RESUMO
BACKGROUND: A systematic review and network meta-analysis was undertaken to examine the effectiveness of different modes of resistance exercise velocity in fast walking speed, timed-up and go, 5-times sit-to-stand, 30-second sit-to-stand, and 6-minute walking tests in older adults. METHODS: CINAHL, Embase, LILACS, PubMed, Scielo, SPORTDiscus, and Web of Science databases were searched up to February 2022. Eligible randomized trials examined the effects of supervised high-velocity or traditional resistance exercise in older adults (ie, ≥60 years). The primary outcome for this review was physical function measured by fast walking speed, timed-up and go, 5-times sit-to-stand, 30-second sit-to-stand, and 6-minute walking tests, while maximal muscle power and muscle strength were secondary. A random-effects network meta-analysis was undertaken to examine the effects of different resistance exercise interventions. RESULTS: Eighty articles describing 79 trials (nâ =â 3 575) were included. High-velocity resistance exercise was the most effective for improving fast walking speed (standardized mean difference [SMD] -0.44, 95% confidence interval [CI]: 0.00 to 0.87), timed-up and go (SMD -0.76, 95% CI: -1.05 to -0.47), and 5-times sit-to-stand (SMD -0.74, 95% CI: -1.20 to -0.27), while traditional resistance exercise was the most effective for 30-second sit-to-stand (SMD 1.01, 95% CI: 0.68 to 1.34) and 6-minute walking (SMD 0.68, 95% CI: 0.34 to 1.03). CONCLUSION: Our study provides evidence that resistance exercise velocity effects are specific in older adults, as evidenced by physical function test dependence. We suggest that prescriptions based on the velocity of contraction should be individualized to address the specific functional needs of participants.
Assuntos
Treinamento Resistido , Humanos , Idoso , Metanálise em Rede , Exercício Físico , Terapia por Exercício , Caminhada , Força Muscular/fisiologiaRESUMO
PURPOSE: This study aimed to analyze whether the effects of resistance exercise on whole-body fat and lean mass are moderated by exercise dosage (i.e., duration, volume, and intensity), age, body mass index, baseline values, assessment methods, and prescription of aerobic exercise and caloric restriction in overweight/obese adults. METHODS: A systematic search was undertaken in 11 databases from inception to December 2020, with an updated search undertaken in April 2022. Eligible randomized controlled trials examined the effects of resistance-based exercise programs on whole-body fat mass and lean mass in adults who were overweight or obese. Meta-analysis was undertaken with a random-effects model. Associations between mean differences and potential moderators were tested by meta-regression models. RESULTS: Sixty-seven articles describing 65 trials ( n = 2537) were included. Resistance-based exercise programs resulted in a significant change of -1.6 kg (95% confidence interval [CI] = -1.9 to -1.3 kg, P < 0.001) in whole-body fat mass and +0.8 kg (95% CI = 0.6 to 0.9 kg, P < 0.001) in lean mass. Male participants experienced greater effects than females ( P < 0.001), whereas those presenting with higher levels of fat mass at baseline experienced greater reductions in this outcome ( P = 0.084). For lean mass, younger adults experienced greater improvements compared with older participants ( P = 0.009), whereas programs comprising resistance exercise and caloric restriction resulted in significant reductions in lean mass ( P = 0.035). Resistance exercise dosage or prescription of aerobic exercise was not associated with change in these outcomes. CONCLUSIONS: Resistance-based programs improve body composition regardless of the resistance exercise dosage or aerobic component prescribed in adults who are overweight or obese. In addition, subgroups based on demographic characteristics, baseline levels, and presence of caloric restriction may present with more favorable responses in body composition.
