Asymmetric vault of an accommodating intraocular lens

We report a case of a new syndrome, late asymmetric vault of the AT45 Crystalens intraocular lens (IOL) (Eyeonics Inc.). The late vault, which occurred in 6 month after implantation of the IOL, caused a decrease in uncorrected distance and near acuities and minus-cylinder axis perpendicular to the haptics. Treatment with neodymium:YAG laser capsulotomy and fibrotic band release was successful.     

Application of toxicity identification evaluation to sediment in a highly contaminated water reservoir in southeastern Brazil

Rasg?o Reservoir, located close to the Metropolitan region of S?o Paulo, Brazil, has been analyzed previously, and its sediment was found to be highly toxic, with high levels of metals and polycyclic aromatic hydrocarbons and a complete absence of benthic life. Polychlorinated biphenyls also were present, as was mutagenic activity, detected with the Salmonella/microsome assay. Because of the extremely complex mixture of contaminants in these sediments, a toxicity identification evaluation was performed on the pore water and elutriate using Ceriodaphnia dubia and Vibrio fischeri. Toxicity characterization, identification, and confirmation procedures were performed in one representative sample of the reservoir, and the results indicated that ammonia was the main cause of the toxicity detected with C. dubia in both sediment pore water and elutriate. Chemical analysis corroborated this observation by revealing un-ionized ammonia concentrations as high as 5.14 mg/L in pore water and 2.06 mg/L in elutriate. These high ammonia levels masked possible toxicity caused by other classes of compounds. The toxicity detected with V. fischeri decreased with the time of sample storage and was related to the organic fraction of the pore water and the elutriate, in which compounds such as benzothiazole and nonylphenol were detected.     

Body composition in patients with chronic obstructive pulmonary disease: which method to use in clinical practice?

The objective of the present study was to compare anthropometry with bioelectrical impedance (BIA) in relation to densitometry (dual-energy X-ray absorptiometry; DEXA) as methods of nutritional assessment and body composition in out-patients with chronic pulmonary obstructive disease (COPD). We conducted a cross-sectional clinical study with sixty-one patients with COPD (forty-two men and nineteen women), mean age of 66.5 (sd 7.9) years and forced expiratory volume in 1 s of 1.3 (sd 0.6) litres (52.2 (sd 19.8) % predicted), referred to the Pulmonary Rehabilitation Center. The patients were evaluated regarding nutrition status and body composition as determined by anthropometry, BIA and DEXA. In the results, 34.4 % showed mild obstruction, 31.2 %, moderate and 34.4 %, severe obstruction. According to the BMI (mean 24.5 (sd 4.5) kg/m2), 45.9 % of the patients exhibited normal weight, while 27.9 % were underweight and 26.2 % were obese. Related to fat-free mass (FFM), anthropometry and BIA compared with DEXA presented high correlations (r 0.96 and 0.95 respectively; P < 0.001) and high reliability between the methods (alpha 0.98; P < 0.001). Agreement analysis between the methods shows that anthropometry overestimates (0.62 (sd of the difference 2.89) kg) while BIA underestimates FFM (0.61 (sd of the difference 2.82) kg) compared with DEXA. We concluded that according to the nutritional diagnosis, half of our population of patients with COPD showed normal weight, while the other half comprised equal parts obese and underweight patients. Body composition estimated by BIA and anthropometry presented good reliability and correlation with DEXA; the three methods presented satisfactory clinical accuracy despite the great disparity of the limits of agreement.     

Segmentation of fetal ultrasound images

This paper describes a new method for segmentation of fetal anatomic structures from echographic images. More specifically, we estimate and measure the contours of the femur and of cranial cross-sections of fetal bodies, which can thus be automatically measured. Contour estimation is formulated as a statistical estimation problem, where both the contour and the observation model parameters are unknown. The observation model (or likelihood function) relates, in probabilistic terms, the observed image with the underlying contour. This likelihood function is derived from a region-based statistical image model. The contour and the observation model parameters are estimated according to the maximum likelihood (ML) criterion, via deterministic iterative algorithms. Experiments reported in the paper, using synthetic and real images, testify for the adequacy and good performance of the proposed approach.     

