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Analysis of refractive outcomes, using biometry data collected with a new biometer (Pentacam-AXL, OCULUS, Germany) and a reference biometer (Lenstar LS 900, HAAG-STREIT AG, Switzerland), in order to assess differences in the predicted and actual refraction using different formulas. Prospective, institutional study, in which intraocular lens (IOL) calculation was performed using the Haigis, SRK/T and Hoffer Q formulas with the two systems in patients undergoing cataract surgery between November 2016 and August 2017. Four to 6 weeks after surgery, the spherical equivalent (SE) was derived from objective refraction. Mean prediction error (PE), mean absolute error (MAE) and the median absolute error (MedAE) were calculated. The percentage of eyes within ± 0.25, ± 0.50, ± 1.00, and ± 2.00 D of MAE was determined. 104 eyes from 76 patients, 35 males (46.1%), underwent uneventful phacoemulsification with IOL implantation. Mean SE after surgery was − 0.29 ± 0.46 D. Mean prediction error (PE) using the SRK/T, Haigis and Hoffer Q formulas with the Lenstar was significantly different (p > 0.0001) from PE calculated with the Pentacam in all three formulas. Percentage of eyes within ± 0.25 D MAE were larger with the Lenstar device, using all three formulas. The difference between the actual refractive error and the predicted refractive error is consistently lower when using Lenstar. The Pentacam-AXL user should be alert to the critical necessity of constant optimization in order to obtain optimal refractive results.

Purpose: Comparison of biometric measurements and calculation of intraocular lens with a new biometer (Pentacam®-AXL, Oculus, Germany) and a reference biometer (Lenstar LS 900®, Haag-Streit AG, Switzerland), in order to assess the agreement between these two devices. Setting: Centro Hospitalar de Leiria, Portugal Materials and methods: Prospective, institutional study, in which measurements of axial length, anterior chamber depth from the corneal epithelium and endothelium to the anterior surface of the lens (anterior chamber depth ext and anterior chamber depth int), central corneal thickness and keratometry readings of the flattest and steepest meridians (K1 and K2) were obtained with the two systems. Intraocular lens calculation was also performed, using the Haigis, SRK/T and HofferQ formulas. Results: The study sample included 136 eyes of 79 patients. Of these, 42 were women and 37 were men. Statistically significant differences were found (p Conclusion: Axial length measurements obtained with the Pentacam® and Lenstar® appear to be interchangeable, while measurements of anterior chamber depth, K1 and K2, and central corneal thickness do not appear to be interchangeable between different devices. Statistically significant differences were found in the calculation of intraocular lenses in all formulas used.

VEGF-A and VEGF-B are proangiogenic and key regulating factors for blood vessel growth. This study aims to compare VEGF-A and VEGF-B levels in the serum and vitreous of patients with neovascular pathology versus non-neovascular pathology. Our findings showed vitreous VEGF-A and VEGF-B levels increased in patients with neovascular disease, with higher levels of VEGF-A compared to VEGF-B (p ≤ .05). In the diabetic retinopathy (DR) group, higher vitreous VEGF-A or VEGF-B were found in proliferative diabetic retinopathy (PDR) than in non-PDR. The strong correlation between VEGF-A and VEGF-B demonstrates a simultaneous pathological increase of cytokines (p, POCI-01-0145-FEDER-007491

Vision loss due to disease or degeneration of the eye (retina, choroid, retinal veins, or macula) is a leading cause of blindness worldwide. In most cases, vision-threatening ocular diseases are accompanied by abnormal changes in the vasculature of the eye, especially the retina, and these conditions are collectively referred to as retinal vasculopathies. Impaired blood supply or hypoxia stimulates angiogenesis in the vascular and non-vascular sections of the eye, which results in neovascularization, leading to conditions such as diabetic retinopathy or age-related macular degeneration. Studies show that vascular endothelial growth factors: VEGF-A, VEGF-B, and placental growth factor (PlGF) are elevated in these diseases, and hence, these factors could be used as markers for disease prognosis and therapy. In this review, we discuss the function of these growth factors in normal development and disease, with focus on ocular disorders and emphasize the importance of accurately determining their levels in the vitreous and serum of patients for correct diagnosis and therapy.

