Corneal Biomechanics in Ectatic Diseases: Refractive Surgery Implications.

BACKGROUND: Ectasia development occurs due to a chronic corneal biomechanical decompensation or weakness, resulting in stromal thinning and corneal protrusion. This leads to corneal steepening, increase in astigmatism, and irregularity. In corneal refractive surgery, the detection of mild forms of ectasia pre-operatively is essential to avoid post-operative progressive ectasia, which also depends on the impact of the procedure on the cornea. METHOD: The advent of 3D tomography is proven as a significant advancement to further characterize corneal shape beyond front surface topography, which is still relevant. While screening tests for ectasia had been limited to corneal shape (geometry) assessment, clinical biomechanical assessment has been possible since the introduction of the Ocular Response Analyzer (Reichert Ophthalmic Instruments, Buffalo, USA) in 2005 and the Corvis ST (Oculus Optikgerate GmbH, Wetzlar, Germany) in 2010. Direct clinical biomechanical evaluation is recognized as paramount, especially in detection of mild ectatic cases and characterization of the susceptibility for ectasia progression for any cornea. CONCLUSIONS: The purpose of this review is to describe the current state of clinical evaluation of corneal biomechanics, focusing on the most recent advances of commercially available instruments and also on future developments, such as Brillouin microscopy.(undefined)info:eu-repo/semantics/publishedVersio

Diabetes changes ionotropic glutamate receptor subunit expression level in the human retina

Early diabetic retinopathy is characterized by changes in subtle visual functions such as contrast sensitivity and dark adaptation. The outcome of several studies suggests that glutamate is involved in retinal neurodegeneration during diabetes. We hypothesized that the protein levels of ionotropic glutamate receptor subunits are altered in the retina during diabetes. Therefore, we investigated whether human diabetic patients have altered immunoreactivity of ionotropic glutamate receptor subunits in the retina.http://www.sciencedirect.com/science/article/B6SYR-4RS9SS1-1/1/232d6ae7147919a2286326863ee69f1

High glucose and diabetes increase the release of [3H]-D-aspartate in retinal cell cultures and in rat retinas

Several evidences suggest that glutamate may be involved in retinal neurodegeneration in diabetic retinopathy (DR). For that reason, we investigated whether high glucose or diabetes affect the accumulation and the release of [3H]-D-aspartate, which was used as a marker of the glutamate transmitter pool. The accumulation of [3H]-D-aspartate did not change in cultured retinal neural cells treated with high glucose (30 mM) for 7 days. However, the release of [3H]-D-aspartate, evoked by 50 mM KCl, significantly increased in retinal cells exposed to high glucose. Mannitol, which was used as an osmotic control, did not cause any significant changes in both accumulation and release of [3H]-D-aspartate. In the retinas, 1 week after the onset of diabetes, both the accumulation and release of [3H]-D-aspartate were unchanged comparing to the retinas of agematched controls. However, after 4 weeks of diabetes, the accumulation of [3H]-D-aspartate in diabetic retinas decreased and the release of [3H]-Daspartate increased, compared to age-matched control retinas. These results suggest that high glucose and diabetes increase the evoked release of D-aspartate in the retina, which may be correlated with the hypothesis of glutamate-induced retinal neurodegeneration in DR

Prevalence of iron deficiency anemia and iron deficiency in a pediatric population with inflammatory bowel disease

OBJECTIVES: Iron deficiency is the most common cause of anemia in children with inflammatory bowel disease, although the real prevalence is unknown. Intravenous iron is suggested as the first line treatment. This study aims to determine the prevalence of iron deficiency anemia in children with inflammatory bowel disease followed in a Pediatric Gastroenterology Unit of a tertiary center and to evaluate this unit's experience with intravenous iron. MATERIALS AND METHODS: A retrospective cohort study was designed involving children with inflammatory bowel disease followed in that unit between January 2001 and April 2016. Laboratory results were collected at the moment of diagnosis, after one-year follow-up and prior each IV iron administration performed during the study period. Anemia was defined according to World Health Organization criteria and the iron deficiency was defined using recent guidelines. RESULTS: Were studied 69 patients 71% had CD and 29% UC. 50.7% were female. Mean patient age at diagnosis was 13.3 years (range 1--17 years). Prevalence of ID and IDA at diagnosis was 76.8% and 43.5%, respectively. After one year follow-up, those values decreased to 68.1% (p=.182) and 21.7% (p=.002), respectively. Hemoglobin significantly increased (p<.001). Intravenous iron was administered to 92.8% of patients. No adverse reactions were reported. CONCLUSIONS: Intravenous iron is the first line in the treatment of Iron deficiency anemia in Inflammatory Bowel disease and it is safe and effective. Persistent anemia and iron deficiency are common.info:eu-repo/semantics/publishedVersio

Elevated glucose changes the expression of ionotropic glutamate receptor subunits and impairs calcium homeostasis in retinal neural cells

