A standardized protocol of laser suture lysis in postoperative management in trabeculectomy with mitomycin C: One-year study.

AIM: To analyse the efficacy and safety of a standardized laser suture lysis protocol following trabeculectomy. MATERIALS AND METHODS: Prospective interventional study conducted at a tertiary centre, between June 2016 and July 2017. Consecutive patients undergoing primary trabeculectomy with mitomycin C (0.4 mg/mL) for open angle glaucoma were enrolled. According to study protocol, a first laser suture lysis was performed routinely when intraocular pressure was greater than 10 mmHg, starting at postoperative day 8, and a second laser suture lysis was done whenever the intraocular pressure was newly greater than 10 mmHg, with a minimum interval of 1 week after the first laser suture lysis. Primary outcome was intraocular pressure (mean value, and mean difference from baseline in percentage). Safety parameters were also analysed. RESULTS: Thirty-three eyes of 28 patients (13 males) were enrolled with a mean age of 69.6 ± 15.1 years. Pre-operative intraocular pressure was 24.9 ± 8.6 mmHg. All eyes underwent a laser suture lysis before the 12th postoperative week, with a mean intraocular pressure-lowering efficacy of 42.4% (p < 0.01). A second laser suture lysis procedure, when performed (n = 14), had an additional intraocular pressure-lowering efficacy of 26.7% (p = 0.02). Mean intraocular pressure at 1-month follow-up was 12.9 ± 8.2 mmHg, and during this period, two cases of self-limited choroidal detachments were noticed. Ten patients needed additional bleb needling. Mean intraocular pressure at 1-year follow-up was 13.8 ± 8.0 mmHg under an average of 0.4 topical intraocular pressure-lowering drugs (p < 0.01). CONCLUSION: In our study, laser suture lysis was an effective tool to lower intraocular pressure during the early postoperative period, with an acceptable safety profile.

Spirituality and quality of life in older adults: a path analysis model.

BACKGROUND: Study older adults' quality of life is becoming increasingly important in the assessment, quality improvement and allocation of health and social care service. The purpose of this study was to enhance knowledge on the relationship between modifiable (psychological variables) and non-modifiable variables (sociodemographic), and quality of life in elderly, regarding psychological and social variables in Portuguese context. METHODS: This is a cross-sectional study, including 604 older adults from general community. 63.6% of the sample was composed by female gender with a mean age of 71.6(SD = 4.81). Participants completed the following instruments: Barthel Index to assess functionality; Satisfaction with Social Support Scale to assess social support; The Spiritual and Religious Attitudes in Dealing with Illness to assess spirituality and Short Form Health Survey 36, to assess mental and physical quality of life. RESULTS: A path analysis model was performed where the presence of a chronic disease, age and functionality has a direct effect on physical quality of life and spirituality had a direct effect on mental quality of life. Social support mediated the relationship between functionality and mental quality of life, and in turn, functionality mediated the relationship between age and physical quality of life. CONCLUSIONS: Results reinforce the effect of age and chronic disease as non-modifiable variables as well as functionality, spirituality and satisfaction with social support as modifiable variables, in the quality of life of older people. Social support, health and education programs in the community should be promoted in order to improve quality of life in this population. Strategies to promote functionality and enhance the social support network, especially in the elder with chronic illness, should be a priority.

Association between sodium intake and hydration status amongst community-dwelling elderly people / Asociación entre la ingesta de sodio y el estado de hidratación en personas mayores que viven en centros comunitarios