Vascular endothelial growth factor B (VEGF-B) is one of the enigmatic members of the VEGF family. The knowledge gap about VEGF-B expression and how its levels are altered in diabetic eyes were the focus of this investigation that was addressed by comparing and correlating vitreous VEGF-B between diabetic and non-diabetic patients. VEGF-B levels were measured by enzyme-linked immunosorbent assay in vitreous samples (n = 33) from diabetic (n = 25) and non-diabetic (n = 8) patients. Results were compared between groups. Optical coherence tomography from diabetic patients was evaluated for central retinal thickness (CRT) and macular volume (MV). Mean vitreous VEGF-B concentration was higher in diabetic (18.82 ± 1.44 pg/mL ) vs. non-diabetic patients (17.90 ± 0.32 pg/mL) (p = 0.006), and in proliferative diabetic retinopathy (PDR) (19.03 ± 1.52 pg/mL) vs. non-PDR (NPDR) patients (18.18 ±0.96 pg/mL) (p = 0.025). In diabetic retinopathy (DR) patients, correlation between VEGF-B and CRT (μm) was positive and moderate: rs = 0.441 (p ≤ 0.05) and the correlation between VEGF-B and MV (mm³) was positive and robust: rs = 0.716 (p ≤ 0.01). VEGF-B levels are overexpressed in vitreous of diabetic patients, and the levels are higher in developed stages of DR. Correlation results show that CRT and MV increase with increased levels of VEGF-B. Targeting VEGF-B inhibition may have therapeutic beneficial implications., CENTRO-07-ST24-FEDER-002014)

Purpose: To report an uncommon case of a 29-year-old Caucasian male diagnosed with unilateral choroidal neovascularization (CNV) secondary to punctate inner choroidopathy leading to visual impairment. Methods: This is a retrospective and descriptive case report based on data from clinical records, patient observation and analysis of ancillary diagnostic tests. Results: A 29-year-old Caucasian male presented to our emergency department with complaints of decreased central vision in his left eye (LE), detected a few hours before. Best-corrected visual acuity (BCVA) in the LE was counting fingers at 50 cm and BCVA in the right eye was 20/20. Fundoscopy of the LE evidenced multiple round and yellowish lesions in the macula and nasal to the optic nerve, without intraocular inflammation signs. Optical coherence tomography showed increased retinal thickness with detachment of the neuroepithelium and a slight retinal pigment epithelium detachment. Fluorescein angiography revealed hyperfluorescent lesions with blurred borders in the macula. An intravitreal injection of bevacizumab (1.25 mg/0.05 ml) was administered in the LE, which resulted in anatomic and visual improvement. Conclusion: We present a rare case of unilateral CNV secondary to punctate inner choroidopathy in a young, myopic male.

Resumen Introduccion Presentamos el caso de una paciente con una hemorragia premacular tratada con neodimio (Nd):YAG laser. Caso clinico Paciente de 54 anos de edad fue a urgencias por perdida repentina de vision en el ojo derecho (OD) desde el dia anterior. La maxima vision corregida del OD era la percepcion de la luz y en el fondo de ojo se vio una hemorragia premacular de gran tamano. Se hizo el tratamiento con Nd:YAG laser en ese dia para que drenase la hemorragia hacia la cavidad vitrea. En la hemorragia intravitrea habia desaparecido al cabo de un mes y despues de 3 meses la vision era 20/25.

This article reviews clinically relevant data regarding punctate inner choroidopathy, mainly the various treatment options. Punctate inner choroidopathy is an uncommon, inflammatory, multifocal chorioretinopathy affecting mostly young myopic women. It is characterized by the presence of multiple, small, well-defined, yellow-white fundus lesions, in the absence of intraocular inflammation. We describe etiology, clinical findings and ancillary tests that help in the diagnosis and detection of complications. Treatment options that have been used to manage patients with PIC and CNV include immunosuppressants, corticoids, laser photocoagulation, photodynamic therapy, intravitreal anti-VEGF agents and submacular surgery.

Ptosis is defined as an abnormally low position of the upper eyelid margin. It can be congenital or acquired, uni or bilateral, and isolated or associated with other ocular and nonocular defects. We report a case of a female child, aged 8 years, with congenital right ptosis increased on right adduction and with left ptosis on left adduction. There was no horizontal ocular movement limitation. Apparent underaction of the right inferior oblique muscle was also present. We believe that within the possible mechanisms it is more likely that it is a congenital innervation dysgenesis syndrome (CID)/congenital cranial dysinnervation disorder (CCDD).

