Search

João Heitor Marques,1 Ana Marta,1,2 Pedro Manuel Baptista,1,2 Daniel Almeida,1 Diana José,1 Paulo JM Sousa,1 Irene Barbosa1,2 1Ophthalmology Department, Centro Hospitalar Universitário do Porto, Porto, Portugal; 2Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, PortugalCorrespondence: João Heitor Marques, Centro Hospitalar Universitário do Porto, Largo Prof. Abel Salazar, Porto, Portugal, Email joaoheitormarques@gmail.comPurpose: To study the clinical benefit of low-level light therapy when associated with intense pulsed light for the treatment of meibomian gland dysfunction.Methods: An observational study. Two groups of patients that were treated with IPL were considered: group 1 (31 subjects, 62 eyes), intense pulsed light followed by low-level light therapy and group 2 (31 subjects, 62 eyes) intense pulsed light alone. In both groups, treatments were performed in 3 sessions and subjects were evaluated at baseline and 3 weeks after the last treatment session. Values are shown as mean difference ± standard deviation.Results: We observed a significant improvement in OSDI-12 score and lipid layer thickness, in both groups (− 22.7± 17.5, p< 0.001 in group 1 and − 23.6± 23.8, p< 0.001 in group 2 for OSDI and +18.6 ± 37.0, p< 0.001 in group 1 and +19.9 ± 26.4, p< 0.001 in group 2 for lipid layer thickness). Despite no differences between groups at baseline (p=0.469), only group 1 had a significant improvement in Schirmer test (+1.6± 4.8, p=0.009 in group 1 and +1.7± 6.9, p=0.057 in group 2). No significant side effects were noted. No patient in any group felt subjectively “worse” after the treatment.Conclusion: Intense pulsed light seems effective and safe for the treatment of meibomian gland dysfunction, improving symptoms and the tear film lipid layer. This study shows no strong evidence of the benefit of low-level light therapy, but it shows weak evidence that it may further improve aqueous tear production.Keywords: dry eye syndromes, meibomian gland dysfunction, phototherapy, intense pulsed light therapy, low-level light therapy

Ana Marta,1,2 João Heitor Marques,1 Daniel Almeida,1 Diana José,1 Irene Barbosa1,2 1Department of Ophthalmology, Centro Hospitalar Universitário do Porto (CHUPorto), Oporto, Portugal; 2Instituto de Ciências Biomédicas Abel Salazar (ICBAS), Oporto, PortugalCorrespondence: Ana MartaDepartment of Ophthalmology, Centro Hospitalar e Universitário do Porto, Largo do Prof. Abel Salazar, Porto, 4099-001, PortugalEmail analuisamarta2@gmail.comPurpose: To analyze the visual performance in contact lens wearers with keratoconus.Methods: A retrospective study including contact lens (CL) wearers was performed. The current best-corrected visual acuity with contact lens (BCVA-CL) and with spectacles (BCVA-S) correction, contrast sensitivity (CS) (by Metrovision-MonPack3®), analysis of light scattering in the retina and vision break-up time (HD Analyzer®), and corneal tomography (Oculus Pentacam® HR) were evaluated.Results: This study included 96 eyes of 59 patients with Keratoconus. Rigid gas permeable contact lenses (RGPCL), hybrid contact lenses (HCL), and silicone hydrogel/hydrogel contact lenses (HGCL) were fitted in 67, 17, and 12 eyes, respectively. Dynamic objective scatter index (OSI) (p = 0.024), minimum OSI (p = 0.037) and maximum OSI (p = 0.040) were significantly better with RGPCL and worse with HGCL. Mean CS in photopic conditions was significantly worse with HGCL and better with HCL (p = 0.006), without differences in mesopic conditions (p = 0.121). RGPCL wearers showed a higher mean K (p = 0.020), and a lower corneal thickness at the thinnest point (p=0.011).Conclusion: Visual quality varied significantly with different types of CL. Although RGPCL was fitted in patients with worse Pentacam tomographic parameters, RGPCL was associated with a better dynamic visual quality.Keywords: keratoconus, contact lens, visual performance, optical quality

Patrick Wang,1 Eric K Chin,2 David Almeida3 1School of Medicine, Queen’s University, Kingston, Ontario, Canada; 2Retina Consultants of Southern California, Redlands, CA, USA; 3Erie Retinal Surgery, Erie, PA, USACorrespondence: David AlmeidaErie Retinal Surgery, 300 State Street, Suite 201, Erie, PA, 16507, USATel +1 814 456-4241Fax +1 814 453-3354Email drpa@pm.meAbstract: Retinal tissue is prone to oxidant burden and oxidative stress secondary to the generation of reactive oxygen species from high metabolic demand. The formation of reactive oxygen species occurs primarily from the mitochondrial respiratory chain as well as several enzymatic and oxidation reactions that occur in the neurosensory retina and retinal pigment epithelium. This oxidative stress has been implicated in the pathogenesis of several retinal diseases and the role of antioxidants as a therapeutic treatment shows promise in slowing the progression of certain diseases. The aim of this narrative review is to describe the mechanisms of retinal oxidative stress and summarize the current available evidence for antioxidants as a treatment for vitreoretinal disorders.Keywords: antioxidant, reactive oxygen species, retina

