Comparative evaluation of intraoperative aberrometry and Barrett’s toric calculator in toric intraocular lens implantation

Purpose: Barrett toric calculator (BTC) is known for its accuracy in toric IOL (tIOL) calculation over standard calculators; however, there is no study in literature to compare it with real?time intraoperative aberrometry (IA). The aim was to compare the accuracy of BTC and IA in predicting refractive outcomes in tIOL implantation. Methods: This was an institution?based prospective, observational study. Patients undergoing routine phacoemulsification with tIOL implantation were enrolled. Biometry was obtained from Lenstar?LS 900 and IOL power calculated using online BTC; however, IOL was implanted as per IA (Optiwave Refractive Analysis, ORA, Alcon) recommendation. Postoperative refractive astigmatism (RA) and spherical equivalent (SE) were recorded at one month, and respective prediction errors (PEs) were calculated using predicted refractive outcomes for both methods. The primary outcome measure was a comparison between mean PE with IA and BTC, and secondary outcome measures were uncorrected distance visual acuity (UCDVA), postoperative RA, and SE at one month. SPSS Version?21 was used; P < 0.05 considered significant. Results: Thirty eyes of 29 patients were included. Mean arithmetic and mean absolute PEs for RA were comparable between BTC (?0.70 ± 0.35D; 0.70 ± 0.34D) and IA (0.77 ± 0.32D; 0.80 ± 0.39D) (P = 0.09 and 0.09, respectively). Mean arithmetic PE for residual SE was significantly lower for BTC (?0.14 ± 0.32D) than IA (0.001 ± 0.33D) (?0.14 ± 0.32D; P = 0.002); however, there was no difference between respective mean absolute PEs (0.27 ± 0.21 D; 0.27 ± 0.18; P = 0.80). At one?month, mean UCDVA, RA, and SE were 0.09 ± 0.10D, ?0.57 ± 0.26D, and ?0.18 ± 0.27D, respectively. Conclusion: Both IA and BTC give reliable and comparable refractive results for tIOL implantation.

Intraoperative aberrometry versus preoperative biometry for intraocular lens power selection in patients with axial hyperopia

Purpose: This study was conducted to evaluate the accuracy of intraoperative aberrometry (IA) in intraocular lens (IOL) power calculation and compare it with conventional IOL formulas. Methods: This was a prospective case series. Eyes with visually significant cataract and axial hyperopia (AL <22.0 mm) underwent IA?assisted phacoemulsification with posterior chamber IOL (Alcon AcrySof IQ). Postoperative spherical equivalent (SE) was compared with predicted SE to calculate the outcomes with different formulas (SRK/T, Hoffer Q, Haigis, Holladay 2, Barrett Universal ? and Hill?RBF). Accuracy of intraoperative aberrometer was compared with other formulas in terms of mean absolute prediction error (MAE), percentage of patients within 0.5 D and 1 D of their target, and percentage of patients going into hyperopic shift. Results: Sixty?five eyes (57 patients) were included. In terms of MAE, both Hoffer Q (MAE = 0.30) and IA (MAE = 0.32) were significantly better than Haigis, SRK/T, and Barrett Universal ? (P < 0.05). Outcomes within ±0.5 D of the target were maximum with Hoffer Q (80%), superior to IA (Hoffer Q > IA > Holladay 2 > Hill?RBF > Haigis > SRK/T > Barrett Universal ?). Hoffer Q resulted in minimum hyperopic shift (30.76%) followed by Hill?RBF (38.46%), Holladay 2 (38.46%), Haigis (43.07%), and then IA (46.15%), SRK/T (50.76%) and Barrett Universal ? (53.84%). Conclusion: IA was more effective (statistically significant) in predicting IOL power than Haigis, SRK/T, and Barrett Universal ? although it was equivalent to Hoffer Q. Hoffer Q was superior to all formulas in terms of percentage of patients within 0.5 D of their target refractions and percentage of patients going into hyperopic shift

Plantas alimentícias não convencionais: revisão / Non-conventional food plants: review / Plantas alimenticias no convencionales: revisión

As plantas alimentícias não convencionais (PANCs) são hortaliças nativas, normalmente encontradas em calçadas ou terrenos abandonados, sempre fizeram parte do cardápio dos antepassados. No entanto, com a modernização da agricultura e do êxodo rural, seu consumo foi esquecido de ser repassado para as gerações futuras. O objetivo deste estudo consistiu em realizar um levantamento bibliográfico sobre as plantas alimentícias não convencionais (PANCs), sua importância na alimentação e farmacológica. A metodologia consistiu na realização de levantamento bibliográfico, com as principais plantas utilizadas como alimento pelos antepassados sendo as plantas Pereskia aculeata Miller, Basella alba, Sonchus oleraceus, Stachys byzantina, Taraxacum Officinale, Xanthosoma sagittifolium, Dioscorea bulbifera, Physalis angulata, Acmella oleracea, Tropaeolum majus. Através deste estudo pode-se constatar que estas plantas são úteis, pois além de apresentar valor nutricional e a sua utilização na alimentação, também são utilizadas como como plantas medicinais, devido à presença de compostos ativos responsáveis pela ação biológica.

