Characterization of meibomian gland dysfunction in patients with rosacea / Caracterização da disfunção das glândulas de Meibomio em pacientes com rosácea

ABSTRACT Purpose: To compare ocular surface parameters in rosacea patients with those of controls. Methods: Ninety-three participants took part in this cross-sectional, observational, non-interventional study. These consisted of a rosacea group (n=40) and a control group (n=53). We compared objective parameters of the ocular surface, including conjunctival hyperemia, tear film stability and volume, meibomian gland dysfunction, dry eye disease, and ocular surface staining, between the two groups. Results: In the rosacea group, 69.23% were female. The mean age was 47.34 ± 12.62 years old. No statistically significant differences between groups were found in visual acuity (p=0.987), tear film parameters (tear meniscus height (p=0.338), noninvasive tear film rupture time (p=0.228), invasive rupture time (p=0.471), Schirmer's test scores (p=0.244), conjunctival hyperemia (p=0.106), and fluorescein staining (p=0.489). Significant differences were found in meibography evaluations (p=0.026), mucous layer integrity (p=0.015), and ocular surface symptoms (p<0.0001). Rosacea patients also showed important eyelid differences in glandular expressibility (p<0.001), glandular secretion pattern (p<0.001), and telangiectasia (p<0.001) compared to controls. Conclusion: Meibomian gland dysfunction is frequently associated with dermatological conditions. It can be observed in morphological findings from meibography as well as lipid secretion impairment, leading to evaporative dry eye, ocular surface dysfunction, and inflammation.

RESUMO Objetivo: Avaliar as alterações da superfície ocular em pacientes com Rosácea, e comparar com grupo controle. Métodos: Noventa e três indivíduos foram selecionados para este estudo transversal, observacional e não intervencionista, dividido em dois grupos: rosácea (n=40) e controles (n=53). Foram avaliados parâmetros objetivos da superfície ocular (hiperemia conjuntival, estabilidade e volume do filme lacrimal, disfunção da glândula meibomiana, doença do olho seco, coloração da superfície ocular) e comparado indivíduos saudáveis com pacientes com rosácea. Resultados: 69,23% dos indivíduos com rosácea eram mulheres, com média de idade de 47,34 ± 12,62 anos. Em comparação com controles pareados, não foram evidenciadas diferenças estatisticamente significativas em relação à acuidade visual (p=0,987) e parâmetros do filme lacrimal (altura do menisco lacrimal (p=0,338), tempo de ruptura do filme lacrimal não invasivo (p=0,228), tempo invasivo de ruptura (p=0,471) e teste de Schirmer (p=0,244), bem como hiperemia conjuntival (p=0,106) e coloração com fluoresceína (p=0,489). Associação significativa foi encontrada na avaliação da meibografia (p=0,026), integridade da camada mucosa (p=0,015) e sintomas de superfície ocular (p<0,0001). Pacientes com rosácea também apresentaram alterações importantes na borda palpebral: expressibilidade glandular (p<0,001), padrão de secreção glandular (p<0,001) e telangiectasia (p<0,001). Conclusão: A disfunção da glândula de Meibômio está frequentemente associada a condições dermatológicas e é caracterizada por achados morfológicos na meibografia, bem como comprometimento da secreção lipídica que leva ao olho seco evaporativo e alterações da superfície ocular e inflamação.

Characterization of meibomian gland dysfunction in patients with rosacea.

