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BACKGROUND: Due to the limited data from clinical trials and real-world settings in the realm of nusinersen, there is a need for further evidence. This study seeks to assess the impact of nusinersen, when combined with standard care, on bulbar function, respiratory function, and the necessity for respiratory support among pediatric patients with spinal muscular atrophy (SMA). METHODS: Prospective observational study, involving pediatric SMA patients (Types 1-3) undergoing nusinersen treatment at the Hospital Universitario Virgen del Rocío in Spain over at least 24 months. The cohort included 11 SMA type 1 patients, comprising 6 type 1b and 5 type 1c, 12 SMA type 2 patients, and 5 SMA type 3 patients. RESULTS: Twenty-eight pediatric patients were enrolled with the majority being male (n = 20). Patients with type 1 were diagnosed and received treatment significantly earlier than those with types 2 and 3 (p < 0.001). Additionally, there was a longer period between diagnosis and the start of treatment in types 2 and 3 (p = 0.002). Follow-up revealed statistically improved functional and respiratory outcomes associated with earlier initiation of nusinersen treatment at 6, 12, and 24 months in all phenotypes. The ability to swallow and feed correctly remained unchanged throughout the study, with SMA type 1c patients maintaining oral feeding in contrast to patients with SMA type 1b. Notably, no deaths were recorded. CONCLUSIONS: This study provides important insights into the real-world clinical progress of pediatric SMA patients and their response to nusinersen treatment, highlighting the significance of early intervention for better functional and respiratory outcomes.
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INTRODUCTION: Five to twelve percent of melanomas show aggregation of melanomas or other related tumors within the same family or individual. Genes such as CDKN2A, or BAP1, among others, have been involved in this condition. MATERIAL AND METHODS: Retrospective descriptive study that includes patients from Cruces University Hospital (2016-2023) who met any of the following criteria: presence of two or more melanomas (1), or a melanoma and a pancreatic cancer (2) in the same individual; presence of a melanoma in an individual and one or more first- or second-degree relatives with melanoma or pancreatic cancer (3); first- or second-degree relationship with an individual with a known deleterious variant in genes related to melanoma predisposition (4); or incidental discovery of deleterious variants in genes related to predisposition to melanoma, within hereditary cancer panels carried out for reasons other than melanoma (5). RESULTS: 59 families were included (69 patients; 63.8% women), of which 8.5% (13% of patients) presented pathogenic/likely pathogenic variants (PV/LPV) in CDKN2A (6% of families and patients, excluding criteria 4 and 5), and 1.7% of families (1.4% of patients) presented PV/LPV in BAP1, BRCA2 and TERF2IP. DISCUSSION AND CONCLUSIONS: The frequencies of PV/LPV in CDKN2A are similar to those previously described. This study could contribute to the knowledge of the characteristics of patients who meet genetic study criteria for hereditary melanoma, in a setting of real clinical practice.
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PURPOSE: To review the rebound effect after cessation of different myopia control treatments. METHODS: A systematic review that included full-length randomised controlled studies (RCTs), as well as post-hoc analyses of RCTs reporting new findings on myopia control treatments rebound effect in two databases, PubMed and Web of Science, was performed according to the PRISMA statement. The search period was between 15 June 2023 and 30 June 2023. The Cochrane risk of bias tool was used to analyse the quality of the selected studies. RESULTS: A total of 11 studies were included in this systematic review. Unifying the rebound effects of all myopia control treatments, the mean rebound effect for axial length (AL) and spherical equivalent refraction (SER) were 0.10 ± 0.07 mm [-0.02 to 0.22] and -0.27 ± 0.2 D [-0.71 to -0.03] after 10.2 ± 7.4 months of washout, respectively. In addition, spectacles with highly aspherical lenslets or defocus incorporated multiple segments technology, soft multifocal contact lenses and orthokeratology showed lower rebound effects compared with atropine and low-level light therapy, with a mean rebound effect for AL and SER of 0.04 ± 0.04 mm [0 to 0.08] and -0.13 ± 0.07 D [-0.05 to -0.2], respectively. CONCLUSIONS: It appears that the different treatments for myopia control produce a rebound effect after their cessation. Specifically, optical treatments seem to produce less rebound effect than pharmacological or light therapies. However, more studies are required to confirm these results.
