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PURPOSE: To assess incidence, risk factors, and treatment of retroprosthetic membrane (RPM) formation in eyes following Boston keratoprosthesis (Kpro) implantation and their correlation with glaucoma drainage device placement (GDD). METHODS: A retrospective review was performed on eyes that underwent Kpro type I or II implantation between 2005 and 2020 at a tertiary academic center. Multiple variables were collected including preoperative characteristics, presence of RPM, management of RPM, and outcomes including corrected visual acuity (VA). A Fischer's exact test was used to evaluate the significance of risk factors of RPM formation and an odds ratio was calculated for each possible risk factor. A Mann-Whitney U test was used to evaluate comparisons between outcomes and qualitative analyses. RESULTS: Of the 87 eyes identified, 37 (43%) developed an RPM within an average of 1.5 years (range, 31 days-7.5 years) following Kpro implantation. Mean follow-up duration was 4.3 years. Eyes that developed RPM had significantly worse preoperative VA compared to those that did not (logMAR 2.55 vs. 2.28, p = 0.022). The mean number of prior penetrating keratoplasty procedures trended higher in eyes that developed RPM (2.46 vs. 2.18, p = 0.44) but was not significant. GDD placement after Kpro implantation was associated with an increased risk of RPM formation (RR = 1.69 p = 0.026). Of the 37 eyes that developed an RPM following Kpro, 17 (47%) were treated with Nd:YAG laser, and four of those 17 (21%) also underwent pars plana vitrectomy (PPV). Seven of 37 eyes (19%) underwent PPV without Nd:YAG. Comparisons between RPM occurrence and final VA were not significant. CONCLUSIONS: The incidence of RPM formation following Kpro implantation was 43%. Eyes that developed RPM had significantly worse preoperative VA. GDD placement after Kpro implantation increased the risk of developing RPM. Final VA and occurrence of RPM were not significantly different between the Nd:YAG and PPV treatment groups.
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Doenças da Córnea , Glaucoma , Complicações Pós-Operatórias , Acuidade Visual , Humanos , Estudos Retrospectivos , Feminino , Masculino , Incidência , Fatores de Risco , Pessoa de Meia-Idade , Glaucoma/cirurgia , Glaucoma/fisiopatologia , Glaucoma/epidemiologia , Idoso , Seguimentos , Doenças da Córnea/cirurgia , Doenças da Córnea/diagnóstico , Complicações Pós-Operatórias/epidemiologia , Órgãos Artificiais , Pressão Intraocular/fisiologia , Implantação de Prótese , Adulto , Próteses e Implantes , Implantes para Drenagem de Glaucoma , Córnea/cirurgia , Idoso de 80 Anos ou maisRESUMO
Plants have always been able to adapt to climate change by reacting through various responses, mainly at the phenological level. The aim of this work is to investigate the behavior of specific tree species located in two phenological gardens in central Italy in relation to the temperature increases recorded in recent years. Specifically, four main phenological phases, BBCH_11, BBCH_19, BBCH_91, and BBCH_65, were monitored during a 14-year time period. The data of the weeks corresponding to the first appearance of each phenological phase and the respective heat accumulations for each species were cross-referenced with the meteorological data recorded by the stations in the two considered areas. Based on average temperature, calculated over reference periods, the species were divided by creating "warm" year groups and "cold" year groups so as to better highlight any differences in the behavior of the same species. In addition, a strong correlation was shown between the maximum temperatures in February and the advances of phenological phases BBCH_11 and BBCH_65. Most of the tree species have shown strong adaptation to climate warming, changing the period of occurrence of the phases themselves.
