Unilateral intravitreal dexamethasone implant for the treatment of cystoid macular edema in intermediate uveitis / Implante unilateral de dexametasona intravítrea para tratamento de edema macular cistoide na uveíte intermediária

ABSTRACT This report aims to describe the effectiveness of a unilateral intravitreal dexamethasone implant (Ozurdex®) used for the treatment of cystoid macular edema in a patient with recurrent intermediate uveitis. Bearing in mind the adverse effects of the prolonged use of systemic corticosteroids, the objective here was to provide a less damaging form of intervention, and also to demonstrate the safety of the dexamethasone implant for patients who fail to respond to conventional treatment. In the present case, there was bilateral improvement in retinal anatomy and function with use of the unilateral intravitreal dexamethasone implant (Ozurdex®).

RESUMO Neste estudo, o objetivo foi descrever, a partir de um relato de caso, a eficácia do uso de implante de dexametasona intravítrea (Ozurdex®) unilateral, para o tratamento de edema macular cistoide, em um paciente com quadro de uveíte intermediária recorrente, visando uma terapêutica menos lesiva, diante dos efeitos colaterais do uso prolongado de corticoesteroides sistêmicos, demonstrando também a segurança desse tratamento alternativo para aqueles pacientes que se apresentam refratários a terapêutica tradicional. No caso relatado, vale ressaltar a melhora bilateral da anatomia e função retiniana com o implante unilateral de dexametasona intravítrea (Ozurdex®).

Long-term Results of Deep Sclerectomy with Small Collagen Implant in Korean

PURPOSE: To describe the long-term results of deep sclerectomy with collagen implant (DSCI) with or without adjuvant mitomycin C in Korean patients with primary or secondary open-angle glaucoma (OAG). METHODS: This retrospective review was comprised of 65 Korean patients who received DSCI with or without adjuvant mitomycin C due to primary or secondary OAG. Patients were followed for 72 months after surgery. Complete success was defined as intraocular pressure (IOP) <21 mmHg without medication and qualified success was defined as IOP <21 mmHg with or without medication. RESULTS: Mean postoperative follow-up period was 53.0 +/- 16.2 months. Mean IOP was 30.5 +/- 11.7 mmHg preoperatively, 8.4 +/- 4.3 mmHg at postoperative day one and 13.4 +/- 3.8 mmHg 60 months after surgery. The mean number of glaucoma medications was decreased from 3.6 +/- 1.1 to 1.6 +/- 1.3 at 60 months after the operation. Complete and qualified success rates were 36.7% and 79.6% at postoperative 60 months, respectively (Kaplan-Meier survival curve). No shallow or flat anterior chamber, endophthalmitis, or surgery-induced significant cataract was observed. CONCLUSIONS: The results of DSCI in Korean patients presented here seem reasonably excellent with qualified success rates of over 70% at six years with negligible complications.

Effects of Combined Therapy with Ezetimibe Plus Simvastatin After Drug-Eluting Stent Implantation in a Porcine Coronary Restenosis Model

The aim of this study was to examine the anti-proliferative and anti-inflammatory effects of ezetimibe/simvastatin (E/S) after drug-eluting stent (DES) implantation in a porcine coronary restenosis model. Pigs were randomized into two groups in which the coronary arteries (23 pigs) had DES. Stents were deployed with oversizing (stent/artery ratio 1.3:1) in porcine coronary arteries. Fifteen pigs were taken 10/20 mg of E/S and eight pigs were not taken E/S. Histopathologic analysis was assessed at 28 days after stenting. In neointima, most inflammatory cells were lymphohistiocytes. Lymphohistiocyte count was not different between two groups (337+/-227 vs. 443+/-366 cells, P=0.292), but neointima area was significantly smaller (1.00+/-0.49 mm2 vs. 1.69+/-0.98 mm2, P=0.021) and percent area stenosis was significantly lower (23.3+/-10% vs. 39+/-19%, P=0.007) in E/S group compared with control group. There were no significant differences in fibrin score (1.99+/-0.79 vs. 1.81+/-0.88, P=0.49), endothelial score (1.75+/-0.66 vs. 1.80+/-0.59, P=0.79), and the percent of endothelium covered lumen (43+/-21% vs. 45+/-21%, P=0.84) between E/S group and control group. Combined therapy with ezetimibe and simvastatin inhibits neointimal hyperplasia, but does not inhibit inflammatory infiltration and arterial healing after DES implantation in a porcine coronary restenosis model.

