Ana Tereza Ramos Moreira

Effect of watery extract of Orbignya phalerata (babassu) in the gastric healing in rats: morfologic and tensiometric study

ABSTRACT Introduction : The large use of plants in the prevention and treatment of different diseases is a milenar practice. In Brazil due to it’s rich flora there is a huge material for research and use in popular medicine. The babassu ( Orbignya phalerata ) is a native tree from North of the Brazil and has a high concentration at the State of Maranhao. The powder of it’s mesocarp is known as amid, and has been used as meal and medication due to the known activity against antiflammatory reaction, pain, pyrexia and immunomodulation. Purpose: To analyze the effect of mesocarp of Orbignya phalerata (babassu) in gastric wound healing in rats under morphologic and tensiometric aspects. Method: Forty Wistar rats, male, adults were submitted to a longitudinal incision of 1 cm in the gastric body and sutured with separated stitches of polypropilene 6.0. After this common procedure the animals were allocated in the aleatory way in two groups Orbignya (GO) and Control (GC) with 20 animals each one. In the GO was used intraperitoneal doses of 50mg/kh of

In vitro and in vivo studies with sodium hyaluronate as a carrier for intraocular gentamicin

Abstract We compared the in vitro growth of common intraocular pathogens Staphylococcus aureus, Staphylococcus epidermidis and Pseudomonas aeruginosa in rabbit vitreous and in sodium hyaluronate (SH) with and without gentamicin. The minimal inhibitory concentration for gentamicin/SH was 0.5, 0.062 and 2.0 mcg/ml for these pathogens, respectively. After posterior capsulotomy, P. aeruginosa was inoculated into the anterior vitreous and all 15 untreated eyes developed endophthalmitis. In a similar group, aqueous gentamicin administered in the anterior chamber reduced the incidence of endophthalmitis to 10 of 15 eyes. Under similar circumstances, the SH/gentamicin combination lowered the incidence of endophthalmitis significantly to 4 of 15 eyes. The half‐life of aqueous gentamicin was 0.9 h, which was shorter than the 2.2 h for SH/gentamicin combination. These results suggest that SH may be a useful carrier for intraocular drug therapy.

Sodium hyaluronate as a carrier for intravitreal gentamicin an experimental study

Abstract Fifty mcg of gentamicin was combined with saline or with 0.8% sodium hyaluronate and injected into the vitreous cavity of rabbit eyes with moderate to severe Staphylococcus aureus endophthalmitis. Endophthalmitis was controlled in 9 of 10 eyes. There was no evidence of toxicity with either treatment regimen. Although the clearance study demonstrated statistical differences at all time points studied, the half‐lives of both treatment regimens were similar (3.3 h for aqueous gentamicin and 3.6 h for sodium hyaluronate/gentamicin). These results suggest that the vitreous played a role in keeping the aqueous gentamicin in the eye for a longer time, as similar half‐lives were shown with both types of treatment. Thus, if a vitrectomy has to be done for the treatment of endophthalmitis, as much as possible of the vitreous should be left in situ to maintain the drug for longer periods in the eye. Also, if it is necessary to remove all vitreous during vitrectomy, it may be more effective to administer the drug with sodium hyaluronate so as to prolong its action inside the eye.

Cochlear implant surgery with local anesthesia and sedation: comparison with general anesthesia.

Objectives The purpose of this study is to evaluate the possibility of performing cochlear implant surgery under local anesthesia and sedation and to evaluate the response of patients under sedation at the time of neural telemetry, comparing the differences with general anesthesia. Patients Twenty adult patients with bilateral sensorineural profound hearing loss submitted to cochlear implant surgery under general anesthesia and 20 patients under local anesthesia and intravenous sedation in the period from February 2011 to February 2012. The study was approved by the ethical committee of the institution. Intervention In both groups, we compared the costs of anesthesia, surgical time, time in recovery room, length of hospital stay, postoperative symptoms (pain, nausea, vomiting, and dizziness) and the degree of patient satisfaction. Besides, the reactions of the patients in the moment of the neural telemetry were also analyzed. Main Outcome Measures The endpoint of this study is to establish the possibility of doing cochlear implant surgery with local anesthesia and sedation, discussing the differences and advantages over general anesthesia. Results By t-test variables, time in recovery room, time in hospital stay, and cost of inpatient anesthesia differ between groups, being always lower in the group of local anesthesia with sedation. The same result can be obtained using the Wilcoxon test. The symptoms of nausea, vomiting, and dizziness did not differ in the 2 groups. Conclusion We conclude that the realization of the cochlear implant surgery under local anesthesia, and sedation is perfectly feasible with some advantages over general anesthesia. There were no problems during the neural telemetry performed by the time of the surgery in patients with local anesthesia with sedation.

