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1.
J Homosex ; 69(10): 1721-1742, 2022 Aug 24.
Artigo em Inglês | MEDLINE | ID: mdl-34009098

RESUMO

Research demonstrates a clear connection between socialization initiatives and college student retention. Less clear are the ways transgender students select an institution to attend and transition into postsecondary education. As scholars dedicate efforts to understand trans college student success, more information is needed to determine how socialization initiatives fit in the success puzzle. Drawing upon an extensive qualitative study of trans college students, this article seeks to identify the factors that affect trans students' college choice process and their experiences with anticipatory socialization initiatives moving into their first semester of study. Findings indicated that students attempted to grasp an institution's commitment to transgender inclusion through various questions and online tools. Additionally, participants indicated the normalization of discussions concerning chosen names and pronouns suggested a supportive campus environment that helped them feel secure in selecting the institution.


Assuntos
Estudantes , Escolaridade , Humanos , Pesquisa Qualitativa , Inquéritos e Questionários , Universidades
2.
Telemed J E Health ; 26(4): 477-481, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-31161968

RESUMO

Introduction:Widespread screening for cognitive decline is an important challenge to address as the aging population grows, but there is currently a shortage of clinical infrastructure to meet the demand for in-person evaluation. Remotely delivered assessments that utilize eye-tracking data from webcams, such as visual paired comparison (VPC) tasks, could increase access to remote, asynchronous neuropsychological screening for cognitive decline but further validation against clinical-grade eye trackers is required.Methods:To demonstrate equivalence between a novel automated scoring system for eye-tracking metrics acquired through a laptop-embedded camera and a gold-standard eye tracker, we analyzed VPC data from 18 subjects aged 50+ with normal cognitive function across three visits. The eye tracker data were scored by the manufacturer's software, and the webcam data were scored by a novel algorithm.Results:Automated scoring of webcam-based VPC data revealed strong correlations with the clinical-grade eye-tracking camera. Correlation of mean VPC performance across all time points was robust: r = 0.95 (T1 r = 0.97; T2 r = 0.88; T3 r = 0.97; p's < 0.001). Correlation of per-trial performance across time points was also robust: r = 0.88 (T1 r = 0.85; T2 r = 0.89; T3 r = 0.92; p's < 0.001). Mean differences between performance data acquired by each device were 0.00.Conclusion:These results suggest that device-embedded cameras are a valid and scalable alternative to traditional laboratory-based equipment for gaze-based tasks measuring cognitive function. The validation of this technique represents an important technical advance for the field of teleneuropsychology.


Assuntos
Disfunção Cognitiva , Tecnologia de Rastreamento Ocular , Idoso , Envelhecimento , Cognição , Humanos , Pessoa de Meia-Idade , Software
3.
Clin Neurol Neurosurg ; 189: 105635, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31855622

RESUMO

OBJECTIVES: To determine if Parkinson's disease (PD) and progressive supranuclear palsy (PSP) differed on retinal measurements using optical coherence tomography (OCT). PATIENTS AND METHODS: In a prospective, controlled, cross-sectional cohort study, we recruited patients with PD or PSP for more than three years, as well as control subjects. We measured peripapillary retinal nerve fiber layer (RNFL) thickness and macular volume using spectral-domain OCT. The association between these OCT measures and the disease characteristics of duration and disability were examined using a linear mixed effect model. RESULTS: We analyzed eyes from n = 12 PD patients, n = 11 PSP patients, and n = 12 control subjects. RNFL thickness was reduced in eyes from patients with PSP, but there were no differences in macular volume between groups. RNFL thickness and macular volume were not significantly different between eyes from patients with PD and controls. Worse disability was associated with reduced macular volumes. CONCLUSION: PSP but not PD is associated with thinning of the peripapillary RNFL when symptoms have been present for more than three years.


