Effectiveness and Safety of Non-Invasive Neuromodulation for Vision Restoration: A Systematic Review and Meta-Analysis.

We carried out a systematic review and meta-analysis to determine the effectiveness and safety of non-invasive electrical stimulation (NES) for vision restoration. We systematically searched for randomised controlled trials (RCTs) comparing NES with sham stimulation, for vision restoration between 2000 and 2022 in CENTRAL, MEDLINE, EMBASE, and LILACS. The main outcomes were as follows: visual acuity (VA); detection accuracy; foveal threshold; mean sensitivity as the parameter for the visual field; reading performance; contrast sensitivity (CS); electroencephalogram; quality of life (QoL), and safety. Two reviewers independently selected studies, extracted data, and evaluated the risk of bias using the Cochrane risk of bias 2.0 tool. The certainty in the evidence was determined using the GRADE framework. Protocol registration: CRD42022329342. Thirteen RCTs involving 441 patients with vision impairment indicate that NES may improve VA in the immediate post-intervention period (mean difference [MD] = -0.02 logMAR, 95% confidence intervals [CI] -0.08 to 0.04; low certainty), and probably increases QoL and detection accuracy (MD = 0.08, 95% CI -0.25 to 0.42 and standardised MD [SMD] = 0.09, 95% CI -0.58 to 0.77, respectively; both moderate certainty). NES likely results in little or no difference in mean sensitivity (SMD = -0.03, 95% CI -0.53 to 0.48). Compared with sham stimulation, NES increases the risk of minor adverse effects (risk ratio = 1.24, 95% CI 0.99 to 1.54; moderate certainty). The effect of NES on CS, reading performance, and electroencephalogram was uncertain. Our study suggests that although NES may slightly improve VA, detection accuracy, and QoL, the clinical relevance of these findings remains uncertain. Future research should focus on improving the available evidence's precision and consistency.

Retinocoroidopatía birdshot, reporte de un caso en Colombia / Birdshot retinochoroidopathy, case report in Colombia

Introducción: La retinocoroidopatía birdshot (RCB) es una uveítis posterior crónica, bilateral de origen autoinmune, con fuerte asociación al antígeno leucocitario humano HLA-A29. Objetivo: Describir un caso de RCB en Colombia. Material y métodos: Mujer caucásica de 57 años, con hallazgos clínicos y exámenes complementarios compatibles con RCB. Recibió terapia biológica durante 15 meses, con mejoría clínica significativa. Resultados y conclusiones: El tratamiento depende del estadio de la enfermedad y consiste en el uso solo de corticoesteroides o combinación con agentes inmunosupresores y biológicos, que han demostrado preservar la función visual y minimizar efectos adversos de los esteroides

Background: Birdshot Retinocoroidopathy (BRC) is a chronic, bilateral posterior uveitis of autoimmune origin, with a strong association with the human leukocyte antigen HLA-A29. Objective: To describe a BRC case in Colombia. Material and methods: A 57-year-old Caucasian woman with clinical findings and complementary tests compatible with BRC. She received biologic therapy for 15 months, with significant clinical improvement. Results and conclusions: Treatment depends on stage of disease and is about corticosteroid use, alone or combination with immunosuppressive and biological agents, which have been shown to preserve visual function and minimize adverse effects of steroids

Prevalence of Metabolic Syndrome and Framingham Risk Score in Apparently Healthy Vegetarian and Omnivorous Men.