This article examines student engagement in an inquiry-based learning activity, planned to provide students with elements in the social, epistemic, and conceptual dimensions related to the scientific practice in immunology. The activity was applied to 39 groups of students enrolled in immunology or biochemistry courses in a public university in Brazil. Students performed data-collection through the execution of an "in vitro" assay. We analyzed how students represent data and use them to support their claims in their written constructs. To clarify which are the productive epistemologies in students' reports, we developed a framework for epistemic practice analysis. Our findings point to a pattern of several epistemic practice categories in their written text, mostly related to the particular contingences of data analysis, rather than to theoretical concepts. In addition, we observed that students performed literary inscriptions to represent their data; however, they tended not to cite all data obtained in their written texts. These results suggest that immunology education strategies should provide students with approaches that explore the role Epistemology of data representation in the scientific text rhetoric.

The Mediterranean region is distinguished by its gastronomic diversity and a wide variety of indigenous nut crops. In line with changing global food consumers' preferences, a noteworthy aspect is the increasing demand to the use of local varieties in recipe formulation. The aim of the present study was to incorporate the Terra Fria chestnut (Portugal) and Negreta hazelnut from Reus (Spain) in traditional Mediterranean recipes. The sensory, technofunctional, nutritional, and shelf‐life characterization were investigated in hazelnut omelette (gluten and gluten‐free) and chestnut pudding (sugar and sugar‐free) formulations. Results conducted by trained assessors using the free choice profiling (FCP) showed that hazelnut omelette samples were described as "creamy," "smooth," and "handmade." In addition, the texture obtained with the hazelnut omelette gluten‐free version showed the softest textural profile analysis attributes, with lower values for hardness (2.43 ± 0.36 N), adhesiveness (−0.38 ± 0.00 g s) and gumminess (2.12 ± 0.14). Furthermore, the shelf‐life studies revealed a more golden color (>14.43 of a* CIELAB coordinate) and a lower moisture content (25.36%–43.59%) in the hazelnut flour formulation, in addition to the enrichment in terms of protein (8.36 g/100 g), fiber, and healthy fats. In the case of chestnut pudding, it was observed that the study parameters did not differ significantly from its sweetened analogue with positive attributes in FCP ("toasted," "fluffy," and "sweet"), positioning it as a viable alternative to sugar in this application. Therefore, both hazelnut flour in hazelnut omelette and oligofructose in chestnut pudding proved to be promising ingredients in the formulation of gluten‐free and sugar‐free developed products, offering attractive organoleptic and textural characteristics. [ABSTRACT FROM AUTHOR]

Hypophosphatemia may cause serious complications. Depending on its severity and duration, signs and symptoms range from fatigue to life-threatening events, like severe rhabdomyolysis and mental status changes. Long-term consequences include osteomalacia. Hypophosphatemia may be secondary to the use of parental iron, mostly associated with ferric carboxymaltose (FCM), with an incidence of around 45% to 70%. We describe three cases of hypophosphatemia in patients with chronic iron deficiency anemia, requiring repeated FCM infusions. The patients’ presentation to the Rheumatology department included musculoskeletal symptoms of severe hypophosphatemia and long-term hypophosphatemic osteomalacia, with fractures. We aim to raise awareness for ferric carboxymaltose-induced hypophosphatemia, an entity increasingly described in the literature that can be responsible for severe disability or potentially life-threatening adverse events. [ABSTRACT FROM AUTHOR]