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Óculos , Miopia , Procedimentos Ortoceratológicos , Refração Ocular , Humanos , Miopia/terapia , Miopia/fisiopatologia , Refração Ocular/fisiologia , Procedimentos Ortoceratológicos/métodos , Terapia com Luz de Baixa Intensidade/métodosRESUMO
BACKGROUND: The removal of impacted lower third molars (ILTMs) is associated with bone defects in the distal area of second molars. Different methods have been described to minimize these defects. PURPOSE: The primary objective was to assess changes in probing depth (PD) over time (up to 36 months) between test (grafted) and control (ungrafted) groups; the graft was obtained from the extracted ILTM. STUDY DESIGN, SETTING, SAMPLE: This split-mouth randomized clinical trial was conducted at the Postgraduate Course in Oral Surgery of the Faculty of Dentistry of the Complutense University of Madrid. Adult patients requiring bilateral ILTM extraction with adjacent second molars were recruited, excluding pregnant/lactating women, patients in treatment with nonsteroidal anti-inflammatory drugs and patients with periodontal diseases. PREDICTOR/EXPOSURE/INDEPENDENT VARIABLE: The predictor variable was the graft technique. The bone defect after ILTM removal was treated with autogenous tooth graft (ATG) in the test group, leaving the control group ungrafted. MAIN OUTCOME VARIABLE: PD on the distobuccal, distomedial, and distolingual surfaces was recorded in both groups and averaged at baseline (T0), 3 (T1), 6 (T2), and 36 months (T3) postoperatively. COVARIATES: Sex, age, surgical time, ILTM situation and position between groups were assessed. ANALYSES: ANOVA repeated measures for comparisons between groups and the Friedman test for comparisons within the groups over time were applied. Statistical significance was established with a confidence interval of 95% (P < .05). RESULTS: The sample comprised 22 patients (6 males, 16 females) with a mean age of 21.68 ± 2.19 years; 44 ILTM extractions were performed. Statistically significant differences in PD average were found between groups (P < .001, 95% confidence interval) at 3 (1.63 ± 0.29), 6 (1.76 ± 0.3), and 36 months (1.74 ± 0.36). Reductions from T0 to T3 of 2.74 ± 0.28 (P < .001) and 0.54 ± 0.3 (P = .43) were observed in test and control groups, respectively. CONCLUSION AND RELEVANCE: ATG placed on the distal surface of lower second molars and almost completely filling the extraction socket improved PD 3, 6 and 36 months after ILTM. Furthermore, no significant changes in PD were observed over time; no major complications occurred. ATG appears to be a viable alternative graft material for this procedure.
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Dente Serotino , Extração Dentária , Humanos , Dente Serotino/cirurgia , Feminino , Masculino , Adulto , Dente Impactado/cirurgia , Cicatrização/fisiologia , Resultado do Tratamento , Adulto Jovem , Perda do Osso Alveolar/cirurgia , Mandíbula/cirurgia , Seguimentos , Autoenxertos/transplante , Alvéolo Dental/cirurgiaRESUMO
The microbiota in humans and animals play crucial roles in defense against pathogens and offer a promising natural source for immunomodulatory products. However, the development of physiologically relevant model systems and protocols for testing such products remains challenging. In this study, we present an experimental condition where various natural products derived from the registered lactic acid bacteria Ligilactobacillus salivarius CECT 9609, known for their immunomodulatory activity, were tested. These products included live and inactivated bacteria, as well as fermentation products at different concentrations and culture times. Using our established model system, we observed no morphological changes in the airway epithelium upon exposure to Pasteurella multocida, a common respiratory pathogen. However, early molecular changes associated with the innate immune response were detected through transcript analysis. By employing diverse methodologies ranging from microscopy to next-generation sequencing (NGS), we characterized the interaction of these natural products with the airway epithelium and their potential beneficial effects in the presence of P. multocida infection. In particular, our discovery highlights that among all Ligilactobacillus salivarius CECT 9609 products tested, only inactivated cells preserve the conformation and morphology of respiratory epithelial cells, while also reversing or altering the natural immune responses triggered by Pasteurella multocida. These findings lay the groundwork for further exploration into the protective role of these bacteria and their derivatives.
