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1.
Rev. cienc. salud (Bogotá) ; 19(1): 74-87, ene.-abr. 2021. tab, graf
Article in English | LILACS | ID: biblio-1289167

ABSTRACT

Abstract Introduction: Multipurpose solutions (MPS) for soft contact lenses (SCL) play an essential role in inhibiting potentially pathogenic agents. Their antimicrobial effectiveness is assessed in vitro and their safety in vivo, with clinical trials that include a combination of different solutions and lens materials. The objective is to assess the biocompatibility of a new SCL MPS produced in Colombia that contains polyhexamethylene biguanide (PHMB) and to determine its antimicrobial activity. Materials and Methods: This was a crossover study with 25 subjects who did not wear lens and who were fitted with different combinations of five SCL materials with either MPS or control physiological saline solution (CS). Corneal thickness, conjunctival hyperemia, corneal staining, and comfort were assessed after two hours of wearing SCL. Antimicrobial effectiveness was measured using ISO 14729 standard assays. Results: When considering SCL material, there was a statistically significant difference between the new MPS and the CS for Comfilcon A (p < 0.05). There was no statistical or clinically significant difference for corneal thickness or corneal staining between the combination of lens material and new MPS with the CS (p > 0.05). After two hours of lens insertion, comfort scores were higher than 7.8. The MPS reduced bacteria colony forming units (CFU) in over 3 log, and fungal CFU in over 1.0 log. Conclusions: The new MPS met the antimicrobial standards of ISO 14729, is considered safe and biocompatible with the ocular surface and retains high comfort levels.


Resumen Introducción: las soluciones multipropósito (SMP) para lentes de contacto blandos (LCB) desempeñan un papel esencial en la inhibición de agentes potencialmente patógenos. Su efectividad antimicrobiana se evalúa in vitro, y su seguridad, in vivo, con ensayos clínicos que incluyen una combinación de diferentes soluciones y materiales para lentes. El objetivo es evaluar la biocompatibilidad de una nueva SMP producida en Colombia que contiene polihexametileno biguanida (PHMB) y determinar su actividad antimicrobiana. Materiales y métodos: estudio cruzado con 25 sujetos no usuarios de lentes, que fueron adaptados con cinco combinaciones diferentes de materiales de LCB con una nueva SMP o solución salina fisiológica de control (CS). El grosor corneal, la hiperemia conjuntival, la tinción corneal y la comodidad se evaluaron después de dos horas de uso del LC. La efectividad antimicrobiana se midió utilizando ensayos estándar ISO 14729. Resultados: considerando el material del LCB, solo hubo una diferencia estadísticamente significativa entre la nueva SMP y el CS para el Comfilcon A (p < 0.05). Tampoco hubo diferencias estadísticamente o clínicamente significativas para el grosor corneal o la tinción corneal, entre la combinación del material del lente y la nueva SMP con el CS (p > 0.05). Después de dos horas de uso del lente, las puntuaciones de confort fueron superiores a 7.8. La SMP redujo las unidades formadoras de colonias (UFC) de bacterias en más de 3 log, y las UFC fúngicas en más de 1.0 log. Conclusiones: la nueva SMP cumplió con los estándares antimicrobianos de ISO 14729, y se considera segura y biocompatible con la superficie ocular, con altos niveles de confort.


Resumo Introdução: as soluções multipropósito (SMP) para lentes de contato macias (LCM) apresentam um papel essencial na inibição de agentes potencialmente patógenos. Sua eficácia como agente antimicrobiano se valia in vitro, e sua segurança, in vivo, como ensaios clínicos que incluem uma combinação de diferentes soluções e materiais para lentes. O objetivo é avaliar a biocompatibilidade de uma nova SMP produzida na Colômbia a base de polihexametileno biguanida (PHMB) e determinar seu potencial antimicrobiano. Materiais e métodos: estudo cruzado com 25 indivíduos não usuários de lentes, que foram adaptados com cinco combinações diferentes de LCM como uma nova SMP ou solução salina fisiológica como controle (CS). A espessura da córnea, a hiperemia conjuntival, a coloração da córnea e a comodidade, foram avaliadas após duas horas de uso da LCB. A eficácia antimicrobiana foi medida com ensaios padrão ISO 14729. Resultados: considerando o material da LCB, houve apenas uma diferença estatisticamente significativa entre a nova SMP e o CS, paro o Comfilcon A (p <0.05). Não houve diferença estatisticamente ou clinicamente significativa para a espessura da córnea ou a coloração da córnea, entre a combinação do material da lente e a nova SMP com o controle CS (p > 0.05). Após duas horas de uso, as pontuações de conforto foram superiores a 7,8. A SMP reduziu as unidades formadoras de colônias (UFC) de bactérias em mais de 3 log, e as UFC fúngicas em mais de 1.0 log. Conclusões: a nova SMP cumpriu com os padrões antimicrobianos ISO 14729, é considerada segura e biocompatível com a superfície ocular, com altos níveis de conforto.


Subject(s)
Humans , Contact Lenses, Hydrophilic , Hyperemia , Stem Cells
2.
Article in English | WPRIM | ID: wpr-787133

ABSTRACT

In vascular smooth muscle, K⁺ channels, such as voltage-gated K⁺ channels (Kv), inward-rectifier K⁺ channels (Kir), and big-conductance Ca²⁺-activated K⁺ channels (BK(Ca)), establish a hyperpolarized membrane potential and counterbalance the depolarizing vasoactive stimuli. Additionally, Kir mediates endothelium-dependent hyperpolarization and the active hyperemia response in various vessels, including the coronary artery. Pulmonary arterial hypertension (PAH) induces right ventricular hypertrophy (RVH), thereby elevating the risk of ischemia and right heart failure. Here, using the whole-cell patch-clamp technique, we compared Kv and Kir current densities (I(Kv) and I(Kir)) in the left (LCSMCs), right (RCSMCs), and septal branches of coronary smooth muscle cells (SCSMCs) from control and monocrotaline (MCT)-induced PAH rats exhibiting RVH. In control rats, (1) I(Kv) was larger in RCSMCs than that in SCSMCs and LCSMCs, (2) I(Kv) inactivation occurred at more negative voltages in SCSMCs than those in RCSMCs and LCSMCs, (3) I(Kir) was smaller in SCSMCs than that in RCSMCs and LCSMCs, and (4) I(BKCa) did not differ between branches. Moreover, in PAH rats, I(Kir) and I(Kv) decreased in SCSMCs, but not in RCSMCs or LCSMCs, and I(BKCa) did not change in any of the branches. These results demonstrated that SCSMC-specific decreases in I(Kv) and I(Kir) occur in an MCT-induced PAH model, thereby offering insights into the potential pathophysiological implications of coronary blood flow regulation in right heart disease. Furthermore, the relatively smaller I(Kir) in SCSMCs suggested a less effective vasodilatory response in the septal region to the moderate increase in extracellular K⁺ concentration under increased activity of the myocardium.


