RESUMO
Clinical manifestations and courses of eye diseases in children are profoundly variable, from minor irritations, pain, infections, inflammations, ocular misalignment, refractive errors and visual impairment, to permanent blindness [...].
RESUMO
AIMS: To examine the additive effect of the z-4 microsatellite polymorphism of aldose reductase gene (ALR2) and glycaemic control on risk of cataract in a prospective cohort of Chinese type 2 diabetic patients. METHODS: The (CA)n microsatellite polymorphism of ALR2 was determined using PCR followed by capillary gel electrophoresis. Cataract was defined by presence of lens opacity on direct ophthalmoscopy or history of cataract surgery. A non-linear curve approach was used to identify the threshold of glycated hemoglobin (HbA1c) at which the odds ratio (OR) for cataract started to increase. The association of z-4 allele with cataract, above and below this threshold, was assessed using multiple logistic regression analysis. RESULTS: Of the 5823 patients analyzed, 28.1% had cataracts. After adjusting for conventional risk factors and using non-z-4 carriers with HbA1c<8.0% as referent group (n = 3173), the OR (95% confidence intervals) for cataract was highest in z-4 carriers with HbA1c ≥ 8.0% [1.43 (1.05-1.96), n = 244], compared to non-z-4 carriers with HbA1c ≥ 8.0 [1.27 (1.10-1.47), n = 1836] and z-4 carriers with HbA1c<8.0%[1.01 (0.77-1.29), n = 420, P(trend) < 0.001]. This additive association remained significant after additional adjustments for drug use (P(trend) = 0.002) and renal function (P(trend) = 0.01). CONCLUSIONS: In type 2 diabetic patients with suboptimal glycaemic control, the z-4 allele of ALR2 (CA)n polymorphism was independently associated with increased susceptibility to cataracts.
Assuntos
Aldeído Redutase/genética , Glicemia/metabolismo , Catarata/sangue , Catarata/genética , Diabetes Mellitus Tipo 2/complicações , Repetições de Microssatélites , Polimorfismo Genético , Adulto , Idoso , Catarata/epidemiologia , China/epidemiologia , Estudos de Coortes , Diabetes Mellitus Tipo 2/epidemiologia , Diabetes Mellitus Tipo 2/genética , Diabetes Mellitus Tipo 2/terapia , Retinopatia Diabética/sangue , Retinopatia Diabética/epidemiologia , Retinopatia Diabética/genética , Feminino , Predisposição Genética para Doença , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
BACKGROUND: To evaluate the intraocular penetration of lidocaine 2% gel after different duration of application and to assess their effects on intraoperative pain. METHODS: Samples of aqueous humor were obtained in 41 eyes that had phacoemulsification under topical anesthesia with 2% lidocaine gel. The duration between lidocaine gel application and paracentesis was recorded. The aqueous concentration of lidocaine was measured using high performance liquid chromatography (HPLC). Patients were also asked to report the severity of intraoperative pain using a verbal analogue scale. Correlation analysis was performed to analyze the relationship between duration of lidocaine gel application, aqueous lidocaine concentration and intraoperative pain score. RESULTS: The mean duration of lidocaine gel application was 20.3+/-6.1 min and the mean aqueous lidocaine level was 14.2+/-8.5 micro g/ml. Longer duration of lidocaine gel application was significantly associated with higher aqueous concentration of lidocaine (Spearman's rho=0.58, P<0.001). Eyes in which lidocaine gel was applied for 20 minutes or more had significantly higher aqueous lidocaine level (two-tailed t-test, P=0.001) However, the duration of lidocaine gel application and the aqueous concentration of lidocaine showed no correlation with the patent's perceived pain score (P=0.20 and P=0.79, respectively). CONCLUSIONS: Increase in duration of lidocaine gel application resulted in higher aqueous concentration of lidocaine. Patients' level of perceived pain during phacoemulsification under lidocaine gel anesthesia was not related to the intraocular lidocaine absorption level after 10 min of gel application.