Avaliação da reutilização de implantes auriculares contendo norgestomet associados ao valerato ou ao benzoato de estradiol em vacas nelore inseminadas em tempo fixo / Evaluation of norgestomet auricular implants reused associated to valerate or to estradiol benzoate in fixed time artifical insemination in Nelore cows

Em fêmeas bovinas a utilização da técnica de inseminação artificial em tempo fixo (IATF) é possibilitada pelo emprego de fármacos que tem como objetivos sincronizar a emergência das ondas foliculares, os estros e a ovulação. Em rebanhos comerciais, o custo de tais fármacos deve estabelecer uma vantajosa relação com os benefícios. O presente estudo, objetivou comparar as taxas de prenhez em vacas Nelore (Bos taurus indicus) inseminadas em tempo fixo, tratadas com implantes auriculares contendo 3mg de norgestomet (Crestar®), novos (IN) ou utilizados uma vez (IR; reutilizados), associados a administração de norgestomet (NG) e valerato de estradiol (VE) ou progesterona (P4) e benzoato de estradiol (BE). Vacas Nelore PO (n=241), amamentando, com o bezerro ao pé, receberam um dos quatro tratamentos: Crestar® novo durante 10 dias associado a administração de 3mg de NG e 5mg de VE (grupo IN/NG+VE; n=61); Crestar® novo inserido durante 8 dias associado a 50mg de P4 e 2mg de E (grupo IN/P4+BE; n=61); Crestar® reutilizado inserido durante 10 dias associado a administração de 3mg de NG e 5mg de VE (grupo IR/NG+VE; n=58) ou Crestar® reutilizado inserido durante 8 dias associado a e 50mg de P4 e 2mg de BE (grupo IR/ P4+BE; n=61). No dia da remoção dos implantes os animais receberam 7,5mg de Luprostiol e 24 horas após a remoção 1mg de BE. A IATF foi realizada 54 a 56 horas após a retirada dos implantes. Após a IATF, as vacas tiveram os estros observados durante um período de 49 dias e em estro foram reinseminadas 12 horas após a observação. O diagnóstico de gestação foi realizado por ultra-sonografia 35 dias após a IATF e após o final da estação de monta. Foram avaliadas as taxas de prenhez na IATF (TP IATF) e no final da estação de monta (TP EM). Não houve interação entre as características dos implantes (novos e reutilizados) e os tratamentos administrados no dia da inserção do implante (NG+VE e P4+BE). A utilização do CIDR® novo ou reutilizado não teve...

The use of fixed -time artificial insemination (IATF) in cows is possible by the use of drugs that aim at the synchronization of the folicular wave pool, the estrus and ovulation. In trading cattle the costs of these drugs must stablish a profitable relation with the benefits. The present study meant to compare the pregnancy rates in Nelore (Bos taurus indicus) cows inseminated at fixed-time, treated with new (IN) or once used (IR; reused) auricular releasing devices with 3mg of norgestomet (Crestar®), associated with the administration of norgestomet (NG) and estradiol valerate (VE) or progesterone (P4 and estradiol benzoate (BE). Pure breed Nelore cows (n=241), on lactation with calf received one of the four treatments: new Crestar® during 10 days administrated with 3mg of NG and 5 mg of VE (group lN/NG+VE; n=61); new Crestar® inserted during 8 days with 50mg of P4 and 2mg of BE (group lN/P4 +BE; n=61); reused Crestar® inserted during 10 days in association with 3 mg of norgestomet and 5 mg of VE (group IR/NG+ VE; n=58) or reused Crestar® inserted during 8 days in association with 50mg of P 4 and 2mg of BE (group lR/P4+BE; n=61). On the day the releasing devices were removed the animals received 7,5mg of Luprostiol and after 24 hours 1mg of BE. A fixed-time artificial insemination was done 54 to 56 hours after the removal of the releasing devices. Cows detected in estrus after the insemination at fixed-time were observed during a period of 49 days and reinseminated. The pregnancy diagnosis was done by ultrassonography 35 days after the IATF and after the end of the breeding season. The pregnancy rates of IATF (TPIATF) and at the end of the breeding season (TP EM) were estimated. There was no interaction between the characteristics of the (new or reused) releasing devices and the treatment given at the day the releasing devices were inserted (NG+ VE e P4 + BE). The use of new or used CIDR® had no effect on TP IATF (48,3%vs 48,7%) and on TP EM (85)...