Subject(s)
Animals , Coronary Vessels , Heart Diseases , Heart Failure , Hyperemia , Hypertension , Hypertrophy, Right Ventricular , Ischemia , Membrane Potentials , Monocrotaline , Muscle, Smooth , Muscle, Smooth, Vascular , Myocardium , Myocytes, Smooth Muscle , Patch-Clamp Techniques , Potassium Channels , Rats , Septum of Brain
3.
Einstein (Säo Paulo) ; 18: eAO5227, 2020. tab, graf
Article in English | LILACS | ID: biblio-1056054

ABSTRACT

ABSTRACT Objective To investigate the efficacy of a behavior change program named Vida Ativa Melhorando a Saúde on cardiovascular parameters in hypertensive patients. Methods Ninety hypertensive patients aged over 40 years were randomly allocated to one of two groups: Vida Ativa Melhorando a Saúde or Control (n=45 respectively). Patients in the Vida Ativa Melhorando a Saúde group took part in a behavior change program aimed to encourage changes in physical activity levels and eating habits, according to the Social Cognitive Theory. The program consisted of 90-minute weekly group meetings conducted by a physical therapist and a dietitian. One chapter of the educational material (workbook) provided was discussed per meeting. Participants in the Control Group attended a single educative lecture on lifestyle changes. Brachial and central blood pressure, arterial stiffness and endothelial function parameters were measured pre- and post-intervention. Results Vida Ativa Melhorando a Saúde led to reduction of brachial (131.3±15.8mmHg to 125.1±17.3mmHg; p<0.01) and central (123.6±16.3mmHg to 119.0±20.6mmHg; p=0.02) systolic and brachial diastolic (123.6±16.3mmHg to 119.0±20.6mmHg; p<0.01) blood pressure values, and improvement of post-occlusive reactive hyperemia (from 5.7±2.5mL·100mL−1 to 6.5±2.1mL·100mL−1 tissue·min−1; p=0.04). No changes in body composition, heart rate and arterial stiffness parameters were detected in both groups (p>0.05). Conclusion Vida Ativa Melhorando a Saúde program improved blood pressure and microvascular reactivity in hypertensive patients. Trial registration: ClinicalTrials.gov: NCT02257268


RESUMO Objetivo Analisar a eficácia do programa de mudança de comportamento Vida Ativa Melhorando a Saúde sobre parâmetros cardiovasculares em pacientes hipertensos. Métodos Noventa pacientes hipertensos ≥40 anos foram aleatoriamente randomizados em dois grupos: Vida Ativa Melhorando a Saúde (n=45) e Controle (n=45). O Grupo Vida Ativa Melhorando a Saúde participou de um programa de mudança de comportamento que objetiva motivar mudanças na atividade física e nos hábitos alimentares, de acordo com a teoria sociocognitiva. O programa foi conduzido em grupos, durante 12 semanas consecutivas, em encontros semanais (~90 minutos), conduzidos por um profissional de edução física e um nutricionista. Um capítulo do material didático era discutido em cada um desses encontros. O Grupo Controle participou de uma única palestra educativa sobre mudanças de estilo de vida. Medidas de pressão arterial braquial e central, rigidez arterial, e de função endotelial foram realizadas nos momentos pré e pós-intervenção. Resultados O Grupo Vida Ativa Melhorando a Saúde reduziu a pressão arterial sistólica braquial (de 131,3±15,8mmHg a 125,1±17,3mmHg; p<0,01) e central (de 123,6±16,3mmHg a 119,0±20,6mmHg; p=0,02) e a pressão arterial diastólica braquial (123,6±16,3mmHg a 119,0±20,6mmHg; p<0,01) e apresentou melhora na hiperemia reativa pós-oclusão (de 5,7±2,5mL·100mL−1a 6,5±2,1mL·100mL−1tecido·min−1; p=0,04). Não houve modificação na composição corporal, na frequência cardíaca e nem nos parâmetros de rigidez arterial em ambos os grupos (p>0,05). Conclusão O Programa Vida Ativa Melhorando a Saúde melhorou a pressão arterial e a reatividade microvascular em pacientes hipertensos. Registro do estudo: ClinicalTrials.gov: NCT02257268


Subject(s)
Humans , Male , Female , Aged , Health Behavior/physiology , Hypertension/physiopathology , Blood Pressure/physiology , Body Composition , Exercise/physiology , Program Evaluation , Treatment Outcome , Feeding Behavior/physiology , Vascular Stiffness/physiology , Heart Rate/physiology , Hyperemia/physiopathology , Hypertension/psychology , Life Style , Middle Aged
4.
Article in Korean | WPRIM | ID: wpr-766862

ABSTRACT

PURPOSE: To report a case of a Corynebacterium macginleyi-infected corneal ulcer of a patient who had been treated for conjunctivitis for more than 3 months. CASE SUMMARY: A 72-year-old female was transferred from a private ophthalmic clinic for evaluation of herpetic keratitis with progressive corneal edema and infiltration in the left eye. She had a history of conjunctival hyperemia and eyeball pain in her left eye 3 months prior to her visit. She was treated with levofloxacin eye drops and acyclovir ointment (Herpesid®, Samil, Co., Ltd. Seoul, Korea). On slit lamp examination, 5.4 × 4.0 mm corneal epithelial defects and stromal infiltrations were observed in the upper to central cornea, and endothelial keratic precipitates were found. Gram positive bacteria were detected on Gram staining and Corynebacterium macginleyi was identified on bacterial cultures from the conjunctiva and cornea. She was treated with topical vancomycin eye drops. After 3 months of treatment, the corneal ulcer was completely resolved, leaving mild superficial opacity on the cornea. CONCLUSIONS: While Corynebacterium macginleyi, normal flora of the conjunctiva, is considered a major causative agent for conjunctivitis and blepharitis, Corynebacterium macginleyi should also be considered a possible cause of slowly progressive keratitis in patients with chronic conjunctivitis.