PURPOSE: To compare ocular surface parameters in rosacea patients with those of controls. METHODS: Ninety-three participants took part in this cross-sectional, observational, non-interventional study. These consisted of a rosacea group (n=40) and a control group (n=53). We compared objective parameters of the ocular surface, including conjunctival hyperemia, tear film stability and volume, meibomian gland dysfunction, dry eye disease, and ocular surface staining, between the two groups. RESULTS: In the rosacea group, 69.23% were female. The mean age was 47.34 ± 12.62 years old. No statistically significant differences between groups were found in visual acuity (p=0.987), tear film parameters (tear meniscus height (p=0.338), noninvasive tear film rupture time (p=0.228), invasive rupture time (p=0.471), Schirmer's test scores (p=0.244), conjunctival hyperemia (p=0.106), and fluorescein staining (p=0.489). Significant differences were found in meibography evaluations (p=0.026), mucous layer integrity (p=0.015), and ocular surface symptoms (p<0.0001). Rosacea patients also showed important eyelid differences in glandular expressibility (p<0.001), glandular secretion pattern (p<0.001), and telangiectasia (p<0.001) compared to controls. CONCLUSION: Meibomian gland dysfunction is frequently associated with dermatological conditions. It can be observed in morphological findings from meibography as well as lipid secretion impairment, leading to evaporative dry eye, ocular surface dysfunction, and inflammation.

Association between neighbourhood green space and biological markers in school-aged children. Findings from the Generation XXI birth cohort.

BACKGROUND: There is considerable literature on the psychological and behavioural benefits of green space. However, less is known about its health-promoting effects, as expressed on biological markers. Additionally, incorporating biomarkers into pediatric research may help elucidate the links between exposures to environmental stressors and lifelong health. OBJECTIVE: To measure the association between geographical accessibility to green spaces and allostatic load (AL), a measure of biological multi-system dysregulation. METHODS: We used data from 3108 7-year old children enrolled in Generation XXI, a population-based birth cohort from the Porto Metropolitan Area (Portugal). We computed an AL index based on seven biomarkers representing four regulatory systems: immune/inflammatory system (high sensitivity C-reactive protein); metabolic system (high density lipoprotein; total cholesterol; glycated hemoglobin; waist-hip ratio) and cardiovascular system (systolic and diastolic blood pressure). Accessibility to green spaces was calculated using a Geographic Information System and crude and adjusted associations were estimated using mixed-effects regression models. RESULTS: Among the 3108 children (51.7% male; mean age 87.3 months), the mean AL index was 0.00 (standard deviation 2.94). Adjusted models showed that having a green space within 400 m and 800 m from the child's school was inversely associated with AL (400 m: beta -0.29 95% CI -0.54 to -0.02; 800 m: -0.29 95% CI -0.51 to -0.07). Also, there was a 12% (0%; 23%) increase in the AL index for every 1 km increase in distance to the nearest green space. No significant associations with AL were observed with residential accessibility to green space or with the presence of a garden at home. CONCLUSION: We found a cross-sectional negative association between accessibility to green space near schools and AL in children, suggesting that the provision of green space may contribute to improvements in population health beginning early in life.

Risco de sarcopenia em idosas com queixa de dor lombar aguda / Riesgo de sarcopenia en ancianas con queja de dolor lumbar agudo / Risk of sarcopenia in community-dwelling older women with complaint of acute low back pain

RESUMO Verificou-se o risco de sarcopenia em idosas comunitárias com queixa de dor lombar aguda e comparou-se o índice de dor e mobilidade/equilíbrio entre aquelas em risco de sarcopenia e as não sarcopênicas. Pesquisa transversal, subprojeto do estudo epidemiológico e multicêntrico Back Complaints in the Elders (Bace). Participaram idosas com ao menos um episódio de dor lombar aguda no prazo de seis semanas antes da coleta de dados. Avaliou-se a velocidade de marcha (4,6m), a força de preensão palmar (dinamômetro Jamar), o índice de dor (escala analógica de dor) e mobilidade/equilíbrio (Timed Up and Go test). O risco de sarcopenia foi estimado por medida percentual e as comparações pelo teste t para amostras independentes; o nível de significância adotado foi de 5%. Participaram deste estudo 322 idosas: o risco de sarcopenia foi de 54%, ou seja, 173 idosas (71,8±5,2 anos) estavam em risco de sarcopenia e 149 (46%) eram não sarcopênicas (71,5±5,1 anos). Houve diferença quanto à intensidade da dor (p=0,02) e à mobilidade/ao equilíbrio (p=0,01), sendo que aquelas em risco de sarcopenia estavam em piores condições. Os resultados demonstraram risco de sarcopenia entre as idosas com dor lombar aguda. Estas apresentavam maior índice de dor e pior mobilidade/equilíbrio, sugerindo que a sarcopenia, se presente em idosas com essa dor, pode influenciar negativamente na funcionalidade.