Assuntos
Sobrepeso , Treinamento Resistido , Adulto , Composição Corporal , Índice de Massa Corporal , Feminino , Humanos , Masculino , Obesidade/terapia , Sobrepeso/terapia , Treinamento Resistido/métodosRESUMO
To systematically review and analyze the effects of resistance-based exercise programs on body composition, regional adiposity, and body weight in individuals with overweight/obesity across the lifespan. Using PRISMA guidelines, randomized controlled trials were searched in nine electronic databases up to December 2020. Meta-analyses were performed using random-effects model. One-hundred sixteen articles describing 114 trials (n = 4184 participants) were included. Interventions involving resistance training and caloric restriction were the most effective for reducing body fat percentage (ES = -3.8%, 95% CI: -4.7 to -2.9%, p < 0.001) and whole-body fat mass (ES = -5.3 kg, 95% CI: -7.2 to -3.5 kg, p < 0.001) compared with groups without intervention. Significant results were also observed following combined resistance and aerobic exercise (ES = -2.3% and -1.4 kg, p < 0.001) and resistance training alone (ES = -1.6% and -1.0 kg, p < 0.001) compared with no training controls. Resistance training alone was the most effective for increasing lean mass compared with no training controls (ES = 0.8 kg, 95% CI: 0.6 to 1.0 kg, p < 0.001), whereas lean mass was maintained following interventions involving resistance training and caloric restriction (ES = ~ - 0.3 kg, p = 0.550-0.727). Results were consistently observed across age and sex groups (p = 0.001-0.011). Reductions in regional adiposity and body weight measures were also observed following combined resistance and aerobic exercise and programs including caloric restriction (p < 0.001). In conclusion, this study provides evidence that resistance-based exercise programs are effective and should be considered within any multicomponent therapy program when caloric restriction is utilized in individuals with overweight or obesity.
Assuntos
Sobrepeso , Treinamento Resistido , Composição Corporal , Índice de Massa Corporal , Peso Corporal , Humanos , Longevidade , Obesidade/terapia , Sobrepeso/terapiaRESUMO
OBJECTIVE: To ascertain the presence of the Th2 response in MS patients by evaluating the level of soluble (s) CD30 across the clinical spectrum of MS and during relapse and remission. BACKGROUND: MS is considered a T-cell-mediated disorder with the immune attack dominated by a Thl cytokine response. Elevated levels of sCD30 have been associated with CD4+ cells that secrete Th2-type cytokines. METHODS: Levels of sCD30 were determined in the serum and CSF of patients with primary progressive MS, secondary progressive MS, relapsing-remitting MS (RRMS), both in relapse and remission, and in patients with other inflammatory neurologic disease (IND) and noninflammatory neurologic disease (NIND). None of the patients were on immunomodulatory treatment. RESULTS: Higher serum levels of sCD30 were detected in all MS subgroups and IND patients compared with NIND patients. RRMS patients in remission had significantly higher levels than those in relapse (median, 45.7 U/mL versus 18.3 U/mL; p = 0.04). Significantly higher CSF levels were also found in all groups, except those with RRMS in relapse compared with NIND patients. Again, RRMS patients in remission had higher CSF sCD30 levels compared with those in relapse (median, 4.0 U/mL versus 3.0 U/mL; p = 0.08). CONCLUSIONS: Serum and CSF levels of sCD30 are increased in MS, particularly during remission. The results provide additional evidence for the presence of a Th2 response and indicate that sCD30 may be of value as a marker of lesion resolution.
Assuntos
Antígeno Ki-1/sangue , Antígeno Ki-1/líquido cefalorraquidiano , Esclerose Múltipla/sangue , Esclerose Múltipla/líquido cefalorraquidiano , Biomarcadores , Humanos , Imunoglobulina G/sangue , Antígeno Ki-1/imunologia , Esclerose Múltipla/imunologia , Remissão Espontânea , Solubilidade , Células Th2/imunologiaRESUMO
Activated cerebral vascular endothelial cells express leukocyte, vascular cell, and intracellular adhesion molecules (E-selectin, VCAM-1 and ICAM-1) which facilitate leukocyte adhesion to endothelium and migration into inflammatory lesions. Paired serum and cerebrospinal fluid (CSF) levels of soluble (s) E-selectin, sVCAM-1 and sICAM-1 were determined by ELISA in patients with clinically definite MS in relapse, and patients with other inflammatory (IND) and non-inflammatory neurological disease (NIND). CSF levels of sVCAM-1 and sICAM-1 were significantly increased in MS patients compared to IND and NIND patients. Elevation of CSF sVCAM-1 in MS patients was the most marked finding (P = 0.0001) and an increased sVCAM-1 index indicated that this was due to intrathecal release of sVCAM-1. There were no differences in serum and CSF sE-selectin levels between the study groups. Measurement of the sVCAM-1 index may provide a marker of disease activity in patients with clinically definite MS.