Unconventional food plants (PANCs) are native vegetables, usually found on sidewalks or abandoned land, have always been part of the ancestors' menu. Nonetheless, with the modernization of agriculture and the rural exodus, its consumption was forgotten to be passed on to future generations. The objective of this study was to carry out a bibliographic survey on unconventional food plants (PANCs), their importance in food and pharmacology. The methodology consisted of carrying out a bibliographic survey, with the main plants used as food by the ancestors being the plants Pereskia aculeata Miller, Basella alba, Sonchus oleraceus, Stachys byzantina, Taraxacum Officinale, Xanthosoma sagittifolium, Dioscorea bulbifera, Physalis angulata, Acmella oleracea, Tropaeolum majus. Through this study it can be seen that these plants are useful, because in addition to presenting nutritional value and their use in food, they are also used as medicinal plants, due to the presence of active compounds responsible for biological action.

Las plantas alimenticias no convencionales (PANC, por sus siglas en inglés) son vegetales nativos, que generalmente se encuentran en las aceras o en terrenos abandonados, y siempre han sido parte del menú de los antepasados. Sin embargo, con la modernización de la agricultura y el éxodo rural, su consumo quedó en el olvido para pasar a las generaciones futuras. El objetivo de este estudio fue realizar un levantamiento bibliográfico sobre las plantas alimenticias no convencionales (PANCs), su importancia en la alimentación y farmacología. La metodología consistió en realizar un levantamiento bibliográfico, siendo las principales plantas utilizadas como alimento por los ancestros las plantas Pereskia aculeata Miller, Basella alba, Sonchus oleraceus, Stachys byzantina, Taraxacum Officinale, Xanthosoma sagittifolium, Dioscorea bulbifera, Physalis angulata, Acmella oleracea , Tropaeolum mayor. A través de este estudio se puede apreciar que estas plantas son útiles, pues además de presentar valor nutritivo y su uso en la alimentación, también son utilizadas como plantas medicinales, debido a la presencia de compuestos activos responsables de la acción biológica.

Corneal biomechanics and glaucoma beyond the bidirectional impact of intraocular pressure and corneal deformation response / Biomecânica corneana e glaucoma além do impacto bididirecional da pressão intraocular e da resposta da deformação corneana

ABSTRACT The purpose of this study was to highlight the impact of biomechanical corneal response in available in vivo tonometry methods for glaucoma management. Systematic review of non-contact air-puff tonometers that analyzes the corneal deformation response, with special focus on the investigation of the correlation of derived parameters with intraocular pressure measurements. The two actual and commercially available in vivo corneal tonometers provide promising information about biomechanical characteristics of the cornea and its relation to glaucoma, allowing the development of new protocols to evaluate, diagnose, and manage this disease.

RESUMO O objetivo deste estudo é destacar o impacto da resposta biomecânica corneana em métodos de tonometria in vivo disponíveis para o manejo do glaucoma. Trata-se de revisão sistemática de tonômetros de ar que analisa a resposta à deformação corneana, com foco especial na investigação da correlação dos parâmetros derivados com as medições da pressão intraocular. Os dois tonômetros mais recentes e comercialmente disponíveis fornecem informações promissoras sobre as características biomecânicas da córnea e sua relação com o glaucoma, permitindo o desenvolvimento de novos protocolos para avaliar, diagnosticar e controlar a doença.

Influence of different parts of cuttings and substrates on vegetative propagation of pereskia aculeata miller / Influência de diferentes partes de estacas e substratos na propagação vegetativa de Pereskia aculeata miller

Pereskia aculeta Miller, commonly know as ora-pro-nóbis in some regions of Brazil, is a plant stands out due to its high protein content, presenting great potential for use. There is na increasing interest in the use of ora-pro-nóbis as raw material by the food industry like as concentrate form (deydrated and ground) or for direct consumption as leafy vegeTables by the population. So, is important to know the best way to propagate this specie. This study was carried out to evaluate the influence of cutting position from stem and the substrate type under growth and development of ora-pro-nóbis during seedlings production. For incresing the seedlings production to supply the demand and the lack scientific studies on this theme, this study is important to development research to vegetative propagation and substrate to produce ora-pro-nóbis seedlings. For vegetative propagation three types of cutting were used: apical, median and from the basal part of the stem. The cuttings were planted in four types of substrate: S1 = soil; S2 = soil + clean sand (1:1); S3 = soil + clean sand + cattle manure (2:1:1) and S4 = Bioplant® commercial substrate. Sixty days after the experiment was set up, the cuttings were examined considering: the Soil Plant Analysis Development (SPAD) index, the number of leaves, the number of shoots, root length, and dry and fresh mass from the root and from the aerial part. The physiological maturation of the stem and the tested substrate type showed differences on the quality of the cutting. The cutting originated from the basal and medium part harvested from the branch of the year and the substrate soil + sand + manure allowed the best growth and development of the ora-pro-nóbis seedlings

Pereskia aculeta Miller, comumente chamada de ora-pro-nóbis em algumas regiões do Brasil, é uma planta que se destaca pelo seu alto teor de proteínas, com grande potencial de uso. Observa-se o crescente interesse pelo uso de ora-pro-nóbis como matéria-prima pela indústria alimentícia na forma de concentrado (desidratado e moído), e da popularização do consumo direto como hortaliça folhosa pela população, diante disto é importante conhecer a melhor forma de propagação da espécie. Objetivou-se com este estudo analisar a influência da posição da estaca retirada do ramo, e o tipo de substrato, sobre o crescimento e desenvolvimento de ora-pro-nóbis durante a fase de produção de mudas. Com necessidade de um aumento deprodução de mudas para atender a demanda, e na ausência de trabalhos científicos sobre este assunto, econsiderando a necessidade de informações na literatura, torna-se necessário o desenvolvimento de pesquisas direcionadas para a propagação vegetativa e substrato para mudas de ora-pro-nóbis. Para a propagação vegetativa foram utilizadas três tipos de estacas: apicais, medianas e da parte basal do ramo. O plantio das estacas foi realizado em quatro tipos de substratos: S1= solo; S2= solo+areia lavada (1:1); S3= solo+areia lavada+esterco bovino curtido (2:1:1) e S4= substrato comercial Bioplant®. Após 60 dias a instalação do experimento, as mudas foram analisadas quanto ao: índice Soil Plant Analysis Development (SPAD), número de folhas, número de brotações, comprimento de raiz e massa da matéria fresca e seca da parte aérea e raiz. A maturação fisiológica do ramo e o tipo de substrato testado evidenciaram diferenças na qualidade de mudas de ora-pro-nóbis. A estaca oriunda da parte basal e mediana do ramo cultivada em solo+areia+esterco proporcionou melhor qualidade nas mudas de ora-pro-nóbis