RESUMEN Se verificó el riesgo de sarcopenia en ancianas comunitarias con queja de dolor lumbar agudo y se comparó el índice de dolor y movilidad/equilibrio entre aquellas en riesgo de sarcopenia y las no sarcopénicas. Investigación transversal, subproyecto del estudio epidemiológico y multicéntrico Back Complaints in the Elders (Bace). Participaron ancianas con al menos un episodio de dolor lumbar agudo hasta seis semanas antes de la recolección de datos. Se evaluó la velocidad de marcha (4,6m), la fuerza de asimiento palmar (dinamómetro Jamar), el índice de dolor (escala analógica de dolor) y movilidad/equilibrio (Timed Up and Go test). El riesgo de sarcopenia fue estimado por medida porcentual y las comparaciones por la prueba t para muestras independientes; el nivel de significancia adoptado fue del 5%. El estudio incluyó a 322 ancianas: el riesgo de sarcopenia fue del 54%, o sea, 173 ancianas (71,8 ± 5,2 años) estaban en riesgo de sarcopenia, y 149 (46%) fueron sarcopénicas (71,5 ± 5,1 años). Se observó una diferencia en cuanto a la intensidad del dolor (p=0,02) y a la movilidad/al equilibrio (p=0,01), siendo que aquellas en riesgo de sarcopenia estaban en peores condiciones. Los resultados demostraron el riesgo de sarcopenia entre ancianas con dolor lumbar agudo. Estas presentaban mayor índice de dolor y peor movilidad/equilibrio, sugiriendo que la sarcopenia, si está presente en ancianas con ese dolor, puede influenciar negativamente en la funcionalidad.

ABSTRACT The risk of sarcopenia was verified in community-dwelling older women with complaints of acute low back pain. The pain index and mobility/balance were compared between patients at risk of sarcopenia and the non-sarcopenic ones. This is a cross-sectional research, subproject of the epidemiological and multicenter study Back Complaints in the Elders (BACE). patients were older women with at least one episode of acute low back pain within six weeks prior to data collection. We evaluated the walking speed (4.6 m), grip strength (Jamar dynamometer), pain index (analog pain scale) and mobility/balance (Timed Up and Go test). Risk of sarcopenia was estimated by percentage measure and comparisons by the Independent Samples t Test. A significance level of 5% was adopted. A total of 322 older women participated in this study. The risk of sarcopenia was 54%, i.e., 173 patients (71.8±5.2 years) were at risk of sarcopenia and 149 (46%) were non-sarcopenic (71.5±5.1 years). There was difference for the pain intensity (p=0.02) and the mobility/balance (p=0.01), given that the ones at risk of sarcopenia were in worse conditions. The results showed risk of sarcopenia among older women with acute low back pain. The latter showed higher pain index and worse mobility/balance, suggesting that sarcopenia, if present in older women with this pain, can influence negatively the functionality.

Diagnósticos de enfermagem do domínio autopercepção em pessoas vivendo com Aids / Diagnósticos de enfermería de dominio autopercepción en las personas que viven con el Sida / Nursing diagnoses of self-perception domain in people living with Aids