Hydroxyapatite granules used in the obliteration of mastoid cavities in rats.

UNLABELLED Prospective experimental study in which we created a bony defect in the mastoids of rats and filled it up with hydroxyapatite to evaluate bone regeneration, to solve the problems of open cavities after mastoidectomies that frequently present with otorrhea, infection, granulation tissue and hearing loss. OBJECTIVE The aim was to evaluate bone regeneration in defects created in the mastoids of rats, using hydroxyapatite, to see how much of the cavity we could reduce. MATERIAL AND METHODS Twelve rats Wistar-Furth were used. A 0.5 x 0.5 cm bone defect was created in both temporal bones of the rats, and filled with 15 micrograms of hydroxyapatite. The left side was used as control. The animals were slaughtered 40 days afterwards and histology analyses were carried out. RESULTS In the hydroxyapatite group, the new bone growth involved an area of 68.53% of the total; and in the control group it was only of 15.97%. DISCUSSION AND CONCLUSION It was observed a very good hydroxyapatite integration to the temporal bone in this experimental model. The microscopic results were superior with the use of hydroxyapatite when compared to the control group. It is a safe method and easy to apply to solve the problems of open cavities with chronic discharge and difficult to clean.

Optical coherence tomography in patients undergoing cataract surgery

PURPOSE To assess the ability of spectral domain optical coherence tomography (SD-OCT) to diagnose macular changes pre- and post-cataract surgery and to identify changes in central foveal thickness (CFT) relative to age, sex, and presence of concomitant ophthalmic pathologies, for a period of 6 months post-surgery. METHODS A prospective study of patients evaluated by SD-OCT within 5 h before surgery at 7, 30, 60, 90, and 180 days post-op, with respect to CFT and presence of maculopathy. RESULTS Ninety-eight eyes of 98 patients were evaluated, with the following mean results: age = 71.4 years, pre-op VA = 0.27 logMAR, and final VA = 0.73 logMAR. There were 21 eyes in patients with diabetes mellitus (DM) and 10 eyes with age-related macular degeneration (AMD), three with epiretinal membrane, and four with glaucoma. Sixty eyes had no other ophthalmic-related pathologies (NOO), and had a mean pre-op CFT of 222 μm, which progressively increased up to the 60th day post-op, reaching a mean of 227.2 μm. No pseudophakic cystoid macular edema was observed. The mean CFT was statistically significantly different (p<0.001) between NOO and diabetic patients from 30 days post-op. Four eyes presented with preoperative diagnosis of AMD as measured by ophthalmoscopy. After completion of the OCT, which was performed within 5 h before surgery, six additional patients were found to have AMD. Of the 98 total eyes, 10 were diagnosed with maculopathy only by OCT exam. Binocular indirect ophthalmoscopy (BIO) was unable to detect such changes. CONCLUSION OCT diagnosed preoperative maculopathies in 21.4% of the patients, and was more effective than BIO (11.2%). OCT showed a progressive increase in CFT in diabetics up to 180 days post-operatively, as well as greater CFT in male patients and patients older than 70 years.

Ichthyosis follicularis, alopecia and photophobia syndrome (IFAP): report of the first case with ocular and cutaneous manifestations in Brazil with a favorable response to treatment

Ichthyosis follicular, alopecia, and photophobia (IFAP) syndrome is a rare disease, with possible X-linked mode of inheritance. The patient presented with ocular findings of photophobia, corneal scarring and erosions, superficial and deep corneal vascularization and myopia. He was treated with artificial tears and punctal occlusion with small improvement of photophobia. After three months using systemic retinoid (Acitretina) and posterior amniotic membrane transplantation in the left eye, there was a significant improvement of photophobia, corneal erosions and neuropsychomotor development.

Long-term visual safety of voriconazole in adult patients with paracoccidioidomycosis.