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Produtos Biológicos , Ligilactobacillus salivarius , Infecções por Pasteurella , Pasteurella multocida , Humanos , Animais , Imunidade Inata , Células Epiteliais , Produtos Biológicos/farmacologia , Infecções por Pasteurella/microbiologia , Infecções por Pasteurella/veterináriaRESUMO
BACKGROUND: During the COVID-19 pandemic, face-to-face delivery of education in schools across Wales was disrupted with repeated school closures to limit risk of infection. Evidence describing the incidence of infection amongst school staff during times when schools were open is limited. A previous research study found infection rates were higher in English primary school settings when compared with secondary. An Italian study suggested teachers weren't at greater risk of infection in comparison to the general population. The aim of this study was to identify whether educational staff had higher incidence rates than their counterparts in the general population in Wales, and secondly whether incidence rates amongst staff differed between primary and secondary school settings and by teacher age. METHODS: We performed a retrospective observational cohort study using the national case detection and contact tracing system implemented during the COVID pandemic. Age stratified person-day COVID-19 incidence rates amongst teaching staff linked to primary or secondary schools in Wales were calculated for the autumn and summer terms during 2020-2021. RESULTS: The observed pooled COVID-19 incidence rates for staff across both terms was 23.30 per 100,000 person days (95% CI: 22.31-24.33). By comparison, the rate in the general population aged 19-65, was 21.68 per 100,000 person days (95%: CI 21.53-21.84). Incidence among teaching staff was highest in the two youngest age groups (< 25 years and 25-29 years). When compared to the age matched general population, incidence was higher in the autumn term amongst primary school teachers aged ≤ 39 years, and in the summer term higher only in the primary school teachers aged < 25 years. CONCLUSION: The data were consistent with an elevated risk of COVID-19 amongst younger teaching staff in primary schools when compared to the general population, however differences in case ascertainment couldn't be excluded as a possible reason for this. Rate differences by age group in teaching staff mirrored those in the general population. The risk in older teachers (≥ 50 years) in both settings was the same or lower than in the general population. Amongst all age groups of teachers maintaining the key risk mitigations within periods of COVID transmission remain important.
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COVID-19 , SARS-CoV-2 , Humanos , Idoso , Incidência , Pandemias , Estudos Retrospectivos , COVID-19/epidemiologia , Instituições AcadêmicasRESUMO
OBJECTIVES: To assess the intraobserver repeatability of automated, objective, and noninvasive measures obtained with the S390L Firefly WDR slitlamp. METHODS: This cross-sectional study included 50 eyes of patients with dry eye disease with a mean age of 55.06±12.96 years. Three consecutively repeated measures of the following variables were obtained: first noninvasive break-up time (F-NIBUT), average noninvasive break-up time (A-NIBUT), tear meniscus height, tear meniscus area (TMA), nasal ciliary hyperemia (NCIH), temporal ciliary hyperemia (TCIH), nasal conjunctival hyperemia (NCOH), temporal conjunctival hyperemia (TCOH), upper loss area meibomian gland (U-LAMG), lower loss area meibomian gland (L-LAMG), upper meibomian gland dysfunction grade (U-MGD grade), and lower meibomian gland dysfunction grade (L-MGD grade). Intraobserver repeatability was estimated with coefficient of variation (CoV), intrasubject standard deviation (SD) (S w ), and Bland-Altman plots. RESULTS: All variables showed no statistically significant differences in the repeated-measures analysis except for L-MGD grade ( P =0.045). F-NIBUT and A-NIBUT obtained the highest CoV with an average value of 0.48±0.41 [0.02-1.00] and 0.34±0.25 [0.02-1.00], respectively. The remaining variables showed CoVs between 0.04±0.11 [0.00-0.43] and 0.18±0.16 [0.00-0.75]. A-NIBUT, TMA, NCOH, and L-LAMG obtained an S w of 2.78s, 0.21 mm 2 , <0.001, and 4.11%, respectively. Bland-Altman plots showed a high level of agreement between pairs of repeated measures. CONCLUSION: The S390L Firefly WDR slitlamp has moderate intraobserver repeatability for F-NIBUT and A-NIBUT, which suggests that F-NIBUT and A-NIBUT are tests with high variability. The remaining variables show satisfactory intraobserver repeatability.
