Strabismus and Health Related Quality of Life in a pediatric Portuguese population.

Introduction: Strabismus is a common condition among children, and its psychosocial impact has been demonstrated in recent years. The interest in a more comprehensive approach was enhanced by the recognition of health as a four-dimensional concept, arising the term Health-related Quality of Life. Therefore, we aim to evaluate the influence of strabismus in Health-Related Quality of Life of a Portuguese pediatric population. Material and Methods: Case-control prospective transversal study enrolling children between 5 and 12 years old. All had a complete orthoptic and ophthalmological evaluation, followed by an interview with a legal representative to answer the Pediatric Quality-of-Life Inventory 4.0, proxy-version. Results: Seventy-one children were included, 35 in the control group (CG) and 36 in the strabismus group (SG). In the SG, 30 (83.3%) patients had esotropia, 20 (55.6%) had more than 10 prismatic diopters and 26 (72.2%) were already surgically treated. Overall, SG was not statistically different from the CG, showing only mild inferior performance (p > .05). Furthermore, children with exotropia, higher deviations, none or gross stereoacuity and treatment-naïve, scored worse, especially in emotional, social, educational and psychosocial scores although not statistically significant (p > .05). Conclusion: This is the first prospective study addressing HRQoL and strabismus in a pediatric Portuguese population. It would be relevant to further address this issue in order to delineate more effective and global treatment strategies, not only considering ophthalmological goals but also the well-being of both children and guardians.

Satisfação e perfil socioeconômico e demográfico dos consumidores das feiras livres de Juiz de Fora-MG / Satisfaction level and socioeconomic and demographic profile of the consumers of the street markets of Juiz de Fora-MG

Resumo Introdução As feiras livres existem há muito tempo no Brasil e apresentam grande importância no abastecimento direto de consumidores, na geração de renda para a população rural e no fomento ao comércio urbano. Objetivo Descrever o perfil socioeconômico e demográfico e avaliar a satisfação dos consumidores das feiras livres de Juiz de Fora-MG. Método Estudo transversal, descritivo, quantitativo e qualitativo. Foram realizadas 385 entrevistas utilizando questionário semiestruturado em 15 feiras. Resultados A maioria dos consumidores é do gênero feminino (65%, n = 252), com idade média de 46 anos (± 22 anos), 50% (n = 192) são casados, 43,4% (n = 167) apresentam o ensino médio e mais da metade não trabalha ou é aposentada (51,9%, n = 199) e 41,4% (n = 159) possuem renda familiar de 1 a 3 salários mínimos. O gasto na feira está associado com estado civil e número de moradores por casa. Dos consumidores, 98,1% (n = 371) estão satisfeitos com a feira que frequentam. Os motivos de satisfação citados: 20% (n = 71) praticidade e localidade; 19% (n = 66) preço e variedade; 12% (n = 60) interação e qualidade e 1% (n = 4) atendimento. A escolaridade do frequentador e a satisfação quanto à higiene pessoal e das barracas/boxes estão associadas. Conclusão O desafio é conquistar o reconhecimento de um público maior, com produtos diversificados e com qualidade. O estabelecimento de novas estratégias pode contribuir para o desenvolvimento das feiras, promover saúde e garantir a segurança alimentar e nutricional.

Abstract Background Street markets have been around for a long time in Brazil and are of great importance in the direct supply of consumers, in the generation of income for the rural population and in the promotion of urban commerce. Objective To describe the socioeconomic and demographic profile, and to evaluate the satisfaction of consumers at the street markets in Juiz de Fora-MG. Method A cross-sectional, descriptive, quantitative, and qualitative study was carried out. The interviews were carried out through a semi-structured questionnaire with 385 consumers at 15 street markets. Results Most consumers are female (65%, n = 252), with a mean age of 46 years (± 22 years), 50% (n = 192) are married, 43.4% (n = 167) have the high school and more than half do not work or are retired (51.9%, n = 199) and 41.4% (n = 159) have a family income of 1 to 3 minimum wages. Spending at the fair is associated with marital status and number of residents per house. 98.1% (n = 371) of consumers are satisfied with the street market where they attend. The reasons for satisfaction cited: 20% (n = 71) convenience and location; 19% (n = 66) price and variety; 12% (n = 60) interaction and quality and 1% (n = 4) service .The schooling of the frequenter and the satisfaction with personal hygiene and the tents are associated. Conclusion The challenge is to gain recognition from a larger audience, with diversified and quality products. The establishment of new strategies can contribute to the development of street markets, promote health, and ensure food and nutritional security.

Safety of intravitreal triamcinolone and its impact on optic nerve morphology in patients treated for diabetic macular edema.