BACKGROUND: Recent studies have shown a lower prevalence of metabolic syndrome (MSyn) in vegetarians (VEG) despite the inconclusive evidence from others. OBJECTIVE: To verify the association between diet and other lifestyle characteristics and the prevalence of MSyn, cardiovascular risk factors (CRF), and Framingham Risk Score (FRS) in apparently healthy VEG and omnivorous (OMN) men. METHODS: In this cross-sectional study, 88 apparently healthy men ≥ 35 years, 44 VEG and 44 OMN, were assessed for anthropometric data, blood pressure, blood lipids, glucose, C-reactive protein (CRP) and FRS. To test the association between lifestyle and MSyn, Student t test, chi-square test, and multiple logistic regression model were used. A significance level of 5% was considered in all statistical analyses. RESULTS: Several CRF were significantly lower in VEG than in OMN: body mass index, systolic blood pressure, diastolic blood pressure, fasting serum total cholesterol, LDL-cholesterol, apolipoprotein b, glucose, and glycated hemoglobin (all p < 0.05). The FRS mean was lower in VEG than in OMN (2.98 ± 3.7 vs 4.82 ± 4.8, p = 0.029). The percentage of individuals with MSyn was higher among OMN than among VEG (52.3 vs.15.9%) (p < 0.001). The OMN diet was associated with MSyn (OR: 6.28 95%CI 2.11-18.71) and alterations in most MSyn components in the multiple regression model independently of caloric intake, age and physical activity. CONCLUSION: The VEG diet was associated with lower CRF, FRS and percentage of individuals with MSyn.

Prevalence of Metabolic Syndrome and Framingham Risk Score in Apparently Healthy Vegetarian and Omnivorous Men / Prevalência de Síndrome Metabólica e Escore de Risco de Framingham em Homens Vegetarianos e Onívoros Aparentemente Saudáveis

Abstract Background: Recent studies have shown a lower prevalence of metabolic syndrome (MSyn) in vegetarians (VEG) despite the inconclusive evidence from others. Objective: To verify the association between diet and other lifestyle characteristics and the prevalence of MSyn, cardiovascular risk factors (CRF), and Framingham Risk Score (FRS) in apparently healthy VEG and omnivorous (OMN) men. Methods: In this cross-sectional study, 88 apparently healthy men ≥ 35 years, 44 VEG and 44 OMN, were assessed for anthropometric data, blood pressure, blood lipids, glucose, C-reactive protein (CRP) and FRS. To test the association between lifestyle and MSyn, Student t test, chi-square test, and multiple logistic regression model were used. A significance level of 5% was considered in all statistical analyses. Results: Several CRF were significantly lower in VEG than in OMN: body mass index, systolic blood pressure, diastolic blood pressure, fasting serum total cholesterol, LDL-cholesterol, apolipoprotein b, glucose, and glycated hemoglobin (all p < 0.05). The FRS mean was lower in VEG than in OMN (2.98 ± 3.7 vs 4.82 ± 4.8, p = 0.029). The percentage of individuals with MSyn was higher among OMN than among VEG (52.3 vs.15.9%) (p < 0.001). The OMN diet was associated with MSyn (OR: 6.28 95%CI 2.11-18.71) and alterations in most MSyn components in the multiple regression model independently of caloric intake, age and physical activity. Conclusion: The VEG diet was associated with lower CRF, FRS and percentage of individuals with MSyn.

Resumo Fundamento: Estudos recentes mostraram menor prevalência de Síndrome Metabólica (SM) em vegetarianos (VEG), apesar de evidências inconclusivas de outros. Objetivo: Verificar associação entre dieta e características do estilo de vida e a prevalência de SM, fatores de risco cardiovascular (FRCV) e Escore de Framingham (EF) em homens VEG e onívoros (ONI) aparentemente saudáveis. Métodos: Neste estudo transversal, 88 homens aparentemente saudáveis ≥ 35 anos, VEG (n = 44) e ONI (n = 44), foram avaliados quanto a dados antropométricos, pressão arterial, lípides plasmáticos, glicemia, proteína C reativa e EF. Para testar associação entre estilo de vida e SM, o teste t de Student, o teste qui-quadrado e a regressão logística múltipla foram utilizados. Foi considerado nível de significância de 5% em todas as análises estatísticas. Resultados: Os níveis dos FRCV avaliados foram menores nos VEG do que nos ONI: índice de massa corporal, pressão arterial sistólica e diastólica, colesterol total, LDL-colesterol, apolipoproteína b, glicemia e hemoglobina glicada (p < 0,05). O EF foi menor nos VEG do que nos ONI (2,98 ± 3,7 vs. 4,82 ± 4,8; p = 0,029). A porcentagem de indivíduos com SM foi maior entre ONI do que entre VEG (52,3 vs.15,9%) (p < 0,001). A dieta ONI foi associada com a SM (OR: 6,28 IC95% 2,11-18,71) e alterações na maioria dos componentes da SM no modelo de regressão logística múltipla, independentemente de ingestão calórica, idade e atividade física. Conclusão: A dieta VEG foi associada com menores taxas de FRC e menores EF e porcentagem de indivíduos com SM.

