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Biomedical subjects

J B Almeida

Publications and source records attributed to J B Almeida.

12 recordsLinked to original sources

Age differences in central and peripheral intraocular pressure using a rebound tonometer.

AIM: To evaluate the influence of age on the measurements and relationships among central and peripheral intraocular pressure (IOP) readings taken with a rebound tonometer. METHODS: The IOPs were measured using the ICare rebound tonometer on the right eyes of 217 patients (88 men and 129 women) aged 18-85 years (mean 45.9 (SD 19.8) years), at the centre and at 2 mm from the nasal and temporal limbus along the horizontal meridian. Three age groups were established: young (< or =30 years old; n = 75), middle aged (31-60 years old; n = 77) and old patients (>60 years old; n = 65). RESULTS: A high correlation was found between the central and peripheral IOP readings, with the central readings being higher than the peripheral ones. Higher IOP values for the central location were found in the younger patients. Older patients had significantly lower temporal IOP readings than those for the remaining two groups (p<0.001), whereas no significant differences were found among groups when IOP was measured at the central and nasal locations. A significant decrease was observed in the nasal and temporal IOP readings as the age increased (p = 0.011 and 0.006, respectively). CONCLUSION: Older patients had lower IOP values than the middle-aged and younger patients in the temporal peripheral location. A negative correlation was found between age and IOP by rebound tonometry in the corneal periphery but not in its centre.

Adolescent↗

Non-contact tonometry synchronized with cardiac rhythm and its relationship with blood pressure.

PURPOSE: The main objectives of this study were to determine the differences between non-synchronized intraocular pressure (IOP_N) and intraocular pressure readings synchronized with cardiac pulse and try to determine if these parameters are related to blood pressure values. METHODS: One hundred and sixty-five right eyes from 165 volunteers (107 females, 58 males) aged from 19 to 73 years (mean +/- S.D., 29.93 +/- 11.17) were examined with the Nidek NT-4000, a new non-contact tonometer that allows the measurement of IOP synchronized with the cardiac rhythm. IOP measurements in the four different modes of synchronization were taken in a randomized order. Three measures of each parameter were taken and then averaged. The blood pressure was determined three times with a portable manometer and mean values of systolic and diastolic pressure and the pulse rate were computed. Mean arterial pressure (MAP) was determined as being 1/3 of systolic plus 2/3 of diastolic blood pressure. RESULTS: The mean +/- S.D. values for the standard intraocular pressure (IOP_N: 14.76 +/- 2.86), intraocular pressure in the systolic instant or peak (IOP_P: 14.99 +/- 2.85), intraocular pressure in the middle instant between heartbeats or middle (IOP_M: 14.68 +/- 2.76), and intraocular pressure in the diastolic instant or bottom (IOP_B: 13.86 +/- 2.61) were obtained. The IOP_P was higher than the remaining values. A significant difference in mean IOP existed between IOP_B and the remaining modes of measuring (p < 0.05). Differences were statistically significant for all pair comparisons involving IOP_B. Arterial blood pressure values were systolic 125.5 +/- 14.22, diastolic 77.7 +/- 8.38 and MAP 93.64 +/- 9.44 mmHg. The pulse rate was 77.3 +/- 12.6 beats per minute. Except for the MAP (p = 0.025) there was no significant correlation between different IOP values and systolic or diastolic blood pressure, or pulse rate. CONCLUSIONS: NT-4000 is able to differentiate IOP values when synchronized with the cardiac rhythm and those differences are expected to be within a range of +/-2.5 to +/- 3.0 mmHg. IOP_B seems to be the parameter whose value differs from the non-synchronized and the remaining synchronized parameters in a significant way. Other than a weak association with MAP, no significant correlation between IOP and BP was found. The measurements of IOP readings for the three modes are consistent with timings during the cardiac cycle and IOP pulse cycle.

Adult↗

The influence of cycloplegia in objective refraction.

The purpose of this study was to compare refractions measured with an autorefractor and by retinoscopy with and without cycloplegia. The objective refractions were performed in 199 right eyes from 199 healthy young adults with a mean age of 21.6 +/- 2.66 years. The measurements were performed first without cycloplegia and repeated 30 min later with cycloplegia. Data were analysed using Fourier decomposition of the power profile. More negative values of component M and J(0) were given by non-cycloplegic autorefraction compared with cycloplegic autorefraction (p < 0.0001). However more positive values for the J(45) vector were given by non-cycloplegic autorefraction, although this difference was not statistically significant (p = 0.233). By retinoscopy, more negative values of component M were obtained with non-cycloplegic retinoscopy (p < 0.0001); for the cylindrical vectors J(0) and J(45) the retinoscopy without cycloplegia yields more negative values (p = 0.234; p = 0.112, respectively). Accepting that differences between cycloplegic and non-cycloplegic retinoscopy are only due to the accommodative response, the present results confirm that when performed by an experienced clinician, retinoscopy is a more reliable method to obtain the objective starting point for refraction under non-cycloplegic conditions.