Dehydration is a common condition in older people and it has been associated with the development of many diseases. The aim of this study was to assess the association between hydration status in community-dwelling elderly people. Data were gathered in 74 community-dwelling elderly individuals (28 males) and included the collection of 24-h urine samples, which were screened for validity using 24-h urinary creatinine excretion in relation to body weight, anthropometric, physical activity, and sociodemographic variables. Hydration status was assessed using urinary indicators (24-h volume, osmolality and urine specific gravity) and sodium intake was assessed by 24-h urinary sodium excretion. Linear regression analysis was performed to quantify the association between sodium excretion (independent variables) and hydration biomarkers (dependent variables). No significant differences were found between males and females in 24-h urine volume (1,982.5 ± 654.5 mL vs 1,832.0 ± 655.8 mL, p = 0.341), 24-h urine osmolality (454.0 ± 158.5 mOsm/kg vs 402.7 ± 149.4 mOsm/kg, p = 0.204) and 24-h urine specific gravity (1.015 ± 0.006 vs 1.013 ± 0.005, p = 0.131). Urine volume and osmolality showed a positive and significant association with sodium excretion (= 0.314, 95%CI: 0.095,0.562 and = 0.390, 95%CI: 0.195,0.679, respectively), even after adjusting for confounders (age, sex, body mass index, and physical activity). Our findings showed that community-dwelling elderly individuals with a higher level of sodium intake had a higher 24-h urine volume and a higher 24-h urine osmolality. These findings suggest that a higher sodium intake is associated with a poorer hydration status in this elderly population, assessed by urine osmolality (AU)

La deshidratación es un problema común en las personas mayores y ha sido asociado con el desarrollo de muchas enfermedades. El objetivo de este estudio consiste en la evaluación de la asociación entre la ingesta de socio y el estado de hidratación en personas mayores que viven en centros comunitarios. Los datos fueron recopilados a partir de 74 personas mayores que vivían en centros comunitarios (28 varones) e incluyeron tomas de muestras de orina de 24h, que fueron examinadas para determinar su validez empleando excreción urinaria de creatinina de 24h en relación con variables de peso corporal, antropometría, actividad física y variables sociodemográficas. El estado de hidratación fue evaluado empleando indicadores urinarios (volumen en 24h, osmolalidad y gravedad específica de la orina) y la ingesta de sodio fue evaluada mediante excreción urinaria de sodio de 24h. Se realizó un análisis de regresión lineal para cuantificar la asociación entre excreción de sodio (variables independientes) y biomarcadores de hidratación (variables dependientes). No se encontraron diferencias significativas entre varones y mujeres en el volumen de orina de 24h (1.982,5 ± 654,5 mL vs 1.832,0 ± 655,8 mL, p = 0,341), 24-h orina osmolalidad (454,0 ± 158,5 mOsm/kg vs 402,7 ± 149,4 mOsm/kg, p= 0,204) y gravedad específica de la orina en 24h (1,015 ±0,006 vs 1,013 ± 0,005, p = 0,131). El volumen de orina y la osmolalidad mostraron una asociación positiva y significativa con la excreción de sodio (= 0,314, 95% CI: 0,095, 0,562 y = 0,390, 95% CI: 0,195, 0,679, respectivamente), incluso después de ajustar factores de distorsión (edad, sexo, índice de masa corporal y actividad física). Nuestros resultados demostraron que las personas mayores en centros comunitarios, con un mayor nivel de ingesta de sodio, tenían un mayor volumen de orina de 24h y una mayor osmolalidad de la orina de 24-h. Estos resultados sugieren que una mayor ingesta de sodio estaría asociada a un peor estado de hidratación en esta población de mayores, evaluado mediante la osmolalidad de la orina (AU)

Ensino de ecoico, tato e mando: uma revisão bibliográfica dos artigos do Journal of Applied Behavior Analysis (JABA) / Echoic, tact and mand teaching: a bibliographical review of articlesin the Journal of Applied Behavior Analysis (JABA)

A reabilitação de crianças com deficiência auditiva e implante coclear registra a necessidade da elucidação das condições necessárias para estabelecimento de repertórios como ecoico, tato e mando vocais, ainda que repertórios receptivos sejam estabelecidos rapidamente e com muito sucesso. Neste contexto foi desenvolvida uma revisão bibliográfica sobre o ensino desses operantes verbais na base de dados do periódico JABA em três fases: levantamento inicial entre 1968 e 2012 que identificou 306 artigos; seleção dos resumos que ensinavam os operantes-alvos, com 45 artigos; e leitura e análise dos artigos selecionados. Tato e mando foram tomados como operante-alvo em 80% dos artigos e o ecoico apareceu como pré-requisito em 70%; dez artigos ensinaram mais de um operante isoladamente ou por procedimentos de transferência de controle de estímulos. Apenas dois artigos relatavam estudos com deficientes auditivos sugerindo investimento no estudo operante das condições em que a fala expressiva é estabelecida nesta população.(AU)