Subject(s)
Acyclovir , Aged , Blepharitis , Conjunctiva , Conjunctivitis , Cornea , Corneal Edema , Corneal Ulcer , Corynebacterium , Female , Gram-Positive Bacteria , Humans , Hyperemia , Keratitis , Keratitis, Herpetic , Levofloxacin , Ophthalmic Solutions , Seoul , Slit Lamp , Vancomycin
5.
Article in Korean | WPRIM | ID: wpr-766829

ABSTRACT

PURPOSE: To report a case of anterior uveitis secondary to Listeria monocytogenes infection. CASE SUMMARY: A 57-year-old male presented to our clinic with ocular pain and decreased vision in the right eye for 2 days. The patient had a history of liver transplantation 2 years prior and used immunosuppressive agents. Listeria monocytogenes was identified in blood cultures 1 month before his visit. At presentation, best-corrected visual acuity (BCVA) of the right eye was counting fingers at 20 cm and the intraocular pressure (IOP) was 50 mmHg. Conjunctival hyperemia, corneal edema, keratic precipitates, and cells in the anterior chamber were observed in the right eye. The patient was diagnosed as anterior uveitis in the right eye. Conventional uveitis treatment was initiated but clinical features did not improve and black hypopyon appeared. The possibility of anterior uveitis caused by Listeria monocytogenes infection was considered. An anterior chamber tap and culture were conducted to identify pathogens. Anterior chamber antibiotic injections and systemic antibiotic injections were performed. One week after injection, the BCVA of the right eye improved to 0.4 and the IOP decreased to 14 mmHg. One month after injection, the BCVA of the right eye improved to 1.0 and the IOP decreased to 16 mmHg. No inflammation of the anterior chamber was observed. CONCLUSIONS: When nonspecific uveitis occurs in immunosuppressed patients, cultures and appropriate antibiotics should be considered because of the possibility of infection.


Subject(s)
Anterior Chamber , Anti-Bacterial Agents , Corneal Edema , Endophthalmitis , Fingers , Humans , Hyperemia , Immunosuppressive Agents , Inflammation , Intraocular Pressure , Listeria monocytogenes , Listeria , Liver Transplantation , Male , Middle Aged , Uveitis , Uveitis, Anterior , Visual Acuity
6.
Article in Korean | WPRIM | ID: wpr-766748

ABSTRACT

Hemodialysis patients rarely experience neurologic symptoms related to their vascular accesses. However, occlusion of venous drainage induces extreme venous hypertension and in rare cases cause intracranial venous congestion. We report a patient with cerebral venous infarction resulting from reflux flow into the cranium induced by an arteriovenous jump graft to the internal jugular vein. Clinicians should take into account the possibility of neurologic deficit related to intracranial venous hypertension in hemodialysis patients.


Subject(s)
Arteriovenous Fistula , Drainage , Humans , Hyperemia , Hypertension , Infarction , Jugular Veins , Neurologic Manifestations , Renal Dialysis , Skull , Transplants , Veins
7.
Article in English | WPRIM | ID: wpr-739377

ABSTRACT

With the recent development in microsurgery, the use of a perforator flap has been widely implemented. If the length of the ALT flap pedicle is insufficient despite adequate preoperative planning, pedicle length extension is necessary. We planned for a reverse ALT free flap using the distal vessel of the descending branch for pedicle length extension in the case of ALT perforator branch originating from the proximal portion of the descending branch. For the management of venous congestion, the distal venae comitantes were anastomosed to the proximal venous stump in an antegrade manner, successfully resolving the venous congestion. Modified reverse-flow ALT free flap, wherein the venae comitantes are anastomosed to the proximal vein stump, is a good option that allows for relatively simple pedicle extension within the same operative field when securing an adequate pedicle length is difficult because of the origin of the perforator from the proximal descending branch, unlike the initial surgical plan.


Subject(s)
Free Tissue Flaps , Hyperemia , Lower Extremity , Microsurgery , Perforator Flap , Surgical Flaps , Thigh , Veins
8.
Article in Korean | WPRIM | ID: wpr-738628

ABSTRACT

PURPOSE: To report polymicrobial keratitis involving Pseudomonas aeruginosa, Acinetobacter baumannii, and Ochrobactrum anthropi. CASE SUMMARY: A 53-year-old female complained of pain and secretion in her right eye, which started 6 weeks before her visit. She applied steroid ointment, which was received from the dermatologist, to her eyelid 7 days prior to her visit but this treatment worsened her symptoms. At the initial visit, the visual acuity of the right eye was light perception, and purulent secretions were observed. Using a slit lamp, severe conjunctival hyperemia, hypopyon, and a ring-shaped central corneal ulcer were observed. The anterior chamber and fundus were not observed due to corneal lesions but ultrasonography showed no intraocular inflammation. Infectious keratitis was suspected and cultured by corneal scraping. During the incubation period, 0.5% moxifloxacin, 2% voriconazole, and 1% cyclopentolate were administered. A total of 400 mg of moxifloxacin and 100 mg of doxycycline were given orally. In the primary culture, Pseudomonas aeruginosa and Acinetobacter baumannii were identified so 5% ceftazidime, which was sensitive for the antibiotic susceptibility results was further instilled. Thereafter, the keratitis improved but the keratitis again worsened while maintaining the topical treatment. A secondary culture was positive for Ochrobactrum anthropi. Treatment with 1.4% gentamicin, which was sensitive for the antibiotic susceptibility test was added and the keratitis improved. A conjunctival flap was performed because of the increased risk of perforation. CONCLUSIONS: We report polymicrobial keratitis involving Pseudomonas aeruginosa, Acinetobacter baumannii, and Ochrobactrum anthropi for the first time in the Republic of Korea.


