Será o Implante de iStent® uma Cirurgia do Canal de Schlemm? Avaliação por OCT Spectral Domain de Segmento Anterior

Introdução: O iStent® “trabecular micro-bypass stent modelo GTS100R/L” tem resultados comprovados na cirurgia do glaucoma de ângulo aberto. Descrito como cirurgia ab interno do canal de Schlemm, visa criar um bypass entre a câmara anterior e este canal, ultrapassando a malha trabecular – principal resistência à drenagem de humor aquoso. Os autores visam estudar o papel do OCT de segmento anterior (SA) na localização do iStent® e uma eventual relação entre o seu posicionamento a eficácia hipotensora. Material e Métodos: Estudo transversal descritivo em que se avaliaram 17 olhos de 17 doentes submetidos a cirurgia de facoemulsificação combinada com iStent®, com um ano de follow-up. Estudou-se o ângulo irido-corneano com OCT spectral domain de SA (Heidelberg Spectralis®) e realizou-se uma avaliação oftalmológica que incluiu medição da pressão intra-ocular (PIO) com tonómetro de Goldmann e gonioscopia. Resultados: Em todos os olhos foi possível localizar o iStent® no ângulo da câmara anterior, porém apenas 4 pareciam estar no canal de Schlemm, estando os restantes na malha trabecular ou esporão escleral. Nos 4 olhos com implante no canal verificou-se uma redução média da PIO de 6,0 mmHg relativamente aos valores pré-operatórios, nos restantes essa redução foi 5,36 mmHg. Esta diferença não é estatisticamente significativa (p>0,05). Conclusões: O OCT spectral domain de SA é um método eficiente para determinar o posicionamento do iStent® no ângulo. Apesar da maioria das extremidades distais dos dispositivos não se encontrarem no canal de Schlemm, estes ultrapassaram a resistência da malha trabecular, pelo que a localização não parece comprometer a eficácia hipotensora.info:eu-repo/semantics/publishedVersio

Prospective unmasked randomized evaluation of the iStent inject (®) versus two ocular hypotensive agents in patients with primary open-angle glaucoma.

PURPOSE: The purpose of this study was to compare outcomes of subjects with open-angle glaucoma (OAG) not controlled on one medication who underwent either implantation of two iStent inject (®) trabecular micro-bypass devices or received medical therapy consisting of a fixed combination of latanoprost/timolol. PATIENTS AND METHODS: Of 192 subjects who qualified for the study and were enrolled, 94 were randomized to surgery with implantation of two iStent inject(®) devices in the treated eye and 98 to receive medical therapy. RESULTS: At the month 12 visit, 94.7% of eyes (89/94) in the stent group reported an unmedicated intraocular pressure (IOP) reduction of ≥20% versus baseline unmedicated IOP, and 91.8% of eyes (88/98) in the medical therapy group reported an IOP reduction ≥20% versus baseline unmedicated IOP. A 17.5% between-group treatment difference in favor of the iStent inject group was statistically significant (P=0.02) at the ≥50% level of IOP reduction. An IOP ≤18 mmHg was reported in 92.6% of eyes (87/94) in the iStent inject group and 89.8% of eyes (88/98) in the medical therapy group. Mean (standard deviation) IOP decreases from screening of 8.1 (2.6) mmHg and 7.3 (2.2) mmHg were reported in the iStent inject and medical therapy groups, respectively. A high safety profile was also noted in this study in both the iStent inject and medical therapy groups, as measured by stable best corrected visual acuity, cup-to-disc ratio, and adverse events. CONCLUSION: These data show that the use of iStent inject is at least as effective as two medications, with the clinical benefit of reducing medication burden and assuring continuous treatment with full compliance to implant therapy as well as having a highly favorable safety profile

Manufactured export performance of Brazil in the ALADI market: Preferential entry and comparative status

This study presents first a brief overview of the efforts towards creating a free trade area in Latin America (Chapter II); it then reviews the developments of preferential trade policies since the foundation of ALADI in 1980 (Chapter III) as well as the development and patterns of preferential and non-preferential intratrade in the area (Chapter IV), with special reference to Brazilian exports of manufactures to the other members of ALADI. A presentation of some hypotheses beyong preferential treatment regarding the determinants of Brazilian exports to the regional market in Chapter V is complemented with an analysis of ALADI latest developments (Chapter VI) and prospects (Chapter VII).

