Suplementación invernal y desempeño reproductivo temprano de hembras para reemplazo.

El presente artículo toma como base algunos de los resultados obtenidos en un reciente estudio del efecto de la alimentación en el primer invierno sobre variables reproductivas en hembras para reemplazo. Se observa la importancia que tienen la distribución y la magnitud de las tasas de ganancia media diarias en esta etapa y su relación con el mantenimiento de la ciclicidad ovárica al alcanzar la pubertad

Treatment of thyroid associated ophthalmopathy with periocular injections of triamcinolone

Aim: To evaluate the efficacy of periocular triamcinolone acetonide for the treatment of thyroid associated ophthalmopathy (TAO), and the presence of ocular or systemic adverse effects. Methods: A multicentre prospective pilot study was performed on patients diagnosed with Graves’ ophthalmopathy less than 6 months before entry to the study. Patients were admitted to the study and were randomised into two groups: treatment and control. The treatment group received four doses of 20 mg of triamcinolone acetate 40 mg/ml in a peribulbar injection to the inferolateral orbital quadrant. Both groups were evaluated by measuring the area of binocular vision without diplopia on a Goldmann perimeter and the size of the extraocular muscles on computed tomography (CT) scans. Ophthalmological and systemic examinations were done to rule out ocular and systemic adverse effects. Follow up was 6 months for both groups. Results: 50 patients were eligible for the study. 41 patients completed the study. There was an increase in the area of binocular vision without diplopia in the treatment group (Σ initial: mean 231.1 (SD 99.9) and final absolute change, mean 107.1 (SD 129.0)) compared to the control group (Σ initial: mean 350.7 (SD 86.5) and final absolute change, mean −4.5 (SD 67.6)). The sizes of the extraocular muscles were reduced in the treatment group (mean (inferior rectus initial values): 1.3 (0.7), final percentage change: −13.2 (25.7), medial rectus initial values: 1.2 (0.6), final percentage change: −8.2 (20.7), superior rectus-levator palpebrae initial values: 1.2 (0.6), final percentage change: −9.5 (29.1), lateral rectus initial values: 1.0 (0.4), final percentage change: −11.5 (20.6)) compared to the control group (inferior rectus initial values: 0.9 (0.3), final percentage change: −4.0 (21.5), medial rectus initial values: 0.9 (0.3), final percentage change: 0.6 (22.4), superior rectus-levator palpebrae initial values: 0.9 (0.3), final percentage change: 12.5 (37.5), lateral rectus initial values: 0.9 (0.4), final percentage change: −0.5 (31.6)). Both measurements (degree of diplopia and muscle thickness) were statistically significant between groups (initial − final). No systemic or ocular adverse effects were found. Conclusions: Triamcinolone administered as a periocular injection is effective in reducing diplopia and the sizes of extraocular muscles in TAO ophthalmopathy of recent onset. This form of treatment is not associated with systemic or ocular side effects

Visão das cores em escolares: avaliação de um novo teste Color vision in school-age children: evalution a new test

OBJETIVO: comparar os resultados de um teste de visão de cores padrão (teste de Ishihara) com um teste criado pelos autores (teste do giz de cera) na detecção da discromatopsia congênita. MÉTODOS: foi realizado um estudo transversal com 712 crianças da rede escolar pública (3 escolas) e privada (1 escola) de Porto Alegre, Rio Grande do Sul. Desta amostra aleatória, haviam sido excluídas crianças com dificuldades na alfabetização e doenças sistêmicas e oculares reconhecidas. Foram aplicados seqüencialmente os testes de Ishihara (versão resumida de 14 pranchas) e o teste do giz de cera (desenvolvido pelos autores). Cada teste foi aplicado por examinadores diferentes e avaliados por um terceiro examinador. RESULTADOS: o teste do giz de cera apresentou especificidade de 100% (99,3-100%) e sensibilidade de 38,5% (15,1-67,7%), quando comparado ao teste de Ishihara. A prevalência da discromatopsia congênita nesta amostra populacional foi de 2,6% nos meninos e 0,9% nas meninas. CONCLUSÕES: o teste do giz de cera apresentou especificidade superior ao teste de Ishihara no grupo estudado, mas sua sensibilidade não se mostrou adequada para um teste de rastreamento. Há necessidade de aperfeiçoá-lo para aumentar sua sensibilidade, isto é, sua capacidade de detectar a discromatopsia congênita.<br>OBJECTIVE: To compare standard color vision test results (Ishihara test) with a new test developed by the authors ("crayon" test) for the detection of congenital dyschromatopsia. METHODS: Cross-sectional study of 712 children from three public schools and one private school in the city of Porto Alegre, state of Rio Grande do Sul. Children with learning disabilities, or systemic and ocular diseases were excluded from this random sample. Two color vision tests, Ishihara test (short version with 14 plates) and crayon test (developed by the authors) were sequentially applied. Each test was applied by different evaluators and analyzed by a third evaluator. RESULTS: The crayon test showed a specificity of 100% (99.3-100%) and sensitivity of 38.5% (15.1-67.7%) when compared to Ishihara test. The prevalence of congenital dyschromatopsia in this population sample was 2.6% for male children, and 0.9% for female children. CONCLUSIONS: The crayon test results showed greater specificity than Ishihara test in the studied group; however, sensitivity was not adequate for a screening test. It is necessary to improve the sensitivity so that congenital dyschromatopsia can be detected by the crayon test

Outcomes of Vogt-Koyanagi-Harada Disease: A Subanalysis From a Randomized Clinical Trial of Antimetabolite Therapies

PURPOSE: To report outcomes of Vogt-Koyanagi-Harada (VKH) disease from a clinical trial of antimetabolite therapies. DESIGN: Subanalysis from an observer-masked randomized clinical trial for non-infectious intermediate, posterior, and pan- uveitis. METHODS: SETTING: clinical practice at Aravind Eye Hospitals, India PATIENT POPULATION: Forty-three of 80 patients enrolled (54%) diagnosed with VKH. INTERVENTION: Patients were randomized to either 25mg oral methotrexate weekly or 1g mycophenolate mofetil twice daily, with a corticosteroid taper. MAIN OUTCOME MEASURES: Primary outcome was corticosteroid-sparing control of inflammation at 5 and 6 months. Secondary outcomes included visual acuity, central subfield thickness, and adverse events. Patients were categorized as acute (diagnosis ≤3 months prior to enrollment) or chronic (diagnosis >3 months prior to enrollment). RESULTS: Twenty-seven patients were randomized to methotrexate and 16 to mycophenolate mofetil; 30 had acute VKH. The odds of achieving corticosteroid-sparing control of inflammation with methotrexate were 2.5 times (95% CI: 0.6, 9.8; P=0.20) the odds with mycophenolate mofetil, a difference which was not statistically significant. The average improvement in visual acuity was 12.5 Early Treatment Diabetic Retinopathy Study (ETDRS) letters. On average, visual acuity for patients with acute VKH improved by 14 more ETDRS letters than those with chronic VKH (P<0.001), but there was no difference in corticosteroid-sparing control of inflammation (P=0.99). All 26 eyes with a serous retinal detachment at baseline resolved, and 88% achieved corticosteroid-sparing control of inflammation. CONCLUSIONS: The majority of patients treated with antimetabolites and corticosteroids were able to achieve corticosteroid-sparing control of inflammation by 6 months. Although patients with acute VKH gained more visual improvement than those with chronic VKH, this did not correspond with a higher rate of controlled inflammation