Assuntos
Fibras Nervosas Amielínicas/patologia , Doença de Parkinson/diagnóstico por imagem , Retina/diagnóstico por imagem , Células Ganglionares da Retina/patologia , Paralisia Supranuclear Progressiva/diagnóstico por imagem , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Tamanho do Órgão , Doença de Parkinson/patologia , Retina/patologia , Paralisia Supranuclear Progressiva/patologia , Tomografia de Coerência Óptica
4.
New Dir Stud Leadersh ; 2019(161): 65-77, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30729741

RESUMO

This chapter discusses strategies that administrators, particularly student affairs educators, can use to support and honor the labor of student activists, using the authors' experiences navigating their responsibilities to campuses and students.


Assuntos
Liderança , Ativismo Político , Racismo , Estudantes , Universidades , Adulto , Feminino , Humanos , Masculino , Adulto Jovem
5.
Sci Rep ; 7(1): 16599, 2017 11 30.
Artigo em Inglês | MEDLINE | ID: mdl-29192244

RESUMO

The conformations of polycarboxylate ether (PCE) type superplasticizer polymers adsorbed on the surface of MgO in cement pore solution are simulated by molecular dynamics (MD). Three types of PCEs commonly applied to concrete are simulated, namely a methacrylate type PCE (PCEM-P), an allyl ether type PCE (PCEA-P), and an isoprenyl ether type PCE (PCEI-P) with ethylene oxide (EO) unit numbers (P) of 25, 34 and 25, respectively. It is observed that the adsorbed layer thickness is inversely proportional to the experimentally measured adsorbed amount at the initial paste flow of 26 ± 0.5 cm. Simulation results indicate that the adsorbed layer thickness is sensitive to the initial polymer orientations against the model MgO surface. I.e., polymer molecules initially placed parallel/perpendicularly against the MgO surface gradually forms a train shaped or a loop and tail adsorption profile, respectively. As a result, the loop and tail shaped conformation gives a higher layer thickness.

6.
Can J Ophthalmol ; 52(6): 552-558, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-29217022

RESUMO

OBJECTIVE: The aim of this study is to summarize the clinical characteristics of patients with contact lens-associated focal limbal stem cell deficiency (FLSCD) from a tertiary corneal referral centre. DESIGN: Retrospective, observational case series in a tertiary care centre. METHODS: Patients with contact lens-associated FLCSD were identified in our database. Clinical data were retrieved by chart review. A questionnaire asking for contact lens brand, type, cleaning solution, and duration of contact lens wear was sent to the patients with telephone follow-up. Clinical features and recovery time were identified. RESULTS: Twenty-seven eyes of 17 patients were identified with superior corneal whorl-like patches of opaque epithelium, sometimes accompanied by neovascularization. Of the patients, 17/17 used soft contact lenses, with a mean wearing duration of 11.4 hours per day. Patients had been wearing lenses for an average of 18.1 years. Silicone hydrogel lenses were noted in 12/17 cases. LSCD was superior in all 27 eyes, and all of them improved with contact lens wear cessation, preservative-free topical steroids, and preservative-free artificial tears. Visual acuity improved from 20/28 to 20/22 (p < 0.001). CONCLUSIONS: Contact lens-associated FLSCD typically presents in the superior cornea with whorl-like epithelial opacities advancing from the limbus. Conservative medical treatment is available and shows a high success rate after a slow recovery.


Assuntos
Lentes de Contato Hidrofílicas/efeitos adversos , Doenças da Córnea/etiologia , Epitélio Corneano/patologia , Limbo da Córnea/patologia , Células-Tronco/patologia , Adolescente , Adulto , Lentes de Contato Hidrofílicas/estatística & dados numéricos , Doenças da Córnea/terapia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Inquéritos e Questionários , Centros de Atenção Terciária , Fatores de Tempo , Acuidade Visual/fisiologia , Adulto Jovem
7.
Front Neurosci ; 11: 370, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28701915

