The Relative Odds of Progressing by Structural and Functional Tests in Glaucoma.

PurposeThe purpose of this study was to evaluate the effect of disease severity and number of tests acquired during follow-up on the relative odds of identifying progression by structural or functional tests in glaucoma.MethodsThis was an observational cohort study involving 462 eyes of 305 patients with glaucoma and 62 eyes of 49 healthy subjects. Glaucoma patients and healthy subjects were followed for an average of 3.6 ± 0.9 and 3.8 ± 0.9 years, with a median (interquantile range) of 8 (6-9) and 7 (6-8) visits, respectively. At each visit, subjects underwent visual field assessment with standard automated perimetry (SAP) and retinal nerve fiber layer (RNFL) evaluation by spectral-domain optical coherence tomography (SD-OCT). Slopes of change in SAP mean sensitivity and OCT RNFL thickness over time were estimated by linear regression using progressively cumulative visits over time. Cutoff values for age-related expected rates of change for each test were obtained from the healthy group. Progression by SD-OCT and/or SAP was determined if the slope of change was statistically significant and also lower (faster) than the fifth percentile cutoff calculated from the healthy group. A generalized estimating equation logistic regression model was used to evaluate the relative odds of progressing by OCT versus SAP in glaucoma eyes.ResultsEyes with less severe disease at baseline had a higher chance of being detected as progressing by SD-OCT but not by SAP, whereas an increase in disease severity at baseline increased the chance that the eye would be detected as progressing by SAP but not SD-OCT. Each 1 dB higher MD was associated with a 5% increase in the odds of detecting progression by SD-OCT versus SAP (odds ratio = 1.05 per 1 dB; 95% confidence interval: 1.01-1.09; P = 0.005).ConclusionsThe ability to detect glaucoma progression by SAP versus SD-OCT is significantly influenced by the stage of disease. Our results may provide useful information for guiding clinicians on the relative utility of these tests for detecting change throughout the disease continuum

Estimated Rates of Retinal Ganglion Cell Loss in Glaucomatous Eyes with and without Optic Disc Hemorrhages

Purpose: To evaluate whether optic disc hemorrhages are associated with faster rates of estimated retinal ganglion cell (RGC) loss in glaucoma.Methods: A longitudinal observational cohort study of 222 eyes of 122 patients with glaucoma recruited from the Diagnostic Innovations Glaucoma Study (DIGS) followed for an average of 3.74 +/- 0.85 years. All subjects had optical coherence tomography and standard automated perimetry during follow up. Optic disc hemorrhages were detected by masked evaluation of stereophotographs. Rates of change in estimated numbers of RGCs were determined using a previously described method. A random coefficients model was used to investigate the relationship between disc hemorrhages and rates of change in estimated RGC counts over time.Results: 19 eyes of 18 subjects had at least one disc hemorrhage during follow up. At baseline, average estimated RGC counts in eyes with and without disc hemorrhages were 677,994 cells and 682,021 cells, respectively (P = 0.929). Eyes with optic disc hemorrhages during follow-up had significantly faster rates of estimated RGC loss than eyes without disc hemorrhages (22,233 cells/year versus 10,704 cells/year, P = 0.020). the effect of disc hemorrhages on the rates of estimated RGC loss remained significant after adjusting for confounding variables.Conclusion: Eyes with disc hemorrhages showed faster rates of RGC loss compared to eyes without disc hemorrhages. These results provide further evidence that disc hemorrhages should be considered as an indicator of increased risk for faster neural loss in glaucoma.National Institutes of Health/National Eye InstituteResearch to Prevent Blindness (New York, N.Y.)Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)AlconAllerganPfizerMerckSantenUniv Calif San Diego, Hamilton Glaucoma Ctr, San Diego, CA 92103 USAUniv Calif San Diego, Dept Ophthalmol, San Diego, CA 92103 USAUniversidade Federal de São Paulo, Dept Ophthalmol, São Paulo, BrazilUniv Edinburgh, Princess Alexandra Eye Pavil, Edinburgh, Midlothian, ScotlandUniv Edinburgh, Dept Ophthalmol, Edinburgh, Midlothian, ScotlandUniversidade Federal de São Paulo, Dept Ophthalmol, São Paulo, BrazilNational Institutes of Health/National Eye Institute: EY021818National Institutes of Health/National Eye Institute: EY11008National Institutes of Health/National Eye Institute: EY14267National Institutes of Health/National Eye Institute: EY019869National Institutes of Health/National Eye Institute: P30EY022589CAPES: 12309-13-3Web of Scienc