Subject(s)
Acinetobacter baumannii , Acinetobacter , Anterior Chamber , Ceftazidime , Corneal Ulcer , Cyclopentolate , Doxycycline , Eyelids , Female , Gentamicins , Humans , Hyperemia , Inflammation , Keratitis , Middle Aged , Ochrobactrum anthropi , Ochrobactrum , Pseudomonas aeruginosa , Pseudomonas , Republic of Korea , Slit Lamp , Ultrasonography , Visual Acuity , Voriconazole
9.
Article in Korean | WPRIM | ID: wpr-738596

ABSTRACT

PURPOSE: We report a case of toxic keratoconjunctivitis resulting from the self-application of human breast milk as a traditional folk remedy for allergic conjunctivitis. CASE SUMMARY: An 82-year-old woman presented with pain and conjunctival hyperemia in the right eye that had been worsening for three days. Two months previously, she was treated with antiallergic eye drops for allergic conjunctivitis at another eye clinic. However, the symptoms did not improve. She applied her daughter-in-law's breast milk into her right eye as a folk remedy for three days. The pain and conjunctival hyperemia worsened. At the initial visit, her corrected visual acuity was 0.3 in the right eye. Slit lamp examination demonstrated conjunctival hyperemia, punctate epithelial erosion at the central cornea, corneal keratic precipitates and white-colored deposits in the peripheral cornea combined with irregularly shaped small nodules. There was no anterior chamber inflammation. There was no medical history of rheumatoid arthritis or tuberculosis. Blood tests for serum and other infectious and inflammatory levels for infection and inflammatory markers were performed followed by application of topical steroids and antibiotics with artificial tears. After 3 weeks of treatment, conjunctival hyperemia and corneal deposits had almost resolved and best-corrected visual acuity improved to 1.0. CONCLUSIONS: The self-application of human breast milk may cause toxic keratoconjunctivitis. Therefore, efforts should be made, actively, to inform and educate the elderly in rural areas not to use human breast milk as a folk remedy.


Subject(s)
Aged , Aged, 80 and over , Anterior Chamber , Anti-Bacterial Agents , Arthritis, Rheumatoid , Breast , Conjunctivitis, Allergic , Cornea , Female , Hematologic Tests , Humans , Hyperemia , Inflammation , Keratoconjunctivitis , Lubricant Eye Drops , Medicine, Traditional , Milk, Human , Ophthalmic Solutions , Slit Lamp , Steroids , Tuberculosis , Visual Acuity
10.
Article in Korean | WPRIM | ID: wpr-738589

ABSTRACT

PURPOSE: We report a case of acute dacryocystitis diagnosed with abscess and rupture of lacrimal sac and fistula to posterior orbit during the operation. CASE SUMMARY: A 71-year-old woman visited our clinic with edema and pain in the eyelid from three days ago. For past four months, there was viscous of the left eye and tears. The patient had severe conjunctival chemosis and hyperemia, compared with the left eyelid edema and redness. Orbital CT scan showed orbital cellulitis, which was followed by systemic antibiotics and steroid therapy. On the 4th day of therapy, orbital abscess formation was observed in orbit MRI and surgical drainage was planned. During surgery, we found rupture of the posterior part of lacrimal sac and fistula to posterior orbit. Pseudomonas aeruginosa was identified in the bacterial cultures, and after the administration of appropriate antibiotics, the disease showed improved progress, and then additional dacryocystorhinostomy was performed. CONCLUSIONS: In our case, acute dacryocystitis rarely spread in orbit, which may lead to delayed diagnosis, orbital cellulitis and abscess, resulting in serious complications of vision threat. So, we think that it is necessary to consider surgical treatment more actively in the stage of chronic dacryocysitis.


Subject(s)
Abscess , Aged , Anti-Bacterial Agents , Dacryocystitis , Dacryocystorhinostomy , Delayed Diagnosis , Drainage , Edema , Eyelids , Female , Fistula , Humans , Hyperemia , Magnetic Resonance Imaging , Nasolacrimal Duct , Orbit , Orbital Cellulitis , Pseudomonas aeruginosa , Rupture , Tears , Tomography, X-Ray Computed
11.
Article in Korean | WPRIM | ID: wpr-738584

ABSTRACT

PURPOSE: We report an unusual case of Leber hereditary optic neuropathy presenting with optic disc hyperfluorescence. CASE SUMMARY: A 17-year-old male with sequential painless visual loss 3 weeks apart affecting first the left and then the right eye presented to our neuro-ophthalmology clinic. His best-corrected visual acuity was counting fingers in the right eye and 0.32 in the left eye. Fundus examination showed mild optic disc edema and hyperemia in both eyes, which were worse in the right eye. Fluorescein angiography revealed dye leakage from the right optic disc in the late phase. The results of magnetic resonance imaging of the brain and spinal cord were normal, and lumbar puncture study was unremarkable. Mitochondrial DNA sequencing revealed a pathognomonic 11778 mutation for Leber hereditary optic neuropathy. His vision deteriorated to 0.03 in both eyes 6 months later, but slowly started to improve 11 months after onset. At 2 years, his corrected visual acuity was 0.2 in both eyes. CONCLUSIONS: To our knowledge, this is the first report of optic disc hyperfluorescence in Leber hereditary optic neuropathy. This finding suggests that this mitochondrial optic neuropathy can masquerade as optic neuritis.


