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BACKGROUND: To report the risk of exudation recurrence and long-term outcomes in patients with choroidal neovascularization secondary to angioid streaks, according to its morphology and characteristics by optical coherence tomography angiography. METHODS: Retrospective analysis of electronic medical records from three hospitals. We enrolled patients with a clinical diagnosis of angioid streaks choroidal neovascularization that had a minimum follow-up of 12 months. From each record, we extracted general demographic data, best corrected visual acuity (baseline, before and after each disease recurrence and last on file), type of treatment, time between last intravitreal injection and disease recurrence, and classification of the neovascular lesion morphology by optical coherence tomography, and optical coherence tomography angiography. Patients with myopic choroidal neovascularization were used as controls. Interobserver agreement was assessed with a Cohen-Kappa test. The Odds ratio was calculated with a chi2 test for significance. Visual acuity change through time was evaluated with an ANOVA for repeated measurements with an alpha value of 0.05 for statistical significance. RESULTS: We enrolled 30 patients in the study group and 14 in the control group. In the study group, the baseline and final BCVA were 0.861 ± 0.59 and 1.095 ± 0.61 logMAR (p = 0.1) respectively. CONTROL GROUP: 1.045 ± 0.57 and 0.617 ± 0.53 logMAR (p < 0.05). In the study group, the predominant CNV type by OCTA was mixed (37%), and interlacing (57%) in the control group. Mixed and cog-wheel patterns at baseline had increased Odds for recurrence in the study group (p = 0.09). Patients in the study group required more intravitreal injections on each recurrence episode to achieve disease control (3.5 ± 1.5 vs.1.4 ± 0.2, p < 0.01). CONCLUSIONS: The benefits of anti-VEGF treatment are lost over time in patients with angioid streaks and CNV. Lesion characteristics by optical coherence tomography angiography could help physicians predict the risk of recurrence. TRIAL REGISTRATION: Retrospective registered, and IRB approved.
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Peru ranks among the three countries with the highest bird species diversity globally and a majority of those species are found in the Peruvian Amazon. However, birds in this area are currently facing serious anthropogenic threats. Genetic and genomic methods are becoming important tools for avian biodiversity monitoring and conservation planning. Comprehensive molecular libraries that are publicly available are key to the effective deployment of these tools. We analyze the information gaps for four molecular markers in the most important genetic sequence databases, Barcode of Life Data Systems (BOLD) and NCBI GenBank, for bird species of the Peruvian Amazonia. We found that 64% of Peruvian Amazonian bird species have gene sequences for COI, 59.5% have CYTB sequences, 16.4% have 12S sequences, and only 0.6% have 18S sequences. However, these numbers decrease drastically to 4.3% for COI sequences when we only consider specimens sampled in Peru. Our data also showed that 43.8% of Peruvian Amazonian endemic species (n = 32) are missing sequences of any screened marker uploaded to GenBank or BOLD. Our results will encourage and guide efforts of the scientific community to complete reference libraries for Peruvian avian species that will be useful for future DNA-based monitoring projects that include birds.
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Biodiversidade , Aves , Animais , Peru , Aves/genética , BrasilRESUMO
INTRODUCTION AND IMPORTANCE: Complications related to silicone oil tamponade are frequent. There are reports of events related to silicone oil (SO) injection during Pars Plana Vitrectomy (PPV). This case presents the unexpected injection of SO in the suprachoroidal space. The proper management of this complication along with the preventive measures are discussed. CASE PRESENTATION: A 38-year-old male presented with a one-week history of decreased vision in his right eye (OD). His visual acuity was hand motion (HM). A late-onset retinal detachment recurrence with proliferative vitreoretinopathy (PVR) in his OD was diagnosed. Cataract surgery and PPV were scheduled. During PPV, a choroidal detachment (CD) secondary to the suprachoroidal injection of silicone oil (SO) was noted. Suprachoroidal SO was identified timely and was managed with external drainage through a posterior sclerotomy. CLINICAL DISCUSSION: Suprachoroidal silicone oil injection is a potential complication during PPV. For the management of this complication, the drainage of the silicone oil from the suprachoroidal space through a posterior sclerotomy may be considered as an option. This complication may be avoided by periodically checking the correct position of the infusion cannula during the PPV, by injecting the SO into the vitreous cavity under direct visualization and by using automated injection systems. CONCLUSION: Suprachoroidal silicone oil injection is an intraoperative complication that might be avoided by cross-checking the correct position of the infusion cannula and by injecting SO under direct visualization.
