Edema corneal em adaptação de sistemas de lentes de contacto especiais

Dissertação de mestrado em Optometria AvançadaO aparecimento de uma grande variedade de lentes de contacto especiais veio ajudar bastante o clínico na correcção visual de várias condições clínicas como o queratocone, o erro refractivo pós-cirúrgico incluindo o astigmatismo irregular, a ectasia pós-cirúrgica, ou a queratoplastia penetrante. Uma das suas maiores preocupações é o impacto a nível fisiológico que estes sistemas de lentes de contacto podem ter sobre a superfície corneal. Um défice significativo de oxigénio na córnea afecta a sua actividade metabólica contribuindo para um quadro de edema (inchamento da córnea – aumento de espessura corneana). O edema corneal pode conduzir a alterações transitórias ou definitivas na histologia do tecido, e por conseguinte, na função visual. Oito sistemas de lentes de contacto especiais foram adaptados em onze sujeitos. Apenas se colocou LC num olho. Sistemas de lentes de contacto como o Piggyback, a LC híbrida, a LC córneo-escleral e as LC hidrófilas de elevada espessura foram incluídos neste estudo. O principal objectivo deste estudo visou determinar o nível de edema que cada sistema provoca após 3 horas de uso, em condições de olho aberto. Os sistemas que provocaram uma menor resposta de edema foram o Piggyback normal quando formado com uma LC de silicone hidrogel (valor médio de 2,745±1,682%) e a lente híbrida SynergEyes ClearKone (valor médio de 2,696±0,827%). As lentes Soft K67 e SH Soft K foram as que causaram um maior impacto fisiológico (5,132±1,828% e 4,61±1,221% respectivamente). Na generalidade, os sistemas de lentes de contacto estudados não apresentaram um edema clinicamente significativo, no entanto lentes como a Soft K67, a SH Soft K e a SO2Clear requerem maior atenção por parte do clínico, pois foram encontrados níveis de edema superiores a 5% em alguns casos. O olho contralateral serviu como controlo, tendo-se verificado diferenças estatisticamente significativas entre os resultados obtidos entre ambos os olhos.The appearance of a wide variety of special contact lenses have been helping the clinician in the correction of visual clinical conditions such as keratoconus, post-surgical refractive error including irregular astigmatism, post-surgical ectasia or penetrating keratoplasty. One of the physician’s major concerns have been the physiological impact provoked by the hypoxic effect that these contact lenses cause. The corneal metabolic activity is affected with the decrease of oxygen levels, contributing to the increase of corneal thickness (corneal edema or corneal swelling). This phenomenon can lead to transient or pemanent changes in the histology of the tissue and, therefore, in the visual function. In this study, eight systems of contact lenses were adapted in eleven subjects. These include the Piggyback systems, the hybrid contact lens, the corneoscleral contact lens and the high thickness hydrophilic systems. The main purpose of this study sought to determine the corneal response induced by each contact lens after 3 hours wearing, in eye opened conditions. The systems which caused a lower corneal swelling were the normal Piggyback, when a low Dk RGP CL was combined with a high Dk soft CL (mean value of 2.745 ±1.682%), and the SynergEyes ClearKone hybrid CL (mean value of 2.696 ±0,827%). Soft K67 and SH Soft K contact lenses were the ones that caused a greater physiological impact (5.132 ± 1.828 and 4.61± 1.221%, respectively). In general, the contact lens systems used in this study did not show a clinically significant edema, however Soft K67, SH Soft K and SO2Clear contact lenses require greater attention by the practitioners due to the maximum levels of edema these CL showed, which were higher than 5%. The contralateral eye was used as a control. It was found statistically significant differences between the results obtained from both eyes

Brincar em tempos de pandemia no pré-escolar: conceções de Encarregados de Educação e de Educadores de Infância