PURPOSE: To assess the impact of one intravitreal injection (IVT) of Triamcinolone Acetonide (TA) on intraocular pressure (IOP) and optic nerve structural parameters in patients treated for Diabetic Macular Edema (DME). METHODS: This retrospective study included patients with DME that were naïve to intraocular steroids and underwent one IVT of TA of 4 mg/0.1 mL and age-matched controls with DME without criteria for IVT. Patients records were reviewed for IOP (at baseline and a month after IVT) and optic nerve parameters measured by optical coherence tomography (up to 6 months before and 6 months after IVT). Exclusion criteria included glaucoma and treatment with hypotensive agents. RESULTS: Twenty-six eyes were included in the Control Group and 29 in the IVT Group, with a mean age of 65.10 ± 10.08 and 67.30 ± 4.71 years, respectively (p = 0.06). At baseline, IOP and optic nerve measurements were equivalent between groups (p > 0.05). One month after IVT, mean IOP measurements in IVT Group were higher than those of controls (17.84 ± 4.50 vs 11.59 ± 3.09 mmHg, p < 0.001). Ocular hypertension (OHT) developed in 17.24% of cases and reversed with topical medication. After one IVT, vertical cup/disc ratio was higher (0.57 ± 0.25 vs 0.60 ± 0.14, p = 0.04) and retinal nerve fiber layer thickness was globally lower (mean: 91.03 ± 4.25 vs 81.33 ± 19.10 µm, p = 0.001) in the IVT Group. CONCLUSION: Our results confirmed that intravitreal TA results in IOP increase. This seems to negatively affect optic nerve morphology, even in patients without OHT or adequately treated with hypotensive agents.

Retinal vascular impairment in patients newly diagnosed with obstructive sleep apnea syndrome.

BACKGROUND: To evaluate retinal morphological and vascular parameters in patients recently diagnosed with obstructive sleep apnea syndrome (OSAS) and determine the correlation between retinal vascular density and the severity of OSAS. METHODS: We performed a retrospective study on the retinal vasculature of patients with OSAS and age-match healthy controls. OSAS was confirmed by full-night cardiorespiratory polygraphy. Patients were divided into three groups according to disease severity given by apnea-hypopnea index (AHI) i.e., mild, moderate or severe. Retinal thicknesses and vascular density were compared among groups, for both the macula and optic disc. Correlation between vascular density and clinical features were also assessed. RESULTS: The study included 30 eyes of patients with OSAS and 12 controls. No differences were found regarding retinal thickness in both the macula and the optic disc between OSAS patients and controls. In contrast, significant differences were found in the peripapillary vessel density between groups versus control patients. The greatest difference being between severe OSAS and controls (49.4% ± 2.1 versus 40.4% ± 4.2 respectively, p=0.01). Peripapillary vessel density was found to significantly and negatively correlate with AHI (p=0.02; r= -0.74) and directly correlate with the lowest percutaneous oxygen saturation (p=0.02; r= 0.58). CONCLUSIONS: This study indicates that OSAS is associated with retinal microvasculature impairment, that seems to mainly affect the optic disc. This suggests that microvascular damage increases with the increasing severity of OSAS. As such, prospective trials are needed to clarify if this vascular peripapillary damage precedes glaucomatous optic neuropathy in OSAS patients.

Horizontal Gaze Palsy and Progressive Scoliosis With ROBO 3 Mutations in Patients From Cape Verde.

Horizontal gaze palsy with progressive scoliosis (HGPPS) is a rare and autosomal recessive syndrome. We describe 2 cases of HGPPS which are the first documented in patients of African ancestry from an isolated population in Cape Verde. They demonstrated typical findings on neuro-ophthalmic examination and brain magnetic resonance imaging. One patient had novel heterozymous mutations of the ROB0 3 gene.

Perfil e percepções dos feirantes em relação ao trabalho e segurança alimentar e nutricional nas feiras livres / Profile and Perceptions of Marketers Regarding of Work and Food and Nutritional Security of the Free Fairs

As feiras livres de Juiz de Fora procuram fomentar a participação dos feirantes e dos pequenos produtores no abastecimento e na oferta de produtos de alta qualidade. O objetivo deste trabalho foi descrever o perfil socioeconômico e demográfico dos feirantes e suas percepções sobre o trabalho e sobre as condições de segurança alimentar e nutricional nas feiras da cidade de Juiz de Fora (MG). Trata-se de um estudo com delineamento transversal, descritivo e quantitativo. Foram realizadas entrevistas com 100 feirantes das 15 feiras da cidade, existentes no período do estudo, utilizando um questionário elaborado para a pesquisa. Os dados foram descritos por meio da distribuição de frequências absolutas e relativas utilizando o programa Excel, processados e analisados por meio do programa Epi Info 7.2.1.0. Utilizou-se o teste de Qui-quadrado para avaliar a associação entre as variáveis (p<0,05). O perfil dos feirantes é representado por homens (64%, n=64) de meia idade, casados (57%, n=57), com escolaridade até o ensino fundamental (37%, n=37) ou médio (48%, n=48) e que atuam nas feiras há mais de uma década (59%, n=59). As feiras têm caráter familiar e são, por vezes, os únicos meios para obtenção do sustento (64%, n=64) dos feirantes. Dentre os problemas enfrentados, o mais citado foi a falta de segurança (32%, n=32). Apesar do relato de preocupação com a higiene (75%, n=75), foram presenciadas condições distantes da garantia de segurança alimentar. São necessárias ações educativas aos feirantes e apoio governamental para melhoria das condições de trabalho dos feirantes e para a garantia da segurança alimentar e nutricional.

