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Madalena B.V.,Hospital do Servidor Publico Estadual de Sao Paulo HSPE | Oshima A.,Servico de Retina e Vitreo | Serracarbassa P.D.,Servico de Retina e Vitreo
Arquivos Brasileiros de Oftalmologia

Purpose: To compare the modified Amsler grid to the Humphrey® 10-2 red visual field in chloroquine users for the detection of early maculopathy, and to correlate with the risk variables. Methods: The study included 116 eyes of 58 patients followed at the Department of Ophthalmology of Hospital do Servidor Público Estadual de São Paulo, from April, 2006 to April, 2008. All users had normal fundus and more than 2 years of chloroquine therapy. Their clinical data were evaluated and they underwent visual acuity examination, fundus biomicroscopy, visual field and Amsler grid. Results: The incidence of early maculopathy was 7 to 10%, depending on the examination considered. The agreement between the Amsler grid and visual field was low. There was statistical significance with the use of high daily dose, elevated cumulative dose and low visual acuity in patients whose eyes had both abnormal tests; patient age and duration of treatment did not show good correlation in these cases, but their averages (67.4 years and 8.4 years, respectively) were within the range of high risk factors. Conclusions: The study suggests that Amsler can be useful in complementing the information on the visual field for chloroquine retinopathy periodic screening, especially for those patients who present high risk factors well established, selecting better candidates for objective tests, such as HD OCT and mfERG. Source

de Vieira Giorelli G.,Hospital do Servidor Publico Estadual de Sao Paulo HSPE | de Matos L.N.,Federal University of Sao Paulo | Saado A.,Hospital do Servidor Publico Estadual de Sao Paulo HSPE | Soibelman V.L.,Hospital do Servidor Publico Estadual de Sao Paulo HSPE | Dias C.B.,Hospital do Servidor Publico Estadual de Sao Paulo HSPE
Sao Paulo Medical Journal

CONTEXT AND OBJECTIVE: Several studies have evaluated the role of low 25-hydroxyvitamin D (25OHD3) in the pathogenesis of type 2 diabetes (T2DM) and have presented controversial results. The metabolic processes that culminate in T2DM begin under prediabetic conditions. Our aim was to analyze the association between 25OHD3 and glucose metabolism in individuals who were free from but at elevated risk of diabetes, DESIGN AND SETTING: Cross-sectional study at a tertiary hospital. METHODS: Anthropometric and laboratory profiles were determined in patients with one or more of the following risk factors: hypertension; body mass index (BMI) ≥ 25 kg/m2; waist circumference > 80 cm for women and > 94 cm for men; first-degree relatives with diabetes; women with large-for-gestational-age newborns or with gestational T2DM; HDL-cholesterol (high density lipoprotein) < 35 mg/dl; and triglycerides > 250 mg/dl. The patients were divided into two groups: one with prediabetes (abnormal fasting plasma glucose or oral glucose tolerance test) and the other with normal glucose (euglycemic). RESULTS: There was no statistically significant difference between the prediabetic group (n = 38) and euglycemic group (n = 15) regarding age (66.4 ± 10.6 versus 62.6 ± 9.1 years), gender (52.6 versus 73.3% female) and BMI (30.1 ± 4.61 versus 27.9 ± 4.7 kg/m2). Low serum levels of 25OHD3 were found in both groups, without any statistically significant difference between them (29.1 ± 11.8 versus 26.87 ± 9.2 ng/dl). CONCLUSION: There was no association between 25OHD3 levels and the clinical or laboratorial variables analyzed. © 2015, Associacao Paulista de Medicina. All right reserved. Source

Baldacara R.P.C.,Hospital do Servidor Publico Estadual de Sao Paulo HSPE | Baldacara R.P.C.,Federal University of Tocantins | Fernandes M.F.M.,Hospital do Servidor Publico Estadual de Sao Paulo HSPE | Fernandes M.F.M.,Federal University of Tocantins | And 8 more authors.
Sao Paulo Medical Journal

context and Objective: Knowledge of the profile of allergen sensitization among children is important for planning preventive measures. The objective of this study was to assess the prevalence and profile of sensitization to inhaled allergens and food among children and adolescents in an outpatient population in the city of Palmas. Design and Setting: Cross-sectional study at outpatient clinics in Palmas, Tocantins, Brazil. Methods: Ninety-four patients aged 1-15 years who were attending two pediatric outpatient clinics were selected between September and November 2008. All of the subjects underwent clinical interviews and skin prick tests. Results: A positive skin prick test was observed in 76.6% of the participants (72.3% for inhalants and 28.9% for food allergens). The most frequent allergens were Dermatophagoides pteronyssinus (34%), cat epithelium (28.7%), dog epithelium (21.3%), Dermatophagoides farinae (19.1%), Blomia tropicalis (18.1%), cow's milk (9.6%) and grasses (9.6%). A positive skin prick test correlated with a history of atopic disease (odds ratio, OR = 5.833; P = 0.002), a family history of atopic disease (OR = 8.400; P < 0.001), maternal asthma (OR = 8.077; P = 0.048), pet exposure (OR = 3.600; P = 0.012) and cesarean delivery (OR = 3.367; P = 0.019). Conclusion: Dermatophagoides pteronyssinus was the most frequent aeroallergen and cow's milk was the most prevalent food allergen. There was a positive correlation between a positive skin prick test and several factors, such as a family history of atopic disease, maternal asthma, pet exposure and cesarean delivery. Source

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