Introduction To report a case of premacular haemorrhage treated with Neodymium (Nd):YAG laser puncture. Case report A 54-year-old Caucasian female was seen in the emergency department with complaints of sudden loss of vision in her right eye (RE), detected on the previous day. The best-corrected visual acuity (BCVA) in the RE was reduced to light perception, and fundoscopy evidenced a large and dense premacular haemorrhage. An Nd:YAG laser puncture was performed that day to drain the haemorrhage into the vitreous cavity. The intravitreal haemorrhage cleared in about 1 month, and the BCVA of the RE was 20/25 after 3 months.

To present the results of a retrospective comparative unicentric institutional study of the incidence of postcataract surgery endophthalmitis before and after the introduction of the European Society of Cataract and Refractive Surgeons (ESCRS) protocol in 2007 in our department.This study included 15,689 eyes of patients undergoing cataract surgery between 2005 and 2011. Surgeries were performed by 9 different surgeons. After June 2007, the ESCRS protocol was introduced, and all patients underwent intracameral injection of 1 mg of cefuroxime (10 mg/mL) at the end of cataract surgery. Cefuroxime was prepared prior to surgery in the operating room. All patients were observed between 6 weeks and 3 months after surgery.Between January 2005 and June 2007, before the introduction of the ESCRS protocol in our department, 2299 patients underwent cataract surgery and there were 6 cases of postoperative endophthalmitis (0.26%). After the introduction of the protocol, 13,390 surgeries were performed and there were no cases of endophthalmitis.Postoperative endophthalmitis is one of the most devastating cataract surgery complications. Our results provide strong evidence of the utility of cefuroxime as prophylaxis of endophthalmitis after cataract surgery.

A several number of mites have been associated with ear problems, namely otitis externa (Scott et al., 2001). Fifty percent or more of all otitis, in cats, and 10%, in dogs, are thought to be caused by ear mites (Sotiraki et al., 2001; Mueller, 2008). Very common in pets, ear mites can be a serious problem. The most common mite is, undoubtedly, Otodectes cynotis, but there are some other mites that can also be found in the ear canal, includding Demodex canis, Demodex cati, Sarcoptes scabiei, Notoedres cati, among others (Cordero del Campillo et al., 1999; Blot et al., 2003; Engler, 2007). Frequently, ear mites can be the initiating factor of the otitis externa. The mechanical irritation, caused by their presence inside the ears, may lead to a higher activity of ceruminal glands and, consequently, the establishment of a favorable environment for secondary infections, caused by bacteria or fungi (August (1988) cited by Souza et al. (2008). These secondary infections and the animal’s individual response may perpetuate and induce the progression of the initial disease (Scott et al., 2001). It was established that the number of mites necessary to promote disease can be very low (only about two to three) triggering an Arthus-type and/or an immediate-type hypersensitivity reaction (Scott et al., 2001; Sotiraki et al., 2001; Angus, 2004). It has been reported that young animals tend to be more susceptible to ear mites than adult ones (Blot et al., 2003; Mueller, 2007; Mueller, 2008; Lefkaditis et al., 2009).

Papel da inovação social nas políticas públicas; Estratégia de Lisboa e política de inovação; exemplos de inovação em políticas públicas

Mestrado em Ciências da Fala e da Audição Mundialmente, assiste-se a um acréscimo ao nível da esperança média de vida, sendo que actualmente a proporção de idosos tem aumentado relativamente ao número de crianças. Esta alteração demográfica tem desencadeado uma mudança ao nível dos cuidados de saúde de modo a responder à necessidades da população idosa, defendendo-se a premência de se desenvolver um Sistema de Saúde Centrado no Utente (SSCU). O presente trabalho propõe-se demonstrar a importância das Tecnologias de Informação e Comunicação para a melhoria dos cuidados de saúde em Terapia da Fala. Tendo-se detectado uma lacuna em Portugal relativamente aos procedimentos na área da Disfagia, pretende-se com esta dissertação sistematizá-los e conceptualizar o modelo de informação que permita registar os procedimentos de avaliação utilizados, tendo um conta os princípios de um Sistema de Saúde Centrado no Utente. ABSTRACT: Worldwide, the average life expectancy level is increasing and the amount of elderly people is higher than the one of children. This demographic change has provoked a serious change of the health system, in order to respond the needs of the elderly population. The development of a Patient Centered Health System is necessary. The present project aims to show the importance of the Information and Communication Technologies in the context of the improvement of health care in Speech Therapy. A gap has been detected in Portugal concerning the procedures in Dysphagia. So, this project aims to systematize and conceptualize the information model that allows registering the evaluation procedures that are used, respecting the Patient Center Health System.