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Síndromes do Olho Seco , Hiperemia , Disfunção da Glândula Tarsal , Humanos , Animais , Adulto , Pessoa de Meia-Idade , Idoso , Vaga-Lumes , Estudos Transversais , Hiperemia/diagnóstico , Lágrimas , Síndromes do Olho Seco/diagnóstico , Glândulas TarsaisRESUMO
OBJECTIVES: To evaluate the improvement in symptoms and signs associated with intense pulse light (IPL) combined with low-level light therapy (LLLT) in the treatment of dry eye disease (DED). METHODS: A systematic review of full-length original studies reporting the effects of IPL combined with LLLT for DED in two databases, PubMed and Scopus, was performed according to the PRISMA statement. The quality assessment tool for case series studies from the National Heart, Lung, and Blood Institute was used to analyze the quality of the studies selected. RESULTS: The search provided a total of 393 articles, of which six were included. Significant decreases in the Ocular Surface Disease Index (OSDI) score, meibomian gland dysfunction (MGD) score, MGD grade, and meiboscore and increases in tear film stability, lipid layer thickness, and loss area of the meibomian gland have been reported. Concerning tear volume, tear meniscus height, and Schirmer test remained unchanged. In relation to tear osmolarity and corneal fluorescein staining, contradictory outcomes were found. CONCLUSIONS: Intense pulse light combined with LLLT for the treatment of dry eye improves OSDI, tear film stability, and meibomian gland function; thus, this treatment may be recommended for DED patients due to MGD.
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Síndromes do Olho Seco , Terapia com Luz de Baixa Intensidade , Disfunção da Glândula Tarsal , Humanos , Disfunção da Glândula Tarsal/terapia , Glândulas Tarsais , Síndromes do Olho Seco/diagnóstico , LágrimasRESUMO
The airway epithelium is a critical component of the respiratory system, serving as a barrier against inhaled pathogens and toxins. It is composed of various cell types, each with specific functions essential to proper airway function. Chronic respiratory diseases can disrupt the cellular composition of the airway epithelium, leading to a decrease in multiciliated cells (MCCs) and an increase in secretory cells (SCs). Basal cells (BCs) have been identified as the primary stem cells in the airway epithelium, capable of self-renewal and differentiation into MCCs and SCs. This review emphasizes the role of transcription factors in the differentiation process from BCs to MCCs and SCs. Recent advancements in single-cell RNA sequencing (scRNAseq) techniques have provided insights into the cellular composition of the airway epithelium, revealing specialized and rare cell types, including neuroendocrine cells, tuft cells, and ionocytes. Understanding the cellular composition and differentiation processes within the airway epithelium is crucial for developing targeted therapies for respiratory diseases. Additionally, the maintenance of BC populations and the involvement of Notch signaling in BC self-renewal and differentiation are discussed. Further research in these areas could provide valuable insights into the mechanisms underlying airway epithelial homeostasis and disease pathogenesis.
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Células Epiteliais , Doenças Respiratórias , Humanos , Células Epiteliais/metabolismo , Mucosa Respiratória/metabolismo , Diferenciação Celular/genética , Regulação da Expressão Gênica , Doenças Respiratórias/metabolismoRESUMO
HIV-associated neurocognitive disorders (HANDs) still persist despite improved life expectancy, reduced viral loads, and decreased infection severity. The number of patients affected by HANDs ranges from (30 to 50) % of HIV-infected individuals. The pathological mechanisms contributing to HANDs and the most serious manifestation of the disease, HIV-associated dementia (HAD), are not yet well understood. Evidence suggests that these mechanisms are likely multifactorial, producing neurocognitive complications involving disorders such as neurogenesis, autophagy, neuroinflammation, and mitochondrial dysfunction. Over the years, multiple pharmacological approaches with specific mechanisms of action acting upon distinct targets have been approved. Although these therapies are effective in reducing viral loading to undetectable levels, they also present some disadvantages such as common side effects, the need for administration with a very high frequency, and the possibility of drug resistance. Genetic studies on HANDs provide insights into the biological pathways and mechanisms that contribute to cognitive impairment in people living with HIV-1. Furthermore, they also help identify genetic variants that increase susceptibility to HANDs and can be used to tailor treatment approaches for HIV-1 patients. Identification of the genetic markers associated with disease progression can help clinicians predict which individuals require more aggressive management and by understanding the genetic basis of the disorder, it will be possible to develop targeted therapies to mitigate cognitive impairment. The main goal of this review is to provide details on the epidemiological data currently available and to summarise the genetic (specifically, the genetic makeup of the immune system), transcriptomic, and epigenetic studies available on HANDs to date. In addition, we address the potential pharmacological therapeutic strategies currently being investigated. This will provide valuable information that can guide clinical care, drug development, and our overall understanding of these diseases.