Avaliação do teor de manganês em Pereskia grandfolia Haw / Evaluation of the manganese content in Pereskia grandfolia Haw

Pereskia grandfolia Haw, popularmente conhecida no Brasil como ora - pro - nobis, é considerada planta medicinal, classificada como uma hortaliça folhosa não convencional. É de fácil cultivo e propagação, de sabor agradável, rica em proteína. Pesquisas experimentais e clínicas têm reforçado a importância do manganês na saúde humana. O trabalho teve como objetivo avaliar a presença do micronutriente manganês nas folhas, no caule e nas flores da P. grandfolia Haw. A análise do mineral foi realizada utilizando espectrofotometria de absorção atômica acoplado a UV visível. Foi observado maior quantidade de manganês nas folhas da hortaliça (63,6 mg/kg). No caule 1,9 mg/Kg e nas flores não foi encontrado este mineral. Portanto, ora-pro-nobis pode complementar as necessidades diárias de manganês.

Avaliação do teor de zinco em Pereskia grandfolia Haw / Evaluation of the zinc content in Pereskia grandfolia Haw

A utilização de alimentos alternativos para o combate à fome na população de baixa renda é assunto que tem recebido atenção no Brasil nos últimos anos. O ora-pro-nobis (Pereskia grandfolia Haw), é uma planta de origem tropical de uso popular como alimento e medicinal, objeto de interesse na indústria alimentícia e farmacológica nos últimos anos, pelo alto teor de proteínas, lisina e mucilagem que apresenta. Estudos têm reforçado a importância do zinco na saúde humana. O trabalho teve como objetivo avaliar a presença do micronutriente zinco nas folhas, no caule e nas flores da Pereskia grandfolia Haw. A análise do mineral foi realizada utilizando espectrofotometria de absorção atômica acoplado a UV visível. Foi observado maior quantidade de zinco nas flores da hortaliça (24,8 mg/Kg). Nas folhas o resultado foi 23,8 mg/Kg e no caule 17,8 mg/Kg. Portanto, ora-pro-nobis pode complementar as necessidades diárias de zinco.

Anticoagulación oral en reintervenciones endovasculares de la aorta / Oral Anticoagulation in Endovascular Aortic Reinterventions

RESUMEN Introducción: La endofuga es la principal causa de reintervención después del tratamiento endovascular de aorta. Algunos pacientes necesitan anticoagulación oral prolongada, lo cual puede aumentar la incidencia de endofugas posoperatorias. Objetivos: Nuestro objetivo es determinar si la anticoagulación oral posoperatoria tiene impacto en la incidencia de endofugas. Material y métodos: Este análisis retrospectivo incluyó todos los pacientes con aneurisma de aorta abdominal tratados por vía endovascular entre 2009 y 2014 en nuestro centro. Se determinaron dos grupos de pacientes de acuerdo con la necesidad de anticoagulación oral y se comparó entre ambos grupos la mortalidad relacionada con la aorta; la supervivencia libre de reintervenciones, de cualquier endofuga y de endofugas no tipo II; supervivencia libre de un punto final compuesto por mortalidad relacionada con la aorta, reintervenciones y endofugas, y la reducción del diámetro del saco aneurismático. Resultados: De 341 pacientes tratados, 33 (9,67%) estaban anticoagulados. No hubo diferencias entre ambos grupos en términos de mortalidad relacionada con la aorta (2,59% vs. 3,03%, p = ns), supervivencia libre de reintervenciones (84,04% vs. 86,2%; p = ns), supervivencia libre de cualquier endofuga (82% vs. 89%; p = 0,81) o supervivencia libre de endofugas no tipo II (88% vs. 88%; p = 0,52). Al analizar la supervivencia libre del punto final compuesto tampoco se encontraron diferencias significativas (80% vs. 85%; p = ns). La reducción promedio del diámetro del saco aneurismático fue de 5,19 mm y 3,51 mm (p = 0,2). Conclusiones: No se registró diferencia en ninguno de los resultados analizados. La anticoagulación oral posoperatoria no tuvo impacto en los resultados del tratamiento endovascular de aorta.