BACKGROUND Voriconazole is an antifungal agent with in vitro activity and clinical efficacy against yeasts, molds, and dimorphic fungi (eg, Paracoccidioides brasiliensis). The safety profile of voriconazole includes transient visual adverse events (VAEs) that resolve while undergoing treatment or after its discontinuation. OBJECTIVE The goal of this study was to assess the long-term (ie, 6-12 months) visual safety of voriconazole in adult patients with paracoccidioidomycosis. METHODS Ophthalmic data were prospectively collected as part of a multicenter, open-label, comparative study. Patients aged ≥18 years with paracoccidioidomycosis were randomized in a 2:1 ratio to receive either voriconazole (200 mg BID orally, after the loading dose of 400 mg BID on day 1) or itraconazole (100 mg BID orally, with no loading dose). Patients were expected to receive treatment for a minimum of 6 months, or longer if needed as determined by the investigator (maximum duration, 1 year). Visual function tests and safety assessments were performed at baseline, week 12, week 24, end of treatment (EOT), and 8 weeks post-EOT. Ophthalmic examinations included visual acuity, color vision, contrast sensitivity, visual field, funduscopy, and slit lamp biomicroscopy. Treatment compliance was monitored via pill counts at each study visit. RESULTS Thirty-five patients (mean age, 48 years; 96.2% male; 83.0% white) were randomized to receive voriconazole and 18 to receive itraconazole. Fourteen voriconazole-treated patients received >6 months of treatment (median, 169 days). Efficacy and overall safety results have been published previously. Sixteen voriconazole-treated patients and 2 itraconazole-treated patients experienced drug-related VAEs; none was considered serious or severe or led to dose reductions or resulted in discontinuation. Overall, visual examination results were not clinically significantly different between patients treated with voriconazole or itraconazole. There was no apparent relationship between changes in visual function test results and the occurrence of VAEs in either treatment group. CONCLUSION Clinical assessment in this study found no evidence of an effect of voriconazole on long-term visual function in these adult patients with paracoccidioidomycosis.

Base eletrônica de dados clínicos e cirúrgicos das doenças da retina e vítreo

PURPOSE: The purpose of this study is to build an automated clinical and surgical database which works with a computer-based program (software), where patients with 19 selected retina and vitreous diseases are included. METHODS: Textbooks from both international and national authors served as a basic structure for the protocol. Specific articles related to each disease, extracted from scientific journals and from specific clinical database sources, searched on the World Wide Web (the internet) were used, as well. Data automation was done by interface with SINPE© (Integrated electronic protocol system) - a software developed at the Informatics and Multimedia Laboratory of the Health Sciences Department at the Universidade Federal do Parana. RESULTS: Along with the data automation the master protocol was created covering all contents in main folders, followed by 19 specific protocols which refer to individual specifications for each disease. The program allows to collect and record data from patients with their clinical characteristics, diagnostic aids, selected treatment as well as follow-up treatment. Likewise, any source of interest in the protocol can be crossed with the Microsoft Excel® program depending on the type of study. CONCLUSIONS: The objective of this study which was to create a wide and updated database of vitreoretinal pathologies of major importance, converting them to a specific software and interfacing it with the SINPE© has been achieved.

Nível de testosterona total em mulheres pós-menopausa com olho seco

PURPOSE The purpose of this study was to compare total testosterone blood level among three groups of postmenopausal women: control, mild to moderate dry eye and severe dry eye. METHODS Twenty-nine postmenopausal women were selected. The exclusion criteria were: hormone replacement therapy in the last 8 weeks, mechanical palpebral abnormalities, pterygium, lacrimal obstructions, intraocular inflammation or contact lens use. A blood sample was collected for total testosterone level determination, and the patients were submitted to an ophthalmologic examination (emphasizing on dry eye detection) and answered the OSDI (Ocular Surface Disease Index) questionnaire. Five patients were excluded. Postmenopausal women were divided into three groups according to OSDI score and the ophthalmic examination. RESULTS Five patients were classified in the no dry eye group (control), fifteen in the mild to moderate dry eye group and four in the severe dry eye group. There were no statistically significant differences regarding mean age (p=0.3915); instruction level (p=0.9333); number of comorbidities (p=0.2551); medication taken (p=0.2844) and total testosterone level among those groups (p=0.1275). CONCLUSION Further research with a greater bigger sample is necessary to establish the relation of androgen levels in dry eye patients.PURPOSE: The purpose of this study was to compare total testosterone blood level among three groups of postmenopausal women: control, mild to moderate dry eye and severe dry eye. METHODS: Twenty-nine postmenopausal women were selected. The exclusion criteria were: hormone replacement therapy in the last 8 weeks, mechanical palpebral abnormalities, pterygium, lacrimal obstructions, intraocular inflammation or contact lens use. A blood sample was collected for total testosterone level determination, and the patients were submitted to an ophthalmologic examination (emphasizing on dry eye detection) and answered the OSDI (Ocular Surface Disease Index) questionnaire. Five patients were excluded. Postmenopausal women were divided into three groups according to OSDI score and the ophthalmic examination. RESULTS: Five patients were classified in the no dry eye group (control), fifteen in the mild to moderate dry eye group and four in the severe dry eye group. There were no statistically significant differences regarding mean age (p=0.3915); instruction level (p=0.9333); number of comorbidities (p=0.2551); medication taken (p=0.2844) and total testosterone level among those groups (p=0.1275). CONCLUSION: Further research with a greater bigger sample is necessary to establish the relation of androgen levels in dry eye patients.