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Complexo AIDS Demência , Infecções por HIV , HIV-1 , Humanos , Infecções por HIV/complicações , Infecções por HIV/tratamento farmacológico , Infecções por HIV/genética , Genômica , Transtornos Neurocognitivos/etiologia , Transtornos Neurocognitivos/genética , Complexo AIDS Demência/tratamento farmacológico , Complexo AIDS Demência/genéticaRESUMO
The Insulin-like growth factor 2 (IGF-2) has been recently proven to alleviate depressive-like behaviors in both rats and mice models. However, its potential role as a peripheral biomarker has not been evaluated in depression. To do this, we measured plasma IGF-2 and other members of the IGF family such as Binding Proteins (IGFBP-1, IGFBP-3, IGFBP-5 and IGFBP-7) in a depressed group of patients (n = 51) and in a healthy control group (n = 48). In some of these patients (n = 15), we measured these proteins after a period (19 ± 6 days) of treatment with antidepressants. The Hamilton Depressive Rating Scale (HDRS) and the Self-Assessment Anhedonia Scale (SAAS) were used to measure depression severity and anhedonia, respectively. The general cognition state was assessed by the Mini-Mental State Examination (MMSE) test and memory with the Free and Cued Selective Reminding Test (FCSRT). The levels of both IGF-2 and IGFBP-7 were found to be significantly increased in the depressed group; however, only IGF-2 remained significantly elevated after correction by age and sex. On the other hand, the levels of IGF-2, IGFBP-3 and IGFBP-5 were significantly decreased after treatment, whereas only IGFBP-7 was significantly increased. Therefore, peripheral changes in the IGF family and their response to antidepressants might represent alterations at the brain level in depression.
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Transtorno Depressivo Maior , Fator de Crescimento Insulin-Like II , Humanos , Ratos , Animais , Camundongos , Fator de Crescimento Insulin-Like II/metabolismo , Proteína 3 de Ligação a Fator de Crescimento Semelhante à Insulina , Proteína 5 de Ligação a Fator de Crescimento Semelhante à Insulina , Transtorno Depressivo Maior/tratamento farmacológico , Fator de Crescimento Insulin-Like I/metabolismo , Anedonia , Antidepressivos/farmacologia , Antidepressivos/uso terapêutico , Proteína 2 de Ligação a Fator de Crescimento Semelhante à InsulinaRESUMO
PURPOSE: To analyze the choroidal thickness between patients with keratoconus undergoing cross-linking treatment and a healthy population, as well as to determine the factors that influence choroidal thickness. METHODS: This was an observational, analytical, case-control study that was conducted from February 2021 to June 2021. Choroidal thickness was measured at different locations, including the subfoveal, nasal (1000 µm), temporal (1000 µm), superior (1000 µm) and inferior (1000 µm) locations using a Spectral-domain optical coherence tomography with enhanced depth imaging, which allowed us to obtain horizontal and vertical B-scans centered on the fovea. RESULTS: This study included 21 patients with keratoconus (mean age, 21.86 ± 5.28 years) and 28 healthy patients (mean age, 24.21 ± 4.71 years). Choroidal thickness was significantly greater in patients with keratoconus than in healthy patients in each of the following measured locations: subfoveal (P < 0.001); nasal (1000 µm) (P < 0.001), temporal (1000 µm) (P < 0.001), superior (1000 µm) (P < 0.001) and inferior (1000 µm) (P < 0.001) locations. Variables such as age (ρ = - 0.09; P = 0.50) and refraction (ρ = 0.14; P = 0.34) were not found to be associated with choroidal thickness. In a stepwise multiple linear regression, the group was the single variable correlated with choroidal thickness (ß = 0.88; P < 0.001). CONCLUSION: Choroidal thickness is thicker in keratoconus patients treated with cross-linking than in the healthy population. This finding could be associated with inflammatory choroidal mechanisms in keratoconus patients, but more studies are needed. Age and refractive error do not seem to influence choroidal thickness.