Assuntos
Moléculas de Adesão Celular/sangue , Moléculas de Adesão Celular/líquido cefalorraquidiano , Esclerose Múltipla/sangue , Esclerose Múltipla/líquido cefalorraquidiano , Biomarcadores/análise , Selectina E/sangue , Selectina E/líquido cefalorraquidiano , Feminino , Humanos , Imunoglobulina G/sangue , Imunoglobulina G/líquido cefalorraquidiano , Imunoglobulinas/sangue , Imunoglobulinas/líquido cefalorraquidiano , Inflamação/fisiopatologia , Molécula 1 de Adesão Intercelular/sangue , Molécula 1 de Adesão Intercelular/líquido cefalorraquidiano , Doenças do Sistema Nervoso/sangue , Doenças do Sistema Nervoso/líquido cefalorraquidiano , Bandas Oligoclonais , Solubilidade , Estatísticas não Paramétricas , Molécula 1 de Adesão de Célula Vascular/líquido cefalorraquidianoRESUMO
Endothelial activation is considered an important step in multiple sclerosis (MS) lesion formation, elevated cerebrospinal fluid (CSF) and serum levels of certain adhesion molecules being associated with varying stages of disease activity and clinical course. CSF and serum sVCAM-1, sICAM-1, sE-selectin and sL-selectin were measured by ELISA in 16 primary progressive (PPMS), 16 secondary progressive (SPMS) and 43 relapsing-remitting MS patients (RRMS) and compared with 20 inflammatory (IND) and 46 non-inflammatory neurological disease (NIND) controls. CSF sVCAM-1 and sICAM-1 were increased in all MS groups vs. NIND with no significant differences between the MS groups. CSF sE-selectin (p = 0.007) and the sE-selectin index (p = 0.01) were elevated in PPMS vs. RRMS in relapse, whilst serum sE-selectin was significantly raised in PPMS compared to RRMS in remission (p = 0.005), RRMS in relapse (p = 0.004), NIND (p = 0.03) and IND (p = 0.05). Adhesion molecule levels in both progressive MS groups were similar. These results provide evidence for a distinct inflammatory component in PPMS and for immunological heterogeneity between the clinical subgroups of MS.
Assuntos
Selectina E/líquido cefalorraquidiano , Molécula 1 de Adesão Intercelular/líquido cefalorraquidiano , Selectina L/líquido cefalorraquidiano , Esclerose Múltipla/líquido cefalorraquidiano , Molécula 1 de Adesão de Célula Vascular/líquido cefalorraquidiano , HumanosRESUMO
AIMS: To assess changes in indicators of nutrition and iron deficiency as possible non-invasive markers of mucosal recovery in patients with coeliac disease on a gluten free diet. METHODS: Concentrations of transthyretin, retinol binding protein, soluble transferrin receptor, IgA anti-gliadin, and IgA anti-transglutaminase, and titres of IgA anti-endomysial antibody were measured in 36 newly diagnosed adult patients with coeliac disease and duodenal villous atrophy before (T0) and after one year (T1) on a gluten free diet. Duodenal biopsies taken at T0 and T1 were compared and graded as no improvement (no change in initial grade of villous atrophy) or improvement. RESULTS: Twenty two patients showed histological improvement and 14 showed no improvement. Transthyretin values increased in all patients with mucosal improvement and decreased in all patients showing no improvement. However, transthyretin values did not correlate with the degree of villous atrophy at T0 and T1 when assessed separately. Changes in retinol binding protein and soluble transferrin receptor values did not correlate with mucosal improvement. Coeliac disease associated antibodies (to gliadin, endomysium, and transglutaminase) decreased in most patients between T0 and T1, irrespective of mucosal recovery. CONCLUSIONS: Serial but not single measurements of transthyretin may be used as a non-invasive test to monitor mucosal recovery and therefore reduce the need for, or frequency of, follow up biopsies in treated patients with coeliac disease.