The rehabilitation process of hearing-impaired and implanted children indicates difficulties and some necessary conditions for the establishment of vocals echoic, tact and mand responses. In this context, a bibliographical review over instruction procedures of operants echoic, tact and mand was made in the periodical JABA’s database in three phases: Initial search over the period of 1968 to 2012, identifying 306 articles; selection of the abstracts about the target operants’ teaching procedures, with 45 selected; and reading and analyzing of the selected studies. Tact and mand were the target operants in 80% of the studies, and echoic was a prerequisite in 70% of the studies; 10 articles reported teaching of more than one verbal operant target individually, or with transference control procedures. Only two studies focused on hearing-impaired participants, suggesting investment on studies about vocal expressive establishment conditions within this population.(AU)

Ensino de ecoico, tato e mando: uma revisão bibliográfica dos artigos do Journal of Applied Behavior Analysis (JABA) / Echoic, tact and mand teaching: a bibliographical review of articles in the Journal of Applied Behavior Analysis (JABA)

A reabilitação de crianças com deficiência auditiva e implante coclear registra a necessidade da elucidação das condições necessárias para estabelecimento de repertórios como ecoico, tato e mando vocais, ainda que repertórios receptivos sejam estabelecidos rapidamente e com muito sucesso. Neste contexto foi desenvolvida uma revisão bibliográfica sobre o ensino desses operantes verbais na base de dados do periódico JABA em três fases: levantamento inicial entre 1968 e 2012 que identificou 306 artigos; seleção dos resumos que ensinavam os operantes-alvos, com 45 artigos; e leitura e análise dos artigos selecionados. Tato e mando foram tomados como operante-alvo em 80% dos artigos e o ecoico apareceu como pré-requisito em 70%; dez artigos ensinaram mais de um operante isoladamente ou por procedimentos de transferência de controle de estímulos. Apenas dois artigos relatavam estudos com deficientes auditivos sugerindo investimento no estudo operante das condições em que a fala expressiva é estabelecida nesta população.

The rehabilitation process of hearing-impaired and implanted children indicates difficulties and some necessary conditions for the establishment of vocals echoic, tact and mand responses. In this context, a bibliographical review over instruction procedures of operants echoic, tact and mand was made in the periodical JABA’s database in three phases: Initial search over the period of 1968 to 2012, identifying 306 articles; selection of the abstracts about the target operants’ teaching procedures, with 45 selected; and reading and analyzing of the selected studies. Tact and mand were the target operants in 80% of the studies, and echoic was a prerequisite in 70% of the studies; 10 articles reported teaching of more than one verbal operant target individually, or with transference control procedures. Only two studies focused on hearing-impaired participants, suggesting investment on studies about vocal expressive establishment conditions within this population.

Polymorphic variation in cytochrome oxidase subunit genes.

Cytochrome oxidase (COX) activity varies between individuals and low activities associate with Alzheimer's disease. Whether genetic heterogeneity influences function of this multimeric enzyme is unknown. To explore this we sequenced three mitochondrial DNA (mtDNA) and ten nuclear COX subunit genes from at least 50 individuals. 20% had non-synonymous mtDNA COX gene polymorphisms, 12% had a COX4I1 non-synonymous G to A transition, and other genes rarely contained non-synonymous polymorphisms. Frequent untranslated region (UTR) polymorphisms were seen in COX6A1, COX6B1, COX6C, and COX7A1; heterogeneity in a COX7A1 5' UTR Sp1 site was extensive. Synonymous polymorphisms were common and less frequent in the more conserved COX1 than the less conserved COX3, suggesting at least in mtDNA synonymous polymorphisms experience selection pressure and are not functionally silent. Compound gene variations occurred within individuals. To test whether variations could have functional consequences, we studied the COX4I1 G to A transition and an AGCCCC deletion in the COX7A1 5' UTR Sp1 site. Cells expressing the COX4I1 polymorphism had reduced COX Vmax activity. In reporter construct-transduced cells where green fluorescent protein expression depended on the COX7A1 Sp1 site, AGCCCC deletion reduced fluorescence. Our findings indicate COX subunit gene heterogeneity is pervasive and may mediate COX functional variation.