Fear of falling and postural reactivity in patients with glaucoma

Purpose To investigate the relationship between postural metrics obtained by dynamic visual stimulation in a virtual reality environment and the presence of fear of falling in glaucoma patients. Methods This cross-sectional study included 35 glaucoma patients and 26 controls that underwent evaluation of postural balance by a force platform during presentation of static and dynamic visual stimuli with head-mounted goggles (Oculus Rift). In dynamic condition, a peripheral translational stimulus was used to induce vection and assess postural reactivity. Standard deviations of torque moments (SDTM) were calculated as indicative of postural stability. Fear of falling was assessed by a standardized questionnaire. The relationship between a summary score of fear of falling and postural metrics was investigated using linear regression models, adjusting for potentially confounding factors. Results Subjects with glaucoma reported greater fear of falling compared to controls (-0.21 vs. 0.27P = 0.039). In glaucoma patients, postural metrics during dynamic visual stimulus were more associated with fear of falling (R-2 = 18.8%P = 0.001) than static (R-2 = 3.0%P = 0.005) and dark field (R-2 = 5.7%P = 0.007) conditions. In the univariable model, fear of falling was not significantly associated with binocular standard perimetry mean sensitivity (P = 0.855). In the multivariable model, each 1 Nm larger SDTM in anteroposterior direction during dynamic stimulus was associated with a worsening of 0.42 units in the fear of falling questionnaire score (P = 0.001). Conclusion In glaucoma patients, postural reactivity to a dynamic visual stimulus using a virtual reality environment was more strongly associated with fear of falling than visual field testing and traditional balance assessment.National Institutes of Health/National Eye Institute [EY021818]Brazilian National Council for Scientific and Technological Development (CNPq) [233829/2014-8]Alcon Laboratories (Fort Worth, TX)Bausch & Lomb (Garden City, NY)Carl Zeiss Meditec (Jena, Germany)Heidelberg Engineering (Heidelberg, Germany)Merck (White House Station, NJ)Allergan (Irvine, CA)Sensimed (Lausanne, Switzerland)Topcon (Livermore, CA)Reichert (Dewey, NY)National Eye Institute (Bethesda, MD)Novartis (Basel, Switzerland)nGoggle (San Diego, CA)Duke Univ, Duke Eye Ctr, Durham, NC 27708 USADuke Univ, Dept Ophthalmol, Durham, NC 27708 USAUniv Fed Sao Paulo, Dept Ophthalmol & Vis Sci, Sao Paulo, BrazilUniv Calif San Diego, Dept Ophthalmol, La Jolla, CA 92093 USAUniv Fed Sao Paulo, Dept Ophthalmol & Vis Sci, Sao Paulo, BrazilCNPq [233829/2014-8]Web of Scienc

Macroalgae from S. Miguel Island as a potential source of antiproliferative and antioxidant products

Ulva compressa, Gelidium microdon, Osmundea pinnatifida, Fucus spiralis and Cystoseira abies-marina from the coast of S. Miguel Island were screened for their in vitro cytotoxicity against HeLa tumour cell line, antioxidant potential and total phenolic content. From each alga, the hexane fraction (HF) of the methanol extract, the methanol residue (MF) and the dichloromethane extract (DE), were obtained and evaluated. The highest antiproliferative activity against HeLa cell line was found in C. abies-marina and F. spiralis DE (IC50 8.8 μg/mL and 10.7 μg/mL, respectively), and presented selective cytotoxicity, when tested against Vero cell line. Fluorescence microscopy studies of the two most active extracts suggest an apoptosis-inducing activity. Concerning the antioxidant activity, high values were found on F. spiralis MF and HF (EC50 0.62 μg/mL and 2.01 μg/mL, respectively), even higher than those obtained for trolox and quercetin. This high antioxidant activity in F. spiralis MF can be explained by its content in phenolic compounds, but not for HF, where the antioxidant compounds must be less polar. These results suggest that some macroalgae from the Azorean sea have great potential which could be considered for future applications in medicine, food production or cosmetics industry

Asymmetric Macular Structural Damage Is Associated With Relative Afferent Pupillary Defects in Patients With Glaucoma

