 92 days. Another eight rabbits were used as the control group. Immunohistochemical analysis was performed using anti-slow myosin (type 1) antibodies. The ImageJ software was used to measure the CSA of the fibers. Six slides were excluded from the analysis. Finally, 7,204 fibers were counted and statistically analysed. RESULTS: The mean CSA was 0.040 µm2 for all the studied fibers. For the orbital layer, mean CSA was 0.038 µm2, whereas the global area measured 0.042 µm2. No statistically significant differences were observed when comparing the orbital layer groups. However, when comparing the mean CSA in the global layer of the control group with the 60-day group an increase was found (0.0339 ± 0.0062 versus 0.0503 ± 0.0114; p = .009). CONCLUSION: This study revealed that 60 days after BUP injection, the extra ocular muscle of rabbits presented an increase in the CSA of myosin 1 type fibers in the global layer.

iStent® e trabeculectomia seletiva a laser (SLT): uma série de casos / iStent® and selective laser trabeculoplasty (SLT): a case series

O tratamento do glaucoma consiste na redução e no controle da PIO, inicialmente realizado com colírios. Algumas intervenções estão disponíveis, como o iStent® e a trabeculopalstia seletiva a laser (SLT). Métodos: Estudo descritivo de uma série de casos. Foram analisados prontuários de pacientes submetidos ao iStent® ou SLT no Hospital de Olhos do Paraná, no ano de 2017 e acompanhados por no mínimo 6 meses. Resultados: Foram incluídos no estudo 37 pacientes com glaucoma primário de ângulo aberto. Destes, 16 implantaram o iStent® e 21 realizaram a SLT; no grupo do iStent®. No período pré-procedimento, o grupo do iStent® utilizava uma média de 1,9 colírio e o grupo da SLT utilizava uma média de 2,0 colírios; no período pós-procedimento, a média do número de colírios utilizados em ambos os grupos passou a ser de 0,8. Conclusão: Tanto iStent® quanto SLT mostram-se como opções viáveis frente ao uso de colírios.

Glaucoma`s treatment is the reduction and control of IOP and is initially done with eye drops. Some of the alternative treatments available are iStent® or SLT. Methods: Descriptive study of a case series. Medical records from patients with iStent® or SLT at the Hospital de Olhos do Paraná, in 2017, were analyzed and followed up for a least 6 months. Results: The study included 37 patients with primary open angle glaucoma. Of these, 16 had the iStent® implanted and 21 had the SLT performed on their eyes. The average number of eye drop medications that the patients were using was 1,9 and 2,0, in the iStent® and SLT groups, respectively; while in the postoperative period the average was 0,8 and 0,8. Conclusion: iStent® and SLT are capable options when confronted against eye drops.

Concordância no diagnóstico e principais dificuldades encontradas por estudantes de medicina ao realizar o "Teste do Olhinho" / Diagnostic concordance and the main difficulties found by medical students to perform the "Red Reflex" examination

OBJETIVOS: Avaliar a concordância diagnóstica para realizar o "Teste do Olhinho" (TO) entre acadêmicos de medicina e pediatras de uma maternidade pública de Curitiba. Definir as variáveis que influenciam na execução do exame. Estudar a curva de aprendizagem semiológica do teste. MÉTODO: Foi realizado um estudo prospectivo, observacional e analítico na maternidade do Hospital do Trabalhador (HT) em Curitiba-PR. A amostra consistiu na análise dos exames de 240 recém nascidos (RN) realizados por 4 acadêmicos de medicina (E1, E2, E3 e E4). Cada acadêmico examinou 60 crianças cada e tiveram seus resultados comparados com os diagnósticos dos médicos pediatras. Os dados coletados por cada examinador foram analisados em intervalos de 20 RN (T1, T2 e T3). RESULTADOS: foram examinados 240 crianças e 480 olhos. Não foram encontradas diferenças significativas entre a curva de aprendizagem de cada aluno e não houve diferença estatística entre os estudantes na quantidade de acertos totais (p>0,05). A dificuldade mais prevalente (70%) foi relacionada às variáveis semiológicas presentes no momento do exame físico. Alterações qualitativas para interpretar o reflexo retiniano foram detectadas em 5 casos ao todo, representando 18,5% das ocorrências. Ao todo, 27 exames (11,2%) não foram concordantes entre os estudantes e os pediatras De toda a amostra, apenas três crianças (1,25%) foram encaminhadas pelo pediatra ao acompanhamento especializado. Destes casos, houve concordância com os alunos em dois exames. CONCLUSÃO: o estudo sugere que estudantes de medicina demonstram boa concordância para avaliar o Teste do Olhinho ao comparar seus desempenhos com Pediatras. As principais dificuldades encontradas para se realizar os exames foram semiológicas, devido à irritabilidade dos neonatos no momento da avaliação. Ainda, houve uma tendência de melhorar a curva de aprendizagem com o aumento da prática