The free fairs of Juiz de Fora seek to foster the participation of small producers in the supply and in the offering of high quality products. The aim of this study was to describe the socioeconomic and demographic profile of the marketers and their perceptions about the work and about the food and nutritional security conditions at the fairs of the city of Juiz de Fora (MG). This is a study with a cross-sectional delineation, descriptive and quantitative. Interviews were conducted with 100 marketers from the 15 free fairs, existing in the study period, using a questionnaire developed for the research. The data were described by means of the distribution of absolute and relative frequencies using the Excel program, processed and analyzed through the program Epi Info 7.2.1.0. The Chi-square test was used to evaluate the association between the variables (p <0.05). The profile of the marketers is represented by men (64%, n = 64) of middle age, married (57%, n = 57), with schooling until middle school (37%, n = 37) or medium (48% n = 48) and working in fairs for over a decade (59%, n = 59). The free fairs have a family character and are sometimes the only means to obtain livelihoods (64%, n = 64) from the marketers. Among the problems faced, the most cited was lack of security (32%, n = 32). Despite the reports of concern about hygiene (75%, n = 75), conditions far removed from food security were observed. Educational actions are required to the marketers and government support to improve the work conditions of the marketers and to guarantee food and nutritional security.

Isolated posterior scleritis associated with tuberculosis.

Ocular tuberculosis (TB) is considered to be rare, although its incidence has varied widely over time and in different populations. Latent TB is diagnosed when a person is infected with Mycobacterium tuberculosis but does not have active TB. During the last decade, interferon-gamma release assay tests have been developed that allow identification of patients with latent TB infection with better specificity than the tuberculin skin test and can differentiate between infection and prior vaccination. Although rare, tuberculous scleritis should be considered in the differential diagnosis of posterior scleritis. Here we describe a patient with posterior scleritis and severe visual loss associated with latent TB without uveitis, anterior scleritis, keratitis, or any other previous ocular disease history. The patient responded well to a combined treatment of antitubercular therapy and oral corticosteroids.

Isolated posterior scleritis associated with tuberculosis / Esclerite posterior isolada associada à tuberculose

ABSTRACT Ocular tuberculosis (TB) is considered to be rare, although its incidence has varied widely over time and in different populations. Latent TB is diagnosed when a person is infected with Mycobacterium tuberculosis but does not have active TB. During the last decade, interferon-gamma release assay tests have been developed that allow identification of patients with latent TB infection with better specificity than the tuberculin skin test and can differentiate between infection and prior vaccination. Although rare, tuberculous scleritis should be considered in the differential diagnosis of posterior scleritis. Here we describe a patient with posterior scleritis and severe visual loss associated with latent TB without uveitis, anterior scleritis, keratitis, or any other previous ocular disease history. The patient responded well to a combined treatment of antitubercular therapy and oral corticosteroids.

RESUMO A tuberculose (TB) ocular foi considerada rara, embora a sua incidência tenha variado significativamente ao longo do tempo e nas diferentes populações. A TB latente é diagnosticada quando alguém é infetado com Mycobacterium tuberculosis sem possuir doença ativa. Durante a última década, testes tendo por base interferon gamma release assay foram desenvolvidos, permitindo a identificação de pacientes com infeção por tuberculose latente com maior especificidade que o teste tuberculínico e diferenciar infeção e vacinação prévia. Embora rara, a esclerite tuberculosa deve ser tida em consideração no diagnóstico diferencial de esclerite posterior. Reportamos um paciente com esclerite posterior e baixa grave de acuidade visual associada a TB latente, sem uveíte, esclerite anterior, ceratite ou história de doença ocular prévia. O paciente respondeu favoravelmente a um tratamento combinado de fármacos antituberculose e corticoides orais.

Arsenic speciation of two specimens of Napoleon's hair.

Since 1960, it has been demonstrated by various analytical procedures that high concentrations of arsenic were present in Napoleon's hair. Various authors, indicating that the detected arsenic levels are a consequence of external contamination, have challenged the results of these examinations. We have tested two strands of hair, referenced as Noverraz and Grand Maréchal Bertrand. Samples were incubated 6h in water at 90 degrees C, and arsenic speciation was carried out by HPLC-ICP/MS. The residue was injected on a cation-exchange PRP-X200 column that allows the detection of arsenobetaine and on an anion-exchange PRP-X100 column to test for the mineral forms. In these conditions, the inorganic species As(III), As(V) and their metabolites (DMA and MMA) were separated. Analysis of hair samples highlighted massive amounts of total arsenic (42.1 and 37.4ng/mg). Arsenical species found in the two samples of analyzed hair are distributed in the following: As(III) 31.1 and 44.7%; As(V) 66.3 and 53.2%; DMA 0.42 and 0.15%. Traces of MMA were detected, and 2% of the species could not be identified. These results prove that more than 97% of the arsenic found in the hair of Napoleon is in inorganic form, which is consistent with a chronic intoxication to arsenic.