RESUMO

Background: Web cameras are increasingly part of the standard hardware of most smart devices. Eye movements can often provide a noninvasive "window on the brain," and the recording of eye movements using web cameras is a burgeoning area of research. Objective: This study investigated a novel methodology for administering a visual paired comparison (VPC) decisional task using a web camera.To further assess this method, we examined the correlation between a standard eye-tracking camera automated scoring procedure [obtaining images at 60 frames per second (FPS)] and a manually scored procedure using a built-in laptop web camera (obtaining images at 3 FPS). Methods: This was an observational study of 54 clinically normal older adults.Subjects completed three in-clinic visits with simultaneous recording of eye movements on a VPC decision task by a standard eye tracker camera and a built-in laptop-based web camera. Inter-rater reliability was analyzed using Siegel and Castellan's kappa formula. Pearson correlations were used to investigate the correlation between VPC performance using a standard eye tracker camera and a built-in web camera. Results: Strong associations were observed on VPC mean novelty preference score between the 60 FPS eye tracker and 3 FPS built-in web camera at each of the three visits (r = 0.88-0.92). Inter-rater agreement of web camera scoring at each time point was high (κ = 0.81-0.88). There were strong relationships on VPC mean novelty preference score between 10, 5, and 3 FPS training sets (r = 0.88-0.94). Significantly fewer data quality issues were encountered using the built-in web camera. Conclusions: Human scoring of a VPC decisional task using a built-in laptop web camera correlated strongly with automated scoring of the same task using a standard high frame rate eye tracker camera.While this method is not suitable for eye tracking paradigms requiring the collection and analysis of fine-grained metrics, such as fixation points, built-in web cameras are a standard feature of most smart devices (e.g., laptops, tablets, smart phones) and can be effectively employed to track eye movements on decisional tasks with high accuracy and minimal cost.

8.
J Neuroophthalmol ; 36(4): 363-368, 2016 12.
Artigo em Inglês | MEDLINE | ID: mdl-27416520

RESUMO

BACKGROUND: Neuromyelitis spectrum disorder (NMOSD) is a rare autoimmune disorder previously thought to be a subtype of multiple sclerosis (MS). NMOSD is characterized by episodes of inflammation and damage to astrocytes that primarily results in damage to optic nerve and spinal cord. The objective of this exploratory study was to use optical coherence tomography (OCT) to measure axonal and neuronal health in NMOSD eyes over time. METHODS: Nine patients with definite NMOSD were assessed at baseline and follow-up visits (time between visits: 35-55 months). OCT assessment involved a macular volume protocol and a retinal nerve fiber layer (RNFL) thickness scan. RESULTS: The temporal, inferior, nasal, or superior quadrant and the mean global RNFL thickness, macular thickness, and volume of each NMOSD patient was unchanged compared with baseline for each eye separately and both together. There also was no change between the 2 time points for the OCT measures for eyes affected and unaffected by optic neuritis and all eyes together except for a significant change in the temporal RNFL quadrant when all NMOSD eyes were pooled together (mean = 2.88 µm, SD = 3.7, P = 0.021). CONCLUSIONS: Unlike in MS eyes, ongoing RNFL and macular thinning secondary to brain and optic nerve atrophy could not be observed in NMOSD eyes during an observation period of 4 years. This might be an additional marker to distinguish these 2 diseases. However, to confirm this finding, more long-term data are needed to compare these 2 diseases longitudinally.


Assuntos
Macula Lutea/patologia , Fibras Nervosas/patologia , Neuromielite Óptica/diagnóstico , Nervo Óptico/patologia , Células Ganglionares da Retina/patologia , Tomografia de Coerência Óptica/métodos , Adulto , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Tempo , Adulto Jovem
9.
Neuroimage Clin ; 11: 743-750, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27330974