Immunization with intestinal microbiota-derived Staphylococcus aureus and Escherichia coli reduces bacteria-specific recolonization of the intestinal tract.

A wide array of microorganisms colonizes distinctive anatomical regions of animals, being the intestine the one that harbors the most abundant and complex microbiota. Phylogenetic analyses indicate that it is composed mainly of bacteria, and that Bacterioidetes and Firmicutes are the most represented phyla (>90% of the total eubacteria) in mice and humans. Intestinal microbiota plays an important role in host physiology, contributing to digestion, epithelial cells metabolism, stimulation of intestinal immune responses, and protection against intestinal pathogens. Changes in its composition may affect intestinal homeostasis, a condition known as dysbiosis, which may lead to non-specific inflammation and disease. The aim of this work was to analyze the effect that a bacteria-specific systemic immune response would have on the intestinal re-colonization by that particular bacterium. Bacteria were isolated and identified from the feces of Balb/c mice, bacterial cell-free extracts were used to immunize the same mice from which bacteria came from. Concurrently with immunization, mice were subjected to a previously described antibiotic-based protocol to eliminate most of their intestinal bacteria. Serum IgG and feces IgA, specific for the immunizing bacteria were determined. After antibiotic treatment was suspended, specific bacteria were orally administered, in an attempt to specifically re-colonize the intestine. Results showed that parenteral immunization with gut-derived bacteria elicited the production of both anti-bacterial IgG and IgA, and that immunization reduces bacteria specific recolonization of the gut. These findings support the idea that the systemic immune response may, at least in part, determine the bacterial composition of the gut.

Neuro-ophthalmological findings in TAFRO syndrome in a patient from South America, a variant of multicentric Castleman's disease.

BACKGROUND: To report the neuro-ophthalmological findings in the TAFRO syndrome in a South American patient. METHODS: This is a case report of a patient with TAFRO syndrome. RESULTS: We present the case of a 66-year-old woman with TAFRO syndrome and multicentric Castleman disease, who developed ophthalmic manifestations, as a rare complication, including optic disk edema and serous retinal detachment, which improved with conventional therapy. CONCLUSIONS: The optic disk edema could be present as a neuro-ophthalmological finding in TAFRO syndrome. To the best of our knowledge, this is the first report on the ophthalmic manifestations in the TAFRO syndrome.

Macular findings in Spectral Domain Optical Coherence Tomography and OCT Angiography in a patient with Kearns-Sayre syndrome.

BACKGROUND: To report the clinical, electrophysiological and the anatomical findings in a patient with Kearns-Sayre syndrome (KSS). CASE PRESENTATION: We present the case of a 55-year-old female with KSS, who developed systemic features and ocular manifestations as ophthalmoplegia and retinal dysfunction, that were corroborated by electrophysiological test and High Definition Spectral Domain Optical Coherence Tomography (HD SD OCT) and OCT-Angiography (OCT-A). CONCLUSION: We report a patient with KSS, accompanied by some alterations of the RPE and photoreceptors observed in the external HD SD OCT and OCT-A. In the best of our knowledge, this is the first report in the literature of HD SD OCT findings in a patient with KSS.

Cortical blindness as severe neuro-ophthalmological manifestation of tuberous sclerosis complex.

Patients with retinal lesions related to tuberous sclerous complex (TSC) commonly have no impairment of visual acuity. We present a case of a 1-year-old Hispanic girl with TSC in which bilateral cortical blindness is documented.

Reduced subclinical carotid vascular disease and arterial stiffness in vegetarian men: The CARVOS Study.