ABSTRACT Introduction: Endoleak is the main cause for reintervention after endovascular aortic repair. Some patientis need prolonged oral anticoagulation, which may increase the incidence of postoperative endoleaks. Objectives: Our objective was to determine whether postoperative oral anticoagulation has an impact on the incidence of endoleaks. Methods: This retrospective analysis included all patientis with endovascular treatment of abdominal aortic aneurysm at our center between 2009 and 2014. Two groups of patientis were determined according to the need for oral anticoagulation. Aortic-related mortality, survival free from reinterventions, any endoleak and non-type II endoleaks, survival free of the composite endpoint of mortality associated with the aorta, reinterventions and endoleaks, and reduction of aneurysmal sac diameter was compared between both groups.Resultis: Among 341 treated patientis, 33 (9.67%) were anticoagulated. There were no differences between the two groups in terms of aorta-related mortality (2.59% vs. 3.03%, p=ns), reintervention-free survival (84.04% vs. 86.2%; p=ns), any endoleak- free survival (82% vs. 89%, p=0.81) or non-type II endoleak-free survival (88% vs. 88%, p=0.52). Similarly, no significant differences were found when analyzing the composite endpoint-free survival (80% vs. 85%, p=ns). The average reduction of aneurysmal sac diameter was 5.19 mm and 3.51 mm (p=0.2). Conclusions: No difference was registered in any of the resultis analyzed. Postoperative oral anticoagulation had no impact on the resultis of endovascular aortic treatment.

Una Aproximación Epidemiológica sobre Patologías Orales desde la Perspectiva de la Radiología / An Epidemiological Approach to Oral Pathologies from a Radiology Perspective

RESUMEN: La cavidad de oral es susceptible de alteraciones de diversa índole, que presentan patrones epidemiológicos variables. La caries y la enfermedad periodontal se reconocen como las de mayor prevalencia, pero sobre otras anormalidades que afectan a las estructuras óseas y los dientes se tienen menos datos. El objetivo del trabajo fue determinar la prevalencia de hallazgos radiográficos sugestivos de patología en 10,000 imágenes panorámicas digitales de adultos, obtenidas en diferentes centros de radiología en Bogotá. Se recolectaron radiografías de pacientes mayores de 18 años, de bajo grado de distorsión, con estructuras completas, y adecuado contraste y densidad que permitieran la lectura de las variables a estudiar. La mayoría de las radiografías pertenecen a pacientes de género femenino, y su promedio de edad es de 39 años. El edentulismo parcial es el hallazgo de mayor prevalencia afectando a un 61 % del grupo, seguido de la presencia de tratamientos de endodoncia con un 45 % y en tercer lugar las inclusiones dentales 24,1 %. Otros hallazgos corroboran que las lesiones apicales son las lesiones quísticas de mayor prevalencia y un aumento en la rehabilitación con prótesis fija e implantes. Este estudio refleja los efectos de la caries y la enfermedad periodontal que afectan a la población estudiada y su principal consecuencia el edentulismo parcial que afecta a todos los grupos de edad examinados. La endodoncia, sugerente de patología pulpar, también es de alta prevalencia y en gran porcentaje asociada a lesiones apicales, pero en general el estudio sugiere la necesidad de programas de prevención para el adulto, para cumplir con las metas de la Organización Mundial de la Salud con miras a disminuir la perdida de dientes.

ABSTRACT: The oral cavity is susceptible to alterations of diverse nature that present variable epidemiological patterns. Caries and periodontal disease are recognized as having the highest prevalence, but thereare less data on other abnormalities that affect bone structures and teeth. The objective of the study was to determine the prevalence of radiographic findings suggestive of pathology in 10,000 digital panoramic images of adults, obtained at different radiology centers in Bogotá. Radiographs were collected from patients over 18 years of age, with a low degree of distortion, with complete structures, and adequate contrast and density to allow the reading of the variables to be studied. Most of the radiographs belong to female patients, and their average age is 39 years. Partial edentulism is the most prevalent finding affecting 61 % of the group, followed by the presence of endodontic treatments with 45 % and thirdly the dental inclusions 24.1 %. Other findings corroborate that the apical lesions are the cystic lesions with a higher prevalence and an increase in rehabilitation with fixed prostheses and implants. This study reflects the effects of caries and periodontal disease that affect the population studied and its main consequence is the partial edentulism that affects all age groups examined. Endodontics, suggestive of pulpal pathology, is also of high prevalence and a large percentage associated with apical lesions, but in general the study suggests the need for adult prevention programs to meet the goals of the World Health Organization with a view to reducing tooth loss.

Comparación en la medición de presión intraocular con los tonómetros de Goldmann, Pascal® y ORA (Ocular Response Analyzer) / Intraocular pressure measurement with Goldmann, Pascal and ORA tonometers

Introducción: el glaucoma es la principal causa de ceguera irreversible en el mundo, siendo la presión intraocular alta el factor de riesgo más importante para desarrollarlo, por eso la importancia de realizar una adecuada medición de la presión intraocular (PIO) durante el examen oftalmológico. Objetivo: evaluar la concordancia de la medida de la presión intraocular tomada con los tonómetros de Goldmann, Pascal® y ORA, en pacientes con glaucoma de la consulta externa del servicio de oftalmología del Hospital de San José. Diseño: estudio descriptivo, de corte transversal y concordancia. Métodos: se compararon las medidas de Goldmann corregido, Pascal® y ORA corregido en 90 pacientes (167 ojos) con diagnóstico de glaucoma que asisten a consulta de oftalmología del Hospital de San José. Resultados: el coeficiente de correlación y concordancia de Lin entre Goldmann corregido y Pascal® es de 0.61; entre Goldmann corregido y ORA corregido de 0.64 y entre Pascal® y ORA corregido de 0.81. Conclusiones: se encontró una concordancia moderada para los tres tonómetros en la medición de la PIO en los ojos con glaucoma del servicio de oftalmología del Hospital de San José. Los tres métodos no son reemplazables, por lo tanto el seguimiento de los pacientes siempre debe ser tomado con un mismo método.