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Jardins , Árvores , Temperatura , Estações do Ano , Itália , Mudança ClimáticaRESUMO
Progressive warming of the grape growing regions has reduced the land capability for sustainable grapevine production and the geographical distribution of grapes. Bud burst, blooming, berry set, veraison, and harvest are the key phenological stages of grapevine, and are crucial for managing vineyard activities. The objective of this study was to evaluate the effect of seasonal temperature variability on the timing of key phenological stages of table grape cultivars in a new emerging viticulture region, i.e., the Pothwar region of Pakistan. Phenological stages of four table grape cultivars were recorded during two consecutive growing seasons at two locations. All phenological stages were attained earlier for the relatively warmer location, i.e., Chakwal. Similarly, the length of the growing season from bud burst to harvest was 15 to 21 days longer for the 2020 growing season than for the 2019 growing season, which corresponds to the inter-annual temperature variability. Moreover, the grapevine cultivars showed a distinct response for each growth phase; cv. Perlette matured earlier while cv. NARC Black was the last to ripen. Despite the large variability in the length of the active growing period from bud burst to harvest, accumulated growing degree days (GDD) varied only in a narrow range, i.e., 1510-1557 for cv. Perlette, 1641-1683 for cv. King's Ruby, 1744-1770 for cv. Sugraone, and 1869-1906 for cv. NARC Black. This implies that seasonal temperature variability using GDD is a better indicator for the phenology of table grape cultivars compared to regular time. It is clear from the results from this study that the variation in phenological responses of table grape cultivars due to temperature differences necessitates genotype and site-specific vineyard management.
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Temperatura , Vitis , Mudança Climática , Frutas , Reprodução , Estações do AnoRESUMO
BACKGROUND: In this study, the quality of land suitability for vine cultivation in south-western Iran was evaluated and a land suitability map for vine cultivation was developed using the fuzzy-analytic hierarchy process (AHP). The best harvest time of vines was determined based on the relationship between total soluble solids (TSS) and titratable acidity (TA) with fruit colour (red, green, and blue or RGB) in ten points and also the growing degree-days (GDD) maps from April to December. The relationship between GDD and effective parameters in vine cultivation was determined using principal component analysis (PCA) and Pearson correlation methods. RESULTS: The results illustrated that the maximum temperature and relative humidity (RH) have the greatest effect on vine cultivation and its yield (weight 0.24). The results of the land suitability map showed that central regions have better conditions for growing vines (32%). The measurements of TA and TSS depicted that vines of the northern parts have higher TA and lower TSS and there is a significant relationship between them and fruit colour. The results of GDD maps showed that the harvest time of ruby vine and Gezel-azm is July and August, respectively. Also, the temperature (Tmean , Tmax and Tmin ), wind speed, and GDD were the most important parameters to determine the best location for vine cultivation. CONCLUSION: Determining land suitability for cultivation, the best harvest time, the time of grape ripening, and following the exact time of export and import of vine has a vital role to increase its productivity and services. © 2022 Society of Chemical Industry.
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Sistemas de Informação Geográfica , Vitis , Frutas , Vitis/química , Técnicas de Apoio para a Decisão , Irã (Geográfico)RESUMO
The Centers for Disease Control and Prevention has established 10 Global Disease Detection (GDD) Program regional centers around the world that serve as centers of excellence for public health research on emerging and reemerging infectious diseases. The core activities of the GDD Program focus on applied public health research, surveillance, laboratory, public health informatics, and technical capacity building. During 2015-2016, program staff conducted 205 discrete projects on a range of topics, including acute respiratory illnesses, health systems strengthening, infectious diseases at the human-animal interface, and emerging infectious diseases. Projects incorporated multiple core activities, with technical capacity building being most prevalent. Collaborating with host countries to implement such projects promotes public health diplomacy. The GDD Program continues to work with countries to strengthen core capacities so that emerging diseases can be detected and stopped faster and closer to the source, thereby enhancing global health security.
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Fortalecimento Institucional/métodos , Diplomacia/métodos , Saúde Global , Vigilância da População/métodos , Administração em Saúde Pública/métodos , Saúde Pública , Fortalecimento Institucional/organização & administração , Doenças Transmissíveis Emergentes/epidemiologia , Doenças Transmissíveis Emergentes/prevenção & controle , Pesquisa sobre Serviços de Saúde , HumanosRESUMO
Despite its low accuracy and consistency, growing degree days (GDD) has been widely used to approximate growing heat summation (GHS) for regional classification and phenological prediction. GDD is usually calculated from the mean of daily minimum and maximum temperatures (GDDmm) above a growing base temperature (T gb). To determine approximation errors and accuracy, daily and cumulative GDDmm was compared to GDD based on daily average temperature (GDDavg), growing degree hours (GDH) based on hourly temperatures, and growing degree minutes (GDM) based on minute-by-minute temperatures. Finite error, due to the difference between measured and true temperatures above T gb is large in GDDmm but is negligible in GDDavg, GDH, and GDM, depending only upon the number of measured temperatures used for daily approximation. Hidden negative error, due to the temperatures below T gb when being averaged for approximation intervals larger than measuring interval, is large in GDDmm and GDDavg but is negligible in GDH and GDM. Both GDH and GDM improve GHS approximation accuracy over GDDmm or GDDavg by summation of multiple integration rectangles to reduce both finite and hidden negative errors. GDH is proposed as the standardized GHS approximation protocol, providing adequate accuracy and high precision independent upon T gb while requiring simple data recording and processing.