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The objective of the study was to evaluate the psychometric properties of the European Bullying Intervention Project Questionnaire (EBIPQ) inPeruvian adolescents and to determine gender-specific differences. The sample comprised 532 students in sixth grade of elementary school to third grade of high school. To validate the instrument, we requested an expert judgement and conducted a pilot test. Subsequently, we performed the exploratory factorial analysis, which showed that all the questions were correctly loaded in both components, an aspect that explained the 48.6%variance. We determined the reliability by means of the internal-consistency method using the Cronbach's alfa (αtotal= .856;αvictimization= .807;αaggression= .828). We found gender-specific differences in bullying roles(p<.001). In conclusion, the factorial structure of the EBIPQ in Peruvian adolescents is similar to the original questionnaire and presents high reliability and construct validity.
El estudio tuvo como objetivo evaluar las propiedades psicométricas del European Bullying Intervention Project Questionnaire (EBIPQ) en adolescentes peruanos y determinar sus diferencias según el género. La muestra estuvo conformada por 532 escolares de sexto grado de Primaria a tercer grado de Secundaria. Para la validez del contenido, se realizó el juicio de expertos y una prueba piloto. Posteriormente, se realizó el análisis factorial exploratorio, el cual mostró que todas las preguntas fueron cargadas en forma correcta en los dos componentes, lo que explica el 48.6% de varianza. La confiabilidad se estableció mediante el método de consistencia interna, a través del Alfa de Cronbach (αtotal=.856;αvictimización= .807;αagresión= .828). Se encontraron diferenciasen el rol de acoso escolar según el género (p<.001).En conclusión, la estructura factorial del EBIPQ en adolescentes peruanos es similar al cuestionario original y presenta elevada confiabilidad y validez de constructo.
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Diabetic retinopathy (DR) is one of the leading causes of blindness worldwide. Multiple treatment options have been used over time to attempt to modify the natural progression of the disease in both proliferative diabetic retinopathy (PDR) and diabetic macular edema (DME). These two retinal complications are the result of microvascular occlusions and vascular hyperpermeability and are considered one of the leading causes of irreversible blindness in patients of working age. It is now well demonstrated that PDR and DME are associated with increased levels of inflammatory and pro-angiogenic factors in the ocular compartment. To date, laser photocoagulation, vascular endothelial growth factor (VEGF) inhibitors, and corticosteroids have demonstrated efficacy in their treatment in large randomized controlled trials and in real-life observational studies. This manuscript aims to provide a comprehensive review of current treatments, including the main drugs used in diabetic pathologic manifestations, as well as new therapeutic alternatives, such as extended-release intraocular devices.
