The use of Ologen Collagen Matrix implants to treat ocular hypotony developing after trabeculectomy: A case series.

PURPOSE: Late hypotony is an undesirable and challenging complication of glaucoma surgery. We describe our use of the Ologen Collagen Matrix to treat late hypotony developing after trabeculectomy. STUDY DESIGN: A retrospective study performed at three eye surgery centers in Brazil. PARTICIPANTS: Eighteen patients who underwent 19 eye surgeries. INTERVENTION: Subconjunctival Ologen was implanted at the trabeculectomy sites to treat over-filtering or leaking blebs in patients experiencing late hypotony after trabeculectomy (obtained 6 months after glaucoma surgery). The primary outcome was the intraocular pressure (IOP); we gathered preoperative data records from 19 Ologen treated eyes and days 1, 7, 30, 60, and 180 postoperatively. The secondary outcomes included visual acuity and macular thickness measured via optical coherence tomography; we compared preoperative data to subsequent ones up to sixth-month-evolution. RESULTS: Over the 6-month period, the IOP rose from 2.89 ± 1.59 mmHg preoperatively to 8.21 ± 3.46 mmHg (p = 0.0001). Visual acuity improved from 0.33 ± 0.29 to 0.21 ± 0.31 LogMar (p = 0.0013). Macular thickness fell from 325.62 ± 58.7 to 283.08 ± 47.35 µm (p = 0.0097). We encountered two complications: one related to suture dehiscence following an ocular trauma and one instance of transitory choroidal detachment. CONCLUSION: Subconjunctival Ologen implants preserved bleb function and successfully treated post-trabeculectomy hypotony as revealed by data collected at the 6-month follow-up. Longer follow-up is necessary to confirm long-term efficacy and safety. There are no financial conflicts of interest to disclose.

Prospective evaluation of intravitreal bevacizumab for ischemic central retinal vein occlusion.

BACKGROUND: Although previous studies have evaluated the effect of anti-VEGF therapies for central retinal vein occlusion (CRVO) patients, the majority of previous studies have excluded or included a very small number of patients with ischemic CRVO (iCRVO). The aim of our study is to examine the effects of bevacizumab on macular edema secondary to ischemic central retinal vein occlusion, as well as the effects on central choroidal thickness and best-corrected visual acuity. METHODS: In this prospective, interventional case series, iCRVO was defined by the presence of ≥ 10 or more disc diameter areas of retinal nonperfusion by fluorescein angiography (FA) and by the presence of a b/a ratio less than 1.5 by full-field electroretinogram (ffERG). Nine eyes with iCRVO received monthly bevacizumab 0.5 mg injections at baseline and months 1 to 5 for a maximum of six injections. Main outcome measures were visual acuity (Snellen), central foveal thickness, and central choroidal thickness as measured by Spectral-Domain Optical Coherence Tomography (SD-OCT) at baseline and at 6 month following initial intravitreal bevacizumab injection. Pairwise t-tests and the Wilcoxon signed-rank test were conducted to compare the outcome measures. RESULTS: After intravitreal administration of bevacizumab, there was a significant reduction of central foveal thickness from 858 ± 311 µm at baseline to 243 ± 106 µm at the 6-month follow-up, as well as a significant reduction of central choroidal thickness from 282 ± 38 µm at baseline to 227 ± 56 µm at the 6-month follow-up (p = 0.0006, p = 0.0003 respectively). The visual acuity worsened from a median of 1.3 to 1.7 (p = 0.02). CONCLUSION: In patients with iCRVO, intravitreal bevacizumab led to a reduction of central macular edema and central choroidal thickness, but a worsening of visual acuity. Intravitreal bevacizumab reduces macular edema but is not able to overcome the poor prognosis of iCRVO.