Accommodation, Ocular↗

A comparison of the ARK-700A autokeratometer and Medmont E300 corneal topographer when measuring peripheral corneal curvature.

PURPOSE: The purpose of this study was to evaluate if corneal topogometry measurements as taken with the ARK-700A autokeratometer are comparable with those measured by the Medmont E300 videokeratoscope at corresponding locations. METHODS: Central and peripheral radius and eccentricity were measured in 122 right eyes of young normal subjects using autokeratometry and videokeratoscopy, obtained in a random order. RESULTS: Curvature measurements obtained with the ARK700A and Medmont E300 correlated well for the central cornea. Larger differences were observed between peripheral autokeratometry readings and the empirically determined corresponding locations with the videokeratoscope. Correlations between the instruments are inconsistent, resulting in unacceptable confidence intervals. Corneal eccentricity was significantly different between the instruments for the vertical (t = 2.4; p = 0.018) and for the horizontal meridians. In the first case, the difference between the averaged values was not clinically significant, but in the horizontal meridian the AK significantly overestimated eccentricity values (t = -11.5; p < 0.001) with differences which were clinically significant. CONCLUSIONS: Central corneal curvature data obtained by ARK700A and Medmont E300 can be interchanged but the same is not true of peripheral determinations of corneal shape. ARK700A probably measures peripheral corneal shape within an elliptical region between 5 and 7 mm in diameter, with the major axis in the vertical meridian.

Adult↗

Clinical performance of non-contact tonometry by Reichert AT550 in glaucomatous patients.

Measuring intraocular pressure (IOP) by non-contact tonometry (NCT) has been demonstrated to be a valid and reliable technique to be used in primary eye care; it is easier to use, it does not transmit infectious diseases, and it is not necessary to use anaesthetic or staining eye drops. Recently, a new NCT device has showed an excellent level of agreement with Goldmann tonometry, but there are no records of its performance in glaucomatous eyes. To rectify this, IOP was measured in twenty-two patients (44 eyes) receiving medical treatment to control elevated IOP, with AT550 and Goldmann tonometry. Mean values of IOP were 18.98 +/- 2.77 and 19.08 +/- 3.02 mmHg using Goldmann and AT550, respectively. Plots of differences against means displayed good agreement (mean difference +/- limits of agreement, -0.09 +/- 3.30); this value was not significantly different from zero (t-test for dependent samples, p = 0.709). In conclusion, IOP values as measured with the AT550 NCT are clinically comparable with those obtained with Goldmann tonometry in glaucomatous patients. This validates this NCT not only for screening of IOP but to follow-up glaucomatous patients with a rapid, non-invasive method.

Exfoliation Syndrome↗

Clinical performance of the Reichert AT550: a new non-contact tonometer.

The aim of the present study was to assess the level of accuracy for measurements of intra-ocular pressure (IOP) obtained with a new non-contact tonometer (NCT) the Reichert AT550. Measurements were compared against those obtained with the Reichert Xpert Plus, Goldmann applanation tonometer and Perkins tonometer. Thirty-five university students were assessed with the four tonometers in a randomised order, with non-contact tonometry performed first. Each of the four measurement devices had its own trained clinical observer. Plots of differences of IOP as a function of the mean for each pair of instruments were obtained. No statistically significant differences were found when comparing the AT550 NCT with contact applanation tonometry (AT) (p> 0.05), displaying the closest level of agreement (as represented by the lowest mean difference and the narrowest confidence interval) with the Goldmann tonometer (limits of agreement, 0.12+/-2.17). In conclusion, readings of IOP with the AT550 NCT are clinically comparable with those obtained with Goldmann tonometry in a population with IOP within the normal range.

Adult↗

Severe hypertension induces disturbances of renal autoregulation.

To study if the severity of hypertension could be associated with disturbances of the autoregulation of renal blood flow and glomerular filtration, we compared the renal hemodynamic and functional responses to acute blood pressure reductions of a group of patients with moderate essential hypertension (n = 10) with those of a group of patients with severe hypertension (n = 10). Blood pressure was reduced to normal levels by a stepwise infusion of sodium nitroprusside, and effective renal blood flow (by 131I-hippuran), glomerular filtration rate (by endogenous creatinine clearance), and filtration fraction were determined. After acute blood pressure normalization, effective renal blood flow and glomerular filtration rate were significantly reduced in patients with severe hypertension (-41.6 +/- 8.3% and -44.7 +/- 6.8%, respectively; p less than 0.01 for both) but not in those with moderate hypertension (+4.9 +/- 9.1% and +6.2 +/- 13.3%, respectively; NS). Filtration fraction remained unchanged in both groups. These results show that severe but not moderate essential hypertensive patients have a displacement to the right of the lower limit of the renal autoregulation curve due to impaired vasodilation to maintain adequate renal blood flow during acute reductions of blood pressure. This impairment may be due to anatomic or functional defects of preglomerular vessels, or to both. Furthermore, the inability to maintain adequate glomerular filtration in these circumstances shows that patients with severe hypertension also have an impaired ability to adjust postglomerular vasomotor tone in the face of reductions in glomerular blood flow.