PURPOSE. Altered glutamatergic neurotransmission and calcium homeostasis may contribute to retinal neural cell dysfunction and apoptosis in diabetic retinopathy (DR). The purpose of this study was to determine the effect of high glucose on the protein content of -amino-3-hydroxy-5-methylisoxazole-4-propionic acid (AMPA) and kainate glutamate receptor subunits, particularly the GluR2 subunit, because it controls Ca2 permeability of AMPA receptor-associated channels. The effect of high glucose on the concentration of cytosolic free calcium ([Ca2 ]i) was also investigated. METHODS. The protein content of GluR1, GluR2, GluR6/7, and KA2 subunits was assessed by Western blot. Cobalt staining was used to identify cells containing calcium/cobalt-permeable AMPA receptors. The [Ca2 ]i changes evoked by KCl or kainate were recorded by live-cell confocal microscopy in R28 cells and in primary cultures of rat retina, loaded with fluo-4. RESULTS. In primary cultures, high glucose significantly decreased the protein content of GluR1 and GluR6/7 subunits and increased the protein content of GluR2 and KA2 subunits. High glucose decreased the number of cobalt-positive cells, suggesting a decrease in calcium permeability through AMPA receptor-associated channels. In high-glucose–treated cells, changes in [Ca2 ]i were greater than in control cells, and the recovery to basal levels was delayed. However, in the absence of Na , to prevent the activation of voltage-sensitive calcium channels, the [Ca2 ]i changes evoked by kainate in the presence of cyclothiazide, which inhibits AMPA receptor desensitization, were significantly lower in high-glucose–treated cells than in control cultures, further indicating that AMPA receptors were less permeable to calcium. Mannitol, used as an osmotic control, did not cause significant changes compared with the control. CONCLUSIONS. The results suggest that elevated glucose may alter glutamate neurotransmission and calcium homeostasis in the retina, which may have implications for the mechanisms of vision loss in DR.Foundation for Science and Technology, Portugal and FEDER (Grant POCTI/CBO/38545/01), The Juvenile Diabetes Research Foundation, The American Diabetes Association and the Pennsylvania Lions Sight Conservation and Eye Eye Research Foundation

Changes of the digestive tract of Golden Retriever dogs affected by muscular dystrophy

O modelo experimental canino Golden Retriever portador da Distrofia Muscular (GRMD) é o melhor substituto entre os modelos animais para estudar a Distrofia Muscular de Duchenne. Além da musculatura estriada, a doença pode afetar a musculatura estriada cardíaca e a musculatura lisa, e desta forma, o funcionamento do trato digestório, já que o músculo liso é o elemento primário dos órgãos tubulares. Através de estudo morfológico descritivo, o objetivo deste trabalho foi verificar se a distrofia muscular afeta a arquitetura geral do trato digestório e como se dispõe sua estrutura muscular em animais afetados. Foram realizadas avaliações descritivas macro e microscópicas com colorações de Hematoxilina-Eosina, Tricrômio de Masson e Picrosirius. Entre os resultados apresentados, verificou-se que o esôfago e o fígado dos animais afetados encontraram-se alterados, assim como o estômago não ocupava seu lugar habitual. O músculo diafragma apresentava-se atrofiado e diferenças histológicas foram encontradas na camada muscular do sistema gastrointestinal, em geral. Outras estruturas do tubo digestório de GRMDs apresentaram-se de maneira similar a de um animal normal.The experimental canine model Golden Retriever carrier of Muscular Dystrophy (GRMD) is the best substitute of animal models to study Duchenne Muscular Dystrophy. Above striated muscle, the disease can affect the heart and smooth muscle, so the functioning of the digestive tract, as the smooth muscle is the primary element of tubular organs. Through morphological description, the purpose of this study was to determine whether the muscular dystrophy affects the overall architecture of the digestive tract and how is willing this muscular structure. Were evaluated macroscopic and microscopic optical description staining with hematoxylin-eosin, Masson's trichrome and Sirius. The esophagus and liver of affected animals were altered. The stomach of the animals did not occupy the usual space. The diaphragm muscle had atrophied. The general histological structure of the digestive tract presented in a manner similar to a normal animal. Changes and histological differences were found in the muscle layer.Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq

Morphofunctional study of Crab-eating Raccoon (Procyon cancrivorus) mammary gland

