Optical coherence tomography angiography in herpetic leucoma.

BACKGROUND: Herpes simplex virus (HSV) keratitis remains a leading infectious cause of blindness worldwide. Although all forms of HSV keratitis are commonly recurrent, the risk is greatest in stromal keratitis, which is the most likely to result in corneal scarring, thinning, and neovascularization. Recent studies showed the ability of Optical Coherence Tomography Angiography (OCTA) to detect and study vascular abnormalities in the anterior segment, including abnormal corneal vessels. This study intends to investigate the potential of OCTA device to image and describe quantitatively the vascularization in eyes diagnosed with herpetic leucoma and to discuss and review the usefulness of this technique in this pathology. METHODS: A Cross-sectional study was made, including 17 eyes of 15 patients with leucoma secondary to herpetic keratitis. All eyes underwent anterior segment Slit-Lamp photography (SLP), and OCTA with en-face, b-scans and c-scans imaging. The vessel density (VD) was analyzed in the inferior, nasal and temporal corneal margin in all patients, and in the central area, in eyes with central corneal neovascularization (CoNV). The measurements were calculated after binarization with ImageJ software, using OCTA scans with 6 × 6 mm in a depth of 800 µm. RESULTS: Patients included had a mean age 53.267 ± 21.542 (years ± SD). The mean total vessel area was 50.907% ± 3.435%. VD was higher in the nasal quadrant (51.156% ± 4.276%) but there were no significant differences between the three analyzed areas (p = 0.940). OCTA was able to identify abnormal vessels when SLP apparently showed no abnormal vessels; OCTA was able to distinguish between larger and smaller vessels even in central cornea; OCTA scans allowed the investigation of several corneal planes and the relation of them with clinical findings. CONCLUSIONS: OCTA can be useful in both qualitative and quantitative follow-up of patients and may become a non-invasive alternative to objectively monitor treatment response in eyes with corneal vascularization due to herpetic infection.

ANALYSIS OF CONJUNCTIVAL VASCULAR DENSITY IN SCLERAL CONTACT LENS WEARERS USING OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY.

PURPOSE: To investigate conjunctival vascular density (VD) using Anterior Segment Optical Coherence Tomography Angiography (OCTA) in Scleral Contact Lens (ScCL) wearers. METHODS: In this cross-sectional study, the conjunctival blood VD was assessed using OCTA with an anterior segment lens adapter. The nasal surface of each eye (6 ×6 mm) was scanned to a depth of 800 µm with ScCL and fifteen minutes after removing the lens. Conjunctival VD was defined as the percentage of the scanned volume occupied by vessels in which blood flow was measured. Measures of limbal indentation were subjectively determined by two independent observers using Anterior Segment Optical Coherence Tomography (AS-OCT). Comparisons between VD measurements before and after ScCL removal and correlations between conjunctival VD, time of use, vault and indentation values were also investigated. RESULTS: A total of 23 patients (3 females, 20 males) with keratoconus, with a mean age (years±SD) of 38.74±10.38 were included in the study. VD was significantly higher without ScCL (71.75%±2.97) than VD measured with ScCL (69.81%±2.63), p=0.02. A moderately negative correlation was found between indentation and vault (r=-0.44, p<0.05) and a positive tendency regarding the time of wearing ScCL and indentation (r=0.11 and r=0.068, respectively). CONCLUSIONS: Using OCTA with an anterior segment lens adapter, the ocular surface blood VD was imaged and assessed with good repeatability and reliability. This study presents a new possible application of OCTA to investigate and monitor conjunctival vasculature in ScCL wearers. This results cautiously suggest that the repeated use of ScCL can cause vascular alterations in conjunctiva of the eyes of ScCL wearers, possibly due to a hidden hypoxia caused by prolonged limbal indentation.

Effects of Concurrent Training with Elastic Tubes in Hypertensive Patients: A Blind Controlled Randomized Clinical Trial.