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Corioide , Crosslinking Corneano , Ceratocone , Estudos de Casos e Controles , Ceratocone/diagnóstico , Ceratocone/terapia , Corioide/anatomia & histologia , Corioide/diagnóstico por imagem , Tonometria Ocular , Humanos , Masculino , Feminino , Adulto , Tomografia de Coerência ÓpticaRESUMO
Proper physiological function of mammalian airways requires the differentiation of basal stem cells into secretory or multiciliated cells, among others. In addition, the self-renewal ability of these basal stem cells is crucial for developing a quick response to toxic agents in order to re-establish the epithelial barrier function of the airways. Although these epithelial missions are vital, little is known about those mechanism controlling airway epithelial regeneration in health and disease. p53 has been recently proposed as the guardian of homeostasis, promoting differentiation programs, and antagonizing a de-differentiation program. Here, we exploit mouse and human tracheal epithelial cell culture models to study the role of MDM2-p53 signaling in self-renewal and differentiation in the airway epithelium. We show that p53 protein regulation by MDM2 is crucial for basal stem cell differentiation and to keep proper cell proliferation. Therefore, we suggest that MDM2/p53 interaction modulation is a potential target to control regeneration of the mammalian airway epithelia without massively affecting the epithelium integrity and differentiation potential.
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Diferenciação Celular/fisiologia , Epitélio/metabolismo , Proteínas Proto-Oncogênicas c-mdm2/metabolismo , Mucosa Respiratória/metabolismo , Células-Tronco/metabolismo , Proteína Supressora de Tumor p53/metabolismo , Animais , Proliferação de Células/fisiologia , Células Epiteliais/metabolismo , Feminino , Homeostase/fisiologia , Humanos , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Regeneração/fisiologia , Transdução de Sinais/fisiologia , Traqueia/metabolismoRESUMO
PURPOSE: This systematic review aims to compare corneal astigmatism correction in cataract surgery through corneal relaxing incision, manually and femtosecond laser assisted. METHODS: The study was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement recommendations. We used PubMed, Scopus, and Web of Science (WOS) as databases from January 2010 to March 30, 2021. Patients with keratoconus, corneal ectasia, and a previous history of eye surgery were excluded because our aim was to analyze only healthy eyes. RESULTS: A total of 1025 eyes were evaluated from 946 patients (mean age was 68.90 ± 5.12) in manual incision group articles, while 1905 eyes of 1483 patients (mean age was 65.05 ± 4.57) were evaluated in femtosecond laser arcuate keratotomy (FLAK) articles. The mean uncorrected distance visual acuity (UDVA) was 0.19 ± 0.12 and 0.15 ± 0.05 logMAR for manual incision and FLAK articles, respectively (p = 0.39). The mean correction index (CI) was similar in both groups: 0.77 ± 0.18 in manual incision and 0.79 ± 0.17 in femtosecond laser assisted incision (p = 0.70). Refractive stability was found after 3 months and no serious complications were reported during the follow-up in any group. CONCLUSION: Both techniques are safe and moderately effective in corneal astigmatism correction in cataract surgery. FLAK represents a more precise and predictable approach. However, since visual and refractive outcomes appear to be similar in both cases, the cost-benefit analysis is controversial.
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Astigmatismo , Extração de Catarata , Catarata , Doenças da Córnea , Humanos , Pessoa de Meia-Idade , Idoso , Astigmatismo/cirurgia , Astigmatismo/etiologia , Extração de Catarata/efeitos adversos , Ceratoplastia Penetrante/efeitos adversos , Refração Ocular , Doenças da Córnea/cirurgia , Catarata/complicações , Lasers , Topografia da CórneaRESUMO
PURPOSE: To study the treatment efficacy of hyaluronic acid 0.3%, cyanocobalamin (vitamin B12), electrolytes, and P-Plus in menopausal patients with moderate dry eye disease. METHODS: Thirty female patients of mean age 53.06 ± 5.20 years (45-65) were enrolled in this prospective longitudinal study. Meibomian gland loss assessment was determined using a scale with four levels. The Ocular Surface Disease Index (OSDI) questionnaire, phenol red thread (PRT) test, and tear film break-up time (TFBUT) were also completed by the patients. Tear eye drops were formulated with 0.3 g of sodium hyaluronate, P-Plus ™, vitamin B12, sodium chloride, potassium chloride, calcium chloride, magnesium chloride, and SCO® (stabilized complex oxychloride). After 30 days, the patients were re-evaluated. RESULTS: The mean meibomian gland loss percentage was 37.97 ± 19.02 % (7.20 to 88.30%). Before treatment, the OSDI was 22.53 ± 14.03 score points (6.25 to 77.08). Posterior OSDI decreased to 16.26 ± 13.69 score points (0.00 to 70.83) (W = 58.00, P < 0.01). Before treatment, PRT was 10.31 ± 4.48 mm (4.00 to 21.00). Posterior PRT increased to 15.41 ± 6.27 mm (4.00 to 21.00) (W = 1520.50, P < 0.01). Before treatment, TFBUT was 6.23 ± 1.75 s (3.00 to 9.00). The posterior TFBUT increased to 8.10 ± 2.06 s (4.00 to 14.00) (W= 1382.50, P < 0.01). CONCLUSION: The hyaluronic acid 0.3% and vitamin B12 eye drops effectively decreased dry eye symptoms in menopausal women and improved tear stability and volume.