Introduction: glaucoma is the leading cause of worldwide irreversible blindness, high intraocular pressure remains the most important risk factor; because of that, it is essential to measure accurately the intraocular pressure (IOP). Objective: to evaluate the intraocular pressure correspondence of Goldmann-correlated IOP, Pascal® dynamic contour tonometer and Reichert Ocular Response Analyzer ORA tonometers in patients with glaucoma diagnosis at Ophthalmology Service, Hospital de San José. Design: a descriptive, cross-sectional and matching. Methods: measurements of Goldmann correlated IOP, Pascal® and ORA corneal compensated IOP were compared, in patients (167 eyes) diagnosed with glaucoma attending at ophthalmology Hospital San José. Results: the correlation coeffi cient and concordance Lin between Goldmann correlated IOP and Pascal® is 0.61; between ORA and Goldmann correlated IOP is 0.64 and between Pascal® and ORA is 0.81. Conclusions: we found a moderate agreement for the three tonometers for measuring IOP in eyes glaucoma attending at ophthalmology Hospital San José. The three methods are not replaceable, therefore monitoring of patients should always be taken with the same method.

Wound healing properties and mucilage content of Pereskia aculeata from different substrates

Physiologic growth parameters Wound healing Pereskia aculeata Mill., Cactaceae, is a cactus with high mucilage production, well-known for its nutritional properties. Folk use consists on skin injuries, and mucilage is probably involved in the wound healing activity. This work studied some aspects of its cultivation, specifically regarding soil (substrate), to correlate the effects of nutritional content to mucilage production and to the wound-healing property. Plants were grown under five different soil treatment (sand, crude soil, sand and soil, sand and cattle manure, soil and cattle manure), and after eight months extracts were prepared by turbo-extraction to obtain a crude hydroethanolic extract. We evaluated the effects of these extracts on swelling index, cytotoxicity, and in vitro wound healing property. The results show that the substrate used in cultivation may interfere with mucilage production, but not with cytotoxicity and wound healing, this shows the safety of its use, despite the soil treatment received along the various biomes where P. aculeata is cultivated. Furthermore, morphological studies demonstrated the beneficial effect of the mucilage-containing extract on the fibroblast cell culture, corroborating its folk use for wound healing.

Relevância da biomecânica da córnea no glaucoma / Relevancy of corneal biomechanical in glaucoma

Relato de caso de uma paciente, com córnea espessa, por distrofia de Fuchs em fase inicial, ainda com transparência corneana preservada (edema corneano subclínico), associado à pressão intraocular (PIO) normal por tonometria de aplanação de Goldman (TAG), que teve entretanto, o diagnóstico de glaucoma primário de ângulo aberto com base em alterações estruturais do nervo óptico. O estudo tomográfico demonstrou padrão de paquimetria espacial compatível com edema subclínico. O estudo biomecânico da córnea com o ORA (Ocular Response Analyzer, ® Reichert), associado à medida corrigida da PIO, possibilitou o entendimento da influência da córnea, que apesar de mais espessa, levava a uma TAG falsamente reduzida (hipoestimada). O estudo da PIO com sistema de tonografia digital de contorno (PASCAL) corroborou com os achados do ORA. Este exemplo ressalta a importância de novas tecnologias na avaliação de pacientes com suspeita de glaucoma, e destaca que a correção da TAG, com base em algoritmos lineares relacionados com a paquimetria central apenas, pode determinar sérios erros de interpretação clínica.

Case report of a patient, with a thick cornea, for Fuchs dystrophy in its early stages, yet with preserved corneal transparency (subclinical corneal edema), associated with normal intraocular pressure (IOP) by Goldman applanation tonometry (GAT), which was however, the diagnosis of primary open-angle glaucoma on the basis of structural changes of the optic nerve. The tomographic study showed a pattern of spatial pachymetry compatible with subclinical edema. The corneal biomechanical study with ORA (Ocular Response Analyzer, Reichert ®) associated with corrected IOP measurement, allowed the understanding of the corneal influence, which, although thicker, leading to a falsely low TAG (underestimated). The IOP study with tonography system digital (PASCAL) corroborated with the findings of ORA. This example highlights the importance of new technologies in patients' evaluation with suspected glaucoma, and highlights that the correction of TAG, based on linear algorithms related to central corneal thickness alone, can determine serious errors in clinical interpretation.

Atividade antioxidante de extratos de folhas de ora-pro-nóbis (Pereskia aculeata Mill. ) usando métodos espectrofotométricos e voltamétricos in vitro / Antioxidant activity of ora-pro-nobis (Pereskia aculeata Mill. ) leaves extracts using spectrophotometric and voltammetric assays in vitro

Atualmente tem crescido a busca por plantas como fontes naturais de antioxidantes. Plantas com esta propriedade podem ser utilizadas para melhorar a qualidade de alimentos, seja para fins nutritivos ou de conservação, como também para a prevenção de doenças relacionadas ao aparecimento de radicais livres. A Pereskia aculeata Mill. (Ora-pro-nóbis) é uma espécie da família Cactaceae e suas folhas são consumidas por muitas pessoas. Neste contexto, este trabalho estudou o teor de fenóis totais (método Folin-Ciocalteau) e de proantocianidinas (vanilina sulfúrica), correlacionando-os com a atividade antioxidante (radical DPPH, sistema b-caroteno/ácido linoleico e voltametria por pulso diferencial) de extratos em acetona 80%, etanol 70% e água das folhas da espécie P. aculeata Mill., apresentando o extrato em acetona 80% maior teor de fenóis totais e proantocianidinas. Com relação à atividade antioxidante frente ao radical DPPH, o extrato em acetona 80% se apresentou ligeiramente melhor que o em etanol 70%. A técnica de voltametria por pulso diferencial mostrou que o extrato em acetona 80% apresenta constituintes com maior potencial redutor que o extrato em etanol 70%. Os dados obtidos a partir da voltametria corroboram com os resultados obtidos pelo método tradicional de DPPH. Os extratos em etanol 70% e em água apresentaram melhor atividade antioxidante pelo sistema b-caroteno/ácido linoleico, o que sugere a presença de outra classe de compostos que atuam na inibição do b- caroteno. Portanto, as folhas da espécie Pereskia aculeata podem ser consideradas como fonte potencial de compostos antioxidantes.