BACKGROUND: Concurrent training (CT) has been recommended to minimize the deleterious effects of aging. However, few studies have investigated whether this type of training reduces blood pressure in the elderly. Therefore, our objective was to evaluate the effects of CT on the hemodynamic, cardiorespiratory, and muscle strength responses in medicated hypertensive patients. METHODS: Twenty-three hypertensives (62.65 ± 6.4 years) of both sexes were allocated to the concurrent training group (CTG) or control group (CG). The CTG performed aerobic training (70-85% of reserve heart rate) combined with resistance training with elastic tubes (2sets × 15 repetitions) for 8 weeks. Resting blood pressure (BP), peak oxygen consumption (VO2peak), and right knee and elbow flexion strength were evaluated. RESULTS: A reduction of 6.37% was observed in BP and increases of 16.68% in VO2peak and 16% in muscle strength for right elbow flexion in the CTG compared to CG (p < .05). Intragroup comparisons showed reduction of 5% for BP, and increases of 6.79% for VO2peak, 24.79% for elbow flexion, and 16.47% for knee flexion in the CTG (p < .05), without significant improvement in the CG. CONCLUSION: CT promoted a reduction in BP, and increased cardiorespiratory fitness and muscular strength of the upper limbs in the hypertensive older adults.

Representações sociais da família para a equipe da estratégia saúde da família / Family social representations for the family health strategy program team / Representaciones sociales de la familia para el equipo de la estrategia salud de la familia

Estudo descritivo qualitativo que objetivou conhecer as representações sociais dos profissionais da estratégia saúde da família sobre família, utilizando como suporte metodológico de análise a Teoria das Representações Sociais. Osparticipantes da pesquisa foram 58 profissionais atuantes em unidades de saúde com ESF, do município de Curitiba, Paraná em 2010. Os dados foram coletados por meio de entrevista semiestruturada, gravada, realizada a análise de conteúdo categorial da transcrição dos depoimentos, da qual emergiram três categorias: Família, meu porto seguro; Família, minhabase; e Família, laços cuidadores. As representações sociais sobre família referiram-se à proteção social e emocional que ela oferece aos seus membros, ao conjunto de pessoas significativas que a compõem e à heterogeneidade dos laços que as unem. A representação da família expressa o contexto social e ideológico que norteia as práticas de cuidado que permitem a reconstrução ou manutenção destas, com vistas a estimular sua autonomia e desenvolvimento.

Qualitative descriptive study aimed at identifying the social representations of health professionals on family healthstrategy program (FHS). Methodological analysis support was framed in the theory of social representations. Survey participants were 58 professionals from primary health units, conducting the FHP, in the municipality of Curitiba, PR, Brazil, in 2010. Data were collected through a recorded semi-structured interview. Categorical content analysis of the transcripts was made out of which three categories emeerged: Family, my safe harbor; Family, my background; and Family, caring ties. Social representation of family referred to the social and emotional protection that it offers to its members, the group of significant people integrating it and the heterogeneous ties they have. The representation of the family translates the social and ideological context guiding the care practices that allow for their reconstruction or maintenance, with a view to encourage their autonomy and development.

Estudio descriptivo cualitativo que tuvo como objetivo identificar las representaciones sociales de los profesionales de la estrategia Salud de la Familia (ESF) sobre la familia, utilizando como apoyo metodológico de análisis la teoría de las representaciones sociales. Participantes de la investigación fueron 58 profesionales que trabajan en unidades de salud, con la ESF, en la ciudad de Curitiba, Paraná – Brasil, en 2010. Los datos fueron recolectados a través de entrevistas semiestructuradas, grabados, realizado el análisis de contenido categórico de la transcripción de las declaraciones, donde surgieron tres categorías: Familia, mi puerto seguro; Familia, mi base; y Familia, lazos cuidadores. La representación social sobre la familia a que se refierea la protección social y emocional que ella ofrece a sus miembros, al grupo de personas importantes que la componen y a la heterogeneidad de los vínculos entre ellos. La representación de la familia expresa el contexto social e ideológico que guía las prácticas de atención que permiten la reconstrucción o mantenimiento de ellas, con el fin de favorecer su autonomía y desarrollo.