Adolescent↗

Pindolol, not propranolol, reverses cardiac hypertrophy in renal hypertensive rats.

Reversal of cardiac hypertrophy has been obtained by treatment with some antihypertensive drugs but has not been achieved consistently with beta blockers. To investigate whether this difference might be explained by the distinct hemodynamic actions of the drugs, we studied the effects of propranolol and pindolol, beta blockers with distinct modes of action, on cardiac hypertrophy of hypertensive male Wistar rats, two-kidney, one clip (2K1C) Goldblatt model (n = 33) and sham-operated control rats (n = 34). We also assessed the effects of such therapies on the ventricular pumping ability during open-chest, transient aortic occlusion. Four weeks after surgery, propranolol (5 mg/kg/day p.o.) was given to hypertensive (n = 8) and control rats (n = 11); pindolol was also given orally (1 mg/kg/day) to similar groups (n = 7 and n = 5, respectively). Untreated animals served as controls for both groups. Cardiac hypertrophy developed with hypertension in the untreated rats of the propranolol (3.38 +/- 0.18 vs 2.60 +/- 0.08 mg/g; p less than 0.01) and pindolol groups (3.93 +/- 0.21 vs 2.40 +/- 0.03 mg/g; p less than 0.001). Treatment reversed cardiac hypertrophy in the pindolol-treated (3.01 +/- 0.19 vs 3.93 +/- 0.21 mg/g; p less than 0.001, NS) but not in the propranolol-treated rats (3.24 +/- 0.18 vs 3.38 +/- 0.21 mg/g, NS). The maximal pressure that developed during aortic occlusion in the propranolol group was similar to that observed in the pindolol group. These results indicate that cardiac hypertrophy is reversed by pindolol but not by propranolol, and that this reversal does not interfere with left ventricular pumping ability.

Animals↗

Consequences of reversal of hypertensive cardiac hypertrophy by captopril on left ventricular pumping ability and performance.

Left ventricular hypertrophy can be reversed by treatment of hypertension with captopril but the consequences of this regression are not yet fully described. We studied the maximal capacity of the hypertrophied and hypertrophy-reversed ventricle to generate pressure during transient total occlusion of the aorta, and also the left ventricular end-diastolic pressure required to meet this maximal effort. Two-kidney, one clip Goldblatt (renal hypertensive rats; RHR) hypertension was induced in 17 Wistar rats, eight of which were treated with captopril (RHR-C: 50 mg/kg given orally) from the fourth to the eighth week. Sham-operated controls (SC) remained untreated, or were treated with similar doses of captopril (SC-C). Significantly lower heart weights were found in RHR-C than in RHR (2.88 +/- 0.15 versus 2.38 +/- 0.04; P less than 0.001). During transient total occlusion of the aorta, the maximal intraventricular pressure developed in RHR-C was not significantly different from that in RHR, but left ventricular end-diastolic pressure was significantly less in RHR-C than in RHR (21.4 +/- 2.2 versus 34.3 +/- 3.8; P less than 0.01). The analysis of pressure-volume characteristics of the hypertrophied left ventricles and those in which hypertrophy was reversed revealed similar compliances between these two groups. Our data suggest that there was a mechanical improvement in the heart function after reversal of left ventricular hypertrophy.

Animals↗

Measurement of corneal thickness by videopachymetry: preliminary results.

Corneal thickness measurements find applications in areas such as diagnosis and management of corneal disorders and corneal surgery. We present a technique for the measurement of corneal thickness using a CCD camera mounted on a slit-lamp biomicroscope and common image processing software. Thickness measurements were performed on three RGP contact lenses of known thickness with an average error of 5 microm, SD of 8 microm. Measurements of a living cornea yielded a thickness of 505 microm and a SD of 8 microm for 10 consecutive measurements; this is an acceptable value.

Cornea↗

[Analysis of nitrocompound pesticides by potentiography (author's transl)].

This paper describes a potentiographic technique developed for determining nitrocompound pesticides. The statistical analysis of the results showed that it is precise and accurate. Rapidity is another important characteristic of the developed potentiographic technique. It is not specific and for that in some cases a column chromatographic cleanup is necessary.

Nitro Compounds↗