Dry Eye Disease Symptoms Among Glaucoma Patients at a Portuguese Hospital.

INTRODUCTION: Glaucoma-related dry eye disease (DED) is often underestimated, but it is an important comorbidity affecting 40% to 59% of glaucoma patients. It may be an exacerbation of a pre-existing condition or a novel disease starting after the initiation of topical medication. The cumulative effect of medication, preservatives and excipients leads to an alteration in tear film composition and ocular surface stability. The main purpose of this investigation was to study a group of Portuguese glaucoma patients regarding the presence of DED symptoms and correlate the severity of the symptoms with the usage of different types of glaucoma topical medications. MATERIALS AND METHODS: This is a cross-sectional observational study of patients diagnosed with primary and secondary open-angle glaucoma. The questionnaire Standardized Patient Evaluation of Eye Dryness (SPEED) translated to Portuguese (SPEED-Vp) was taken by patients followed in the Glaucoma Department of Unidade Local de Saúde Entre Douro e Vouga, Santa Maria da Feira, Portugal. Data was collected regarding their age, gender, type of topical medication in use as well as frequency and duration of usage. A statistical analysis was performed. RESULTS: A total of 75 patients answered the SPEED-Vp questionnaire. The mean age was 72 ± 7 years old. Fifty-two percent (n=39) were male, and 48% (n=36) were female patients. About 49.33% (n=37) had been on intraocular pressure (IOP)-lowering eyedrops for more than five years. About 61.43% (n=43) of patients used IOP-lowering eyedrops with preservatives. Most of the patients used prostaglandin analogs (75.71%, n=53) and beta-blockers (72.86%, n=51). SPEED score average was 2.75. About 25.33% (n=19) had no DED symptoms, 58.67% (n=44) had mild symptoms, 8% (n=6) had moderate symptoms and 8% (n=6) had severe symptoms. No statistically significant correlation was found between SPEED score and age, gender, number of eyedrop containers, number of active principles, application frequency, presence of preservatives, number of eyedrop containers with preservatives, duration of eyedrops usage or any of the medication groups. CONCLUSION: Although a high percentage of patients were on eyedrops with preservatives, this low rate of symptoms might be because patients tended to devalue these symptoms; were already on treatment with artificial tears; or have an underestimation of the sensation of dry eye due to decreased neuronal corneal nerve responses and density. These results were surprisingly positive. This might also be the result of the healthcare provider's sensibilization to this issue (early diagnosis, early prescription of artificial tears and change from preservative to preservative-free medication).

Influence of cigarette smoking on the Index of Cardiac Electrophysiological Balance in apparently healthy Angolans.

Background: Tobacco use accelerates atherosclerosis and is one of the predictors of death from ischemic heart disease, arrhythmias, heart failure, and sudden death. A new non-invasive parameter, the Index of Cardiac Electrophysiological Balance (iCEB) between depolarization and repolarization of the action potential, was considered a new biomarker for the identification of patients at increased arrhythmic risk. Objectives: We aimed to evaluate the iCEB in apparently healthy Angolans with habitual cigarette smoking compared to non-smokers. Subjects and methods: Data were obtained from the CardioBengo study, a cross-sectional community-based study in which a random sample of individuals aged between 15 and 84 years was selected. In total, 214 apparently healthy subjects, 102 smokers, and 112 non-smokers in the same age group were included in the final analysis. Results: The average age of the participants was 42.17 ± 13.04 years old and 26.6% of the sample was female. Smoking subjects had higher iCEB and corrected Index of Cardiac Electrophysiological Balance (iCEBc) values compared with non-smoking controls (4.39 vs. 4.25; p = 0.024, respectively), and (4.74 vs. 4.57; p = 0.030, respectively). Conclusions: In summary, iCEB and iCEBc were significantly higher in habitual smokers than in nonsmokers, which represents an increased risk of ventricular arrhythmogenesis in healthy habitual smokers. To the best of our knowledge, this is the first study performed in Africa to evaluate iCEB in smokers, making this type of study very important in low- and middle-income countries in the context of epidemiological transition.

Fellowship in surgical oncology: The results of an experience in Portuguese-speaking African countries.

Cancer incidence rates are increasing worldwide including in Portuguese speaking African countries. We present the results of the fellowship in surgical oncology promoted by the Portuguese Institute of Oncology in Porto (IPO), Fernando Pessoa University, Portugal, and the Calouste Gulbenkian Foundation, which involved the training of residents and surgeons from Portuguese-speaking African countries in Portugal. The program's structure and content was the same of UMES/ESSO. The hands-on activity took place at the IPO. After the fellowship, a theoretical and practical assessment was held, and all fellows scored above the threshold to pass. The surgical performance of the fellows was assessed in their workplaces in Africa. The impact of the training was evaluated by a questionnaire completed by all the fellows. It was reported an increase in knowledge, skills and organizational skills that fellows are committed to implement. As the fellowship is certified by a Portuguese University, it may be recognized by the Local Health and University Authorities, impacting on the professional progression of fellows.