Currently, the search for plants as natural sources of antioxidants has been growing because they can be used to improve the nutritive or preservation properties of food, as soon as for the prevention of diseases related to free radicals. The Pereskiaaculeata Mill. (Ora-pro-nóbis,) is a specie of Cactaceae family and its leaves are consumed by many people. In this context, this paper studied the total phenols (Folin-Ciocalteu) and proanthocyanidins (vanillin sulfuric) correlating with the antioxidant activity (DPPH, b-carotene/linoleic acid system and differential pulse voltammetry) of extracts of 80% acetone, 70% ethanol and water of Pereskiaaculeata Mill. leaves. The 80% acetone extract showed higher total phenols and proanthocyanidins. Regarding to the antioxidant activity by DPPH radical scavenger, the 80% acetone extract was slightly better than 70% ethanol extract. The differential pulse voltammetry technique displayed that the 80% acetone extract presented constituents with greater reducing potential than the ones presented in 70% ethanol extract, what can corroborate the results obtained. The 70% ethanol and water extracts has shown better antioxidant activity by b-carotene/linoleic acid system, what probably suggests the presence of another compounds classes that are responsible for the inhibition the b-carotene. Therefore, the Pereskiaaculeata Mill. showed that its leaves may be considered as a potential source of antioxidant compounds.

Translocation of gut flora and its role in sepsis.

Bacterial translocation is the invasion of indigenous intestinal bacteria through the gut mucosa to normally sterile tissues and the internal organs. Sometimes instead of bacteria, infl ammatory compounds are responsible for clinical symptoms as in systemic infl ammatory response syndrome (SIRS). The difference between sepsis and SIRS is that pathogenic bacteria are isolated from patients with sepsis but not with those of SIRS. Bacterial translocation occurs more frequently in patients with intestinal obstruction and in immunocompromised patients and is the cause of subsequent sepsis. Factors that can trigger bacterial translocation from the gut are host immune defi ciencies and immunosuppression, disturbances in normal ecological balance of gut, mucosal barrier permeability, obstructive jaundice, stress, etc. Bacterial translocation occurs through the transcellular and the paracellular pathways and can be measured both directly by culture of mesenteric lymph nodes and indirectly by using labeled bacteria, peripheral blood culture, detection of microbial DNA or endotoxin and urinary excretion of non-metabolisable sugars. Bacterial translocation may be a normal phenomenon occurring on frequent basis in healthy individuals without any deleterious consequences. But when the immune system is challenged extensively, it breaks down and results in septic complications at different sites away from the main focus. The factors released from the gut and carried in the mesenteric lymphatics but not in the portal blood are enough to cause multi-organ failure. Thus, bacterial translocation may be a promoter of sepsis but not the initiator. This paper reviews literature on the translocation of gut fl ora and its role in causing sepsis.

Utilização de cactáceas do gênero Pereskia na alimentação humana em um município de Minas Gerais / Utilization of cacti of the genus Pereskia in the human diet in a municipality of Minas Gerais

O objetivo deste trabalho foi avaliar a utilização de cactáceas do gênero Pereskia na alimentação humana. A pesquisa foi realizada nos 1.525 domicílios da cidade de São Gonçalo do Abaeté (MG). Nessa cidade, onde foi aplicado o questionário socioeconômico e quanto ao uso alimentar desta planta, comumente chamada de ora-pro-nóbis, somente 25 domicílios possuíam plantas do gênero Pereskia. Em 22 domicílios, havia a presença da Pereskia grandifolia, em três, havia a de Pereskia aculeata e, em um, havia os dois tipos. A presença de nutrientes na ora-pro-nobis foi citada por 83,33% dos entrevistados, sendo que 33,37% citaram um consumo mensal. A planta foi citada por 66,67% dos entrevistados como importante no tratamento da anemia ferropriva, por 16,67%, como agente terapêutico para o câncer, por 12,50%, para prevenção ou tratamento da osteoporose e, por 8,33%, para o tratamento da constipação intestinal. A classificação da ora-pro-nobis na categoria das hortaliças foi citada por 54,17% dos entrevistados. Concluiu-se que o resgate cultural do consumo desse tipo de planta poderá melhorar a condição nutricional e de renda das pessoas menos favorecidas economicamente, tanto no ambiente urbano quanto rural, de diferentes regiões do Brasil.

The objective of this study was to evaluate the use of cacti of the genus Pereskia, for human consumption food. The study was conducted in 1.525 households in the city of São Gonçalo do Abaeté (MG). In this city where the socioeconomic questionnaire was applied regarding the dietary use of this plant, commonly referred to as ora-pro-nobis, only 25 of the households possessed plants of the genus Pereskia. In 22 households there was the presence of Pereskia grandifolia, in three households there was Pereskia aculeata, and one had both types. The presence of nutrients in the ora-pro-nobis was cited by 83.33% of respondents, where 33.37% cited monthly consumption. The plant was cited by 66.67% of the respondents as important in the treatment of iron deficiency anemia, by 16.67% as a therapeutic agent for cancer, by 12.50% for prevention or treatment of osteoporosis and 8.33% for the treatment of constipation. ora-pro-nobis was classified as a vegetable by 54.17% of respondents. It was concluded that the cultural revival of consumption of this type of plant may improve nutritional status and income of lower-class families in both urban and rural regions, from different regions of Brazil.