OBJECTIVE: Evaluate the diagnostic agreement to perform the "Red Reflex" (RR) exam between medical students and pediatricians of a public hospital's maternity in the city of Curitiba-Brazil, and to define the variables that influences in the execution of the exam and to study the semiological learning curve of the test. METHOD: a prospective, observational and analytical study was performed at the Hospital do Trabalhador (HT) maternity in Curitiba-Brazil. The sample consisted in he analysis of the exams from 240 newborns (NB) performed by four medical students (E1, E2, E3 and E4). Each medical student examined 60 children, and their results were then compared with the pediatrician's diagnoses. The data collected by each examiner were analyzed at intervals of 20 NBs (T1, T2 and T3) RESULTS: at the end of the study, 240 children and 480 eyes were examined. Each participating medical student evaluated 60 children. No significant differences were found between the learning curve of each student and there was no statistical difference between the students in the number of total hits (p> 0,05). The most prevalent difficulty (70%) was related to the semiological variables present at the time of physical examination. Qualitative changes to interpret the retinal reflex were detected in 5 cases, representing 18,5% of the non-concordant group of exam. In all, 27 exams (11,2%) were not concordant among students and pediatricians. Of the whole sample, only three children (1,25%) were referred by the pediatrician to the specialized attendance. In these cases, there was agreement with the students in two exams. CONCLUSION: the study suggests that medical students demonstrate good agreement to evaluate the "Red Reflex" axam when comparing their performances with pediatricians. The main difficulties found to perform the exams were essentially semiological, due to the irritability of the newborns at the time of the evaluation. Still, there was a tendency to improve the learning curve with increasing practice

Topographic outcomes after corneal collagen crosslinking in progressive keratoconus: 1-year follow-up.

PURPOSE:: We aimed to report and analyze topographic and refractive outcomes following corneal collagen crosslinking (CXL) in patients with progressive keratoconus (KC). METHODS:: We performed a retrospective, analytical, and observational study of 100 eyes from 74 progressive KC patients who underwent CXL at the Eye Hospital of Paraná. Keratometric values were analyzed preoperatively as well as 3 and 12 months postoperatively. RESULTS:: For a total of 100 eyes, 68 belonged to male patients. The mean age of our study population was 19.9 ± 5.61 years. The average visual acuity and topographic parameters overall were stable after 1 year (p<0.05). After 3 months, steepest keratometry reading (K2) and maximum keratometry (Kmax) were significantly decreased (p<0.05). Regarding topographic astigmatism (dK), there was no significant difference between the 3-month and 12-month follow-ups. When we made comparisons between genders following CXL, there were no significant differences related to the changes in Kmax, K2, and spectacle-corrected distance visual acuity (SCDVA). CONCLUSIONS:: CXL promoted stabilization or improvement of keratometric values and visual acuity. We found that keratoconus apex stability may be achieved 3 months after the procedure. There was no significant difference in keratometric and refractive values measured between male and female patients.

Topographic outcomes after corneal collagen crosslinking in progressive keratoconus: 1-year follow-up / Resultados topográficos após crosslinking de colágeno corneano em ceratocone progressivo: 1 ano de seguimento

ABSTRACT Purpose: We aimed to report and analyze topographic and refractive outcomes following corneal collagen crosslinking (CXL) in patients with progressive keratoconus (KC). Methods: We performed a retrospective, analytical, and observational study of 100 eyes from 74 progressive KC patients who underwent CXL at the Eye Hospital of Paraná. Keratometric values were analyzed preoperatively as well as 3 and 12 months postoperatively. Results: For a total of 100 eyes, 68 belonged to male patients. The mean age of our study population was 19.9 ± 5.61 years. The average visual acuity and topographic parameters overall were stable after 1 year (p<0.05). After 3 months, steepest keratometry reading (K2) and maximum keratometry (Kmax) were significantly decreased (p<0.05). Regarding topographic astigmatism (dK), there was no significant difference between the 3-month and 12-month follow-ups. When we made comparisons between genders following CXL, there were no significant differences related to the changes in Kmax, K2, and spectacle-corrected distance visual acuity (SCDVA). Conclusions: CXL promoted stabilization or improvement of keratometric values and visual acuity. We found that keratoconus apex stability may be achieved 3 months after the procedure. There was no significant difference in keratometric and refractive values measured between male and female patients.