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Síndromes do Olho Seco , Ácido Hialurônico , Síndromes do Olho Seco/diagnóstico , Síndromes do Olho Seco/tratamento farmacológico , Eletrólitos , Feminino , Humanos , Estudos Longitudinais , Menopausa , Pessoa de Meia-Idade , Estudos Prospectivos , Lágrimas , Vitamina B 12RESUMO
BACKGROUND: This study investigated the association between xerostomia and health risk behaviours, general and oral health and quality of life. METHODS: A cross-sectional study involving 800 adults over 65 years of age residing in Spain using a computer-assisted telephone questionnaire. The severity of xerostomia was assessed through the Xerostomia Inventory (XI). Both univariate and adjusted multinomial logistic regression were used to determine the risk (OR) of xerostomia. RESULTS: The sample comprised of 492 females (61.5%) and 308 males, with a mean age of 73.7 ± 5.8 years. Some, 30.7% had xerostomia: 25.6% mild, 4.8% moderate and 0.3% severe, the majority being female (34.8% vs 24%; p = 0.003). The mean XI was 24.6 ± 6.3 (95% CI 19.2-24.8) for those with poor health, whereas it was 17.4 ± 6.3 (95%CI 16.1-18.6) in those reporting very good health (p < 0.001). This difference was also observed in terms of oral health, with the XI mean recorded as 14.7 ± 10.7 for very poor oral health and 6.4 ± 5.4 for those with very good health (p = 0.002). Logistic regression showed that the highest OR for xerostomia was observed among adults with poor general health (2.81; 95%CI 1.8-4.3; p < 0.001) and for adjusted model the OR was still significant (2.18; 95%CI 1.4-3.4; p = 0.001). Those who needed help with household chores had 2.16 higher OR (95%CI 1.4-3.4; p = 0.001) and 1.69 (95%CI 1.1-2.7; p = 0.03) in the adjusted model. Females had a higher risk of suffering from xerostomia than males. CONCLUSION: The strong association between xerostomia and the general and oral health status of older adults justifies the need for early assessment and regular follow-up.
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Saúde Bucal , Xerostomia , Masculino , Humanos , Feminino , Idoso , Qualidade de Vida , Estudos Transversais , Comportamentos de Risco à Saúde , Inquéritos e Questionários , PercepçãoRESUMO
PURPOSE: To provide a relationship between materials developed for silicone hydrogel contact lenses and multipurpose care solutions to identify improvements in wettability, for prelens noninvasive break-up time and subjective score. METHODS: This systematic review was completed according to the updated PRISMA 2020 statement recommendations and followed the explanation and elaboration guidelines. The PubMed, Web of Science, and Scopus scientific literature databases were searched from January 2000 to November 2021. RESULTS: A total of four clinical trials published between 2011 and 2017 were included in this investigation. All included studies were randomized clinical trials. The success of contact lenses is related to the comfort of their use and therefore to the stability of the tear film and the wettability of its surface. The relationship between these parameters and changes in the ocular surface and inflammatory and infectious processes has been demonstrated. CONCLUSION: Hyaluronan and propylene glycol multipurpose solution (MPS) wetting agents achieved slightly higher prelens noninvasive break-up times than poloxamine. Polyquaternium-1 achieved better wettability and patient comfort than polyhexamethylene biguanide in medium-term studies. Short-term studies did not demonstrate differences between MPSs in their effect on contact lens wettability.