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Estações do Ano , Temperatura , Vitis/crescimento & desenvolvimento , California , Fatores de TempoRESUMO
Herbivorous birds are hypothesized to migrate in spring along a seasonal gradient of plant profitability towards their breeding grounds (green wave hypothesis). For Arctic breeding species in particular, following highly profitable food is important, so that they can replenish resources along the way and arrive in optimal body condition to start breeding early. We compared the timing of migratory movements of Arctic breeding geese on different flyways to examine whether flyways differed in the predictability of spring conditions at stopovers and whether this was reflected in the degree to which birds were following the green wave. Barnacle geese (Branta leucopsis) were tracked with solar GPS/ARGOS PTTs from their wintering grounds to breeding sites in Greenland (N = 7), Svalbard (N = 21) and the Barents Sea (N = 12). The numerous stopover sites of all birds were combined into a set of 16 general stopover regions. The predictability of climatic conditions along the flyways was calculated as the correlation and slope between onsets of spring at consecutive stopovers. These values differed between sites, mainly because of the presence or absence of ecological barriers. Goose arrival at stopovers was more closely tied to the local onset of spring when predictability was higher and when geese attempted breeding that year. All birds arrived at early stopovers after the onset of spring and arrived at the breeding grounds before the onset of spring, thus overtaking the green wave. This is in accordance with patterns expected for capital breeders: first, they must come into condition; at intermediate stopovers, arrival with the food quality peak is important to stay in condition, and at the breeding grounds, early arrival is favoured so that hatching of young can coincide with the peak of food quality. Our results suggest that a chain of correlations between climatic conditions at subsequent stopovers enables geese to closely track the green wave. However, the birds' precision of migratory timing seems uninfluenced by ecological barriers, indicating partly fixed migration schedules. These might become non-optimal due to climate warming and preclude accurate timing of long-distance migrants in the future.
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Migração Animal , Cadeia Alimentar , Gansos/fisiologia , Animais , Regiões Árticas , Europa (Continente) , Feminino , Masculino , Estações do AnoRESUMO
BACKGROUND & AIMS: Current treatment strategies for hepatitis C virus (HCV) infection include pegylated interferon (IFN)-alfa and ribavirin. Approximately 50% of patients control HCV infection after treatment, but the broad range of patients' outcomes and responses to treatment, among all genotypes, indicates a role for host factors. Although the IFN system is important in limiting HCV replication, the virus has evolved mechanisms to circumvent the IFN response. However, direct, IFN-independent antiviral processes also might help control HCV replication. We examined the role of IFN-independent responses against HCV replication. METHODS: We analyzed replication of the subgenomic JFH1 replicon in embryonic fibroblasts and primary hepatocytes from mice with disruptions in genes encoding factors in the IFN-dependent and alternative antiviral pathways (signal transducers and activators of transcription 1 [STAT1], protein kinase R, interferon regulatory factors (IRF) IRF-1, IRF-3, IRF-5, IRF-7, mitochondrial antiviral signaling molecule [MAVS], and IFN receptor [IFNAR]). We also assessed the effects of expression of these factors by mouse primary hepatocytes on HCV replication. RESULTS: In addition to IRF-3- and IFN-mediated antiviral responses, IFN-independent, but IRF-1- and IRF-5-dependent mechanisms, restrict HCV replication in mouse embryonic fibroblasts. In primary hepatocytes these IFN-independent require MAVS and IRF-1. CONCLUSIONS: HCV replication is limited by interferon-mediated pathways as well pathways that are independent of type I IFNs. IRF1 and IRF5 control IFN-independent signaling events that lead to antiviral responses. We observed antiviral roles of IRF1 and IRF5 that were IFN-independent and cell-type specific. These mechanisms are important in controlling viruses that interfere with the IFN signaling because cells retain the ability to induce functional but local antiviral states through expression of interferon-stimulated genes.