Location of quinacrine pellets in different positions of non-surgical female sterilization.

OBJECTIVE: To compare quinacrine pellets distribution in the uterine cavity between women standing up promptly after insertion and those lying down for a further 30-minutes. DESIGNS: Randomized controlled trial MATERIAL AND METHOD: Twenty women who, desired interval female sterilization, were equally randomized into 2 groups. Quinacrine pellets were inserted twice, one month apart in both groups. Transvaginal ultrasonography (TVS) was performed after insertion in order to locate the position of the quinacrine pellets. In group I, the TVS was performed after the women stood up promptly. In group II, the TVS was performed after the women lay down for 30-minute. The distribution of quinacrine pellets, measured from the uterine fundus to the lowest pellet, were compared. RESULTS: There was no difference at the baseline and 30 minutes measurement of both groups. In the first insertion, there was statistical difference of the distance of the quinacrine pellets when compared in the same group immediately and the 30-minute measurement (Gr 1: 19.10+/-3.28 mm vs 22.30+/-3.50 mm); (Gr 2: 18.70+/-3.40 mm vs 24.40+/-5.95 mm). In the same manner, the authors found statistical difference in the same group of the second insertion (Gr 1: 21.80+/-5.39 mm vs 24.70+/-7.24 mm); (Gr 2 : 20.89+/-4.78 mm vs 28.30+/-7.59 mm) CONCLUSIONS: There was statistical difference of quinacrine pellet distribution in uterine cavity after time. However, body movement did not effect the position of the pellets. The failure rate of quinacrine pellet insertion for non-surgical female sterilization may not be explained by the changes of position after insertion.

Motivos de retiro de implantes norplant

Objetivo: Conocer si los efectos secundarios de los implantes anticonceptivos subdérmicos a base de Levanorgestel: Norplant son motivo de retiro. Material y Métodos: Comprende 7.776 implantes colocados entre abril/30/86 a agosto 31/93(88 meses). Se realizaron 1859 retiros por motivos descritos por las usuarias (23.90 por ciento). El estudio Institucional se agrupó en cinco categorías. Resultados: I. Motivo esperado de retiro: 681 pac. (36.63 por ciento); a) Deseo de embarazo:378 pac.(55.50 por ciento); b)Cumplieron los cinco años de uso: 257 pac.(37.73 por ciento); c) Cambio de Método: 46 pac. (6.75 por ciento). II. retiro de Norplant por un motivo(médicos o extramédicos) 958 pac. (51.53 por ciento). III. Retiro de Norplant por dos motivos: 192 pac. (10.32 por ciento).IV.Retiro por tres motivos: 24 pac.(1.29 por ciento).V_. Retiro pos cuatro motivos. 4 pac.(0.21 por ciento). Hallazgo Sobresaliente: II. Mótivo único: 958 pac. (51.61 por ciento): Disfunciones mestruales: 329 pac. (34.34 por ciento); Médicos Generales, 198 pac. (20.66 por ciento); especialidades médicas: 125 pac. (13.02 por ciento); cefalea: 117 pac. (12.21 por ciento); motivos personales; 101 pac.(10.54 por ciento); várices: 55 pac. (5.74 por ciento); embarazo: 33 pac. (3.44 popr ciento). Conclusión: Efectos secundarios:relativos. Prima un motivo de retiro. Continuidad de uso de 76.10 por ciento