Refractive changes following surgery for correction of esotropia

Purpose: To evaluate changes in refraction and corneal curvature following surgery for correction of acquired esotropia. Methods: 42 eyes of 21 patients with acquired moderate angle esotropia without any other form of strabismus were prospectively enrolled and submitted to a complete ophthalmological examination followed by recess/resect procedure in a single eye. Data from the fellow eye were selected as control. Ophthalmological assessment was carried out preoperatively, 1 month after surgery and 6 months after surgery, where astigmatism was compared using vector analysis and the polar value concept. Results: The eyes submitted to surgery revealed a significant (p<0.05) decrease in spherical equivalent, from 3.28 ± 1.98 diopters to 3.05 ± 1.95 diopters. Refraction data disclosed a significant increase in the 90° component of net astigmatism, from 0.458 ± 0.594 diopters to 1.002 ± 0.718 diopters, which was also observed in keratometric readings:1.083 ± 0.560 diopters to 1.690 ± 0.591 diopters. Surgically induced astigmatism, assessed using refraction data was 0.63 ± 0.27 diopters at an average axis of 92.30 ± 14.91 degrees, and 0.71 ± 0.27 diopters at an average axis of 94.45 ± 15.69 degrees as obtained by keratometric readings. This is visually demonstrated by the corneal topography difference map. Conclusions: There is a statistically significant and clinically relevant increase in with-the-rule astigmatism in esotropic patients submitted to monocular recess/resect surgery. This change is stable at a 6 month follow-up and is associated with a decrease in mean spherical equivalent.Objetivo: Estudar o comportamento da refração e da curvatura corneana em pacientes com esotropia essencial submetidos à cirurgia monocular para correção do estrabismo. Métodos: Estudo prospectivo em que 42 olhos de 21 pacientes com esotropia essencial de ângulo moderado, sem quaisquer outros estrabismos associados, foram selecionados e submetidos ao exame oftalmológico completo e à cirurgia monocular. O olho contralateral serviu como grupo controle. Foram feitas avaliações de pré-operatório, pós-operatório de 1 mês e pós-operatório de 6 meses. O astigmatismo pré-operatório foi confrontado com os astigmatismos pós-operatórios por análise vetorial e cálculo do valor polar. Resultados: Obtivemos, nos olhos operados, redução significante (p<0,05) na médio do equivalente esférico, de 3,28 ±1,98 dioptrias para 3,05 ± 1,95 dioptrias. Na refração houve um aumento significante da média do componente a 90° do astigmatismo, de 0,458 ± 0,594 dioptrias para 1,002 ± 0,718 dioptrias, também observado na ceratometria: 1,083 ± 0,560 dioptrias para 1,690 ± 0,591 dioptrias. A média do astigmatismo induzido pela cirurgia, na refração, foi de 0,63 ± 0,27 dioptrias a um eixo médio de 92,30 ± 14,91 graus e de 0,71 ± 0,27 dioptrias a um eixo médio de 94,45 ± 15,69 graus na ceratometria, evidenciáveis graficamente pelo mapa diferencial da topografia corneana. Conclusões: Observa-se aumento estatisticamente significante e clinicamente relevante do astigmatismo a-favor-da-regra em pacientes esotrópicos submetidos ao retrocesso/ressecção monocular. Essa mudança é estável ao longo do tempo e é acompanhada de diminuição significante do equivalente esférico.Faculdade de Medicina da Universidade de São Paulo Hospital das Clínicas Departamento de OftalmologiaSanta Casa de São Paulo Departamento de OftalmologiaUniversidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Departamento de OftalmologiaUNIFESP, EPM, Depto. de OftalmologiaSciEL

Dynamics of the seasonal airborne propagation of Staphylococcus aureus in academic dental clinics