Investigating Imperfect Cloning for Extending Quantum Communication Capabilities.

Quantum computing allows the implementation of powerful algorithms with enormous computing capabilities and promises a secure quantum Internet. Despite the advantages brought by quantum communication, certain communication paradigms are impossible or cannot be completely implemented due to the no-cloning theorem. Qubit retransmission for reliable communications and point-to-multipoint quantum communication (QP2MP) are among them. In this paper, we investigate whether a Universal Quantum Copying Machine (UQCM) generating imperfect copies of qubits can help. Specifically, we propose the Quantum Automatic Repeat Request (QARQ) protocol, which is based on its classical variant, as well as to perform QP2MP communication using imperfect clones. Note that the availability of these protocols might foster the development of new distributed quantum computing applications. As current quantum devices are noisy and they decohere qubits, we analyze these two protocols under the presence of various sources of noise. Three major quantum technologies are studied for these protocols: direct transmission (DT), teleportation (TP), and telecloning (TC). The Nitrogen-Vacancy (NV) center platform is used to create simulation models. Results show that TC outperforms TP and DT in terms of fidelity in both QARQ and QP2MP, although it is the most complex one in terms of quantum cost. A numerical study shows that the QARQ protocol significantly improves qubit recovery and that creating more clones does not always improve qubit recovery.

Volatile Compounds and Biological Activity of the Essential Oil of Aloysia citrodora Paláu: Comparison of Hydrodistillation and Microwave-Assisted Hydrodistillation.

Aromatic plants are a remarkable source of natural products. Aloysia citrodora Paláu (Verbenaceae), commonly known as lemon verbena, is a relevant source of essential oils with potential applications due to its lemony scent and bioactive properties. Studies carried out on this species have focused on the volatile composition of the essential oil obtained by Clevenger hydrodistillation (CHD), with little information available on alternative extraction methodologies or the biological properties of the oil. Therefore, this work aimed to compare the volatile composition, antioxidant activity, cytotoxicity, anti-inflammatory and antibacterial activities of the essential oil extracted by conventional hydrodistillation by Clevenger (CHD) and Microwave-Assisted Hydrodistillation (MAHD). Significant differences (p < 0.05) were observed for some compounds, including the two major ones, geranial (18.7-21.1%) and neral (15.3-16.2%). Better antioxidant activity was exhibited by the MAHD essential oil in DPPH radical scavenging and reducing power assays, while no differences were observed in the cellular antioxidant assay. The MADH essential oil also presented higher inhibition against four tumoral cell lines and exhibited lower cytotoxicity in non-tumoral cells as compared with Clevenger-extracted essential oil. In contrast, the latter showed higher anti-inflammatory activity. Both essential oils were able to inhibit the growth of eleven out of the fifteen bacterial strains tested.

Supporting Heterogenous Traffic on Top of Point-to-Multipoint Light-Trees.

New 5 G and beyond services demand innovative solutions in optical transport to increase efficiency and flexibility and reduce capital (CAPEX) and operational (OPEX) expenditures to support heterogeneous and dynamic traffic. In this context, optical point-to-multipoint (P2MP) connectivity is seen as an alternative to provide connectivity to multiple sites from a single source, thus potentially both reducing CAPEX and OPEX. Digital subcarrier multiplexing (DSCM) has been shown as a feasible candidate for optical P2MP in view of its ability to generate multiple subcarriers (SC) in the frequency domain that can be used to serve several destinations. This paper proposes a different technology, named optical constellation slicing (OCS), that enables a source to communicate with multiple destinations by focusing on the time domain. OCS is described in detail and compared to DSCM by simulation, where the results show that both OCS and DSCM provide a good performance in terms of the bit error rate (BER) for access/metro applications. An exhaustive quantitative study is afterwards carried out to compare OCS and DSCM considering its support to dynamic packet layer P2P traffic only and mixed P2P and P2MP traffic; throughput, efficiency, and cost are used here as the metrics. As a baseline for comparison, the traditional optical P2P solution is also considered in this study. Numerical results show that OCS and DSCM provide a better efficiency and cost savings than traditional optical P2P connectivity. For P2P only traffic, OCS and DSCM are utmost 14.6% more efficient than the traditional lightpath solution, whereas for heterogeneous P2P + P2MP traffic, a 25% efficiency improvement is achieved, making OCS 12% more efficient than DSCM. Interestingly, the results show that for P2P only traffic, DSCM provides more savings of up to 12% than OCS, whereas for heterogeneous traffic, OCS can save up to 24.6% more than DSCM.