PURPOSE. We examined the relationship between relative afferent pupillary defects (RAPDs) and macular structural damage measured by macular thickness and macular ganglion cell-inner plexiform layer (mGCIPL) thickness in patients with glaucoma. METHODS. A cross-sectional study was done of 106 glaucoma patients and 85 healthy individuals from the Diagnostic Innovations in Glaucoma Study. All subjects underwent standard automated perimetry (SAP) and optic nerve and macular imaging using Cirrus Spectral Domain Optical Coherence Tomography (SDOCT). Glaucoma was defined as repeatable abnormal SAP or progressive glaucomatous changes on stereo photographs. Pupil responses were assessed using an automated pupillometer, which records the magnitude of RAPD (RAPD score), with additional RAPD scores recorded for each of a series of colored stimuli (blue, red, green, and yellow). The relationship between RAPD score and intereye differences (right minus left eye) in circumpapillary retinal nerve fiber layer (cpRNFL) thickness, mGCIPL, macular thickness, and SAP mean deviation (MD), was examined using linear regression. RESULTS. There was fair correlation between RAPD score and asymmetric macular structural damage measured by intereye difference in mGCIPL thickness (R-2 = 0.285, P < 0.001). The relationship between RAPD score and intereye difference in macular thickness was weaker (R-2 = 0.167, P < 0.001). Intereye difference in cpRNFL thickness (R-2 = 0.350, P < 0.001) and SAP MD (R-2 = 0.594, P < 0.001) had stronger association with RAPD scores compared to intereye difference in mGCIPL and macular thickness. CONCLUSIONS. Objective assessment of pupillary responses using a pupillometer was associated with asymmetric macular structural damage in patients with glaucoma.National Institutes of Health/National Eye InstituteResearch to Prevent Blindness (New York, NY, USA)AlconAllerganPfizerMerckSantenBrazilian National Research Council-CAPESUniv Calif San Diego, Hamilton Glaucoma Ctr, 9500 Gilman Dr, La Jolla, CA 92093 USAUniv Calif San Diego, Dept Ophthalmol, La Jolla, CA 92093 USAUniv Fed Sao Paulo, Dept Ophthalmol, Sao Paulo, BrazilUniv Edinburgh, Princess Alexandra Eye Pavil, Edinburgh EH8 9YL, Midlothian, ScotlandUniv Edinburgh, Dept Ophthalmol, Edinburgh EH8 9YL, Midlothian, ScotlandUniv Fed Sao Paulo, Dept Ophthalmol, Sao Paulo, BrazilNIH/NEI: EY021818NIH/NEI: EY11008NIH/NEI: EY14267NIH/NEI: EY019869NIH/NEI: P30EY022589CAPES: 12309-13-3Web of Scienc

Corpus Callosum Microstructural Changes Correlate with Cognitive Dysfunction in Early Stages of Relapsing-Remitting Multiple Sclerosis: Axial and Radial Diffusivities Approach

The corpus callosum is the largest fiber bundle in the central nervous system and it takes part in several cognitive pathways. It can be affected by multiple sclerosis (MS) early in the disease. DTI is capable of infering the microstructural organization of the white matter. The vectorial analysis of the DTI offers the more specific indices of axial diffusivity (AD) and radial diffusivity (RD), which have shown to be useful to discriminate myelin damage from axon loss, respectively. This study presents DTI results (mean diffusivity (MD), fractional anisotropy (FA), RD, and AD) of 23 relapsing-remitting MS patients and its correlation with cognitive performance. There were 47.8% of cognitive impaired patients (MS CI). We found signs of demyelination, reflected by increased RD, and incipient axon loss, reflected by AD increase, which was slightly higher in the MS CI. The cognitive changes correlated with the DTI parameters, suggesting that loss of complexity in CC connections can impair neural conduction. Thus, cognitive impairment can be related to callosal disconnection, and DTI can be a promising tool to evaluate those changes

Oficina: Alfabetização Digital

O objetivo da oficina é ensinar para as crianças de ensino fundamental a utilização de recursos computacionais a seu favor, afim de desenvolver a lógica de raciocínio para a resolução de problemas habituais. Para tanto, buscar-se-á: - Alfabetizar o indivíduo com recursos computacionais básicos para a resolução de problemas habituais utilizando software. - Instruir os alunos nas ferramentas e demonstrar como podem ser utilizadas no cotidiano escolar. - Demonstrar que tais recursos computacionais estão presentes em qualquer software do gênero, independente de versão ou modelo. - Demonstrar conceitos, tendo como base o letramento caminhando em paralelo com a alfabetização digital. - Praticar exercícios básicos de digitação afim de desenvolver coordenação motora na utilização do teclado de um computador, assim como seus atalhos (exemplificando: ctrl+c. ctrl+v, alt gr.