RESUMO Introdução: Atualmente existem 34,0 milhões de pacientes com o Vírus da Imunodeficiência Humana (HIV) no mundo. Na América Latina estima-se que 1,6 milhões de pacientes vivem com o vírus. Objetivo: Identificar diagnósticos de enfermagem do domínio autopercepção da NANDA-Internacional e analisar a associação entre os diagnósticos mais frequentes e suas características definidoras, fatores relacionados/risco em pessoas vivendo com Aids. Métodos: Estudo transversal, quantitativo, realizado com 113 pessoas vivendo com Aids em um hospital de doenças infectocontagiosas. Os dados foram coletados utilizando-se um roteiro de histórico de enfermagem e exame físico. Os diagnósticos foram elaborados de forma processual, seguindo os passos do julgamento clínico de Risner. Para associação das variáveis utilizou os testes qui-quadrado de Pearson e Exato de Fisher. Resultados: Identificaram-se 11 diagnósticos de enfermagem os mais frequentes, foram: distúrbio da imagem corporal; risco de dignidade humana comprometida; baixa autoestima situacional; desesperança; baixa autoestima crônica. Em geral, as características definidoras e os fatores dos diagnósticos apresentaram associação significativa. Conclusões: O estudo corroborou para a identificação dos diagnósticos de enfermagem associado a seus componentes na clientela(AU)

RESUMEN Introducción: En la actualidad hay 34,0 millones de pacientes con virus de inmunodeficiencia humana (VIH) en el mundo. En América Latina se estima que 1,6 millones de pacientes viven con el virus. Objetivo: Identificar los diagnósticos de enfermería de dominio de la percepción de la NANDA-Internacional y analizar la asociación entre los diagnósticos más frecuentes y sus características definitorias, factores relacionados / riesgo en personas que viven con el Sida. Métodos: Estudio transversal, cuantitativo, realizado con 113 personas que viven con Sida en un hospital de enfermedades infecciosas. Los datos fueron recolectados a través de una historia de la escritura de enfermería y el examen físico. Los diagnósticos fueron desarrollados de vista del procedimiento, siguiendo los pasos de la Risner ensayo clínico. Para la asociación de las variables que se utilizan pruebas de ji cuadrado y exacta de Fisher. Resultados: Se identificaron 11 diagnósticos de enfermería, los más frecuentes fueron: alteración de la imagen corporal; riesgo de la dignidad humana en entredicho; situacional autoestima baja; desesperanza; autoestima baja crónica. En general, las características definitorias y factores de diagnósticos se asociaron significativamente. Conclusiones: El estudio corroborado para la identificación de los diagnósticos de enfermería relacionados con sus componentes en la clientela(AU)

ABSTRACT Introduction: There are currently 34.0 million patients with the human immunodeficiency virus (HIV) worldwide. In Latin America, an estimated 1.6 million patients live with the virus. Objective: To identify nursing diagnosis within the domain of perception by NANDA-International and to analyze the association between the most frequent diagnosis cases and their defining characteristics, related factors/risk in people living with AIDS. Methods: Cross-sectional, quantitative study conducted on 113 people living with AIDS in a hospital for infectious diseases. The data was collected through a history of nursing reports and physical examination. The diagnoses were performed in view of the procedure, following the steps of the Risner clinical trial. For the association of the variables, we used the chi-square and Fisher's exact tests. Results: We identified 11 nursing diagnoses, the most frequent were: alteration of body image; the risk of human dignity in question; situational low self-esteem; despair; chronic low self-esteem. In general, the defining characteristics and diagnostic factors were significantly associated. Conclusions: The study was corroborated for the identification of nursing diagnoses related to its components in the clientele(AU)

Psychosocial and ergonomic survey of office and field jobs in a utility company.

INTRODUCTION: The effect of different kinds of work on the psychosocial assessment of workers under the same management and organizational environment is investigated. METHODS: A voluntary assessment in a utility company was carried out using the short version of the Copenhagen psychosocial questionnaire (CoPsoQ) on two occasions, 1.5 years apart. Initially, 25 office workers (11 men and 14 women) participated, while 14 of those workers (8 women and 6 men) participated in the second assessment together with 32 field workers. The sewage, water treatment and maintenance workers, totaling 32 men, also participated in a field ergonomics assessment using the Washington State Department of Labor and Industries field work ergonomic checklist. RESULTS: The longitudinal outlook was fairly stable, with sustained severe scores in many CoPsoQ subscales and intensification of severity of workers' control over work and esteem for men. A significantly higher esteem score resulted for field rather than office workers. Workers subjected to foul odors showed similar severity of psychosocial factors. DISCUSSION: For most psychosocial dimensions, the organizational design and management system in place, as well as the overall cultural environment in which it operates, create a much stronger and more decisive impact than job-specific factors.