Honey bee (Apis mellifera) wing images: a tool for identification and conservation.

BACKGROUND: The honey bee (Apis mellifera) is an ecologically and economically important species that provides pollination services to natural and agricultural systems. The biodiversity of the honey bee in parts of its native range is endangered by migratory beekeeping and commercial breeding. In consequence, some honey bee populations that are well adapted to the local environment are threatened with extinction. A crucial step for the protection of honey bee biodiversity is reliable differentiation between native and nonnative bees. One of the methods that can be used for this is the geometric morphometrics of wings. This method is fast, is low cost, and does not require expensive equipment. Therefore, it can be easily used by both scientists and beekeepers. However, wing geometric morphometrics is challenging due to the lack of reference data that can be reliably used for comparisons between different geographic regions. FINDINGS: Here, we provide an unprecedented collection of 26,481 honey bee wing images representing 1,725 samples from 13 European countries. The wing images are accompanied by the coordinates of 19 landmarks and the geographic coordinates of the sampling locations. We present an R script that describes the workflow for analyzing the data and identifying an unknown sample. We compared the data with available reference samples for lineage and found general agreement with them. CONCLUSIONS: The extensive collection of wing images available on the Zenodo website can be used to identify the geographic origin of unknown samples and therefore assist in the monitoring and conservation of honey bee biodiversity in Europe.

Reduced cardiovascular risk score following bilateral cataract phacoemulsification surgery: A retrospective observational cohort study.

OBJECTIVE: To assess the cardiovascular risk (CV risk) change following bilateral phacoemulsification cataract surgery. METHODS: We performed a retrospective observation cohort study on 112 selected patients who underwent uncomplicated bilateral cataract surgery at Centro Hospitalar de Entre o Douro e Vouga (CHEDV) between 2018 and 2019. This patient cohort was further subdivided in 2 different groups: Good VA - no to mild visual impairment, ≤0.48 LogMAR; Bad VA - moderate to severe visual impairment, >0.48 LogMAR. We compared the changes in the CV risk score components in our patient cohort and between subgroups Good VA and Bad VA, before and after surgery, using paired t-test or Wilcoxon rank-sum test, and repeated measures ANOVA with Tukey post-hoc tests, respectively. Visual Acuity (VA) before and after surgery was correlated with the patients' CV risk score. At last, linear regression models were built to explain changes in CV risk variables considering the change in VA. RESULTS: Cataract surgery resulted in improved VA. Notably, following surgery our patient cohort showed reduced low-density lipoprotein (LDL) levels after surgery, from 111.17±36.26 mg/dL to 104.22±37.53 mg/dL, and reduced systolic arterial pressure (SAP), from 139.1±15.0 mmHg to 133.7±12.0 mmHg. Ultimately, this translated to an improved CV risk score within 6 months of cataract surgery, from 17.39±11.44% to 16.51±11.27%. Of note, these improvements were mostly present in the Bad VA group of patients, where baseline VA and incidence of dyslipidemia were worse. CONCLUSION: Our results suggest that phacoemulsification cataract surgery may be an important tool in addressing CV risk.

Poststroke psychosis: a case report.

BACKGROUND: Stroke is currently the second leading cause of death in the elderly population. Neuropsychiatric complications following stroke are common, can be overlooked, and are associated with low quality of life, increase in the burden of caregiving and impaired functional status. METHODS: We report a case of poststroke psychosis in a woman without prior psychiatric history. In addition, a brief, nonsystematic review of the pertinent literature was performed. RESULTS: Psychosis can present in almost 5% of stroke survivors. Many patients with poststroke psychosis have no previous psychiatric history and the most common lesion locations include the right frontal, temporal and parietal lobes, the white matter connecting those areas, as well as the right caudate nucleus. Compared to other stroke survivors, patients with poststroke psychosis are more likely to depend on assistance in their everyday lives, can have more difficulty coping with the sequelae of stroke, and have an increased 10-year mortality risk. Guidelines for diagnosing and managing poststroke psychosis are needed. CONCLUSION: Psychosis is a possible complication of stroke and is associated with impairment and increased mortality. Guidelines for diagnosing and managing poststroke psychosis are currently lacking. To assure evidence-based care, further research is needed.