Qualidade de Vida de pacientes hipertensos e comparação entre dois instrumentos de medida de QVRS / Quality of life of hypertensive patients and comparison of two instruments of HRQOL measure

FUNDAMENTO: Medir Qualidade de Vida (QV) relacionada à saúde auxilia na avaliação da eficiência de um tratamento e identifica problemas de maior impacto na QV do paciente. No entanto, essas medidas são mais seguras se avaliadas por instrumentos genéricos e específicos conjuntamente, fazendo-se necessário verificar se há compatibilidade entre esses e evitar repetições e contradições entre os domínios. OBJETIVO: Descrever o perfil de qualidade de vida de pacientes hipertensos e avaliar a compatibilidade de um instrumento específico (MINICHAL) e outro genérico (SF-36). MÉTODOS: Cem pacientes hipertensos adultos em tratamento ambulatorial entrevistados. A média da QVRS medida pelo MINICHAL foi de 6,64 (DP 6,04) no estado mental e média de 5,03 (DP 4,11) no estado manifestações somáticas. As médias para o instrumento SF-36 foram por ordem de classificação: limitação por aspectos físicos 47,3 (DP 42,9), vitalidade 57,4 (DP 19,7), limitação por aspectos emocionais 58 (DP 44,7), capacidade funcional 58,7 (DP 27,8), dor 60,4 (DP 26,3), estado geral de saúde 60,7 (DP 22,7), saúde mental 66,8 (DP 22,1) e aspectos sociais 78 (DP 26,1). RESULTADOS: O MINICHAL apresentou correlação significativa (p < 0,001) com o SF-36 em todos os domínios. CONCLUSÃO: O MINICHAL provou ser um instrumento útil na avaliação da QVRS em pacientes hipertensos. (Arq Bras Cardiol. 2012; [online].ahead print, PP.0-0).

BACKGROUND: Measuring health-related quality of life (QOL) helps evaluating the efficiency of a treatment and identifies problems with major impact on the patient's QOL. However, these measures are safer if assessed by generic and specific instruments together, where it is necessary to check for compatibility between these and avoid repetitions and contradictions between the domains. OBJECTIVE: To describe the quality of life of hypertensive patients and to evaluate the compatibility of a specific instrument (MINICHAL) and a generic instrument (SF-36). METHODS: One hundred adult hypertensive under outpatient care were interviewed. The mean HRQOL as measured by MINICHAL was 6.64 (SD 6.04) in mental status and average of 5.03 (SD 4.11) in the state of somatic manifestations. The means for the instrument SF-36 were in ranking order: limitation due to physical aspects 47.3 (SD 42.9), vitality 57.4 (SD 19.7), limitation due to emotional aspects 58 (SD 44.7), functional capacity 58.7 (SD 27.8), pain 60.4 (SD 26.3), general health condition 60.7 (SD 22.7), mental health 66.8 (SD 22.1) and social aspects 78 (SD 26.1). RESULTS: The MINICHAL significantly correlated (p <0.001) with the SF-36 in all domains. CONCLUSION: The MINICHAL proved to be a useful tool in the assessment of HRQOL in patients with hypertension. (Arq Bras Cardiol. 2012; [online].ahead print, PP.0-0).

Quality of life of hypertensive patients and comparison of two instruments of HRQOL measure.

BACKGROUND: Measuring health-related quality of life (QOL) helps evaluating the efficiency of a treatment and identifies problems with major impact on the patient's QOL. However, these measures are safer if assessed by generic and specific instruments together, where it is necessary to check for compatibility between these and avoid repetitions and contradictions between the domains. OBJECTIVE: To describe the quality of life of hypertensive patients and to evaluate the compatibility of a specific instrument (MINICHAL) and a generic instrument (SF-36). METHODS: One hundred adult hypertensive under outpatient care were interviewed. The mean HRQOL as measured by MINICHAL was 6.64 (SD 6.04) in mental status and average of 5.03 (SD 4.11) in the state of somatic manifestations. The means for the instrument SF-36 were in ranking order: limitation due to physical aspects 47.3 (SD 42.9), vitality 57.4 (SD 19.7), limitation due to emotional aspects 58 (SD 44.7), functional capacity 58.7 (SD 27.8), pain 60.4 (SD 26.3), general health condition 60.7 (SD 22.7), mental health 66.8 (SD 22.1) and social aspects 78 (SD 26.1). RESULTS: The MINICHAL significantly correlated (p <0.001) with the SF-36 in all domains. CONCLUSION: The MINICHAL proved to be a useful tool in the assessment of HRQOL in patients with hypertension.