BACKGROUND: Dietary habits play an important role in the development of atherosclerosis, the most important cause of morbidity and mortality in the world. The objective of this study was to verify if vegetarian (VEG) diet could be related a better profile of subclinical vascular disease evaluated by arterial stiffness and functional and structural properties of carotid arteries, compared to omnivorous (OMN) diet. METHODS: In this cross-sectional study, 44 VEG and 44 OMN apparently healthy men ≥35years of age, in order to not have confounding risk factors of subclinical atherosclerosis, were assessed for anthropometric data, blood pressure, blood lipids, glucose, C reactive protein (CRP), and arterial stiffness determined by carotid-femoral pulse wave velocity (PWV). Also, carotid intima-media thickness (c-IMT) and distensibility were evaluated. RESULTS: VEG men had lower body mass index, systolic and diastolic blood pressures, fasting serum total cholesterol, LDL and non-HDL-cholesterol, apolipoprotein B, glucose and glycated hemoglobin values in comparison with OMN individuals (all p values <0.05). Markers of vascular structure and function were different between VEG and OMN: PWV 7.1±0.8m/s vs. 7.7±0.9m/s (p<0.001); c-IMT 593±94 vs. 661±128µm (p=0.003); and relative carotid distensibility 6.39±1.7 vs. 5.72±1.8% (p=0.042), respectively. After a multivariate linear regression analysis, a VEG diet was independently and negatively associated with PWV (p value 0.005). CONCLUSIONS: A VEG diet is associated with a more favorable cardiovascular diseases biomarker profile and better vascular structural and functional parameters.

Estudio de la fuerza muscular del cuádriceps en pacientes post operados de ligamento cruzado anterior / Study of the muscle strength of the quadriceps in patients post operated of anterior cruciate ligament

Objetivo: Establecer el valor de la disminución de la fuerza muscular del cuádriceps en pacientes post operados de ligamento cruzado anterior. Material y métodos: Estudio de enfoque cuantitativo, de diseño no experimental y de tipo transversal, a pacientes con diagnóstico médico de post-operado de ligamento cruzado anterior, diagnosticados en el Servicio de Medicina Física y Rehabilitación del Centro Médico Naval Cirujano Mayor Santiago Távara entre 20 y 50 años de edad. Se evaluó mediante una ficha que contiene el test de fuerza máxima y medición del trofismo muscular del muslo. La muestra estuvo compuesta por 20 personas cumpliendo con los correspondientes criterios de inclusión. Resultados: Los resultados promedios de la fuerza muscular dinámica máxima por implante quirúrgico, de la muestra en el miembro operado y no operado evidencia que los que habían sido operados con implante quirúrgico de Autoinjerto presentaron una fuerza muscular dinámica máxima promedio de índice 0.37, que según la escala de aptitud muscular en relación a la masa corporal es de categoría mala; y en el miembro no operado una fuerza muscular de índice 0.64, siendo de categoría buena. Por su parte los que habían sido operados con implante quirúrgico de Aloinjerto presentaron una fuerza muscular promedio de índice 0.38, equivalente a una categoría mala; y en el miembro no operado un índice de 0.66, siendo de categoría buena. Conclusiones: Los pacientes post operados de ligamento cruzado anterior muestran 41.3 por ciento de disminución de la fuerza muscular en el miembro operado en relación al miembro no operado. En el análisis estadístico, la diferencia es considerada significativa. Además, el valor promedio de fuerza muscular se encuentra en la categoría de mala aptitud muscular. Con todo ello se establece que si existe disminución de la fuerza muscular del cuádriceps en pacientes post operados de ligamento cruzado anterior.