Assuntos
Doença Celíaca/dietoterapia , Mucosa Gástrica/metabolismo , Pré-Albumina/análise , Adulto , Idoso , Análise de Variância , Atrofia/metabolismo , Autoanticorpos/sangue , Biomarcadores , Biópsia , Estudos de Casos e Controles , Doença Celíaca/metabolismo , Doença Celíaca/patologia , Ensaio de Imunoadsorção Enzimática , Feminino , Técnica Indireta de Fluorescência para Anticorpo , Mucosa Gástrica/patologia , Gliadina/imunologia , Humanos , Imunoglobulina A/imunologia , Masculino , Pessoa de Meia-Idade , Receptores da Transferrina/sangue , Proteínas de Ligação ao Retinol/análise , Estatísticas não Paramétricas , Transglutaminases/imunologia , Resultado do TratamentoRESUMO
AIMS: To determine the clinical performance of three cerebrospinal fluid (CSF) IgG synthesis formulae using data obtained from two quantitation methods. METHODS: Receiver operator characteristic (ROC) analysis and decision index plots were used to compare a rate nephelometric (RN) and a rocket immunoelectrophoretic (RIEP) method for quantitating albumin and IgG for use in CSF IgG synthesis formulae. Further analysis was used to determine the most clinically accurate of these formulae for a diagnosis of multiple sclerosis with regard to technical accuracy and cost effectiveness. RESULTS: Values for albumin and IgG determined by RN gave better sensitivities and specificities than the RIEP method when applied to all three formulae; however, when the 95% confidence limits were considered, the difference was not significant. Using the RN method with an agreed "rule in" threshold value of 90% specificity, the IgG index gave the best clinical performance. CONCLUSION: ROC curve analysis and decision index plots provide valuable tools in assessing and comparing the clinical performance of new and existing laboratory assays.
Assuntos
Imunoglobulina G/biossíntese , Esclerose Múltipla/imunologia , Curva ROC , Albuminas/análise , Estudos de Avaliação como Assunto , Humanos , Imunoeletroforese , Imunoglobulina G/líquido cefalorraquidiano , Esclerose Múltipla/líquido cefalorraquidiano , Nefelometria e Turbidimetria , Sensibilidade e EspecificidadeRESUMO
AIM: To determine the effect of low to moderate levels of smoking and alcohol consumption on immunoglobulin concentrations. METHODS: Serum samples from 1787 subjects with approximately equal numbers in each five year group from 15 to 64 years were obtained from a large random population survey in Northern Ireland. Details were available on each subject concerning the number of units of alcohol consumed per week and the number of cigarettes smoked per day. IgG, IgM, and IgA concentrations were measured by laser nephelometry on all serum samples. RESULTS: Low to moderate consumption of alcohol was associated with a decrease in IgG and IgM median concentrations in contrast to an increase in IgA median concentrations. The decrease in IgM and especially IgG median concentrations appeared to be related to the smoking habits of the subjects. Alcohol consumption alone was associated with increased IgA median concentrations whereas cigarette smoking alone was associated with reduced IgG median concentrations. CONCLUSION: Low levels of alcohol consumption and cigarette smoking influence IgG, IgM, and IgA serum concentrations. This should be borne in mind when selecting subjects for use in research and clinical settings.