Changes in the volume and histology of endometriosis foci in rats treated with copaiba oil (Copaiferalangsdorffii).

PURPOSE: The aim of this study was to analyze the changes that occur in rats with experimental endometriosis after treatment with copaiba oil. METHODS: Experimental endometriosis was induced in rats. The experimental group received copaiba oil (Copaiferalangsdorffii) orally (0.63 mg/day), and the control group received a 0.9% sodium chloride solution orally (1 ml/100 g of body weight/day). Both groups were treated with gavage for 14 days. After this period, the animals were euthanized, and the implant volume was calculated. The autologous transplants were removed, dyed with hematoxylin-eosin, and analyzed by light microscopy. RESULTS: The average final volumes were significantly different between the groups (p=0.007). There was a significant increase (p=0.012) between the initial and final volumes in the control group, whereas treatment with Copaiferalangsdorffii caused a marked reduction in endometrial growth over time (p=0.016). Histologically, 6/11 (55.00%) rats in the experimental group had a well-preserved epithelial layer, and 3 (45.00%) had mildly preserved epithelium. The control group had seven cases (58.30%) of well-preserved epithelial cells and five cases (41.70%) of mildly preserved epithelial cells (p>0.05). CONCLUSION: Copaiba oil (Copaiferalangsdorffii) appears to be a promising alternative treatment for endometriosis.

[Weaving the web of abandonment: beyond the perceptions of mothers of preterm infants]. / Tecendo as teias do abandono: além das percepções das mães de bebês prematuros.

The scope of this study was to analyze the events involved in preterm infant abandonment by their mothers. A qualitative study was carried out with 12 mothers of preterm infants interned in the NICU of the Federal University of Maranhão - Brazil. The techniques were semi-structured interviews and a focus group performed during internment and in follow-up in the outpatient unit. The sample was defined according to saturation criteria. Content analysis was utilized by thematic scrutiny. The results showed several modes of abandonment in the mothers' life history: abandonment by relatives, social abandonment, and abandonment by the partner. Abandonment by the family was seen in childhood and adolescence as well as in pregnancy, and during infant internment. Another point was the perception of caring as a maternal duty leading to the building of the ideal model that a good mother is loving and does not abandon her offspring. Family, social, and health professional support networks can contribute to maternal empowerment that leads to refraining from abandonment. It was concluded that an abandoned mother might in turn become an abandoning mother, and that, support networks providing attention and protection may turn the history of the abandonment cycle around.

Tecendo as teias do abandono: além das percepções das mães de bebês prematuros / Weaving the web of abandonment: beyond the perceptions of mothers of preterm infants

O objetivo foi analisar a rede de eventos envolvidos na intenção de abandono de bebês prematuros por suas mães. Pesquisa qualitativa realizada com 12 mães de prematuros internados na UTIN, do HUUMI. As técnicas foram entrevistas semiestruturadas e grupo focal realizados na internação e no ambulatório de seguimento. Amostra definida pelos critérios de saturação, a partir da repetição das falas. Utilizou-se análise de conteúdo na modalidade de análise temática. Resultados evidenciaram as dificuldades em ser mãe de prematuros e diversas formas de abandono em suas histórias de vida: abandono familiar, abandono social, abandono do companheiro que podem ter contribuído para a manifestação da intenção de abandono e/ou negligência materna. O abandono familiar materno foi evidenciado na infância, adolescência, na gravidez e no período de internação do bebê. Destacando-se a percepção do cuidado como obrigação materna, levando à construção do tipo idealizado de que boa mãe é a que cuida e não abandona. Redes de suporte podem empoderá-las facilitando a construção de vínculos e levando ao desejo de não abandonar. Conclui-se que existe uma rede de eventos e fenômenos sociais, familiares e políticos que contribuem para a intenção ou a efetiva realização do abandono. A mãe abandonada pode ser uma mãe abandonante.