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Fibroblastos/virologia , Hepacivirus/fisiologia , Hepatócitos/virologia , Interferons/fisiologia , Transdução de Sinais/fisiologia , Replicação Viral/fisiologia , Proteínas Adaptadoras de Transdução de Sinal/deficiência , Proteínas Adaptadoras de Transdução de Sinal/genética , Proteínas Adaptadoras de Transdução de Sinal/fisiologia , Animais , Antivirais/uso terapêutico , Fibroblastos/patologia , Hepatite C/tratamento farmacológico , Hepatócitos/patologia , Fatores Reguladores de Interferon/deficiência , Fatores Reguladores de Interferon/genética , Fatores Reguladores de Interferon/fisiologia , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Knockout , Receptores de Interferon/deficiência , Receptores de Interferon/genética , Receptores de Interferon/fisiologia , Fator de Transcrição STAT1/deficiência , Fator de Transcrição STAT1/genética , Fator de Transcrição STAT1/fisiologiaRESUMO
Hypoxic ischemic encephalopathy (HIE) is a critical condition affecting neonates due to oxygen deprivation and insufficient flow of blood to the brain. It is associated with high neonatal mortality and the risk of developmental psychomotor disorders, including cerebral palsy. The global epidemiology of HIE reveals significant disparities, with more advanced healthcare systems reporting lower incidence rates. The aim of the study is to contribute to the understanding of effective rehabilitation strategies for children with HIE and global developmental delay (GDD), with the goal of improving outcomes and quality of life for these individuals. This case report focuses on an 11-month-old male child with a history of perinatal HIE, highlighting the developmental challenges and interventions undertaken. The child showed delayed gross and fine motor development, sensory awareness deficits, and postural coordination issues. A comprehensive physiotherapy intervention plan was implemented, resulting in significant improvements in post-treatment outcome measures. This case highlights the importance of early and holistic physiotherapy interventions in addressing HIE patients' developmental delays and improving their quality of life.
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Background: HMGXB4 (additionally known as HMG2L1) is a non-histone DNA-binding protein that contains a single HMG-box domain. HMGXB4 was originally described in Xenopus where it was seen to negatively regulate the Wnt/ß-catenin signaling pathway. Materials and methods: In this study, we conducted a genetic and clinical evaluation of a single family with three affected individuals suffering from intellectual disability (ID), global developmental delay (GDD) and dysmorphic facial features.Whole genome sequencing (WGS) and Sanger sequencing were performed on the affected individuals' DNA to identify genetic variations. Additionally, a reverse transcription-quantitative polymerase chain reaction (RT-qPCR) was used to assess gene expression in both the affected and unaffected individuals in the family. Result: WGS identified a homozygous frameshift variant c.1193_1196del p. (Lys398Argfs × 25) in exon 5 of the HMGXB4 gene (OMIM 604702), which completely segregated the disease phenotype in the family. Furthermore, RT-qPCR revealed a substantial decrease in the HMGXB4 gene expression in the affected individuals as compared to the unaffected individuals of the family. Conclusions: The current study is the first evidence linking a genetic variant in the HMGXB4 gene to ID, GDD, and dysmorphic facial features. Therefore, it is possible that HMGXB4 contributes significantly to developmental milestones and may be responsible for neurodevelopmental disorders in humans.
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Contrast agents is used in magnetic resonance imaging (MRI) to improve the visibility of the details of the organ structures. Gadolinium-based contrast agent (GBCA) has been used since 1988 in MRI for diagnostic and follow-up of patients, the gadolinium good properties make it an effective choice for enhance the signal in MRI by increase its intensity and shortening the relaxation time of the proton. Recently, many studies show a gadolinium deposition in different human organs due to release of free gadolinium various body organs or tissue, which led to increased concern about the use of gadolinium agents, in this study, the potential diseases that may affect the patient and side effects that appear on the patient and related to accumulation of gadolinium were clarified, the study focused on the organs such as brain and bones in which gadolinium deposition was found and the lesions associated with it, and the diseases associated with gadolinium retention includes Nephrogenic Systemic Fibrosis (NSF) and Gadolinium deposition disease (GDD). Some studies tended to improve the contrast agents by developing a new non-gadolinium agents or development of next-generation gadolinium agents. In this review article the latest knowledge about MRI contrast agent.