Relatório Final de Prática de Ensino Supervisionada do Mestrado em Educação Pré-escolar e Ensino do 1.º Ciclo do Ensino Básico apresentado na Escola Superior de Educação do Instituto Politécnico de Viana do CasteloEste relatório foi desenvolvido no âmbito da unidade curricular Prática de Ensino Supervisionada (PES), inserida no Mestrado em Educação Pré-Escolar e Ensino do 1.º Ciclo do Ensino Básico da Escola Superior de Educação de Viana de Castelo, e está dividido em três partes. A intervenção da PES decorre num contexto de Educação Pré-Escolar e num contexto de 1.º Ciclo do Ensino Básico, dando assim a oportunidade de desenvolver um estudo investigativo numa destas etapas escolares. O estudo inseriu-se na Educação Pré-Escolar e teve como objetivo central refletir sobre as repercussões que a pandemia COVID-19 teve na vida e no desenvolvimento das crianças, para isso, procurou-se dar resposta a três questões investigativas: (i) Qual a perceção dos Educadores de Infância e dos Encarregados de Educação sobre a importância de brincar em idade pré-escolar?; (ii) Quais foram os constrangimentos e oportunidades decorrentes do confinamento causado pela pandemia COVID-19 nas brincadeiras das crianças em idade pré- escolar?; (iii) Como é que foi operacionalizada a relação entre Família/Jardim de Infância durante o confinamento? Deste modo, optou-se por uma metodologia predominantemente quantitativa e, como método e instrumento de recolha de dados recorreu-se ao inquérito por questionário. A amostra deste estudo é constituída por 72 encarregados de educação e 70 educadores de infância. Após a análise dos dados foi possível verificar que os educadores de infância e os encarregados de educação consideram que brincar é muito importante para o desenvolvimento global das crianças, sendo por isso uma fonte de desenvolvimento, aprendizagem e construção de conhecimentos. Com a pandemia causada pelo vírus SARS-CoV-2, concluiu-se que houve uma maior aproximação entre a família durante as brincadeiras e as crianças ficaram a conhecer melhor os seus gostos e preferências, contudo, o confinamento conduziu à falta de socialização com outras crianças, ao uso excessivo de tecnologias e à diminuição da brincadeira no exterior. A dinamização feita entre Família/ Jardim de Infância decorreu principalmente através de sessões síncronas e assíncronas, onde foi mantido o contacto com entusiasmo entre ambas as partes.This report was developed within the scope of the Supervised Teaching Practice (PES) curricular unit, inserted in the Master's Degree in Pre-School Education and Teaching of the 1st Cycle of Basic Education at the Higher Education School of Viana de Castelo, and is divided into three parts. The intervention of PES takes place in a context of Pre-School Education and in a context of the 1st Cycle of Basic Education, thus giving the opportunity to develop an investigative study in one of these school stages. The study was part of Pre-School Education and had as its central objective to reflect on the repercussions that the COVID-19 pandemic had on the lives and development of children. What is the perception of Early Childhood Educators and Parents about the importance of playing at preschool age?; (ii) What were the constraints and opportunities arising from the confinement caused by the COVID-19 pandemic in the play of preschool children?; (iii) How was the relationship between Family/Kindergarten operationalized during confinement? In this way, a predominantly quantitative methodology was chosen and, as a method and instrument for data collection, a questionnaire survey was used. The sample for this study consists of 72 guardians and 70 kindergarten teachers. After analyzing the data, it was possible to verify that kindergarten teachers and guardians consider that playing is very important for the overall development of children, being therefore a source of development, learning and construction of knowledge. With the pandemic caused by the SARS-CoV-2 virus, it was concluded that there was a closer relationship between the family during games and children got to know their tastes and preferences better, however, confinement led to a lack of socialization with other children, the excessive use of technology and the decrease in outdoor play. The dynamism carried out between the Family/ Kindergarten took place mainly through synchronous and asynchronous sessions, where contact was maintained with enthusiasm between both parties

Improving scheduled maintenance by missing data reconstruction: A double-loop Monte Carlo approach

This article describes a Monte Carlo-based approach for reconstructing missing information in a dataset used by General Electric for reliability analysis, which contains data coming from field observations at inspection of gas turbine components. The approach is based on a combination of maximum likelihood estimation technique to estimate the failure model parameters, Fisher information matrix to estimate the confidence intervals on the estimated parameters, and a double-loop Monte Carlo approach to estimate the missing equivalent starts (i.e. data of turbine state without the relative equivalent starts). The proposed methodology reduces the uncertainty in the estimation of the parameters of the turbine. The results of the application of the novel approach to a real industrial dataset are discussed along with a sensitivity analysis for the quantification of the robustness of the methodology to deal with different sizes of datasets

The global burden of chronic respiratory diseases

Key points Currently, the serious consequences of chronic diseases and their risk factors are not fully recognised by the international health community. In the period of 1990–2020, COPD deaths are expected to increase from 2.2 to 4.7 million worldwide. Reducing chronic disease death rates by an additional 2% annually would avert 36 million deaths by 2015. The abatement of the main risk factors for respiratory diseases, in particular tobacco smoking, environmental tobacco smoke, indoor biomass fuels, outdoor air pollution and unhealthy diet, can achieve huge health benefits. Educational aims To define the burden of chronic respiratory diseases all over the world. To underline the importance of chronic diseases recognition by the international health community. To provide details about the burden of chronic obstructive pulmonary disease (COPD): the predicted third cause of death by 2020. Summary Currently, the serious consequences of chronic diseases and their risk factors are not fully recognised by the international health community. Moreover, chronic diseases are not only a problem of the ageing population in developed countries. In fact, it has been estimated that 80% of mortality for chronic diseases occurred in low-income and middleincome countries in 2005. Thus, the World Health Organization (WHO) Dept of Chronic Diseases and Health Promotion has suggested a new Millennium Development Goal for the next few years: to reduce chronic disease death rates by an additional 2% annually, in order to avert 36 million deaths by 2015