Subject(s)
Adolescent , Brain , DNA, Mitochondrial , Edema , Fingers , Fluorescein Angiography , Humans , Hyperemia , Magnetic Resonance Imaging , Male , Optic Atrophy , Optic Atrophy, Hereditary, Leber , Optic Nerve Diseases , Optic Neuritis , Spinal Cord , Spinal Puncture , Visual Acuity
12.
Article in English | WPRIM | ID: wpr-741434

ABSTRACT

OBJECTIVE: A developmental venous anomaly (DVA) is a vascular malformation of ambiguous clinical significance. We aimed to quantify the susceptibility of draining veins (χvein) in DVA and determine its significance with respect to oxygen metabolism using quantitative susceptibility mapping (QSM). MATERIALS AND METHODS: Brain magnetic resonance imaging of 27 consecutive patients with incidentally detected DVAs were retrospectively reviewed. Based on the presence of abnormal hyperintensity on T2-weighted images (T2WI) in the brain parenchyma adjacent to DVA, the patients were grouped into edema (E+, n = 9) and non-edema (E−, n = 18) groups. A 3T MR scanner was used to obtain fully flow-compensated gradient echo images for susceptibility-weighted imaging with source images used for QSM processing. The χvein was measured semi-automatically using QSM. The normalized χvein was also estimated. Clinical and MR measurements were compared between the E+ and E− groups using Student's t-test or Mann-Whitney U test. Correlations between the χvein and area of hyperintensity on T2WI and between χvein and diameter of the collecting veins were assessed. The correlation coefficient was also calculated using normalized veins. RESULTS: The DVAs of the E+ group had significantly higher χvein (196.5 ± 27.9 vs. 167.7 ± 33.6, p = 0.036) and larger diameter of the draining veins (p = 0.006), and patients were older (p = 0.006) than those in the E− group. The χvein was also linearly correlated with the hyperintense area on T2WI (r = 0.633, 95% confidence interval 0.333–0.817, p < 0.001). CONCLUSION: DVAs with abnormal hyperintensity on T2WI have higher susceptibility values for draining veins, indicating an increased oxygen extraction fraction that might be associated with venous congestion.


Subject(s)
Brain , Edema , Humans , Hyperemia , Magnetic Resonance Imaging , Metabolism , Oxygen , Retrospective Studies , Vascular Malformations , Veins
13.
Article in English | WPRIM | ID: wpr-741316

ABSTRACT

PURPOSE: We sought to evaluate the outcomes of external dacryocystorhinostomy (DCR) and mono-canalicular intubation in patients with total obstruction of one canalicus. METHODS: Sixteen eyes of 16 patients with nasolacrimal duct obstruction and a single canaliculus obstruction who had undergone external DCR and monocanalicular intubation of the intact canaliculus were retrospectively included in the present study. The monocanalicular tube (Mini Monoka) was left in place for at least two months. Munk epiphora grading for the evaluation of epiphora and irrigation was performed both preoperatively and at 6 months postoperatively. RESULTS: Mean patient age was 46 ± 14.2 (range, 18 to 76) years. The inferior canaliculus was obstructed in nine eyes (group A) and the superior canaliculus was obstructed in seven eyes (group B), respectively. Eight eyes had chronic dacryocystitis and two of these eyes also had a history of acute dacryocystitis attack. Mean preoperative Munk scores were 3.89 in group A and 4.0 in group B. Ocular surface irritation occurred in one eye in group A. Artificial eye drops were prescribed and early tube removal was not performed. Spontaneous tube dislocation was recorded in one eye in group B. No other corneal, punctal, or canalicular complications were found. At six months, irrigation of intact canaliculus was patent in all eyes. Mucoid discharge, conjunctival hyperemia, and chronic conjunctivitis were also resolved. Postoperative Munk scores were 1.11 ± 0.9 in group A and 0.86 ± 0.9 in group B. Of note, preoperative and postoperative Munk scores were significantly different in both groups (group A, p = 0.006; group B, p = 0.017). The postoperative Munk scores were not statistically different between the two groups (p = 0.606). CONCLUSIONS: In patients with nasolacrimal duct obstruction and a total of one canaliculus obstruction, external DCR and monocanalicular intubation of the intact canaliculus is an effective surgical option.


Subject(s)
Conjunctivitis , Dacryocystitis , Dacryocystorhinostomy , Joint Dislocations , Eye, Artificial , Humans , Hyperemia , Intubation , Lacrimal Apparatus Diseases , Lacrimal Duct Obstruction , Nasolacrimal Duct , Retrospective Studies
14.
Article in English | WPRIM | ID: wpr-758876

ABSTRACT

An 8-year-old Shih Tzu, a 5-year-old Maltese, and a 10-year-old Maltese presented with conjunctival hyperemia and peripheral corneal edema. Severe conjunctival thickening with varying degrees of corneal extension was observed. Cytological examination showed many large lymphocytes with malignant changes in the conjunctiva which was consistent with findings in fine-needle aspiration samples taken from regional lymph nodes. They were diagnosed as having Stage V multicentric lymphoma. When conjunctival thickening is observed in canine patients with multicentric lymphoma, conjunctival metastasis with infiltration of neoplastic lymphoid cells should be included in the differential diagnosis.


Subject(s)
Animals , Biopsy, Fine-Needle , Child , Child, Preschool , Conjunctiva , Cornea , Corneal Edema , Diagnosis, Differential , Dogs , Humans , Hyperemia , Lymph Nodes , Lymphocytes , Lymphoma , Neoplasm Metastasis , Uvea
15.
Intestinal Research ; : 227-236, 2019.
Article in English | WPRIM | ID: wpr-764136

ABSTRACT

BACKGROUND/AIMS: Consistently defining disease activity remains a critical challenge in the follow-up of patients with Crohn's disease (CD). We investigated the potential applicability of abdominal ultrasonography with color Doppler (USCD) analysis for the detection of morphological alterations and inflammatory activity in CD. METHODS: Forty-three patients with CD ileitis/ileocolitis were evaluated using USCD analysis with measurements obtained on the terminal ileum and right colon. Sonographic parameters included wall thickening, stricture, hyperemia, presence of intra-abdominal mass, and fistulas. Patients were evaluated for the clinical activity (Harvey-Bradshaw Index [HBI]), fecal calprotectin (FC) and C-reactive protein (CRP). The USCD performance was assessed using magnetic resonance enterography (MRE) as a criterion standard. RESULTS: Most measurements obtained with USCD matched the data generated with MRE; however, the agreement improved in clinically active patients where sensitivity, positive predictive value, and accuracy were >80%, considering wall thickening and hyperemia. Complications such as intestinal wall thickening, stricture formation, and hyperemia, were detected in the USCD analysis with moderate agreement with MRE. The best agreement with the USCD analysis was obtained in regard to FC, where the sensitivity, positive predictive value, and accuracy were >70%. The overall performance of USCD was superior to that of HBI, FC and CRP levels, particularly when considering thickening, stricture, and hyperemia parameters. CONCLUSIONS: USCD represents a practical noninvasive and low-cost tool for evaluating patients with ileal or ileocolonic disease, particularly in clinically active CD. Therefore, USCD might become a useful asset in the follow-up of patients with CD.