RESUMO Objetivos: Relatar e analisar os resultados topográficos e refracionais após crosslinking de colágeno corneano (CXL) em pacientes com ceratocone (KC) progressivo. Métodos: Estudo retrospectivo analítico e observacional incluindo 100 olhos de 74 pacientes com KC progressivo submetidos a CXL no Hospital de Olhos do Paraná. Valores ceratométricos foram analisados no pré-operatório, 3 e 12 meses de pós-operatório. Resultados: Em um total de 100 olhos, 68 eram do sexo masculino. A idade média foi de 19,9 ± 5,61. As médias de parâmetros topográficos e acuidade visual em geral, tiveram estabilidade após 1 ano de follow-up (p<0,05). Após 3 meses, a ceratometria mais curva (K2) e a ceratometria máxima (Kmax) tiveram reduções estatisticamente significativas (p<0,05). Em relação ao astigmatismo topográfico (dK), não houve diferença estatisticamente significativa aos 3 e 12 meses de seguimento. Comparando ambos os sexos após o procedimento, não houve diferenças estatisticamente significativas relacionadas às mudanças em Kmax, K2 e acuidade visual corrigida. Conclusões: CXL promoveu a estabilidade ou melhora dos valores ceratométricos e da acuidade visual. Encontramos que a estabilidade do ápice do KC pode ser obtida nos três primeiros meses de follow-up. Não houve diferença estatisticamente significativa nos valores topográficos e refracionais medidos entre pacientes do sexo masculino e feminino.

Perfil demográfico e comportamental de pacientes com indicação médica óptica de lentes de contato / Demographic and behavioral profile of patients with optic medical indication of contact lenses

RESUMO Objetivos: Avaliar o perfil demográfico e comportamental de pacientes com indicação médica óptica de lentes de contato (LC) em um hospital público de Curitiba. Métodos: Estudo transversal realizado através de questionário em pacientes atendidos no serviço de lentes de contato do ambulatório do SUS do Hospital de Olhos do Paraná, no período de 02 de setembro de 2014 a 04 de agosto de 2015. Resultados: Dos 69 entrevistados, 56,52% fizeram LC. Destes, 55,07% têm entre 20-49 anos, 69,56% são mulheres, 40,58% com ensino médio completo e 36,23% com 2 a 6 salários mínimos. Predominaram a lente rígida com 66,67%, com menos de 8 horas de uso em 41,02% e desconforto durante o uso em 59%. A limpeza das LC é feita ao colocar e ao retirar em 87,18% dos casos, com 71,8% utilizando solução própria para LC. Alto custo da compra foi o principal motivo do não uso de LC, com 70% dos pacientes que não fizeram uso desse recurso. Conclusões: Dos entrevistados, 56,52% iniciaram o uso de LC, sendo o ceratocone a doença mais indicada. Foi demonstrado nesse estudo que os pacientes em questão têm boa orientação quanto a manuseio e manutenção das LC. Apesar dos inquestionáveis avanços da tecnologia médica, continuam ocorrendo a desistência do uso desse recurso principalmente pelo custo e medo do manuseio. É responsabilidade do especialista esclarecer os benefícios que os pacientes com indicação médica terão com o uso de LC, assim como motivar o seu uso.

ABSTRACT Objectives: To assess the demographic and behavioral profile of patients with optic medical indication of contact lenses (CL) in a public hospital in Curitiba. Methods: Cross-sectional questionnaire study of patients who attended the contact lens service of the national health system (SUS) outpatient clinic from the "Hospital de Olhos do Paraná" between September 2nd, 2014 and August 4th, 2015. Results: Of the 69 people interviewed, 56.52% acquired CL. Of these, 55.07% are between 20-49 years old, 69.56% are women, 40.58% had finished high school and 36.23% earned a salary of 2 to 6 times the minimum wage. Rigid lenses prevailed, representing 66.67% of the total, with less than 8 hours of usage in 41.02% of the cases and discomfort during usage was assessed in 59%. The cleaning of CL was done at the moment of insertion and removal in 87.18% of cases, and 71.8% used contact solution. High purchase cost was the main reason for not using CL for 70% of patients who did not use this resource. Conclusions: Of the patients interviewed, 56.52 % started using LC. Keratoconus was the main disease for which CL were indicated. It was demonstrated in this study that patients in question have good guidance on handling and maintenance of LC. Despite the unquestionable advances in medical technology continue to occur the abandonment of the use of this feature mainly the cost and fear of handling. It is the responsibility of the expert clarify the benefits that patients with medical indication will have with the use of LC, as well as encourage their use.