RESUMO

BACKGROUND: The optic nerve is frequently injured in multiple sclerosis and neuromyelitis optica, resulting in visual dysfunction, which may be reflected by measures distant from the site of injury. OBJECTIVE: To determine how retinal nerve fiber layer as a measure of axonal health, and macular volume as a measure of neuronal health are related to changes in myelin water fraction in the optic radiations of multiple sclerosis and neuromyelitis optica participants with and without optic neuritis and compared to healthy controls. METHODS: 12 healthy controls, 42 multiple sclerosis (16 with optic neuritis), and 10 neuromyelitis optica participants (8 with optic neuritis) were included in this study. Optical coherence tomography assessment involved measurements of the segmented macular layers (total macular, ganglion cell layer, inner plexiform layer, and inner nuclear layer volume) and paripapillary retinal nerve fiber layer thickness. The MRI protocol included a 32-echo T2-relaxation GRASE sequence. Average myelin water fraction values were calculated within the optic radiations as a measure of myelin density. RESULTS: Multiple sclerosis and neuromyelitis optica eyes with optic neuritis history had lower retinal nerve fiber layer thickness, total macular, ganglion cell and inner plexiform layer volumes compared to eyes without optic neuritis history and controls. Inner nuclear layer volume increased in multiple sclerosis with optic neuritis history (mean = 0.99 mm(3), SD = 0.06) compared to those without (mean = 0.97 mm(3), SD = 0.06; p = 0.003). Mean myelin water fraction in the optic radiations was significantly lower in demyelinating diseases (neuromyelitis optica: mean = 0.098, SD = 0.01, multiple sclerosis with optic neuritis history: mean = 0.096, SD = 0.01, multiple sclerosis without optic neuritis history: mean = 0.098, SD = 0.02; F3,55 = 3.35, p = 0.03) compared to controls. Positive correlations between MRI and optical coherence tomography measures were also apparent (retinal nerve fiber layer thickness and ganglion cell layer thickness: r = 0.25, p = 0.05, total macular volume and inner plexiform layer volume: r = 0.27, p = 0.04). CONCLUSIONS: The relationship between reductions in OCT measures of neuro-axonal health in the anterior visual pathway and MRI-based measures of myelin health in the posterior visual pathway suggests that these measures may be linked through bidirectional axonal degeneration.


Assuntos
Esclerose Múltipla/patologia , Bainha de Mielina/patologia , Neuromielite Óptica/patologia , Vias Visuais/patologia , Adulto , Axônios/patologia , Feminino , Humanos , Processamento de Imagem Assistida por Computador , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Esclerose Múltipla/diagnóstico por imagem , Fibras Nervosas Mielinizadas/patologia , Neuromielite Óptica/diagnóstico por imagem , Tomografia de Coerência Óptica , Vias Visuais/diagnóstico por imagem
10.
Mult Scler ; 22(1): 43-50, 2016 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-25948623

RESUMO

BACKGROUND: Both multiple sclerosis (MS) and neuromyelitis optica (NMO) can present with transverse myelitis; however, NMO symptoms are usually more severe and may present with more extensive axonal loss. Transcranial magnetic stimulation (TMS)-based input-output recruitment curves can quantitatively assess the excitability of corticospinal tract pathways and myelin water imaging can quantify the amount of myelin within this same pathway. OBJECTIVE: To compare differential effects of MS and NMO on TMS recruitment curves and myelin water imaging. METHODS: Ten healthy controls, 10 individuals with MS and 10 individuals with NMO completed clinical assessments, a TMS assessment and magnetic resonance imaging scan to measure recruitment curves and myelin water fraction in the corticospinal tract. RESULTS: Individuals with NMO had lower recruitment curve slopes (mean 13.6±6 µV/%) than MS (23.6±11 µV/%) and controls (21.9±9 µV/%, analysis of variance (ANOVA) P=0.05). Corticospinal tract myelin water fraction was lower in individuals with NMO (mean 0.17±0.02) compared to MS (0.19±0.02) and controls (0.20±0.02, ANOVA P=0.0006). CONCLUSION: Corticospinal pathway damage in individuals with NMO was evident by reduced recruitment curve slope and lower myelin water fraction. These specific measures of corticospinal function and structure may be used to obtain a better understanding and monitor brain injury caused by inflammatory central nervous system disorders.


Assuntos
Esclerose Múltipla/patologia , Esclerose Múltipla/fisiopatologia , Neuromielite Óptica/patologia , Neuromielite Óptica/fisiopatologia , Tratos Piramidais/patologia , Tratos Piramidais/fisiopatologia , Adulto , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Estimulação Magnética Transcraniana
11.
Clin Transplant ; 29(2): 118-23, 2015 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-25430052