Accurate Low Complex Modulation Format and Symbol Rate Identification for Autonomous Lightpath Operation.

Network automation promises to reduce costs while guaranteeing the required performance; this is paramount when dealing with the forecasted highly dynamic traffic that will be generated by new 5G/6G applications. In optical networks, autonomous lightpath operation entails that the optical receiver can identify the configuration of a received optical signal without necessarily being configured from the network controller. This provides relief for the network controller from real-time operation, and it can simplify the operation in multi-domain scenarios, where an optical connection spans across more than one domain. Consequently, in this work, we propose a blind and low complex modulation format (MF) and symbol rate (SR) identification algorithm. The algorithm is based on studying the effects of decoding an optical signal with different MFs and SRs. Extensive MATLAB-based simulations have been carried out which consider a coherent wavelength division multiplexed system based on 32 and 64 quadrature amplitude modulated signals at up to 96 GBd, thus enabling bit rates of up to 800 Gb/s/channel. The results show remarkable identification accuracy in the presence of linear and nonlinear noise for a wide range of feasible configurations.

Using the Software DeepWings© to Classify Honey Bees across Europe through Wing Geometric Morphometrics.

DeepWings© is a software that uses machine learning to automatically classify honey bee subspecies by wing geometric morphometrics. Here, we tested the five subspecies classifier (A. m. carnica, Apis mellifera caucasia, A. m. iberiensis, Apis mellifera ligustica, and A. m. mellifera) of DeepWings© on 14,816 wing images with variable quality and acquired by different beekeepers and researchers. These images represented 2601 colonies from the native ranges of the M-lineage A. m. iberiensis and A. m. mellifera, and the C-lineage A. m. carnica. In the A. m. iberiensis range, 92.6% of the colonies matched this subspecies, with a high median probability (0.919). In the Azores, where the Iberian subspecies was historically introduced, a lower proportion (85.7%) and probability (0.842) were observed. In the A. m mellifera range, only 41.1 % of the colonies matched this subspecies, which is compatible with a history of C-derived introgression. Yet, these colonies were classified with the highest probability (0.994) of the three subspecies. In the A. m. carnica range, 88.3% of the colonies matched this subspecies, with a probability of 0.984. The association between wing and molecular markers, assessed for 1214 colonies from the M-lineage range, was highly significant but not strong (r = 0.31, p < 0.0001). The agreement between the markers was influenced by C-derived introgression, with the best results obtained for colonies with high genetic integrity. This study indicates the good performance of DeepWings© on a realistic wing image dataset.

Sintomas depressivos em angolanos com HIV em período pré-pandêmico / Depressive symptoms in Angolans with HIV in the pre-pandemic period / Síntomas depresivos en angoleños con VIH en el período prepandemia

Objetivo: conhecer os níveis de depressão e sintomas depressivos em angolanos com HIV. Método: estudo descritivo e misto, com estratégia exploratória sequencial, em período pré-pandêmico em um hospital público de Angola. Realizou-se entrevistas semiestruturadas, com aplicação do Inventário de Depressão de Beck. Para fins de análise, considerou o conceito de depressão a partir da classificação internacional de doenças. Resultados: prevaleceu depressão leve a moderada para ambos os sexos e estado civil. No G1, a maioria além da tristeza ou infelicidade não conseguem suportar a angústia, alguns verbalizam ter consciência de que os choros não os levará a ter vida anterior desta realidade. Agora se sentem irritados o tempo todo e não sentem mais prazer nas coisas como antes. No G2, expressaram ideias e sentimentos suicidas, estavam desanimados quanto ao futuro, percebem-se fracassados mais do que uma pessoa sem a doença, e adiam a tomada de decisão mais do que o costume. Conclusão: embora não tenha prevalecido formas severas (graves) de depressão, a ocorrência de sintomas negativos em variadas esferas da vida pode evoluir, especialmente no contexto angolano.

Objective:to know the levels of depression and depressive symptoms in Angolans with HIV. Method: descriptive and mixed study, with sequentialexploratory strategy, in the pre-pandemic period in a public hospital in Angola. Semi-structured interviews were carried out, with the application of the Beck Depression Inventory. For analysis purposes, it considered the concept of depression from the international classification of diseases. Results: mild to moderate depression prevailed for both sexes and marital status. In G1, the majority, in addition to sadness or unhappiness, cannot bear the anguish, some verbalize being aware that crying will not lead them to have a previous life in this reality. Now they feel irritable all the time and they don't enjoy things the way they used to. In G2, they expressed suicidal ideas and feelings, were discouraged about the future, perceived themselves as failures more than a person without the disease, and postponed decision-making more than usual. Conclusion: although severe forms of depression have not prevailed, the occurrence of negative symptoms in various spheres of life can evolve, especially in the angolan context.