Subject(s)
C-Reactive Protein , Colon , Constriction, Pathologic , Crohn Disease , Fistula , Follow-Up Studies , Humans , Hyperemia , Ileitis , Ileum , Leukocyte L1 Antigen Complex , Magnetic Resonance Imaging , Ultrasonography , Ultrasonography, Doppler, Color
16.
Article in English | WPRIM | ID: wpr-761723

ABSTRACT

A 46-year old man visited our outpatient clinic with complaint of foreign body sensation in throat after consuming raw freshwater fish 5 days ago. Laryngoscopic examination revealed a motile worm attached on posterior pharyngeal wall. The worm was removed using biopsy forceps under transnasal endoscopy and evidently identified as Clinostomum complanatum after microscopic examination. Patient’s subjective foreign body sensation of throat and hyperemia of laryngeal mucosa remained for approximately 2 weeks post-removal, which were eventually resolved after administration of non-steroidal anti-inflammatory drug and anti-refluxant drug for 2 weeks. Treatment was ended at three weeks since the first visit. C. complanatum infections in humans are rare, and only four cases have been reported in Korea. Symptoms resembling pharyngitis or laryngitis occurs by consumption of raw, infected freshwater fish and treatment is done by mechanically removing the parasite.


Subject(s)
Ambulatory Care Facilities , Biopsy , Endoscopy , Foreign Bodies , Fresh Water , Humans , Hyperemia , Korea , Laryngeal Mucosa , Laryngitis , Parasites , Pharyngitis , Pharynx , Sensation , Surgical Instruments
17.
Arq. bras. cardiol ; 111(6): 833-840, Dec. 2018. tab
Article in English | LILACS | ID: biblio-973814

ABSTRACT

Abstract Background: Observational studies have highlighted an association between serum uric acid (SUA) levels and cardiovascular risk factors. Despite the growing body of evidences, several studies were conducted in older individuals or in carriers of diseases susceptible to affect SUA levels and cardiometabolic risk markers. Objective: To evaluate the relationship of SUA with body adiposity, metabolic profile, oxidative stress, inflammatory biomarkers, blood pressure and endothelial function in healthy young and middle-aged adults. Methods: 149 Brazilian adults aged 20-55 years, both sexes, underwent evaluation of body adiposity, SUA, fasting glucose and insulin, lipid profile, malondialdehyde (MDA), high sensitivity C-reactive protein (hs-CRP), adiponectin, blood pressure and endothelial function. Endothelial function was assessed by the reactive hyperemia index (RHI) derived from peripheral arterial tonometry method. Participants were allocated in two groups according to SUA levels: control group (CG; n = 130; men ≤ 7 mg/dL, women ≤ 6 mg/dL) and hyperuricemia group (HG; n = 19; men > 7 mg/dL, women > 6 mg/dL). A P-value < 0.05 was considered statistically significant. Results: After adjustment for confounders, participants in HG compared with those in CG displayed higher body mass index (BMI): 34.15(33.36-37.19) vs.31.80 (26.26-34.42) kg/m2,p = 0.008, higher MDA: 4.67(4.03-5.30) vs. 3.53(3.10-4.07) ng/mL, p < 0.0001 and lower RHI: 1.68 ± 0.30 vs. 2.05 ± 0.46, p = 0.03). In correlation analysis adjusted for confounders, SUA was positively associated (p < 0.05) with BMI, waist circumference, LDL-cholesterol, triglycerides and MDA, and negatively associated (p < 0.05) with HDL-cholesterol, adiponectin and RHI. Conclusions: This study suggests that in healthy young and middle-aged adults higher SUA levels are associated with higher body adiposity, unfavorable lipid and inflammatory phenotype, higher oxidative stress and impaired endothelial function.


Resumo Fundamento: Estudos observacionais têm destacado uma associação entre níveis de ácido úrico sérico (AUS) e fatores de risco cardiovascular. Apesar do crescente conjunto de evidências, vários estudos foram realizados em indivíduos mais velhos ou em portadores de doenças passíveis de influenciar os níveis de AUS e marcadores de risco cardiometabólico. Objetivo: Avaliar a relação do AUS com adiposidade corporal, perfil metabólico, estresse oxidativo, biomarcadores de inflamação, pressão arterial e função endotelial em adultos jovens e de meia-idade saudáveis. Métodos: 149 adultos, brasileiros, com idades entre 20 e 55 anos, de ambos os sexos, foram submetidos a avaliação de adiposidade corporal, AUS, glicose e insulina de jejum, perfil lipídico, malondialdeído (MDA), proteína C-reativa ultra-sensível (PCR-us), adiponectina, pressão arterial e função endotelial. A função endotelial foi avaliada pelo índice de hiperemia reativa (RHI) derivado do método de tonometria arterial periférica. Os participantes foram divididos em dois grupos de acordo com os níveis de AUS: grupo de controle (GC; n = 130; homens ≤ 7 mg/dL, mulheres ≤ 6mg/dL) e grupo de hiperuricemia (GH; n = 19; homens > 7mg/dL, mulheres > 6mg/dL). Valor de p < 0,05 foi considerado estatisticamente significativo. Resultados: Após ajuste para fatores de confundimento, os participantes do GH comparados aos do GC apresentaram índice de massa corporal (IMC) mais alto: 34,15 (33,36-37,19) vs. 31,80 (26,26-34,42) kg/m2, p = 0,008, MDA mais alto: 4,67(4,03-5,30) vs. 3,53(3,10-4,07) ng/mL, p < 0,0001 e RHI mais baixo: 1,68 ± 0,30 vs. 2,05 ± 0,46, p = 0,03. Na análise de correlação ajustada para fatores de confundimento, o AUS se associou positivamente (p < 0,05) com IMC, circunferência da cintura, LDL colesterol, triglicérides e MDA, e se associou negativamente (p < 0,05) com HDL colesterol, adiponectina e RHI. Conclusões: Este estudo sugere que, em adultos jovens e de meia-idade saudáveis, níveis mais altos de AUS estão associados a maior adiposidade corporal, fenótipo inflamatório e de lipídios desfavorável, maior estresse oxidativo e função endotelial comprometida.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Young Adult , Uric Acid/blood , Metabolic Syndrome/blood , Hyperuricemia/blood , Blood Pressure , C-Reactive Protein/analysis , Diet Surveys , Cholesterol/blood , Cross-Sectional Studies , Risk Factors , Oxidative Stress , Metabolic Syndrome/complications , Hyperuricemia/complications , Adiposity , Hyperemia/blood , Inflammation/blood , Malondialdehyde/blood
18.
Rev. SOBECC ; 23(3): 136-141, jul.-set. 2018.
Article in Portuguese | LILACS, BDENF | ID: biblio-911455