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Neurodevelopmental disorders (NDDs) are classified as a group of disorders affecting function and development of the brain and having wide clinical variability. Herein, we describe two affected individuals segregating a recessive NDD. The affected individuals exhibited phenotypes such as global developmental delay (GDD), intellectual disability (ID), microcephaly and speech delay. Whole-exome sequencing (WES) followed by bidirectional Sanger sequencing techniques identified a homozygous nonsense variant (c.466C > T; p.Gln156*) in the PPFIBP1 gene (NM_003622.4) that segregated with the disease phenotype. Further, to elucidate the effect of the variant on protein structure, 3D protein modelling was performed for the mutant and normal protein that suggested substantial reduction of the mutant protein. Our data support the evidence that PPFIBP1 has a pivotal role in neurodevelopment in humans, and loss-of-function variants cause clinically variable neurodevelopmental phenotypes.
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Deficiência Intelectual , Microcefalia , Malformações do Sistema Nervoso , Transtornos do Neurodesenvolvimento , Humanos , Transtornos do Neurodesenvolvimento/genética , Proteínas de Transporte/genética , Deficiência Intelectual/genética , Microcefalia/genética , Encéfalo , Proteínas/genética , Fenótipo , Proteínas Adaptadoras de Transdução de Sinal/genéticaRESUMO
Modeling phenological phases in a Mediterranean environment often implies tangible challenges to reconstructing regional trends over heterogenous areas using limited and scattered observations. The present investigation aimed to project phenological phases (i.e., sprouting, blooming, and pit hardening) for early and mid-late olive cultivars in the Mediterranean, comparing two phenological modeling approaches. Phenoflex is a rather integrated but data-demanding model, while a combined model of chill and anti-chill days and growing degree days (CAC_GDD) offers a more parsimonious and general approach in terms of data requirements for parameterization. We gathered phenological observations from nine experimental sites in Italy and temperature timeseries from the European Centre for Medium-Range Weather Forecasts, Reanalysis v5. The best performances of the CAC_GDD (RMSE: 4 days) and PhenoFlex models (RMSE: 5-9.5 days) were identified for the blooming and sprouting phases of mid-late cultivars, respectively. The CAC_GDD model was better suited to our experimental conditions for projecting pit hardening and blooming dates (correlation: 0.80 and 0.70, normalized RMSE: 0.6 and 0.8, normalized standard deviation: 0.9 and 1.0). The optimization of the principal parameters confirmed that the mid-late cultivars were more adaptable to thermal variability. The spatial distribution illustrated the near synchrony of blooming dates between the early and mid-late cultivars compared to other phases.
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Background Global developmental delay (GDD) is common and has a significant impact on affected children, families, and society. Understanding its etiology is crucial for management and prevention strategies. However, data on the etiological profile of GDD in developing countries are limited. This study aimed to identify the etiological profile of GDD at a tertiary care hospital in India. Methodology This observational study included children aged three months to five years with a developmental quotient below 70%. Data on demographics, clinical features, relevant investigations, and diagnoses were collected. Etiologies were categorized into prenatal, perinatal, postnatal, and unknown causes. Informed consent was obtained from the parents. Results A total of 52 children, with a median age of 15.5 months, were included in the study, with 69.2% being males. Prenatal causes accounted for half of the cases, with genetic abnormalities (32.7%) and chromosomal abnormalities (7.7%) being prominent. Perinatal causes were the next most common (34.6%), including hypoxic-ischemic encephalopathy (26.7%). Postnatal causes were rare (3.8%). The overall etiological yield was 88.4%, with some cases remaining unidentified. Conclusions Prenatal causes, including genetic and chromosomal abnormalities, are common in GDD. The utilization of genetic testing enhances etiological yield. Hypoxic-ischemic encephalopathy remains a significant factor and highlights the importance of perinatal care in preventing developmental delays. Large multicentric studies are needed for a comprehensive database of etiological profiles.