RESUMO

INTRODUCTION: Preferences for the testing and treatment of antibody-mediated rejection (AMR) in renal transplant patients vary among programs and individual practitioners. The description of these preferences and identification of commonalities can contribute to creating a standard of care. METHODS: A survey was distributed through the Transplant Listserv of the American College of Clinical Pharmacy (ACCP) and via email to members of the American Society of Transplantation Community of Pharmacy (AST CoP), collected, and analyzed. RESULTS: Most clinicians (26/28) test for donor-specific antibodies (DSAs) when evaluating a patient with possible AMR. Treatments for AMR varied widely among responding clinicians and included intravenous immune globulin (IVIG, n = 25), plasmapheresis (n = 24), rituximab (n = 8), bortezomib (n = 4), rabbit antithymocyte globulin (n = 2), and eculizumab (n = 1). Weight-based dosing of IVIG averaged 1.8 g/kg total dose. Six centers use rituximab as initial therapy, while two use rituximab if other therapy fails. Four centers use bortezomib as initial therapy, while two centers use it for severe/persistent AMR. One center uses eculizumab as initial therapy and one center uses it for severe AMR. CONCLUSION: Methods for the detection of AMR are similar, yet treatment of AMR varies widely. Most centers utilize DSA for detection and a combination of IVIG and plasmapheresis for treatment.


Assuntos
Rejeição de Enxerto/terapia , Imunoglobulinas Intravenosas/uso terapêutico , Isoanticorpos/imunologia , Transplante de Rim , Plasmaferese/métodos , Inquéritos e Questionários , Rejeição de Enxerto/imunologia , Humanos , Fatores Imunológicos/uso terapêutico , Resultado do Tratamento
12.
J Neuroophthalmol ; 33(3): 213-9, 2013 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-23863782

RESUMO

BACKGROUND: Neuromyelitis optica (NMO) is a demyelinating syndrome of the central nervous system. NMO might be underdiagnosed at early stages when patients have not yet developed the full spectrum of disease. The aim of this study was to analyze the retinal nerve fiber layer (RNFL) with optical coherence tomography (OCT) and to compare RNFL measurements between NMO patients, patients with relapsing-remitting multiple sclerosis (RRMS), and healthy controls to determine whether differences in RNFL thickness could be an early diagnostic marker for NMO. METHODS: In a cross-sectional study, eyes of 25 NMO patients, 25 RRMS patients, and 50 healthy controls underwent RNFL measurements by OCT. Clinical parameters were collected by history and chart review. Pairwise Wilcoxon rank sum tests with Holm correction were used to compare means of RNFL thickness among 6 groups (NMO, RRMS, and healthy control) of patients [without or with 1 or more episode of optic neuritis (ON)]. The association between RNFL thickness and patient characteristics for NMO group was examined via linear mixed-effects models (adjusting for within-patient intereye correlations and history of ON, where appropriate). RESULTS: Based on the pairwise Wilcoxon rank sum tests with Holm correction, significant differences were found between NMO with 1 episode of ON and non-ON eyes (mean RNFL 63.7 vs 97.0 µm, P < 0.0001), multiple sclerosis (MS) non-ON eyes, and controls (RNFL 93.2 vs 98.4 µm, P = 0.03). No significant differences were found between NMO and MS with 1 attack of ON eyes (RNFL 63.7 vs 73.9 µm, P = 0.46), NMO non-ON eyes and healthy controls (RNFL 97.0 vs 98.4 µm, P = 0.56), and NMO non-ON and MS non-ON (RNFL 97.0 vs 93.2 µm, P = 0.56). For NMO group, RNFL thickness was associated with a history of ON (P < 0.001) but not with disability or disease duration when adjusting for the history of ON (P > 0.1). CONCLUSIONS: RNFL in NMO is not different enough to distinguish NMO ON from MS ON eyes, but the intereye difference in RFNL with a history of unilateral ON may be a better diagnostic marker for NMO.