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Purpose: To assess the relationship and prognostic value of the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) with poor final best-corrected visual acuity (BCVA) after surgical repair of open globe injuries (OGI) in adults. Design: Retrospective analysis of data from an ongoing prospective cohort of consecutive patients. Methods: In a tertiary university hospital, 197 eyes of 197 patients were included between 2013 and 2017. NLR and PLR were obtained from pre-operative blood tests to analyze its relationship with poor final BCVA. Results: Severe visual impairment (SVI) was defined as ≤20/200, and was observed in 96 (48.7%) patients after surgical repair of OGI. SVI patients had higher NLR (7.4 ± 6.6 vs. 4.0 ± 3.2, p < 0.001), and PLR (167 ± 92 vs. 139 ± 64; p = 0.021) than non-SVI. NLR ≥ 3.47 and PLR ≥ 112.2 were the best cut-off values for SVI, were univariate risk factors for SVI, and had sensitivity: 69.0, 71.4, and specificity: 63.6, 44.8, respectively. In multivariate analysis, only OTS, athalamia, and hyphema remained as risk factors. NLR had significant correlation with ocular trauma score (OTS) (r = -0.389, p < 0.001) and final BCVA (r = 0.345, p < 0.001). Limitations: Simultaneous trauma in other parts of the body that could influence the laboratory findings. Conclusion: Patients with SVI after a repaired OGI had increased pre-operative NLR and PLR levels. High NLR and PLR are risk factors for SVI in univariate analysis. It is confirmed that low OTS is a risk factor for SVI. High NLR and PLR could be used as a prognostic tool to identify patients at higher risk for SVI after repair of OGI.
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Since the ancient Egyptians, people have always been worried about their physical appearance. Nowadays, for some cultures like Latin American, physical appearance depends on the context, and the concept of beauty is to have wider hips and more prominent buttocks. One way to achieve these goals is to inject foreign modelants that include some oils to modify certain body regions. Until today, the search continues to find a modelling agent that is nonteratogenic, noncarcinogenic, and not susceptible to infection and can stay at the spot where it was injected (not migration). This review is aimed at providing a brief, comprehensive assessment of the use of modeling agents and summarizes some key imaging features of filler-related complications. The topics of this review are historical data, epidemiology, classification of dermal fillers (xenografts, hyaluronic acid derivatives, autografts, homografts, synthetic materials), adverse reactions, imaging method used in the detection of injectable fillers, MRI patterns observed in complications of injectable fillers, and histological findings of immune response, treatment, and conclusions. We present several classifications of injectable fillers based on composition, degradation, and complications. Additionally, readers will find some representative cases of the most common locations of injectable fillers demonstrating their infiltrative MRI patterns.
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Materiais Biocompatíveis/metabolismo , Preenchedores Dérmicos/metabolismo , Animais , Técnicas Cosméticas , Egito , Humanos , Ácido Hialurônico/metabolismo , Injeções Subcutâneas/métodos , Imageamento por Ressonância Magnética/métodos , Polímeros/químicaRESUMO
Resumen En este trabajo realizamos una revisión exhaustiva de bases de datos de colecciones científicas y literatura especializada con el objetivo de actualizar la lista de los mamíferos menores no voladores (<1000 g aprox.) del departamento de Loreto. Como resultado se contabilizaron 536 localidades en la que se registran 75 especies, agrupadas en cuatro órdenes y seis familias, equivalente al 13% y 28.6% de la diversidad de mamíferos de Perú y Loreto, respectivamente. Además, cinco de las 83 especies de mamíferos endémicos a nivel nacional están presentes en Loreto: Akodon orophilus, Neusticomys peruviensis, Hadrosciurus "sp. 3", Marmosops (Marmosops) soinii y Monodelphis (Mygalodelphys) handleyi; siendo las tres últimas, especies con registros sólo en este departamento. Asimismo, 23 especies son consideradas especies raras y 12 comunes, dos están consideradas como Vulnerables y tres como datos insuficientes por la legislación peruana, y alrededor de 16 especies no han sido evaluadas por la International Union for Conservation of Nature (IUCN). Por otro lado, mientras que la diversidad de especies de mamíferos pequeños no voladores está comparativamente bien representada en las distintas provincias de Loreto, algunas como Putumayo es una de las menos exploradas (< 15 localidades) y registra solamente 10 especies. Además, se evidenciaron cinco zonas de vacíos de información, distribuidas principalmente en las zonas fronterizas con otros departamentos o países: 1) toda la provincia del Putumayo y noreste de Maynas, 2) sur del río Amazonas en la provincia de Mariscal Ramón Castilla, 3) norte de la provincia del Datem del Marañón, 4) suroccidente del Datem del Marañón y 5) al sur y occidente de la provincia de Ucayali; cuya extensión podría explicar por qué la diversidad de los mamíferos menores no voladores estaría subestimada en este departamento.
