Roberto Martins Gonçalves

The role of chemokines in uveitis

Inflammation is part of the physiological process that aims at repairing the damage produced by different causes such as infection, trauma, and autoimmune disease. However, when this physiological process is not regulated, it can contribute to the increase in tissue damage. Chemokines and their receptors are major factors involved in the process of cell migration into inflamed tissues. In the ocular diseases, mainly in uveitis, such proteins have been identified as important mediators of the inflammation process. This review discusses the role of chemokines in several ocular diseases, with emphasis on the uveitic process.

Characteristics of people involved in accidents with two-wheel-vehicles

A Tabela mostra as caracteristicas das vitimas dosacidentes com veiculos de duas rodas. Pode-se ob-servar um predominio da faixa etaria entre 15 e 24anos, tanto para os acidentes com motocicletas quantopara bicicletas (p < 0,01). Por outro lado, em relacaoapenas as vitimas fatais, a idade nao influenciou namortalidade (p = 0,39). Apesar de o numero de viti-mas fatais decorrentes de acidentes com bicicletaster sido maior do que o registrado com motocicletas,a diferenca entre os dois valores nao atinge a signifi-cância (p = 0,055). Os acidentes com motocicletascausaram 60 % do total de vitimas, enquanto 40 % de-las decorreram de acidentes com bicicletas (p < 0,01).Os resultados evidenciam, principalmente, a gra-vidade dos acidentes com bicicletas. O desconheci-mento ou a pouca divulgacao dos dados pode, tal-vez, contribuir para a manutencao ou aumento donumero de vitimas em acidentes com veiculos de duasrodas. A visao que se tem da bicicleta, apenas comouma forma de lazer, reduz a consciencia de risco e asmedidas de prevencao a acidentes sao tomadas ape-nas por uma pequena parcela dos ciclistas.A falta de ciclovias e outro fator que propicia taisocorrencias. Lamentavelmente, e notoria a inefica-cia das campanhas publicitarias voltadas a conscien-tizacao dos usuarios de tais veiculos sobre a necessi-

Increased serum levels of soluble tumor necrosis factor receptor-2 (sTNFR2) in patients with active toxoplasmic retinochoroiditis

This study aimed to investigate the serum levels of the cytokine TNF-α and its soluble receptors (sTNFR1 and sTNFR2) in patients with toxoplasmosis retinochoroiditis (TR) and controls. 37 patients with TR and 30 subjects with positive serology for toxoplasmosis but without history and signs of uveitis were included in this study. Serum concentrations of TNF-α, sTNFR1, and sTNFR2 were determined by ELISA. Serum concentrations of TNF-α and sTNFR1 were similar in controls (mean ± SD median values; 56.57±141.96 and 504.37±163.87, respectively) and TR patients (mean ± SD values, 121.62±217.56 and 511.15±189.30, respectively). Serum concentrations of sTNFR2 were higher in the uveitis group when compared to the control group (respectively, mean ± SD values, 1734.84±379.32 and 1442.75±309.47; p=0.002). There was no association between the serum levels of the molecules and the time of first symptoms, severity of vitreous haze, size or localization of active lesions, levels of visual acuity, and presence of vasculitis. These results suggest that TR is associated with changes in the circulating levels of inflammatory biomarkers, but they are not correlated with local/ocular signs.

Antiphospholipid syndrome and retinal vein occlusion

A 34-year-old white man presented with a sudden unilateral recurrent visual loss. Fundus examination and fluorescein angiography revealed severe retinal vein occlusion. An antiphospholipid syndrome was discovered during etiological check up. A mutation of Leiden V factor was discovered and the patient started long term anticoagulation after the second occlusive event. However, secondary neovascular glaucoma has developed and despite treatment the affected eye had an important reduction of visual acuity. The purpose of this case report is to demonstrate that retinal vascular occlusion can be the initial manifestation of the antiphospholipid syndrome and that its diagnosis is important because this disease generally affects young people and may endanger ocular and vital prognosis. This diagnosis may imply a long lasting anticoagulative or antiaggregative treatment to reduce the risk of recurrent thrombotic events.

Posterior scleritis in Cogan's syndrome.

Purpose: To describe an unusual case of atypical Cogans syndrome with features of posterior scleritis. Methods: Interventional case report. Results: A 53-year-old man presented with bilateral posterior scleritis, along with sensorineural hearing loss and systemic vasculitis. Systemic corticosteroid therapy was started with resolution of ophthalmic findings and improvement of vestibuloauditory symptoms. Conclusions: In the setting of atypical Cogans syndrome, ophthalmic manifestations may be the first sign of disease.