ABSTRACT

Objetivo: Identificar marcadores potenciais para auxiliar na busca ativa de endoftalmite após cirurgia de catarata. Método: Estudo retrospectivo, descritivo e longitudinal, realizado por meio da revisão de prontuários de pacientes submetidos à cirurgia de catarata. Resultados: A amostra incluiu 20 pacientes (grupo de estudo ­ GE) que desenvolveram endoftalmite pós-operatória e 309 pacientes (grupo controle ­ GC) que não apresentaram endoftalmite. Os dados foram analisados para identificar os marcadores clínicos e epidemiológicos com uma diferença percentual ≥30% entre os grupos. Em comparação com o GC, o GE teve frequência ≥30% em: sinais e sintomas pós-operatórios definidos (dor, reação da câmara anterior, hipópio, edema da córnea, hiperemia conjuntival e opacidade vítrea); mais de 4 retornos pós-operatórios; e realização de injeção de antibiótico intravítreo. Conclusão: Os indicadores selecionados são sugeridos para incorporação na busca ativa das infecções pós-operatórias de endoftalmite, visando à facilidade operacional do sistema de vigilância epidemiológica


Objective: To identify potential markers to assist in the active search of endophthalmitis after cataract surgery. Method: Retrospective, descriptive, and longitudinal study, conducted through review of medical records of patients who underwent cataract surgery. Results: The sample included 20 patients (study group - SG) who developed postoperative endophthalmitis and 309 patients (control group - CG) who did not have endophthalmitis. The data were analyzed to identify the clinical and epidemiological markers with a percentage difference ≥30% between groups. In comparison with the CG, the SG demonstrated frequency ≥30% in established postoperative signs and symptoms (pain, anterior chamber reaction, hypopyon, corneal edema, conjunctival hyperemia, and vitreous opacity); more than four postoperative appointments; and administration of an intravitreal antibiotic injection. Conclusion: The selected markers are suggested for incorporation into the active search for post-operative endophthalmitis, in order to facilitate the operation of the epidemiological surveillance system


Objetivo: Identificar marcadores potenciales para auxiliar en la búsqueda activa de endoftalmitis tras cirugía de facectomía. Método: Estudio retrospectivo, descriptivo y longitudinal, realizado por medio de la revisión de prontuarios de pacientes sometidos a la cirugía de catarata. Resultados: La muestra incluyó 20 pacientes (grupo de estudio ­ GE) que desarrollaron endoftalmitis pos-operatoria y 309 pacientes (grupo control ­ GC) que no presentaron endoftalmitis. Los datos fueron analizados para identificar los marcadores clínicos y epidemiológicos con una diferencia porcentual ≥30% entre los grupos. En comparación con el GC, el GE tuvo frecuencia ≥30% en: señales y síntomas pos-operatorios definidos (dolor, reacción de la cámara anterior, hipopión, edema de la córnea, hiperemia conjuntival y opacidad vítrea); más de 4 retornos pos-operatorios; y realización de inyección de antibiótico intravítreo. Conclusión: Los indicadores seleccionados son sugeridos para incorporación en la búsqueda activa de las infecciones pos-operatorias de endoftalmitis, buscando la facilidad operacional del sistema de vigilancia epidemiológica


Subject(s)
Humans , Ophthalmologic Surgical Procedures , Eye Infections , Endophthalmitis , Eye Diseases , Postoperative Care , Vitreous Body , Corneal Edema , Eye Infections, Bacterial , Eye Pain , Epidemiological Monitoring , Hyperemia
19.
Rev. bras. ter. intensiva ; 30(2): 135-143, abr.-jun. 2018. tab, graf
Article in Portuguese | LILACS | ID: biblio-959315