Abstract In this work, we conducted an exhaustive review of databases of scientific collections and specialized literature with the goal to update the list of the smaller non-volant mammals (<1000 g approx.) of the department of Loreto. Results show 536 localities where are including records of 75 species, grouped in four orders and six families, this represent to 13% and 28.6% of the mammal diversity of Peru and Loreto, respectively. In addition, five of the 83 endemic mammal species of Peru occur in Loreto: Akodon orophilus, Neusticomys peruviensis, Hadrosciurus "species 3", Marmosops (Marmosops) soinii and Monodelphis (Mygalodelphys) handleyi; the last three species are only recorded in this department. Likewise, 23 species are considered rare and 12 common. In addition, two are considered Vulnerable and three as Data Deficient by Peruvian legislation, and about 16 species have not been evaluated by the International Union for Conservation of Nature (IUCN). On the other hand, while the species diversity of small non-volant mammals is comparatively well represented in the different provinces of Loreto, Putumayo province is the least explored with only 10 species. In addition, five large areas of information gaps were found, distributed mainly in the border areas: 1) the entire province of Putumayo and northeast of Maynas, 2) south of the Amazon River in the province of Mariscal Ramón Castilla, 3) north of the province of Datem del Marañón, 4) southwest of Datem del Marañón and 5) south and west of the province of Ucayali, which explain why the diversity of this group is largely underestimated in this department.
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Resumen En este trabajo presentamos una lista actualizada de los murciélagos de Loreto basada en la revisión de bases de datos, colecciones científicas y literatura especializada. Encontramos que Loreto es el departamento con mayor diversidad de murciélagos del Perú, con 114 especies agrupadas en 7 familias (19.9% de la mastofauna peruana), y que incluyen dos de las nueve especies endémicas para Perú: Micronycteris (Micronycteris) matses y Hsunycteris dashe. Además, se encontraron 444 localidades diferentes con registros de especímenes, principalmente ubicadas a lo largo de ríos. Las especies registradas en cuatro o menos localidades únicas fueron consideradas como raras, mientras que las especies registradas en 111 o más localidades únicas fueron consideradas comunes. Presentamos un mapa de las ecorregiones de Loreto con las localidades únicas, tanto históricas como contemporáneas, además de un mapa de densidad de localidades por cada 25 km2 donde se identifican 6 zonas de vacíos de información: 1) norte y centro de Putumayo 2) noroeste de Maynas y noreste de Loreto, 3) centro de Maynas, 4) centro-norte del Datem del Marañón, norte de Alto Amazonas y extremo occidental de Loreto, 5) centro-sur de Requena y extremo oriental de Ucayali y 6) extremo occidental de Ucayali. Finalmente presentamos mapas de distribución para cada especie aquí reportada para Loreto.
Abstract In this work, an updated list of species of bats from Loreto is presented, this was elaborated using information of databases, zoological collections, and specialized literature. The results confirm Loreto as the most diverse department of Peru with 114 species of bats grouped into 7 families (19.9% of the Peruvian mastofauna), which include two of the nine endemic species to Peru: Micronycteris (Micronycteris) matses and Hsunycteris dashe. Additionally, 444 different locations were found with specimen records, located mainly along rivers. Species recorded in four or less different locations are considered rare, while species recorded in 111 or more different locations are considered common. We present a map of the Loreto ecoregions with the different localities, both historical and contemporary, as well as a map of density of locations per 25 km2, which identifies 6 areas of information gaps: 1) North and middle Putumayo, 2) Northwest Maynas and northeast Loreto, 3) Middle Maynas, 4) North-middle Datem del Marañón, north Alto Amazonas and western end of Loreto, 5) South-middle Requena and eastern end of Ucayali and 6) Western end of Ucayali. Finally we present distribution maps for each species reported here for Loreto.