Relevância da biomecânica da córnea no glaucoma / Relevancy of corneal biomechanical in glaucoma

Relato de caso de uma paciente, com córnea espessa, por distrofia de Fuchs em fase inicial, ainda com transparência corneana preservada (edema corneano subclínico), associado à pressão intraocular (PIO) normal por tonometria de aplanação de Goldman (TAG), que teve entretanto, o diagnóstico de glaucoma primário de ângulo aberto com base em alterações estruturais do nervo óptico. O estudo tomográfico demonstrou padrão de paquimetria espacial compatível com edema sub-clínico. O estudo biomecânico da córnea com o ORA (Ocular Response Analyzer, ® Reichert), associado à medida corrigida da PIO, possibilitou o entendimento da influência da córnea, que apesar de mais espessa, levava a uma TAG falsamente reduzida (hipoestimada). O estudo da PIO com sistema de tonografia digital de contorno (PASCAL) corroborou com os achados do ORA. Este exemplo ressalta a importância de novas tecnologias na avaliação de pacientes com suspeita de glaucoma, e destaca que a correção da TAG, com base em algoritmos lineares relacionados com a paquimetria central apenas, pode determinar sérios erros de interpretação clínica.

Case report of a patient, with a thick cornea, for Fuchs dystrophy in its early stages, yet with preserved corneal transparency (subclinical corneal edema), associated with normal intraocular pressure (IOP) by Goldman applanation tonometry (GAT), which was however, the diagnosis of primary open-angle glaucoma on the basis of structural changes of the optic nerve. The tomographic study showed a pattern of spatial pachymetry compatible with subclinical edema. The corneal biomechanical study with ORA (Ocular Response Analyzer, Reichert ®) associated with corrected IOP measurement, allowed the understanding of the corneal influence, which, although thicker, leading to a falsely low TAG (underestimated). The IOP study with tonography system digital (PASCAL) corroborated with the findings of ORA. This example highlights the importance of new technologies in patients' evaluation with suspected glaucoma, and highlights that the correction of TAG, based on linear algorithms related to central corneal thickness alone, can determine serious errors in clinical interpretation.

Reproducibility of Ocular Response Analyzer and Comparison with Goldmann Applanation Tonometer and Non-Contact Tonometer

PURPOSE: To evaluate the inter- and intra-observer variability of ocular response analyzer (ORA) measurements, and to evaluate the relationships among the intraocular pressures (IOPs) obtained by ORA, Goldmann applanation tonometer (GAT) and non-contact tonometer (NCT). METHODS: The present study included 45 normal eyes from 45 volunteers. Three masked observers performed ORA measurements. NCT and GAT measurements were performed by one independent observer. The reproducibility of ORA was assessed by ANOVA-based intraclass correlation coefficient (ICC) and coefficient of variation (CV). Comparison among the tonometers was performed using the Bland-Altman plot and paired t-test. RESULTS: The ICC for inter-observer reproducibility of ORA parameters was 0.90 to 0.97. The corresponding CV values were 13.2% to 19.1%. The intra-observer ICC values for IOP cc were 0.78 to 0.88. CV was 11.2% to 16.8%. For CRF, ICC values were 0.80 to 0.84 with CV values as 11.6% to 15.9%. For CH, ICC values were 0.74 to 0.82 and CV values were 13.0% to 15.9%. The difference in mean IOP values between IOP cc and IOP g was statistically significant (p = 0.04). However, no difference was found among other tonometers, and only IOP cc did not result in significant correlation with central corneal thickness (CCT) (p = 0.38). CONCLUSIONS: The intra- and inter-observer reproducibility was substantial for IOP cc, IOP g, CH and CRF, for all observers. Additionally, IOP measured with ORA did not result in significant differences from GAT and NCT.

Motilidad intestinal y microflora / Intestinal motility and microflora

La microflora es el conjunto de colonias microbacterianas que cubren la superficie del tubo digestivo. Cada sujeto humano alberga unos 100 billones de colonias de unas 400 especies distintas, biodiversidad que facilita la vida y el desarrollo del conjunto. La concentración de bacterias va aumentando a lo largo del tubo digestivo, alcanzando concentraciones de 1012 UFC/ml. en el colon. La motilidad del intestino delgado es propulsiva con una fase de barrido que no permite el crecimiento de bacterias. Por el contrario, la motilidad del colon es muy lenta y no propulsiva durante el ayuno y el sueño. Sólo en vigilia y en período postprandial existen ondas de contracción de alta amplitud y rápidamente progresivas en dirección oral-anal. La interacción entre las bacterias presentes en el lumen y las ondas de contracción motora es muy difícil de evaluar. Este efecto se ha estudiado en base a los fármacos que alteran la motilidad y que al aumentar ésta, barren con la flora bacteriana presente. En ese sentido se sabe que el uso de cisaprida acelera el tránsito, reduciendo la densidad de bacterias metanogénicas con un aumento de la excreción de hidrógeno. En cambio, loperamida disminuye el tránsito, aumentando la flora metanogénica (hecho que representa lo que sucede a pacientes constipadas, que tienen flora mayoritariamente productora de metano). Conclusión: La interacción entre motilidad y flora bacteriana es compleja y está poco estudiada fundamentalmente debido a dificultades técnicas.