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Soluções para Lentes de Contato , Lentes de Contato Hidrofílicas , Soluções para Lentes de Contato/farmacologia , Humanos , Hidrogel de Polietilenoglicol-Dimetacrilato , Hidrogéis , Silicones , MolhabilidadeRESUMO
Introduction: The pandemic produced by SARS-CoV-2 has obliged us to set up the tele-assistance to offer a continuity of care. This implies an innovation, being the degree of satisfaction of patients unknown. Methods: A telephonic survey was conducted with the validated in the Spanish tool Telehealth Usability Questionnaire (Telehealth Usability Questionnaire; rating from 1-7) of all candidate patients assisted consecutively in the Coloproctology Unit. We included demographic variables, education level, job status, diagnosis and consultation type. A descriptive study was done. The relationship between the willingness of consultation model in the future (telemedicine vs traditional) and the categorical variables was analysed through the chi-squared test. Results: A total of 115 patients were included. The average age was 59.9 years, being 60% women. The average score in each of the survey items was higher than 6 in all the questions but 1. 26.1% of the surveyed patients confessed being advocated to tele-assistance in the future. The only factors related to greater willingness to tele-assistance were male gender (37% vs 18.8%; P = .03) and a higher academic preparation level in favour of higher technical studies (35.9%) and university studies (32.4%) opposite to the rest (P = .043). The rest of variables studied, job status, labour regimen, diagnostic group and consultation type did not show any relationship. Conclusions: A vast majority of patients answered favourably to almost all the items of the survey. However, only 26.1% of them would choose a model of tele-assistance without restrictions.
Assuntos
COVID-19 , Cirurgia Colorretal , Consulta Remota , Telemedicina , COVID-19/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Satisfação do Paciente , Satisfação Pessoal , SARS-CoV-2 , TelefoneRESUMO
PURPOSE: To review all case series of refractive corneal inlay implantation: Flexivue (Presbia, Netherlands), Invue (BioVision, Brügg, Switzerland) and Icolens (Neoptics, Hünenberg, Switzerland) performed in presbyopia patients and to evaluate the reported visual outcomes. In addition, our aim is to provide assessment for complications and to report the satisfaction rates. METHODS: PubMed, Web of Science and Scopus databases were consulted using "refractive corneal inlay", "Flexivue Inlay", "Invue Inlay" and "Icolens inlay" as keywords. 147 articles were found, and they were assessed considering the inclusion and exclusion criteria. After filtering, this systemic review included ten articles, published between 2011 and 2020. RESULTS: 308 eyes from 308 participants were enrolled in this systematic review. Mean maximum follow-up was 13.9 months. Nine of the ten case series included used femtosecond laser for the corneal pocket creation. Mean pocket depth was 293.75 µm. 77.5% of the eyes reported a postoperative uncorrected near visual acuity of 20/32 or better, and 19.20% of the inlay-implanted eyes achieved an uncorrected distance visual acuity of 20/20 or better. The most prominent complications were halos, pain, photophobia, and poor distance visual acuity. 27 eyes (8.7%) had to be explanted due to complications, such as near-distance spectacle dependence or blurred distance vision. CONCLUSION: Refractive corneal inlay outcomes demonstrated high efficacy, safety, and satisfaction rates. Furthermore, it is a reversible technique. However, the findings must be viewed with caution due potential conflict of interest. Further research with higher sample size is needed to validate these findings.
Assuntos
Substância Própria , Presbiopia , Substância Própria/cirurgia , Topografia da Córnea , Olho Artificial , Humanos , Presbiopia/cirurgia , Estudos Prospectivos , Próteses e Implantes , Implantação de Prótese , Refração OcularRESUMO
In vertebrates, planar polarization of ciliary basal bodies has been associated with actin polymerization that occurs downstream of the Frizzled-planar cell polarity (Fz-PCP) pathway. In Drosophila wing epithelial cells, which do not have cilia, centrioles also polarize in a Fz-PCP-dependent manner, although the relationship with actin polymerization remains unknown. By combining existing and new quantitative methods, we unexpectedly found that known PCP effectors linked to actin polymerization phenotypes affect neither final centriole polarization nor apical centriole distribution. But actin polymerization is required upstream of Fz-PCP to maintain the centrioles in restricted areas in the apical-most planes of those epithelial cells before and after the actin-based hair is formed. Furthermore, in the absence of proper core Fz-PCP signalling, actin polymerization is insufficient to drive this off-centred centriole migration. Altogether, the results reveal that there are at least two pathways controlling centriole positioning in Drosophila pupal wings - an upstream actin-dependent mechanism involved in centriole distribution that is PCP independent, and an unknown mechanism that links core Fz-PCP and centriole polarization.