Pedro Manuel Baptista,1,2 Ana Ambrósio Marta,1,2 João Heitor,1 Diana José,1 Daniel Almeida,1 António Ribeiro,1 Irene Barbosa1,2 1Ophthalmology Department, Centro Hospitalar Universitário do Porto, Porto, Portugal; 2Instituto de CIências Biomédicas Abel Salazar, Universidade do Porto, Porto, PortugalCorrespondence: Pedro Manuel BaptistaCentro Hospitalar Universitário do Porto, Largo Prof. Abel Salazar, Porto, 4099-001, PortugalEmail pedroyybaptista@gmail.comPurpose: To address the long-term visual function after bilateral pan-retinal photocoagulation (PRP) and its impact in real life, namely on visual field (VF) legal criteria to drive. To determine potential predictors related to clinical factors and treatment strategies.Patients and Methods: Observational cross-sectional study. Eyes from diabetic patients diagnosed with diabetic retinopathy who underwent bilateral PRP, with or without macular treatments and with visual acuity legal criteria for non-professional driving were randomly assigned. Main outcomes were: demographic and clinical data including best corrected visual acuity; binocular visual field (EBST-Esterman Binocular Suprathreshold Test, Humphrey analyzer3®); contrast sensitivity (CS-Metrovision-MonPack3®); light scattering in the retina (HD Analyzer, Visiometrics®).Results: Seventy-one diabetic patients included (44 men and 27 women), with a mean age of 62.2± 11.8 years. PRP was performed, on average, 9.7± 6.9 years before the study. The average EBST Score was 85.8± 17.0 and the average CS (2– 5cpd) was 19.5± 2.9 dB in photopic and 14.2± 4.1 dB in mesopic conditions. Through a multivariate regression model, after adjusting to the clinical and demographic factors as possible confounders, we found that treatment factors associated with worse results were the use of Argon laser for the EBST Score, the very confluent PRP for the number of non-viewed points in the central 30°x20° of the EBST and the presence of macular treatments for the CS tests. According to Portuguese law, 79% (n=56) of patients had minimal EBST amplitudes for non-professional driving.Conclusion: The functional results achieved in our sample are compatible with an active life, allowing most of the patients included to overcome the requirements of Portuguese legislation for driving light vehicles, namely at the level of the binocular visual field. These results highlight the role of PRP in the treatment of diabetic retinopathy in an era with evolving less aggressive laser options.Keywords: diabetic retinopathy, pan-retinal photocoagulation, retinal laser, Esterman binocular visual field, contrast sensitivity

Pedro Manuel Baptista,1 Nisa Silva,1 João Coelho,1 Diana José,1 Daniel Almeida,1 Angelina Meireles1,2 1Ophthalmology Department, Centro Hospitalar Universitário do Porto, Porto, Portugal; 2Instituto de Ciências Biomédicas Abel Salazar, Porto, PortugalCorrespondence: Pedro Manuel BaptistaCentro Hospitalar Universitário do Porto, Largo Prof. Abel Salazar, Porto 4099-001, PortugalTel +351 917868372Email pedroyybaptista@gmail.comPurpose: To characterize a population of high myopes with myopic traction maculopathy (MTM), to assess their retinal function, and to correlate it with anatomic status.Patients and Methods: This was an observational cross-sectional study including 50 eyes from 27 patients. Demographic and clinical data were analyzed. Macular structure was assessed with spectral domain optical coherence tomography (SD-OCT, Heidelberg®) and macular function was studied with Microperimeter MP-3, NIDEK®.Results: The average for central foveal thickness (CFT) and choroid thickness (CT) was 213± 151 μm and 36± 23 μm, respectively, in a total of 50 eyes from 27 patients. In the microperimetry analysis, the average sensitivity on the foveal-centered 12º polygon (CPS) was 14.37± 9.1 dB. CT was negatively associated with the bivariate contour ellipse areas (BCEA) 1 (r=− 0.314; p=0.034), 2 (r=− 0.314; p=0.034), and 3 (r=− 0.316; p=0.033). CPS had a strong positive correlation with best-corrected visual acuity (BCVA) (r=0.661; p=0.000). We found a trend to worse microperimetric results in eyes with schisis (n=19) (p> 0.05) but eyes with atrophic areas (n=33) presented significant inferior CPS (p< 0.001). The presence of staphyloma showed significant impact on macular sensitivities in eyes with areas of macular atrophy/fibrosis (p< 0.05).Conclusion: Macular microperimetry analysis can have a role as part of a multimodal anatomo-functional assessment for a more precise characterization of the high myopic patients with MTM, optimizing medical and surgical decisions.Keywords: foveoschisis, high myopia, microperimetry, myopic traction maculopathy, retinal atrophy, staphyloma

The goal of the present study is to provide a direct comparison of the results of informal judgment collection methods with the results of formal judgment collection methods, as a first step in understanding the relative merits of each family of methods. Although previous studies have compared small samples of informal and formal results, this article presents the first large-scale comparison based on a random sample of phenomena from a leading theoretical journal (Linguistic Inquiry). We tested 296 data points from the approximately 1743 English data points that were published in Linguistic Inquiry between 2001 and 2010. We tested this sample with 936 naïve participants using three formal judgment tasks (magnitude estimation, 7-point Likert scale, and two-alternative forced-choice) and report five statistical analyses. The results suggest a convergence rate of 95% between informal and formal methods, with a margin of error of 5.3-5.8%. We discuss the implications of this convergence rate for the ongoing conversation about judgment collection methods, and lay out a set of questions for future research into syntactic methodology. © 2013 Elsevier B.V.