Glaukos iStent inject® Trabecular Micro-Bypass Implantation Associated with Cataract Surgery in Patients with Coexisting Cataract and Open-Angle Glaucoma or Ocular Hypertension: A Long-Term Study

Purpose. To evaluate the long-term efficacy and safety of the iStent inject device (Glaukos Corporation, Laguna Hills, CA) combined with phacoemulsification in patients with coexistent cataract and open-angle glaucoma or ocular hypertension (OHT). Methods. A prospective, uncontrolled, nonrandomized, interventional case series study was conducted in patients with both mild or moderate open-angle glaucoma or OHT and cataract. Patients underwent cataract surgery along with the implant of two iStent inject devices. Outcome measures were intraocular pressure (IOP), topical hypotensive medications required, and best-corrected visual acuity (BCVA). Results. 20 patients were enrolled. Mean follow-up was months. Mean baseline IOP was  mmHg with medication and  mmHg after washout. Mean end-follow-up IOP was  mmHg, representing an IOP decrease of 36.92%,  mmHg (), from baseline washout IOP. The mean number of medications was significantly reduced from to (). 45% of patients were medication-free by the end of follow-up. Mean BCVA improved significantly from to (). No complications of surgery were observed. Conclusion. The iStent inject device combined with cataract surgery served to significantly reduce both IOP and medication use in the long term in patients with coexistent open-angle glaucoma or ocular hypertension (OHT) and cataract

Media Discourse and the Feminization of Poverty

Source diversity models suggest that by using non-conventional, non-official sources for news content, the prevailing perceptions about poor people and their needs would be undermined in news coverage. This study found that major newspapers are making efforts to diversify the sources quoted in their coverage of poverty issues. However, the portrayals of poor people have not changed, particularly for women and people of color. Results of this study suggest that source diversity research must go further to explore how sources are used to address the problems of the poor and how media influence public perceptions of public policy related to welfare and welfare reform

The coexistence of terms to describe the presence of multiple concurrent diseases

Background: Consensus on terminology for multiple diseases is lacking. Because of the clinical relevance and social impact of multiple concurrent diseases, it is important that concepts are clear. Objective: To highlight the diversity of terms in the literature referring to the presence of multiple concurrent diseases/conditions and make recommendations. Design: A bibliometric analysis of English-language publications indexed in the MEDLINE database from 1970 to 2012 for the terms comorbidity, multimorbidity, polymorbidity, polypathology, pluripathology, multipathology, and multicondition, and a review of definitions of multimorbidity found in English-language publications indexed from 1970 to 2012 in the MEDLINE and SCOPUS databases. Results: Comorbidity was used in 67,557 publications, multimorbidity in 434, and the other terms in three to 31 publications. At least 144 publications used the term comorbidity without referring to an index disease. Thirteen general definitions of multimorbidity were identified, but only two were frequently used (91% of publications). The most frequently used definition (48% of publications) was “more than one or multiple chronic or long-term diseases/conditions”. Multimorbidity was not defined in 51% of the publications using the term. Conclusions: Comorbidity was overwhelmingly used to describe any clinical entity coexisting with an index disease under study. Multimorbidity was the term most frequently used when no index disease was designated. Several definitions of multimorbidity were found. However, most authors using the term did not define it. The use of clearly defined terms in the literature is recommended until a general consensus on the terminology of multiple coexistent diseases is reached.Journal of Comorbidity 2013;3(1):4–9 