Objectives: To establish the decrease in quadriceps muscle strength in patients undergoing post anterior cruciate ligament. Material and Methods: We studied quantitative approach, non-experimental cross-sectional design, people with medical diagnosis of post-surgery for anterior cruciate ligament, diagnosed in the Department of Physical Medicine and Rehabilitation Medical Center Naval Surgeon Santiago Mayor Tavara between 20 and 50 years old. It was assessed using a tab that contains the maximum strength test and measurement of thigh muscle trophism. The sample consisted of 20 individuals fulfilling the corresponding criteria. Results: The average results of dynamic muscle strength maximum for surgical implant sample member in the operated and non-operated evidence that those who had been operated on with surgical implantation of autograft showed a mean maximal dynamic muscle strength index 0.37, which according muscular fitness scale in relation to body mass is poor category; and the member unoperated muscle strength index 0.64, being upmarket. Meanwhile those who had been operated on with surgical implantation of allograft had an average index 0.38, equivalent to poor muscle strength category; and the member unoperated index 0.66, being upmarket. Conclusions: The patients undergoing post ACL have mostly, muscle strength values that are in the category of poor muscular fitness. In addition to significant differences between unoperated member relative to operated, which states that there is decreased quadriceps muscle strength in patients undergoing post anterior cruciate ligament.

Pre-historic eating patterns in Latin America and protective effects of plant-based diets on cardiovascular risk factors.

In this review, we present the contributions to nutrition science from Latin American native peoples and scientists, appreciated from a historic point of view since pre-historic times to the modern age. Additionally, we present epidemiological and clinical studies on the area of plant-based diets and their relation with the prevention and treatment of cardiovascular diseases conducted in recent decades, and we discuss challenges and perspectives regarding aspects of nutrition in the region.

Pre-historic eating patterns in Latin America and protective effects of plant-based diets on cardiovascular risk factors

In this review, we present the contributions to nutrition science from Latin American native peoples and scientists, appreciated from a historic point of view since pre-historic times to the modern age. Additionally, we present epidemiological and clinical studies on the area of plant-based diets and their relation with the prevention and treatment of cardiovascular diseases conducted in recent decades, and we discuss challenges and perspectives regarding aspects of nutrition in the region.

Meningioma de la vaina del nervio optico y venas optociliares: su demostración mediante el empleo combinado de angiografía fluoresceínica y angiografía digital con verde de indocianina / Harboring optic nerve sheath, meningiomas and collateral optociliary veins in whom conmbined fluorescein angiography and digital indocyanine green angiography

Describimos cuatro pacientes con meningioma de la vaina del nervio óptico primarios y secundarios y vasos colaterales optociliares de diversos grados de desarrollo a quienes se realizó combinadas, angiografía fluoresceínica del fondo ocular y angiografía digital con verde de indocianina. De esta forma fue posible trazar claramente el trayecto de estas colaterales desde su origen en tributarias de la vena central de la retina, su unión a venas coroideas y su desembocadura en el sistema de venas vorticosas. Se notó una relación inversa entre el grado de elevación del disco óptico y el desarrollo de las venas retinociliares. Es la primera vez que estas colaterales son demostradas "in vivo" por un método fotográfico.

Receptores de calcio en el citoplasma de la mucosa gástrica: caracterización / Calcium receptors in cytoplasm gastric mucosa: characterization

En el presente trabajo se demostró la presencia de sitios receptores de alta afinidad para el calcio en la fracción citosólica de la mucosa gástrica de Bufo marinus. El análisis de Scatchard sugirió la existencia de una sola clase de sitios receptores, con una constante aparente de asociación, Ka. de 2,2x10 5 M-1, y una máxima capacidad de ligazón de aproximadamente 3,5 moles de calcio/mg de proteínas. La ligazón de calcio no fue afectada por los cationes monovalentes Na+ y K+ a una concentración de 10mM, pero fue inhibida significativamente por cationes bivalentes. La efectividad relativa de estos cationes fue en el orden siguiente: Zn2+ > Mn2+ > Mg2+. La ligazón de calcio con el receptor dependió de la concentración de H+, mostrando un aumento continuo entre pH 5,5 y pH 8,5. Los nucleótidos cíclicos y el ATP no afectaron apreciablemente la combinación del Ca2+ con el receptor. La estimulación de la secreción ácida con histamina se asoció con un aumento significativo (94%) en la capacidad de ligazón de calcio en el citoplasma. Los receptores descritos podrían participar en la regulación de la concentración intracelular de Ca2+ y/o en algunas de las acciones regulatorias del Ca2+ en la mucosa gástrica, como por ejemplo, en la secreción ácida