Oral benign fibrous histiocytoma: two case reports

Fibrous histiocytoma is a benign soft tissue tumour arising as a fibrous mass everywhere in the human body. The involvement of the oral cavity is rare. We report two cases of benign fibrous histiocytoma that localized in the oral cavity. The clinical and histological features of the lesion are reported. Finally, a literature revision of this pathology at the level of the oral cavity is reported

Progetto ARGA (Allergopatie Respiratorie: studio di monitoraggio delle linee guida GINA e ARIA): studio osservazionale tra i Medici di Medicina Generale del territorio nazionale.

non presenteBackground: le linee guida (LG) internazionali GINA (Global Initiative for Asthma) ed ARIA (Allergic Rhinitis and its Impact on Asthma) per la gestione dell\u27asma e RA non sono sufficientemente applicate nella pratica clinica. Obiettivi: valutare il grado di applicabilit? delle LG ed il loro impatto sulla qualit? della vita del paziente in Medicina Generale. Metodi: studio osservazionale prospettico; 168 Medici di Medicina Generale (MMG) (71 del gruppo A (+ corso sulle LG) e 97 del gruppo B (- corso)) sono stati selezionati per arruolare i pazienti con diagnosi di asma/RA. Sia il MMG sia il paziente hanno compilato il questionario sulle Allergopatie Respiratorie e la scheda per la rilevazione delle Reazioni Avverse da Farmaci. Il follow-up verr? eseguito dopo 12 mesi

Inhalation therapy in the next decade : Determinants of adherence to treatment in asthma and COPD

Peer reviewedPublisher PD

Active surveillance for carbapenemaseproducing Klebsiella pneumoniae and correlation with infection in subjects attending an Italian tertiary-care hospital: a 7-year retrospective study

Objectives The distribution of carbapenemase-producing Klebsiella pneumoniae (CPKP) phenotypes and genotypes in samples collected during 2011–2018 was evaluated. The association between patients with CPKP-positive rectal swab and those with CPKP infection, as well as the overall analysis of CPKP-infected patients, was performed. Setting The study was performed in a tertiary-care hospital located in Northern Italy. Participants Two groups were considered: 22 939 ‘atrisk’ patients submitted to active surveillance for CPKP detection in rectal swabs/stools and 1094 CPKP-infected patients in which CPKP was detected in samples other than rectal swabs. Results CPKP-positive rectal swabs were detected in 5% (1150/22 939). A CPKP infection was revealed in 3.1% (719/22 939) of patients: 582 with CPKP-positive rectal swab (50.6% of the 1150 CPKP-positive rectal swabs) and 137 with CPKP-negative rectal swab. The 49.4% (568/1150) of the patients with CPKP-positive rectal swab were carriers. The overall frequency of CPKP-positive patients (carriers and infected) was almost constant from 2012 to 2016 (excluding the 2015 peak) and then increased in 2017–2018. blaKPC was predominant followed by blaVIM. No difference was observed in the frequency of CPKP-positive rectal swab patients among the different material groups. Among the targeted carbapenemase genes, blaVIM was more significantly detected from urine than from other samples. Conclusions The high prevalence of carriers without evidence of infection, representing a potential reservoir of CPKP, suggests to maintain the guard about this problem, emphasising the importance of active surveillance for timely detection and separation of carriers, activation of contact precautions and antibiotic treatment guidance on suspicion of infection

Single-Cell Redox Imaging Demonstrates a Distinctive Response of Dopaminergic Neurons to Oxidative Insults

Producción CientíficaAims: The study of the intracellular oxido-reductive (redox) state is of extreme relevance to the dopamine (DA) neurons of the substantia nigra pars compacta. These cells possess a distinct physiology intrinsically associated with elevated reactive oxygen species production, and they selectively degenerate in Parkinson's disease under oxidative stress conditions. To test the hypothesis that these cells display a unique redox response to mild, physiologically relevant oxidative insults when compared with other neuronal populations, we sought to develop a novel method for quantitatively assessing mild variations in intracellular redox state. Results: We have developed a new imaging strategy to study redox variations in single cells, which is sensitive enough to detect changes within the physiological range. We studied DA neurons' physiological redox response in biological systems of increasing complexity--from primary cultures to zebrafish larvae, to mammalian brains-and identified a redox response that is distinctive for substantia nigra pars compacta DA neurons. We studied simultaneously, and in the same cells, redox state and signaling activation and found that these phenomena are synchronized. Innovation: The redox histochemistry method we have developed allows for sensitive quantification of intracellular redox state in situ. As this method is compatible with traditional immunohistochemical techniques, it can be applied to diverse settings to investigate, in theory, any cell type of interest. Conclusion: Although the technique we have developed is of general interest, these findings provide insights into the biology of DA neurons in health and disease and may have implications for therapeutic intervention