Prevalência do diagnóstico de Enfermagem ansiedade em pessoas com a Síndrome da Imunodeficiência Adquirida / La prevalencia de los diagnósticos de Enfermería: ansiedad en personas con Síndrome de Inmunodeficiencia Adquirida / Prevalence of Nursing diagnosis of anxiety in people with the Acquired Immunodeficiency Syndrome

RESUMO Introdução: a ansiedade tem impacto biopsicossocial acarretando baixa adesão à terapêutica antirretroviral altamente eficaz, o qual tem contribuído, ao longo das últimas décadas, para a longevidade e manutenção da qualidade de vida das pessoas vivendo com Aids. Objetivo: identificar a prevalência do diagnóstico de enfermagem ansiedade em pessoas vivendo com Aids, suas características definidoras que apresentaram associação estatística e verificar suas razões de prevalência. Métodos: pesquisa transversal realizada com 113 pessoas vivendo com Aids. Os dados foram coletados no período de março a setembro de 2014 em hospital de referência para o tratamento de doenças infectocontagiosas, por meio de um roteiro de anamnese e exame físico. A elaboração dos diagnósticos foi processual, e para o tratamento dos dados utilizou-se os testes de qui-quadrado de Pearson e exato de Fisher, sendo calculadas também as razões de prevalência. Resultados: foram identificados 21 diagnósticos de enfermagem, a qual ansiedade esteve presente em 98 porcento da população estudada. A razão de prevalência ratifica que as chances das pessoas que vivem com Aids desenvolverem o diagnóstico de enfermagem Ansiedade foram de aproximadamente: 3,1 vezes para Desesperado, 2,9 vezes para Medo, 1,6 vezes para irritabilidade, 1,2 vezes angustiado e 1,2 vezes Apreensivo quando comparados aos pacientes que não apresentaram essas características. Conclusão: as pessoas vivendo com Aids apresentaram características definidoras peculiares ao diagnóstico ansiedade, e algumas com associação estatística significativa(AU)

RESUMEN Introducción: la ansiedad tiene un impacto psicosocial, causando una baja adherencia al tratamiento antirretroviral, que ha contribuido a lo largo de las últimas décadas, a la longevidad y el mantenimiento de la calidad de vida de las personas que viven con el SIDA. Objetivo: identificar la prevalencia del diagnóstico de enfermería de ansiedad en personas que viven con el SIDA, sus características definitorias que están estadísticamente asociadas y comprobar sus tasas de prevalencia. Métodos: estudio transversal con 113 personas que viven con el SIDA. Los datos fueron recolectados de marzo a septiembre de 2014 en un hospital de referencia para el tratamiento de enfermedades infecciosas a través de la historia clínica y el examen físico. La elaboración del diagnóstico fue de procedimiento, y para el tratamiento de los datos se utilizó la prueba de Pearson chi-cuadrado y exacta de Fisher, y también se calcularon las tasas de prevalencia. Resultados: se identificaron 21 diagnósticos de enfermería, que la ansiedad estaba presente en el 98 por ciento de la población estudiada. La razón de prevalencia confirma que las posibilidades de las personas que viven con SIDA y desarrollaron el diagnóstico de enfermería de la ansiedad eran aproximadamente: 3,1 veces por la desesperación; 2,9 veces por temor; 1,6 veces por irritabilidad, 1,2 veces por angustia y 1,2 veces por aprensión en comparación con los pacientes sin estas características. Conclusión: las personas que viven con SIDA presentan características definitorias del diagnóstico ansiedad, y algunas de ellas con una asociación estadísticamente significativa(AU)