Assuntos
Consumo de Bebidas Alcoólicas/imunologia , Imunoglobulinas/sangue , Fumar/imunologia , Adolescente , Adulto , Feminino , Humanos , Imunoglobulina A/sangue , Imunoglobulina G/sangue , Imunoglobulina M/sangue , Masculino , Pessoa de Meia-Idade , Valores de Referência , Fatores de TempoRESUMO
Leucocyte invasion into the central nervous system in multiple sclerosis (MS) is complex, involving T-cell/endothelium interaction dependent upon initial adhesion mediated by molecules such as E-selectin, L-selectin, intracellular adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule-(VCAM-1). Circulating levels of these can be measured by sensitive enzyme-linked immunoassay (ELISA) techniques. To assess whether serum concentrations of soluble adhesion molecules vary across the spectrum of patients with relapsing-remitting (RR), secondary progressive (SP) and primary progressive (PP) MS, we measured circulating levels of soluble (s)E-selectin, sL-selectin, sICAM-1 and sVCAM-1 in serum obtained from 78 PPMS patients, 71 patients with RRMS, 65 patients with SPMS and 66 patients with other neurological disease using commercially available ELISA systems. Levels of serum sVCAM-1 were significantly elevated in PPMS compared with RRMS in remission (P = 0.0001) and in relapse (P = 0.0001), whilst sICAM-1 was significantly elevated in PPMS compared with all other MS groups (vs SPMS, P = 0.006; vs RRMS in relapse, P = 0.003; vs RRMS in remission, P = 0.0001). Serum sE-selectin levels were significantly higher in PPMS compared with all other groups except inflammatory neurological disease (IND) [vs SPMS, P = 0.029; vs RRMS in relapse, P = 0.002; vs RRMS in remission, P = 0.001; vs non-inflammatory neurological disease (NIND), P = 0.002; vs IND, P = 0.076]. In PPMS there was no correlation between levels of any adhesion molecule and disability or disease duration. These results provide evidence for significant immunological heterogeneity in MS and suggest that different leucocyte/endothelial cell interactions may be active in various MS subgroups. It also challenges the hypothesis that PPMS is a less inflammatory form of the disease.
Assuntos
Selectina E/sangue , Molécula 1 de Adesão Intercelular/sangue , Esclerose Múltipla/sangue , Molécula 1 de Adesão de Célula Vascular/sangue , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores , Barreira Hematoencefálica , Quimiotaxia de Leucócito , Progressão da Doença , Ensaio de Imunoadsorção Enzimática , Estudos de Avaliação como Assunto , Feminino , Humanos , Inflamação , Selectina L , Masculino , Transtornos Mentais/sangue , Pessoa de Meia-Idade , Doenças do Sistema Nervoso/sangueRESUMO
PURPOSE: To report two patients in their seventh decade who exhibited findings consistent with multiple evanescent white dot syndrome. METHODS: Case reports of two patients referred for evaluation of decreased vision, visual field loss, and retinal white spots. RESULTS: A 60-year-old man and a 67-year-old woman had photopsia, visual field loss, and decreased central visual acuity. Examination disclosed numerous white retinal spots, ranging from 50 to 400 microm, with eventual foveal granularity. Visual field testing showed an enlarged blind spot and peripheral field defects. Fluorescein angiography, electroretinography, and electrooculography results were consistent with multiple evanescent white dot syndrome. Eventually, the retinal lesions resolved in both patients and baseline visual acuity was recovered. CONCLUSION: A diagnosis of multiple evanescent white dot syndrome should be considered in patients with retinal findings typical of multiple evanescent white dot syndrome, regardless of age.