Assuntos
Neuromielite Óptica/diagnóstico , Neurite Óptica/diagnóstico , Retina/patologia , Células Ganglionares da Retina/patologia , Tomografia de Coerência Óptica , Adulto , Idoso , Estudos Transversais , Diagnóstico Diferencial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Esclerose Múltipla Recidivante-Remitente/patologia , Neuromielite Óptica/patologia , Neurite Óptica/patologia
13.
Mult Scler ; 19(10): 1275-81, 2013 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-23401130

RESUMO

BACKGROUND/OBJECTIVE: Retinal nerve fiber layer (RNFL) thickness has been linked to brain atrophy in multiple sclerosis (MS). However, little is known about retinal atrophy in 'benign' MS. We compared RNFL thickness in benign MS with healthy controls. METHODS: Patients with benign MS (Expanded Disability Status Scale (EDSS) ≤ 3; ≥15 years' disease duration), identified through the British Columbia MS database, along with age-matched healthy controls, were recruited. RNFL thickness was measured using spectral-domain optical coherence tomography. Analysis of variance (ANOVA) was used to compare groups. The association between RNFL thickness and MS patient characteristics was examined via linear mixed-effects models (adjusting for within-patient inter-eye correlations and history of optic neuritis (ON), where appropriate). RESULTS: Overall, 29 benign MS patients and 29 healthy controls were included, totaling 116 eyes. RNFL thickness was lowest for the benign MS eyes, with and then without a history of ON, followed by healthy controls (mean=73.2 µm, SD ± 0.4; 89.9 µm, SD ± 12.5; 96.7 µm, SD ± 10.4; p<0.02). RNFL thickness was associated with a history of ON (p<0.0001), but not EDSS or disease duration (p>0.1). CONCLUSIONS: RNFL thickness was lower in patients with benign MS than healthy controls, regardless of the previous history of ON. However, no association was found between RNFL values and disability or MS disease duration.


Assuntos
Esclerose Múltipla/patologia , Fibras Nervosas/patologia , Retina/patologia , Adulto , Idoso , Atrofia/patologia , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
14.
Cornea ; 32(1): 98-103, 2013 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-22467004

RESUMO

PURPOSE: To explore the safety of a new technique of lamellar dissection, using enzymatic digestion of the corneal stroma and extracellular matrix. METHODS: This was a wetlab-based pilot study of hyaluronidase and trypsin-assisted deep anterior lamellar keratoplasty (DALK) in cadaveric human corneal tissue. Enzyme-assisted DALK was performed on 17 tissues. These underwent histologic analysis using a pneumatic dissection specimen as control. Rates of perforation and Descemet membrane (DM) exposure were recorded by clinical observation and by optical coherence tomography in selected cases. Where possible, pre- and postsurgical endothelial cell counts were obtained via specular microscopy. Two tissues from the same donor were halved, with each half soaked in a different solution (Optisol, balanced salt solution, hyaluronidase, and trypsin) for 13.5 hours to observe maximal effect. RESULTS: Successful exposure of DM was achieved in 8 specimens. In the remaining 9, manual dissection was possible to a residual depth of 25 to 90 µm where measured with optical coherence tomography. Three tissues had perforation of DM, all via manual maneuvers. No deleterious effects on residual host tissue were observed by light microscopy with no significant rates of endothelial cell loss in 8 tissues in which a predissection cell count was obtainable. The 2 enzymes had differing effects on soaked specimens that were reflected intraoperatively. CONCLUSION: Preliminary results of this ex vivo study are encouraging that enzymolysis may represent an effective innovation in DALK surgery with an acceptable safety profile. Further studies are required to refine the technique and application of the enzymes in vivo.


Assuntos
Córnea/efeitos dos fármacos , Transplante de Córnea/métodos , Hialuronoglucosaminidase/farmacologia , Tripsina/farmacologia , Contagem de Células , Lâmina Limitante Posterior/patologia , Dissecação/métodos , Quimioterapia Combinada , Endotélio Corneano/patologia , Humanos , Projetos Piloto
15.
J Ophthalmol ; 2012: 564627, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-22685631