"Szükségtelen bibliothécák” és folyton csak olvasó lelkészek a Békési Református Egyházmegyében a 18. század végén

1797-ben Fábián József békési tanítót börtönbüntetésre ítélték, mert egy olyan kátét készített, amely erősen emlékeztetett a magyar jakobinus mozgalom kátéjára. Ebben a szövegben egy érdekes megállapítást is találhatunk a könyvtárakkal kapcsolatban, ugyanis Fábián azt állította, hogy „hazugságban” imádja az az Istent, aki „minden féle pompás, szükségtelen... Bibliothécákat” állít fel.Ez a kijelentés elég furcsának hangzik, hiszen magának Fábiánnak is 290 tételből álló magánygyűjteménye volt, és arról volt híres, hogy békési tartózkodása alatt tanítási időben is folyton csak olvasott és fordításokat készített: „Tudom hogy csomó kőnyvel járt bé a Klassisba, ott pipázott, olvasgatott háttal a gyermekek felé, akik osztán azt tselekedték a mit akartak.

Class Day Program, 1972 Commencement

Class Day Program, 1972 Commencement, 2pm, Bryant University

An evaluation of the welfare effects of United States meat import quotas using the concept of economic surplus : a thesis presented in partial fulfilment of the requirements for the degree of Master of Agricultural Science in Agricultural Economics and Marketing at Massey University

The original objective of this study was to estimate the effect of United States Meat Import Quotas on economic welfare in the United States and New Zealand. Welfare was to be estimated as the changes in the economic rent of United States producers, in United States consumers' surplus, and in revenue of the New Zealand beef industry, resulting from a change in quotas. An economic model was formulated expressing the relationship between the beef markets in the United States, New Zealand, and the rest of the world. The model was used to estimate the values of endogenous variables assuming the absence of United States meat import quotas. This was done by estimating the coefficients of the model based on those years in which quotas were not effective. It was expected that the projected values for endogenous variables, obtained by experimentation with the model, would provide a basis for the estimation of the welfare effects of quotas. However initial experimentation demonstrated that the estimated values for endogenous variables in the model were inconsistent with economic theory. As the New Zealand sector of the model required the use of inputs generated by the United States sector, experimentation with the New Zealand sector was abandoned. The points of disagreement between economic theory and the estimated model on the effect of quotas were as follows; (i) The supply and demand for fed beef was expected to rise, but the model predicted a fall. (ii) Domestic supply of manufacturing beef was expected to rise, but the model predicted a fall. (iii) Demand for manufacturing beef was expected to fall, but the model predicted a rise. (iv) Import supply was expected to fall, but the model predicted a rise. Disagreement (iv) is the most serious in terms of the objectives of this study as the restrictive effect of quotas on imports is the reason for their use. It was concluded that the unsatisfactory results obtained in the analysis were due to deficiencies in the econometric model or the data used to estimate the coefficients of the model. Four types of error were considered in term of their possible relevance to the model estimated in the study; specification error; errors in variables; multicollineanity; and autocorrelation. The most important source of error is considered to be in the specification of the model however the other sources of error mentioned are also considered to have been present. Although this study has not achieved the original objective it demonstrates a method whereby the welfare effects of restrictive trade practices can be assessed. For this reason it is considered that some contribution to applied economics has been made

[Review of] Harold A. McDougall, Black Baltimore: A New Theory of Community, and W. Edward Orser, Blockbusting in Baltimore: The Edmondson Village Story

This essay seeks to make a comparative review of two books: 1) Harold A. McDougall\u27s, Black Baltimore: A New Theory of Community; and 2) W. Edward Orser\u27s, Blockbusting in Baltimore: The Edmondson Village Story. The method of procedure used in this review essay will describe and evaluate the organizational structure of the books in a three-fold manner: 1) summary of the texts; 2) use of oral history in the texts; and 3) contribution of books to oral history= literature and conclusion, drawing upon common themes between the two books