Assuntos
Doenças Retinianas/complicações , Idoso , Eletroculografia , Eletrorretinografia , Feminino , Angiofluoresceinografia , Fundo de Olho , Humanos , Masculino , Pessoa de Meia-Idade , Doenças Retinianas/diagnóstico , Síndrome , Acuidade Visual , Campos VisuaisRESUMO
PURPOSE: To evaluate the complications of laser-induced chorioretinal venous anastomosis in nonischemic central retinal vein occlusion (CRVO) and to identify the associated risks. METHODS: A retrospective consecutive series of 91 eyes (91 patients) with nonischemic CRVO with a mean +/- SD duration of 15.0 +/- 15.2 weeks (range, 3 to 72 weeks )and corrected visual acuity reduced to 20/100 or less because of perfused macular edema were reviewed. All eyes had one or more anastomotic attempts using argon laser (combined with Nd-YAG laser in 46 eyes) and a minimum of 12 months of follow-up. RESULTS: Successful chorioretinal venous anastomoses were created in 49 eyes (54%). Eighteen eyes (20%) had neovascular complications. These consisted of intravitreal, intraretinal, and subretinal neovascular membranes and were significantly associated with retinal ischemia (P < .001). There was avascular fibrous tissue proliferation at the anastomotic site in eight eyes (9%), and it was not associated with retinal ischemia (P = .727). No eye developed further capillary nonperfusion once an anastomosis became functional. A chorioretinal venous anastomosis was associated with improved vision (P < .001); 84% of eyes had an average +/- SD improvement of 4.3 +/- 3.8 lines (range, 2 to 20 lines), with the remaining 16% having no improvement or reduced vision. CONCLUSION: The major vision-threatening complication of laser-induced chorioretinal venous anastomosis for nonischemic CRVO is neovascular membranes occurring at the anastomotic site; these are associated with retinal ischemia. Prompt laser photocoagulation to areas of retinal ischemia that develop after the anastomotic attempt has been made may reduce the risk and severity of this complication.
Assuntos
Corioide/irrigação sanguínea , Terapia a Laser/efeitos adversos , Complicações Pós-Operatórias , Oclusão da Veia Retiniana/cirurgia , Veia Retiniana/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Anastomose Cirúrgica , Corioide/patologia , Corioide/cirurgia , Feminino , Angiofluoresceinografia , Seguimentos , Humanos , Isquemia/etiologia , Isquemia/patologia , Isquemia/cirurgia , Fotocoagulação a Laser , Masculino , Pessoa de Meia-Idade , Neovascularização Retiniana/etiologia , Neovascularização Retiniana/patologia , Neovascularização Retiniana/cirurgia , Veia Retiniana/patologia , Oclusão da Veia Retiniana/patologia , Estudos Retrospectivos , Fatores de Risco , Acuidade VisualRESUMO
Giant papillary conjunctivitis (GPC) is an external ocular inflammatory disorder associated with contact lens wear. GPC seems to occur less frequently with hard than with soft contact lens wear. The management of soft contact lens related GPC has included refitting with hard lenses, specifically the newer rigid gas permeable (RGP) lenses. We retrospectively studied 14 RGP lens wearers in whom GPC developed. Three patients had had GPC associated with soft contact lens wear and had been fitted with RGP lenses in an effort to restore contact lens tolerance. The interval of time between the initiation of RGP lens wear and the onset of GPC was inversely related to the lens oxygen transmissibility (DK value). Ophthalmologists should be aware of the association between GPC and rigid gas permeable lens wear.
Assuntos
Conjuntivite Alérgica/etiologia , Lentes de Contato/efeitos adversos , Adolescente , Adulto , Lentes de Contato Hidrofílicas/efeitos adversos , Feminino , Humanos , Masculino , Metilmetacrilatos/efeitos adversos , Pessoa de Meia-Idade , Fatores de RiscoRESUMO
In many clinical situations, the standard for evaluating extraocular muscle (EOM) size, particularly in thyroid ophthalmopathy, has been use of the computerized tomography (CT) scanner. The impression is generally reported as "enlarged or normal EOMs." If the report of "normal EOM" on CT scan weighs heavily against the diagnosis of thyroid eye disease, how does this qualitative assessment compare with the diagnostic modality of ultrasound? The technique of standardized A-scan measurement of extraocular muscles has been extremely accurate. In this paper, standardized A-scan measurements and CT scan estimates of EOMs are compared in a series of ten patients with a clinical diagnosis of Graves' disease. Three of ten patients displayed enlarged EOMs by CT interpretations; seven of ten patients were categorized as consistent with Graves' disease by correlation with current ultrasonographic criteria for muscle enlargement, asymmetry, and high irregularity of tissue reflectivity.