Técnica para preparação e conservação de olhos de porco para cirurgia experimental

PURPOSES: To evaluate Dextran 40 10% efficacy to maintain pig eye corneal transparency in order to indicate the best method (0.9% physiological saline, Dextran 40 10% and the mixture of both at equal parts) of conservation to maintain the transparency. METHODS: Twenty pig eyes, all of them prepared with Dextran injection in the anterior chamber and soaked in this solution for 20 minutes. Four groups, each group with five eyes and kept at 6oC in the following solutions: Group 1 (0.9% physiological saline), Group 2 (Dextran 40 10% + 0.9% physiological saline at equal parts), Group 3 (Dextran 40 10%), Group 4 (humid chamber - control group). The eyes were observed after 12, 24, 48, 56, 72 hours and then classified according to their transparency. RESULTS: Corneal transparency occurred in 100% of the eyes with Dextran solution. 0.9% physiological saline and Dextran at equal parts achieved a longer period of transparency. CONCLUSIONS: Dextran 40 10% is an efficient solution to promote corneal transparency in post mortem pig eyes. The mixture of equal parts 0.9% physiological saline and Dextran can be used to keep feasible the prepared eyes for a period as long as 72 hours.

Nucleofragmentação horizontal: uma nova técnica para a cirurgia de catarata

PURPOSE: To study in vitro the efficacy of a pair of instruments designed to capture and split human nuclei obtained from extracapsular surgeries. METHODS: The sample is a compound of 47 cataract nuclei. They were classified as mature (4+) and immature (1 to 3+), and the visual acuity ranged from 20/60 to light perception. The instruments were used to split the nuclei. A methylcellulose over a gel base was made for this purpose. RESULTS: The average age was 67,38 years. Most patients (66%), had a visual acuity less than 20/400. 42,6% of the cataracts were mature. The capturing and splitting was easily done in over 90% of the nuclei. CONCLUSIONS: The designed instruments are effective to capture and split cataract nuclei.

Morfometria comparativa entre discos ópticos de familiares de glaucomatosos e normais pelo HRTII

PURPOSE: To investigate whether there is a difference in topographic characteristics of optic nerve head analyzed by Heidelberg retina tomography (HRTII) in relatives of normal patients with or without history of open angle glaucoma. METHODS: Retrospective study analyzing the optic disc morphometry of normal patients with or without family history of glaucoma. Each participant underwent a routine examination, visual field testing, pachimetry and optic nerve head topography. Patients were classified according their family history of glaucoma in groups as first-degree (group 1), far second-degree (group 2) and no siblings with glaucoma (control group). Optic disc analyzed parameters were: disc area, rim area, cup area, cup/disc ratio (E/D) and linear cup/disc ratio. Statistical analysis was made through the SPSS 12.0 program considering only one randomized eye. A P value of less than 0.05 was considered statistically significant. RESULTS: Seventy-four patients (74 eyes) were included. The average age was 42.58 years. In the stereometric analysis, the comparison between the disc area from the group 1 and group 2 was statistically significant (P < 0.005), with marked overlap in group 1, fact that was repeated for the variables disc area, cup area, cup/disc ratio linear cup/disc ratio comparing first -degree and control group. There was no statistical difference comparing group 2 and 3 in the stereometric analysis. CONCLUSION: First-degree siblings of glaucoma patients present stereometric differences in optic disc when compared with patients without history of glaucoma. These differences were found in patients with no signs of the disease.

Influence of physical exercise and sodium intake on arterial pressure and cardiac hypertrophy in rats

Evidence shows that cardiac hypertrophy (CH) is a risk factor for many cardiovascular diseases. Several stimuli may cause CH-like manifestations and promote volume or pressure overload. Exercise-induced cardiac hypertrophy is an expected adaptation to regular exercise training. Salt intake has been shown to be the most important determinant of blood pressure in different populations. The purpose of the present work was to verify the influence of physical exercise and sodium intake on the blood pressure and myocardium. The study was performed on 36 rats divided into six groups: Group I (diet without salt overload), Group II (diet without salt overload and swimming), Group III (diet with 2.5% NaCl solution and swimming), Group IV (diet with 5% NaCl solution and swimming), Group V (diet with 2.5% NaCl solution without exercise), Group VI (diet with 5% NaCl solution without exercise). The arterial pressure was significantly lower in Group I when compared with Group IV. The ratio of cardiac mass/body mass was increased in Groups III and IV. In conclusion, there was evidence that exercise training and NaCl intake promotes arterial hypertension and cardiac hypertrophy.