Objective:&nbsp; Staphylococcus aureus strains can be disseminated during dental treatments and occasionally lead to the contamination and infection of patients and dentists, which is an important public health problem. The dynamics of the airborne propagation and the genetic diversity of S. aureus isolated in an academic dental clinic environment were investigated using isoenzyme typing. Material and Methods: The isoenzymes of 44 previously reported isolates were obtained from fresh cultures and extracted using glass beads. Nine isoenzymes were investigated using multilocus enzyme electrophoresis (MLEE). The genetic diversity and relationship among the strains (electrophoretic type – ET) were determined using statistics previously described by Nei25 (1972) and the SAHN grouping method (UPGMA algorithm). Results: Clonal pattern analyses indicated a high level of genetic polymorphism occurring among the 33 ETs, which were grouped into five taxa. Each taxon presented one or more clusters that were moderately related and that contained two or more identical/highly related isolates, revealing seasonal airborne propagation in these dental clinic environments. Conclusions: These data suggest the occurrence of active microevolutionary processes in S. aureus as well as the possibility of environmental propagation during a 14-month time span. Such findings are important to show that multiuser academic dental clinics can retain certain strains that are spreadable to different niches

Avaliação do tempo de presa e da radiopacidade de diferentes cimentos endodônticos / Evaluation of setting time and radiopacity of different endodontic cements

Na endodontia o conhecimento das propriedades físico-químicas se faz necessário para realização de um adequado tratamento endodôntico. O objetivo do estudo foi realizar uma avaliação do tempo de presa e da radiopacidade de diferentes cimentos endodônticos. Para o tempo de presa, os cimentos manipulados foram inseridos em anéis metálicos com 10 mm de diâmetro e 2,0 mm de altura (n=5). Os espécimes foram mantidos em estufa a 37°C e umidade relativa de 95%. Uma agulha Gilmore de 113,4g foi utilizada para determinar o tempo de presa inicial e a presa final com uma agulha de 453,6g. Para teste de radiopacidade os cimentos foram manipulados, inseridos em anéis metálicos medindo 10,0 mm de diâmetro e 1,0 mm de altura (n=3), armazenados em estufa a 37°C e 95% de umidade. Após a presa foram verificados com um paquímetro e sensibilizados com aparelho de raio-x. O valor de radiopacidade foi determinado de acordo com a densidade radiográfica, convertida em mmAl, segundo a fórmula proposta por Duarte. Os resultados mostram que o cimento AH Plus apresentou maior de tempo de presa, seguido pelo Sealer 26. Quanto a radiopacidade o cimento AH Plus apresentou o maior média em mmAl, seguido pelo N-Rickert, Sealer 26, Endofill, Sealer Plus e menor mmAl foi o MTA Fillapex. Concluímos que todos os cimentos analisados quando ao tempo de presa estão de acordo com a ISO, menos o MTA Fillapex que não tomou presa e em relação a radiopacidade não está de acordo com a ISO

Deep neural network-estimated electrocardiographic age as a mortality predictor

The electrocardiogram (ECG) is the most commonly used exam for the evaluation of cardiovascular diseases. Here we propose that the age predicted by artificial intelligence (AI) from the raw ECG (ECG-age) can be a measure of cardiovascular health. A deep neural network is trained to predict a patient’s age from the 12-lead ECG in the CODE study cohort (n = 1,558,415 patients). On a 15% hold-out split, patients with ECG-age more than 8 years greater than the chronological age have a higher mortality rate (hazard ratio (HR) 1.79, p < 0.001), whereas those with ECG-age more than 8 years smaller, have a lower mortality rate (HR 0.78, p < 0.001). Similar results are obtained in the external cohorts ELSA-Brasil (n = 14,236) and SaMi-Trop (n = 1,631). Moreover, even for apparent normal ECGs, the predicted ECG-age gap from the chronological age remains a statistically significant risk predictor. These results show that the AI-enabled analysis of the ECG can add prognostic information

Stabilization time of chemical attributes and nutritional quality of manipueira for biofertilization