Assuntos
Músculos Oculomotores/patologia , Tomografia Computadorizada por Raios X , Ultrassonografia , Exoftalmia/diagnóstico , Exoftalmia/diagnóstico por imagem , Doença de Graves/diagnóstico , Doença de Graves/diagnóstico por imagem , Humanos , Músculos Oculomotores/diagnóstico por imagem , Doenças Orbitárias/diagnóstico , Doenças Orbitárias/diagnóstico por imagemRESUMO
OBJECTIVES: Accumulating evidence indicates significant heterogeneity in MS and soluble (s) adhesion molecules are postulated as markers of disease activity. We sought to evaluate intrathecal production of these and other molecules across the clinical spectrum of MS. METHODS: CSF indices of IgG, sICAM-1, sVCAM-1, sE-selectin and sCD30 were calculated in 17 primary progressive (PPMS) patients, 15 secondary progressive patients (SPMS), 28 relapsing-remitting patients in relapse (RRMSR) and 14 RRMS patients in remission (RRMSNR) using commercially available ELISA kits. Patients had not received any immunomodulating therapy within the previous 6 months. MS patients were compared with 44 patients with non-inflammatory neurological diseases (NINDs). RESULTS: The most sensitive CSF index at a 90% level of specificity was for IgG which had 93% sensitivity in RRMSR and 92% sensitivity in RRMSNR. Corresponding sensitivity in PPMS and SPMS was 71% and 73% respectively. None of the other indices had sensitivity >50% apart from sVCAM-1 (64% in RRMSR and 52% RRMSNR) and sCD30 (53% in PPMS). CONCLUSIONS: Unsurprisingly the strongest association in MS was with the intrathecal production of IgG. Similar results in PPMS and SPMS may reflect comparable rates of progression in these 2 groups. Of the other molecules only intrathecal sVCAM-1 production is significantly associated with MS and only in relapsing-remitting disease.
Assuntos
Selectina E/líquido cefalorraquidiano , Imunoglobulina G/líquido cefalorraquidiano , Molécula 1 de Adesão Intercelular/líquido cefalorraquidiano , Antígeno Ki-1/líquido cefalorraquidiano , Esclerose Múltipla/líquido cefalorraquidiano , Molécula 1 de Adesão de Célula Vascular/líquido cefalorraquidiano , Biomarcadores/líquido cefalorraquidiano , Estudos de Casos e Controles , Ensaio de Imunoadsorção Enzimática , Feminino , Humanos , Masculino , Esclerose Múltipla/diagnóstico , Esclerose Múltipla/imunologia , Curva ROC , Sensibilidade e EspecificidadeRESUMO
Despite generalized consensus that pilocarpine-induced miosis results in some degree of visual field constriction, studies describing the predictability of this occurrence, as well as the nature of the field defects that may be seen, have not been undertaken. We studied 20 normal subjects, ranging in age from 24 to 57 years. Baseline refraction, pupillary measurements, and visual fields were performed in both eyes on a standardized Goldmann perimeter with the I-2e, I-3e, and I-4e test objects. Pilocarpine 2% was then instilled into the study eye and the field repeated at 30 and 120 minutes. An IBM PC computer program, designed by the authors, was used to calculate the area contained within each isopter. The probability of visual field constriction at 30 and 120 minutes after instillation of pilocarpine was found to be significant, especially with pupillary diameters of 2 mm or less. The I-2e isopter was most sensitive to miosis. Visual field constriction persisted with correction of ciliary spasm induced myopia, suggesting that miosis, especially when marked, can independently alter the visual field. The clinician, then, should make every effort to control visual field testing conditions in glaucoma patients on miotics to allow reliable serial comparisons.