RESUMO

Objective. The aim of this study was to compare retinal nerve fiber layer thickness (RNFLT) between spectral-domain (SD-) and time-domain optical coherence tomography (TD-OCT) in MS patients and healthy controls (HC). Furthermore, RNFLT between MS eyes with and without optic neuritis (ON) and HC should be explored. Finally, the relationship between RNFLT, disease duration, EDSS, and disease modifying therapy (DMT) should be established. Design. Prospective, cross-sectional study. Participants. 28 MS patients and 35 HC. Methods. Both groups underwent TD- and SD-OCT measurements. RFNLT was correlated between the two machines and between MS eyes with and without ON and HC. Furthermore, RNFLT was correlated to disease duration, EDSS and DMT. Results. A strong correlation (Pearson's r = 0.921, P < 0.001), but a statistically significant difference of 2 µm (P < 0.001), was found between the two devices. RNFLT was significantly different between MS eyes with history of ON (mean RFNLT (SD) 72.21 µm (15.83 µm)), MS eyes without history of ON 93.03 µm (14.25 µm), and HC 99.07 µm (7.23 µm) (P < 0.001). Conclusions. The measurements between different generation of OCT machines are not interchangeable, which should be taken into account if comparing results between different machines and switching OCT machine in longitudinal studies.

17.
Biochem J ; 443(1): 111-23, 2012 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-22214556

RESUMO

Glucose metabolism in the liver activates the transcription of various genes encoding enzymes of glycolysis and lipogenesis and also G6pc (glucose-6-phosphatase). Allosteric mechanisms involving glucose 6-phosphate or xylulose 5-phosphate and covalent modification of ChREBP (carbohydrate-response element-binding protein) have been implicated in this mechanism. However, evidence supporting an essential role for a specific metabolite or pathway in hepatocytes remains equivocal. By using diverse substrates and inhibitors and a kinase-deficient bisphosphatase-active variant of the bifunctional enzyme PFK2/FBP2 (6-phosphofructo-2-kinase-fructose-2,6-bisphosphatase), we demonstrate an essential role for fructose 2,6-bisphosphate in the induction of G6pc and other ChREBP target genes by glucose. Selective depletion of fructose 2,6-bisphosphate inhibits glucose-induced recruitment of ChREBP to the G6pc promoter and also induction of G6pc by xylitol and gluconeogenic precursors. The requirement for fructose 2,6-bisphosphate for ChREBP recruitment to the promoter does not exclude the involvement of additional metabolites acting either co-ordinately or at downstream sites. Glucose raises fructose 2,6-bisphosphate levels in hepatocytes by reversing the phosphorylation of PFK2/FBP2 at Ser32, but also independently of Ser32 dephosphorylation. This supports a role for the bifunctional enzyme as the phosphometabolite sensor and for its product, fructose 2,6-bisphosphate, as the metabolic signal for substrate-regulated ChREBP-mediated expression of G6pc and other ChREBP target genes.


Assuntos
Fatores de Transcrição de Zíper de Leucina e Hélice-Alça-Hélix Básicos/metabolismo , Frutosedifosfatos/metabolismo , Regulação da Expressão Gênica , Glucose-6-Fosfatase/genética , Glucose/fisiologia , Hepatócitos/metabolismo , Transporte Ativo do Núcleo Celular , Animais , Fatores de Transcrição de Zíper de Leucina e Hélice-Alça-Hélix Básicos/genética , Células Cultivadas , Desoxiglucose/farmacologia , Di-Hidroxiacetona/farmacologia , Glucose/metabolismo , Glucose/farmacologia , Glucose-6-Fosfatase/metabolismo , Glicólise , Hepatócitos/enzimologia , Hexosaminas/metabolismo , Masculino , Fosfofrutoquinase-2/metabolismo , Fosforilação , Regiões Promotoras Genéticas , Ligação Proteica , Ratos , Ratos Wistar , Xilitol/farmacologia
18.
ISRN Ophthalmol ; 2012: 860819, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-24558593