Effect of bosentan treatment on surrogate markers in pulmonary arterial hypertension

OBJECTIVE: The aim of this study was to evaluate the effect of the oral dual ET(A)/ET(B) receptor antagonist bosentan on different surrogate markers in patients with pulmonary arterial hypertension (PAH). DESIGN AND SETTING: Prospective, open label, uncontrolled study in a University Hospital in Brazil. POPULATION: Fifteen PAH patients (11 females) with mean age of 40 +/- 11 years (5 in WHO functional class II, 10 in class III). METHODS: All patients were investigated at baseline and after 16 weeks of bosentan treatment. We used the following surrogate markers for patients' evaluation: 6-min walk test, quality of life questionnaire (Short Form SF-36) and N-terminal proBNP (B type natriuretic peptide) fraction levels in blood. RESULTS: Between the evaluation at baseline and week 16, the 6-min walk test distance changed from 396 +/- 135 to 434 +/- 137 m (p < 0.05). Each of the eight domains of the SF-36 was significantly improved. Mean NT-proBNP levels were decreased from a mean of 1670 pg/mL to 1010 pg/mL (p = 0.01). CONCLUSION: The study suggests that bosentan treatment results in the improvement of different kinds of surrogate markers independently of their specificity to reflect functional capacity, quality of life and myocardial stress. It is concluded that the combined use of these different markers may be an alternative endpoint for future short duration clinical trials.     

Partial and full PTSD in Brazilian ambulance workers: prevalence and impact on health and on quality of life

A cross-sectional survey for posttraumatic stress disorder (PTSD) was conducted with 234 Brazilian ambulance workers (180 men and 54 women) using a sociodemographic questionnaire, the Posttraumatic Stress Disorder Checklist-Civilian Version, and the Short Form Health Survey-36. Current prevalence rates for full and partial PTSD were 5.6% (men = 6.7%, women = 1.9%) and 15% (men = 13.3%, women = 20.4%), respectively. Male workers with full PTSD were more likely to be nonmarried (75% vs. 43%) and those with partial PTSD reported more emotional problems (65.2% vs. 30%) and medical visits (67% vs. 44%) than the controls. Workers with PTSD showed impairment in the physical and mental domains of the SF-36, whereas workers with partial PTSD had only the later compromised. The characteristics and the level of exposure to trauma of the study population may account for the low prevalence of PTSD.     

Alcohol expectancies, drinking refusal self-efficacy and drinking behaviour in Asian and Australian students

The effects of alcohol expectancies (AE) and drinking refusal self-efficacy (DRSE) in predicting alcohol consumption in Caucasians has been well studied. However, the role of AE and DRSE in Asian students is still not well understood. This study reported on this using Caucasian (n=98) and Asian (n=92) student samples. Participants completed the Alcohol Use Disorder Identification Test (AUDIT) to measure their hazardous alcohol consumption, and the drinking expectancy profile (DEP) to assess their alcohol related expectancies and ability to resist drinking in certain situations. Results showed that Caucasians reported significantly higher confidence, higher sexual interest, and higher tension reduction expectancies than Asians. Conversely, Asians significantly expected cognitive enhancement and negative consequences more than Caucasians. Relative to Caucasians, the Asian sample also reported that they would be more able to refuse alcohol when under social pressure. Results from regression analyses showed that for the Caucasian sample, AE, DRSE and their interactions were significant predictors of alcohol consumption. For the Asian group, the only significant effect to emerge was that DRSE was negatively related to alcohol consumption. The clinical implications of the differential pattern of results between the samples are discussed in terms of self-efficacy and negative consequences of alcohol consumption, especially when dealing with university aged individuals.