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Angelman syndrome (AS) is a rare pediatric neurological condition in which patients most commonly present with inappropriate laughter, microcephaly, speech difficulties, seizures, and movement disorders. AS can be diagnosed clinically and confirmed with genetic testing. In this case report, the patient presented with 9.3% weight loss at two days of age. Although there were multiple attempts at lactational counseling and nutritional guidance, the patient was admitted to the hospital due to failure to thrive. Due to continued global developmental delay and upper and lower extremities hypotonia by the age of nine months, the patient was referred to a neurologist. Brain MRI was negative, and genetic testing revealed 15q11.2q13.1 deletion, which is consistent with AS. Through different therapies and intervention, the patient showed slow improvements in symptoms. This case illustrates the importance of early recognition of nonspecific clinical manifestations of AS. The general management for all AS patients includes physical therapy, speech therapy, mobility support devices, education, and behavioral therapy as they progress through life. Establishing an early diagnosis has potential long-term benefits of improved quality of life and outcomes for patients via early interventions such as physical therapy starting at the age of six months to improve gross motor function. When infants present with nonspecific clinical presentations such as failure to thrive and hypotonia, clinicians should maintain a lower threshold for suspecting genetic conditions, which will facilitate early diagnosis of AS.
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Background Monitoring children's acquisition of developmental milestones is integral to pediatric practice. Though pediatricians are responsible for evaluating children's development, parents have a crucial role in addressing delays as early as possible, where early detection of developmental delay can help in early intervention and ultimately potentiate a child's cognitive and social abilities toward an independent life. This study assesses parental knowledge of the warning signs denoting delayed developmental milestone acquisition, in addition to analyzing demographic variables that may influence their level of knowledge. Methods This cross-sectional study included 376 parents of children attending pediatric clinics in National Guard Health Affairs- King Abdulaziz Medical City, in Jeddah, Saudi Arabia. A two-section structured questionnaire was utilized. It included 16 option-based questions with one correct answer, while the other options were either an under or overestimate of the age at which the child should acquire a particularly significant milestone development across different domains. A score of 10 out of 16 was chosen as the minimum to show the appropriate level of knowledge. Results Most participants (n=282; 75%) were women, and 174 (46.27%) were between 29 and 39 years old. The highest reported level of education was college or higher (n=214; 56.91%). Only 41 (11%) parents had the required level of knowledge, while the remaining 335 (89%) fell short of meeting the passing level (mean 6.59, SD= 2.72). The motor domain had the highest level of accuracy, followed closely behind the cognitive domain. The language and social domains exhibited lower levels of accuracy. Conclusions Despite the majority of parents in this group possessing a college education and availing multiple health resources, there is a significant gap in their knowledge of typical trajectories of development milestones. Thus, there is a need for a nationwide initiative to promote the parent's proactive role in monitoring their children's growth.
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Cereal forages, such as triticale forage, progressively gain interest as alternative crop for maize. The main study objective was to investigate the variation in potential feeding value of triticale forage among maturity stage, growing season and genotype, using total plant and stem fractions. Therefore, near infrared spectroscopy (NIRS) was evaluated as fast screening tool. The prediction ability was good (ratio of prediction to deviation, RPD ≥3.0) for total plant residual moisture, starch, sugars and for stem crude ash (CAsh) and neutral detergent fibre (aNDFom); suitable for screening (2.0 ≤ RPD <3.0) for total plant CAsh, acid detergent fibre (ADFom), in vitro digestibility of organic matter (IVOMD), in vitro digestibility of neutral detergent fibre (IVNDFD) and for stem total lignin (TL) and IVNDFD; poor (1.5 ≤ RPD <2.0) for total plant crude protein, crude fat, aNDFom, lignin (sa) and for stem Klason lignin (KL); unreliable (RPD <1.5) for stem residual moisture and acid soluble lignin (ASL). The evolution in potential feeding value of 36 genotypes harvested at the medium and late milk to the early, soft and hard dough stage was followed. The most important changes occurred between the late milk and early dough stage, with little variation in quality after the soft dough stage. During 2 growing seasons, variation in feeding value of 120 genotypes harvested at the soft dough stage was demonstrated. Interestingly, variation in stem IVNDFD is almost twice as high as for the total plant (CV 12.4% versus 6.6%). Furthermore, Spearman correlations show no link between dry matter yield and digestibility of genotypes harvested at the soft dough stage. Based on linear regression models ADFom appears as main predictor of both plant IVOMD and plant IVNDFD. Stem IVNDFD is particularly determined by KL.