Objetivo:conocer los niveles de depresión y síntomas depresivos en angoleños con VIH. Método:estudo descriptivo y misto, con estratégia exploratória secuencial, en el período pré-pandêmico en un hospital público de Angola. Se realizaron entrevistas semiestructuradas, con la aplicación del Inventario de Depresión de Beck. Para efectos de análisis, se consideró el concepto de depresión de la clasificación internacional de enfermedades. Resultados:predominó la depresión leve a moderada para ambos sexos y estado civil. En G1, la mayoría, además de la tristeza o la infelicidad, no pueden soportar la angustia, algunos verbalizan siendo conscientes de que el llanto no los llevará a tener una vida anterior en esta realidad. Ahora se sienten irritables todo el tiempo y no disfrutan las cosas como antes. En G2 expresaron ideas y sentimientos suicidas, estaban desanimados sobre el futuro, se percibían como fracasados más que una persona sin la enfermedad y postergaban la toma de decisiones más de lo habitual. Conclusión:aunque no han prevalecido formas severas de depresión, la aparición de síntomas negativos en diversas esferas de la vida puede evolucionar, especialmente en el contexto angoleño.

Electrocardiographic findings in pregnant women in Angola.

BACKGROUND: Studies on the electrocardiogram findings in African pregnant women are limited. There is no information available in the literature on the electrocardiographic parameters of pregnant Angolan women. OBJECTIVES: The aim of this study was to describe electrocardiographic findings in women with normal pregnancies in Bengo Province, Angola. METHODS: This is a community-based study with a cross-sectional design conducted between September 2013 and March 2014 in Bengo. The study involved 114 black pregnant women, compared with a paired control group comprising of 120 black non-pregnant women, aged 15 to 42 years. A 12-lead electrocardiogram and a rhythm strip were recorded for all participants. RESULTS: In this study, the mean age was 26.2 ± 7.3 years. Comparing pregnant women vs. non-pregnant, we found the following mean values: Heart rate (83 bpm vs. 74 bpm, p < .001), PR interval (146 ms vs. 151 ms, p = .034), QT interval (360 ms vs. 378 ms, p < .001), QTIc Fridericia (398 ms vs. 403, p = .017), QTIc Framingham (399 ms vs. 404 ms, p = .013) and T-wave axis (340 vs. 410 , p = .001).The main electrocardiographic changes found were: Sinus tachycardia (4.4% vs. 2.5%), T-wave inversion (14.9% vs. 1.7%), Minor ST segment depression (4.5% vs. 0%) and left ventricular hypertrophy (11.4% vs. 11.7%, p = .726). CONCLUSIONS: Pregnant Angolan women compared with controls, had several significantly higher values for heart rate, and significantly lower values of systolic blood pressure and diastolic blood pressure, PR interval, QT interval, QTc interval by Fridericia and Framingham and T-wave axis. Sinus tachycardia, T-wave inversion, and left ventricular hypertrophy, were the main electrocardiographic changes found.

Palliative Care in Patients with Advanced Heart Failure: A Systematic Review.

INTRODUCTION: Heart failure is a disease with survival estimates of around 10% after 10 years of the disease. Being a chronic and debilitatingillness, it is important to investigate the potential efficacy of a palliative care approach for these patients. The aim of this study is to systematically review the efficacy of integrating palliative care in patients with advanced heart failure, including the outcomes overall quality of life and well-being, overall symptom burden and possible specific symptoms, hospital admission rates and mortality. MATERIAL AND METHODS: The MEDLINE, Cochrane, EMBASE and CINAHL databases were searched for articles published between January 2010 and December 2020 about palliative care interventions in patients with heart failure. Clinical studies with humans with symptomatic heart failure were included, comparing the integration of palliative care with usual cardiac care. RESULTS: The search protocol resulted in seven eligible studies for review and qualitative synthesis. The overall risk of bias within studies was moderate to high. Most studies demonstrated improvements with the integration of palliative care in terms of quality of life and reduction of admission rates. The evidence to support a significant improvement in overall symptom burden was not so robust among studies. CONCLUSION: Palliative care interventions seem, overall, to be significantly effective in patients with heart failure. Future studies with more rigorous study designs are needed, in order, to further develop the role of palliative care in heart failure patients.