ABSTRACT Introduction: Anxiety demand psychosocial impact causing low adherence to ART, which has contributed over the last decades, for longevity and maintenance Quality of life of people living with AIDS. Objective: To identify the prevalence of anxiety nursing diagnosis in people living with AIDS, their defining characteristics that are statistically associated and check their prevalence ratios. Methods: Cross-sectional survey of 113 people living with AIDS. Data were collected from March to September 2014 in a referral hospital for the treatment of infectious diseases through a script by history and physical examination. The preparation of the diagnostic was procedural, and for the treatment of the data was used the test of Pearson chi-square and Fisher exact, and also calculated the prevalence ratios. Results: 21 nursing diagnoses were identified, which anxiety was present in 98 percent of the study population. The prevalence ratio confirms that the chances of people living with AIDS develop the nursing diagnosis of anxiety were approximately: 3.1 times to despair, 2.9 times for fear, irritability 1.6 times to 1.2 times Anguished and 1.2 times apprehensive when compared to patients without these characteristics. Conclusion: people living with AIDS presented unique defining characteristics at diagnosis anxiety, and some with significant statistical association(AU)

Intraocular Pressure Control after Implantation of an Ahmed Glaucoma Valve in Eyes with a Failed Trabeculectomy.

AIM: To evaluate the results of Ahmed glaucoma valve (AGV) in eyes with a failed trabeculectomy. MATERIALS AND METHODS: This retrospective study evaluated 61 eyes with a failed trabeculectomy that underwent implantation of an AGV due to uncontrolled intraocular pressure (IOP) on maximal medical therapy. Success was defined as IOP ≤ 21 mm Hg (criterion 1) or 20% reduction in IOP (criterion 2) with or without antiglaucoma medications. Persistent hypotony, loss of light perception, and reoperation for IOP control were defined as failure. RESULTS: Mean preoperative IOP and mean lOPs at 6, 12, and 24 months were 21.93 ± 6.32 mm Hg (n = 61), 14.15 ± 4.33 mm Hg (n = 59), 13.21 ± 4.44 mm Hg (n = 56), and 13.60 ± 3.27 mm Hg (n = 25) respectively. Mean number of antiglaucoma medications preoperatively and at 6, 12, and 24 months was 3.95 ± 0.85, 2.19 ± 1.38, 2.48 ± 1.44, and 2.40 ± 1.32 respectively. The reductions in the number of medications and IOP measurements were statistically significant at all time intervals (p < 0.001, Wilcoxon signed rank test). According to criterion 1, the Kaplan-Meier survival curve disclosed success rates of 75% at 12 and 24 months. According to criterion 2, the success rates were 57% at 12 months and 55% at 24 months. The most frequent complications were hypertensive phase (18%) and shallow anterior chamber (16.4%). CONCLUSION: The AGV may effectively reduce IOP in eyes that had a failed trabeculectomy. CLINICAL SIGNIFICANCE: The AGV is an alternative in eyes with a failed trabeculectomy. HOW TO CITE THIS ARTICLE: Schimiti RB, Abe RY, Tavares CM, Vasconcellos JPC, Costa VP. Intraocular Pressure Control after Implantation of an Ahmed Glaucoma Valve in Eyes with a Failed Trabeculectomy. J Curr Glaucoma Pract 2016;10(3):97-103.