A comparison study of corneal topographic changes following 20-, 23-, and 25-G pars plana vitrectomy.

PURPOSE: To evaluate and compare corneal topographic changes following pars plana vitrectomy with the 23-gauge (G) and 25-G transconjuntival sutureless vitrectomy system as well as the standard 20-G vitrectomy system. METHODS: We prospectively evaluated corneal topographic changes in 45 eyes of 45 patients divided into three groups according to vitrectomy system used (20-, 23-, and 25-G). All patients underwent computer-assisted videokeratography using an EyeSys System 3000 topographer preoperatively and at one week, one month, and three months postoperatively. RESULTS: In the 20-G vitrectomy group, we found statistically significant postoperative changes in corneal curvature parameters with an average steepening of 0.98 ± 0.18 D (P<0.001) and 0.93 ± 0.21 D (P<0.001) at one week and one month, respectively. No statistically significant difference was observed at the three-month follow-up visit. In the 23- and 25-G groups, no statistically significant changes in corneal curvature parameters were observed at any postoperative follow-up visit. CONCLUSION: Twenty-three-gauge and 25-gauge transconjunctival sutureless vitrectomy did not induce topographic corneal changes following surgery, whereas 20-G vitrectomy was found to induce transient topographic corneal changes that had returned to preoperative levels at three months postoperatively.

A comparison study of corneal topographic changes following 20-, 23-, and 25-G pars plana vitrectomy / Um estudo comparativo das alterações topográficas da cornea após a vitrectomia via pars plana com 20, 23 e 25 gauge

ABSTRACTPurpose:To evaluate and compare corneal topographic changes following pars plana vitrectomy with the 23-gauge (G) and 25-G transconjuntival sutureless vitrectomy system as well as the standard 20-G vitrectomy system.Methods:We prospectively evaluated corneal topographic changes in 45 eyes of 45 patients divided into three groups according to vitrectomy system used (20-, 23-, and 25-G). All patients underwent computer-assisted videokeratography using an EyeSys System 3000 topographer preoperatively and at one week, one month, and three months postoperatively.Results:In the 20-G vitrectomy group, we found statistically significant postoperative changes in corneal curvature parameters with an average steepening of 0.98 ± 0.18 D (P<0.001) and 0.93 ± 0.21 D (P<0.001) at one week and one month, respectively. No statistically significant difference was observed at the three-month follow-up visit. In the 23- and 25-G groups, no statistically significant changes in corneal curvature parameters were observed at any postoperative follow-up visit.Conclusion:Twenty-three-gauge and 25-gauge transconjunctival sutureless vitrectomy did not induce topographic corneal changes following surgery, whereas 20-G vitrectomy was found to induce transient topographic corneal changes that had returned to preoperative levels at three months postoperatively.

RESUMOObjetivos:Avaliar e comparar as alterações topográficas da córnea após a vitrectomia via pars plana com o sistema transconjuntival sem suturas de 23 gauge (g) e 25 g e com o sistema tradicional de vitrectomia via pars plana 20 g.Método:Neste estudo prospectivo, as alterações topográficas da córnea foram avaliadas em 45 olhos de 45 pacientes, divididos em 3 grupos de acordo com o sistema de vitrectomia utilizado (20, 23 e 25 g). Todos os pacientes foram submetidos a topografia corneana computadorizada utilizando-se o topógrafo EyeSys System 3000 antes da cirurgia, e com 1 semana, 1 mês e 3 meses após a cirurgia.Resultados:No período pós-operatório, no grupo de vitrectomia 20 g, foram encontradas alterações estatisticamente significativas nos parâmetros da curvatura corneana estudados, com um aumento médio da curvatura de 0,98 ± 0,18 D (p<0,001) e 0,93 ± 0,21D (p<0,001) após uma semana, e um mês, respectivamente. Não se observou diferença estatisticamente significativa na visita realizada 3 meses após a cirurgia. Nos grupos 23 g e 25 g, não se observaram alterações estatisticamente significativas nos parâmetros da curvatura corneana em nenhum dos momentos analisados no pós-operatório.Conclusão:A vitrectomia transconjuntival sem suturas 23 g e 25 g não induziu alterações topográficas da córnea após a cirurgia, enquanto que a vitrectomia 20 g induziu alterações topográficas da córnea transitórias que retornaram aos níveis pré-operatórios três meses após a cirurgia.