Introdução: A insuficiência cardíaca apresenta estimativas de sobrevivência de cerca de 10% após 10 anos de doença. Tendo em conta que se trata de uma doença crónica debilitante, é importante investigar os potenciais benefícios e eficácia de uma abordagem de cuidados paliativos. Foi objectivo deste estudo rever de forma sistemática a eficácia dos cuidados paliativos destinados a doentes com insuficiência cardíaca avançada, em termos de qualidade de vida, controlo sintomático, admissões hospitalares e mortalidade. Material e Métodos: Pesquisa na base de dados MEDLINE, Cochrane, EMBASE e CINAHL por artigos publicados entre janeiro de 2010 a dezembro de 2020, tendo sido incluídos estudos clínicos em humanos com insuficiência cardíaca sintomática que compararam a integração de cuidados paliativos com a terapêutica padrão. Os outcomes selecionados para extração de dados foram a qualidade de vida, controlo sintomático, internamentos hospitalares e mortalidade. Resultados: O protocolo de pesquisa resultou em sete estudos elegíveis para revisão e análise qualitativa. O risco geral de viés foi considerado moderado a alto. A maioria dos estudos demonstrou uma melhoria com a integração de cuidados paliativos em termos de qualidade de vida e redução de hospitalizações. A evidência de suporte de uma melhoria significativa no controlo sintomático geral não foi tão robusta. Conclusão: Os cuidados paliativos aparentam ser, em geral, significativamente eficazes para doentes com insuficiência cardíaca avançada. É necessária investigação futura, com estudos mais rigorosos, para realçar o papel dos cuidados paliativos nos doentes com insuficiência cardíaca.

Optical coherence tomography angiography in herpetic leucoma.

BACKGROUND: Herpes simplex virus (HSV) keratitis remains a leading infectious cause of blindness worldwide. Although all forms of HSV keratitis are commonly recurrent, the risk is greatest in stromal keratitis, which is the most likely to result in corneal scarring, thinning, and neovascularization. Recent studies showed the ability of Optical Coherence Tomography Angiography (OCTA) to detect and study vascular abnormalities in the anterior segment, including abnormal corneal vessels. This study intends to investigate the potential of OCTA device to image and describe quantitatively the vascularization in eyes diagnosed with herpetic leucoma and to discuss and review the usefulness of this technique in this pathology. METHODS: A Cross-sectional study was made, including 17 eyes of 15 patients with leucoma secondary to herpetic keratitis. All eyes underwent anterior segment Slit-Lamp photography (SLP), and OCTA with en-face, b-scans and c-scans imaging. The vessel density (VD) was analyzed in the inferior, nasal and temporal corneal margin in all patients, and in the central area, in eyes with central corneal neovascularization (CoNV). The measurements were calculated after binarization with ImageJ software, using OCTA scans with 6 × 6 mm in a depth of 800 µm. RESULTS: Patients included had a mean age 53.267 ± 21.542 (years ± SD). The mean total vessel area was 50.907% ± 3.435%. VD was higher in the nasal quadrant (51.156% ± 4.276%) but there were no significant differences between the three analyzed areas (p = 0.940). OCTA was able to identify abnormal vessels when SLP apparently showed no abnormal vessels; OCTA was able to distinguish between larger and smaller vessels even in central cornea; OCTA scans allowed the investigation of several corneal planes and the relation of them with clinical findings. CONCLUSIONS: OCTA can be useful in both qualitative and quantitative follow-up of patients and may become a non-invasive alternative to objectively monitor treatment response in eyes with corneal vascularization due to herpetic infection.

Prevalence of major and minor electrocardiographic abnormalities and their relationship with cardiovascular risk factors in Angolans.

AIMS: To identify the prevalence of major and minor electrocardiographic abnormalities and their association with the main risk factors for cardiovascular disease in a population in the province of Bengo, northern Angola. METHODS: A cross-sectional community-based study was conducted and a representative random sample stratified by sex and age was selected. In total, 2379 black individuals were included in the final analysis. A standard 12-lead ECG were recorded from all participants, analyzed and processed by the University of Glasgow software and coding by the Minnesota code. RESULTS: 22.3% of participants had minor electrocardiographic abnormalities and 4.58% major ECG abnormalities. The most common minor ECG abnormalities were abnormal T wave inversion, minor isolated ST abnormalities and premature beats. The most common major ECG abnormalities were Left ventricular hypertrophy with major ST-T abnormalities, Ventricular conduction defects and major Q-wave abnormalities. Hypertension, diabetes mellitus, hypercholesterolemia, alcohol consumption and smoking, were significantly associated with major and minor electrocardiographic abnormalities. CONCLUSIONS: In this study several participants had minor and major electrocardiographic abnormalities. Minor electrocardiographic abnormalities were more prevalent in men and major abnormalities in women. The electrocardiographic abnormalities had significant associations with the main cardiovascular risk factors.