ESTRUTURA POPULACIONAL E CONDIÇÃO FISIOLÓGICA DE Hoplias malabaricus (BLOCH, 1794) NO BAIXO RIO CAPIBARIBE

This research aimed to determine population structure and physiological condition of Hoplias malabaricus in the Capibaribe river (PE), northeastern Brazil. Monthly sampling were carried out between September/2013 and August/2014, using gill nets. The sex was identified by macroscopic and microscopic viewing of gonads, following the classification proposed by Vazzoler (1996). The specimens were distributed in length classes, being applied Kolmogorov-Smirnov test to evaluate the presence of sexual dimorphism. The length-weight relationship was calculated assessing differences through Kruskal Wallis test and physiological condition was calculated through allometric condition factor (K) between sexes, being applied the Spearman correlation test. Was collected 30 males and 42 females. No sexual dimorphism was observed relative to the size. Was observed positive allometric growth for females and negative for males. Was evidenced physiological condition variations along the year regarding seasonality. Population structure and physiological condition of the Hoplias malabaricus differed from that found in other environments, being this research, an important tool support the development of future management plans and conservation of Hoplias malabaricus, especially in this region.Keywords: population dynamics; fishing; reproduction.Esta pesquisa objetivou determinar a estrutura populacional e condição fisiológica de Hoplias malabaricus no rio Capibaribe (PE), nordeste brasileiro. Foram realizadas coletas mensais entre setembro/2013 e agosto/2014, utilizando redes de espera. O sexo foi identificado pela visualização macroscópica e microscópica das gônadas, seguindo a classificação proposta por Vazzoler (1996). Os indivíduos foram distribuídos entre classes de comprimento, sendo aplicado teste de Kolmogorov-Smirnov para verificar a presença de dimorfismo sexual. A relação peso-comprimento entre sexos foi calculada, avaliando diferenças pelo teste Kruskal-Wallis e a condição fisiológica foi avaliada pelo fator de condição alométrico (K) entre sexos, sendo aplicado teste de correlação de Spearman. Foram coletados 30 machos e 42 fêmeas, não sendo observado dimorfismo sexual relativo ao tamanho. Além disto, verificou-se um crescimento alométrico positivo para as fêmeas e negativo para os machos. Também foram evidenciadas variações na condição fisiológica ao longo do ano em relação à sazonalidade. A estrutura populacional e condição fisiológica de Hoplias malabaricus diferiram do encontrado em outros ambientes, sendo este estudo uma importante ferramenta para embasar o desenvolvimento de futuros planos de manejo e conservação de Hoplias malabaricus, especialmente nesta região.Palavras-chave: dinâmica populacional, pesca, manejo de recursos pesqueiros

Yeast-Host Interactions: Anadenanthera Colubrina Modulates Virulence Factors of C. Albicans and Inflammatory Response In Vitro

Oral candidiasis is one of the most common fungal infections in humans. Its incidence has increased widely, as well as the antifungal resistance, demanding for the search for novel antifungal therapeutic agents. Anadenanthera colubrina (Vell.) Brenan is a plant species that has been proven to possess pharmacological effects, including antifungal and anti-inflammatory activities. This study evaluated in vitro the effects of standardized A. colubrina extract on virulence factors of Candida albicans and its regulation on immune response through C. albicans-host interaction. Antifungal activity was evaluated by Broth Microdilution Method against reference Candida strains (C. albicans, C. glabrata, C. tropicalis; C. dubliniensis). Anti-biofilm effect was performed on C. albicans mature biofilm and quantified by CFU/mL/g of biofilm dry weight. Proleotlytic enzymatic activities of proteinase and phospholipase were assessed by Azocasein and Phosphatidylcholine assays, respectively. Cytotoxicity effect was determined by Cell Titer Blue Viability Assay on Human Gingival Fibroblasts. Co-cultured model was used to analyze C. albicans coexisting with HGF by Scanning Electron Microscopy and fluorescence microscopies; gene expression was assessed by RT-PCR of C. albicans enzymes (SAP-1, PLB-1) and of host inflammatory cytokines (IL-6, IL-8, IL-1β, IL-10). Cytokines secretion was analysed by Luminex. The extract presented antifungal effect with MIC<15.62 μg/ml against Candida strains. Biofilm and proteolytic activity were significant reduced at 312.4 μg/ml (20 × 15.62 μg/ml) extract concentration. Cell viability was maintained higher than 70% in concentrations up to 250 μg/ml (LD(50) = 423.3 μg/ml). Co-culture microscopies demonstrated a substantial decreased in C. albicans growth and minimal toxicity against host cells. Gene expressions of SAP-1/PLB-1 were significantly down-regulated and host immune response was modulated by a significant decreased on IL-6 and IL-8 cytokines secretion. A. colubrina had antifungal activity on Candida strains, antibiofilm, and anti-proteolytic enzyme effects against C. albicans. Presented low cytotoxicity to the host cells and modulatory effects on the host immune response