Manioc flour and gum (starch) have a cultural value for Amazonians. The processing of cassava roots releases manipueira, a liquid waste with a high polluting potential, due to its high levels of hydrocyanic acid. The large volumes of manipueira produced in this sector require safe disposal, whether for cooking (tucupi, flour), drinking or agronomic purposes. The aim of this study was to evaluate the stabilization time of chemical attributes and the nutritional quality of manipueira. For this study, cassava roots of the Amazonas cultivar (bitter or wild) harvested 12 months after the manioc was grown, were processed to extract the manipueira, which was stored and sampled at 0; 2; 5; 8; 11; 18; 25; 32; 46; 62 and 92 days. The variables evaluated were: pH and total cyanide content. Nutrients (N, P, K, Ca, Mg and S) were assessed at 0, 47, 62 and 92 days after storage (DAA). The pH stabilized at 10 DAA, varying between 3.8 and 4.0. The total cyanide content stabilized at 62 DAA, containing 410 mg L-1. The macronutrient contents did not vary with storage time, with the following decreasing order of concentration: K &gt; N &gt; P &gt; Mg &gt; Ca &gt; S, corresponding to the contents: 7.49; 1.25; 1.06; 0.68; 0.41 and 0.18 g-1, respectively

Electrocardiographic findings and prognostic values in patients hospitalised with COVID-19 in the World Heart Federation Global Study

BACKGROUND COVID-19 affects the cardiovascular system and ECG abnormalities may be associated with worse prognosis. We evaluated the prognostic value of ECG abnormalities in individuals with COVID-19. METHODS Multicentre cohort study with adults hospitalised with COVID-19 from 40 hospitals across 23 countries. Patients were followed-up from admission until 30 days. ECG were obtained at each participating site and coded according to the Minnesota coding criteria. The primary outcome was defined as death from any cause. Secondary outcomes were admission to the intensive care unit (ICU) and major adverse cardiovascular events (MACE). Multiple logistic regression was used to evaluate the association of ECG abnormalities with the outcomes. RESULTS Among 5313 participants, 2451 had at least one ECG and were included in this analysis. The mean age (SD) was 58.0 (16.1) years, 60.7% were male and 61.1% from lower-income to middle-income countries. The prevalence of major ECG abnormalities was 21.3% (n=521), 447 (18.2%) patients died, 196 (8.0%) had MACE and 1115 (45.5%) were admitted to an ICU. After adjustment, the presence of any major ECG abnormality was associated with a higher risk of death (OR 1.39; 95% CI 1.09 to 1.78) and cardiovascular events (OR 1.81; 95% CI 1.30 to 2.51). Sinus tachycardia (>120 bpm) with an increased risk of death (OR 3.86; 95% CI 1.97 to 7.48), MACE (OR 2.68; 95% CI 1.10 to 5.85) and ICU admission OR 1.99; 95% CI 1.03 to 4.00). Atrial fibrillation, bundle branch block, ischaemic abnormalities and prolonged QT interval did not relate to the outcomes. CONCLUSION Major ECG abnormalities and a heart rate >120 bpm were prognostic markers in adults hospitalised with COVID-19

VISITA DE INSPEÇÃO PREDIAL REALIZADA NO CONDOMÍNIO IRISVILLE

Este trabalho caracteriza-se pela inspeção predial como um “Check-up” da edificação, tendo como primordial um diagnóstico geral sobre o Residencial Irisville  região leste de Goiânia-Goiás , identificando as anomalias construtivas e falhas de manutenção – com a análise do risco oferecido aos usuários, ao meio ambiente e ao patrimônio – que interferem e prejudicam a saúde e habitabilidade, frente ao desempenho dos sistemas construtivos e elementos vistoriados da edificação, especialmente ao terreno, estrutura e fundações, instalações elétricas e hidro sanitárias. Neste contexto, a ANOMALIA representa a irregularidade relativa à construção e suas instalações, enquanto que a FALHA diz respeito à manutenção, operação e uso das casas do residencial