ANALYSIS OF CONJUNCTIVAL VASCULAR DENSITY IN SCLERAL CONTACT LENS WEARERS USING OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY.

PURPOSE: To investigate conjunctival vascular density (VD) using Anterior Segment Optical Coherence Tomography Angiography (OCTA) in Scleral Contact Lens (ScCL) wearers. METHODS: In this cross-sectional study, the conjunctival blood VD was assessed using OCTA with an anterior segment lens adapter. The nasal surface of each eye (6 ×6 mm) was scanned to a depth of 800 µm with ScCL and fifteen minutes after removing the lens. Conjunctival VD was defined as the percentage of the scanned volume occupied by vessels in which blood flow was measured. Measures of limbal indentation were subjectively determined by two independent observers using Anterior Segment Optical Coherence Tomography (AS-OCT). Comparisons between VD measurements before and after ScCL removal and correlations between conjunctival VD, time of use, vault and indentation values were also investigated. RESULTS: A total of 23 patients (3 females, 20 males) with keratoconus, with a mean age (years±SD) of 38.74±10.38 were included in the study. VD was significantly higher without ScCL (71.75%±2.97) than VD measured with ScCL (69.81%±2.63), p=0.02. A moderately negative correlation was found between indentation and vault (r=-0.44, p<0.05) and a positive tendency regarding the time of wearing ScCL and indentation (r=0.11 and r=0.068, respectively). CONCLUSIONS: Using OCTA with an anterior segment lens adapter, the ocular surface blood VD was imaged and assessed with good repeatability and reliability. This study presents a new possible application of OCTA to investigate and monitor conjunctival vasculature in ScCL wearers. This results cautiously suggest that the repeated use of ScCL can cause vascular alterations in conjunctiva of the eyes of ScCL wearers, possibly due to a hidden hypoxia caused by prolonged limbal indentation.

EVALUATION OF POST-SURGICAL MANAGEMENT OF FRAGILITY FRACTURES.

OBJECTIVE: To evaluate the conduct of Brazilian orthopedists regarding preventive treatment after fragility fracture surgery. METHODS: A questionnaire was applied to Brazilian orthopedists. Statistical analyses were performed using the SPSS 16.0 program. RESULTS: 257 participants were analyzed. Most participants, 90.7% (n = 233), reported that they cared for patients with fractures and 62.3% (n = 160) treated them. The most indicated treatments were vitamin D (22.6%; n = 134) and calcium supplementation (21.4%; n = 127). According to the experience of the physicians - experienced (n = 184) and residents (n = 73) - fragility fractures were more common in the routine of residents (98.6%; n = 72) than experienced physicians (87.5%; n = 161), p = 0.0115. While treatment conduction was more reported by experienced physicians (63.6%; n = 117) than residents (58.9%; n = 43), p = 0.004. More experienced orthopedists (21.4%; n = 97) indicated treatment with bisphosphates than residents (14.2%; n = 20), p = 0.0266. CONCLUSION: Although most professionals prescribe treatment after fragility fracture surgery, about 40% of professionals still do not treat it, with differences in relation to experience. In this sense, we reinforce the importance of secondary prevention in the management of fragility fractures. Level of Evidence II, Prospective comparative study.

OBJETIVO: Avaliar a conduta adotada por ortopedistas brasileiros em relação ao tratamento adjuvante após a cirurgia de fraturas de fragilidade. MÉTODOS: Foi aplicado um questionário aos ortopedistas brasileiros. A estatística foi realizada no programa SPSS 16.0. RESULTADOS: Foram analisados 257 participantes. A maioria dos participantes 90,7% (n = 233) relataram atender os pacientes com fraturas e 62,3% (n = 160) relataram tratar. Os tratamentos mais indicados foram a suplementação de vitamina D (22,6%; n = 134) e de cálcio (21,4%; n = 127). De acordo com a comparação médicos experientes (n = 184) versus médicos residentes (n = 73), a rotina de fraturas de fragilidade foi mais observada por médicos residentes (98,6%; n = 72) que por médicos experientes (87,5%; n = 161), p = 0,0115. Enquanto a conduta de tratamento foi mais relatada por médicos experientes (63,6%; n = 117) versus médicos residentes (58,9%; n = 43), p = 0,004. A maior proporção de médicos experientes (21,4%; n = 97) indicaram o tratamento com bifosfatos versus médicos residentes (14,2%; n = 20), p = 0,0266. CONCLUSÃO: Apesar da maioria dos profissionais prescreverem um tratamento após a cirurgia de fraturas de fragilidade, cerca de 40% dos profissionais ainda não tratam, sendo observadas diferenças em relação à experiência. Neste contexto, reforçamos a importância da prevenção secundária na conduta de fraturas de fragilidade. Nível de Evidência II, Estudo prospectivo comparativo.

