Correlation between hyperglycemia and glycated albumin with retinopathy of prematurity

Funding Information: The present publication was funded by Fundação Ciência e Tecnologia, IP national support through CHRC (UIDP/04923/2020).To determine the association between hyperglycemia, glycated albumin (GlyA) and retinopathy of prematurity (ROP). Prospective study of all infants under ROP screening from March 2017 to July 2019. All demographic, clinical and laboratory data were collected. Glucose was measured at birth and every 8 h for the first week and serum GlyA was evaluated at birth, 1st, 2nd and 4th weeks after birth. Reference range for GlyA was obtained. Univariate logistic regression was used to examine risk factors for ROP followed by multivariate regression. A total of 152 infants were included in the study. Median gestational age was 30 weeks and median birth weight 1240 g. Thirty-three infants (21.7%) had ROP. Hyperglycemia was present in 24 (72.7%) infants diagnosed with any ROP versus 6 (0.05%) in those without ROP. Median GlyA at birth, 1st, 2nd and 4th and respective reference ranges were 8.50% (6.00–12.65), 8.20% (5.32–11.67), 8.00% (5.32–10.00) and 7.90% (5.30–9.00) respectively. After multivariate logistic regression, hyperglycemia but not GlyA, remained a significant risk factor for ROP overpowering the other recognized risk factors (Exp (B) 28.062, 95% CI for Exp(B) 7.881–99.924 p < 0.001). In our cohort, hyperglycemia but not GlyA, remained a significant risk factor for ROP overpowering the other recognized risk factors.publishersversionpublishe

Venoarterial extracorporeal membrane oxygenation bridge to HeartMate 3: An Iberian first

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Cataract surgery and IOP: a systematic review of randomised controlled trials

© The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2022Purpose: Cataract and glaucoma are two of the most common ocular comorbidities. Cataract surgery has been shown to influence intra-ocular pressure (IOP) in patients with glaucoma; nevertheless, the extent of this effect remains controversial, especially in patients with open-angle glaucoma (OAG). The aim of this review is to determine the real effect of cataract surgery on IOP change in patients with OAG, focusing on data retrieved from randomised controlled trials (RCTs). Methods: A systematic review was performed, including six different RCTs that studied the net effect of cataract surgery on IOP. Eligibility criteria required a full washout from hypotensive therapy, allowing accurate measurement of unmedicated IOP, both before and after surgery. Results: Included studies revealed a consistent reduction on IOP occurring after surgery, varying between 4.1 and 8.5 mmHg depending on the RCT. There was also a decrease in the number of glaucoma medications, with a mean reduction of 0.2-1.0 agents postoperatively. Evaluation of adverse outcomes of cataract surgery showed a very favourable safety profile. Conclusion: Although the role of cataract surgery in the algorithm of glaucoma treatment remains to be established, this review highlights a consistent decrease on IOP following surgery and a reduced dependency on glaucoma medications. Potential downgrade in medication can thus be considered in well-controlled glaucoma patients after phacoemulsification.info:eu-repo/semantics/publishedVersio

Dispositivo de Redução do Seio Coronário no Tratamento de Angina Refratária: uma Experiência Multicêntrica