Effect of thickness on fluorescence of resin composites and dental substrates / Efeito da espessura sobre a fluorescência de resinas compostas e substratos dentais

Objective: This study evaluated the effect of thickness on fluorescence of resin composites and tooth substrates (enamel and dentin). Material and methods: Ninety bovine incisors were used, resulting in 45 dentin and 45 enamel disks (6 mm diameter and 0.5, 1, or 1.5 mm in thickness). Ninety discs of Charisma, Filtek Z350 and IPS Empress Direct (for enamel and dentin) resins at same dimensions were built. Fluorescence measurements were performed using a fluorescence spectrophotometer (RF-5301PC, Shimadzu Corp) with excitation at 365 nm. Data were submitted to 2-way ANOVA and Tukey’s post hoc tests (α = 0.05). Results: The 2-way ANOVA revealed statistically significant differences for all factors, as well as the interaction between them (p <0.05). Dentin specimens (1.5 mm) showed highest fluorescence (128.33 A.U.), while Filtek Z350 (dentin - 1.0 mm) showed the lowest fluorescence (29.84 A.U.). Thickness influenced fluorescence values of enamel substrate. Conclusion: The thickness influenced fluorescence of enamel and all resin composite assessed showed fluorescence lower than natural dentin.

Objetivo: Este estudo avaliou o efeito da espessura de resinas compostas e substratos dentais (esmalte e dentina) sobre a fluorescência. Materiais e Métodos: Noventa incisivos bovinos foram utilizados, resultando em 45 discos de dentina e 45 discos de esmalte (6 mm de diâmetro e 0,5, 1 ou 1,5 mm mm de espessura). Noventa discos das resinas compostas Charisma, Filtek Z350 e IPS Empress Direct (para esmalte e dentina) foram confeccionados com a mesma dimensão. A fluorescência foi analisada por meio de espectrofluorímetro (RF-5301PC, Shimadzu Corp) com excitação de 365nm. Os dados foram submetidos ao teste ANOVA dois fatores e Teste de Tukey (α = 0,05). Resultados: O teste ANOVA dois fatores revelou diferenças significativas para todos os fatores, bem como para interação entre eles (p < 0,05). As amostras de dentina (1,5 mm) apresentaram alta fluorescência (128,33 A.U.), enquanto a resina composta Filtek Z350 (dentina - 1,0 mm) apresentou menor fluorescência (29,84 A.U.). A espessura influenciou os valores de fluorescência para o substrato esmalte. Conclusão: A espessura influenciou na fluorescência do esmalte e todas as resinas compostas avaliadas apresentaram uma fluorescência menor do que a dentina natural.

Working conditions under multiple exposures: A cross-sectional study of private sector administrative workers.

BACKGROUND: Office workers are increasingly exposed to physical and psychosocial risk factors. OBJECTIVE: To assess the association between environmental, physical and organizational working conditions and the physical and psychosocial well-being of a sample of private sector office workers. METHODS: Musculoskeletal pain was collected from a body map and the Disabilities of the Arms, Shoulders and Hands questionnaire. The short version of the Copenhagen Psychosocial Questionnaire enabled collecting information on six job related satisfaction and dissatisfaction subscales. A checklist for ergonomics in computer work guided the analysis of ergonomic factors and measurements were taken to characterize environmental conditions. Association between exposures and outcomes was calculated using IBM SPSS Statistics 20 software. RESULTS: Significant moderate positive association was found between dissatisfaction with job psychological demands and musculoskeletal pain in the upper body (0.40; p= 0.05), as well as between postural ergonomic mismatches and dissatisfaction with job insecurity towards the future (0.42; p= 0.04). A significant moderate negative association (-0,47; p= 0.02) was found as well between satisfaction with job social support and with leadership quality and location of the work station in an open-plan office as opposed to smaller office rooms. CONCLUSIONS: The results show how raising awareness of the risk factors encountered in contemporary office work is still necessary to promote widespread improvement of working conditions, from both a physical and a psychosocial perspective.

Ahmed Glaucoma Valve Implantation for Refractory Glaucoma in a Tertiary Hospital in Brazil.