[Technology for access to water in the Amazonian floodplain: positive impacts on the lives of riverine communities in the Middle Solimões, Amazonas State, Brazil]. / Tecnologia para acesso à água na várzea amazônica: impactos positivos na vida de comunidades ribeirinhas do Médio Solimões, Amazonas, Brasil.

The study presents an assessment of the health and social impacts from the implementation of water supply systems in riverine communities in the Middle Solimões region, Amazonas State, Brazil. Data were collected in 21 rural communities, 19 of which received the water access technology experimentally in the last 14 years. For comparison, three rural communities that had not received the technology participated in the study. A quantitative/qualitative methodology was used with the following techniques: focus groups, semi-structured interviews, questionnaires, parasitological tests, and water quality analysis. Even without a reduction in the prevalence of parasite infections, the systems showed impacts on comfort, privacy, and reduction in the time spent on household chores such as fetching water or having to wash clothes and pots and pans outdoors and far from home. The impacts point to an improvement in living conditions from the perspective of wellbeing.

Este estudo apresenta uma avaliação dos impactos de saúde e social com base na implantação de sistemas de abastecimento de água em comunidades ribeirinhas na Região do Médio Solimões, Estado do Amazonas, Brasil. Os dados foram levantados em 21 comunidades rurais, dentre elas 19 que receberam a tecnologia de acesso à água de forma experimental nos últimos 14 anos. Para a comparação, participaram da pesquisa três comunidades rurais que não receberam a tecnologia. A metodologia utilizada foi quanti/quali, com aplicação das técnicas: grupos focais, entrevistas semiestruturadas, questionários, exames parasitólogicos e análise da qualidade da água. Avaliou-se que mesmo não ocorrendo a redução da prevalência de parasitoses, os sistemas apresentaram impactos quanto ao conforto, a privacidade e na redução do tempo gasto em atividades domésticas, como buscar água no rio ou lavar roupas e vasilhas fora do domicílio. Os impactos apontam para a melhoria das condições de vida com base na perspectiva do bem-estar.

Este estudio presenta una evaluación de los impactos de salud y social, a partir de la implementación de sistemas de abastecimiento de agua en comunidades ribereñas en la región del Médio Solimões, estado de Amazonas, Brasil. Los datos se recabaron en 21 comunidades rurales, entre las cuales 19 contaron con tecnología de acceso al agua de forma experimental durante los últimos 14 años. Para la comparación, participaron en la investigación tres comunidades rurales que no recibieron esta tecnología. La metodología utilizada fue cuanti/cualitativa, con aplicación de las siguientes técnicas: grupos focales, entrevistas semiestructuradas, cuestionarios, exámenes parasitológicos, así como análisis de la calidad del agua. Se evaluó que, incluso no produciéndose la reducción de la prevalencia de parasitosis, los sistemas presentaron impactos en cuanto al confort, la privacidad y en la reducción del tiempo empleado en actividades domésticas, como buscar agua en el río o lavar la ropa y la vajilla fuera del domicilio. Los impactos apuntan hacia una mejoría de las condiciones de vida, desde el punto de vista del bienestar.

The sustainable development goals in two sustainable development reserves in central amazon: achievements and challenges.

The 2030 Agenda was set in 2015 by the United Nations, with 17 Sustainable Development Goals. The Amazonian riverine people are recognized as traditional communities that have their own culture and use the local natural resources of their territories in an ancestral and traditional way. The Sustainable Development Reserve is a Brazilian protected area category which aims to ensure the protection of the natural environment while allowing the residence and the use of these lands by traditional populations. This article reports and discusses the achievements and challenges of the Sustainable Development Goals in two sustainable development reserves in Central Amazonia. The goals were evaluated in the Mamirauá and Amanã Sustainable Development Reserves, due to the large research programs developed in those areas along the past 20 years. The 17 Sustainable Development Goals have a clear connection with the mission of these sustainable development reserves in Central Amazon. Despite the many achievements conquered over the years, there are many challenges yet to overcome; and while striving to achieve the goals from the 2030 Agenda, new challenges will emerge. The current main challenges to reach the Sustainable Development Goals in the Mamirauá and Amanã Sustainable Development Reserves, in Central Amazon, are connecting to the reality of rural areas.