Microflora is the set of microbacterium colonies covering the digestive tract surface. Each human subject hosts ca. 100 billions of colonies of 400 different species, b23wiodiversity that facilitates life and development of the whole. Bacteria concentration increases throughout the digestive tract, reaching concentrations of 1012 CFU/ml in the colon. Motility of the small intestine is propulsive with a sweeping phase, allowing for the growth of bacteria. On the contrary, motility of the colon is very slow and non-propulsive during fasting and sleeping. Only during wakefulness and postprandial period there are wide-ranging and quickly progressive contraction waves in oral-anal direction. Interaction between bacteria present in lumen and the contraction waves is very hard to assess. This effect has been studied based on drugs that alter motility, and when it increases, they sweep the existing gut flora. In this sense, it is known that the use of cisapride accelerates the transit, reducing the density of methanogenic bacteria with an increase in the hydrogen excretion. On the other hand, loperamide slows down transit, causing an increase of the methanogenic flora (which represents what happens to constipated patients with flora that produces mainly methane). Conclusion: Interaction between motility and gut flora is complex and has not been enough studied mainly due to technical difficulties.

Factors Affecting the Ocular Response Analyzer Parameters in Normal Korean

PURPOSE: To identify the normal range of factors which can be measured with Ocular Response Analyzer (ORA, Reichert Inc., Depew, NY, USA) in normal Korean, and to analyze factors affecting ORA by measuring intraocular pressure (IOP) of noncontact tonometer (NCT) and central corneal thickness (CCT). METHODS: Three hundred and one normal Korean subjects who did not have specific ophthalmological diseases and surgeries in the past were recruited for this study. Corneal hysteresis (CH), corneal response factor (CRF), corneal-compensated IOP (IOPcc), and Goldmann correlated IOP (IOPg) were measured using ORA. In addition, IOP of NCT and CCT were measured and the results and factors analyzed. RESULTS: The mean CH measured among normal Korean subjects in this study was 10.70 mmHg. The mean CRF was 10.40 mmHg. CH and CRF were significantly higher in the juvenile group. IOPcc and IOPg as measures of IOP using the ORA had significant correlation with IOP of NCT. In particular, IOPcc appeared to be independent of CCT. CONCLUSIONS: CH and CRF were different according to age, indicating a difference in biomechanical properties of the cornea. In particular, IOPcc is more important as it is independent of corneal thickness and should be compensated in general measurements of IOP reflecting biomechanical properties.

La modulación del sistema inmune de mucosas con polisacáridos: Bases para una atractiva alternativa en terapia / Modulation of the mucosal immune system with polysaccharides: Basis for an attractive therapeutic alternative

El sistema inmune de mucosas del intestino presenta propiedades únicas: está expuesto a una gran variedad y cantidad de antígenos, desarrolla una actividad inmunológica permanente y mantiene un microambiente fisiológicamente desviado hacia respuestas anti-inflamatorias. Es capaz de distinguir y neutralizar agentes nocivos y reconocer antígenos inocuos, generando entonces un estado de no respuesta llamado tolerancia oral. Este fenómeno natural representa una forma fisiológica, segura e inocua de manipular las respuestas inmunes, para el tratamiento de enfermedades autoinmunes, inflamatorias o alérgicas. Aquellos compuestos que presenten la habilidad de favorecer la tolerancia permitirían optimizar el desarrollo de nuevos protocolos de inmunointervención. Quitosano (Q) es un polisacárido que abunda en la naturaleza con características fisicoquímicas y biológicas particulares: carece de toxicidad y alergenicidad, es biocompatible y biodegradable, presenta propiedades mucoadhesivas que favorecen el transporte y la absorción de proteínas a través del epitelio. Tiene actividad adyuvante, aumentando los niveles de IgA en la mucosa. Estas características lo convierten en un candidato ideal para la inmunointervención a nivel de mucosas. En este trabajo se describe el mecanismo de acción del Q luego de la administración oral, demostrando por primera vez que Q contribuye a mantener la homeostasis intestinal y a modular a nivel local y sistémico las respuestas inmunes hacia un antígeno proteico. Esta caracterización ayuda a comprender cómo participa un polisacárido en la fina regulación de las respuestas de mucosa y sugiere alternativas de manipulación que permitirán el desarrollo de terapias que requieran de microambientes anti-inflamatorios.

The mucosal immune system exhibits distinctive traits: it is permanently exposed to an overwhelming amount and variety of antigens; it maintains a continuous immune activity and it sustains a physiological environment biased to anti-inflammatory responses. Although it mounts efficient responses against pathogens, it reacts to innocuous antigens developing the oral tolerance state. Oral tolerance is a natural process that can be safely applied for the treatment of autoimmune, inflammatory or allergic diseases. Compounds able to promote the tolerance phenomenon can be used to optimize the development of alternative therapies. Chitosan (Q) is a natural and abundant polysaccharide with singular biological and physico-chemical properties that make it a good candidate to modulate the mucosal immunity: non toxic, biocompatible and biodegradable, strongly mucoadhesive favoring the transepithelial absorption of proteins and adjuvant, enhancing the levels of IgA to co-administered antigens. This work describes the Q activity mechanism early after its oral administration, for the first time showing, Q´s contribution to the intestinal homeostasis and also its modulation of the immune response to a protein antigen at local and systemic level. These studies will help understand how the intestinal regulatory activity occurs, and develop new therapeutic approaches to stimulate anti-inflammatory environments at mucosal level.