Purpose. To evaluate the efficacy of Ahmed Glaucoma Valve (AGV) implantation in patients with refractory glaucoma in a tertiary hospital in Brazil. Methods. Retrospective case series of patients who underwent AGV implantation. Primary outcome was to assess the rate of failure, which was defined as intraocular pressure (IOP) in two consecutive visits greater than 18 or lower than 5 mmHg (criterion 1) or IOP greater than 15 or lower than 5 mmHg (criterion 2). The secondary outcome was to investigate risk factors for failure. Results. 112 eyes from 108 patients underwent AGV implantation between 2000 and 2012. Mean follow-up time was 2.54 (±1.52) years. Kaplan-Meier survival analysis showed cumulative probabilities of success of 80.3%, 68.2%, and 47.3% at 1, 3, and 5 years using 18 mmHg as endpoint. When adopting 15 mmHg as endpoint, cumulative success rates were 80.3%, 60.7%, and 27.3% at 1, 3, and 5 years, respectively. Multivariate analysis with generalized estimating equations revealed that African American ancestry and early hypertensive phase were risk factors for failure (P = 0.001 and P = 0.002, resp.). Conclusion. A success rate of approximately 50% was obtained 5 years after the implantation of an AGV. African American ancestry and early hypertensive phase were associated with increased risk of failure.

Conditioned food aversion to control poisoning by Ipomoea carnea subsp. fistulosa in goats / Aversão alimentar condicionada para o controle da intoxicação por Ipomoea carnea subsp. fistulosa em caprinos

Ipomoea carnea is a toxic plant often ingested by livestock in Brazil. Three experiments were conducted to determine if conditioned food aversion was effective in reducing goats' consumption of I. carnea. In the first experiment, 10 mildly intoxicated goats that had been eating I. carnea were averted using LiCl (175 to 200mg kg-1 body weight). These intoxicated goats did not develop an aversion to I. carnea, demonstrating that the technique is not effective in goats that are already accustomed to consuming the plant. In the second experiment, 14 naïve goats were placed in a pasture with I. carnea, and averted after they ingested the plant. In this group the aversion persisted until the end of the experiment, 2 years and 8 months after the initial aversion. In another experiment, 20 goats were placed in a pasture with I. carnea, and after consuming the plant were averted with LiCl. The averted goats were transferred to Marajo Island and periodically observed over a 2 year period at 2-3 month intervals to determine if they were still averted. The averted goats did not ingest the plant while grazing in the pasture, whereas in 6 neighboring goat farms the prevalence of intoxication from I. carnea poisoning was estimated to be about 40%. These results demonstrated the efficacy of conditioned food aversion to avoid ingestion of I. carnea in formerly naïve goats that had only recently begun to ingest the plant.

Para testar a técnica de aversão alimentar condicionada como método de controle para a intoxicação por I. carnea, foram realizados 3 experimentos administrando cloreto de lítio (LiCl) na dose de 175-200mg kg-1 após a ingestão da planta por caprinos. No primeiro, foram induzidos à aversão 10 caprinos que tinham o hábito de ingerir a planta e com sinais clínicos da intoxicação. Apesar da realização de diversos tratamentos aversivos, após os animais ingerirem a planta, a aversão não foi eficiente, demonstrando que a técnica não é eficiente em caprinos que já estão habituados a ingerir a planta. No segundo experimento, 14 caprinos foram adaptados a ingerir a planta na pastagem e, após ingerirem a planta a campo, foram induzidos à aversão com LiCl. Neste grupo, a aversão persistiu até o fim do Experimento, 2 anos e 8 meses após a aversão. Em outro experimento, 20 caprinos foram adaptados a consumir I. carnea e, em seguida, induzidos à aversão com LiCl. Esses animais foram transferidos para uma propriedade na Ilha de Marajó, onde foram realizadas 9 visitas com intervalos de 2-3 meses para verificar a duração da aversão. Após 2 anos de observações, nenhum animal voltou a ingerir a planta na pastagem e não foram observados casos de intoxicação, enquanto que, em 6 propriedades vizinhas, a doença foi observada com uma prevalência de até 60%. Esses resultados demonstram a eficiência da aversão alimentar condicionada para evitar a ingestão de I. carnea em caprinos recém adaptados a ingerir a planta, nas regiões invadidas por esta planta e nas condições naturais da Ilha de Marajó.