Para a descrição macro e microscópica das glândulas mamárias foram utilizadas três fêmeas de Mão Pelada (Procyon cancrivorus). As amostras das glândulas foram processadas conforme técnicas rotineiras para histologia. As fêmeas estudadas apresentaram 3 pares de glândulas mamárias, sendo um par de glândula mamária abdominal cranial, um par de abdominal caudal e um par de inguinal. As papilas mamárias apresentaram formato pendular, como os canídeos domésticos. Microscopicamente, a glândula mamária apresentou da porção externa para a interna: epiderme (epitélio estratificado pavimentoso queratinizado), derme (tecido conjuntivo frouxo e tecido conjuntivo denso não modelado), fibras musculares lisas e ductos papilíferos que abrem em vários ósteos papilares em formato de "chuveiro". A porção secretora glandular era caracteristicamente túbulo alveolar, com células cuboidais dispostas em camada simples. Os resultados indicam que o conjunto glandular estudado é semelhante ao da cadela (Cannis familiaris) tanto em seu aspecto macroscópico quanto em seu aspecto microscópico, este fato sugere que podemos utilizar o Mão Pelada e o Cão como modelos similares de estudo, para identificação de patologias relacionadas a este sistema.Three Procyon cancrivorus females were studied with emphasis for gross and microscopical description of the mammary glands. Samples of the glands were processed with routine techniques for histology. The females studied presented three pairs of mammary glands: one pair of cranial abdominal mammary glands, a second pair of caudal abdominal and a third one, as inguinal mammary glands. Mammary papillae presented a pendulum shape, as in the domestic dogs. Microscopically, the mammary gland consisted from the external to the internal portion (1) of stratified squamous epithelium of the epidermis, (2) dense irregular connective tissue of the derma, and (3) smooth muscle fibers and papillary ducts that flowed with "shower" shape into the lactiferous sinus. The secretory portion consisted of tubule-alveolar glands with cuboidal cells disposed in a simple layer. The results indicate that the set of glandular studies is similar to ones related to dog (Canis familiaris) in such a way in its gross aspect that how much in its microscopically structure. This fact suggests that we can use the raccoon and the dog as similar models of study, for identification of pathologies related to this system.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP

Impact of facial conformation on canine health: Brachycephalic Obstructive Airway Syndrome

The domestic dog may be the most morphologically diverse terrestrial mammalian species known to man; pedigree dogs are artificially selected for extreme aesthetics dictated by formal Breed Standards, and breed-related disorders linked to conformation are ubiquitous and diverse. Brachycephaly–foreshortening of the facial skeleton–is a discrete mutation that has been selected for in many popular dog breeds e.g. the Bulldog, Pug, and French Bulldog. A chronic, debilitating respiratory syndrome, whereby soft tissue blocks the airways, predominantly affects dogs with this conformation, and thus is labelled Brachycephalic Obstructive Airway Syndrome (BOAS). Despite the name of the syndrome, scientific evidence quantitatively linking brachycephaly with BOAS is lacking, but it could aid efforts to select for healthier conformations. Here we show, in (1) an exploratory study of 700 dogs of diverse breeds and conformations, and (2) a confirmatory study of 154 brachycephalic dogs, that BOAS risk increases sharply in a non-linear manner as relative muzzle length shortens. BOAS only occurred in dogs whose muzzles comprised less than half their cranial lengths. Thicker neck girths also increased BOAS risk in both populations: a risk factor for human sleep apnoea and not previously realised in dogs; and obesity was found to further increase BOAS risk. This study provides evidence that breeding for brachycephaly leads to an increased risk of BOAS in dogs, with risk increasing as the morphology becomes more exaggerated. As such, dog breeders and buyers should be aware of this risk when selecting dogs, and breeding organisations should actively discourage exaggeration of this high-risk conformation in breed standards and the show ring

Evaluation of Intereye Corneal Asymmetry in Patients with Keratoconus. A Scheimpflug Imaging Study

Purpose: To assess the correlation between keratoconus severity and intereye asymmetry of pachymetric data and posterior elevation values and to evaluate their combined accuracy in discriminating normal corneas from those with keratoconus. Methods: This study included 97 patients: 65 subjects with bilateral normal corneas (NC) and 32 with keratoconus (KC). Central corneal thickness (CCT), thinnest corneal thickness (ThCT) and posterior elevation (PE) at the thinnest point of the cornea were measured in both eyes using Scheimpflug imaging. Intereye asymmetry and its correlation with keratoconus severity were calculated for each variable. The area under the receiver operating characteristic curve (AUROC) was used to compare predictive accuracy of different variables for keratoconus. Results: In normal eyes, intereye differences were significantly lower compared with the keratoconus eyes (p<0.001, for CCT, ThCT and PE). There was a significant exponential correlation between disease severity and intereye asymmetry of steep keratometry (r(2) = 0.55, p<0.001), CCT (r(2) = 0.39, p<0.001), ThCT (r(2) = 0.48, p<0.001) and PE (r(2) = 0.64, p<0.001). After adjustment for keratoconus severity, asymmetry in thinnest pachymetry proved to be the best parameter to characterize intereye corneal asymmetry in keratoconus. This variable had high accuracy and significantly better discriminating ability (AUROC: 0.99) for KC than posterior elevation (AUROC: 0.96), ThCT (AUROC: 0.94) or CCT (AUROC: 0.92) alone. Conclusions: There is an increased intereye asymmetry in keratometry, pachymetry and posterior corneal elevation values in keratoconic patients compared to subjects with normal corneas. Keratoconus patients with more severe disease are also more asymmetric in their disease status which should be taken into account during clinical care