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Purpose: To compare the quality of life (QoL) in patients with glaucoma on medical therapy and after trabeculectomy and glaucoma drainage device (GDD) using vision, glaucoma, and surgery-specific questionnaires. Methods: This cross-sectional study enrolled 30 patients of moderate to severe glaucoma, each in medical, trabeculectomy, and GDD groups. National Eye Institute Visual Function Questionnaire 25 (NEIVFQ-25), Glaucoma Quality of Life (GQL-15), and Surgery Specific Questionnaire (SSQ) were administered, and cumulative scores were compared. Results: The mean age of the participants was 58.95 ± 13.6 years with a male preponderance (73.3%, n = 66). The mean scores (SD) in the medical, trabeculectomy, and GDD groups using NEIVFQ-25 were 68.97 (6.98), 72.83 (7.81), and 75.20 (8.77), respectively, those using GQL-15 were 20.63 (6.00), 26.23 (9.12), and 28.43 (7.74), respectively, and for the SSQ, they were 74.33 (8.75) and 72.10 (5.92) in trabeculectomy and GDD groups, respectively. NEIVFQ-25 showed a better QoL in the GDD group compared to the medical group, whereas GQL-15 showed a better QoL in the medical group and comparable QoL in trabeculectomy and GDD. Both these QoL scores correlated to the LogMAR visual acuity. SSQ scores did not show a significant difference in the QoL across both surgical groups. Conclusion: NEIVFQ-25 questionnaire scores provided a holistic measure of QoL. GQL-15 assessed the activity limitation and visual disability of the patients but did not take into account the general health and psychological factors influencing the QoL. We did not find a significant difference between trabeculectomy and GDD using the SSQ. For QoL assessment in medically or surgically treated glaucoma, vision-specific and disease-specific questionnaires should always be used in conjunction.
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Implantes para Drenagem de Glaucoma , Glaucoma , Trabeculectomia , Humanos , Masculino , Pessoa de Meia-Idade , Idoso , Qualidade de Vida , Estudos Transversais , Glaucoma/cirurgiaRESUMO
Epidemics represent a threat to human life and economy. Meanwhile, medical and non-medical approaches to fight against them may result in additional economic shocks. In this paper, we examine the economic impact of the 2003 SARS outbreak in China and associated government policies. Although the epidemic caused a substantial economic loss in the short term, the interventions for medical purposes positively impacted the economy of the severely affected regions through the increase in investments such as other fiscal stimuli. There is strong and robust evidence suggesting that the SARS epidemic and its associated countermeasure policies boosted local output by around 4% and industrial production by around 5%. The positive growth was mainly derived from the increase in investment and government activity, especially government expenditure. Besides that, lagged impacts were particularly pronounced to the economic system and lasted for longer even than the epidemic period in a biological sense. We attribute this to the relatively aggressive stance of policymakers in the face of the epidemic situation.
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Epidemias , Síndrome Respiratória Aguda Grave , Humanos , Síndrome Respiratória Aguda Grave/epidemiologia , Surtos de Doenças , China/epidemiologia , Governo , Desenvolvimento EconômicoRESUMO
The eyeWatchTM is a new glaucoma drainage device that includes an adjustable mechanism that can vary the resistance to aqueous humor outflow during the postoperative period to reduce the burden of postoperative intraocular pressure (IOP) management. The mechanism contains a magnetic rotor that can be adjusted using an external magnetic control unit. Adjustments of the position of the rotor are performed mostly in the initial postoperative follow-up period in order to reach the target IOP. However, for some patients, it might be necessary to perform MRI for the sake of medical investigations. As the MRI is creating a strong magnetic field, this magnetic field is likely to interact with the adjustable rotor of the eyeWatchTM, resulting in modification of the IOP. We report the case of an 82-old female patient successfully operated with the implantation of an eyeWatchTM. The patient underwent a cerebral MRI for persistent headache. Shortly after the MRI procedure, the patient was checked at the eye clinic to assess the position of the rotor and to measure the IOP. The eyeWatchTM was readjusted to the former position set before undergoing the MRI. No complications were reported in the follow-up after MRI. This case demonstrates that MRI examinations can be safely performed after glaucoma surgery using an eyeWatchTM without compromising on the quality of the imaging or the stability of the IOP. This is a complication-free procedure that only requires checking the new position of the rotor and re-adjusting the implant, if necessary, to achieve the target IOP.