RESUMO

Objective. The aim of this study was to test the reproducibility of the Heidelberg Spectralis SD-OCT and to determine if provided software retest function for follow-up exam is superior to manual centration. Design. Prospective, cross-sectional study. Participants. 20 healthy subjects. Methods. All subjects underwent SD-OCT testing to determine retinal nerve fiber layer (RNFL) measurements sequentially on two different days and with two different centration techniques. Within-subject standard deviation, coefficient of variation, and intraclass correlation coefficient were used to assess reproducibility. Results. RNFL measurements showed high reproducibility, low within-subject standard deviation (1.3), low coefficient of variation (0.63%), and low intra-class correlation coefficient (0.98 (95% CI 0.97-0.99)) in the automated centration and manual centration groups for average RNFL Thickness. Quadrants showed slightly higher variability in the manual group compared to the automated group (within-subject standard deviation 2.5-5.3 versus 1.1-2.4, resp.). Conclusions. SD-OCT provides high-resolution RNFL measurements with high reproducibility and low variability. The re-test function allows for easier recentration for longitudinal examinations with similar results in average RNFL, but less variability in quadrant RNFL. SD-OCT high reproducibility and low variability is a promising fact and should be further evaluated in longitudinal studies of RNFL.

19.
Case Rep Ophthalmol ; 2(3): 302-6, 2011 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-22087104

RESUMO

PURPOSE: Vitamin A deficiency is a very rare condition in the developed world and can lead to a variety of ocular changes from xerosis and xerophthalmia to corneal ulcer and perforation. The treatment of this devastating disease is simple and inexpensive. It is therefore important to recognize and treat accordingly, especially in the event of ulcers unresponsive to treatment or in the presence of severe malnutrition/malabsorption syndromes. The purpose of this case report is to remind physicians of the potentially devastating effects of vitamin A deficiency on the eyes and to demonstrate outcomes after vitamin A treatment. METHODS: Single observational case report. RESULTS: A 29-year-old male with known eosinophilic gastroenteropathy was treated with oral steroids for peripheral ulcerative keratitis. Two weeks after resolution, the patient suffered from peripheral ulcerative keratitis in his other eye, with a self-sealing perforation. Vitamin A deficiency was confirmed and successfully treated, leading to subsequent resolution of signs and symptoms. CONCLUSIONS: Vitamin A deficiency can be present in patients with malabsorption and malnutrition syndromes and should be considered as cause of corneal ulceration.

20.
Graefes Arch Clin Exp Ophthalmol ; 249(9): 1367-71, 2011 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-21567210

RESUMO

BACKGROUND: Straylight gives the appearance of a veil of light thrown over a person's retinal image when there is a strong light source present. We examined the reproducibility of the measurements by C-Quant, and assessed its correlation to characteristics of the eye and subjects' age. PARTICIPANTS AND METHODS: Five repeated straylight measurements were taken using the dominant eye of 45 healthy subjects (age 21-59) with a BCVA of 20/20: 14 emmetropic, 16 myopic, eight hyperopic and seven with astigmatism. We assessed the extent of reproducibility of straylight measures using the intraclass correlation coefficient. RESULTS: The mean straylight value of all measurements was 1.01 (SD 0.23, median 0.97, interquartile range 0.85-1.1). Per 10 years of age, straylight increased in average by 0.10 (95%CI 0.04 to 0.16, p < 0.01]. We found no independent association of refraction (range -5.25 dpt to +2 dpt) on straylight values (0.001; 95%CI -0.022 to 0.024, p = 0.92). Compared to emmetropic subjects, myopia reduced straylight (-.011; -0.024 to 0.02, p = 0.11), whereas higher straylight values (0.09; -0.01 to 0.20, p = 0.09) were observed in subjects with blue irises as compared to dark-colored irises when correcting for age. The intraclass correlation coefficient (ICC) of repeated measurements was 0.83 (95%CI 0.76 to 0.90). CONCLUSIONS: Our study showed that straylight measurements with the C-Quant had a high reproducibility, i.e. a lack of large intra-observer variability, making it appropriate to be applied in long-term follow-up studies assessing the long-term effect of surgical procedures on the quality of vision.


Assuntos
Emetropia/fisiologia , Oftalmoscopia/normas , Estimulação Luminosa/métodos , Erros de Refração/fisiopatologia , Retina/fisiologia , Adulto , Astigmatismo/fisiopatologia , Feminino , Ofuscação/efeitos adversos , Humanos , Hiperopia/fisiopatologia , Luz , Masculino , Pessoa de Meia-Idade , Miopia/fisiopatologia , Oftalmoscopia/métodos , Reprodutibilidade dos Testes , Espalhamento de Radiação , Acuidade Visual/fisiologia , Adulto Jovem
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