The scope of this study was to analyze the events involved in preterm infant abandonment by their mothers. A qualitative study was carried out with 12 mothers of preterm infants interned in the NICU of the Federal University of Maranhão - Brazil. The techniques were semi-structured interviews and a focus group performed during internment and in follow-up in the outpatient unit. The sample was defined according to saturation criteria. Content analysis was utilized by thematic scrutiny. The results showed several modes of abandonment in the mothers' life history: abandonment by relatives, social abandonment, and abandonment by the partner. Abandonment by the family was seen in childhood and adolescence as well as in pregnancy, and during infant internment. Another point was the perception of caring as a maternal duty leading to the building of the ideal model that a good mother is loving and does not abandon her offspring. Family, social, and health professional support networks can contribute to maternal empowerment that leads to refraining from abandonment. It was concluded that an abandoned mother might in turn become an abandoning mother, and that, support networks providing attention and protection may turn the history of the abandonment cycle around.

Changes in the volume and histology of endometriosis foci in rats treated with copaiba oil (Copaiferalangsdorffii) / Mudanças no volume e histologia do foco de endometriose em ratas tratadas com óleo de Copaíba (Copaiferalangsdorffii)

PURPOSE: The aim of this study was to analyze the changes that occur in rats with experimental endometriosis after treatment with copaiba oil. METHODS: Experimental endometriosis was induced in rats. The experimental group received copaiba oil (Copaiferalangsdorffii) orally (0.63 mg/day), and the control group received a 0.9 percent sodium chloride solution orally (1 ml/100 g of body weight/day). Both groups were treated with gavage for 14 days. After this period, the animals were euthanized, and the implant volume was calculated. The autologous transplants were removed, dyed with hematoxylin-eosin, and analyzed by light microscopy. RESULTS: The average final volumes were significantly different between the groups (p=0.007). There was a significant increase (p=0.012) between the initial and final volumes in the control group, whereas treatment with Copaiferalangsdorffii caused a marked reduction in endometrial growth over time (p=0.016). Histologically, 6/11 (55.00 percent) rats in the experimental group had a well-preserved epithelial layer, and 3 (45.00 percent) had mildly preserved epithelium. The control group had seven cases (58.30 percent) of well-preserved epithelial cells and five cases (41.70 percent) of mildly preserved epithelial cells (p>0.05). CONCLUSION: Copaiba oil (Copaiferalangsdorffii) appears to be a promising alternative treatment for endometriosis.

OBJETIVO: O objetivo deste estudo foi analisar as mudanças que ocorreram em ratas com endometrioses experimental tratadas com óleo de copaíba. MÉTODOS: Foi induzida a endometriose experimental nas ratas. O grupo experimental recebeu óleo de copaíba (Copaiferalangsdorffii) oralmente (0,63mg/dia) e o grupo controle recebeu oralmente solução salina 0,9 por cento (1mL/100g/dia). Ambos grupos foram tratados por gavagem por 14 dias. Depois desse período, foi realizada a eutanásia dos animais e calculado o volume do implante. Os transplantes autólogos foram removidos, corados com Hematoxilina-eosina e realizada a microscopia óptica. RESULTADOS: A média final dos volumes foi significativamente diferente entre os grupos (p=0,007). Houve um aumente significante (p=0,12) entre o volume inicial e final do grupo controle, enquanto no grupo tratado com Copaiferalangsdorffii causou uma redução acentuada no crescimento endometrial ao longo durante o período (p=0,016). Histologicamente,6 das 11 (55 por cento) ratas do grupo experimental tinha uma camada epitelial bem preservada e 3 (45 por cento) apresentaram epitélio levemente preservado. O grupo controle apresentou sete casos (58,3 por cento) de células epiteliais bem preservadas e cinco casos (41,7 por cento) de células epiteliais levemente preservadas (p>0,05). CONCLUSÃO: O óleo de copaíba (Copaiferalangsdorffii) parece ser um tratamento alternativo promissor para endometriose.