ABSTRACT

RESUMO Objetivo: Os distúrbios microcirculatórios estão implicados no prognóstico do choque séptico. A hiporresponsividade microvascular pode ser avaliada por meio do índice de perfusão, derivado da oximetria de pulso e hiperemia reativa. Com utilização do índice de perfusão, investigamos a hiperemia reativa e sua relação com a perfusão periférica e os parâmetros clínico-hemodinâmicos no choque séptico. Métodos: Avaliaram-se 82 pacientes, 47 deles com choque séptico e 35 controles. Os exames foram realizados dentro de 24 horas após a admissão. O índice de perfusão foi avaliado antes e após uma oclusão do fluxo sanguíneo durante 3 minutos, utilizando-se análise de resposta temporal por 5 minutos. O índice de perfusão foi também avaliado nas fases hiperêmicas, principalmente com derivação de mecanismos mecanossensitivos (ΔIP0-60) e metabólicos (ΔIP60-120). Realizaram-se testes de correlação entre a hiperemia reativa e dados clínicos hemodinâmicos. Resultados: A hiperemia reativa, medida pelo índice de perfusão, foi significantemente mais baixa no choque séptico apenas até 45 segundos após a desinflação do manguito. No período restante, não houve diferenças estatisticamente significantes entre os grupos. Os picos de índice de perfusão foram similares entre os grupos, embora o pico tenha sido atingido de forma mais lenta no grupo séptico. Os valores de ΔIP0-60 foram mais baixos no choque [1% (-19% - -40%) versus 39% (6% - 75%); p = 0,001]. No entanto, o ΔIP60-120 foi similar entre os grupos [43% (18% - 93%) versus 48% (18% - 98%); p = 0,58]. O tempo até o pico do índice de perfusão se correlacionou de forma positiva com o SOFA e negativamente com os níveis de proteína C-reativa. O pico de índice de perfusão se correlacionou de forma positiva com as doses de vasopressores; os valores de ΔIP60-120 tiveram correlação positiva com o nível de proteína C-reativa e as doses de vasopressores. Não ocorreram outras correlações significantes. Conclusões: Este estudo com base no índice de perfusão sugere que o choque séptico promove hiporresponsividade vascular periférica, enquanto a reatividade vascular posterior é consideravelmente preservada. Estes resultados demonstram resposta hiperêmica periférica dependente do tempo e significante reserva isquêmica no choque séptico.


ABSTRACT Objective: Microcirculation disturbances are implicated in the prognosis of septic shock. Microvascular hyporesponsiveness can be assessed by an oximetry-derived perfusion index and reactive hyperemia. Using this perfusion index, we investigated reactive hyperemia and its relationship with peripheral perfusion and clinical-hemodynamic parameters in septic shock. Methods: Eighty-two patients were evaluated: 47 with septic shock and 35 controls. Tests were performed within 24 hours after admission. The perfusion index was evaluated before and after a 3-min blood flow occlusion using a time-response analysis for 5 min. The perfusion index was also evaluated in the hyperemic phases and was mainly derived by mechanosensitive (ΔPI0-60) and metabolic mechanisms (ΔPI60-120). Correlation tests were performed between reactive hyperemia and clinical-hemodynamic data. Results: Reactive hyperemia measured by the perfusion index was significantly lower in patients with septic shock, but this was only observed for the first 45 seconds after cuff-deflation. In the remaining period, there were no statistical differences between the groups. The peaks in the perfusion index were similar between groups, although the peak was reached more slowly in the septic group. Values of ΔPI0-60 were lower in shock [01% (-19% - -40%) versus 39% (6% - 75%); p = 0.001]. However, ΔPI60-120 was similar between the groups [43% (18% - 93%) versus 48% (18% - 98%); p = 0.58]. The time-to-peak of the perfusion index was correlated positively with the SOFA scores and negatively with C-reactive protein; the peak of the perfusion index was positively correlated with vasopressor doses; and the ΔPI60-120 values were positively correlated with C-reactive protein and vasopressor doses. No other significant correlations occurred. Conclusions: This perfusion index-based study suggests that septic shock promotes initial peripheral vascular hyporesponsiveness and preserves posterior vascular reactivity to a considerable degree. These results demonstrate a time-dependent peripheral hyperemic response and a significant ischemic reserve in septic shock.


Subject(s)
Humans , Male , Female , Aged , Shock, Septic/therapy , Fluid Therapy/methods , Hyperemia/metabolism , Shock, Septic/physiopathology , Time Factors , Vasoconstrictor Agents/administration & dosage , C-Reactive Protein/metabolism , Oximetry/methods , Case-Control Studies , Organ Dysfunction Scores , Hemodynamics , Microcirculation , Middle Aged
20.
Univ. salud ; 20(2): 139-148, mayo-ago. 2018. tab, graf
Article in Spanish | LILACS, COLNAL | ID: biblio-904696

ABSTRACT

Resumen Introducción: La evaluación de la reactividad vascular (RV) se hace mediante la respuesta hiperémica después de una isquemia producida por oclusión arterial. Existen técnicas de medición de RV que permiten evaluar la función vascular con menor costo y sin dependencia del operador, pero se encuentran en desarrollo y requieren validación y aceptación clínica. Objetivo: Modelar computacionalmente la mecánica vascular con el fin de evaluar el desempeño de una técnica de RV. Materiales y métodos: Se modificó el modelo eléctrico de la vasculatura del brazo, obteniendo el volumen periférico con y sin oclusión de la arteria braquial. Se realizó una identificación computacional que relaciona el volumen periférico con los resultados de una técnica de evaluación de RV que presenta cambios de color en la mano ocluida durante hiperemia reactiva. El software utilizado fue Matlab(r). Resultados: El modelo modificado permitió obtener el volumen periférico con y sin oclusión representando la perfusión en la microvascultura. El modelo no lineal Hammerstein-Weiner fue el mejor descriptor de los cambios de color en función de la dinámica del sistema vascular y presentó porcentaje de ajuste promedio de 95,69%. Conclusiones: Es posible modelar computacionalmente la técnica de evaluación de la función vascular utilizando identificación no lineal.


Abstract Introduction: The evaluation of vascular reactivity (VR) is done by the hyperemic response after ischemia produced by arterial occlusion. There are VR measurement techniques that allow the evaluation of vascular function at lower cost and without dependence on the operator, but they are in development and require validation and clinical acceptance. Objective: To model vascular mechanics computationally in order to evaluate the performance of a VR technique. Materials and methods: The electrical model of the vasculature of the arm was modified, obtaining the peripheral volume with and without brachial artery occlusion. A computational identification, which relates the peripheral volume to the results of a VR evaluation technique and presents color changes in the occluded hand during reactive hyperemia, was performed. The software used was Matlab(r). Results: The modified model allowed to obtain the peripheral volume with and without occlusion, representing the perfusion in the microvasculature. The Hammerstein-Weiner non-linear model was the best descriptor of color changes depending on the dynamics of the vascular system and it presented an average adjustment percentage of 95.69%. Conclusions: It is possible to model computationally the technique of evaluation of vascular function using nonlinear identification.


Subject(s)
Cardiovascular Diseases , Computer Simulation , Hyperemia , Models, Biological
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