Introduction: The coronary sinus Reducer (CSR) device has emerged as a complementary therapy in patients with severe angina refractory to optimal medical therapy and not amenable to revascularization. Our aim was to assess the safety and efficacy of the CSR in a real-world setting. Methods: Twenty-six patients with refractory angina (RA) and evidence of myocardial ischemia attributable to the left coronary artery considered unsuitable for revascularization were treated with the CSR at two centers between May 2017 and July 2019. Safety endpoints were procedural success and complications. Efficacy endpoints, assessed at six-month follow-up, were reduction in CCS class, improvement in quality of life (QoL) assessed using the short version of the Seattle Angina Questionnaire (SAQ-7), and reduction in antianginal therapy. Results: Twenty-three patients had end-stage coronary artery disease without revascularization targets and three had microvascular disease without epicardial stenosis. Procedural success was achieved in 23 patients, with two device/procedure-related complications and one anatomically-related failure to deliver the device. A total of 24 patients had the device implanted and entered the efficacy analysis. Eighteen patients (75.0%) had a reduction of at least one CCS class, 41.7% had a reduction of at least two classes, and 16.7% became asymptomatic, with a mean reduction in CCS class of 1.3±0.2 (p=0.001) at six-month follow-up. All SAQ-7 domains improved, notably physical limitation (p=0.001), angina frequency (p=0.005) and QoL (p=0.006). There was a mean reduction in anti-ischemic drugs from 3.4±1.1 to 2.9±1.2 (p=0.010). Conclusion: In this real-world, multicenter experience, implantation of the CSR was associated with improvement in angina and QoL in patients with RA.Introdução: O dispositivo de redução do seio coronário (DRSC) constitui uma terapêutica complementar em doentes com angina refratária à terapêutica médica e não passíveis de revascularização. O objectivo era avaliar a segurança e eficácia do DRSC numa coorte do mundo real. Métodos: Vinte e seis doentes com angina refratária, evidência de isquemia miocárdica atribuível à artéria coronária esquerda e considerados inadequados para revascularização foram tratados com o DRSC em dois centros terciários portugueses entre maio de 2017 e julho de 2019. Os endpoints de segurança foram o sucesso do procedimento e complicações. Os endpoints de eficácia, avaliados aos seis meses de follow-up, foram uma redução na classe de angina da CCS, melhoria na qualidade de vida avaliada pela versão abreviada do Seattle Angina Questionnaire (SAQ-7) e redução na terapêutica antianginosa. Resultados: Vinte e três doentes tinham doença coronária sem alvos de revascularização e três, doença microvascular sem estenoses epicárdicas. O sucesso do procedimento foi alcançado em 23 doentes, com duas complicações relacionadas com dispositivo/procedimento e uma falha na entrega do dispositivo. No total, 24 doentes implantaram o dispositivo e entraram na análise de eficácia. Dezoito doentes (75,0%) sofreram uma redução de pelo menos uma classe CCS, 41,7% sofreram uma redução de pelo menos duas classes e 16,7% tornaram-se assintomáticos, com uma redução média da classe CCS de 1,3±0,2 (p=0,001), seis meses de follow-up. Verificou-se uma melhoria de todos os domínios do SAQ-7, nomeadamente limitação física (p=0,001), frequência de angina (p=0,005) e qualidade de vida (p=0,006). Verificou-se uma redução média de fármacos antianginosos de 3,4±1,1 para 2,9±1,2 (p=0,010). Conclusão: Nesta experiência multicêntrica do mundo real, a implantação do DRSC foi associada à melhoria das queixas anginosas e da qualidade de vida em doentes com angina refratária não passível de revascularização.info:eu-repo/semantics/publishedVersio

Retrospective comparison between growth and retinopathy of prematurity model versus WINROP model

© Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.Objective: To compare the weight and insulin-like growth factor-1 in neonatal retinopathy (WINROP) to the growth and retinopathy of prematurity (G-ROP) model in a Portuguese cohort. Design: Retrospective case series. Methods: Clinical records of consecutive infants who underwent retinopathy of prematurity (ROP) screening from April 2012 to May 2019 were retrospectively reviewed. Both WINROP and G-ROP models were accessed for sensitivity and specificity for type 1 ROP. A separate analysis of both algorithms was performed in infants with gestational age (GA) <30 weeks. Results: Of the 375 infants included in the study, 313 were eligible for G-ROP analysis and 311 for WINROP. In the G-ROP group, 22 infants developed type 1 ROP (sensitivity 90.91%, 95% confidence interval [CI] 70.84%-98.98%). In the WINROP group, 23 infants needed treatment (sensitivity of 86.96%, 95% CI 66.41%-97.22%). Both models reached 100% sensitivity for type 1 ROP if restricted to GA <30 weeks. Conclusions: Both models were easy to use and had similar sensitivities. If restricted to GA <30 weeks, both models detected all type 1 ROP.info:eu-repo/semantics/publishedVersio

DIGIROP efficacy for detecting treatment-requiring retinopathy of prematurity in a Portuguese cohort

© The Author(s), under exclusive licence to The Royal College of Ophthalmologists 2021Background/objectives: To determine the efficacy of the DIGIROP model in detecting treatment-requiring retinopathy of prematurity (TR-ROP) in a Portuguese cohort. Subjects/methods: Multicentre, retrospective cohort study of all consecutive preterm infants who underwent ROP screening from April 2012 to May 2019 in two neonatal units. Gestational age (GA), birth weight (BW) and sex were inserted in the DIGIROP platform. The optimal cut-off point to achieve 100% sensitivity was calculated. Area under the receiver operating characteristic curve (AUC) was calculated. Results: Of the 431 infants who underwent ROP screening, 257 were eligible for DIGIROP analysis and 174 infants were excluded for having a GA outside the range 24-30 weeks imposed by the DIGIROP algorithm. Median GA was 29 weeks (range 24-30) and BW was 1060 g (range 408-2080). Twenty-tree infants (8.9%) developed TR-ROP. The highest risk obtained for TR-ROP was 0.5404 (95% CI 0.4343-0.6616) with a median achieved risk of 0.0938 (range 0.0016-0.5404). The optimal cut-off point to achieve 100% sensitivity on TR-ROP was 0.0016. The number of infants receiving ROP examinations would have been reduced from 257 to 187 infants (-27.2%) if the model was applied. Conclusions: In our cohort, of 257 infants, the optimal cut-off point to achieve 100% sensitivity for TR-ROP was 0.0016 with moderate accuracy in the AUC (0.70). The number of infants requiring screening would have decreased 27.2% if the model was applied. It is essential that algorithms continue to be tested in different populations, especially in cohorts that include both younger and older GA infants.info:eu-repo/semantics/publishedVersio